Takaaki Kamatani

Isolated metastasis from hepatocellular carcinoma to the mandibular condyle with no evidence of any other metastases: a case report

Regional metastasis of hepatocellular carcinoma (HCC), the most common primary tumour of the liver to the mandible is rare. We present a case of a HCC metastasis to the mandibular condyle with no other extrahepatic metastases sites in a 59-year-old man. Incidental extrahepatic lesions in more uncommon sites should perhaps be investigated as potential areas for metastases, even if metastatic disease has not been found in the more common areas.

Effectiveness of piezoelectric surgery in reducing surgical complications after bilateral sagittal split osteotomy.

Our aim was to investigate the effectiveness of piezoelectric surgery, where the osteotomy is made using ultrasonic vibration, in reducing surgical complications after bilateral sagittal split osteotomy (BSSO). Fifty-nine patients with skeletal mandibular prognathism who had mandibular setback with BSSO between January 2009 and April 2011 were included in the study. Piezosurgery was used in 29 cases, and the bone was split using a separator. In the remaining 30 cases, a Lindeman bur was used for the osteotomy and a chisel was used to split the bone. The amount of intraoperative bleeding and the Semmes Weinstein test scores were used as objective variables to evaluate the degree of neurosensory disturbance, and sex, age, use of piezosurgery, degree of setback, operating time, and method of fixation were used as explanatory variables. We used analysis of covariance (ANCOVA) to assess the significance of differences. Intraoperative bleeding was significantly less with age (p=0.003), and longer when operating time was prolonged (p=0.017), and was not influenced by the use of piezosurgery. The Semmes Weinstein test score significantly increased with age (p=0.01), and was significantly greater when piezoelectric surgery was used (p=0.008), and at 3 months, there were signs of more neurosensory disturbance in older patients and those who had had piezoelectric surgery. In this retrospective non-random study piezoelectric surgery reduced neither blood loss nor the incidence of neurosensory disturbance in BSSO.

Tyrosine‐nitration of caspase 3 and cytochrome c does not suppress apoptosis induction in squamous cell carcinoma cells

The influence of tyrosine nitration of cytochrome c and caspase 3 on apoptosis induction was investigated in an established squamous carcinoma cell line, OSC‐4. The intracellular NO and O  −2 levels were increased up to about 110–120% and 140–180% of the control levels, respectively, after the treatment of OSC‐4 cells with 5‐FU (100 μg/ml), PLM (10 μg/ml), CDDP (10 μg/ml), or γ‐rays (20 Gy). The treatment of OSC‐4 cells with ONOO− (1 mM) and the above anticancer agents induced tyrosine nitration of 14, 32 kDa protein among others and nitration of tyrosine residues of cytochrome c and caspase 3 was identified by the Western blotting of immunoprecipitates obtained by antibodies to these proapoptotic proteins. When cytochrome c and procaspase 3 were treated with ONOO−, tyrosine nitration was increased in a ONOO−‐dose dependent manner. Tyrosine nitration of cleaved (17 kDa) caspase 3, however, was not induced by ONOO−. Procaspase 3 in the cytosol of HeLa cells was activated by the addition of ONOO−‐treated as well as ONOO−‐untreated cytochrome c. In addition, cleavage of ICAD and PARP were not suppressed in OSC‐4 cells by pretreatment with ONOO−. Activity of cleaved caspase 3 was not suppressed at low concentrations or by treatment with ONOO− or NO donors, SIN‐1 and SNP. Furthermore, apoptosis of OSC‐4 cells by the anticancer agents was not suppressed by ONOO−. In conclusion, these results suggest that nitration of tyrosine residues of cytochrome c and procaspase 3 is induced by chemoradiotherapy but their nitration does not suppress cancer cell apoptosis.

Interleukin-1 beta in unstimulated whole saliva is a potential biomarker for oral squamous cell carcinoma

The objective of this study was to evaluate cytokines in unstimulated whole saliva (UWS) of oral squamous cell carcinoma (OSCC) patients as compared to those with pre- and post-operation for evaluation as markers of OSCC. Sixteen OSCC patients were included in this study. Cytokine concentrations in resting saliva were measured using a Bio-Plex suspension array system. Only interleukin-1 (IL-1) beta showed significantly different cytokine concentration in saliva between pre- and post-operation. IL-1 beta was released from cultured OSCC cells confirmed by ELISA and immunohistochemistry. From this study, IL-1 beta in UWS may be useful for detection of early stage OSCC. More studies are needed to accept the utility of IL-1 beta in UWS for predicting, diagnosis and evaluation of OSCC.

Comparison of codon usage and tRNAs in mitochondrial genomes of Candida species

To gain insight into the nature of the mitochondrial genomes (mtDNA) of different Candida species, the synonymous codon usage bias of mitochondrial protein coding genes and the tRNAs in C. albicans, C. parapsilosis, C. stellata, C. glabrata and the closely related yeast Saccharomyces cerevisiae were analyzed. Common features of the mtDNA in Candida species are a strong A+T pressure on protein coding genes, and insufficient mitochondrial tRNA species are encoded to perform protein synthesis. The wobble site of the anticodon is always U for the NNR (NNA and NNG) codon families, which are dominated by A-ending codons, and always G for the NNY (NNC and NNU) codon families, which is dominated by U-ending codons, and always U for the NNN (NNA, NNU, NNC and NNG) codon families, which are dominated by A-ending codons and U-ending codons. Patterns of synonymous codon usage of Candida species can be classified into three groups: (1) optimal codon-anticodon usage, Glu, Lys, Leu (translated by anti-codon UAA), Gln, Arg (translated by anti-codon UCU) and Trp are containing NNR codons. NNA, whose corresponding tRNA is encoded in the mtDNA, is used preferentially. (2) Non-optimal codon-anticodon usage, Cys, Asp, Phe, His, Asn, Ser (translated by anti-codon GCU) and Tyr are containing NNY codons. The NNU codon, whose corresponding tRNA is not encoded in the mtDNA, is used preferentially. (3) Combined codon-anticodon usage, Ala, Gly, Leu (translated by anti-codon UAG), Pro, Ser (translated by anti-codon UGA), Thr and Val are containing NNN codons. NNA (tRNA encoded in the mtDNA) and NNU (tRNA not encoded in the mtDNA) are used preferentially. In conclusion, we propose that in Candida species, codons containing A or U at third position are used preferentially, regardless of whether corresponding tRNAs are encoded in the mtDNA. These results might be useful in understanding the common features of the mtDNA in Candida species and patterns of synonymous codon usage.

Retropharyngeal dissection: a case report of cervicofacial subcutaneous emphysema and mediastinal emphysema during attempted nasotracheal intubation.

To the Editor: Nasotracheal intubation is an established airway management technique in patients undergoing oral and maxillofacial surgery. We encountered a case of retropharyngeal dissection by the tip of the endotracheal tube with severe complications of cervicofacial subcutaneous emphysema and mediastinal emphysema. A 58-year-old Japanese woman (height 147.9 cm, body weight 82.5 kg) with mandibular odontogenic cyst was scheduled for a cystectomy. The patient’s past medical history was diabetes mellitus, hypertension and dyslipidemia. She had no difficulties in extension and flexion of her neck. The maximum distance between the upper and lower incisors was 35 mm when she opened her mouth. General anesthesia with nasotracheal intubation using a nasotracheal tube was planned. Propofol 80 mg, vecuronium bromide 50 mg and remifentanil 0.3 lg/kg/min were administered intravenously during induction. The right nasal passage was lubricated with the direct application of 3 mL of lidocaine hydrochloride jelly. A 7.0-mm endotracheal tube (Smiths Medical, Lower Pemberton Ashford, UK) for nasotracheal intubation by an experienced anesthetist could not be advanced distally because of resistance. The left nasal passage was lubricated in the same manner. Rigid laryngoscopy then provided a satisfactory view, and orotracheal intubation was performed. Anesthesia was maintained for the 2-h surgical procedure using sevoflurane, remifentanil, and oxygen. After the operation, the tracheal tube was extubated without difficulty. Physical examination revealed crepitations in the buccal, submandibular, and neck region. An urgent computed tomography showed a discontinuity of the retropharyngeal mucosa and the false tract of the retropharyngeal space filled with air (Fig. 1), extending from the infratemporal space to the buccal region, branching into the submandibular, parapharyngeal, retropharyngeal, and mediastinal spaces. Endoscopic examination of the nasal cavity and the nasopharynx showed no active bleeding or hematoma formation. The diagnosis of cervicofacial subcutaneous emphysema and mediastinal emphysema due to retropharyngeal dissection by the tip of the nasotracheal tube was made. The patient remained clinically stable and received an intravenous injections of amoxicillin 4 g daily. The retropharyngeal dissection was therefore managed without intubation or surgery. The emphysema had completely resolved by post-operative day 10. Retropharyngeal dissection is a rare complication of nasotracheal intubation and has seldom been reported in the literature [1]. Forceful insertion of the nasotracheal tube is the most commonly mechanism accounting for retropharyngeal dissection [2]. Multiple intubation attempts, overinflation of the cuff, malposition of the tube, use of a stylet, use of a double-lumen tube, or improper tube size can also increase the risk of this complication [3]. The T. Kamatani (&) S. Kondo T. Shirota S. Shintani Department of Oral and Maxillofacial Surgery, Showa University School of Dentistry, 2-1-1 Kitasenzoku, Ota City, Tokyo 145-8515, Japan e-mail: kamatani@dent.showa-u.ac.jp

Clinicopathological implications of vascular endothelial growth factor 165b expression in oral squamous cell carcinoma stroma

Vascular endothelial growth factor (VEGF) is one of the most important angiogenic factors. VEGF165b was recently isolated as the anti-angiogenic VEGF splice variant. In the present study, we examined the association between VEGF165b expression and clinicopathological characteristics in order to determine how VEGF165b produced from oral squamous cell carcinoma (OSCC) affects the stromal cell biological activity. We examined the relationships between the expressions of both VEGF isoforms in normal human dermal fibroblasts (NHDFs) and OSCC cell lines (HSC2, 3, 4 and SAS). Our analyses indicated that both the mRNA and protein expression levels of VEGF165b in the HSC2 and SAS cells were higher than those in the NHDFs. VEGF165b did not promote cell growth or invasive capabilities, but it induced the cell adhesive capabilities to ECM. Although strong expression of the VEGF165 isoforms in tumor cells of OSCC tissues was observed, there was no significant difference in the VEGF165b expression level among the various degrees of malignancy. OSCC cells secrete VEGF165b into the stroma, and this factor may contribute to the process of anti-angiogenesis by inhibiting gelatinase-expressing cells and activating cell adhesive capabilities to ECM, such as that of fibroblasts surrounding tumor cells.

Interleukin-1 (IL-1) Immunohistochemistry Assay in Oral Squamous Cell Carcinoma

This chapter describes an immunohistochemistry method to analyze interleukin-1 (IL-1) in oral squamous cell carcinoma. The described protocol has been optimized for IL-1 detection in formalin-fixed paraffin-embedded oral tissue sections by light microscopy. A few common pitfalls and problems associated with immunohistochemical staining are discussed.

Intramuscular hemangioma with phleboliths of the tongue

Intramuscular hemangioma (IMH) is relatively rare benign tumor of vascular origin. Phleboliths are calcified thrombi found in the presence of hemangioma. The main treatment of the hemangioma is a surgical extirpation based on location, accessibility, and cosmetic considerations. We herein report a rare case of IMH with phleboliths of the tongue with clinical, imaging, and histopathological findings.

Orthodontic Treatment and Maxillary Anterior Segmental Distraction Osteogenesis of a Subject with Williams–Beuren Syndrome and Isolated Cleft Palate: A Long-Term Follow-Up from the Age of 5 to 24 Years

Williams–Beuren syndrome (WBS) is a rare multisystem disorder caused by a hemizygous deletion of the elastin gene on chromosome 7q11.23. WBS patients have characteristic skeletal features and dental anomalies accompanied by mental retardation, a friendly outgoing personality, and mild to moderate intellectual disability or learning problems. In this case report, we present the combined orthodontic and surgical treatment of a WBS patient with an isolated cleft palate through a long-term follow-up from the age of 5 to 24 years. During the period of active treatment, comprehensive orthodontic treatment combined with maxillary anterior segmental distraction osteogenesis and prosthetic treatment using dental implants were effective in dramatically improving the patients malocclusion. The patients mental abilities and the cooperation shown by the patient and her family were crucial for the success of this complex and long-term treatment course.