Evaluation of caspase-3 and caspase-8 deregulation in tongue squamous cell carcinoma, based on immunohistochemistry and computerised image analysis.

AIMS: To investigate the potential role of caspase-3 and caspase-8 protein expression in the biological behaviour of tongue squamous cell carcinoma. MATERIALS AND METHODS: We conducted immunohistochemical analyses of 87 specimens of primary tongue squamous cell carcinoma, using monoclonal anti-caspase-3 and anti-caspase-8 antibodies. A digital image analysis assay was also performed in order to evaluate the results. RESULTS: Reduced expression of caspase-8 and -3 proteins was observed in 30/87 (34.5 per cent) and 79/87 (90.5 per cent) cases, respectively. Cox regression analysis showed no prognostic significance for the association between overall protein expression of either marker and survival probability (p = 0.174 for caspase-3; p = 0.608 for caspase-8). Interestingly, the size of the examined tumours was strongly correlated with survival status (p = 0.024). CONCLUSIONS: Simultaneous deregulation of caspase-8 and -3 is a frequent event in tongue squamous cell carcinoma. Activation of caspase-3, which is predominantly down-regulated, may be a crucial process for induction of apoptosis and response to therapeutic strategies.

The maxillary sinus and its endodontic implications: clinical study and review.

OBJECTIVES: Endodontic infections of posterior maxillary teeth sometimes spread to the maxillary sinus, generating severe complications. The aim of this study is to present the various problems encountered during endodontic treatment of these teeth. METHODS: The files of 125 cases of odontogenic chronic maxillary sinusitis were reviewed retrospectively. RESULTS: Chronic apical periodontitis was the cause in 99 cases and traumatising endodontic treatment in 26 cases. Foreign intra-sinusal bodies were occasionally seen as a consequence of different endodontic treatments of posterior maxillary teeth. CONCLUSIONS: A knowledge of dento-antral relationships is particularly important in the prevention of sinusal accidents and complications during various therapeutic manoeuvres, which should be performed according to and depending on the regional morphology.

Ameloblastomas of the jaws: clinico-pathological review of 11 patients.

AIMS: The ameloblastoma is an uncommon benign odontogenic neoplasm of the maxillofacial region constituting less than 1% of tumours of the oral cavity. The purpose of this paper is to discuss and evaluate the surgical treatment and the outcome from a series of 11 patients with ameloblastomas. METHODS: Between the years 1995 and 2003, 11 patients (eight female and three male) aged 17-86 years (mean 52.7) suffering from ameloblastomas of the jaws were seen in our Department. RESULTS: Ten patients were treated surgically. In eight of those radical surgery was applied. Patients with maxillary tumours were subjected to hemimaxillectomy and local excision. Radical treatment with segmental resection of the mandible was performed in six patients with multilocular (solid) mandibular ameloblastomas, with immediate reconstruction of the defect. Follow-up ranged from 3 months to 7.5 years. CONCLUSION: Multilocular (solid) type of tumours should be approached with radical surgical treatment. Enucleation and rarely marsupialization can be applied selectively to unilocular ameloblastomas.

Tumours of the head and neck in the elderly: analysis of 190 patients.

Tumours of the head and neck represent approximately 5% of human neoplasms. More than 50% of the patients are above 65 years of age. During the years 1991-1996, 190 patients aged 65 or more and suffering from oro-facial neoplasms were treated in our department. They represent 48.6% of the total number of hospitalized tumour patients. One hundred and ten were male and 80 female. Benign tumours were found in 42 patients whereas 148 patients presented with malignant tumours. Of the malignant tumours, squamous cell carcinoma occurred in 103 patients and salivary gland tumours were the most frequently encountered benign tumours (12 patients). All patients with benign tumours were treated surgically. Of the 148 patients with malignant neoplasms, 116 were treated by surgery alone or in combination with radiotherapy and/or chemotherapy, and the remaining 32 with radiotherapy. Mortality from cancer was 28.1% and mortality from other causes was 5.8%. Postoperative morbidity in the benign tumour group of patients was minimal. In the malignant tumour group of patients, where the magnitude of surgical treatment was greater, there were no intraoperative or immediate postoperative deaths. Five patients died postoperatively whilst in hospital. Deaths were attributed to pre-existing medical problems. It is concluded that the age of the patient is not an important factor in determining the extent of surgical treatment in patients with tumours of the head and neck.