The Effectiveness of Simultaneous Combination Therapy Using S-1 and Nedaplatin with Radiation for Five Cases of Maxillary Cancer

In our department, we provide treatment for malignant head and neck tumors with the goal of preserving organs and function. We report the treatment outcomes for five patients with maxillary cancer who underwent S-1 and nedaplatin treatment with concurrent radiation therapy (SN therapy) in our department from April 2005 to March 2009. The patients included one case classified as T2N0M0 and four cases classified as T4N0M0. All patients were male and were aged between 29 and 67 years with a mean age of 55.6 years. Among the five cases, four achieved cancer-free survival with preservation of all functions after undergoing treatment. In the remaining case, the tumor did not disappear but was locally controlled via superselective arterial injection and CyberKnife treatment; however, pulmonary metastasis occurred and the patient is surviving with cancer. SN therapy has allowed a reduction in the extent of surgery required and the preservation of organs and function. It will be necessary to study an increased number of cases in the future to determine the survival rate and the effectiveness of organ and function preservation in maxillary cancer patients after SN therapy

Influence of Anatomical Variation in the Nasal Cavity on Inflammation of the Paranasal Sinuses

We investigated the correlation between the incidence of anatomical variations in the nasal cavity and mucosal inflammation in the paranasal sinuses, using computed tomography (CT). In total, 239 patients (478 sides; 138 men and 101 women; age range, 8-89 years) underwent coronal plane CT for screening from November 2001 to October 2006. Patients with facial trauma, paranasal sinus carcinoma, inverted papilloma, or previous sinus surgery were excluded from this study. We evaluated the incidence of agger nasi air cells, Haller\u27s cells, middle and superior turbinate pneumatization, paradoxically curved uncinate processes, paradoxically curved middle turbinates, and septal deviation. The mucosal condition and ostiomeatal complex were evaluated by the Lund-Mackay staging system, and correlations between groups were analyzed using Mann-Whitney\u27s U tests. The incidence of nasal septal deviation was 14.6% and the incidences of agger nasi air cells, concha bullosa (pneumatization of the middle nasal turbinate) and Haller\u27s cells were 47.7%, 22.4% and 10.7%, respectively. Paranasal CT showed partial or total opacification of the sinuses in approximately 40% of the anterior and posterior ethmoid and maxillary sinuses. Concha bullosa increased the CT opacification of the paranasal sinuses, except for the sphenoid sinus. There was no significant association between the occurrence of concha bullosa and nasal septal deviation. Our results suggest anatomical variations in the nasal cavity induce mucosal inflammation in the paranasal sinuses

Low-grade Myofibroblastic Sarcoma at the Base of the Tongue

Low-grade myofibroblastic sarcoma (LGMS) represents a distinct atypical myofibroblastic tumor that occurs at several sites, primarily within the head and neck regions. A painless, enlarged mass is the most common clinical presentation, but a definitive diagnosis requires both histopathological and immunohistochemical analyses. Histologically, LGMS commonly presents as a cellular lesion composed of spindle-shaped tumor cells arranged primarily in fascicles with a diffusely infiltrative pattern. Immunohistochemically, LGMS shows positive staining for at least one myogenic marker, such as desmin or muscle actin. Here we report a case of LGMS in the base of the tongue. Our case showed positive immunostaining for desmin and vimentin, and was thus diagnosed as LGMS. The patient received surgery, but no chemotherapy or radiotherapy, and was completely without evidence of the disease 38 months after the surgery

Determination of In-vivo Glenohumeral Translation during Loaded and Unloaded Arm Elevation

An understanding of normal joint kinematics is essential to develop treatments that restore normal joint mechanics; however, reports of kinematics during dynamic motion are rare. This study thus investigated glenohumeral (GH) translation in vivo during loaded and unloaded shoulder abduction. Nine healthy shoulders were studied from our patient cohort (average age, 31 years). We created 3D models of the scapula and humerus using computed tomography (CT) images and recorded fluoroscopic images during active abduction in neutral rotation in the plane of the scapula using a hand-held 3kg weight or no additional load. 3D motions were determined using model-based 3D-to-2D registration. Glenohumeral translation was determined by finding the location on the humeral head with the smallest separation from the plane of the glenoid. The humerus moved an average of 2 mm during arm abduction, from inferior to the center of the glenoid. There were no statistically significant differences between the unloaded and loaded conditions. Variability in humeral translation decreased with abduction using both 3-kg and 0-kg conditions, with significantly lower variability showing above a 70° GH abduction. We showed that humeral translation to the center of the glenoid maximizes joint congruency for optimal shoulder function and joint longevity. This data should lead to better strategies for shoulder injury prevention, enhanced rehabilitation, and improved surgical treatments

Immunohistochemical Analysis of Various Salivary Gland Carcinomas Focusing on the Possibility of Molecular-targeted and Hormonal Therapy

This study aimed to determine the expression of c-kit, human epidermal growth factor receptor type 2 (HER2), insulin-like growth factor receptor (IGFR), estrogen receptor (ER), progesterone receptor (PgR), vascular endothelial growth factor (VEGF), c-MET, and survivin in adenoid cystic carcinomas (ACC), carcinomas ex pleomorphic adenomas (CXPA), and mucoepidermoid carcinomas (MEC) of the salivary glands. These expression levels and locations were compared to estimate the availability of molecular and hormonal targets for therapy in salivary gland carcinomas. Forty patients with a salivary gland carcinoma, diagnosed and treated at our hospital, were studied. On the basis of histopathology, 13, 12, and 15 patients were diagnosed with ACC, CXPA, and MEC, respectively. Associations between histological types were evaluated by Fisher\u27s exact test, with a significance level of P < 0.05. Compared with the other two histological types, ACC samples demonstrated significantly higher c-kit (85%), IGFR (77%), and ER (38%) expression, while CXPA demonstrated significant HER2 (75%) staining, and MEC demonstrated significant IGFR (77%) staining. The differences in expression of the tested markers among the histological types in our study suggested that c-kit- and IGFR-targeted therapy and anti-estrogen treatment could be effective in ACC, HER2-targeted therapy could be effective in CXPA, and that IGFR-target therapy could be effective in MEC of the salivary glands