OBJECTIVE To study the frequencyof extracapsular spread (ECS) in neck metastasis and its impact on prognosis in supraglottic carcinoma. METHODS A total of 177 patients with radical or modified neck dissection between Jan. 1994 and Dec. 1997 for supraglottic carcinoma were summarized. Transparent lymph node detection and a series of sectioning method were applied on all neck dissection specimens. The SPSS software package (version 11.5) was used to make statistical analysis. Survival curves were calculated with the Kaplan-Meier model. Impact of extracapsular spread on prognosis was assessed for significance with the Log-Rank test. RESULTS Eighty one patients were pathologically positive in neck specimens and the neck metastatic rate was 45.8 %. ECS was found in 32 cases and the ECS frequency was 39.5 % (32/81). The ECS was related with pathological N stage and the number of positive nodes. Patients with ECS had a higher possibility of regional recurrence and contralateral metastasis. The 5-year survival rates of patients with neck metastasis ECS- and patients with ECS+ were 61.9 % and 22.2 % respectively. The differences had statistically significance. CONCLUSION ECS in neck metastasis affects the prognosis in patients with supraglottic carcinoma. If bilateral neck dissection was not selected simultaneously, close follow-up on contralateral neck should be selected in patients with ECS because of a higher incidence of contralateral neck metastasis.

Objective To identify the disease-causing gene mutation and investigate the genotypephenotype correlation in a Chinese pedigree with familial hypertrophic cardiomyopathy.Methods In this study we collected a large multigenerational Chinese family with FHCM.Total genome DNA was extracted from 67 subjects' peripheral leucocytes.The exons and boundary introns of MYH7 gene was amplified by PCR and directly sequenced by ABI PRISM 3700 DNA sequencer.Then,the mutation was examined.Results Fourteen family members had hypertrophic cardiomyopathy,including 4 deceased 2 of whom died from sudden death at young age.Analysis by echocardiography showed all the 10 living affected individuals have a maximal leftventricular-wall thickness of at least 13 mm.Three single nucleotide polymorphisms (SNP) which had been reported in NCBI SNP database,were found mutated.No mutation co-seperated with the disease was identified.Conclusion FHCM of this family was not caused by MYH7 mutation.Other genes should be screened to further identify the disease-causing gene mutation in hypertrophic cardiomyopathy.

Objective To evaluate the clinical reliability and feasibility of computerized endoscopic balloon manometry in vitro and in vivo, in measurement of pressure of esophageal varices. Methods Computerized endoscopic balloon manometry was used to measure the pressure of variceal model with different diameter (3 mm, 6 mm and 8 mm) and intraluminal pressures (ranging from 8 to 36 mm Hg), and the findings were compared with actual pressures. The technique was also applied in 23 patients with liver cirrhosis and esophageal varices, and its correlation with hepatic venous pressure gradient and other factors related with varices bleeding. Results The study in vitro showed that the measured intraluminal pressure was correlated significantly with the actual value ( r ≥ 0. 993, P ＜ 0. 001 ) without obvious measurement bias(95% CI = -0.13 cm H2O to 0. 33 cm H2O). The measurement in 23 patients were success with little variation coefficient (r≥0. 998) between repeated procedures. Regression analysis showed a good correlation between variceal pressure and hepatic venous pressure gradient (r=0. 858, P ＜ 0. 001 ). A higher variceal pressure was strongly associated with presence of previous bleeding episodes, vascular diameter and presence of red color signs, but did not correlate with the parameter of Child-Pugh classification ( t = 0. 31, P =0. 76). Conclusion Computerized endoscopic balloon manometry is reliable and feasible to examine esophageal variceal pressure, and is very likely to be a valuable clinical index for variceal bleeding.

OBJECTIVETo investigate the relationship of Fas mRNA and protein expression and apoptosis in human oral squamous cell carcinoma.

METHODSNorthern blot and flow cytometry (TUNEL method) were used to detect the expression of Fas mRNA and Fas protein, cell cycle and apoptotic level in oral squamous cell carcinoma. The relationship between Fas gene expression and OSCC apoptosis was analyzed statistically.

RESULTSFas mRNA and protein could be detected in all five normal oral mucosa specimens. There was positive correlation between expression of Fas mRNA/protein and cell differentiation as well as apoptosis in OSCC (P < 0.005).

CONCLUSIONThe expression of Fas gene was highly correlated with the differentiation and apoptosis in OSCC.

Apoptosis ; Carcinoma, Squamous Cell ; metabolism ; Humans ; Mouth Neoplasms ; metabolism ; fas Receptor ; metabolism

OBJECTIVETo observe the induction of apoptosis of cisplatin (DDP) to oral squamous cell carcinoma cell line (Tca8113) in vitro and study the role of Survivin on the apoptosis of Tca8113 cells induced by cisplatin.

METHODSThe inhibitory effects of different doses of DDP on Tca8113 cells were assayed with MTT test. Apoptosis was determined by flow cytometry. The expression of Survivin was detected by RT-PCR and immunocytochemistry.

RESULTSCisplatin obviously inhibited Tca8113 cells growth in a dose and time dependent manner. The apoptotic index showed the similar trend. Survivin gene expression was decreased with increasing of time and reached the lowest level at 24 hours after DDP treatment, then increased after that time.

CONCLUSIONCisplatin gene can effectively induce apoptosis in Tca8113 cells and the inhibition of Survivin gene expression may play a critical role on Tca8113 cell apoptosis induced by cisplatin.

Apoptosis ; Carcinoma, Squamous Cell ; Cell Line, Tumor ; Cell Proliferation ; Cisplatin ; Humans ; Inhibitor of Apoptosis Proteins ; Microtubule-Associated Proteins

OBJECTIVETo evaluate an island pectoralis major myocutaneous flap for immediate reconstruction of the total tongue body and the floor of the mouth after radical resection of bilateral tongue carcinoma involved.

METHODSForm October 2000 to December 2002, seven patients with bilateral tongue carcinoma were selected to treat with salvage surgery, and an island pectoralis major myocutaneous flap were applied for immediate reconstruction of total body of tongue and floor of mouth.

RESULTSSix flaps survived well. Only one flap showed a partial necrosis, with no submandibular fistula, infection, and other complications. The reconstructed tongue and floor of mouth worked well. The speaking and swallowing functions were satisfactory after 2 approximately 16 months' follow-ups. Only one patient died of lung metastasis carcinoma in 9 months after the operation.

CONCLUSIONSThe island pectoralis major myocutaneous flap could be an ideal selection for the immediate reconstruction of the total tongue body and the floor of mouth.

Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Mouth Floor ; surgery ; Pectoralis Muscles ; transplantation ; Reconstructive Surgical Procedures ; methods ; Surgical Flaps ; Tongue ; surgery

OBJECTIVETo evaluate the impact of extracapsular spread (ECS) in ipsilateral neck metastasis on prognosis and its related factors in laryngeal cancer.

METHODSThe study included 184 patients who underwent laryngectomy and simultaneous radical or modified radical neck dissection between January 1994 and December 1997 for laryngeal cancer. All of them had a complete 5-year follow-up. We used transparent lymph node detection and continuous slicing method on all neck dissection specimens. Kaplan-Meier model was used for survival analysis and the log-rank test was used to assess significance.

RESULTSWe found pathological neck metastases in 80 patients. Among them, 26 cases (32.5%) had ECS in ipsilateral neck. ECS incidence increased with advanced pathological N (pN) stages (pN1 3.7%, pN2a 25.0%, pN2b 50.0%, and pN2c 55.6%; P = 0.001). ECS incidence also increased with number of positive nodes (1 positive node 8.6%, 2 positive nodes 33.3%, 3 and more positive nodes 66.7%; P < 0.001). Incidences of contralateral neck metastases and ipsilateral neck recurrence in patients with ECS were higher than those in patients without ECS (46.2% vs. 24.1%, P = 0.046; 34.6% vs. 7.4%, P = 0.002). The 5-year survival rate of patients with ECS was significantly lower than that of patients without ECS (23.1% vs. 57.4%, P = 0.013).

CONCLUSIONECS is an important prognostic factor in laryngeal cancer. Patients with ECS have a higher incidence of contralateral neck metastasis, so bilateral neck dissection should be selected.

Adult ; Aged ; Female ; Humans ; Laryngeal Neoplasms ; pathology ; surgery ; Lymphatic Metastasis ; pathology ; Male ; Middle Aged ; Neck ; Neck Dissection ; Prognosis ; Survival Analysis

The high price of the reference substances is an obstacle for the HPLC analysis of Lonicerae Japonicae Flos. To solve this problem, a new method based on the standard reference extract (SRE) was proposed. In this study, the extract of Lonicerae Japonicae Flos was calibrated, and the long-term stability was investigated. Different concentration solutions of SRE were prepared for establishment of the calibration profiles, and 6 organic acids were determined. T-test was used for the comparison of the determination results via reference substances and SRE, and the results demonstrated that there is no significant difference between the two methods. The presented method can be used for the quality control of Lonicerae Japonicae Flos, and will also offer reference to resolve similar problems.
Flowers ; chemistry ; Lonicera ; chemistry ; Plant Extracts ; standards ; Quality Control ; Reference Standards

OBJECTIVETo evaluate the impact of extracapsular lymph node spread (ECS) in the ipsilateral neck on the contralateral neck metastasis and prognosis of laryngeal cancer.

METHODSThe data of 184 laryngeal cancer patients who underwent laryngectomy and simultaneous radical or modified radical neck lymph node dissection between Jan. 1994 and Dec. 1997 were retrospectively analyzed. Of these 184 patients, 144 underwent unilateral neck lymph node dissection and 40 bilateral; 159 had supraglottic lesion and 25 transglottic. All had squamous cell carcinoma. The clinical T stage was T1 in 3, T2 63, T3 77, T4 41; N stage: NO in 123, N1 38, N2a 5, N2b 11, N2c 7. Transparent lymph node detection and continuous sectioning method were applied to all dissected neck lymph nodes. Statistical analysis was carried out using SPSS software package ( version 11.5). Survival curves were calculated through the Kaplan-Meier model. Impact of extracapsular lymph node spread in the ipsilateral neck on prognosis was assessed using the Log rank test.

RESULTSOf these 184 patients, neck lymph node metastasis was pathologically proven in 80, 26 had ECS in the ipsilateral neck with a ECS rate of 32.5% (26/80). The ECS incidence was positively correlated with advanced pathological N stage and metastatic lymph nodes (P < 0.01). The incidence of the contralateral neck metastasis and ipsilateral neck recurrence with ECS were higher than those without ECS, which was 46.2% versus 24.1%, and 34.6% versus 7.4%, respectively (P < 0.05). The 3- and 5-year survival rates of patients with ECS were significantly lower than those of patients without ECS, which was 53.9% versus 70.4%, and 23.1% versus 57.4%, respectively (P = 0.0125).

CONCLUSIONExtracapsular lymph node spread is found to be an important prognostic factor in the laryngeal cancer. Bilateral neck dissection may be mandatory due to patients with ECS have a higher incidence of contralateral neck metastasis. The capsule of metastatic lymph nodes should be pathologically checked and reported in order to determine the extra-capsular spread status.

Adult ; Aged ; Carcinoma, Squamous Cell ; secondary ; surgery ; Female ; Follow-Up Studies ; Head and Neck Neoplasms ; secondary ; surgery ; Humans ; Kaplan-Meier Estimate ; Laryngeal Neoplasms ; pathology ; surgery ; Laryngectomy ; methods ; Lung Neoplasms ; secondary ; Lymph Nodes ; pathology ; Lymphatic Metastasis ; Male ; Middle Aged ; Neck Dissection ; methods ; Neoplasm Recurrence, Local ; Neoplasm Staging ; Prognosis ; Retrospective Studies

OBJECTIVETo examine the benefit of restaging recurrent oral squamous cell carcinoma (R-OSCC) and the effect on salvage surgery.

METHODSAn analysis was performed on 30 patients with local only first failure (n = 13) or loca-regional only first failure (n = 9) or first recurrence in the neck (n = 8) after surgery and/or radiation treatment given for oral squamous cell carcinoma. All the 30 patients were restaged and treated with salvage surgery.

RESULTSThe overall survival time and disease-free survival time of patients with early staged R-OSCC was longer than that of patients with advanced staged R-OSCC. The 1-year survival and 1-year disease-free survival rates for early staged R-OSCC is also higher than that of advanced staged R-OSCC.

CONCLUSIONSThe re-stage of the recurrent tumor is significantly correlated with survival. The salvage surgery is an effective measure in patients with recurrent oral squamous cell carcinoma, especially in early staged patients of R-OSCC.

Adult ; Aged ; Carcinoma, Squamous Cell ; mortality ; surgery ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Mouth Neoplasms ; mortality ; surgery ; Neoplasm Recurrence, Local ; mortality ; surgery ; Salvage Therapy ; Survival Rate