Tenascin (TN), an extracellular matrix component, is known to be an embryonic cancer antigen. This antigen is specifically found in the interstitial tissue of breast or lung cancer. This study immunohistochemically analyzed the expression and distribution of TN in the interstitial tissue of malignant salivary gland tumors, for which no detailed reports are available, and attempted to define the significance of TN. The subjects comprised 48 patients with malignant salivary gland tumors, 49 with benign salivary gland tumors, 8 with chronic sialoadenitis, and 20 with normal submandibular glands. In addition, another extracellular matrix component, fibronectin (FN), which has TNbinding properties, was also analyzed. In normal salivary glands, TN was detected in the basal layers of intercalated, striated and excretory ducts and not in serous or mucinous acinar cells, myoepithelial cells, or the stromal tissue. In chronic sialoadenitis, TN was detected in the same sites as in the normal submandibular gland in addition to the interstitial tissue surrounding the striated and excretory ducts. The presence of TN was demonstrated in the interstitial tissue, but not in the parenchyma, of pleomorphic adenomas in 26 of 30 patients (86.4%). For malignant salivary gland tumors, TN was detected in the interstitial tissue, but not in the parenchyma, in 45 of 48 patients (93.8%). These findings suggest that TN may be specific to the interstitium of malignant gland tumors. TN was diffusely distributed in the interstitium at the focal point of cancerous invasion and in the border area between cancer nests and normal tissue. Comparson of the appearance and distribution of TN and FN, suggested that TN may contribute to the proliferation and invasion of malignant salivary gland tumors. The higher the histological malignancy, the higher was the detection rate of TN in the interstitial tissue of adenoid cystic carcinomas and mucoepidermoid carcinomas, suggesting that TN may objectively reflect the histological malignancy of malignant salivary gland tumors. In addition, the rate of highly positive TN in the interstitium increased parallel to higher grades of malignancy, suggesting that TN may also be a useful indicator of the biological malignancy of malignant salivary gland tumors.
To study the effects of puncture of the articular cavity on articular tissues. during TMJ arthrography and TMJ arthroscopy, a puncture procedure for the superior articular cavity of the TMJ was established in the rabbit. Using this animal model, changes in intraarticular and periarticular tissues after articular puncture were studied histopathologically and, in part, histochemically. 1. The superior articular cavity of the rabbit was very narrow and percutaneous puncture was impossible. However, puncture from a posterosuperior direction was enabled by partially detaching the skin and muscles after making a skin incision at the site of the TMJ and retracting the mandible posterroinferiorly to the puncture side. 2. After retraction of the mandible alone, detached synovial cells and microhemorrhage were observed in the superior articular cavity, and the anterior ligament of the articular disk was found to be relaxed on Day 1. However, singns of cure were observed already on Day 3, and a nearly normal state was restored on Day 7. No clear functional effects of treatment were observed in the articular structure. 3. After puncture, the synovial membrane showed edematous degeneration; necrotic cell debris was observed in the superior articular cavity, and a degenerative, necrotic layer was noted at the puncture wound on Day 1. However, these changes were reversible and nearly disappeared by Day 7, and no serious organic effects of puncture were noted in intraarticular or periarticular tissues. 4. Cure of the damaged synovial membrane appeared to be promoted by the presence of an adjacent microvascular network. These findings suggest that changes in the intra-articular and periarticular tissues due to puncture of the articular cavity are very mild and reversible, and can be repaired with in a short period. In addition, the rabbit model used in this puncture procedure is considered to be useful for investigation of histological changes caused by puncture of the TMJ.
Hydrolysis of 1-hexylcarbamoyl-5-fluorouracil (HCFU) to 5-fluorouracil (5-FU) is temperature dependent. We have previously reported the antitumor effects and cytotoxicity of HCFU combined with hyperthermia in vivo and in vitro. In vivo, we found that the highest 5-FU concentration in tumor tissue was produced by combined treatment with HCFU and hyperthermia. In this study, changes in membrane permeability to HCFU were studied at elevated temperature using Nakahara-Fukuoka sarcoma (NF-sarcoma) cells. There were significant increases in the rate of [14C] HCFU uptake at 42°C compared with control cells (37°C) treated for 30min. 1 hour and 1.5 hours, whereas the rate of [3H] 5 -FU uptake only increased slightly compared with control after heat treatment for various times. The efflux of [14C] HCFU and [3H] 5 -FU was unaffected by hyperthermia applied for various times. Therefore, the increased intracellular retention of HCFU that was caused by elevated temperature was attributed to an increase in influx. The magnitude of the increase in intracellular HCFU levels at elevated temperature was one factor involved in the great increase in cytotoxicity of HCFU.
In this study, the relationship between osseous hiealing and microvascular changes was investigated utilizing an osseous-microvascular corrosion casting specimen of mandibular segmental defects (5×3mm) made using an ultrasonic blade in the rabbit. Specimens were prepared at 1, 2, 3 and 4 weeks postoperatively, and studied under light and scanning electron microscopes. At 1 week, neovascularization arose from preexisting vessels of inferior alveolar artery and mandibular periosteum. New bone formation was first seen at the fundus of the defect, and newly-formed trabeculae spread richly between new sinusoidal capillaries. At 2 weeks, there were increased signs of vascularization at the fundus of the defect, and the sinusoidal capillaries gave rise to new capillarise that had independent lumina and formed an interconnected network. Newly formed trabeculae developed to establish a bridge between the cut ends of the defect. At 3 weeks, the new bone formation or deposition observed previously increased in thickness. At 4 weeks, the defects were filled with the newly-formed bone, which rose to the level of the mandibular border. The periosteal vascular network was gradually remodeled to a normal pattern. It is concluded that microvasculature formed during all stages of osseous healing after mandibular segmental resection contributes to new bone formation and development. It is therefor beneficial to maintain the existing vessels of the inferior alveolar artery using an ultrasonic blade.
Using VX 2 carcinoma transplanted into the tongue of domestic rabbits, morphological changes in the collagen fibers of the tongue tumor and metastatic lymph nodesas well as the kinetics of the enzymatic activities of collagenase and plasminogen activator were examined. The relation between these enzymes was analyzed with reference to degradation of collagen fibers in the tumor tissue, and the levels of these enzymes in the serum and urine. Light microscopic examination revealed that the tongue tumor grew rapidly 7 days after transplantion, associated with increased cells in the stroma. Observations using Fastgreen and Sirius-red stain indicated that collagen fibers gradually disappeared as the tumor grew. However, no marked changes were observed in the collagen fibers of metastatic foci in the deep cervical lymph nodes. Scanning electron microscopic observation used concurrently with the NaOH maceration method revealed stereoscopically that collagen fibers in the tongue tumor were compressed and degraded, and the architecture of the collagen tissue was coarse in the metastatic foci of the lymph nodes, suggesting that degradation of collagen fibers had occurred. The hydroxyproline concentration significantiy decreased with time in the center of the tongue tumor, while it rapidly increased in the serum and in the urine, being especially remarkable in the latter. Collagenase activity peaked in the center of the tongue tumor 14 days after transplantation. Collagenase activity in the polymorphonuclear leukocytes in peripheral blood increased and peaked 21 days after transplantation. Plasminogen activator exhibited a time-dependent increase in activity in the center and marginal regions of the tongue tumor. There was also a significant increase in plasminogen activator activity in the metastatic lymph nodes. The activity of plasminogen activator rapidly decreased in the serum after transplantation, but significantly increased in the urine 21 days after transplantation. These results indicate that collagenase and plasminogen activator show different kinetics, but when they interact, both enzymes become deeply involved in the degrada-tion and lysis of collagen fibers. Furthermore, analysis of blood and urine tor collagenase and plasminogen activator activity, and hydroxyproline concentration provides useful clinical parameters for the estimation of tumor growth.
The purpose of this study was to examine the closure of root canal at the apex by using 2 % fuchsin dye solution after application of retrofilling materials. Retrofilling was done with gutta-percha point, gutta-percha point by Amagasa's method, composite resin, and amalgam. As control, teeth undergoing apicoectomy teeth were filled with orthograde guttea-percha. We compared and investigated the results obtained with each material. The conclusions were as follows: (1) Amagasa's method showed the best blockage as well as good treatment results. (2) The results indicated that sealer was indispensable for good blockage by retrofilling with gutta-percha point. (3) Composite resin is expected to be a promising material after establishment of its biocompatibility as a retrofilling material, because it showed good blockage comparable to Amagasa's method and requires a simple operative procedure. (4) The results mentioned above showed that in cases undergoing apicoectomy with orthograde gutta-percha filling Amagasa's method or retrofilling of composite resin should be concrrently performed to ensure complete blockage of the root apex.
Hemangioma occurs most frequently in the head and neck region, but hemangioma in the buccal fat pad region is rare. Here, a case of venous hemangioma with phleboliths in buccal fat pad region is reported. A 22-year-old female consulted the Department of Oral Surgery, Dental Hospital, Hokkaido University with a chief complaint of swelling in her right cheek. MRI showed a mass in the buccal fat pad extending to infratemporal fossa. The lesion had mixed iso-and hight-signal intensities on T 2 WI, but flow voids in the lesion were not seen on proton WI. Plain CT showed the lesion with several round calcifications. Angiography did not demonstrate the feeding vessels or venous pooling of the tumor. The lesion was clinically diagnosed as a buccal hemangioma. It was removed intraorally under general anesthesia. A part of the lesion consisted of mainly small blood vessels conglomerated like a strawberry and the remaining part was a mixture of vessels and fat tissue. Soft X-ray of the extirpated material revealed several round calcified foci. Histologically, the tumor consisted mainly of numerous vessels within adipose tissue of the buccal fat pad. Mature smooth muscle fibers were observed in the outer portion of blood vessels accompanied by phleboliths in some areas. The lesion was diagnosed to be a venous hemangioma with phleboliths.
A 65-year-old man visited us complaining of a swelling of left cheek with paresthesia of the lower lip. Computerized tomographic surverys disclosed a radiopaque mass in the ascending ramus of the left mandible. 99Tc scintigraphy revealed multiple spots of accumlation throughout the entire body. A diagnosis of prostate carcinoma with multple bone metastases, including the left mandible, was made through urological examination and open biopsy of the mandibular lesion. In addition to the clinical course of this rare case, a brief review of the literature is included.
Osteosarcoma of jaws does not always have characteristic clinical symptoms or X-ray findings. Moreover, the disease is sometimes difficult to diagnose histopathologically even based on biopsy specimens. Here, two cases of osteosarcoma of the mandible, which were difficult to diagnose definitely, are reported. Case: A 38-year-old female complained of paresthesia of the mental region. Osteomyelitis was suspected on clinical examination. A biopsy was performed, but a definitive diagnosis could not be established. Subsequently, the swelling increased and the radiological examination showed a ‘sun-ray’ appearance. On histopathological re-examination, a diagnosis of osteosarcoma was established. Case 2: A 38-year old male complained of paresthesia of the left lower lip and swelling of the buccal gingiva of the left lower premolar region. A biopsy was performed under a clinical diagnosis of a malignant tumor of the mandible. However, the histological diagnosis was an aneurysmal bone cyst. After total enucleation, a diagnosis of osteosarcoma was histopathologically established.
Pleomorphic adenoma is the most common tumor of the salivary gland. This tumor most frequently arises from the parotid gland in the major salivary gland, and from the palate in the minor salivary gland. Pleomorphic adenoma arising from the lip is rare. We describe two cases of the pleomorphic adenoma occurring in the upper lip. Both tumors were well demarcated and movable, and could be easily removed under local anesthesia. They were pathologically diagnosed as pleomorphic adenoma. No recurrence has occurred. It is difficult to set a safe surgical margin owing to the risk of causing deformity and dysfunction of the lip.
We reported a case of epidural abscess which was induced by tooth extraction. A 59-year-old man was referred to our hospital due to a complaint of pain and swelling that extended from the left cheek to the temporal region. After admission, we started an intravenous regimen of latamoxef, 2g/day. After three hours, we observed a sudden pulasatory discharge of bloody, serous pus with an odor of putrefaction from the left ear. We found marked swelling that involved the left medial pterygoid muscle, masseter muscle, parotid gland, and subcutaneous tissue from the left tempora to the neck on computed tomography. We also found an epidural abscess containing air that extended from the left pterygopalatine fossa to the middle cranial fossa. After consulting an otorhinolaryngologist and a neurosurgeon, we decided to treat the patient conservatively with massive doses of systemic antibiotics. The epidural abscess disappeared by the 86th hospital day. The patient has had sequelae and his prognosis is excellent.
It is rare for osteoma to arise in the buccal soft tissue. Only six cases arising in this site have been reported in the literature abroad. The case described here was an osteoma arising in the right buccal soft tissue of a 65-year-old Japanese male. Its size was 26× 21× 8mm. Microscopically, the outer surface of the tumor consisted of lamellar bone, and the inside was fatty bone marrow with thin bone trabeculae. Abundant osteoblasts surrounded newly formed osseous tissue. The mass was surrounded by a fibrous connective tissue capsule. The microscopic findings were basically the same as an osteoma of the jaw.
Recently, microvascular tissue transplantation has come to be generally used for oral and maxillofacial reconstruction. The present status of clinical use of microvascular tissue transplantation for maxillofacial lesions was investigated at 335 oral and maxillofacial surgery centers in Japan. The number of reported was cases 687. Among these, 497 (72.4%) received forearm flap transplantation. A rectus abdominis flap was employed in 104 cases (15.2%). The total survival rate of all transplants was 89.1%