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ABSTRACT: The anterior and the lateral approach for resecting an invading tumor in the pterygopalatine fossa region were compared. An anterior approach was applied for resecting a malignancy that originated from the maxillary tuberosity, upper hard plate, and maxillary sinus, and a lateral approach was applied for resecting a malignancy that originated from the upper gingiva and buccal mucosa. The anterior approach was capable of exposing the whole maxilla, although it was difficult to achieve such exposure by the lateral approach. However, the submandibular incision technique used in the Dingman approach was useful for upper neck dissection as well as for exposure of the artery and vein to anastomose them for reconstruction. The anterior approach should be useful for resection of the pterygopalatine fossa concomitant with total maxillectomy. On the other hand, the lateral approach might have an advantage in terms of its cosmetic effects.
The Journal of craniofacial surgery 03/2013; 24(2):536-9. · 0.81 Impact Factor
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ABSTRACT: The results of long-term follow-up for reimplantation of the mandibular bone treated with pasteurization are reported. Mandibulectomy was performed for mandibular malignancy in 3 cases. The resected bones were subsequently reimplanted after treatment with pasteurization in 3 cases to eradicate tumor cells involved in the resected bone. Although postoperative infection was observed in 2 of 3 cases, reimplantation of the resected mandibular bone treated by pasteurization was finally successful. Ten to 22 years of follow-up was carried out. Pasteurization was able to devitalize tumor cells involved in the resected bone and to preserve bone-inductive activity. Reimplantation of pasteurization could be a useful strategy for reconstruction of the mandible in patients with mandibular malignancy.
The Journal of craniofacial surgery 11/2012; · 0.81 Impact Factor
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ABSTRACT: BACKGROUND: Photodynamic therapy (PDT) is an effective laser treatment for locally treating advanced bile duct carcinoma (BDC). The study objective was to evaluate the synergic effect of PDT using a new photosensitizer, talaporfin sodium (Laserphyrin), in combination with conventional anticancer drug treatments. METHODS: The range of the necrotic area, the percentage of apoptosis-positive cells, the vascular endothelial growth factor expression quantification, and the proliferating cell nuclear antigen-labeling index, as treatment effects, were examined in the BDC cell line (NOZ) in vitro and in vivo (4-wk-old male BALB/c mice). RESULTS: Tumor viability was determined by an in vitro MTS assay. PDT with a single treatment of 5-fluorouracil, gemcitabine, oxaliplatin, and cis-diamminedichloroplatinum showed a significantly lower viability compared with the control or the PDT-alone group (P<0.05). Furthermore, administering PDT combined with two anticancer drugs showed a further decline in the tumor viability. A treatment of PDT combined with oxaliplatin and gemcitabine showed the least viability (P<0.05). Thus, this regimen was administered in the in vivo study. The tumor necrotic area, apoptosis positivity, and the vascular endothelial growth factor expression rate were higher in the PDT with anticancer drugs group compared with those of the other groups (P<0.05). The proliferating cell nuclear antigen-labeling index results in the PDT with the anticancer drugs group were significantly lower than those of the other groups (P<0.05). CONCLUSIONS: A treatment of PDT combined with gemcitabine and oxaliplatin showed the best synergic effect for necrosis, apoptosis, and cytostatic alterations for the treatment of BDC.
Journal of Surgical Research 07/2012; · 2.25 Impact Factor
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Journal of oral and maxillofacial surgery: official journal of the American Association of Oral and Maxillofacial Surgeons 02/2012; 70(11):2701-12. · 1.58 Impact Factor
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ABSTRACT: Superselective intra-arterial concurrent chemoradiotherapy(SIACC)for oral cancer has been favored for its efficacy and ability to not damage organs. SIACC was applied to 13 previously untreated patients with oral cancer for the purpose of avoiding surgical resection of the primary tumor in our hospital from 2007 to 2009. Although a complete response of the primary tumor was achieved in all cases, various adverse events also occurred. All patients experienced leucopenia, and most patients suffered from mucotitis and dry mouth. One patient had dizziness and nausea due to the catheter insertion into the vertebra artery. Although SIACC is an important treatment strategy for oral cancer, careful attention for adverse events should be taken into account during and after treatment.
Gan to kagaku ryoho. Cancer & chemotherapy 11/2011; 38(11):1803-7.
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ABSTRACT: The aim of this study was to investigate the correlation between the immunohistochemical expression of proliferating cell nuclear antigen (PCNA), factor VIII, and CD34 (markers of endothelial cells), and vascular endothelial growth factor (VEGF) and the recurrence of oral squamous cell carcinoma (OSCC) and oral epithelial dysplasia (OED) subjected to photodynamic therapy (PDT).
Twenty-one biopsy specimens (14 cases of OSCC and 7 cases of OED) before PDT were immunohistochemically investigated in terms of their expressions of PCNA, factor VIII, CD34 and VEGF. The percentages of the total sample area that were immunopositive for factor VIII (percentage factor VIII immunopositive area: PFIA) CD34 (PCIA) and VEGF (PVIA) were calculated using computer-assisted image analysis for quantitative assessment of endothelial cells or VEGF expression in the lesions. The PCNA labelling index (LI) was evaluated as a proliferation marker.
Five cases of OSCC and one case of OED recurred 4 to 30 months after PDT. We found that the average PVIA was 14.5% in the no-recurrence group and 1.7% in the recurrence group. The difference between these values was statistically significant (P=0.0483). On the other hand, the average PCNA LI was 30.3% in the no-recurrence group and 24.3% in the recurrence group; the average PFIA was 3.7% in the no-recurrence group and 1.6% in the recurrence group; and the average PCIA was 2.0% in the no-recurrence group and 1.4% in the recurrence group. There were no significant differences between the two groups for any of these markers (P=0.3379, P=0.1195, P=0.4835, respectively).
These results provide clinical data indicating that VEGF expression may be a useful predictive marker for the effects of PDT in OSCC and OED.
Archives of oral biology 05/2011; 56(11):1366-72. · 1.65 Impact Factor
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ABSTRACT: The aim of this study was to compare the effects of laserphyrin-PDT (L-PDT) on biliary cancer with those of the conventional photosensitizer, photofrin-PDT (P-PDT).
An animal tumor model was established by inoculation of NOZ cells in 4-week-old male BALB/c mice. The laser light wavelength was set at 630 nm for P-PDT and 660 nm for L-PDT, at a frequency of 10 Hz. Each group received a total energy flux of 60 J/cm(2). The proportion of TUNEL (terminal deoxynucleotidyl transferase-mediated dUTP-biotin nick-end labeling)-positive cells, expression of VEGF (vascular endothelial growth factor) and the PCNA (proliferating cell nuclear antigen)-labeling index (LI) were assessed after PDT.
L-PDT had significantly more potent apoptotic effects at 48 and 72 h after light exposure compared with P-PDT (P < 0.001). The mean PCNA-LI was significantly lower in the L-PDT group than the P-PDT group and the index was significantly lower at several time points after PDT (6, 12, 24, 48 and 72 h after laser light exposure) in the L-PDT than P-PDT (P < 0.001 vs. control). The cell proliferative activity was significantly decreased at 12 and 24 h after P-PDT compared with the control (P < 0.001). VEGF expression was significantly higher at 3 h after L-PDT compared with the control (P < 0.05), whereas it was significantly higher at many time points after P-PDT (3, 6, 48 and 72 h; P < 0.05 vs. control).
L-PDT is a better approach for biliary cancer than the conventional P-PDT, based on its potent apoptotic and cytostatic effects.
Journal of hepato-biliary-pancreatic sciences. 03/2011; 18(4):592-600.
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Kaoru Kawazoe,
Hajime Isomoto,
Naoyuki Yamaguchi,
Naoki Inoue,
Ryohei Uehara,
Kayoko Matsushima,
Tatsuki Ichikawa,
Fuminao Takeshima,
Takashi Nonaka,
Atsushi Nanashima,
Takeshi Nagayasu, Masataka Uehara,
Izumi Asahina,
Kazuhiko Nakao
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ABSTRACT: Photodynamic therapy (PDT) is an ablative treatment leading to intracellular photoexcitation and injury. A total of 15 patients with superficial esophageal squamous cell carcinoma (ESCC) without metastasis underwent PDT and 48-72 h after intravenous Photofrin, the patients were treated with a 630-nm excimer dye laser. A total of 13 patients had local tumor recurrence after definitive chemoradiotherapy (CRT) consisting of 5-fluorouracil (5-FU) and cisplatin (CDDP). Of 6 patients, 5 had submucosal ESCC and were treated with S-1. Complete reponse was achieved by 11 patients with initial PDT, but 2 had recurrences. The recurrent/residual tumors were successfully treated with repeated PDT. Two patients with intramucosal ESCC succumbed due to metastatic disease, but 11 patients were disease-free. The 5 patients treated with S-1 remained alive despite submucosal ESCC. PDT was applied to human ESCC cells in vitro in the presence or absence of 5-FU or CDDP. The combination of PDT with 5-FU or CDDP resulted in enhanced cytotoxic effects, thereby reducing the effective dosage of each drug. PDT is a promising treatment option for selected ESCC cases, particularly for local recurrence following CRT. Our experience suggests that PDT is more effective when combined with chemotherapy.
Oncology letters 09/2010; 1(5):877-882. · 0.11 Impact Factor
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ABSTRACT: Photodynamic therapy (PDT) is a relatively new approach for the treatment of biliary tract carcinoma, and its effects have not been investigated in detail to date. This study investigated the mechanisms of human biliary cancer cell death by PDT by focusing on apoptosis induction in vitro and in vivo.
In vitro, NOZ cells were incubated with porfimer sodium (Photofrin) for up to 24 hours before exposure to laser light. Cell viability was assessed using a methyltetrazolium assay after PDT. DNA fragmentation, cell cycle analysis and caspase-3 activity assay were performed to evaluate apoptotic cells induced by PDT. In vivo, DNA fragmentation was detected by TUNEL assay.
DNA ladder formation and activation of caspase-3 were observed within 24 hours. The proportion of cells with DNA fragmentation on flow cytometric analysis was increased significantly to 22.2% at 24 hours after PDT. In the in vivo model, TUNEL-positive cells began to increase in the implanted tumour from 6 hours after PDT, and peaked 12 hours later.
PDT with Photofrin in this human biliary cancer cell line has antitumor effects and induces apoptotic cell death after PDT.
Anticancer research 06/2010; 30(6):2113-8. · 1.73 Impact Factor
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ABSTRACT: Superselective intra-arterial infusion of anticancer agents with concurrent delivery of external beam radiotherapy was applied to 13 previously untreated cases of oral cancer for the purpose of avoiding surgical resection of the primary tumor.
The catheter tips were placed in the tumor feeder arteries via the superficial temporal artery and/or occipital artery. The catheters were retained for 6 weeks to infuse anticancer agents daily with concurrent radiotherapy for 6 weeks. The total radiation doses to the primary tumor and neck were 60.0 Gy and 40.0 Gy, respectively.
Complete response of the primary tumor was achieved in all 13 patients; complete response of neck node metastasis was achieved in 5 out of 6 patients.
This strategy is quite effective for oral cancer at both the primary site and metastatic lymph nodes, and it has the potential to be curative in advanced cases that are inoperable.
Oral surgery, oral medicine, oral pathology, oral radiology, and endodontics 04/2010; 110(2):172-7. · 1.50 Impact Factor
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ABSTRACT: The aim of this study was to investigate the kinetics of heat shock protein 47 (HSP47) and proliferating cell nuclear antigen (PCNA) immunohistochemistry in periodontal ligament (PDL) cells during orthodontic tooth movement in a mouse model. An orthodontic appliance was set between the upper incisors and the upper left first molar. The mice were killed 2, 6 and 10 days after initiation of orthodontic tooth movement. Computer-assisted image analysis was used to compare the quantitative expression of HSP47 in the PDL. HSP47 expression was significantly higher on the tension side 2 days after application of the appliance, whereas no significant change was observed on the pressure side at any time point. Furthermore, the PCNA labelling indices of PDL cells were increased significantly on the tension side 6 and 10 days after application of the appliance, and on the pressure side 2, 6 and 10 days after application of the appliance. These data suggest that collagen is metabolised predominantly on the tension side, and that PDL cells actively proliferate on both the tension and pressure sides during orthodontic tooth movement.
Archives of Oral Biology 10/2008; 53(9):890-5. · 1.60 Impact Factor
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Journal of oral and maxillofacial surgery: official journal of the American Association of Oral and Maxillofacial Surgeons 08/2008; 66(7):1534-7. · 1.58 Impact Factor
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ABSTRACT: The aim of this study was to investigate the correlation between the expression of hypoxia-inducible factor 1 alpha (HIF-1 alpha) and proliferative activity in tumor cells, lymph node metastasis, as well as prognosis in patients with oral squamous cell carcinoma (OSCC). Fifty-seven biopsy specimens of OSCC were investigated for the expression of HIF-1 alpha and proliferating cell nuclear antigen (PCNA) by immunohistochemistry. None of the patients had received any prior treatments. The percentage of HIF-1 alpha immunopositive area (PHIA) was calculated using computer-assisted image analysis for quantitative assessment of HIF-1 alpha expression. The PCNA labeling index (LI) was evaluated as a proliferation marker. We found that the mean PHIA in all stages was 12.1% in the poor prognosis patients, and it was 6.4% in the good prognosis patients. There was a significant difference of PHIA between poor prognosis and good prognosis patients (P=0.0065). Furthermore, the mean PHIA in the patients who had no metastatic lymph nodes was 7.5%, while it was 11.7% in the patients who had metastatic lymph nodes. There was also a significant difference of PHIA between patients who had no metastatic lymph nodes and those who had metastatic lymph nodes (P=0.0487). On the other hand, significant correlation between PHIA and PCNA LI was not observed. These results provide the clinical data indicating that HIF-1 alpha may play an important role in lymph node metastasis and prognosis in patients with OSCC.
Oral Oncology 08/2008; 45(3):241-6. · 2.86 Impact Factor
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ABSTRACT: The reaction of normal fibrous tissue adjacent to tumours subjected to photodynamic therapy (PDT) was investigated by assessment of the immunohistochemical expression of heat shock protein 47 (HSP47) and proliferating cell nuclear antigen (PCNA), as well as by immunoblot analysis of procollagen type I. PDT was administered to NR-S1 mouse squamous cell carcinoma or normal mouse skin. Each of four mice was investigated at several time points after receiving PDT. The levels of HSP47 expression were determined by computer-assisted image analysis. The expression of procollagen type I in the fibrous tissue adjacent to the tumours was examined by immunoblot analysis at intervals of 24 and 48h after PDT. The expression of HSP47 was first detected 6h post-PDT in the tumour-bearing mice, but no such expression was observed in the normal mice. It was also revealed that, after PDT, the fibroblast PCNA labeling indices at 24, 48, and 72h were significantly higher in both the tumour-bearing and the normal mice than in the control animals that did not receive PDT. Furthermore, procollagen type I was detected in the fibrous tissue adjacent to the tumours at 24 and 48h after PDT, but was not detected in the fibrous tissue adjacent to tumours of mice that did not receive PDT. Therefore, the present results suggest that PDT enhances the synthesis of collagen type I in the fibrous tissue adjacent to NR-S1 squamous cell carcinoma in mice, which contributes to the resultant encapsulation of such tumours.
Oral Oncology 10/2007; 43(8):804-10. · 2.86 Impact Factor
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ABSTRACT: Subcutaneous emphysema is one potential complication of dental procedures, although most cases of emphysema implicate operative procedure. We present a rare case of subcutaneous emphysema which arose due to using an air syringe to dry the gingiva in the lower jaw.
International Dental Journal 09/2007; 57(4):286-8. · 0.96 Impact Factor
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ABSTRACT: Sano K, Yoshida S, Ninomiya H, Ikeda H, Ueno K, Sekine J, Iwamoto H, Uehara M, Inokuchi T: Assessment of growth potential by MIB-1 immunohistochemistry in ameloblastic fibroma and related lesions of the jaws compared with ameloblastic fibrosarcoma. J Oral Pathol Med 1998; 27: 59–63. © Munksgaard, 1998.Specimens from two ameloblastic fibromas (including one recurrent case), two ameloblastic fibro-odontomas, and one ameloblastic fibrosarcoma were subjected to investigation by MIB-1 immunohistochemistry in order to elucidate the growth potential of these tumors. MIB-1 labeling indices in the epithelial component of these tumors ranged from 2.9 to 7.5%, whereas those in the mesenchymal component ranged from 1.5 to 13.5%. Of these, labeling indices in the mesenchymal component of the recurrent ameloblastic fibroma and ameloblastic fibrosarcoma were quite high. These findings suggest that evaluation of growth potential in ameloblastic fibroma and related lesions could be of help in understanding tumor aggressiveness and in selecting appropriate surgical procedures.
Journal of Oral Pathology and Medicine 07/2007; 27(2):59 - 63. · 1.63 Impact Factor
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Journal of Oral and Maxillofacial Surgery 04/2007; 65(3):560-1. · 1.64 Impact Factor
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ABSTRACT: The aim of this study was to define the appropriate fractionation interval between photodynamic therapies (PDTs) for enhanced anti-tumour effects on human oral squamous cell carcinoma (HOSCC). Reoxygenation of HOSCC and the proliferative kinetics of the tumour cells following PDT exposure were evaluated in terms of immunohistochemical expression of vascular endothelial growth factor (VEGF) and the proliferating cell nuclear antigen (PCNA). The immunohistochemical expression of VEGF was quantitatively determined by computer-assisted image analysis. The VEGF expression and the PCNA labeling indices (LIs) of the tumour cells were assessed at varying time intervals after PDT. No significant differences were observed in PCNA LIs between the control group and experimental groups at 24, 48, and 72 h after PDT. The expression of VEGF after PDT exposure was demonstrated to be higher in the experimental group at 6 h than the control group, and then was comparable at 24 h between the both groups. These results indicate that the tumour cells surviving from PDT have proliferative potential, and that oxygenation in tumours subjected to PDT may be recovered after 24 h. In the next experiment, two protocols of laser irradiation in PDT were assessed on the basis of tumour volume between fractionated exposure with a 24-h interval and continuous exposure. Regrowth of the tumour was significantly suppressed by fractionated PDT. We propose here that fractionated light exposure with a 24-h interval should be utilized in PDT for an enhanced anti-tumour effect.
Oral Oncology 06/2006; 42(5):526-32. · 2.86 Impact Factor
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ABSTRACT: We have investigated the antitumor effect of photodynamic therapy (PDT), using Photofrin as the photosensitizer, combined with low-dose cisplatin (CDDP) on NR-S1 mouse squamous cell carcinoma.
CDDP (5 mg/kg body weight) was injected intraperitoneally either 1 hour or 3 hours prior to PDT or immediately afterward. Twenty-four hours after each protocol, the antitumor effects were evaluated by percentage area of the tumor necrosis in hematoxylin-eosin stained specimens as well as terminal deoxynucleotidyl transferase-mediated d-UTP nick-end labeling indices. Furthermore, the tumor sizes were evaluated at 3, 7, and 10 days after each protocol.
The antitumor effect of PDT was enhanced by administration of CDDP 3 hours before PDT, whereas the administration of CDDP 1 hour before PDT or immediately after PDT did not potentiate a PDT antitumor effect.
Administration of low-dose CDDP 3 hours before PDT appears to be a useful treatment modality.
Journal of Oral and Maxillofacial Surgery 04/2006; 64(3):390-6. · 1.64 Impact Factor
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ABSTRACT: The diachronic changes in nuclei in tumor cells subjected to photodynamic therapy (PDT) were investigated using computer assisted analysis to elucidate the degeneration process of tumor cell nuclei.
A photosensitizer was injected intraperitoneally to mice bearing NR-S1 mouse squamous cell carcinoma in the dorsum 48 hours before laser irradiation. Mice were sacrificed at intervals of 0, 0.5, 1.5, 2.5, 6, 24, 48, and 72 hours after PDT, and tumors were excised. Neither photosensitizer nor laser irradiation was administered to control mice. A 4-mum section was prepared from each specimen, followed by hematoxylin and eosin staining. The nuclei of the tumor cells were examined under a light microscope. The mean nuclear area and coefficient of variation of the nuclear area of 100 nuclei per slide were calculated.
Both nuclear area and coefficient of variation of the nuclear area were significantly lower in the experimental groups nuclei than in control mouse nuclei at 24 and 48 hours after PDT.
These results suggest that maximum damage to tumor nuclei occurs between 24 to 48 hours after PDT.
Journal of Oral and Maxillofacial Surgery 03/2005; 63(2):244-6. · 1.64 Impact Factor
