[Surgical Procedure for Postoperative Reconstruction of Swallowing Function in a Very Elderly Patient with Advanced Tongue Cancer].

Surgical ablation and reconstruction are the first-line treatment strategies for squamous cell carcinoma of the tongue. However, locally advanced cases can be complicated by postoperative dysphagia. Here, we report a case of advanced tongue cancer in a very elderly patient who regained good swallowing function following a reconstructive surgery using a pectoralis major musculocutaneous flap with elevation of the hyoid bone. Case: An 89-year-old man diagnosed with advanced squamous cell carcinoma of the tongue(cT4aN2bM0, cStage ⅣA)underwent tracheostomy, right modified radical neck dissection type Ⅱ, left supraomohyoid neck dissection, subtotal glossectomy, and pectoralis major musculocutaneous flap reconstruction under general anesthesia. Intraoperatively, holes were created in the lower edge of the mandible, and the hyoid bone was suspended and fixed to the mandibular border using 2-0 nylon sutures. The postoperative course was uneventful. The flap had been completely engrafted and was in a good condition. The pharyngeal stage of swallowing function was reproduced through a reconstructive surgery with suspension and fixation of the hyoid bone toward the border of the mandible. Video fluorography 6 months postoperatively showed that good swallowing function was achieved using a palatal augmentation prosthesis.

[A Case of Medical Leech Therapy for Venous Congestion Following Forearm Flap Reconstruction].

Leeches have been used for medical treatment for at least 2,500 years. Plastic surgeons have recently begun to use leeches to reduce venous congestion after flap reconstruction. However, few reports of leech use in the oral region have been published. We report a case of medical leech therapy used to treat venous congestion after forearm flap reconstruction for oral cancer. A 67-year-old female was diagnosed with squamous cell carcinoma of the left tongue margin(cT2N0M0, Stage Ⅱ). The patient underwent tracheostomy, supraomohyoid neck dissection, hemiglossectomy, and reconstruction using a free forearm flap under general anesthesia. Venous congestion in the forearm flap was detected 21 hours postoperatively, and reanastomosis of the flap was performed. However, venous congestion continued after revision surgery. Therefore, we introduced medical leech therapy to treat the venous congestion. Leeches were used twice daily for 5 days, and the total hematophagy volume was 21.6 g. After leech treatment, continuous bleeding from the skin flap decreased and skin color improved. The medial skin flap survived, and the patient was able to eat 13 days after the initial operation. The rest of the treatment has been uneventful to date without dysfunction of the skin flap.

Investigation of the mechanism of the fluorescent emission of the silylated pyrene modified DNA.

Modified DNA containing silylated pyrene derivative at the 5'-terminus showed the obvious discrimination ability of the duplex formation, that the modified DNA showed the strong fluorescence emission in the presence of the complementary DNA, in spite of the very weak emission in the absence of the complementary DNA. The intensity of the fluorescence emission of the double strand found to increase about 10 times compared with that of the single strand. In this paper, we tried to disclose the detailed mechanism of such a discrimination ability of the silylated pyrene-modified DNA.

Synthesis and properties of oligonucleotides containing silylated pyrene derivatives.

Preparation and properties of the novel fluorescently labelled oligonucleotides, containing the silylated pyrene derivatives are reported. The silylated pyrene derivatives were introduced into both 5'-terminus and C-5 position of the deoxyuridine derivatives. The fluorescent spectra indicated the possibility of the discrimination of the duplex formation by the simple denaturation.

Specific binding of heat shock protein 70 with HN-protein inhibits the HN-protein assembly in Sendai virus-infected Vero cells.

The production of hemagglutinating virus of Japan (HVJ; Sendai virus) was inhibited at 41 degrees C, whereas it was normal at 37 degrees C. In the infected Vero cells, viral specific proteins were synthesized even at 41 degrees C, but the synthesized HN protein was not integrated into the cell membrane, resulting in the inhibition of viral production. To investigate the relationship of HSP70 to the inhibition of HN-protein integration, the expression of HSP70 was induced by prostaglandin A1 (PGA1) at 37 degrees C, and the influence on viral infection was examined. The induction of HSP70 at 37 degrees C inhibited the viral production. Viral proteins were also synthesized, even in the presence of PGA1. However, HN protein was not as present on the cell membrane following PGA1-treatment as it was at 41 degrees C, whereas F protein was detected. An immunoprecipitation assay showed that HSP70 was coprecipitated with HN protein, but not with F protein. The results suggested that the specific interaction of HSP70 with HN protein prevented the protein from integrating into the cell membrane. In addition, the abnormal virus-like particles, of which HN protein and nucleocapsid were ablated, were released in the culture medium at 41 degrees C, although the size was smaller than the normal viral virions. The results suggest that HN protein is necessary for viral morphogenesis.