Induction chemotherapy for organ preservation in advanced squamous cell carcinoma of the oral cavity and oropharynx.
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Two plaque morphology variants, a cell aggregating variant and a syncytial variant, were isolated from MDBK cells infected with the MP mutant of herpes simplex virus, type 1. The variants differed in the polypeptides produced in infected MDBK cells. The properties of the variants were stable on passage in cells and both variants produced only syncytia in KB and Hep-2 cells. The physiological state of MDBK cells influenced the cytopathological expression of the infecting virus, so that, under certain conditions, each variant could shift from one type of plaque morphology to the other. However, attempts to correlate this plaque morphology shift with a difference in the glycopolypeptides synthesized in the infected cells were unsuccessful.
Human glutathione S-transferase pi has been known to be a good marker for several tumor types because of the high frequency with which it is overexpressed. In order to determine whether GST pi is useful as an indicator for head and neck cancers, expression of GST pi was investigated by Northern analysis. Overexpression of mRNA was detected in 9 of 36 primary head and neck squamous cell carcinomas. To examine the relationship between overexpression and amplification of GST pi gene, Southern analysis was performed on all samples. Only 3 of the 36 tumors showed amplification GST pi genes, indicating that gene amplification may not play a key role in GST pi mRNA overexpression in these cancers.
In a prospective study, the influence of the status of the peri-implant hard and soft tissues on the success of enosseous dental implants in tumor patients was assessed. Out of 59 tumor patients with 261 implants, treated between July 1988 and August 1996, a pool of 23 patients with 99 implants provided with dentures for at least 1 year was obtained. Eighteen of these patients suffered from a squamous cell carcinoma of the oral cavity. Seventeen patients underwent preoperative radiation (40 Gy). A total of 68 out of 99 implants were inserted into autologous bone transplanted to reconstruct the mandible. In order to assess the peri-implant hard and soft tissues, the Hygiene Index, the Sulcus Bleeding Index, the Gingiva Index, the pocket-probing depth. the peri-implant bone resorption, and the periotest were used. The results in the tumor patients were compared with the results in a pool of nontumor patients. Tumor patients had significantly worse periimplant parameters than nontumor patients. The peri-implant pocket-probing depth proved to have significant influence on the success rate. The overall success rate was 77.8%.
The German-Swiss-Austrian Group on Maxillofacial Tumors (DOSAK) has been performing observational studies in oral cancer. Since 1989, approximately 1600 cases of tumor of the head and neck per years has been collected in a central tumor registry. The database consists of more than 16,000 patients from 71 clinics; almost two-thirds are primary cases of squamous cell carcinoma. The data show great differences in patho-anatomical findings, therapy concepts, and five-year survival rates among the hospitals.
BACKGROUND AND OBJECTIVE: Betel chewing is common in India and southeast Asia. It shows mild psychostimulatory effects but with prolonged use there is a risk of oral and extraoral disease. Surprisingly, betel nut associated disorders are rarely discussed in the dermatological literature. METHODS: A review about betel nut associated disease is given based on a literature review and our own experiences. RESULTS: Both benign and malignant diseases can be induced by betel nut chewing. Betel causes reddish discoloration of teeth, periodontitis and buccal mucositis. Submucous fibrosis is a precancerous disease that may eventually develop into oral squamous cell cancer (OSCC). Among malignant diseases induced by betel quid, OSCC is the most important but esophageal cancer and hepatocellular cancer can also be observed. The available treatments are of limited value. CONCLUSIONS: Betel nut chewing has its own morbidity and mortality due to the induction of benign and malignant diseases. There is a lack of controlled trials although both betel nut chewing and the associated diseases are common.
Dysphagia is a common complaint following surgical intervention in the oral cavity and hypopharynx, often leading to prolonged postoperative recovery. Videofluoroscopy allows detailed visualization of deglutition, demonstrating the morphology as well as the functional aspects. Therefore, videofluoroscopy provides the basis for further therapeutic management. We discuss the pathology of deglutition in 19 patients recovering from tumor surgery of the oro- and hypopharynx. In most cases the results demonstrated severe impairment of both the oral and pharyngeal phase of deglutition. Our data emphasize the importance of the oral phase of deglutition for preparation and initiation of the following phases.
CT with multiplanar reconstruction of the jaws (DentaScan) is the method of choice for the radiographic assessment of the mandible and maxilla. It is instrumental in delineating the relationship between bony lesions and the adjacent anatomy. Therefore, this technique allows precise evaluation of the intricate details of the oral cavity. Using it, distinct characterization of pathology including infectious, metabolic, congenital and neoplastic lesions can be obtained.
Reconstruction of the oral cavity is an intricate subject that reflects the complexity of the oral cavity itself. There is no perfect reconstruction. Presented here are the current optimal choices for the various regions within the oral cavity. We are constantly seeking to improve these reconstructions in an effort to restore optimal function to patients unfortunate enough to require surgical excision of this most elaborate of anatomic structures.
A 59-year-old woman who had received cobalt-60 (60Co) interstitial radiation therapy (total 44 Gy) in the right bucco-gingival region for inflammatory pseudotumour was found to have metachronous double malignant neoplasms. Initial osteosarcoma of the right mandibular angle and subsequent squamous cell carcinoma of the right buccal mucosa were identified 28 and 33 years after the radiation, respectively. Since both tumours were located very close to the focus of previous radiation, the therapy was considered to be responsible for their genesis. The patient had systemic metastases of the osteosarcoma.
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