Factors affecting volume change of myocutaneous flaps in oral cancer.

After oral cancer resection with flap reconstruction, the volume of the flap decreases over time. The purpose of this study was to estimate the volume change in myocutaneous flaps and to identify the clinical factors associated with this volume decrease. Postoperative computed tomography scans and magnetic resonance images of 30 patients, obtained at 1, 6, and 12 months after oral cancer resection with myocutaneous flap reconstruction, were reviewed retrospectively. Changes in the volume of the flaps over time were assessed. The residual flap ratio was calculated using the flap volume at 1 month after reconstruction as the denominator. The residual ratios in relation to clinical factors were compared at 6 and 12 months using the Student t-test. Overall, the flap residual ratio was 78.1% (range 64.1-93.9%) at 6 months and 71.4% (range 48.8-87.2%) at 12 months. Hypertension, diabetes mellitus, and postoperative radiotherapy were significantly associated with volume changes at 6 months, and postoperative infection and decreased serum albumin levels were associated with volume changes at both 6 months (P=0.015 and P=0.001, respectively) and 12 months (P=0.026 and P=0.017, respectively). Flap reconstruction must be performed with postoperative flap atrophy in mind in order to preserve optimum speech and swallowing function.

Overexpression of nucleostemin contributes to an advanced malignant phenotype and a poor prognosis in oral squamous cell carcinoma.

BACKGROUND: Nucleostemin (NS) is essential for the maintenance of stem cell properties, the functions of which remain poorly understood in cancer cells. The purpose of this study was to explore the impact of NS on malignancy and its clinical significance in oral squamous cell carcinoma (OSCC) patients. METHODS: We investigated the effects of NS on the proliferation and invasion of OSCC using NS-overexpressing or -knockdown OSCC cells. We assessed the activation of the STAT3 (signal transducer and activator of transcription 3) signalling pathway and the downstream targets in the cells with different expression levels of NS. An immunohistochemical analysis of NS was also performed in 54 OSCC patients who were treated with preoperative chemoradiotherapy and surgery. RESULTS: The overexpression of NS significantly enhanced the proliferation and invasive potential of OSCC cells. On the other hand, downregulation of NS suppressed the invasiveness of the cells. The alterations of these malignant phenotypes were associated with the activation of STAT3 signalling and its downstream targets. An immunohistochemical analysis demonstrated that a high NS tumour expression level significantly correlated with an advanced T-stage and N-stage. Furthermore, a Cox regression analysis revealed that the NS status (hazard ratio, 9.09; P=0.002) was a significant progression factor for OSCC patients. CONCLUSIONS: Our results suggest that targeting NS may provide a promising treatment for highly malignant OSCC.

Preparation of white-cell-poor blood components using a quadruple bag system.

A method for the preparation of white-cell-poor red cells from 400 ml of blood collected in a quadruple bag with one 80-ml and two 300-ml satellite bags is described. In this procedure, a platelet concentrate was prepared from the buffy coat fraction obtained by the first centrifugation of whole blood. After centrifugation of whole blood for 5 minutes at 3500 X g, the plasma was transferred into the 300-ml bag until the interface of red cells and plasma reached a level 32 mm from the top of the bag; then approximately 70 g of plasma and buffy coat were collected into the 80-ml bag. The buffy coat fraction was centrifuged further for 5 minutes at 170 X g, and the supernatant (concentrated platelets in plasma) was transferred into the second 300-ml bag. In this blood processing, the recovery of red cells into the packed red cells and of platelets into the platelet concentrate was 93 +/- 4 percent and 52 +/- 13 percent, respectively, of the original value. White cells in the packed red cells were 70 +/- 28 X 10(7) with recovery of 32 +/- 9 percent of the original value, and the lymphocytes in the white cells were only 7 +/- 5 X 10(7) (7 +/- 4% of the original value). White cell contamination of platelet concentrate was below the threshold of white cell detection by the microcell counter (less than 300 cells per microliter of concentrate).