Seiji Obara

A comparison of three methods used for treatment of ranula

PURPOSE This report compares the treatment results for oral and plunging ranulas. PATIENTS AND METHODS Twenty-seven patients were retrospectively examined concerning treatment methods and recurrence on the basis of their medical records. The surgical specimens were also examined microscopically. RESULTS Four patients had excision of the ranula only, 22 had marsupialization, and nine had removal of the sublingual gland combined with the excision of the ranula. These treatments showed a 25.0%, 36.4% and 0% recurrence rate, respectively. Histological observation revealed no epithelial lining in any of the examined specimens. CONCLUSIONS Removal of the sublingual gland combined with the ranula was the most reliable method among the above three used.

Treatment modalities for oral verrucous carcinomas and their outcomes: contribution of radiotherapy and chemotherapy

AbstractBackground. This clinical study focused, firstly, on the results of treatment and, secondly, on the anaplastic transformation, of oral verrucous carcinomas (OVCs) diagnosed and treated from 1981 to 1997 at the Department of Oral and Maxillofacial Surgery at Shimane Medical University Hospital. Methods. We analyzed the treatment modalities and outcomes for 15 patients with OVC. Results. Excluding the results for 4 palliatively treated patients, the disease-free survival rates of the patients after the initial treatments, were 82% at 5 years and 66% at 10 years; for all 15 patients, these rates were 57% and 46%, respectively. Surgery alone and surgery combined with other treatments (such as radiotherapy and chemotherapy) appeared to yield disease-free survival rates to those achieved superior with other treatments whether single or combined; (78% vs 33% for 5-year disease-free survival; 52% vs 33% for 10-year disease-free survival); however, the difference was not significant (P = 0.47). Well differentiated squamous cell carcinomas (W-SCCs) (n = 5) as well as spindle cell carcinoma (n = 1) were found in subsequent operative or biopsy specimens. Conclusion. Surgery was the most reliable treatment method for OVC; however, radiotherapy combined with chemotherapy was the next most preferable treatment when surgery was not undertaken. We also found that highly malignant transformation (anaplastic transformation) occasionally occurred during treatments for OVC.

Clinical characteristics of oral adenosquamous carcinoma: report of a case and an analysis of the reported Japanese cases.

We present a case of adenosquamous carcinoma (ASC) which developed in the floor of the mouth of a 72-year-old Japanese man, and review 19 reported ASC cases in Japan from between 1986 and 2001, including the subject case herein. These ASCs occurred at an average age of 63 years, with 74% of the ASCs occurring in the floor of the mouth (8) and the tongue (6); the other sites of occurrence were the palate (3) and mandibular alveolus (2). Chief complaints were painless mass formation (28%), pain and/or sensational abnormality (28%), painful ulcer or swelling (22%), simple ulcer (11%), and miscellaneous others (11%). The clinical presentations of ASC were tumor with ulceration (58%), tumorous mass (26%), and ulcer (16%). Tumor size at first examination varied from bean-size to approximately 65 x 40 mm. In the pretreatment period, 31.3% were known to have cervical lymph node involvement, and descriptions on distant metastasis were not noted in any of the 19 cases. Some of the ASCs were initially diagnosed as other types of lesions, such as squamous cell carcinoma (SCC; 41%), adenocarcinoma (Ad.C; 12%) mucoepidermoid carcinoma (MEC; 6%), and MEC or SCC (6%). After initial treatments, neck and distant metastases were ascertained in 47.1 and 17.6% of the cases, respectively. Generally, a surgical procedure was performed as one of the most critical methods of treatment. The overall 5-year survival rate was 57.0%, with that of patients who underwent active treatment at 60.6%. Our study demonstrates the extent of the varied nature of ASC.

Full-thickness skin grafting of postsurgical oral defects: Short- and long-term outcomes

PURPOSE This study evaluated the use of full-thickness skin grafts (FTSGs) following excision of precancerous and cancerous oral lesions. MATERIALS AND METHODS Fourteen oral lesions, including five leukoplakias, one carcinoma in situ, two verrucous carcinomas, and six squamous cell carcinomas with varying grade of keratinization and invasion were skin grafted after excision. The size of the graft ranged from 16 x 22 mm to 40 x 50 mm, and the fixation period was 8 to 13 days. The grafts were evaluated for necrosis as a short-term result and shrinkage and recurrence of the lesion as long-term results. RESULTS Three cases with more than moderate necrosis of the grafted skin were observed (21.4%). Shrinkage was observed in 23% of the 14 skin grafts and tumor recurrence was observed in three FTSGs (2 patients). CONCLUSIONS The results suggest that the paucity of the blood supply in the grafted bed, and the uneven pressure and immobilization of the grafted skin, influence the success of the procedure, and that proper case selection is necessary.

DNA-regulated arginine-specific mono(ADP-ribosyl)ation and de-ADP-ribosylation of endogenous acceptor proteins in human neutrophils.

Arginine-specific mono(ADP-ribosyl)ation and de-ADP-ribosylation reactions of endogenous acceptor proteins were examined using human neutrophils. The cells contained arginine-specific ADP-ribosyltransferase, acceptor proteins and hydrolase catalyzing the release of ADP-ribose from the ADP-ribose/acceptor conjugate. One major acceptor protein with an apparent molecular mass of 27 kDa was detected in the neutrophils. The ADP-ribosylation of this protein was greatly enhanced when double-stranded DNA was added. The release of ADP-ribose from the ADP-ribosyl core-histones was suppressed. These findings provide clues as to the physiological function of neutrophil ADP-ribosyltransferase.

Arginine-specific ADP-ribosyltransferase from rabbit skeletal muscle sarcoplasmic reticulum is solubilized as the active form with trypsin: partial purification and characterization.

Arginine-specific ADP-ribosyltransferase from rabbit skeletal muscle sarcoplasmic reticulum was solubilized as the active form with trypsin. The enzyme was partially purified by subsequent chromatography, successively on DE-52, Con A-Sepharose and Sephadex G-75. An approximately 2,000-fold purification was achieved from the 105,000 x g supernatant of trypsin-treated membrane with a recovery of 2.8%. Dithiothreitol, which activates hen liver nuclear ADP-ribosyltransferase, inhibited the enzyme.

Superoxide anion generation from peripheral blood neutrophils stimulated by N-formyl-methionyl-leucyl-phenylalanin in oromaxillary cancer patients

Superoxide anion (O2-) generation levels in peripheral blood neutrophils stimulated by N-formyl-methionyl-leucyl-phenylalanine were evaluated in patients with oromaxillary cancer. The levels in patients with benign tumors were nearly equal to those of normal controls. Patients with squamous cell carcinoma in stage I and II had levels that were widely distributed. On the other hand, O2- generation levels in the advanced stages (III and IV) of squamous cell carcinoma showed lower levels than those of controls (P < .01). All cases of oromaxillary carcinoma showed low levels of O2- generation within 1 month before death compared with controls (P < .01). The generation levels of O2- in the posttreatment period were lower than those before combination cancer treatments. Among cancer treatments such as chemotherapy, surgery, and irradiation, the latter had the strongest effects on O2- generation. These results suggest that low levels of O2- generation by peripheral blood neutrophils may reflect a worsening status of oromaxillary cancer patients.

Interval Presentation of Non-cancerous Lesions Following Neck Surgery for Oral Squamous Cell Carcinoma

Objective: Lumps developing in the neck after neck surgery for oral squamous cell carcinoma usually indicate recurrent disease but, on occasion, a non-cancerous lesion may be present. A study was performed to evaluate the clinical and histological features of newly formed non-cancerous lesions in the neck area previously treated for regional lymph node metastasis. Patients and Methods: Twenty three patients presenting with newly developed lumps in the neck area following neck surgery for oral squamous cell carcinoma were investigated. Results: Eleven patients had metastatic disease, while 12 had benign tumours. Fifteen specimens obtained from the 12 patients with benign tumours were histopathologically examined. The 12 patients revealed usual clinical features and were treated similarly to other patients with oral squamous cell carcinoma. The noncancerous lesions occurred in the submandibular and upper neck regions, revealing the following range of histological features: abscesses or granulomatous tissues (6); lymph nodes with reactive inflammation or no particular changes (6); simple subcutaneous tissues containing muscle and nerve (2), and amputation neuroma (1). Conclusion: There is a need for precise biopsy from a suitable part of the neck using an excisional procedure for accurate diagnosis.

A case of a large osteoplastic epulis on the mandibular gingiva

エプーリスは歯肉に生じた良性の限局性腫瘤の総称で, 比較的よくみられる疾患である。今回われわれは, 下顎歯肉に発生した巨大な骨形成性エプーリスの1例を経験したので報告する。患者は78歳, 女性。右側下顎臼歯部歯肉の腫瘤形成を主訴に来院。腫瘤は右側下顎臼歯部歯肉にあり, 弾性硬, 有茎性であった。表面は平滑であるが数か所の潰瘍を伴っていた。X線写真では, 腫瘤内に小さな放射線不透過性陰影が散在し, 多くの石灰化物を思わせた。また, 生検組織所見は炎症性肉芽組織であった。全身麻酔下に腫瘤摘出術を行ったところ, 腫瘤下に歯槽窩を確認した。摘出物は約61×48×40mm, 重さ約50gであり, 組織学的には膠原線維の増生を伴う線維性結合組織と, 骨芽細胞に囲まれた層板骨が散在していた。最近10年間で長径3cm以上の巨大なエプーリスについて20症例の文献を渉猟することができ, 中でもわれわれの症例は中程の大きさであった。自験例を含めこれらの報告について, 患者の年令, 性別, 病変の部位, 大きさ, 治療について考察した。

Comparison of CYFRA 21-1 with Squamous Cell Carcinoma Antigen and Relationship with Anti-cytokeratin 19 Antibody Staining in Oral Squamous Cell Carcinoma

Abstract Objective: To distinguish a reliable marker for oral squamous cell carcinoma. Patients and Methods: Serum levels of CYFRA 21-1 and squamous cell carcinoma-antigen were compared, and the relationship of CYFRA 21-1 with immunohistochemical staining of anti-cytokeratin 19 antibody was evaluated in 40 patients with oral squamous cell carcinoma. Twenty six biopsy specimens obtained from previously untreated patients were immunohistochemically stained using the streptoavidin-biotin-peroxidase complex method with cytokeratin 19 monoclonal antibody. Tissue levels of CYFRA 21-1 were also measured in 3 patients with squamous cell carcinoma. Results: CYFRA 21-1 revealed almost the same sensitivity as squamous cell carcinoma-antigen in patients with oral squamous cell carcinoma (40.0% and 35.0%, respectively), and there was no correlation between these 2 makers (r = 0.007). There was no relationship between the immunoreactivity with cytokeratin 19 antibody and the serum levels of CYFRA 21-1. High CYFRA 21-1 levels in squamous cell carcinoma tissue were observed. Conclusion: A combination assay of CYFRA 21-1 and squamous cell carcinoma-antigen is a useful technique for monitoring and screening of oral squamous cell carcinoma. Tissue levels of CYFRA 21-1 and the immunoreactivity of cytokeratin 19 suggest that serum CYFRA 21-1 were affected by not only the expression of cytokeratin 19 in squamous cell carcinoma cells but also by the release of cytokeratin 19 soluble fragment (CYFRA 21-1) from squamous cell carcinoma cells.