Background. The aim of the study was to evaluate the effectiveness of endoscopic CO 2 laser microsurgery in the management of supraglottic cancer.Methods. One hundred twenty-four patients (116 men and eight women; mean age, 59 years; range, 31 -81 years) with supraglottic cancer underwent CO 2 laser surgery (mean followup 5 years). The study patients were classified as follows: 45 patients, T1N0M0; 61 patients, T2N0M0; and 18 patients, T3N0M0. According to the staging, the following procedures were adopted: epiglottectomy, resection of aryepiglottic fold or false vocal cord in T1 patients (group A); resection of the false vocal cord and adjacent structures in T2 patients (group B); and supraglottic laryngectomy in T3 patients (group C). Statistical comparison of survival parameters was carried out with Wilcoxon test, considering p < .05 the minimum significance value.Results. Overall actuarial survival, adjusted actuarial survival, and no evidence of disease at 5 years were 91%, 97%, and 82% in group A; 88%, 94%, and 59% in group B; and 81%, 81%, and 51% in group C, respectively. The statistical analysis of survival parameters showed a significant difference in the comparison of T1 versus T2 and T2 versus T3 tumors (p < .01). Actuarial local control, actuarial nodal control, and actuarial distant metastasis control at 5 years were 82%, 82%, and 100% in T1 patients; 63%, 90%, and 98% in T2 patients; and 77%, 75%, and 93% in T3 patients. Laryngeal preservation rate was 88.6% in T1 patients, 85.4% in T2 patients, and 93.7% in T3 patients. Patients in groups A and B were discharged after 3 to 12 days, and patients in group C were discharged after 14 to 20 days.Conclusions. The results of this study show that endoscopic CO 2 laser surgery is highly effective in the treatment of T1 and T2 supraglottic cancer. In T3 cancer, the CO 2 laser should be implemented in those cases in which radical excision by endoscopic route is feasible. In 1978, Vaughan 1 first described the use of CO 2 laser in the treatment of early supraglottic cancer. In 1984, Motta et al illustrated the endoscopic surgical technique of supraglottic laryngectomy 2 and subsequently indicated the guidelines for supraglottic cancer resection with CO 2 laser, 3 which were validated and confirmed by other authors. 4 -7 The aim of this study was to evaluate the effectiveness of CO 2 laser microsurgery in the management of supraglottic cancer.

Purpose: Osteopontin is a secreted cytokine that binds to the cell surface CD44v6 receptor.We studied osteopontin and CD44v6 expression in laryngeal squamous cell carcinomas and correlated osteopontin expression levels with clinicopathologic tumor features. Experimental Design: We used immunohistochemistry, immunoblotting, and reverse transcription-PCR to study osteopontin expression in 58 laryngeal squamous cell carcinomas. Cultured squamous carcinoma cells were treated with exogenous osteopontin or with RNA interference to knockdown osteopontin expression. Results: Osteopontin expression was higher in all the invasive carcinomas than in patientmatched normal mucosa. Its expression levels were significantly correlated with tumor stage and grade and with the presence of lymph node and distant metastases. Osteopontin positivity was negatively correlated with overall survival (P = 0.03). Osteopontin expression was paralleled by intense cell surface reactivity for CD44v6. Treatment of squamous carcinoma cells with recombinant osteopontin sharply increased proliferation and Matrigel invasion in comparison with the untreated cells parallel to activation of the mitogen-activated protein kinase/extracellular signalregulated kinase kinase/mitogen-activated protein kinase signaling cascade. Osteopontin knockdown by RNA interference, anti-CD44 antibodies, and mitogen-activated protein kinase/ extracellular signal-regulated kinase kinase inhibition prevented these effects. Conclusions: These results identify osteopontin as a marker and a potential therapeutic target in cases of aggressive laryngeal squamous cell carcinomas.Head and neck squamous cell carcinoma (HNSCC) is the sixth most frequent cancer. Laryngeal squamous cell carcinoma (LSCC) is the most common HNSCC (1 -3). Notwithstanding primary prevention, screening, surgical treatment, and radiotherapy, the long-term survival rate of LSCC patients has remained substantially unchanged in the last two decades (4, 5). Stage and histologic grade are prognostic factors in LSCC but do not always distinguish between high-risk and low-risk patients (1-5). Various biological prognostic markers have been identified for LSCC and other HNSCC types: mutation in the p53 tumor suppressor gene (6), amplification of cyclin D1 (7, 8), overexpression of the epidermal growth factor receptor (9) and vascular endothelial growth factor (10), and reduced expression of the CIP/KIP cell cycle inhibitory proteins (11). However, little is known about the molecular mechanisms that govern the establishment and maintenance of the LSCC neoplastic phenotype.Osteopontin, also known as secreted phosphoprotein 1, is a highly acidic calcium-binding glycosylated phosphoprotein. It is a cytokine (early T lymphocyte antigen-1 or interleukin-28) that regulates T helper cell-1 function (12, 13). In addition, osteopontin binds to the cell surface receptors a v -or h 1 -containing integrins and CD44 (14, 15), thereby supporting chemotaxis, attachment, and migration of many epithelial cell types (16,17)...

No abstract

Increasing interactions between humans, domestic animals and wildlife may result in inter-species transmission of infectious agents. To evaluate the presence of pathogenic E. coli and Salmonella spp. and to test the antimicrobial susceptibility of isolates, rectal swabs from 36 different free-ranging wild mammals were taken from two distinct natural sites in Brazil: Cantareira State Park (CSP, state of São Paulo) and Santa Isabel do Rio Negro Region (SIRNR, state of Amazonas). The swabs were randomly collected and processed for bacterial isolation, identification, characterization and antimicrobial resistance. Eighteen E. coli strains from CSP and 20 from SIRNR were recovered from 14 and 22 individuals, respectively. Strains from animals captured in CSP, the site with the greatest anthropization, exhibited a higher range and percentage of virulence genes, including an eae+/bfpA+ strain. Antimicrobial resistance was verified in strains originating from both sites; however, in strains from SIRNR, aminopenicillins were almost the exclusive antimicrobial class to which strains exhibited resistance, whereas in CSP there were strains resistant to cephalosporins, sulfonamide, aminoglycoside, tetracycline and fluoroquinolone, in addition to strains exhibiting multidrug resistance. Two strains of Salmonella enterica that are known to be associated with reptiles, serotypes Belem and 60:r:e,n,z15, were recovered only from Amazonian animals and showed susceptibility to all classes of antimicrobials that were tested. Although the potential impact of these pathogens on wildlife remains unknown, bacteria isolated from free-ranging wild animals may provide relevant information about environmental health and should therefore be more deeply studied.

Laryngeal dysplasia is a common clinical concern. Despite major advancements, a significant number of patients with this condition progress to invasive squamous cell carcinoma. Osteopontin (OPN) is a secreted glycoprotein, whose expression is markedly elevated in several types of cancers. We explored OPN as a candidate biomarker for laryngeal dysplasia. To this aim, we examined OPN expression in 82 cases of dysplasia and in hyperplastic and normal tissue samples. OPN expression was elevated in all severe dysplasia samples, but not hyperplastic samples, with respect to matched normal mucosa. OPN expression levels correlated positively with degree of dysplasia (P ¼ 0.0094) and negatively with disease-free survival (Po0.0001). OPN expression was paralleled by cell surface reactivity for CD44v6, an OPN functional receptor. CD44v6 expression correlated negatively with disease-free survival, as well (P ¼ 0.0007). Taken as a whole, our finding identify OPN and CD44v6 as predictive markers of recurrence or aggressiveness in laryngeal intraepithelial neoplasia, and overall, point out an important signalling complex in the evolution of laryngeal dysplasia.