In the present study, we used a modified primary culture method to establish human cancer cell lines derived from the primary lesion and lymphnode metastases in a patient with oral cancer. Three novel cell lines were established: MO-T from a primary squamous cell carcinoma of the tongue, and MO-N 1 and MO-N 2 from neck lymphnode metastases. These cell lines have been cultured for more than 1 year and are in good condition. The population doubling time of MO-T, MO-N 1, and MO-N 2 are approximately 48.0, 46.5, and 36.0 hours, respectively. The cell lines were implanted in nude mice, and the resulting tumors histopathologically resembled the original lesions. Epidermal growth factor (EGF) binding assay was performed with the use of 125I-labeled human EGF, and the number of cell surface receptors was estimated by Scatchard plot. The number of epidermal growth factor receptors (EGFR) of MOT, MO-N 1, and MO-N 2 was 7.80×105, 1.01×106, and 7.60×105 per cell, respectively. These cells expressed both high-and low-affinity receptors. We also investigated whether or not these cells carry an amplified gene for EGFR by Southern blot analysis using its complimentary DNA, pE 7 insert, as a probe. None of the cell lines shbwed distinct evidence of an amplified gene for EGFR. Moreover, we examined mRNA expression of EGFR by Northern blot analysis. The mRNA levels differed among the three cell lines. These findings suggest that the three cell lines derived from a single patient are useful for studying the biological features and the mechanism of invasion and metastasis of oral cancer.
We have previously reported that the ilium was best suited for reconstruction of the mandible because of its shape and volume, including both thickness and height. Here we report the results of clinical studies of 38 patients in whom vascularized iliac crest (VIC) was used to reconstruct the mandible. The procedure used for resection of the mandible was unilateral segmentectomy in 23 patients, bilateral segmentectomy in 11 patients, and hemimandibulectomy in 3. The mandible underwent primary reconstruction in 30 of the 38 patients. For the skin flap, a forearm flap was used in 18 of the patients. The complications included gait disturbances in 32 of the 38 patients (81%) within 3 months after the operation, but this disturbance resolved within 1 year. Dysesthesisa of the femoral region was experienced by 18 of the 38 patients and disapperared within 1 year after the operation in most cases. The VIC had to be removed in 4 of the 38 patients (10%). Dentures were worn by 32 patients (85%) from 3 to 6 months after mandibular reconstruction. The reasons for removal of the graft were necrosis of the groin flap and VIC in one patient, and thrombosis in two patients. The absorption rate of the grafted bone was measured by orthopantomography. At of 3 years after the operation, the average bone resorption rate was about 5 % in 34 patients. Ten patients of 38 patients received implant-anchored prostheses, and 41 Brånemark Mark II and 7 ITI Bonefit implants were inserted via an intraoral approach. After treatment with the implant-anchored prosthesis, masticatory function was better than while wearing conventional dentures, but speech function was not improved. We conclude that the use of a VIC in a one-stage operation for reconstruction of the mandible allows the patient to wear dentures early after the operation and facilitates the recovery of mastication and facial appearance, with no serious complications. Bone volume was sufficient, and the success rate of the bone grafts was high. Masticatory function was improved by having the patient wear an implantanchored prosthesis.
To assess the depth of tumor invasion, we performed ultrasonography (US) in patients with T1 and T2 carcinomas of the tongue, using a 7.5 MHz intraoral electronic sector scanner (SSD-650; ALOKA, Tokyo, Japan). The ultrasonographic findings were compared with pathologic findings. The study cohort consisted of 21 patients with squamous cell carcinoma of the tongue who were admitted to our institution from April 1993 through October 1996. Pathologic findings of primary lesions obtained by resection, were studied. The results were as follows. 1) US detected all lesions, irrespective of the depth of carcinoma invasion. 2) The mean depth of T1 carcinoma invasion on pathological examination was 3.6mm, and that of T2 was 8.4mm. The mean error in the depth of T1 carcinoma invasion between US and pathologic findings was 0.4mm and that between T2 and pathological findings was 0.8mm. Our results suggest that US with an intraoral scanner is useful for detecting early tongue cancer and should be used routinely in clinical practice.
The ability of tobacco-specific N-nitrosamine 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone (NNK) to induce chromosome aberrations and DNA damage was examined in an immortal cell line (NDUSD-1 cells) of human keratinocytes from gingival tissues. Treatment of NDUSD-1 cells with NNK at 1-10 mM for 3-10 days reduced cell survival in a dose-and treatment-time-dependent manner. Survival of cells treated with NNK (1-10 mM) for 7 days was similar to that of cells treated with NNK (1-10 mM) for 2 hours in the presence of exogenous metabolic activation with rat liver post-mitochondrial supernatant. No significant increases in the frequency of chromosome aberrations were observed in NDUSD-1 cells treated with NNK (1-10 mM) for 6 hours, but significant levels of chromosome aberrations were found in cells treated with NNK (3-10 mM) for 2 hours with exogenous metabolic activation. DNA damage as detected by unscheduled DNA synthesis (UDS) was not induced in cells exposed to NNK (0.1-10 mM) for 2 hours, but was induced in cells exposed to the same concentrations of NNK for 24 hours. Induction of UDS by NNK was also observed in cells treated with NNK (1-10 mM) for 2-6 hours in the presence of exogenous metabolic activation. These results suggest that conversion of NNK to active metabolites is required for the induction of cytotoxicity and genotoxicity of NNK in NDUSD-1 cells, and that NDUSD-1 cells retain a weak capability to metabolize NNK
In 169 patients with postoperative maxillary cysts who were operated on at our clinic, we examined the clinical course of disease, clinical symptoms, characteristics of the cysts, location and size of the cysts, location and size of the bone defects, and positional relationship between the cysts and teeth. Furthermore, factors associated with the expression and the type of symptoms were also examined, and the following results were obtained. 1) Characteristics of cysts: Multilocular cysts were associated with more frequent and severer symptoms than unilocular cysts. 2) Location and size of cysts: Cysts in a lower position were frequently associated with symptoms, especially intraoral symptoms. Cysts in a higher position were associated mainly with buccal symptoms. Cyst size was not significantly associated with the occurrence of symptoms. 3) Location and size of bone defects: Cysts with bone defects in the anterior part of the maxillary sinus were frequently associated with symptoms, especially buccal symptoms. Furthermore, large bone defects were more frequently associated with symptoms. 4) Positional relationship between cysts and teeth: Cysts with root chip (s) in their cavities were frequently associated with symptoms, especially intraoral symptoms. Examination of factors associated with the occurrence and type of symptoms will help to predict the outcome of postoperative maxillary cysts and help to determine whether or not an operation is indicated for symptom-free cysts.
A case of necrotizing sialometaplasia (NSM) of the oral floor accompanied by squamous cell carcinoma of the submandibular region is reported. The patient was a 76-year-old man with a painless swelling of the submandibular region. Although a biopsy of the floor of the mouth provided histological evidence of NSM histologically, that in the submandibular region revealed squamous cell carcinoma. NSM most commonly affects the minor salivary glands of the palate, but may occur at other sites such as the parotid gland and the glands of the buccal mucosa. However, this case is very unusual because NSM arose in the floor of the mouth. The lesion was considered to be caused by ischemia secondary to compression by the tumor in the submandibular region.
This report describes the case of 44-year-old man with sensory paralysis of the left side of the lower lip who visited our hospital. An orthopantomographic examination showed an ill-defined radiolucency around the left mental foramen. Angiography showed a beadlike-shadow surrounding the left mental foramen. Examination of a biopsy specimen suggested a hemangioma. Segmental resection of the mandibular bone was performed under general anesthesia. Histological examination revealed round or polygonal tumor cells, some of which showed mitotic figures. Immunohistological staining with FactorVIII related antigen showed tumor cells with distinctly positive findings. Histopathological examination resulted in a diagnosis of epithelioid hemangioendothelioma. Recurrence and metastasis have not been detected, and the patient's progress has been good as of 40 months after the operation.
Vascular leiomyoma is a benign tumor of smooth muscle that mainly occurs in the hands and legs. However, it rarely occurs in the oral cavity. A case of vascular leiomyoma of the buccal mucosa is reported. A 73-year-old woman visited our department because of a swelling in the buccal mucosa. CT examination revealed a smooth tumorous lesion in the left buccal mucosa. The clinical diagnosis was a benign tumor, and enucleation of the tumor was performed. The histopathological diagnosis was vascular leiomyoma.
Intravascular papillary endothelial hyperplasia (IPEH) is an unusual, benign, non-neoplastic vascular lesion characterized histologically by papillary fronds lined by proliferating endothelium. It may occur in any blood vessel in the body but is most common in the head and neck region and the fingers. Reports of IPEH of the oral region are rare in Japan. In this report, we describe a case of IPEH of the tongue.
Nevocellular nevi (pigmented nevi) are less common in the oral cavity than on the skin. Most reported cases are lesions within 10 mm in diameter, and few are over 40mm. This article reports a case of nevocellular nevus occurring on the hard palate. In addition, 31 cases of pigmented nevi reported in the Japanese literature are reviewed. The patient was a 42-year-old man. Swelling and a pigmented lesion ware first noted by a dentist in November 1990, but he refused further treatment because there was no pain. In August 1994, he was referred to our clinic for prosthetic treatment. The swelling was a domelike, dark-red pigmented mass occupying the left half of the hard palate. The size of this lesion was 45×38mm. There was no bleeding or ulceration. Under the clinical diagnosis of a benign tumor of the salivary gland, surgical excision was performed under general anesthesia. No resorption of the bone adjacent to the hard palate as evident. Histopathological examination revealed the lesion to be a nevocellular nevus, intradermal type. The postoperative course was uneventful, and there has been no evidence of recurrence as of 2 years after surgery.
Clinical findings and the treatment of 14 cases (14 teeth) of tooth displacement in the maxillary sinus were studied.The following results were obtained. The peak age distribution was in the third decade. Tooth displacement into the antrum was caused by the tooth extraction procedure. The first maxillary molar was the most frequently displaced tooth, and before displacement the teeth were the most frequently remaining roots. The period from displacement to presentation at our department was 0 to 20 days (average, 6days). At the presentation, maxillary sinusitis was observed in 13 of the 14 cases (93%). The period from displacement to removal was 0 to 69 days (average, 28days). The displaced teeth were removed from their sockets in 4 cases and by an approach via an opening at the anterior wall of the maxillary sinus in 10 cases.In one patient with a tooth displaced for 69 days in the maxillary sinus, both removal of the sinus membrane and creation of a nasoantral window were performed because severe sinusitis. All cases had good clinical courses. The results suggest that early removal is recommended after tooth dislodgement into the maxillary sinus to prevent the development of complications.
We clinically studied 158 cases of glossodynia at our clinic from 1991 through 1994. The male to female ratio was 1 to 10. The patients visited our clinic within 3 months after becoming aware of symptoms. Most patients were between 50 and 69 years. The principal locati of pain was the apex of the tongue followed by the lateral margin, dorsum, and base of the tongue. Almost all patients had slightl pain. Many patients cases were treated by psychotherapy and medication.