Prognostic value of LYVE-1-positive lymphatic vessel in tongue squamous cell carcinomas.

The density of lymphatic vessels in 52 cases of human tongue squamous cell carcinoma (TSCC) and normal portions was analyzed. TSCC specimens were immunostained with antibodies against lymphatic vessel endothelial hyaluronan receptor 1 (LYVE-1) and podoplanin monoclonal antibody (D2-40). The significance of the LYVE-1-positive vessel density (LVD) was calculated in 6 topographic areas and investigated on the basis of specific clinical and histo-pathological parameters. LYVE-1 positivity was more evident in the muscular area than the submucosal area, while small D2-40-positive lymphatic vessels were not demonstrable in muscular endomysium. The LVD in peri-tumoral submucosal and peri-tumoral muscular areas was lower than in normal counterparts (p<0.01). LVD was higher in the tumor invasion front as compared to tumor-associated stroma (p<0.01). Low LVD in invasion front and peri-tumoral submucosal area was significantly related to regional lymph node metastasis (p<0.05 and p<0.01, respectively). The decrease of LYVE-1-positive lymphatic vessels in the invasion front and peri-tumoral submucosal area would seem to predict cervical lymph node metastasis in TSCC.

Detection of fascin and CCR-7 positive mature dendritic cells in oral lichen planus.

BACKGROUND: Dendritic cells (DC) play a crucial role in the pathogenesis of oral lichen planus (OLP) with respect to antigens presented to T cells. We performed immunohistochemical analysis to elucidate the process of activation of DC in OLP. METHODS: Thirty biopsy specimens were obtained from the patients with OLP. The expressions of CD1a, Langerin, S-100, fascin, chemokine receptor-7 (CCR-7), D2-40, cyclooxygenase-2 (COX-2), and microsomal prostaglandin E synthase-1 (mPGES-1) in DC from OLP and disease free control were investigated using specific antibodies. The distribution and number (1 mm(2)) of DC were assessed in the intra-epithelium and the submucosa specimens. Correlation between the number of DC and epithelium thickness was also determined. RESULT: Immature DC (Langerin(+), CD1a(+), and S-100(+)) were identified in the epithelia from OLP patients and control, though the numbers of Langerin(+) and CD1a(+) positive cells were decreased in the OLP samples as compared to the control. Mature DC (fascin(+)) were identified in the submucosa specimens, not found in the epithelium from OLP or control. Double immunostaining revealed DC positive for fascin and CCR-7 in the submucosa, which had migrated into D2-40(+) lymph vessels. Furthermore, keratinocytes expressed both Prostaglandin E(2) (PGE(2)) converting enzymes, COX-2, and mPGES-1, indicating PGE(2) synthesis in the epithelial layer of the OLP specimens. CONCLUSION: Our results indicate that DC change from immature to mature in the epithelium and are then drawn out to the submucosa. We demonstrate that mature DC localized in the submucosa, it consequently migrates into lymph vessels. This maturation process of DC is an important immunopathological feature of OLP.

Clinical case reports of injectable tissue-engineered bone for alveolar augmentation with simultaneous implant placement.

This clinical study was undertaken to evaluate the use of tissue-engineered bone, mesenchymal stem cells, platelet-rich plasma, and beta-tricalcium phosphate as grafting materials for maxillary sinus floor augmentation or onlay plasty with simultaneous implant placement in six patients with 3- to 5-mm alveolar crestal bone height. All 20 implants were clinically stable at second-stage surgery and 12 months postloading. A mean increase in mineralized tissue height of 7.3+/-4.6 mm was evident when comparing the pre- and postsurgical radiographs. Injectable tissue-engineered bone provided stable and predictable results in terms of implant success.

Long-term results of osseointegrated implant-retained facial prostheses: a 5-year retrospective study.

In this study a questionnaire survey was prepared and distributed to patients who had been fitted with a facial prosthesis at least 5 years earlier, with the aim of: 1) reviewing the implants statistically, and 2) examining psychological changes before and after the use of an implant-supported prosthesis. Twelve patients had been fitted with implant-supported prostheses that had a survival rate of 97.5% after 5 years. To examine psychological changes, the patients were given the Cornell Medical Index-Health Questionnaire (CMI) and a questionnaire we originally developed. Eight of the 12 responded to the questionnaire. The CMI results from those 8 patients confirmed that none of them had sustained any emotional impairment. Our results revealed that, although the patients wore their prosthesis both indoors and out, eyeglasses were still necessary. However, wearing the prosthesis lessened the psychological impact of the facial defect, while also easing anxiety with regard to interpersonal relations.

Clinical application of zygomatic implants for rehabilitation of the severely resorbed maxilla: a clinical report.

PURPOSE: A zygomatic implant can be an effective device for rehabilitation of the severely resorbed maxilla. If zygomatic implants are used, onlay bone grafting or sinus augmentation would likely not be necessary. Where an anterior onlay bone graft is required, extension of the graft in the posterior region could be reduced. The results of the application of zygomatic implants in 9 patients and clinical evaluation of this therapy are reported. MATERIALS AND METHODS: Nine patients received a total of 15 zygomatic implants. Six to 8 months elapsed for healing before second-stage surgery was performed. Six months after prosthetic treatment, patients' opinions were solicited by means of a questionnaire. RESULTS: No implant was removed at the time of abutment connection surgery or during the follow-up period. In many cases, the zygomatic implant platform was located palatal to the alveolar ridge. However, no patients complained of any continuing speech impediment following superstructure fabrication. Computed tomograms taken before implant placement and 6 months after implant placement showed no sign of sinusitis in any patient. DISCUSSION: The zygomatic implant allows shorter treatment time and hospitalization. However, there can be some problems in the application of zygomatic implants. CONCLUSION: It is necessary to investigate long-term clinical prognosis.

Bone regeneration following injection of mesenchymal stem cells and fibrin glue with a biodegradable scaffold.

AIM: The purpose of this study was to determine whether a combination of fibrin glue, beta-tricalcium phosphate as a biodegradable (beta-TCP) and mesenchymal stem cells would provide three-dimensional templates for bone growth resulting in new bone formation at heterotopic sites in the rat with plasticity. MATERIAL AND METHODS: Growing stem cells and developing matrices, explanted from the rat femur, were fragmented and mixed with fibrin glue in a syringe. The cells/beta-TCP fibrin glue admixtures were injected into the subcutaneous space on the dorsum of the rat. RESULTS: Eight weeks after implantation, gross morphology revealed a pearly opalescence and firm consistency. Histological inspections showed newly formed bone structures in all admixtures, but none in the control groups when only fibrin glue and beta-TCP were injected. Osteopontin, a protein important in bone development, was identified by using antibodies in all cells/beta-TCP fibrin glue admixtures. CONCLUSION: Mesenchymal stem cells/beta-TCP fibrin glue admixtures can result in successful bone formation. This technique holds the promise of a minimally invasive means of generating autogenous bone to correct or reconstruct bony defects.

Tissue-engineered bone using mesenchymal stem cells and a biodegradable scaffold.

Bone marrow has been shown to contain a population of rare cells capable of differentiating to the cells that form various tissues. These cells, referred to as mesenchymal stem cells (MSCs), are capable of forming bone when implanted ectopically in an appropriate scaffold. The aim of this study was to investigate the potential of a new beta-tricalcium phosphate (beta-TCP) as a scaffold and to compare the osteogenic potential between beta-TCP and hydroxyapatite (HA). The beta-TCP and HA loaded with MSCs were implanted in subcutaneous sites and harvested at 1, 2, 4, and 8 weeks after implantation for biochemical and histological analysis. Biochemically, in both beta-TCP and HA composites, the alkaline phosphatase activity in the composites could be detected and was maintained at a high level for 8 weeks. In the histological analysis, active bone formation could be found in both the beta-TCP and HA composites. These findings suggest that beta-TCP could play a role as a scaffold as well as HA. The fabricated synthetic bone using biodegradable beta-TCP as a scaffold in vivo is useful for reconstructing bone, because the scaffold material is absorbed several months after implantation.