Oral cancer accounts for an estimated 650,000 new cases annually with a high mortality rate of approx. 50%. Oral cancer is typically treated with a combination of surgery, radiation and chemotherapy, but patients suffer from high recurrence rates due to delayed detection and invasiveness of the disease. Surgical standards require surgeons to resect a margin of healthy tissue surrounding cancerous tissue in order to reduce the rate of recurrence. Frozen section (FS) analysis is a common intraoperative technique for examination of surgical margins, but is limited in its sensitivity of detecting positive margins of resected tissue (especially in deep margins where most positive sites originate). Elastic Scattering Spectroscopy (ESS) is a fiber optic based backscattering optical technique which utilizes a small source detector separation allowing for examination of subcellular changes in tissue. In addition, ESS is a point measurement technique making it impossible to take a grid of coordinated measurements over a tissue surface. ESS has been used extensively for the classification of cancerous tissue in vivo, but current instrumentation limits the physical and financial availability of ESS devices across various clinical studies. The goal of this thesis is the design and implementation of a low cost, portable and modular ESS device that allows for scanning across an area of tissue for the quantification and assessment of deep margins of resected oral cancer samples. A low-cost ESS device has been developed and validated for use across various clinical studies which utilize ESS. A scanning module has been developed to allow for imaging of resected tissue over an area of 1cm2 with a pixel resolution down to 100 μm. This system will be utilized in a clinical study to assess deep margins of resected oral cancer tissue to test the feasibility for using ESS as an adjunct for FS.

Background: Oral cancer, the largest subset of head and neck cancer, has become one of the most lethal malignancies during the last two decades. Although several diagnostic tools have been applied for the early detection of oral malignancies, it is still urgent to identify novel tumor markers. In this study, we explored the cell surface N-glycomes of primary cultured human oral keratinocytes (HOK), immortalized human gingival keratinocytes (SG cells), and oral squamous cell carcinoma (OC2). Methods: Enzymatically hydrolyzed cell surface N-glycans were analyzed by MALDI-TOF mass spectrometry. Results: High levels of fucosylated N-glycans, especially core-fucosylated N-glycans, were observed on the OC2 cell surface whereas the major N-glycans on SG and HOK cells were high mannose type. In addition, the mRNA expression level of fucosyltransferase 8 was elevated significantly in OC2 cells than in SG and HOK cells. Core-fucosylated glycoproteins of OC2 cells were then purified with lectin affinity chromatography and a key adhesion molecule in cancer cells, CD147, was identified. Finally, overexpression of cell surface CD147 was confirmed on OC2 cells and oral cancer tissues (tissue array). Conclusions: CD147 was discovered by glycoproteomic approaches and suggested to be a potential novel tumor marker for oral cancer diagnosis.

Background: Oral cancer, the largest subset of head and neck cancer, has become one of the most lethal malignancies during the last two decades. Although several diagnostic tools have been applied for the early detection of oral malignancies, it is still urgent to identify novel tumor markers. In this study, we explored the cell surface N-glycomes of primary cultured human oral keratinocytes (HOK), immortalized human gingival keratinocytes (SG cells), and oral squamous cell carcinoma (OC2). Methods: Enzymatically hydrolyzed cell surface N-glycans were analyzed by MALDI-TOF mass spectrometry. Results: High levels of fucosylated N-glycans, especially core-fucosylated N-glycans, were observed on the OC2 cell surface whereas the major N-glycans on SG and HOK cells were high mannose type. In addition, the mRNA expression level of fucosyltransferase 8 was elevated significantly in OC2 cells than in SG and HOK cells. Core-fucosylated glycoproteins of OC2 cells were then purified with lectin affinity chromatography and a key adhesion molecule in cancer cells, CD147, was identified. Finally, overexpression of cell surface CD147 was confirmed on OC2 cells and oral cancer tissues (tissue array). Conclusions: CD147 was discovered by glycoproteomic approaches and suggested to be a potential novel tumor marker for oral cancer diagnosis.

Background and objective Dexmedetomidine is characterized with effects of sedation, analgesia, amnesia and lack of respiratory depression. Hence, it should be suitable for awake fibreoptic intubation (AFOI). Methods We enrolled 30 oral cancer patients with limited mouth openings who were undergoing AFOI for elective surgery. Patients were randomly allocated into two groups; the Dex group (nU16) that received dexmedetomidine (1.0mgkg-1) infusion and the Control group (nU14) that received fentanyl (1.0mgkg-1) infusion. Main outcomes were evaluated by grading scores presenting conditions for nasal intubation and postintubation. Other analysed parameters included airway obstruction, haemodynamic changes, consumption time for intubation, amnesia level and satisfaction. Results Intubation score (1-5) representing condition for nasal intubation was significantly better in the Dex group [2(1-3)] than in the Control group [3(2-5)] (PU0.001). Postintubation score (1-3) representing tolerance to intubation also showed more favourable results in the Dex group[1(1-3)] than intheControl group[2(2-3)] (PU0.002). The Dex group showed significantly reduced haemodynamic response to intubation than the Control group. Incidence requiring temporary haemodynamic support was higher in the Dex group but not of significance. Both levels of amnesia and satisfaction score were significant in the Dex group. Other analysed parameters such as consumption time for intubation, airway obstruction score and postoperative adverse events did not differ significantly. Conclusion Combination of dexmedetomidine loading with topical anaesthesia provides significant benefit for AFOI in intubation condition, patient tolerance, haemodynamic response, amnesia and satisfaction. Dexmedetomidine is effective for AFOI in anticipated difficult airway with only minor and temporary haemodynamic adverse effects.

Syftet med denna litteraturstudie var att belysa sväljningssvårigheter hos patienter som genomgått kirurgisk behandling på grund av munhålecancer genom att undersöka vad som bidrar till sväljningssvårigheter, hur patienterna upplever sväljningen samt hur vårdpersonalen kan hjälpa dessa patienter. Studien baserades på 12 vetenskapliga artiklar som söktes fram i databaserna PubMed och Cinahl. Resultatet indelades utifrån vilket metodologiskt tillvägagångssätt som använts i studierna, videofluoroskopi respektive frågeformulär. Förekomst och resektion av tumör i orofarynx, särskilt tungbasen, gav större sväljningsdysfunktion jämfört med orala tumörer i flera av videofluoroskopistudierna. När frågeformulär användes för att undersöka patienternas självupplevda sväljning sågs att strålbehandling var en viktig negativ faktor för sväljningen. I flera av studierna sågs att större resektionstorlek/tumörstorlek eller ett avancerat sjukdomsstadie hade negativ inverkan på sväljningen. Aspekter av munfunktionen rankades som mest betydande av 12 viktiga funktioner i en studie, med sväljningen på fjärde plats. I en studie som undersökt livskvalitet relaterad till sväljningssvårigheter var ”tid för ätande”, ”problem att tugga”, ”problem med mat som fastnar i munnen” de faktorer som gav lägst livskvalitet. Vid sökning efter studier som kunde svara på vilka åtgärder omvårdnadspersonal kan tillämpa för att hjälpa munhålecanceropererade patienter med sväljningssvårigheter framkom ingen relevant studie. / The aim of this literature review was to illuminate swallowing difficulties in oral and oropharyngeal cancer patients treated with surgery by studying which factors contribute to swallowing difficulties, how these patients experience their swallowing and how nursing staff can assist them. The study was based on 12 research articles. The literature search was performed in the PubMed and Cinahl databases. The result was subdevided on the basis of the methods used in the studies, videofluoroscopy and questionnaires. The presence and resection of tumours of the oropharynx, in particular of the base of the tongue, resulted in more severe swallowing dysfunction compared to tumours of the oral cavity in several of the videofluoroscopic studies. Self-assessment questionnaires showed that radiation therapy had a mayor negative effect on swallowing. In several studies large tumours/resections and an advanced stage had a negative impact on swallowing. In one study aspects of mouth function was ranked to be the most important of 12 important issues, swallowing coming in fourth place. One study that evaluated quality of life related to swallowing after surgery, found that the main factors effecting the quality of life were “eating duration”, “problems chewing” and “food sticking in your mouth”. In the search for studies answering the question of what actions nursing staff can apply in caring of oral and oropharyngeal cancer patients with swallowing difficulties after surgery no relevant study was found.

No description available.

Purposes/Aims: The purpose of this study is to examine the role of self-transcendence along with illness perception and selected demographic factors in the experience of depression in Taiwanese men who have oral cancer. There are three main research questions: 1) What are the relationships among the following variables: demographic variables (age, education level, marital status, income, and work class), illness perception, self-transcendence, and depression? 2) How does self-transcendence relate to depression–directly or as a mediator between illness perception and depression? 3) What set of variables best explain the variance in depression? Significance and Conceptual Framework Oral cancer is the fourth leading cause of cancer deaths among men in Taiwan since 2003. Depression is common in oral cancer patients and is associated with poor quality of life and negative health outcomes, such as morbidity and mortality. Illness perception is the person’s understanding of his/her health threat based upon previous experiences and how perceptions affect an individual’s coping. Self-transcendence is an inner resource of which research evidence suggests that it promotes well-being and decreases level of depression in the context of significant life-altering health events. It is proposed then that during the crisis of diagnosis and treatment of oral cancer, self-transcendence may be an independent contributor to well-being, or function as a mediator in alleviating depression. Method: This is a cross-sectional, descriptive design. A convenience sample of men who have a confirmed diagnosis of oral cancer was recruited from the department of Oral and Maxillofacial Surgery and Oncology, which is located at two medical centers in the same county in Taiwan. The inclusion criteria are male, ages 18 or older, ability to communicate in Mandarin or Taiwanese, and agreeing to participate in this study. Participants completed a Demographic and Health Related Questionnaire, a Chinese version of the Self- Transcendence Scale, Chinese versions of the Revised Illness Perception Questionnaire, and a Chinese version of Beck’s Depression Inventory. Data analysis included use of descriptive statistics, correlation coefficients, and multiple regression. Results and Implications The results of this study support a clinical focus on facilitating self-transcendence to improve healing outcomes during this stressful event. Obtaining information about the role of self-transcendence in Taiwanese men with oral cancer may be particularly helpful in designing interventions or support programs to prevent or minimize depressive symptoms. Self-transcendence practices may help mediate the impact of negative illness perceptions on the emotional distress of men with oral cancer. Continued research and evaluation of practice applications of the theory will contribute to nursing knowledge concerning the relationships of illness perception, self-transcendence and demographic and health-related factors in depression among Taiwanese men with oral cancer.

Previous research in our laboratory found that inhibiting expression of vimentin, a marker of epithelial-to mesenchymal transition, inhibited cell growth and motility in vitro and in vivo. Tumors derived from vimentin knockdown cells showed features of epithelial redifferentiation and increased expression of differentiation-specific keratins. It is unknown what causes re-expression of keratins when vimentin is inhibited. Although, canonical Wnt signaling may activate NF-κB and repress of keratin and/or induce vimentin expression through β-catenin. We hypothesize that downregulation of differentiation-specific keratins contributes to tumor progression, mediated directly or indirectly by expression of vimentin. Vimentin-negative HN4 cells were transfected with plasmids encoding wild-type, PKCε-phosphomimetic, or unphosphorylatable versions of vimentin. Expression of vimentin was confirmed by western blot and immunofluorescence. Effects on cell growth and motility were determined using MTT, cell proliferation, and wound-closure assays. These results indicate that mutation of vimentin PKCε-phosphorylation sites cause changes in proliferation and filament assembly. Treatment of cells with an NF-κB inhibitor or 5-Aza-C, which allows re-expression of the Wnt inhibitor DKK3, led to a decrease in proliferation. These results suggest that inhibiting Wnt signaling removes the inhibition on GSK-3β and prevents activation of NF-κB, which decreases proliferation.

Objetivo. Investigar o papel da dieta no câncer oral. Métodos. Este estudo utilizou dados do Município de São Paulo obtidos em um estudo multicêntrico tipo caso-controle de base hospitalar. Participaram 845 indivíduos (366 casos incidentes de câncer oral e 469 controles). Os dados de consumo alimentar foram obtidos por um questionário de freqüência alimentar (QFA). Verificou-se o risco associado ao consumo de alimentos e de grupos de alimentos definidos a priori e a posteriori, por análise fatorial, estes últimos denominados \"fatores\". O primeiro fator, rotulado como \"prudente\", caracterizou-se pelo consumo de vegetais, frutas, queijo e carne de aves. O segundo, \"tradicional\", pelo consumo de arroz e massas, feijão e carne; o terceiro fator, pelo consumo de pão, manteiga, embutidos, queijos, doces e sobremesas. O último fator, \"monótono\", associou-se negativamente ao consumo de frutas, vegetais e alimentos lácteos. Após categorização dos fatores dietéticos em tercis, foram estimados os valores da Razão de Chances e Intervalos de Confiança de 95 por cento por regressão logística múltipla não condicional. Resultados. Verificaram-se associações inversas para o consumo mais elevado de feijão e vegetais crus e para o tercil intermediário de arroz e massas; e diretas para o consumo de ovos, batata e leite. O padrão tradicional associou-se inversamente ao câncer oral, e o monótono positivamente. Nossos dados sugerem que a dieta tradicional do brasileiro, composta por arroz e feijão, além do consumo de frutas, vegetais e quantidades moderadas de carnes, pode conferir proteção para o câncer oral, independente de fatores de risco reconhecidos, como o fumo e o consumo alcoólico. / Objective: to identify dietary factors related with oral cancer in the city of São Paulo, Brazil. Methods: this study is part of a Latin American multicentre hospital based case-control. Participated 366 incident cases of oral cancer in Sao Paulo City, and 469 controls, frequency matched with cases by sex and age. The dietary data was collected by a food frequency questionnaire (FFQ). The risk associated to the intake of food and food groups, defined a priori and a posteriori, through factor analysis (so-called factors) was analyzed. The first factor, labeled \"prudent\', was characterized for the intake of vegetables, fruits, cheese and poultry. The second, \"traditional\', for the intake of rice, pasta, pulses and meat, while the third, named \"snacks\" was characterized for the intake of bread, butter, salami, cheese, cakes and desserts. The last, \"monotonous\", was associated inversely with the intake of fruits, vegetables and most of the others food items. After categorization of the food items and the scores of the factors into tertiles, the Odds Ratio and 95 per cent Confidence lnterval were calculated by unconditional multiple logistic regression. Results: The intake of rice, beans and raw vegetables was associated with lower risk, whereas eggs, potatoes and milk were associated with increased risk. The traditional pattern was inversely related with the oral cancer, while the monotonous was positively associated. Conclusions: Our data suggest that the Brazilian traditional habit of eating meals composed by rice and beans, plus moderated quantities of meat, may conter protection against the oral cancer, independent of other risk factors, as alcohol and tobacco consumption.

RESUMO O objetivo deste estudo foi avaliar o conhecimento de cirurgiões dentistas inscritos em cursos de estética quanto aos fatores predisponentes e de diagnóstico do câncer bucal, a partir de um questionário previamente testado. O desenvolvimento de materiais e técnicas odontológicas e o anseio cada vez maior do ser humano em busca da beleza têm levado um número crescente de pacientes aos consultórios odontológicos. Julgamos este momento oportuno para informar a população e diagnosticar precocemente o câncer de boca. Com relação às características gerais dos 465 participantes, houve predominância de uma população jovem, com idade inferior a 39 anos, maior participação feminina e quase 1/3 formados de 10 a 20 anos. As características clínicas da ocorrência desta neoplasia não estão claras para os entrevistados, uma vez que somente metade indicou o carcinoma espinocelular como o tipo mais comum, e aproximadamente metade tem conhecimento das características do linfonodo em metástase cervical. Cerca de 20% desconhece a região da boca e a faixa etária de maior ocorrência deste tumor, e também o seu aspecto inicial. Entretanto, 75,7% reconhecem a leucoplasia como a condição mais comumente associada ao câncer bucal. Com relação aos fatores de risco, o consumo de tabaco, história familiar e consumo de álcool estão claros para quase todos os participantes, mas, em se tratando das demais condições apresentadas como fatores de risco, as dúvidas e contradições estão evidentes. Na prática clínica relacionada ao câncer de boca, observa-se que 14,2% não realizam exames para identificar lesões bucais, sendo que, destes, 80,3% não sabem como fazê-lo. Apenas 5,8% realizam procedimentos de diagnóstico, com a grande maioria considerando regular ou insuficiente seu conhecimento na área. Somente 16,6% têm confiança para realizar o diagnóstico. Mais da metade está há mais de 5 anos sem realizar um curso de atualização em câncer de boca, apesar de terem interesse em faze-lo no futuro. Concluindo, os cirurgiões dentistas ainda não apresentam conhecimento e treinamentos ideais para difundir os meios de prevenção e detecção precoce do câncer de boca. / ABSTRACT The purpose of this paper is assessing the knowledge of dentists who are registered at aesthetics courses as for predisposing and diagnosis factors of oral cancer, through a previously tested questionnaire. The development of odontological materials and techniques allied to a longing of a human being who is more and more in search of beauty, has taken an increasing number of patients to odontoligical consultation rooms. We consider this an opportune moment to inform the population and to do the early diagnosis of oral cancer. On what concerns the general characteristics of the 465 participants, there was a predominance of a young population, whose age was under 39 years, more female participation and almost 1/3 who had been graduated for 10 to 20 years. The clinical characteristics of this neoplasia occurrence are not clear for the persons interviewed, since only half of them have indicated the spinocellular carcinoma as the most common one and approximately half of them are aware of the lymph node characteristics in cervical metastasis. Around 20%, ignores the region of the mouth and the age group where this tumor occurs more frequently, and also its initial aspect. Notwithstanding, 75,7% recognizes the leucoplasia as the condition more frequently associated with oral cancer. On what concerns risk factors, the use of tobacco, family history and alcohol intake are clear for almost all the participants, but on what refers to the other conditions presented as risk factors, the doubts and contradictions are evident. On the clinical practice related to oral cancer, it is observed that 14,2% don’t do examinations for identifying buccal lesions, and among these ones, 80,3% don’t know how to do it. Only 5,8% does diagnosis procedures, and the great majority considers their knowledge in the area, regular or insufficient. Only 16,6% has enough confidence to do the diagnosis. In spite of being interested in doing courses in the future, more than half of them have not taken any upgrading course on oral cancer for more than 5 years. Concluding, the dentists still don’t present ideal knowledge and training to diffuse the means for prevention and early detection of mouth cancer.