We investigated the effects of interferon-γ(IFN-γ) and tumor necrosis factor (TNF-α) treatment on NR-S 1 cells (murine squamous cell carcinoma). Since NR-S 1 cells treated with a combination of IFN-γand TNF-αincreased susceptibility to conjugation and lysis by lymphokine activated killer (LAK) cells, we examined the participation of celladhesion molecules on the NR-S 1 cells in this phenomenon. Untreated NR-S 1 cells expressed MHC class I, MHC class II, intercellular-adhesion molecule-1 (ICAM-1), and ICAM-2. Treatment with IFN-γinduced the expression of MHC class I and ICAM-1 molecules, but had no effect on the expression of MHC class II and ICAM-2 molecules on NRS 1 cells. Treatment with TNF-αinduced the expression of ICAM-1 molecules, but had no effect on the expression of MHC class I, MHC class II and ICAM-2 molecules. However, treatment with a combination of IFN-γand TNF-αstrongly induced expression of MHC class I and ICAM-1 molecules and slightly induced expression of ICAM-2 molecules, as compared with IFN-γor TNF-αalone. The results indicate that the expression of ICAM-1 molecules, makes NR-S 1 cells more adhesive to LAK cells and more susceptible to lysis by LAK cells.
To clarify the role of superoxide dismutase (SOD) in the tissue of jaw-cyst walls, the enzyme activity and the localization of SOD were investigated using various kinds of cyst walls that were surgically removed as samples. The enzyme activity of copper-zinc (Cu, Zn) and manganese (Mn) SOD were determined by an MCLA-dependent chemiluminescence method and the localization of Cu, Zn-SOD was studied by an immunohistochemical staining method, as compared with the normal gingiva as control. The mean activities of both Cu, Zu and Mn SOD of the cyst walls were lower than that of control. On the other hand, Mn-SOD activity was slightly higher than Cu, Zn-SOD activity. Cu, Zn-SOD immunoreactive staining was mainly observed in the cyst-wall epithelium. The intensity of Cu, Zn-SOD staining was markedly increased in the squamous cells, especialy in the hyperkeratinzed squamous cells of the cyst wall. Moreover, vascular endothelial cells and inflammatory cells in the connective tissue showed positive SOD staining according to the degree of inflammatory changes in the cyst wall. These findings suggested that SOD in the jaw cyst wall might provide protection against tissue injury caused by oxidative stress.
We analyzed clinically 36 patients in whom dental implants were unsuccessful. The patients presented for implants treatment at the Department of Oral Surgery, Nihon University School of Dentistry at Matsudo from January 1989 through December 1993. The results were as follows: 1. The male: female ratio of the patients was 1: 1 and the largest age group was from 40 to 69 years. 2. Type of implant: endosteal implant (31 cases), subperiosteal implant (3 cases), endodontic implant (1 case), endosteal implant and endodontic implant concurrently (1 case). 3. Chief complaint: excessive implant mobility (8 cases), gingival swelling (7 cases), occlusal pain (6 cases), spontaneous pain (5 cases). 4. Present condition: excessive implant mobility (23 cases), resorption of alveolar bone (17 cases), pus discharge (12 cases), swelling (9 cases), spontaneous pain (9 cases), occlusal pain (7 cases), bleeding (4 cases), paralysis (4 cases). 5. Secondary conditions: alveolar ostitis (28 cases), maxillary sinusitis (5 cases), ostitis of the jaw (3 cases), temporomandibular arthrosis (3 cases), paralysis of the inferior alveolar nerve (3 cases). 6. Some symptoms developed in 15 patients from immediately after implant operation. In spite of discomfort, implants were used for an average of 5.1 years.
HLA-C genotyping was performed for 71 Japanese patients with Behcet's disease and 74 unrelated healthy Japanese volunteers by the PCR-SSP (polymerase chain reaction-sequence specific primers) method. Based on previous studies, 19 allele specific primer sets were synthesized and used for HLA-C genotyping. The frequency of the Cw *14 allele was 52.1% in Behcet's disease patients, which was remarkably higher than the frequency of 23.0% in healthy controls (chi-square [χ2]=13.16, relative risk [R. R.]=3.6). The frequency of HLA-Cw *15 was also significantly higher in the patients with Behcet's disease (16.9% in patients vs. 6.8% in controls, χ2=3.60, R. R.=2.8). On the other hand, the frequency of HLA-Cw 0304 was significantly lower in the patient group than in the control group (7.0% in patients vs. 27.0% in controls, χ2=10.14, R. R.=0.20). The HLA-Cw 14 and Cw 15 alleles, which were significantly higher in patients, are in linkage disequilibrium with the B51 antigen and hence may have increased in association with B51. Therefore, the HLA-C allele frequencies were compared between B51-positive and-negative individuals, within each group, and no HLA-C allele showed a significant difference between the patient and control groups. Analysis, with emphasis on the linkage to HLA-Cw *14, revealed that in healthy controls, HLA-Cw *14 was associated with B44 and B51 at the frequencies of 60.0% and 35.0%, respectively. In the patient group, the rate of an association between Cw *14 and B44 was only 14.0% while an association between Cw *14 and B51 was very common (81.4%). These facts suggest that the pathogenic gene of Behcet's disease is not the HLA-C gene (HLA-Cw *14 and/or HLA-Cw *15) but the HLA-B51 gene itself or some other gene located near the HLAB locus centromeric to the HLA-C gene.
Of 326 patients with oral carcinomas treated between 1978 and 1993, 19 (5.8%) were under 40 years of age. We retrospective surveyed these young patients (11 males, 8 females). Carcinoma in these patients occurred most frequently in the tongue (10 cases), followed by the hard palate (3), the lower gingiva, (3) the upper gingiva (2), and the floor of the mouth (1).Fourteen patients (73.7%) had T 1 and T 2 primary lesions. Swelling of the cervical lymph nodes (N 1-N 3) was present in 3 patients (15.8%). Histopathological diagnosis revealed 13 squamous cell carcinomas, 4 mucoepidermoid carcinomas, and 2 adenoid cystic carcinomas. A combination of treatments, including surgery, was performed in 8 patients, only surgery in 5 patients, and a combination of radiotherapy and chemotherapy in 6 patients. Of 6 patients with recurrence or metastasis after initial therapy, 5 died from uncontrolled disease. The 3-and 5-year survival rates were 75.6% and 68.0%, respectively, which were similar to those of older patients in our series. The implications of these observations are discussed with respect to the management of oral cancer in younger patients.
We report two cases of acinic cell carcinoma of the minor salivary glands. Case 1: The patient, a 73-year-old woman, presented with swelling of the left buccal mucosa. The tumor measured 30×30 mm and was elastic hard in consistency. Surgical excision was performed. The postoperative course has been uneventful for four years. Case 2: The patient, a 40-year-old female, presented with swelling of the right hard palate. The tumor measured 22×3 mm and was elastic hard in consistency. Partial resection of the right maxilla was performed. The postoperative course has been uneventful for ten years. Both tumors were well encapusulated histologically, and there has been no evidence of recurrence or metastasis after only surgical treatment. These facts suggest that acinic cell carcinoma is a low grade malignancy.
We have encountered a patient with acanthosis nigricans maligna. The patient was an edentulous 81-year-old man with gastric cancer as a complication. His main complaint was many white lesions in the oral cavity. He had remarkable symptoms of the skin. In addition, leukoplakia was observed in many parts of the oral cavity. After the resection of gastric cancer, skin symptoms did not improve. We suspected the persistence of cancer and attempted to resect and investigate the white lesions. Histopathologically, the lesions showed no evidence of dysplasia, and leukoplakia was diagnosed. Although the patient wore dentures and smoked, the oral leukoplakia was apparently a rare symptom of acanthosis nigricans maligna. At present, there is no evidence of recurrence of the oral lesions, but the symptom of the skin remain unchanged.
We report a case of inverted papilloma in the maxiallry sinus associated with a non-healing extraction socket. A 61-year-old man, complaining of discomfort in upper left alveolar region was referred to our clinic for a non-healing extraction wound (7). CT and MRI revealed a mass in the left maxillary sinus with bone destruction. The lesion was suspected to be squamous cell carcinoma on initial biopsy. The patient underwent surgical excision, and radiation therapy was performed before and after the surgery. The pathological diagnosis of the operation material was inverted papilloma.
A case of leiomyosarcoma of the palate in a 41-year-old man is reported. A thumbsized tumor was found on the palate, behind the right upper incisor and first premolar. Leiomyosarcoma was diagnosed on histopathological examination of a biopsy specimen, and a partial maxillectomy was performed. The tumor underwent immunohistochemical and electron microscopic studies to confirm the diagnosis of leiomyosarcoma.
A case of rhabdomyosarcoma in the submandibular gland is reported. A 57-year-old man consulted the Department of Oral Surgery, Dental Hospital, Hokkaido University with a chief complaint of swelling in the right submandibular region. An elastic hard, uneven mass, 40 mm in diameter, was palpated on the lateral surface of the submandibular gland. Surgical resection was carried out under a diagnosis of a submandibular gland tumor. The tumor was located in the submandibular gland, and it showed continuity to the adjacent glandular tissue. The tumor cells showed a positive reaction for vimentin, desmin, and myoglobin immunohistochemically. The tumor was diagnosed as rhabdomyosarcoma.
A case of synovial sarcoma of the mental region is reported. The patient was a 38-year-old man with swelling and tenderness of the right mental region. The pathological diagnosis of a biopsy specimen was “sarcoma”, and the tumor was resected radically with the skin, muscle, and cortical bone of the mandible. Microscopic examination of the tumor showed dominant atypical spindle cells distributed in bands and a few slit-like structures lined by epithelioid cells. Immunohistochemical studies showed epithelial membrane antigen (EMA) and keratin positive sites in part of the slit-like structures. The spindle cells were vimentin positive. Ultrastructural findings revealed microvilli and desmosomes. Based on these findings, the pathological diagnosis of this tumor was synovial sarcoma (monophasic fibrous type). There have been no symptoms or clinical signs of recurrence or metastasis as of 21 months after the operation.
We report a case of ganglioneuroma arising in the neck of a 66-year-old woman. The patient noticed a nodule of her neck which had increased in size, and was referred to our hospital. A benign tumor was diagnosed clinically, and complete excision was performed under general anesthesia. Although the tumor was well encapsulated, the upper end of the tumor deeply invaded and adhered to the cervical nerve. Histopathological examination of the surgical specimen showed tumorous proliferation of ganglion cells among the spindle-shaped cells and neurofibrils. These findings led to a pathological diagnosis of ganglioneuroma. The postoperative course was uneventful, except for Horner's syndrome, which appeared transiently.
A case of multiple eosinophilic granuloma occuring in the maxilla and mandible of a 48-year-old woman is reported. The tumors were surgically removed from the maxilla and mandible under general anesthesia, and medicaltherapy with prednisolone was given in addition to surgical therapy. The pathological diagnosis was eosinophilic granuloma in all lesions, and histiocytes showed a positive reaction to S-100 protein. The patient has shown no evidence of recurrence as of 3 years 2 months after surgery, but long-term follow up studies are necessary for the early detection and treatment of recurrence.
Three cases of recurrent dislocation of the temporomandibular joint (TMJ) treated by arthroscopic suturing technique are reported. The patients were a 24-year-old woman (case 1), a 23-year-old woman (case 2), and a 28-year-old man (case 3). Their chief complaint was impairment of mouth closing. As the clinical diagnosis was a recurrent dislocation of the TMJ, an arthroscopic suturing technique as described by Ohnishi was used under general anesthesia. There was no disturbance of mouth closing in any patient after surgery.
A case of arteriovenous fistula in the submandibular region is reported. A 34-year-old woman visited the Department of Oral Surgery, Dental Hospital, Hokkaido University with a chief complaint of swelling in the left submandibular region. She noticed the swelling about 2 years ago. On the first visit, the patient had a movable mass in her left submandibular region. USG showed a clearly demarcated echo-free area. MRI showed a solid mass with dilated blood vessels around the region. The lesion was clinically diagnosed as a tumor or vascular lesion. It was removed surgically by an extraoral approach under general anesthesia. The lesion was covered with a fibrous capsule, and histologically it consisted mainly of many blood vessels. Arterialization of veins was observed and it was diagnosed as arteriovenous fistula.