Humans ; Jaw Neoplasms ; pathology ; surgery ; Mouth Neoplasms ; pathology ; surgery ; Pharyngeal Neoplasms ; pathology ; surgery ; Skull Base ; pathology ; surgery

Face ; surgery ; Humans ; Mouth ; surgery ; Reconstructive Surgical Procedures ; Retrospective Studies

Humans ; Neck Dissection ; methods ; Tongue Neoplasms ; surgery

Humans ; Oral Surgical Procedures ; instrumentation ; methods ; Robotics ; instrumentation ; methods ; Surgery, Computer-Assisted ; instrumentation

Objective To analyze our clinical results of head and neck reconstruction using microsur- gical free flap transfer techniques.Methods The free flap donor sites with long vascular pedicle and large diameter of vessel were routinely chosed,and chose receipt vessels with large diameter and proper position, and perform vessel ananstomosis under surgical loups instead of microscope.The un-buried free flap with a mo- nitoring window were harvest,and do double venous anastomoses in some flaps to ensure adequate venous out- flow.Results From May 1999 to March 2005,1066 consecutive free flap transfers were used to reconstruct head and neck defects.The overall success rate of free flap was 98.3%.The vessel thrombosis rate was 3.1%,and the flap salvage rate was 45.5%.Conclusion Head and neck reconstruetion using microsurgi- cal free flap transfer technique is safe and reliable,and good clinical results can be obtained.

Objective To investigate the efficacy of twice irradiating with focused ultrasound on recurrent and metastasized U14 cervical cancer implanted in the legs of mice. Methods Seventy-two mice with U14 cervical cancer cells implanted in their legs were divided into three groups randomly,with 24 rats in each group.One group received a single dose of focused ultrasound,while mice in the second group were irradiated twice and surgery resection was administered to the third group 7 or 8 days after the tumor was implanted.After 23 days post implantation of the tumor,local tumor recurrence and metastasis to the lungs and lymph nodes were evaluated. Results The inhibition rate after double irradiation was 61.70％ for local recurrence and 68.18％ for metastasis,significantly higher than in the other two groups. Conclusions Both single and double irradiation with focused ultrasound are effective for inhibiting local recurrence and metastasis,but double irradiation is more effective.

OBJECTIVETo investigate the clinical iatrogenic factors related to delay in diagnosis of oral squamous cell carcinoma.

METHODSA total of 102 consecutive patients with squamous cell carcinoma of the oral cavity, treated in Department of Oral and Maxillofacial Surgery, Peking University Hospital of Stomatology were included in the study. For iatrogenic (professional) delay, stepwise multiple logistic regression and monofactor analysis, chi-square, test with 95% confidence interval (CI), were applied to analyze the correlation between the professional delay in diagnosis and the possible related clinical factors.

RESULTSWhether adopting biopsy at the first clinical management, length of time from the first clinical visit to adopting biopsy, number of clinical departments visited and whether taking any treatment before definitive diagnosis had significant influence on the delay.

CONCLUSIONSTaking biopsy at the first clinical visit, shortening the time from the first visit to biopsy and less undirected treatment can reduce the iatrogenic delay.

Adult ; Aged ; Aged, 80 and over ; Carcinoma, Squamous Cell ; diagnosis ; Diagnostic Errors ; Female ; Humans ; Logistic Models ; Male ; Middle Aged ; Mouth Neoplasms ; diagnosis ; Young Adult

OBJECTIVEMutations of the iduronate-2-sulfatase (IDS) gene is the ultimate cause of Hunter syndrome. Clarification of the nature of mutations will create a necessary premise for prenatal gene diagnosis. A mucopolysaccharidosis (MPS) type II patient and his parents from an ethnic minority in Yunnan province were studied to identify their possible mutation in IDS gene to establish the basis for prenatal gene diagnosis.

METHODSThe patient was a boy, 6 years and 10 months old. Urine glycosaminoglycans (GAGs) assay was used for preliminary diagnosis of the patient and his parents with the disease. The three related persons' DNA was extracted and the concentration and purity of the DNA were measured after the urine test results confirmed the diagnosis. Polymerase chain reaction-denaturing high performance liquid chromatography (PCR-DHPLC) analysis was performed to detect the position of the mutation around the hot spots of mutation in exon 9, 3, 8 of the IDS gene. DNA bidirectional direct sequencing was applied to analyze the mutation detected by PCR-DHPLC.

RESULTSThe results of GAGs test showed that in the child with MPS, dermatan sulfate (DS) was positive (+++), heparan sulfate (HS) (+++), chondroitin sulfate (CS) and keratan sulfate (KS) were negative (-); while in his parents none of DS, HS, CS and KS was positive. Abnormal peaks in exon 9 of IDS gene shown by PCR-DHPLC were found in the patient. His mother had heterozygotic peaks. A new frame-mutation (1343-TT) in exon 9 of IDS gene of this patient was confirmed by DNA sequencing. The position where mutation occurred was inside codon 407 (TTT), that means two "T" deleted at position 1343 base pair (1343-TT) in cDNA of the IDS gene, caused a new frame-mutation. It caused elongation of the amino acid chain to a terminal codon TGA at position 429. Thus the peptide chain was shortened from 550 to 428 amino acids. The patient is a hemizygote of the mutation and his mother is a heterozygote.

CONCLUSIONA new frame-mutation (1343-TT) on the IDS gene was identified in this study. The patient is a hemizygote and his mother is a heterozygote. The mutation (1343-TT) resulted in loss of 122 amino acids, which probably caused seriously decreased enzyme activity of IDS, and the authors speculate that this mutation may be the pathological basis of the disease. So, if the mother becomes pregnant again, a prenatal gene diagnostic test for the same mutation should be performed. Furthermore, PCR-DHPLC followed by DNA sequencing are effective methods for diagnosis, including prenatal diagnosis of MPS II.

Amino Acid Sequence ; Asian Continental Ancestry Group ; Base Sequence ; Child ; China ; Chromatography, High Pressure Liquid ; Genotype ; Humans ; Iduronate Sulfatase ; genetics ; Male ; Molecular Sequence Data ; Mucopolysaccharidosis II ; diagnosis ; genetics ; Mutation ; Reverse Transcriptase Polymerase Chain Reaction

Objective:To compare the differences of anatomical and histological characteristics of lymph nodes between BALB/c nude mice and BALB/c mice.Methods:Firstly,twenty BALB/c nude mice and twenty BALB/c mice were dissected by using a surgical microscope.Secondly,the differences of T cells and B cells at the lymph node were compared by the expressions of CD3 and CD20 immunohistochemistry dyes.Results:There were,on average,23 nodes per mouse contained within the large lymph node assembly in the BALB/c nude mouse.The anatomical features of the lymph node distribution in the nude mice were mainly found in the neck with relatively higher density.There were two lymph nodes both in the submandible lymph nodes group and in the superficial cervical lymph nodes group (the constituent ratios were 95％ and 90％,respectively) in the BALB/c nude mice,but there were four lymph nodes (the constituent ratios were 95％ and 90％,respectively) in the BALB/c mice.There were significant difference between the BALB/c nude mice and the BALB/c mice.Mostly there were two lymph nodes of deep cervical lymph nodes both in the BALB/c nude mice and the BALB/c mice (the constituent ratios were 95％ and 100％,respectively).There were no significant difference between the BALB/c nude mice and the BALB/c mice.We confirmed that the number of CD3-positive T lymphocytes in lymph nodes of the nude mice decreased greatly as compared with the BALB/c mice.Expressions of CD3 in T cells were 95％ and 100％ in the BALB/c nude mice and in the BALB/c mice,respectively.There were significant differences between the BALB/c nude mice and the BALB/c mice.Expressions of CD2o in B cells were 95％ and 100％ in the BALB/c nude mice and in the BALB/c mice,respectively.There was no significant difference between the BALB/c nude mice and BALB/c mice.Conclusion:The anatomi cal pictures of lymph node distribution in the nude mouse will be benefit to those who are interested.The anatomical features of the lymph node local higher density in neck of the nude mouse and lack of CD3-positive T lymphocytes would be useful for obtaining a better understanding of localized lymph node metastasis of oral transplant tumors.

OBJECTIVETo investigate the effect of gene transfection at different time on bone mineral density and strength of newly formed bone in mandibular distraction gap in rabbit, so as to explore the optimal time for gene therapy and enhance the therapeutic effect.

METHODS48 New-Zealand rabbits were employed to receive mandibular osteotomy and implantation of distraction devices bilaterly. Then the rabbits were randomly divided into 4 groups as group A, B and C and D. The animals in group A, B, and C were transfected with recombinant plasmids pIRES-hBMP2-hVEGF165 via electroporation-mediated approach at latency period, distraction period, consolidation period respectively. Group D was used as control group without gene transfection. After 3 days of latency period, the distraction devices were activated at the rate of 0.8 mm per day for 10 days. Three rabbits in each group were sacrificed at 1 wk, 2 wk, 4 wk and 8 wk of consolidation respectively. The mandibles were harvested and the left mandible received X-ray examination for bone healing, and quantitative computed tomography (QCT) dectection for the bone mineral density (BMD) of newly formed bone in the distraction gap. The biomechanical properties of the new generation bone at 4 th and 8 th week of consolidation in each group were detected by three point bending test.

RESULTSThe bone mineral density and the biomechanical strength of newly formed bone increased along the length of consolidation in each group. After 1 week of consolidation, there was no significant difference in BMD among group A (83.43 +/- 9.96), group B (92.29 +/- 11.25), group C (89.93 +/- 14.15), P > 0.05. But the BMD of group A, B and C was higher than that of group D (70. 31 +/- 3.30), P < 0.05. After 2wk, 4 wk and 8 wk of consolidation, the BMD of group B (137.54 +/- 7.20,492.93 +/- 17.57, 790.48 +/- 12.19) was significantly higher than those of group A (121.44 +/- 9.27, 396.15 +/- 15.70, 603.39 +/- 16.46), C (125.06 +/- 7.24, 464.15 +/- 15.45, 764.15 +/- 17.28), and D (98.86 +/- 8.13, 336.45 +/- 11.95, 577.89 +/- 18.43), P < 0.05. The biomechanical parameters were also higher in group B than those of group A, C and D after four and eight weeks of consolidation (P < 0.05).

CONCLUSIONIt is better to transfect gene at the beginning of distraction (distraction period) than at other stages of DO. In this way, more remarkable effect could be obtained on new bone formation. It suggests that the distraction stage is the optimal time for gene therapy.

Animals ; Bone Density ; genetics ; physiology ; Electroporation ; Genetic Therapy ; Mandible ; physiology ; surgery ; Osteogenesis, Distraction ; Osteotomy ; Rabbits ; Time Factors ; Transfection