Background: Tumor-infiltrating lymphocytes (TILs) have been used to predict the prognosis of solid tumors. In this study, we investigated which molecules in TILs play a role in the prognosis of patients with oral squamous cell carcinoma (OSCC). Methods: In a retrospective case-control study, we immunohistochemically evaluated the expression of CD3, CD8, CD45RO, Granzyme B, and the major histocompatibility complex class I chain-related molecule A (MICA) of the histocompatibility complex as predictors of prognosis in 33 patients with OSCC. The patients were classified as TILs^High or TILs^Low according to the number of TILs for each molecule in the central tumor (CT) and invasive margin (IM). Furthermore, MICA expression scores were determined based on the intensity of the staining. Results: CD45RO⁺/TIL in the nonrecurrent group were significantly higher than those in the recurrent group in the CT and IM areas (p < 0.05). The disease-free survival/overall survival rate of the CD45RO⁺/TILs^Low group in the CT and IM areas and the Granzyme B⁺/TILs^Low group in the IM area was significantly lower than that of the CD45RO⁺/TILs^High group and the Granzyme B⁺/TILs^High group, respectively (p < 0.05). Furthermore, the MICA expression score of tumors around the CD45RO⁺/TILs^High group was significantly higher than that of the CD45RO⁺/TILs^Low group (p < 0.05). Conclusions: A high ratio of CD45RO-expressing TILs was associated with a disease-free/overall survival improvement in OSCC patients. Furthermore, the number of TILs that express CD45RO was associated with the expression of MICA in tumors. These results suggest that CD45RO-expressing TILs are useful biomarkers for OSCC.

Suture granuloma is a benign tumor that develops because of the presence of surgical suture materials. It commonly occurs several years after different types of surgeries. Here we report a case involving a 64-year-old man who underwent head and neck surgery for oral squamous cell carcinoma and developed multiple suture granulomas mimicking tumor recurrence in the radiation field just a few days after the completion of adjuvant chemoradiation therapy. The patient underwent surgery for lymph node metastasis in the neck at 6 months after the resection of primary oral squamous cell carcinoma. Fifteen days after the completion of adjuvant chemoradiation therapy at a total dose of 50 Gy, small nodules appeared in the radiation field, along the areas of the subcutaneous surgical sutures. Cancer recurrence was initially suspected, but histopathological analysis of a biopsy specimen confirmed foreign body granuloma. Chemoradiation therapy may enhance the immunoreaction of macrophages in the radiation field and promote the formation of granulation tissue in a short period of time. In addition, cisplatin, which was concurrently administered with radiation in our case, could have influenced the development of the suture granuloma. In addition to tumor recurrence, suture granulomas should be considered a differential diagnosis for nodules occurring after surgery, even if they develop in the field of radiation.

Background: Early-stage tongue cancer has a good prognosis in general; however, high-risk patients with late cervical lymph node and distant metastases have a poor prognosis. Elective neck dissection and postoperative chemoradiotherapy are considered for these patients, although no clear criteria have been identified for their evaluation. Methods: This retrospective observational study aimed to determine the predictive factors for late cervical lymph node and distant metastases in 102 patients with cT1-2N0 tongue cancer. The data regarding the demographic characteristics, as well as the depth of invasion, tumor budding, histological grade, and tumor–stromal ratio, among other things, were extracted from medical records. Results: We found that the potential lymph node metastasis rate was 27.5%. The significant clinical predictors of late cervical lymph node metastasis were the tumor thickness and endophytic growth pattern and the significant histopathological factors were poorly and moderately differentiated tumors and ≥3 tumor buds. In addition, the prognostic factors for distant metastasis included ≥4 lymph node metastases, ≥7 tumor budding, and moderate and poor tumor differentiation. Conclusions: The usefulness of tumor budding as a predictor of metastasis for tongue cancer was suggested. The findings of this study can help establish the criteria for evaluating the metastasis risk and prognosis of patients with tongue cancers.

Malocclusion and morphological abnormalities of the jawbone often affect the stomatognathic function and long-term postoperative stability in patients with jaw deformities. There are few reports on the effect of maximum tongue pressure (MTP) in these patients. We investigated the relationship between the MTP and jawbone morphology and the effect of the MTP on surgery in 42 patients with jaw deformity who underwent surgical orthodontic treatment at Hiroshima University Hospital. The MTP was measured using a tongue pressure measurement device; the average value was considered as the MTP. Based on the MTP measured before surgery, patients were classified into the high- or the low-MTP group. The clinical findings and results of the cephalometric analysis were compared. Posterior movement of the mandible in the high-MTP group was significantly lower than that in the low-MTP group. The ANB angle, overjet, and overbite in the high-MTP group were significantly smaller than those in the low-MTP group. On the other hand, there was no difference between the two groups in the measured values, indicating a labial inclination of the anterior teeth (U1 to SN, U1 to FH, IMPA, and FMIA). MTP has been suggested to affect mandibular prognathism in patients with jaw deformities.

One of the causes of ventilator-associated pneumonia (VAP) is aspiration of oropharyngeal fluid containing pathogenic microorganisms into the lower respiratory tract. In this study, we aimed to investigate whether antibiotic ointment applied to the oral cavity can reduce the number of bacteria in the fluid on the cuff of a tracheal cannula. Tetracycline ointment was applied intraorally once to a patient under endotracheal intubation by postoperative tracheostomy for oral cancer. The tetracycline concentrations in the oropharyngeal fluid and fluid on the cuff of tracheal cannula were determined by bioassay, and the total viable bacterial count was determined by delayed real-time polymerase chain reaction developed by the authors from before to 6 h after application. A total of seven patients were enrolled. Very high antibiotic concentrations were maintained, ranging from 481 μg/ml to 2060 μg/ml in oropharyngeal fluid and from 267 μg/ml to 858 μg/ml in fluid on the cuff from 1 h to 6 h after application. Compared to the pre-application results, the inhibition rates of viable bacteria were 80.0–97.7% for oropharyngeal fluid and 47.6%–91.9% for fluid on the cuff at 1–6 h after application, indicating that antibiotic ointment can inhibit bacteria entering the lower respiratory tract for a long period of time in intubated patients. Oral application of antibiotic ointment reduced the number of bacteria entering the lower respiratory tract, suggesting that it may be useful in the prevention or treatment of VAP.

This paper introduces a grid-purlin system, which was composed of secondary rectangular-hollow-section grids welded onto the top flange of I-shaped beams of moment frames. The welded grid-purlin itself may play a role of a lateral bracing member for the welded beam. However, the ultimate strength, plastic rotation capacity, or other structural characteristics of this grid-purlin system remain poorly understood. This paper presents two full-scale cyclic loading tests on specimens with I-shaped beams 700 mm deep, 240 mm wide, and 13 m long. The diagonal length of grids in the square grid-purlin of the specimen was 1.3 m on-center, and two different depths of the sections were selected for the purlin sections. Both specimens successfully achieved fully plastic moments at a plastic rotation exceeding 0.04 rad. This shows that the grid-purlin system provides reliable lateral bracing. Continuum finite-element (CFE) analysis was performed to simulate the hysteretic experimental response of the grid-purlin system. This CFE model was used to examine the plastic rotation capacity for a variety of combinations of I-shaped beams and grid-purlins.