Protocol for a multicentre, prospective observational study of elective neck dissection for clinically node-negative oral tongue squamous cell carcinoma (END-TC study)

Introduction: In early-stage oral tongue squamous cell carcinoma (OTSCC), elective neck dissection (END) is recommended when occult lymph node metastasis is suspected; however, there is no unanimous consensus on the risks and benefits of END in such cases. The management of clinically node-negative (cN0) OTSCC remains controversial. This study, therefore, aimed to evaluate the efficacy of END and its impact on the quality of life (QoL) of patients with cN0 OTSCC. Methods and analysis: This is a prospective, multicentre, nonrandomised observational study. The choice of whether to perform END at the same time as resection of the primary tumour is based on institutional policy and patient preference. The primary endpoint of this study is 3-year overall survival. The secondary endpoint are 3-year disease-specific survival, 3-year relapse-free survival and the impact on patient QoL. Propensity score-matching analysis will be performed to reduce selection bias. Ethics and dissemination: This study was approved by the Clinical Research Review Board of the Nagasaki University. The protocol of this study was registered at the University Hospital Medical Information Network Clinical Trials Registry. The datasets generated during the current study will be available from the corresponding author on reasonable request. The results will be disseminated internationally, through scientific and professional conferences and in peer-reviewed medical journals

Protocol for a multicentre, prospective observational study of elective neck dissection for clinically node-negative oral tongue squamous cell carcinoma (END-TC study)

Introduction In early-stage oral tongue squamous cell carcinoma (OTSCC), elective neck dissection (END) is recommended when occult lymph node metastasis issuspected; however, there is no unanimous consensus on the risks and benefits of END in such cases. The management of clinically node-negative (cN0) OTSCCremains controversial. This study, therefore, aimed to evaluate the efficacy of END and its impact on the quality of life (QoL) of patients with cN0 OTSCC.Methods and analysis This is a prospective, multicentre, nonrandomised observational study. The choice of whether to perform END at the same time as resection of the primary tumour is based on institutional policy and patient preference. The primary endpoint of this study is 3-year overall survival. The secondary endpoints are3-year disease-specific survival, 3-year relapse-free survival and the impact on patient QoL. Propensity score-matching analysis will be performed to reduce selection bias.Ethics and dissemination This study was approved by the Clinical Research Review Board of the Nagasaki University. The protocol of this study was registered at the University Hospital Medical Information Network Clinical Trials Registry. The datasets generated during the current study will be available from the correspondingauthor on reasonable request. The results will be disseminated internationally, through scientific and professional conferences and in peer-reviewed medical journals

CsmA, a Class V Chitin Synthase with a Myosin Motor-like Domain, Is Localized through Direct Interaction with the Actin Cytoskeleton in Aspergillus nidulans

One of the essential features of fungal morphogenesis is the polarized synthesis of cell wall components such as chitin. The actin cytoskeleton provides the structural basis for cell polarity in Aspergillus nidulans, as well as in most other eukaryotes. A class V chitin synthase, CsmA, which contains a myosin motor-like domain (MMD), is conserved among most filamentous fungi. The ΔcsmA null mutant showed remarkable abnormalities with respect to cell wall integrity and the establishment of polarity. In this study, we demonstrated that CsmA tagged with 9× HA epitopes localized near actin structures at the hyphal tips and septation sites and that its MMD was able to bind to actin. Characterization of mutants bearing a point mutation or deletion in the MMD suggests that the interaction between the MMD and actin is not only necessary for the proper localization of CsmA, but also for CsmA function. Thus, the finding of a direct interaction between the chitin synthase and the actin cytoskeleton provides new insight into the mechanisms of polarized cell wall synthesis and fungal morphogenesis

Recurrent Intrathoracic Locking of the Scapula after Lung Cancer Resection and Combined Rib Resection

We report a case of recurrent locking of the scapula in the thorax after combined lobectomy and thoracic wall resection for advanced lung cancer. The patient was a 52-year-old man with advanced spindle cell carcinoma in his right lung. He had undergone right lung lobectomy and thoracic wall excision (Th1–5). Intrathoracic repair had not been performed to address the defect in the thoracic wall. Two months after the operation he experienced sudden acute pain in the right shoulder. Three-dimensional computed tomography revealed locking of the scapula intrathoracically. The diagnosis was recurrent locking of the scapula in the thorax. He underwent conservative treatment. Because his symptoms were not alleviated and he continued to experience recurrent locking, we performed partial resection of the inferior part of the scapula. Although scapular locking diminished after this procedure, there were still some pain and “catching” between the scapula and the thoracic wall (T6) when he undertook certain movements. No further surgery could be performed, however, because the cancer from the primary lesion had recurred near the previously operated thoracic wall. A procedure for recurrent intrathoracic locking of the scapula was not successful in this case

Surgical simulation for dentigerous cyst in the maxillary sinus using full-color 3D salt modeling: Report of a case

Dentigerous cysts are one type of odontogenic cyst frequently associated with impacted teeth. If a cyst is formed in the maxillary sinus by the opposing buried tooth, surgery accompanied by sinus fenestration is required. We describe a case of surgical simulation for a dentigerous cyst in the maxillary sinus using full-color 3D salt modeling. A 23-year-old woman was referred to our hospital for further examination of an impacted tooth in the left maxillary sinus. Panoramic radiography and computed tomography (CT) examinations revealed an impacted third molar tooth and a cystic lesion in the posterior wall of the maxillary sinus. A full 3D salt model was constructed based on the CT data, and surgical simulation was performed. Thereafter, the patient received cystectomy through the anterior approach and extraction of the impacted tooth in the same manner as the surgical simulation. The 3D salt model may be useful for reducing trauma in surgery for intra-maxillary sinus odontogenic cysts, and restoration of the mucosa and bony wall