[Evaluation of cryosurgery for the management of oral malignant mucomembranous melanoma-A survey of 107 cases reports]

OBJECTIVE:There were 13 cases underwent operation.24 cases underwent cryosurgery only and 70 cases received comprehensive management,which as cryosurgery,operation,chemotherapy and immuno-therapy.RESULTS:The 3'and 5' year survival rate of three groups were 0.0%,0.0%,37.50%,31.25% and 57.14%,36.07%.There are significant differences between operation group and cryosurgery group and between operation group and comprehensive treatment group.Although the third group got the better result,but the difference between late two groups was not statistical significant.CONCLUSION:It is suggested that comprehensive treatment be the routine regime of melanoma in head and neck. Our experience with review of literature covered the classification, surgical principle and complication was presented.

[Experimental study of radiosensitization of buthionine sulffoximine (BSO) on Acc-2 transplanted tumor]

OBJECTIVE:The effect of radiosensitization of BSO on Acc-2 transplanted tumor was studied in vivo.METHODS: There were four groups in this experiment:control group,radiation group and BSO+radiation group.The drug dose of BSO is 5mmol/kg and the radiation dose was 10Gy. RESULTS:The result demonstrated that the tumor inhibitive rate was 8.5%,12.6% and 45.37% respectively compared with control group. CONCLUSION: BSO has radiosensitizative effect on Acc-2 transplanted tumor.

Skin necrosis due to photodynamic action of benzoporphyrin depends on circulating rather than tissue drug levels: implications for control of photodynamic therapy

In an ideal world, photodynamic therapy (PDT) of abnormal tissue would reliably spare the surrounding normal tissue. Normal tissue responses set the limits for light and drug dosimetry. The threshold fluence for necrosis (TFN) was measured in normal skin following intravenous infusion with a photosensitizer, benzoporphyrin derivative monoacid ring A (BPD-MA) Verteporin as a function of drug dose (0.25-2.0 mg/kg), wavelength of irradiation (458 and 690 nm) and time interval (0-5 h) between drug administration and irradiation. The BPD-MA levels were measured in plasma and skin tissue to elucidate the relationship between TFN, drug kinetics and biodistribution. The PDT response of normal skin was highly reproducible. The TFN for 458 and 690 nm wavelengths was nearly identical and the estimated quantum efficiency for skin response was equal at these two wavelengths. Skin phototoxicity, quantified in terms of 1/TFN, closely correlated with the plasma pharmacokinetics rather than the tissue pharmacokinetics and was quadratically dependent on the plasma drug concentration regardless of the administered drug dose or time interval between drug and light exposure. This study strongly suggests that noninvasive measurements of the circulating drug level at the time of light treatment will be important for setting optimal light dosimetry for PDT with liposomal BPD-MA, a vascular photosensitizer.

[Clinical study of benign cementoblastoma: A report of 32 cases]

This paper reported 32 cases of benign cementoblastoma and studied both clinical and radiographic features and also discussed their treatment.It was found that cementoblastoma was occurred more often than it was being described at past.The main site of tumor involvement is retromolar area of the jaw with common symptom of pain and swelling.In sciagram,the mass was more linked with teeth roots and periodontium,there is compact radiolucency in peripheral part.The tumor's image was seen often as a single,lower radiolucency area.We suggest a regime of curettage and tooth extraction to get a good therapeutic result.

Predictive dosimetry for threshold phototoxicity in photodynamic therapy on normal skin: red wavelengths produce more extensive damage than blue at equal threshold doses

The goal of this investigation was to establish methodology to determine and prevent phototoxic responses of normal skin to photodynamic therapy (PDT). The drug used was a second-generation photosensitizer, benzoporphyrin derivative monoacid ring A (BPD-MA). The dependence of skin phototoxicity on drug dose (0.5-2.0 mg/kg), fluence (1.2-390 J/cm2), and wavelength (690 nm and 458 nm) was studied in the New Zealand albino rabbit in the first 5 h after injection. Skin responses were recorded for 2 wk after irradiation. Noninvasive measurements of drug fluorescence were made on unexposed skin sites during the first 5 h after drug injection. Immediate responses to PDT included erythema induced by 458 nm light and blanching induced by 690 nm light. Delayed reactions included edema on the day of exposure, purpura at 24 h, eschar by day 2 or 3, and scar by the end of follow-up. The threshold fluence for immediate responses correlated strongly with the threshold fluence for delayed reactions. The induction of threshold purpura on day 1 was a reliable index for skin phototoxicity that led to necrosis. The minimum purpura dose on day 1 after irradiation increased exponentially with the interval between drug injection and irradiation, independent of irradiation wavelength, for all drug doses. The action spectrum for threshold purpura mimics closely the absorption spectrum of BPD-MA. The in vivo drug fluorescence correlated with skin phototoxicity, thus allowing predictive dosimetry. This model system defines the safety limits for skin phototoxicity of PDT with BPD-MA.

Picosecond grating spectroscopy for characterizing the acoustic properties of biological material

We present measurements of the ultrasound attenuation and sound velocity of a number of liquids, transparent biological materials (the vitreous and lens of the bovine eye), and biological fluids (whole blood) at frequencies between 925 and 1020 MHz by using a picosecond thermal grating. Sound velocity and attenuation measurements of liquids (e.g., methanol and ethanol) agree very well with those reported in the literature. The sound velocity in the biological materials studied also agrees with the reported values in the literature. In contrast, the attenuation coefficients measured for biological materials, 2000-5000 dB/cm, are much higher than would be extrapolated from published low-frequency data.

[The management of the treatment and diagnosis for the calcifying odontogenic cyst]

18 Patients with calcifying odontogenic cyst underwent surgery in our Department from 1977 to 1993 were reported.8 male and 10 female aged from 11 to 52 with medium or 33 years were included.16 cases were pathologically confirmed as primary intraosseous cyst(central),and 2 as extraosseous cyst(peripheral).There was no recurrence after the local excision for preripheral calcifying odontogenic cyst and local curettage for central one.There were 3 in 6 cases of tumor typed cyst who had recurred postoperatively,two of them had recurred repeatedly and cured by means of local radiotherapy.The authors recommend that the tumor type of intraosseous calcifying odontogenic cyst be classified as a border-line tumor and treated as well as the principles of low malignant tumor.Post-operative radiotherapy could be used for recurrent cases.

[A randomized clinical trial for the evaluation of head and neck squamous cell carcinoma treating with traditional Chinese medicine]

This paper described the research design,research process and statistical analysis of randomized clinical trial by treatment with traditional Chinese medicine in patients with squamous cell carcinoma of the head and neck.At first we found there was no significant difference between treating group and contral group(P>0.05) using log-rank test on Kaplan-Meier survival curves. With further multivariate analysis Cox model and after adjusting for sex,age,legth of taking the assigned medication,grade of tumor differentiation and using of chemotherapy,the rate of tumor-related death for control group was significantly higher than that for treating group :hazards ratio estimate was 1.939(95% confidence interval 1.008-3.729,(P<0.05).The length of taking Chinese medicine was one of the most important prognostic factors(P<0.001).The results suggest that the prescribed medication contributed to the improved survival,and it was an independent prognostic factor.

[Effect of Chinese traditional prescription "Shen Yang" on the immune function of oral squamous cells carcinoma patients.]

This report tries to compare the immunologic function of being take the Chinese medicine "Fu-Fang Shen Yang" or placebo C which is based on randomized clinical trials after operation for 238 cases of oral squamous cancer.DNCB test is for observable index.The results as follows:DNCB position rate of 1 "Shen Yang" group is significantly increased to compare with the placebo C group,after 3m(P<0.01) 6m (P<0.001).Two groups are significantly increased after one year.This suggestion that "Fu-Fang Shen Yang" can enhance immunologic function after operation fro oral squamous cells carcinoma patients.

[The Chinese traditional treatment with "ShengYang" prescription as a post-operative auxiliary method using on the oral squamous cells carcinoma patients.]

This paper observed the clinic investigation.Which prove the relationship among the Chinese dialectical fur condition pulse condition,dialectical divided into types and survival time,immunity function before and after therapy,which will provide scientific basis and new train of thinking for recovery of stomatological carcinoma patient following operation.These patients according to dialectical type.were divided into type of feeble kidney and type of mixed excess and deficiency syndrome that the survive time compare with control group through treat by statistics,were P<0.05.The positive cases of immunity response of administration group were more increased than control group, the rate was 22.2%,maintenance and decrease rate were 7.5% and 14.6% compare with control group,with multiple factor computer analysis in two groups.There is some evidence that the traditional Chinese prescription of "ShengYang" treat in tumor patients with the type of feeble kidney and type of mixed excess an deficiency syndrome were remarkably regulate the immunity function and promote the action of anti tumor.For recovery therapy after tumor operation which reach a fairly action.

[The evaluation of panoramic sialography applied in the diagnosis of parotid tumas]

Panoramic sialography is a new method applied in the diagnosis of parotid tumors.we have examined 33 cases of parotid tumors by this way and: 1.In sialograms of benign tumors,we discovered obvious filling-deficiency areas and moving position of ducts as well as margins of mass. 2. We also found interrupted branches of duct and transudation of contrast medium in sialograms of malignant tumor,in addition, the region of tumor could be depicted. 3.Thus,panoramic sialography has its distinctive advantages in nature of parotid tumors according to variations of ducts and globs with parotid gland.

[Evaluation of effect of the surgical therapy for the oral and maxillofacial arteriovenous malformations.]

Since 1986,the diagnosis and treatment of 23 patients with oral and maxillofacial malformations have been prospectively studied.We have put forward a planned managing programme including the selective external carotid arterograph,accessory preoperatively arterial embolization,radical resection of lesion and immediate reconstruction of defect after primary resection for oral and maxillofacial arteriovenous malformations.We have got a satisfactory clinical effect.All these patients were followed up.The longest follow-up time was 6 years and 10 months.The average follow-up time was 4 years and 3 months.The rate of recurrence was only 4.3%(1/23).In this paper,we compared the different effect between the accessory arterial embolization and the arterial ligation.The result of comparing between two methods was that the arterial embolzation was superior to the arterial ligation.

[The diagnosis value of malignant tumors in the Oral and Maxillofacial region using healthy person's free radical of hair]

Electron spin Resonance(ESR) was used to determine the free radical of hair from 324 cases.These cases included 185 healthy persons,33 benign tumor patients,84 malignant cases and 22 oral mucosa disease cases.The determined results were controlled with pathologic diagnosis to analyse the accordance. The result showed the positive rates of above mentioned cases were 5.9%,6.1%,84.52%and 9.1% respectively.The significant differences were observed when comparing the results of malignant cases with healthy person and benign tumor cases with healthy person and benign tumor cases(P<0.01).The ESR saturation power points of some malignant cases rose to above border-line(>10.0mW) after treatment.These results indicated using ESR to diagnosis early malignant cases and follow treatment effect possess certain clinical value.

[The measurement of EMG and deglutition pressure after glossal reconstruction]

Newly designed computer system (SAMP-EMG) was utilized,to measure the myoelectric signal in each region of the 100ms integral values and do the power spectral analysis in 10 normal people and 20 patients.At the same time,the pressure of deglutition was determined with the liquid pressure conducting electronic device.The results were :1.In normal EMG,the myoelectric power in anterior tongue is the highest,that in the margin of the tongue is the second,that in dorsum central area is the lowerest;2.There in no effective myoelectric signal detected in any kind flap;3.Normal swallowing pressure is 21.1+/-5.7kPa,the average value of FA is 10.3kPa,PM is 10.8,GC is 14.6.

[A contour and mineral content comparison of vascularized and non-vascularized bone grafts]

This study made a comparison between vascularized bone graft (VBG) and non-vascularized bone graft (NVBG) in mandible of canine by using electron computer to assess the contour of grafted bone and measuring the mineral contents. On the 3rd, 5 th, 7 th, 15 th postoperative day, the contour of VBG and NVBG were similar and all of them kept the original contour. On the 30 th,60th,90th,180th postoperative day, VBG remained the original contour, but the contour of NVBG became thicker obviously than that of VBG for the remained cortical bone(most of which was resorbed) were enveloped with a lot of new bone. The kind of resorption of NVBG cortical bone in our study was characterized by extensive resorption on the surface just like nibbling of silkworm, unlike "tunnel" described in the literatures. There were no statistically differences between mineral contents of VBG and that of NVBG.

[A preliminary study of BCG adjuvant therapy in oral and maxillofacial malignant melanoma.]

Malignant melanoma is a kind of tumor with higher malignant and lower therapeutic effect.it is demonstrated by experiment that melanoma cells have antigenicity and refer to immunology.BCG is a kind of biologic response modifier(BRM).it is able to promote physical antitumor ability.There were 42 patients with oral and maxillofacial malignant melanoma who received freezing therapy and surgery in this paper.11 cases of them added BCG immunotherapy.The result is that the median survival time of therapy plus BCG group is 4 years,and 3 years,5 years,7 years survival rate are 89%,72% and 32%,over 8 years survival rate is 18%.The median survival time of another group is 2 years,and 3 years,5 years,7 years survival rate are 55%,24% and 12%,over 8 years survival rate is 3%.There is a statistically significant difference between these two groups and BCG group has a longer survival time.This preliminary study demonstrated that BCG adjuvant therapy could decrease recurrence of metastases and increase patients survival time.

[Clinical assessment of rehabilitation after radical surgery of tongue cancer.]

It is same important to consider both patient's own evaluation and the clinical examination.It is helpful to judge the state of the functional rehabilitation. We have followed up 128 cases of tongue cancer postoperatively,recieved 104 letters and checked up 87 patients in the clinic.It has been discovered:1.the female patients paid more attention to the speech and apperance,while the male to the eating;2.on the donor site of flaps,some patients complained of the numbness in the fingers and the obvious scars in the forearm flap,while the fracilis myocutaneous flap is a relatively good method;3.in the cases of 1/2 anterior glossal defect,the forearm flap is available;to that more than 2/3 defect of the tongue,we used the myocutaneous flaps which have great volume of tissue;4.it is necessary to concern the mobility of the essential factors effecting the functional rehabilitation.

[A study of absorbed x-ray doses and protection to critical organs of the head and neck during siaglography]

A tissue equivalent phantom was used in the study and absored x-ray doses.It measuring for some important organs of head and neck by four routive sialography methods (panoramic conventional x-ray radioagraphy,tomography,fluoroscope,CT) and also the X-ray absorbed doses of thyroid and len when lead containing loop and spectacles of head containing glass were used for prevention.All the data were processed statistically and a compartive study of absorbed x-ray doses of four sialography methods:Doses of submandibular gland were higher in CT,tomography and fluoroscope among them,CT was the highest indicating that it was superior to other methods for accurately locating that it was superior to other methods for accurately locating the within-gland tumor.Fluoroscope will be use more frequently in clinic,because it can observe the living gland panoramic and normal radiography can be used routinely because they had the minimum doses in measured organs.2.The absorbed x-ray doses of len and thyroid decreased by 93%-% when prevention was taken in CT or fluoroscope,65%-85% doses was decreased in normal radiography or panoramic with prevention.

[Reconstruction of large performated maxillofacial defect with immediated revascularized flap]

Patients with large perforated maxillofacial defects resulting from combined craniomaxillofacial resection or extended extra cranio-maxillofacial resection due to malignances in this region had been reconstructed with large revascularized myocutaneous flap or combined pedicled myocutaneous flap with revascularized flap.Since January,1981,a total of 29 flaps was used,of which 28 flaps survived successfuly,whereas one free forearm flap being failed to survive due to venous embolization was replaced with pedicled forehead flap.The results in postoperative appearance and rehabilitation of physiological function were relatively satisfactory.Finally,selection of flap and method of reconstruction were introduced and experiences on immediate reconstruction after malignance resection reported.