Shigetaka Yanagisawa

A study on the differences between oral squamous cell carcinomas and normal oral mucosas measured by Fourier transform infrared spectroscopy

We investigated the differences of Fourier transform infrared (FTIR) spectra between oral squamous cell carcinoma (OSCC) and normal gingival epithelium (NGE) or normal subgingival tissue (NST). We used 15 specimens of OSCC which had not been treated before measurement and 10 of NGE or NST. We also used cultured oral squamous cell carcinoma (COSCC) and the tissue (MSCC) which massed for 3 months after the cultured oral squamous cell carcinoma was transplanted into the lower back of a rat. Those tissue spectra were compared with the purified human collagens and human keratin. One half of every tissue specimen was measured with FTIR and the other half was investigated histologically. The differences of FTIR spectra between OSCC and NGE were observed in the bands between 1431 and 1482 cm(-1) and between 1183 and 1274 cm(-1). The shoulder at 1368 cm(-1) tended to disappear in OSCC, and the peaks at 1246 and 1083 cm(-1) found in NGE tended to shift to those at 1242 and 1086 cm(-1) in OSCC, respectively. The infrared spectrum of NST was noticed to be strongly influenced by the presence of collagen. Significant differences were also observed in the second derivative FTIR spectra between OSCC and NGE. Our data suggested that this infrared technique is applicable to clinical diagnostics.

Genotyping of the cagA gene of Helicobacter pylori on immunohistochemistry with East Asian CagA-specific antibody

The cytotoxin‐associated antigen A (CagA) of Helicobacter pylori prevalent in East Asian countries, where the mortality rate due to gastric cancer is high, has been reported to be structurally different from that in Western countries, where the gastric cancer mortality rate is relatively low. Based on the structural features of the EPIYA motifs located at the carboxyl terminal of the protein, CagA was subdivided into two types: East Asian CagA and Western CagA. A recent study suggested that immunohistochemistry with anti‐East Asian‐specific antibody (α‐EAS Ab), which was specifically immunoreactive with East Asian CagA but not with Western CagA, may be useful for diagnosis of the cagA genotype. To further evaluate the value of this diagnostic method in terms of sensitivity, specificity, and accuracy, 143 gastric biopsy specimens with α‐EAS Ab were analyzed on immunohistochemistry and compared with the sequencing of the cagA gene. It was found that diagnosis of the cagA genotype of H. pylori on immunohistochemistry using the α‐EAS Ab was highly sensitive (sensitivity 93.2%) and specific (specificity 72.7%), suggesting that immunohistochemical diagnosis of the cagA genotype is useful for diagnosis of the cagA genotype.

Predictive value of laminin-5 and membrane type 1-matrix metalloproteinase expression for cervical lymph node metastasis in T1 and T2 squamous cell carcinomas of the tongue and floor of the mouth

Laminin‐5 (Ln‐5) cleaved by membrane type 1‐matrix metalloproteinase (MT1‐MMP) enhances the migration of tumor cells. The purpose of this study was to determine whether or not enhanced expression of both Ln‐5 and MT1‐MMP was associated with lymph node metastasis in patients with T1 and T2 squamous cell carcinoma (SCC) of the tongue and floor of the mouth.

Fine structure and distribution of lymphatic vessels in the human dental pulp: a study using an enzyme-histochemical method

Abstract.The existence of lymphatic vessels in the human dental pulp and their distribution were established by light and electron microscopy using an enzyme-histochemical method. The distinction between lymphatic and blood vessels was made by light microscopy on cryostat sections of undecalcified and decalcified teeth using 5′-nucleotidase(5′-Nase)-alkaline phosphatase double staining. On the tissue surface, 5′-Nase-positive lymphatic vessels were highlighted with good contrast and resolution by backscattered electron imaging using scanning electron microscopy. By transmission electron microscopy, dense granular precipitations resulting from the 5′-Nase reaction were seen on the luminal surface of the lymphatic endothelial cells as well as in the area at the basal side, but were absent in the blood vessels. These lymphatic vessels were more numerous in the central part than in the peripheral odontoblastic layer.

Primary neck management among patients with cancer of the oral cavity without clinical nodal metastases: A decision and sensitivity analysis.

A standardized neck management strategy for oral cancer patients without clinical nodal metastases remains to be established. Consequently, a decision and sensitivity analysis of two neck management protocols, involving either prophylactic neck dissection or careful observation, was conducted using the Oral Cancer Registry of Kyushu, Japan.

The number of microvascular complications is associated with an increased risk for severity of periodontitis in type 2 diabetes patients: Results of a multicenter hospital-based cross-sectional study

To explore the relationships between periodontitis and microvascular complications as well as glycemic control in type 2 diabetes patients.

The pro-α2(XI) collagen gene is expressed in odontoblasts

Since the dentine is analogous to bone, its extracellular matrix shares many similarities to bone tissues. Similar to the bone, type I collagen is the major organic component in dentine. However, little is known about minor fibrillar collagens, which seem to be co-expressed such as type I or II collagen. The present study examined the gene expression of type V and XI collagens, which play important roles in collagen fibril formation and skeletal morphogenesis, using RT-PCR and in situ hybridization combined with immunohistochemistry. The transcripts of pro-alpha1(XI), pro-alpha2(XI), pro-alpha1(V) and pro-alpha2(V) chains were present, but not pro-alpha3(V) and pro-alpha1(II) chains, of which an overglycosylated variant is pro-alpha3(XI) chain, in mouse incisor tooth, using RT-PCR and in situ hybridization. The pro-alpha2(XI) protein, which is mainly expressed in cartilage, were observed in the odontoblast using a specific polyclonal antibody. Real-time RT-PCR showed that the transcripts of pro-alpha2(XI), pro-alpha1(V) and pro-alpha2(V) were predominant in crown and that of pro-alpha1(XI) in root of the tooth. Finally, the expression of pro-alpha2(XI) was confirmed with an odontoblastic cell line transformed with human telomerase reverse transcriptase (hTERT) both in vitro and in vivo. The data suggest a new subtype of the V/XI collagen molecule containing alpha2(XI) chain.

Cystadenoma Arising from the Retromolar Region: A Case Report

Abstract Cystadenoma is an uncommon benign epithelial neoplasm. Cystadenoma usually occurs on the palatal and buccal mucosa, but is less commonly found in the retromolar regions. A 43-year-old male patient noticed a swelling on his gingiva distal to the right mandibular second molar. Physical examination showed a diffuse poorly circumscribed swelling extending from the lingual gingiva distal to the right mandibular second molar to the floor of the mouth and pharynx. The tumor size was 20 × 27 mm. The surface mucosa was purply-blue in parts. About 4 ml of pale yellow serous fluid was aspirated. The tumor was surrounded by a capsule and was excised successfully above the periosteum, incorporating a 2 mm safety margin including the surface mucosa. The tumor consisted of a fibrous capsule with multiple cystic cavities of various sizes. The cysts were lined by a layer of columnar epithelium, with intracystic papillary proliferation in some areas. No cytologic atypia or invasion of the surrounding tissues were observed. There is no evidence of recurrence ten years after excision, suggesting that complete excision is sufficient treatment in such cases.

Secondary Squamous Cell Carcinoma of the Oral Cavity in Young Adults after Hematopoietic Stem Cell Transplantation for Leukemia: Report of Two Cases with Human Papillomavirus Infection

Abstract Two cases of secondary oral squamous cell carcinoma (SCC), which developed in recipients of hematopoietic stem cell transplantation (HSCT) for leukemia, are reported. The first patient underwent allogeneic HSCT for chronic myelogenous leukemia at 32 years of age. He suffered from chronic graft-versus-host-disease (GVHD) of the oral mucosa after HSCT, and has subsequently received immunosuppressive therapy. He experienced metachronous multiple SCCs in the maxillary gingiva and the dorsum of the tongue at 36 years and 40 years of age, respectively. The second patient received autologous HSCT for acute myelogenous leukemia at 22 years of age, and she did not experience GVHD after transplantation. SCC developed in the lateral border of the tongue at 27 years of age. PCR analysis detected both HPV16 and HPV18 in the tongue tumor of the first patient, and only HPV18 in that of the second patient, suggesting that the infection of highrisk HPVs was possibly involved in the development of post-HSCT oral cancers in these patients. Since risk factors for post-HSCT oral SCC are not yet well recognized, long-term close follow-up is necessary for the early detection of secondary oral cancers in all transplant recipients.

Radicality and QOL of Adenoid Cystic Carcinoma invading the Upper Jaw intraosseously with Lung Metastasis.

34歳女性の左側口蓋粘膜に発症した腺様嚢胞癌を経験した。その初回来院時は, 他院処置後の当該部歯原性炎症の処置の依頼であって, その処置を遂行することによって, 症状は軽快治癒した。口蓋部にはび慢性腫脹が残されたが, これに対する次回の当科での検索処置まで6年余が経過し, 本腫瘍の治療に当たって大きな困難が経験された。本例は, 2回目の初診後, 生検確定診と共に肺転移巣の存在が疑われ, 腺様嚢胞癌T2N0M1 (T2bN0M1, 岡部提案) の診断が確定された。その主治療は初め3者併用療法によったが不充分で, 上顎左半側広範切除・D-P皮弁再建を行った。本研究では, 患者のQOLを考慮する立場から, 原発巣に対する治療方針・切除範囲, 胸部肺転移巣の処置などにおいて, 患者と主治医の立揚から多くを思考した。特に, 腺様嚢胞癌のもつ生物学的特性と対比して, 患者のQOLを考え, informed consentに格段の考慮をなすべき諸課題を見いだした。主治療の結果, 菲薄化した上赤唇左側を過剰となった皮膚組織を利用してcomposite skin graftを行い, 患者の機能的並びに美容的障害を回復した。これは, 患者の退院後のQOLに大きな役割を果たしたものである。当報告症例は現在, 腫瘍治療手術を開始してから, 3年6か月余を経過し, 家庭・社会生活に復帰している。