Inhibition effects of tumor necrosis factor-alpha gene transduced tumor drainage node of lymphocytes from tongue cancer on SCID mice transplanted tumor established with human tongue carcinoma cell lines / 华西口腔医学杂志

<p><b>OBJECTIVE</b>To observe the in vivo inhibition effects of tumor necrosis factor-alpha (TNF-alpha) gene transduced tumor drainage node of lymphocytes (DNL) from tongue cancer on SCID mice transplanted tumor.</p><p><b>METHODS</b>15 human tongue carcinoma models were established in SCID mice by subcutaneously injection of squamous cell carcinoma line Tca8113. TNF-alpha gene introduced DNL, combined with low dose Pinyancin (PYC), were locally injected into tumor site. The inhibition rate was determined by the weights at the 8th week after tumor dissection and fresh specimens were prepared and subject to histopathologic examination under transmission electron microscope, and in situ TUNEL was used to detect apoptosis.</p><p><b>RESULTS</b>The TNF/DNL and rIL-2 group, and the TNF/DNL and rIL-2 and PYC group both exerted a strong inhibition effect on the implanted tumor. Treated tumors of the TNF/DNL and rIL-2 and PYC group were significantly reduced in comparison with those of the TNF/DNL and rIL-2 group (P < 0.05). The apoptosis of tumor in the TNF/DNL and rIL -2 group was evidenced based on transmission electron microscope and TUNEL analysis, and the apoptosis index was higher than that of control group (P < 0.05).</p><p><b>CONCLUSION</b>Local injection of DNL modified with TNF-alpha gene, combined with low dose PYC, exert a synergistic antitumor effect. Apoptosis may be an important mechanism of squamous cell carcinoma killed by TNF/DNL.</p>

Occult cervical lymph node metastases in 100 consecutive patients with cN0 tongue cancer / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Squamous cell carcinoma (SCC) of the tongue is one of the most common cancers in the oral and maxillofacial region. To provide clinical evidence for selective neck dissection in management of cN0 patients by analyzing the characteristics and correlation of factors of occult cervical lymph node metastases (OCLNM) in patients with SCC of the tongue.</p><p><b>METHODS</b>From 2002 to 2006, 100 consecutive patients with SCC of the tongue were reviewed by analyzing the characteristics of OCLNM, diameter of the tumor, T classifications, depth of invasion, forms of growth, pathological grade and degree of differentiation.</p><p><b>RESULTS</b>The rate of OCLNM in 100 patients with SCC of the tongue was 22%. The most common region with OCLNM was level II in the ipsilateral neck, followed by levels I and III. There were 51.61% (16/31) of OCLNM in level II and 87.10% (27/31) of OCLNM in levels I - III. There was no significant correlation between the diameter of tumor and OCLNM (P > 0.05). OCLNM was statistically significantly correlated with the depth of invasion, forms of growth, pathological grade and degree of differentiation (P < 0.05). The rate of occult metastases increased with the increased pathological grade, the decreased degree of differentiation and the increased depth of invasion.</p><p><b>CONCLUSIONS</b>The most common regions with OCLNM in cN0 patients with SCC of the tongue were levels I - III in the ipsilateral neck. Supraomohyoid neck dissection should be the elective treatment to the neck in patients with cN0 SCC of the tongue by consideration of the clinical and pathological factors for the depth of invasion, forms of growth, pathological grade, and degree of differentiation.</p>

A new mutation of PTCH gene in a Chinese family with nevoid basal cell carcinoma syndrome / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Nevoid basal cell carcinoma syndrome (NBCCS) is a rare autosomal dominant disease characterized by a combination of development anomalies and a predisposition to tumour formation. Mutation of patched gene (PTCH), considered the molecular defect of NBCCS, in a Chinese NBCCS family was investigated in this study.</p><p><b>METHODS</b>Genomic DNA was isolated from blood samples of all 12 members of this family. The mutated PTCH gene was screened by polymerase chain reaction amplification and direct sequencing.</p><p><b>RESULTS</b>A new mutation of 3 bp (GAT deletion) was found in all seven affected members of this family. This mutation caused one aspartate deletion in the fourth transmembrane domain of the PTCH protein located within the sterol sensing domain (SSD). This deletion was not found in any unaffected members of this family nor in 200 control samples.</p><p><b>CONCLUSIONS</b>Our findings suggest that one 3-bp deletion in PTCH gene was the cause of nevoid basal cell carcinoma in a Chinese family through affecting the conformation and function of PTCH protein.</p>

Surgery of the carotid artery: a retrospective study of 35 consecutive cases / 中华口腔医学杂志

<p><b>OBJECTIVE</b>To retrospectively analyze a single institution's experience with surgery of the carotid artery performed as part of an oncological procedure and emergency hemostasis, with the aim to determine the preoperative methods for evaluation of cerebral circulation, selection of surgical procedures and perioperative complications.</p><p><b>METHODS</b>From January 1999 to December 2004, a total of 35 patients underwent carotid artery surgery including repair of carotid artery in 7 cases, ligation or resection of carotid artery in 17 cases, and reconstruction of carotid artery in 11 cases. All the patients were evaluated for blood flow in the circle of Willis with DSA, DSA plus TBO plus SPECT, and TCD and followed up from 4 months to 4 years. The perioperative complications and surgical outcomes were recorded and analyzed.</p><p><b>RESULTS</b>There were 16 carotid body tumors, 1 malignant carotid body tumor, 17 malignant tumors involving the carotid artery and 1 traumatic arterio-venous fistula. Twenty-seven patients underwent carotid occlusion test, 10 were positive and 17 were negative (tolerable). Of 7 cases with repair of the carotid artery, 1 patient died of uncontrolled bleeding due to rupture of the anastomosis, and the remaining was uneventful. Of 17 cases with ligation or resection of the carotid artery, 4 developed neurologic deficit 2 weeks postoperatively. Three patients with malignant tumors died 1 month, 4 months, and 4 months postoperatively, respectively. One patient with carotid artery body tumor complained of inarticulate speech 4 months after operation; another patient complained of incapability and limited movement of the ipsilateral upper limbs; 5 patients complained of dizziness 4, 6, 12, 24 and 48 months postoperatively. Of 11 patients who underwent carotid reconstruction, no major cerebral complications were noted after operation. One patient died of recurrence, 1 patient with carotid body tumor complained inarticulate speech and incapability of the contralateral limbs, the remaining was uneventful. Color Doppler showed patent vascular graft 1 year postoperatively.</p><p><b>CONCLUSIONS</b>TBO plus SPECT is a reliable method for evaluation of the circle of Willis currently. The short term and long term complications of ligation of carotid artery are high, therefore, resection and revascularization of the carotid artery is advocated for carotid artery tumors when possible.</p>

Diagnosis and treatment of high-flow vascular malformation of the jaws / 中华口腔医学杂志

<p><b>OBJECTIVE</b>To report our experience on diagnosis and treatment of the high-flow vascular malformation of the jaws.</p><p><b>METHODS</b>Thirty-seven cases of high-flow vascular malformation of the jaws (6 cases in maxilla and 31 in mandible) were comprised this study. Twenty-one patients were embolized with coils and N-buty1-2-cyanoacrylate, and 16 cases underwent surgery. The embolization was carried out with both arterial and venous route.</p><p><b>RESULTS</b>Different signs of the lesions were demonstrated on X-ray plain film, such as locular, rough of bone trabecula and soap bubble-like changes, frequently accompanied by dilatation of the mandibular nerve canal. CT scan showed unilocular and multilocular radiolucency. T(1)WI and T(2)WI on MRI exhibited low signal, and varix was found on DSA. The high-flow vascular malformation of the jaws classified into two groups: arterial malformation and arteriovenous malformation according to CT and DSA. The acute bleeding of 16 cases was effectively controlled by embolization. The chronic bleeding in the other 5 cases stopped after the 4 - 59 months and new bone formation was found in the follow-up radiography.</p><p><b>CONCLUSIONS</b>The characteristic signs were not unique on X-ray plain film, and MRI and DSA had diagnostic value. Arteriovenous malformation of the jaws should be embolized by direct puncture in conjunction with endovascular therapy, and arterial malformation be superselectively embolized with NBCA.</p>

Clinical study on laser therapy of the venous malformations and hemangioma in oral and maxillofacial regions / 中华口腔医学杂志

<p><b>OBJECTIVE</b>To try to find the best method of laser therapy for the management of venous malformation and hemangioma in oral and maxillofacial regions.</p><p><b>METHODS</b>From June, 1999 to July, 2002, 2 481 cases of venous malformations and hemangiomas were treated by several kinds lasers in our department. The lesions included port-wine stains, venous malformations, telangiectasia and hemangioma. The lasers used were continuous wave CO(2), Nd:YAG and Krypton lasers, pulsed dye laser and ultra-pulsed CO(2) lasers. The treatment modalities were direct irradiation, irradiation after surgical flap raising and photodynamic therapy.</p><p><b>RESULTS</b>Follow up between 2 - 5 years revealed the treatment results as follows: excellent is 79.24%, good is 14.31% and poor is 6.45%.</p><p><b>CONCLUSIONS</b>Laser therapy is one of the best method to treat venous malformations and hemangiomas. The key point is to apply different lasers properly.</p>

Carotid body tumor: a retrospective study of 26 consecutive cases / 华西口腔医学杂志

<p><b>OBJECTIVE</b>To study the clinical features, diagnoses and operative intervention of carotid body tumors.</p><p><b>METHODS</b>The medical records of 26 patients with carotid body paragangliomas between 1993 and 2004 were retrospectively reviewed.</p><p><b>RESULTS</b>Two of twenty-six patients had bilateral tumors. One patient had malignant tumors with cervical lymph nodes metastases. Twenty-one patients were evaluated with a preoperative angiography. No preoperative embolization was performed. Eleven patients underwent ultrasonography, nine had CT scan of the neck, five had magnetic resonance imaging. Twenty-six patients were all operated. Vascular reconstruction was performed in five cases. The ligation of carotid artery was carried out in four cases and another patient had vagus nerve resection. No death and recurrence occurred in all cases.</p><p><b>CONCLUSION</b>Angiography and ultrasonography are valuable in the diagnosis of carotid body tumor. Surgical removal should be made early to avoid the possibility of eventual metastasis and progressive local invasion. The pattern of operation should be chosed according to the relation of tumor and carotid.</p>

Chemosensitivity testing of oral squamous cell carcinomas with teniposide / 中华口腔医学杂志

<p><b>OBJECTIVE</b>To investigate the antitumor effectiveness of teniposide in oral squamous cell carcinomas (OSCC) and to find evidence for using teniposide for treatment of patients with OSCC.</p><p><b>METHODS</b>Seventy-five patients with OSCC from the School of Stomatology, Shanghai Second medical University during 1999 to 2001 were evaluated. Tumors were diagnosed pathologically, and drug sensitivity tested. The antitumor drugs tested were cisplatin (CDDP) and teniposide (VM-26). Fresh drug was diluted in complete medium at fold of five times of peak plasma concentration (PPC x 5) achieved by intravenous administration of clinical doses. The concentrations were VM-26 60 mg/L, CDDP 15 mg/L.</p><p><b>RESULTS</b>The MTT assay was performed in 75 of 81 patients (success rate 92.6%). The clinical stages of the 75 patients according to the UICC TNM classification of malignant tumors were 28 with stage IV, 34 with stage III, 11 with stage II and 2 with stage I. The pathological grades of the 75 patients according to three step classification were 18 with Grade I, 37 with Grade I approximately II and 20 with Grade III. At a drug concentration of PPC x 5, the inhibition rates of tumor cells for VM-26 and CDDP were 63.34% and 24.08%, respectively. The inhibition rates of tumor cells for VM-26 were significantly higher than those for CDDP (P < 0.01).</p><p><b>CONCLUSIONS</b>The inhibition rates of OSCC cells for VM-26 are significantly higher than for CDDP. VM-26 may be the first selected drug for treating patients with OSCC.</p>