Transplantation of dedifferentiated fat cells combined with a biodegradable type I collagen-recombinant peptide scaffold for critical-size bone defects in rats.

Tissue engineering is a promising approach to supplement existing treatment strategies for craniofacial bone regeneration. In this study, a type I collagen scaffold made from a recombinant peptide (RCP) with an Arg-Gly-Asp motif was developed, and its effect on regeneration in critical-size mandibular bone defects was evaluated. Additionally, the combined effect of the scaffold and lipid-free dedifferentiated fat (DFAT) cells was assessed. Briefly, DFAT cells were separated from mature adipocytes by using a ceiling culture technique based on buoyancy. A 3 cm × 4 cm critical-size bone defect was created in the rat mandible, and regeneration was evaluated by using RCP with DFAT cells. Then, cultured DFAT cells and adipose-derived stem cells (ASCs) were seeded onto RCP scaffolds (DFAT/RCP and ASC/RCP) and implanted into the bone defects. Micro-computed tomography imaging at 8 weeks after implantation showed significantly greater bone regeneration in the DFAT/RCP group than in the ASC/RCP and RCP-alone groups. Similarly, histological analysis showed significantly greater bone width in the DFAT/RCP group than in the ASC/RCP and RCP-alone groups. These findings suggest that DFAT/RCP is effective for bone formation in critical-size bone defects and that DFAT cells are a promising source for bone regeneration.

Ultraviolet treatment restores bioactivity of titanium mesh plate degraded by contact with medical gloves.

Titanium mesh plate (Ti mesh) used for bone augmentation inadvertently comes into contact with medical gloves during trimming and bending. We tested the hypotheses that glove contact degrades the biological capability of Ti mesh and that ultraviolet treatment (UV) can restore this capability. Three groups of Ti mesh specimens were prepared: as-received (AR), after glove contact (GC), and after glove contact followed by UV treatment. The AR and GC meshes were hydrophobic, but GC mesh was more hydrophobic. AR and GC meshes had significant amounts of surface carbon, and Si content was higher for GC mesh than for AR mesh. UV mesh was hydrophilic, and carbon and silicon content values were significantly lower in this group than in the AR and GC groups. The number, alkaline phosphatase activity, and mineralization ability of attached osteoblasts were significantly lower in the GC group than in the AR group and markedly higher in the UV group than in the AR group. In conclusion, glove contact caused chemical contamination of Ti mesh, which significantly reduced its bioactivity. UV treatment restored bioactivity in contaminated Ti mesh, which outperformed even the baseline Ti mesh.

Postoperative radiation protocol for keloids and hypertrophic scars: statistical analysis of 370 sites followed for over 18 months.

BACKGROUND: Before 2002, keloids and intractable hypertrophic scars were treated at our facility with postoperative irradiation of 15 Gy (the traditional protocol). Analysis of the therapeutic outcomes of patients treated with this protocol showed that the recurrence rates of keloids and intractable hypertrophic scars in the anterior chest wall, as well as the scapular and suprapubic regions, were statistically higher than at other sites, while the recurrence rates in earlobes were lower. Thus, we customized doses for various sites. This report describes our trial of postoperative radiation therapy. METHODS: Between January 2002 and September 2004, 109 patients with 121 keloid and intractable hypertrophic scar sites were treated with surgical excision following the new protocol: electron-beam irradiation at total doses of 10, 15, or 20 Gy, depending on the site. The recurrence rates and toxicities were historically followed in 218 patients with 249 keloid and intractable hypertrophic scar sites treated with the old protocol of surgical removal followed by irradiation at 15 Gy (without variation by site). The minimal follow-up time was 18 months. Statistical analysis was performed using Fisher exact probability test. RESULTS: Total recurrence rates were 29.3% before 2002 and 14.0% after 2003. The recurrence rate in the anterior chest wall was statistically reduced. Outcomes of earlobe did not differ between irradiation with 15 Gy or 10 Gy. CONCLUSIONS: Keloids and intractable hypertrophic scars should be treated with dose protocols customized by site. Our results suggest that keloid and intractable hypertrophic scar sites with a high risk of recurrence should be treated with 20 Gy in 4 fractions over 4 days and that earlobe should be treated with 10 Gy in 2 fractions over 2 days.

[Strategy to reduce esophageal cancer by dietary reformation].

BACKGROUND AND OBJECTIVE: From 1920 to 1940, many people were affected by esophageal carcinoma in villages in the mountains of Nara Prefecture in Japan. However, a movement for the improvement of living conditions, especially concerning food, diminished the incidence of cancer of the esophagus. Today Xinjiang in China, esophageal cancer is also one of the main causes of death. Therefore, we analyzed in Xinjiang whether the improvement of dietary habits can reduce mortality of esophageal cancer. METHODS: The mortality of esophageal cancer and related matters obtained from the Japanese Literature and Governmental Information, Xinjiang Medical School Cancer Center Hospital, and the Chinese Literature were analyzed. RESULTS: The Kazaks have a higher incidence of esophageal cancer and a lower male/female ratio than other ethnic groups and Japanese people. Kazaks eat very hot meals rapidly, and male Kazaks are more likely to drink hard liquors. In Japan, people in regions with high alcohol consumption tend to have increased mortality of esophageal cancer, but regions with high smoking rates show no correlation with esophageal cancer mortality. There were no data relevant to the incidence of esophageal cancer and alcohol consumption or smoking rates in Xinjiang. The male mortality rate in Nara Prefecture was much higher than that in other areas in the 1930s, but it decreased gradually and eventually reached national levels. The female mortality rate in Nara decreased at a sluggish pace, but retained a several-fold incidence rate until the 1980s. In 1995, women in Nara reached the national level at last. The male/female ratio was low in Nara all the time, and alcohol consumption in Nara was low, too. CONCLUSION: Recently, it has been indicated that alcohol consumption is strongly related to esophageal cancer. However, women in Xinjiang do not drink strong liquor at all. One of their causes of esophageal cancer is dietary habits, which concerns both genders. Therefore, the incidence of esophageal carcinoma could be reduced by dietary reform in Xinjiang, where women as well as the overall population have a high incidence of esophageal carcinoma.

[Effect of nedaplatin, 5-FU, and leucovorin combined with radiation therapy in unresectable esophageal carcinoma].

A 51-year-old male was assessed as having esophageal squamous cell carcinoma with trachea invasion and cervical lymph node metastasis. After one course of chemotherapy using cisplatin (CDDP), 5-fluorouracil (5-FU) and Leucovorin (LV), the patient had progressive disease (PD) of the primary lesion and metastatic lymph nodes, and a side effect of severe nausea. One course of nedaplatin, 5-FU and LV combined with radiation was performed alternatively. The effect was evaluated as a partial response (PR) of the primary lesion and metastatic lymph nodes. There were no adverse side effects such as nausea or renal dysfunction except for pancytopenia of grade 2. Increased serum levels of vascular endothelial growth factor (s-VEGF) decreased after the chemoradiotherapy and increased again during continued radiotherapy alone. More information is needed as to whether changes in s-VEGF relate to the clinical effects of the treatment.

Ultrasonographic demonstration of retropharyngeal lymph nodes: preliminary report.

The aim of this study was to describe the results of ultrasonography of upper retropharyngeal lymph node (RPN) metastasis in patients with pharyngeal carcinomas. A total of 10 patients with metastatic RPN were examined using percutaneous ultrasound (US) with 3.5-MHz probes. Primary cancer sites were the nasopharynx in two patients, the oropharynx in three and the hypopharynx in five. Metastatic RPNs lay in the level of occipital bone in five patients, C1 in nine, and C2 in five. US images were compared with previously obtained computerized tomography (CT) images based on size and depth. In all of the 10 patients, metastatic RPNs were ultrasonographically demonstrated as hypoechoic masses. Nodal sizes ranged from 1.5 cm to 3.5 cm both in CT and in US. Depths of the RPN centers were from 3.5 cm to 7.0 cm in CT, and from 3.5 cm to 6.5 cm in US. Differences of sizes and depths between CT and US were from -0.5 cm to 0.5 cm and from 0.0 cm to 1.0 cm, respectively. RPNs that are 1.5 cm or more in size can be demonstrated with percutaneous US using CT guidance. This technique should be utilized for the purpose of monitoring in a radiation therapy setting.

Breast-conserving therapy in the management of early stage breast cancer: Our experience in 103 cases.

PURPOSE: The aim of this study is to determine whether our results in breastconserving therapy of 103 patients with earlystage breast cancer are comparable to those of other facilities or not. MATERIALS AND METHODS: From January 1990 to October 1999, 103 patients with earlystage breast cancer were treated by breastconserving surgery and whole breast irradiation. All patients were of Stages I or II, and the greatest dimensions of primary tumor were less than 3 cm. The median followup time was 47 months from the completion of postoperative radiotherapy. Local, regional and distant failure rates, and survival rate were presumed using the KaplanMeyer method. RESULTS: One patient suffered from local recurrence 30 months later. She was followed by simple mastectomy and kept from further recurrence. No regional relapse occurred. Distant metastases were seen in three patients:two patients in bones, and one patient in a bone and the liver after 19, 35, and 32 months, respectively. One patient died from disseminated cancer in 41 months. Only one patient died due to intercurrent disease. Both 5year and 10year diseasefree survival rates were 94.2%, and both 5year and 10year causespecific survival rates were 98.3%. CONCLUSION: Our results were comparable to previously reported data. In this stage although the followup time was too short to define the longterm outcome, it suggested that breast conserving therapy was acceptable and effective in the management of earlystage breast cancer.