In our department, we provide treatment for malignant head and neck tumors with the goal of preserving organs and function. We report the treatment outcomes for five patients with maxillary cancer who underwent S-1 and nedaplatin treatment with concurrent radiation therapy (SN therapy) in our department from April 2005 to March 2009. The patients included one case classified as T2N0M0 and four cases classified as T4N0M0. All patients were male and were aged between 29 and 67 years with a mean age of 55.6 years. Among the five cases, four achieved cancer-free survival with preservation of all functions after undergoing treatment. In the remaining case, the tumor did not disappear but was locally controlled via superselective arterial injection and CyberKnife treatment; however, pulmonary metastasis occurred and the patient is surviving with cancer. SN therapy has allowed a reduction in the extent of surgery required and the preservation of organs and function. It will be necessary to study an increased number of cases in the future to determine the survival rate and the effectiveness of organ and function preservation in maxillary cancer patients after SN therapy.

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Standard CD44 (CD44s) is reported to play an important role in determining the malignant potential of various carcinomas. The aim of the present study was to evaluate CD44s expression in T2-T3 gastric cancer (Japanese Classification of Gastric Cancer stages MP, SS, SE) and the relationship between CD44s expression and clinicopathological parameters. CD44s expression was measured using immunohistochemistry in tumors from 98 patients with primary gastric cancer. Cases were categorized into two groups based on CD44s staining; the CD44s positive group had > 10% positively stained tumor cells and the CD44s negative group had < 10%. CD44s positivity was demonstrated in 59.1% (58/98) of tumors. CD44s expression showed no significant relationship with patient age or gender, or tumor location, size or macroscopic/microscopic classification. However, CD44s expression showed a significantly negative relationship with metastasis to lymph nodes (p < 0.0001). Thus, in T2-T3 gastric cancer, loss of CD44s expression suggests that metastasis of the tumor to lymph nodes is likely.

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The aim of this study was to determine the expression of human epidermal growth factor receptor type 2 (HER2), epidermal growth factor receptor (EGFR), peroxisome proliferator-activated receptor γ (PPARγ), CD44 and androgen receptor (AR) in adenoid cystic carcinomas (ACC), carcinoma ex pleomorphic adenomas (CXPA) and mucoepidermoid carcinomas (MEC) of the salivary glands, to investigate their molecular difference and to estimate the availability of molecular-targeted and hormonal therapy in salivary-gland tumors. Forthy patients with a salivary gland tumor, diagnosed and treated at our hospital, were studied. On the basis of histopathology, 10, 19 and 11 patients were identified with ACC, CXPA and MEC, respectively. The associations between histological types were evaluated by the chi-square test. Differences were considered statistically significant at P < 0.05. HER2-positive expression was observed in 10% of ACC, 84% of CXPA and 18% of MEC. EGFR-positive expression was observed in 40% of ACC, 68% of CXPA and 91% of MEC. CD44-positive expression was observed in 40% of ACC, 47% of CXPA and 91% of MEC. PPARγ-positive expression was observed in 10% of ACC, 53% of CXPA and 18% of MEC. AR-positive expression was observed in 20% of ACC, 32% of CXPA and 9% of MEC. Compared with other histological types, CXPA demonstrated significant HER2 and PPARγ staining and MEC demonstrated significant EGFR and CD44 staining. The differences in expression of markers between histological types in our study suggests the possibility that HER2- and PPARγ-targeted therapy may be effective in CXPA, and that EGFR-target therapy may be effective in MEC of the salivary glands.

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Patients with nonfunctioning pituitary adenoma (NFPA) have normal circulating levels of anterior pituitary hormones. Here we examined the expression of exocytic trafficking regulators, Rab27b and Rab3a, in surgically resected pituitary adenoma tissues by immunohistochemical (IHC) analysis using anti-Rab27b and anti-Rab3a antibodies. Among the examined tissues, just over half of the null-cell adenomas and one-third of the gonadotropin-producing adenomas were immunonegative for both Rab27b and Rab3a. However, no Rab-negative samples were observed among the functioning adenomas. These results suggested that downregulated Rab protein expression in anterior pituitary endocrine cells could underlie, at least in part, the hormone-secretion defects of nonfunctioning adenoma cells. Rab27b, Rab3a, and their cellular regulators might therefore be promising pathological markers of patients with NFPA.

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Fisher syndrome (FS) is an autoimmune peripheral neuropathy that occurs in 1 person per 2 million population. The present report is of a patient with FS who presented with diplopia and discomfort of the right cheek and in whom differentiation from maxillary sinus cysts was necessary. The patient was a 43-year-old man with a history of radical surgery of the right maxillary sinus, so we suspected that his symptoms were due to postoperative maxillary sinus cysts. Although computed tomography demonstrated right maxillary sinus cysts, these cysts were not likely to be the cause of the patient's diplopia. Close neurological examination revealed external ophthalmoplegia, cerebellar ataxia, and the absence of a deep tendon reflex; on this basis, a diagnosis of FS was made. Diplopia is caused by various disorders and FS should be taken into consideration when making a differential diagnosis.

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