Shou-Yee Chao

Nutritional factors and survival of patients with oral cancer.

Our objective was to determine the survival rate of patients with oral cancer who were treated at a medical center in central Taiwan. Furthermore, we attempted to investigate whether nutritional factors influence the survival.

Glutathione concentration in oral cancer tissues

Glutathione (GSH) concentrations in human epidermoid carcinoma tissues were measured by high performance liquid chromatography. The mean glutathione content of 26 epidermoid carcinoma intratumor tissue specimens was 24.36 nmol/mg protein, which was significantly higher than that in adjacent non-tumor tissue parts (3.04 nmol/mg protein). The mean concentration found in normal oral mucosa was 4.80 nmol/mg protein. Tissue GSH levels were not correlated with the age of the patients or tumor size. Additionally, cellular GSH levels in nine different cell lines were found to spread over a wide range from 0.97 to 50.97 nmol/mg protein. Elevated GSH levels in cancer tissues were probably due to their abnormal proliferative activities. These results indicate that the glutathione level of oral tissues may be a useful marker for oral cancer, which is in agreement with findings from lung squamous cell carcinoma, cervical squamous cell carcinoma and other squamous cell carcinomas.

Leiomyosarcoma of gingiva: Report of a case and review of the literature

Leiomyosarcoma of the oral region has rarely been reported. A review of the literature yield only 24 cases. The histopathology with special reference to ultrastructural findings and immunohistochemical examination of an additional case of leiomyosarcoma of mandibular gingiva has been presented. The manifestation and symptoms, treatment and prognosis, and the origin of this tumor are discussed. Because of the high rate of local recurrence and metastases, extensive surgical excision and long-term follow-up are mandatory.

Establishment and characterization of an oral melanoma cell line (ME)

A new cell line, ME, has been established from a melanoma of the palatal mucosa. The cultured monolayer of cells was fusiform and melanin-producing. The cells were highly tumorigenic and metastatic in nude mice. The xenographic tumors resembled the original tumor in morphology, melanin production, and the expression of S-100 and HMB-45 antigens. The metaphase karyotype of ME indicated multiple aberrations of chromosomes 2, 3, 5, 7-11, 13, 19, 21 and X. A homozygous loss of the p16/MTS1 gene during the establishment of ME correlated with karyotypic evidence of chromosome 9 abnormalities. Absence of nm23 protein expression and elevated expression of CD44 protein (indicative of metastatic phenotypes) were demonstrated in primary and xenographic tumors. ME cells could be valuable in developing novel therapeutic strategies for oral melanoma.

The Prognostic Significance of Adequate Surgical Margin for Head and Neck Sarcomas: A Retrospective Study of Thirty-one Cases

The aim of this study is to report our experience in the treatment of head and neck sarcomas. The medical charts and histopathologic features of thirty- one head and neck sarcomas at Taichung Veterans General Hospital between 1982 and 2007 were reviewed. Seventeen (54.8%) of the patients were male, while 14 (45.2%) were female. The common sites were the mandible (n=13), maxilla (n=7) and neck (n=7). Malignant fibrous histiocytoma (n=11) and osteosarcoma (n=8) are the most common lesions. Surgical resections were performed in 28 cases. Among them, local recurrence was found in 9 patients, and distant metastasis was proved in 4 patients. The overall 5-year survival rate was 50%. Surgical margin involvement and local recurrence were the main causes of death (P=0.006 and P=0.010, respectively). Of 13 patients with margin involvement, six developed local recurrence within a mean period of 20 months; and the mean survival period of expired patients with margin involvement was 33 months. In our series, young-to-middle-aged (＜50 years) females had poor 5-year survival rates (30%). Inadequate soft tissue margin resection may be due to gender, age and cosmetic concerns.

Intra-osseous Lipoma of the Mandible: Review of the Literature and Case Report

Intra-osseous lipoma is extremely rare in the jaw bones. Characteristic histopathological finding consists of the presence of only mature adipose cells. The majority of jawbone intra-osseous lipomas are found in adults, and of uncertain origin and etiology but are usually associated with molar teeth. We present here a case of a fifteen-year-old boy who experienced a painless, gradual swelling of the right side mandibular angle for 3 years. We also discuss and compare this case with the other intra-osseous lipoma cases.

Desmoplastic Ameloblastoma: A Retrospective Study

Desmoplastic ameloblastoma is a variant of ameloblastoma first described in 1984. The histopathologic features of 60 ameloblastomas diagnosed at Taichung Veterans General Hospital during years 1982-2001 were reviewed with special reference to the incidence of the desmoplastic variant. Only two cases fulfilled the criteria of a desmoplastic ameloblastoma, representing 3.3% (2/60) of all the intraosseous ameloblastomas. One of the rumor occurred in the mandible and the other located in the maxilla. Both cases contained abundant coarse collagenous stroma, and scattered islands and nests of atypical odontogenic epithelium with a surrounding acellular or hyalinized zone. Stellate cells within the central area of some of the neoplastic cell nests were observed. Radiographically, both cases exhibited a mixed radiolucent/radiopaque appearance with poorly defined borders, suggestive of fibro-osseous lesions. The clinical, radiographic, ad microscopic aspects of this unusual lesion are presented, and the relevant literature is reviewed.

Patient Dose from Panoramic Dental X-Ray Exposures with Different Screen/Film Combinations

Forty-eight male patients who needed panoramic radiographic examination were randomly divided into 16 groups and were examined with different kVp/mA/intensifying screen/film combinations. The images were evaluated by two oral and maxillofacial radiologists without knowledge of exposure settings. The groups imaged with 80 kVp/10 mA/Kyokko PS-Ⅱ intensifying screen/Kodak X-Omat film and 70 kVp/8 mA/Konica KR intensifying screen/Kodak T-mat G film showed satisfactory radiographic contrast. The absorbed doses of tissue-equivalent phantom at the same settings of these two groups were estimated by the readings from thermoluminescent dosimeters (TLDs) placed on various anatomic sites. Reduction of absorbed doses in the later group ranging from 20% to 60% was detected. The results of this study suggested that it is possible to obtain diagnostically satisfactory radiographs and, at the same time, reduce radiation dose through the use of rare-earth screen/film combination and proper adustment of exposure setting.

Clinical Applications of Lag Screws for Facial Bone Fractures

A technique of applying lag screws for treating facial bone fracture is presented. It provides a maximum amount of interfragmental compression with minimum amount of implantable material. The purplse of this artical is to present a review of 6 patients who had been treated with lag screws at Taiching Veterans General Hospital. Our experience confirmed that it is a successful method of providing rigid internal fixation.