No abstract

Key words: HPV; viral physical status; squamous cell carcinoma of the head and neckThe etiology of squamous cell carcinoma of the head and neck (HNSCC) is considered to be multifactorial. In addition to wellknown risk factors such as tobacco and alcohol, 1 human papillomaviruses (HPVs) may play an etiologic role in a subset of the head and neck cancers. 2 Particularly HPV-16 infection may be a risk factor for oropharyngeal HNSCC. 3 Integration of high-risk HPV DNA into the human cellular genome is considered an important step in malignant transformation. 4,5 Viral DNA integration often leads to disruption of the HPV-16 E2 gene, 6 which in an intact genome controls the expression of E6 and E7 oncogenes, resulting in increased expression of these oncogenes. 4,7 Application of a real-time PCR technique in determination of HPV-16 viral physical status has been recently evaluated. 8,9 It is based on the assumptions that 1) in integrated viral DNA, the E2 gene is disrupted; 2) episomal viral DNA has equivalent copy numbers of the E2 and the E6 genes; however, deleted forms, including E2 deletion, of episomal HPV DNA, although not very common, have been observed in the tonsillar carcinoma; 10 and 3) mixed forms have smaller copy numbers of the E2 than the E6 genes. 8 The aims of our study were to determine the prevalence, genotypes, and physical status of HPV DNA in HNSCC samples at diagnosis and to correlate these findings with clinical outcome. Moreover, we wanted to find out whether cutaneous HPV types play a role in head and neck carcinogenesis. PATIENTS, MATERIAL AND METHODS PatientsWe assessed HNSCC patients treated at Helsinki University Central Hospital during the years 1993 to 2002 whose fresh-frozen samples were available and obtained at diagnosis. These patients (n ϭ 61; 11 females, mean age 63.7 years, range 57-91; 50 males, mean age 59.6, range 40 -85) whose tumor biopsies contained at least 40% of neoplastic cells were included in the study. Clinical data concerning TNM classification, treatment of the primary tumor and the neck and overall survival at the end of follow-up were collected on data sheets from case records. Of these 61 patients, 2 were excluded from survival analysis because their samples had been taken after the defined endpoint for survival analysis. The mean follow-up time of the patients was 24.5 months (range 1.4 -89.6 months). Specimens and DNA extractionBiopsies from primary tumors were taken at diagnosis and stored immediately at Ϫ70°C. 50 -100 m thick cryo-sections, containing a minimum of 40% (typically 60 -70%) neoplastic cells, as examined by toluidine blue staining at both ends of the section, served for DNA extraction (QIAGEN GmbH, Hilden, Germany). Distilled H 2 O and human embryonic skin (HES) fibroblasts served as negative controls. DNA was stored at Ϫ20°C until PCR analysis. HPV PCR and genotypingThe prevalence of HPV DNA was analyzed with a broadspectrum SPF10 PCR and a microtiterplate-based probe hybridization assay as described earlier. 11 Amplicons from HPV-positive sam...

A retrospective study was undertaken to assess causes of maxillofacial fractures in Helsinki in 1981 and 1997. Hospital records of 725 patients were analyzed according to several factors including age, sex, cause of fracture and time of the injury. The time intervals between the accident and hospital examination were also evaluated. Number of maxillofacial fractures was 318 in 1981 and 407 in 1997 (27.9% increase) and most patients were men. The male to female ratio was 2.8:1 in 1981, 3:1 in 1997. In 1981, most affected patients were in the age group of 31-40 years (33.2% of men, 28.9% of women). Sixteen years later the most affected age group was 41-50 years (23.3% of men, 30.4% of women). Assault was the cause of the injury in 42% of patients followed by traffic accidents (26%) and fall (17%). During the study period violence had become more severe in nature. Kicking as the cause of maxillofacial fracture increased by 7.3% and use of a weapon by 5.7% between the years studied. Bicycle accidents increased by 19.3% but motor vehicle accidents decreased by 31.6% between the years. Falls, and bicycle and pedestrian accidents were the causes that accounted for most of the increase in maxillofacial fracture. In 1997, maxillofacial fractures were slightly more common from June to August and from Friday to Sunday than at other times (45.2 and 50%, respectively).

If you would like to write for this, or any other Emerald publication, then please use our Emerald for Authors service information about how to choose which publication to write for and submission guidelines are available for all. Please visit www.emeraldinsight.com/authors for more information. About Emerald www.emeraldinsight.comEmerald is a global publisher linking research and practice to the benefit of society. The company manages a portfolio of more than 290 journals and over 2,350 books and book series volumes, as well as providing an extensive range of online products and additional customer resources and services.Emerald is both COUNTER 4 and TRANSFER compliant. The organization is a partner of the Committee on Publication Ethics (COPE) and also works with Portico and the LOCKSS initiative for digital archive preservation. AbstractPurpose -The purpose of this paper is to develop a workflow for 3D modeling and additive manufacturing (AM) of patient-specific medical implants. The comprehensive workflow consists of four steps: medical imaging; 3D modelling; additive manufacturing; and clinical application. Implants are used to reconstruct bone damage or defects caused by trauma or disease. Traditionally, implants have been manually bent and shaped, either preoperatively or intraoperatively, with the help of anatomic solid models. The proposed workflow obviates the manual procedure and may result in more accurate and cost-effective implants. Design/methodology/approach -A patient-specific implant was digitally designed to reconstruct a facial bone defect. Several test pieces were additive manufactured from stainless steel and titanium by direct metal laser sintering (DMLS) technology. An additive manufactured titanium EOS Titanium Ti64 ELI reconstruction plate was successfully implanted onto the patient's injured orbital wall. Findings -This method enables exact fitting of implants to surrounding tissues. Creating implants before surgery improves accuracy, may reduce operation time and decrease patient morbidity, hence improving quality of surgery. By using AM methods it is possible to manufacture a volumetric net structure, which also allows cells and tissues to grow through it to and from surrounding tissues. The net is created from surface and its thickness and hole size are adjustable. The implant can be designed so that its mass is low and therefore sensitivity to hot and cold temperatures is reduced. Originality/value -The paper describes a novel technique to create patient-specific reconstruction implants for facial bony defects.

No abstract