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COMMCAT IS-2000^は顎顔面領域専用の断層エックス線撮影装置で,顎関節の矢状断および冠状断撮影の機能を有する。本装置の顎関節撮影における有用性をエックス線不透過性の鋼鉄製マーカーを付けた4個のヒト乾燥頭蓋骨を用いて検討した。スライス位置の正確性を調べるため下顎頭の表面中央にマーカーを固定し,マーカー直上,それより近心,遠心にそれぞれ1mm,2mm離れた計5点に対して矢状断撮影を行ったところ,スライス位置の誤差は±1mmの範囲内であった。写真の寸法精度を調べるため,下顎頭の実測値と断層写真上での寸法をデジタルキャリパーを用いて比較した。両者の差は前後径では平均0.43mm,近遠心径では平均0.52mmであった。断層軌道および断層厚さの違いが写真画質におよぼす影響を調べた。同一撮影条件下ではhypocycloidal軌道で1mmの断層厚さで撮影した場合,ぶれや周囲の構造物の写り込みが少ないため,最も写真画質が良好であることがわかった。以上の結果よりCOMMCAT IS-2000^はTMJの骨構造を画像化する上で有用な診断装置であることが示唆された。, The COMMCAT IS-2000^ (Imaging Sciences International, Hatfield, PA, USA) is a tomographic machine for scanning the dentomaxillofacial region and is capable of imaging the sagittal and coronal sections of the temporomandibular joint (TMJ). The feasibility and accuracy of tomography for the TMJ were examined by use of the COMMCAT IS-2000^ and four dried human skulls with radiopaque steel markers. To assess the setting accuracy of the slice position, a steel marker was fixed at the center of the superior surface of the condyle, and images of five sagittal sections were taken, i.e., directly above the marker and 1 mm and 2 mm distance from it in both the medial and distal planes. The deviation of the slice position was found to be within ± 1 mm for all test subjects. To evaluate the dimensional accuracy of this method, the difference between the actual value and the graphically observed value with respect to the tomographic image of the condyle was examined using a digital caliper. The difference between values for the anteroposterior distance was 0.43 mm and that for the mediolateral distance was 0.52 mm. The effect of the difference in tomographic motion and slice thickness on the image quality was then evaluated. Under identical exposure conditions, hypocycloidal tube motion and the slice thickness of 1 mm produced the best image quality because blurring of the image and the degree of superimposition of the surrounding structures were minimal. These results suggest that the COMMCAT IS-2000^ is a high-quality diagnostic tool for visualizing the bone structure of the TMJ.

Beta-catenin is an undercoat protein of cadherin, a cellular adhesion molecule. Beta-catenin also functions as a transcriptional activator downstream of the Wnt signaling pathway. Intracellular beta-catenin is regulated by the formation of a complex with APC (adenomatous polyposis coli) protein. The activation of this pathway by stabilization with beta-catenin has been shown to be an important step in the development of colorectal carcinoma, which is mainly caused by inactivating mutations in the APC tumor suppressor gene or by activating mutations in exon 3 of the beta-catenin gene. This study was conducted to clarify the contribution of beta-catenin accumulation and the mutation of the beta-catenin gene to the carcinogenesis of head and neck cancer. Beta-catenin accumulation was examined immunohistochemically in 49 frozen or formalin-fixed, paraffin-embedded samples of head and neck tumors. We also performed a direct sequence analysis of APC and beta-catenin to examine the cause of beta-catenin accumulation. Genomic DNA was extracted and purified from fresh tissue samples of head and neck cancers. We examined the APC mutation cluster region in 15 samples and analyzed beta-catenin exon 3 mutations in 31 cases. Twelve out of 49 (24.5%) cases exhibited beta-catenin accumulation in our histochemical study. The 5 year survival rate was 0% in the beta-catenin accumulation group, compared to 50% in the non-accumulation group, (p < 0.01). This finding strongly suggests that beta-catenin may play an important role in the carcinogenesis or progression of head and neck cancer. One of the 15 cases exhibited an APC missense mutation that led to the replacement of amino acids; this case died in 12 months. Regarding the beta-catein mutation, non of the 31 samples exhibited a gene mutation in beta-catenin exon 3. Thus, the rate of APC and beta-catenin mutation in head and neck cancer may be very low.

The purpose of this study was to evaluate the benefit of cochlear implant for Japanese elderly people with profound hearing loss. A questionnaire was administered to the five Japanese elderly people over 65 years old with the Nucleus 22 channel device and their family. The questionnaire was designed to gain insight into the patient's daily use and to evaluate the quality of life. Elderly patients who were implanted with the Nucleus device showed good ability to identify environmental sound and revealed no significant deterioration compared to younger patients. Implanted patients showed some difficulties in understanding speech in the noisy environment and conversation among several persons. Nevertheless, 80% of patients over 65 and their family reported communication benefits in the family and in social activities. In addition, 80% of the patients reported that they felt the better or improved quality of life after the implantation. All patients considered the implant was good for their life and would recommend a cochlear implant to a deaf friend. It is notable that 60% of patients and their family report that the recipients have become more cheerful. This study showed the cochlear implant contributes to the better quality of life in the Japanese elderly.

We report a case of mucoepidermoid carcinoma in the nasopharynx. A woman, aged 59, who suffered from chronic otitis media with effusion was referred to our department due to a mass lesion on the Rosenmuller's fossa. The mass lesion was pathologically diagnosed as a mucoepidermoid carcinoma. CT and MRI scans showed a well bordered round shadow which was limited to the orifice of the left eustachian tube, without invasion of the skull base.As the patient did not agree to surgical treatment, we selected radiotherapy using a gamma knife for treatment of the nasopharyngeal tumor. The tumor responded well to gamma knife treatment and disappeared with 30Gy irradiation (Edge dose). The patient has shown no recurrence of the tumor for a year and 6 months after treatment. Gamma knife radiotherapy may be one potential treatment strategy for intractable lesions of the head and neck such as mucoepidermoid carcinoma in the nasopharynx.

頭頸部悪性腫瘍細胞におけるE-カドヘリンの消失に伴い, 細胞は接着特性を失った。また, 再構成基底膜への浸潤性は増強した。この変化は, E-カドヘリン陽性細胞で認められたが, 陰性細胞では認められなかった。頭頸部癌患者の血清中には, 健常人, 良性疾患患者に比べて, 可溶性E-カドヘリンが高値を示した。治療反応例では, 血清可溶性E-カドヘリン値は減少した。治療後に血清可溶性E-カドヘリンが高値を示した症例は, 遠隔転移が多く, 予後不良であった。E-カドヘリンは, 単に接着因子としての機能を有するのみならず, 腫瘍細胞の浸潤, 転移にも深く関係していると考えられた。臨床において, 血清可溶性E-カドヘリンは, 腫瘍の悪性度, 遠隔転移を知るうえで重要なパラメーターとなる可能性が示唆された。

ウシガエル交感神経節細胞にカフェインを投与すると, 膜のCa2+-activated K+電流の周期的発生によってリズミックな過分極 (RMH) 性応答が細胞内記録により得られる。外液のCa2+濃度を1.8mMから0.5mMに下げるとRMHの振幅は徐々に小さくなり最後には消失した。外液のCa2+を他の2価の陽イオンに置き換えて調べてみると, Ba2+, Mn2+ではRMHは発生しなかった。しかし, Sr2やに置き換えるとCa2+で発現するのと同じようなRMHが出現した。さらに, Ca2+アンタゴニストのMg3+, verapamil, diltiazem, cimetidineを投与するとRMHは著しく抑制された。次に, アデノシン誘導体のATP, ADPの投与ではRMHの振幅の増大が見られた。しかし, アデノシンやc-AMP, c-GMPの投与ではRMHに何の影響も与えなかった。P2-purinoceptorアンタゴニストのスラミンを投与すると, ATPによるRMHの増強やATPの脱分極性応答は抑制された。さらに, Ca2+-induced Ca2+-releaseの機構を選択的に阻害するライアノジンを投与するとRMHは非可逆的に阻害された。そこで, ATPおよびADPを投与してみたがRMHの再度の発現はなく, 脱分極性応答のみが記録された。これらの結果より, 交感神経節細胞内Ca2+振動は外液のCa2+濃度に依存し, また膜のP2-purinoceptorにATPやADPが結合すると, ホスフォリパーゼCの活性化により, 細胞内フリーCa2+濃度の上昇が起こり, Ca2+-induced Ca2+-release機構が活性化し, 細胞内Ca2+振動が発生するかもしれないと考えられる。

Severe tinnitus in 32 patients wtih senile deafness was treated with Lipoprostaglandin E1 10μg i. v. once a week. The tinnitus score was significantly decreased from 10 to 3.9±2.4. Slight to marked improvement was recorded in 90.6% of the patients. Early treatment, within 4 weeks of the onset of tinnitus, was more effective than later treatment. There were 4 patterns of improvement. No severe side effect was observed.The results of this study suggest that Lipoprostaglandin E1 is very useful in the treatment of tinnitus.

Two cell lines were established one from a primary site (OKK-TKp) and the other from a metastatic lymph node (OKK-TKm), from a maxillary squamous cell carcinoma (in the same patient). These cell lines were characterized with regard to morphology, chromosome numbers, tumorigenicity, growth kinetics, expression of tumor markers, sensitivity to immunological effector cells and anticancer agents. The two cell lines had the same modal chromosome number of 69, and formed tumors in nude mice. The median doubling time of OKK-TKp was 14.6 hrs and that of OKK-TKm was 24.3 hrs. Immunohistochemistry showed transferrin receptor (TfR), Ki-67, and epidermal growth factor receptor (EGFR) in OKK-TKm, but less or none in OKK-TKp. OKK-TKm was more sensitive to lysis by lymphokine-activated killer cells (LAK) on a 4-h 51Cr release assay, but was less sensitive to anticancer agents (CDDP, CBDCA) in modified MTT assay. We are convinced that these results are of value for understanding the mechanism of metastasis.

頭頸部癌患者35症例の転移のない所属リンパ節リンパ球 (LN(-)-L) および末梢血単核球 (PBMC) を, recombinant interleukin-2 (rIL-2) とともに培養し, それぞれ, LN(-)-LAK, PBMC-LAKとした。LN(-)-LAKの4時間51Cr release assay による細胞障害活性は, 562に対してはPBMC-LAKと同等で, Daudi に対してはPBMC-LAKよりも高かった。自己腫瘍細胞に対しては, 形態学的に follicular lymphoid hyperplasia を示したリンパ節からのLN(-)-LAKはPBMC-LAKに比べて高い細胞障害活性を示した。自己腫瘍細胞に対するLN(-)-LAKの effector 細胞はCD8+細胞 (特にCD8+ CD11b-細胞) とCD56+細胞と考えられた。

Cytotoxic activities of rIL-2-stimulated effector cells from peripheral blood mononuclear cells (PBMC-LAK), and those from the regional lymph node cells (LN-LAK) from patients with head and neck malignant tumor were examined by 4-hour 51Cr release assay. Cytotoxicity of LAK cells from involved lymph node (LN (+)-LAK) were significantly lower than those of PBMC-LAK. LAK cells from non-involved lymph node (LN (-)-LAK) had a significantly higher cytotoxicity against Daudi cell than PBMC-LAK. Cytotoxic activities against K562 cell and autologous tumor cells mediated by LN (-)-LAK were not significantly different from those by PBMC-LAK. However, autologous tumor cell lysis by LN (-)-LAK from lymph nodes showing follicular lymphoid hyperplasia (FLH) pattern was higher than that by PBMC-LAK. The effector cells against autologous tumor cells were characterized CD56+ cells and CD8+ cells (CD8+CD11b- cells) by phenotypic analysis and negative selection assay using immunomagnetic isolation technique.

Papilloma is a typical laryngeal benign tumor. Although a laser surgery was used to treat this tumor, recurrence often occurred. In this report, two cases of laryngeal papilloma effectively treated with β-interferon are presented. Case 1 had received laser operations repeatedly. Finally, we did not succeed to remove the tumor by laryngofissure. We then injected 3, 000, 000 IU of β-interferon at the posterior commissure by a direct laryngoscope. As a result, the tumor disappeared. Case 2 was treated with the local injection of β-interferon. The laryngeal papilloma was completely disappeared. We may consider that β-interferon is an expectable agent for papilloma-treatment, not only tumor diminishing factor, but also recurrence preventing factor.

The term apoptosis stands for a mechanism of controlled cell deletion which maintains the homeostasis of living bodies. In palatine tonsil, apoptosis seems to be mainly observed in lymphocytes which have accomplished their immunological role. In this study, we demonstrate the presence of apoptotic cells in palatine tonsil using a histochemical technique, and we compare the number of apoptotic cells in inflammatory and non-inflammatory conditions using an image analyzing system. In the mantle zone, fewer apoptotic cells were observed than in the germinal center. Under inflammatory conditions, apoptotic cells were increased in the interfollicular space. Apoptosis may play an important role in the immunological equilibrium of tonsils by eliminating hyperreactive clones.

To date an increasing number of T-cell epitopes derived from various tumor-associated antigens have been reported, and they proved to play significant roles for tumor rejection both in vivo and in vitro. Survivin was originally identified as a member of the inhibitor of apoptosis protein family. Expression of this gene is developmentally regulated. Although survivin is expressed during normal fetal development, the expression is barely detected in terminally differentiated adult tissues except for testis, thymus, and placenta. In contrast, it is abundantly expressed in a wide variety of malignant tissues. We examined the expression of survivin and the two splicing variants survivin-2B and survivin-DeltaEx3 in various cancer cells, immortalized cells, and normal adult tissues. It was demonstrated that two splicing variants were detected in various types of cancer cells as well as survivin, and their expression was more restricted to cancer cells as compared with survivin expression. To identify HLA-A24-restricted T-cell epitopes from survivin and the variant proteins, three peptides were selected from amino acid sequence of these proteins, based on the HLA-A24-binding motif. Peptide binding assay to HLA-A24 revealed that only one peptide designated as survivin-2B80-88 (AYACNTSTL) was capable of binding to HLA-A24. By stimulating peripheral blood lymphocytes with the peptide-pulsed antigen-presenting cells, CTLs were successfully induced in vitro from five of five HLA-A24-positive cancer patients. The CTLs showed significant cytotoxicity against HLA-A24-positive survivin-2B-positive cancer cells. These data suggest that survivin-2B80-88 may be a potent T-cell epitope eliciting CTL response against a splicing variant survivin-2B, which is specifically expressed in many kinds of cancer cells.