Gender specific quality of life in patients with oral squamous cell carcinomas

<p>Abstract</p> <p>Background</p> <p>The goal of this study was to evaluate the somatic and psychological effects by means of QUALITY OF LIFE (QOL) of surgical treatment of patients with oral squamous cell carcinoma. The factors gender, age, nicotine consumption, and tumour stage were taken into consideration.</p> <p>Methods</p> <p>54 patients after surgical resection of oral squamous cell carcinomas (OSCC) were analysed from 01.09.2005 to 31.05.2008. Inclusion criteria for the study were: age at least 18 years, no indication or treatment of synchronous and metachronous tumours.</p> <p>German translations of the EORTC H&N-35 and EORTC QLQ-C-30 questionnaires, as well as a general socioeconomic patient history were used as measuring instruments. The questionnaires were completed independently by the patients. The answers were translated into scale values for statistical evaluation using appropriate algorithms.</p> <p>Results</p> <p>Analysis of the EORTC-QLQ-C-30 questionnaires demonstrated a tendency of more negative assessment of emotional function among the female participants, and a more negative evaluation of social function among the male participants. Greater tumour sizes showed significantly lower bodily function (p = 0.018). While a smaller tumour size was significantly associated with lower cognitive functioning (p = 0.031). Other cofactors such as age, nicotine consumption, and tumour stage only showed a tendency to influence the quality of sleep and daily life.</p> <p>Conclusions</p> <p>The data obtained within this investigation demonstrated that gender had the most significant power on the subjectively perceived postoperative quality of life. This factor is important e.g. in preoperative decision making regarding immediate microvascular reconstruction after e.g. mandibular resection and therefore QOL assessment should become integral component of the care of patients with OSCC.</p

Distant metastases of a squamous cell carcinoma of the tongue in peripheral skeletal muscles and adjacent soft tissues

A 66-year-old female patient was admitted to our department with a large tumor of the tongue measuring 10 cm in diameter. The tumor occupied nearly the entire oral cavity and showed exophytic and ulcerative areas. Histological analysis revealed a low grade squamous cell carcinoma (SCC) of the tongue. Bilateral enlarged cervical lymphatic masses were also present. The extent of the tumor infiltration was assessed by fluoro-2-deoxy-glucose-positron emission tomography (PET) scans showing an elevated activity of the tracer corresponding to the assumed cervical metastases. Additionally, pulmonary metastases were identified. Contrast enhanced computed tomography (CT) scans showed metastases in the soft tissues of the abdomen, legs and arms. Foci of distant metastases were found in the left upper anterior thoracal wall, near the intraabdominal portion of the aorta, near the right iliac crest and in both the right vastus medialis- and adductor magnus muscles. The final diagnosis was a T4N3M1(G3)(C3) SCC of the tongue with multiple distant thoracal, abdominal and intramuscular metastases. The survival expectancy was five weeks, and the patient finally deceased by cardiopulmonary complications

Intracranial expression of Fas (CD95) and Fas ligand (CD95L) is associated with neuronal cell death and inflammation following closed head injury in mice

Der nach einer traumatischen Hirnverletzung auftretende Zelltod von Nervenzellen führt zu einer fortschreitenden Gewebeatrophie und verursacht damit in der Folge eine neurologische Dysfunktion. Fas (CD95/APO-1) und Fas Ligand (FasL/CD95L/APO-1L) sind wichtige Mediatoren des extrinsischen apoptotischen Signalweges, die zuvor sowohl in entsprechenden Tierversuchsmodellen als auch bei hirntraumatisierten Patienten in verletzten Gehirnarealen in erhöhtem Ausmass nachgewiesen werden konnten. In der vorliegenden Studie wurde an "Knockout" (-/-)-Mäusen, denen ein geschlossenes Schädel-Hirn-Trauma (SHT) zugeführt wurde, untersucht, ob das Fehlen von Genen, die für entzündungsmodulierende Zytokine kodieren, das Ausmass des Zelltodes und das Auftreten von Fas und FasL in den intrakraniellen Kompartimenten verändert. Darüber hinaus ist der mögliche Zusammenhang zwischen Zelltod und Entzündung bewertet worden. Zu diesen Zwecken wurden fortlaufende Hirnschnitte bei Tumor-Nekrose-Faktor/Lymphotoxin- -/- -Mäusen, Interleukin- 6 -/- -Mäusen und ihren entsprechenden Wildtyp-Kontrollgruppen jeweils 24 Stunden und 7 Tage nach Zufügung eines geschlossenen SHT mit TUNEL/Hoechst 33342 Doppelfärbung sowie Immunhistochemie eingefärbt und analysiert. 24 Stunden nach Traumasetzung zeigte sich das Maximum TUNEL-positiver Zellen im verletzten Kortex, deren Anzahl auch nach 7 Tagen noch leicht erhöht war. Übereinstimmende Ergebnisse konnten für Fas registriert werden. FasL dagegen war nach 24 Stunden nur mässig stark erhöht, präsentierte jedoch seinen Maximalwert nach 7 Tagen. Apoptotische TUNEL-positive Zellen fanden sich grösstenteils in örtlichem Zusammenhang mit Neuronen und Fas- und FasL-Immunoreaktivität. Allen Mäusegruppen gleich war das maximale Auftreten von polymorphkernigen Leukozyten und CD11b-positiven Zellen in den verletzten Hemisphären 24 Stunden nach erfolgter Traumatisierung. Die Ergebnisse zeigen, dass Fas und FasL nach einem geschlossenen SHT eine wichtige Rolle in der neuronalen Apoptose spielen könnten. Zudem scheint die Aufregulierung von Fas und FasL unabhängig von der Entzündungsreaktion zu sein, da kein Unterschied zwischen den Zytokin -/- -Mäusen und den Wildtyp-Kontrollmäusen gefunden werden konnte. Neuronal cell death occurring after traumatic brain injury causes progressive tissue atrophy and consequent neurological dysfunction. Fas (CD95/APO-1) and Fas ligand (FasL/CD95L/APO-1L) are important mediators of the extrinsic apoptotic pathway and were previously found to be upregulated in injured brains, in both patients and animal models. In this study, we examined whether the lack of genes for inflammatory cytokines altered the extent of cell death and expression of Fas and FasL in the intracranial compartment in knockout (-/-) mice subjected to closed head injury (CHI). Furthermore, the possible interrelation between cell death and inflammation was assessed. Consecutive brain sections of tumor necrosis factor/lymphotoxin- -/- and interleukin-6 -/- mice and respective wild type littermates were analyzed at 24 hours and 7 days after CHI using TUNEL/ Hoechst 33342 double staining and immunohistochemistry. The results demonstrate a peak incidence of TUNEL positive cells in the injured cortex at 24 hours that remained slightly elevated at 7 days and coincided with maximal Fas expression. FasL was only moderately increased at 24 hours and showed maximal expression at 7days. Apoptotic TUNEL positive cells mostly co-localized with neurons and with Fas- and FasL immunoreactivity. The amount of accumulated polymorphonuclear leukocytes (PMNs) and CD11b positive cells was uniformly maximal in the injured hemispheres at 24 hours. We show strong evidence that Fas and FasL might be involved in neuronal apoptosis after CHI. Furthermore, Fas- and FasL upregulation seems to be independent of neuroinflammation since no differences were found between cytokine -/- and wild type mice

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Analysis of trigeminal nerve disorders after oral and maxillofacial intervention

Abstract Background Quantitative sensory testing (QST) is applied to evaluate somatosensory nerve fiber function in the spinal system. This study uses QST in patients with sensory dysfunctions after oral and maxillofacial surgery. Methods Orofacial sensory functions were investigated by psychophysical means in 60 volunteers (30 patients with sensory disturbances and 30 control subjects) in innervation areas of the infraorbital, mental and lingual nerves. The patients were tested 1 week, 4 weeks, 7 weeks and 10 weeks following oral and maxillofacial surgery. Results QST monitored somatosensory deficits and recovery of trigeminal nerve functions in all patients. Significant differences (p Conclusion QST can be applied for non-invasive assessment of sensory nerve function (Aβ-, Aδ- and C-fiber) in the orofacial region and is useful in the diagnosis of trigeminal nerve disorders in patients.</p