[Show abstract][Hide abstract] ABSTRACT: Patients receiving oral bisphosphonates (BP) are at risk for developing bisphosphonate-related osteonecrosis of the jaw (BRONJ), but to a much lesser degree than those treated with intravenous BP. Patients treated with oral BP were reported to have less extensive and / or refractory BRONJ. However, the risk of BRONJ associated with oral BP is reported to increase when the duration of therapy exceeds 3 years.We performed 208 extractions in 99 patients who received oral BP for more than 3 years, and their postoperative course was evaluated retrospectively. These subjects were all female (average age, 72 years). BP was orally administered to 73 patients with osteoporosis, 13 with RA, 3 with SLE, and 10 with other diseases. The mean duration of oral BP exposure was 60 months (median 54 months). Treatment with oral BP was discontinued in 83 patients. There were 24 patients receiving steroids, 13 receiving immunosuppressants, and 14 with diabetes mellitus.Six patients had delayed healing with bone exposure in sockets 4 weeks after tooth extraction ; furthermore, BRONJ developed in 2 other patients (2%). In these 8 patients, we studied the relations between delayed healing and various clinical factors such as age, the type, duration, and holidays of BP, risk factors, steroids, immunosuppressants, steroids plus immunosuppressants, anti-inflammatory treatment before extraction, site and type of extraction, and closure of the extraction socket. Discontinuation of BP, steroids plus immunosuppressants, and type of extraction were significant independent risk factors for delayed healing.
Preview · Article · Jan 2014 · Nippon Koku Geka Gakkai zasshi
[Show abstract][Hide abstract] ABSTRACT: We describe a large ameloblastic carcinoma of the mandible with multiple pulmonary metastases. The patient was a 62-year-old woman. In March 1994, she underwent enucleation of a tumor in the anterior part of the mandible at another hospital. The histopathological diagnosis was a typical ameloblastoma. She was lost to followup soon after the operation. In March 2008, she was referred to Hokkaido University Hospital. She had a large hemorrhagic tumor, which projected outside of the mouth. Chest radiography revealed many nodular opacities in both lung fields. In May 2008, we performed a segmental mandibulectomy to improve her quality of life. The histological diagnosis was an ameloblastic carcinoma-secondary type, intraosseous. There has been no sign of tumor recurrence for 2 years postoperatively.
No preview · Article · Jan 2012 · Nippon Koku Geka Gakkai zasshi
[Show abstract][Hide abstract] ABSTRACT: Patients with an oral squamous cell carcinoma (OSCC) often develop multiple malignant lesions. This report examined whether individual tumours developed in a patient show the same genetic alteration, such as p53 mutations. This case study describes three SCCs and three leukoplakias which developed simultaneously in a single 67-year-old Japanese man. A p53 mutation was detected in two of the three SCCs and one of the three leukoplakias. One SCC had a missense mutation at codon 285 (GAG>AAG, Glu>Lys) and the other a nonsense mutation at codon 336, and the leukoplakia had a missense mutation at codon 273 (CGT>CAT, Arg>His). This case showed that individual oral tumours may have different genetic changes even when they develop in a single patient. Therefore, this report provided strong evidence that in cases of multiple tumours it is necessary to design tailor-made therapies for each individual tumour rather than a single standardised therapy for all multiple tumours.
Full-text · Article · Nov 2010 · Anticancer research
[Show abstract][Hide abstract] ABSTRACT: We report a case of severe trismus due to cicatrical changes in the left temporal region after treatment for liposarcoma. A 51-year-old woman was referred to our hospital because of severe trismus. Mouth opening range was only 8 mm.Computed tomography and magnetic resonance imaging showed no findings of temporomandibular ankylosis. Decreased signal intensity around the left coronoid process was seen on magnetic resonance images. A diagnosis of severe trismus due to cicatrical changes around the left coronoid process was strongly suggested, and coronoidectomy was performed. At operation, the mouth could be opened up to 45mm. A mouth opening range of 40mm has been maintained by the mouth opening training after operation.
[Show abstract][Hide abstract] ABSTRACT: We describe procedures for arthrocentesis based on arthroscopic findings and report the therapeutic usefulness of these procedures in 46 patients with closed lock of the temporomandibular joint.Arthroscopic examination was done under local anesthesia in the outpatient clinic. An 18-gauge needle and a trocar for a 0.8-mm rod-lens fiberscope were inserted into the anterior and posterior compartments of the upper joint space, respectively. The anterior compartment was then observed with special respect to the presence of adhesion. In joints without adhesion, irrigation was done under low hydraulic pressure. In joints with adhesion, irrigation was performed under sufficient hydraulic pressure (maximum pressure exerted, 40 KPa) to widen the upper joint space. Manipulation was performed after irrigation.Eight weeks after these two procedures, the range of maximum mouth opening increased from 2 to 20 mm and averaged 10.3 mm in 18 patients without adhesion. In 28 patients with adhesion, the increase in maximum mouth opening ranged 3 to 25 mm and averaged 9.1 mm. There was no significant difference in the increase in maximum mouth opening between these two groups.
[Show abstract][Hide abstract] ABSTRACT: Leukocyte adhesion molecules expressed on the lymphatic endothelium in human small intestine and submandibular lymph node were studied immunohistochemically. Lymphatic capillaries in the lamina propria, mucosal muscle layer, and submucosal connective tissue of the intestine and in the capsule of the lymph node showed strong expression of platelet-endothelial cell adhesion molecule-1 (PECAM-1). A few lymphatic capillaries that weakly expressed intercellular adhesion molecule-1 (ICAM-1) were found in the capsule of the lymph node but in the small intestine, no lymphatic capillaries expressed detectable amounts of ICAM-1. Lymphatic capillaries also did not express detectable amounts of endothelial cell-selectin in the small intestine and lymph node. When lymphocytes migrate from tissue into lymphatic capillaries, multiple adhesion molecules may not be required for the migration. PECAM-1, however, may contribute to adherence of lymphocytes to lymphatic endothelium and the expression of adhesion molecules on lymphatic endothelium may be different between tissues.
No preview · Article · Jun 1999 · Microvascular Research
[Show abstract][Hide abstract] ABSTRACT: The expression of leukocyte adhesion molecules on lymphatic vessels of the human tongue was examined using histochemical and immunohistochemical methods. Three different types of lymphatic vessels were distinguished: type I vessels expressed intercellular adhesion molecule-1 (ICAM-1), platelet-endothelial cell adhesion molecule-1 (PECAM-1), and endothelial cell-selectin (ELAM-1); type II vessels expressed ICAM-1 and PECAM-1; and type III vessels expressed PECAM-1 only. The lymphatic vessels located very close to the oral epithelium (lymphatic capillaries) and the other lymphatic vessels near the oral epithelium were type I. The lymphatic vessels in the submucosal connective tissue (collecting lymphatic vessels) were type II and type III. The results suggest that there may be functional differences in the lymphatic endothelium, where lymphatic capillaries are more active than collecting lymphatic vessels in lymphocyte migration from tissue into the lymphatic vessels.
[Show abstract][Hide abstract] ABSTRACT: The existence of lymphatic vessels in dental pulp has been a matter of continuing controversy because of the difficulty of discriminating them in ordinary stained tissue sections. Recently, we have succeeded in establishing a new identification method for lymphatic vessels in human frozen sections by using a commercial monoclonal antibody specific for the human thoracic duct and anti-human laminin antiserum. The present study aimed to examine the lymphatic vessels in human dental pulp using the new immunostaining method, and compared the results with those in human small intestine. The study clearly demonstrated the distribution of lymphatic vessels in human dental pulp. Large lymphatic vessels are located in the central part of the pulp and there are small lymphatic vessels in the periphery of the pulp. This suggests that lymphatic drainage of the human dental pulp starts from the periphery of the pulp and collects in the central part of the pulp. A notable difference between the small intestine and dental pulp was found in the immunoreactivity of lymphatic vessels to anti-human laminin anti-serum. In small intestine, immunoreactivity was significantly weaker than that of the blood vessels, whereas in dental pulp, that of lymphatic vessels was almost the same as blood vessels, except for some lymphatic vessels showing very weak reactivity. These findings suggest that the development of the basement membrane in both the lymphatic and blood vessels of human dental pulp is not as marked as in other tissue.
[Show abstract][Hide abstract] ABSTRACT: The main objective of this study was to compare the actual distribution and thickness of aponeuroses in cadavers with the distribution and thickness as determined by means of magnetic resonance imaging for the sake of evaluating magnetic resonance imaging as a diagnostic modality for assessing masseter muscle aponeuroses.
The aponeuroses of 26 masseter muscles from 13 intact cadavers were examined by magnetic resonance imaging.
The ratio of concordance between gross findings and magnetic resonance imaging findings was 99.0%, although depiction of thin parts of the aponeuroses on magnetic resonance imaging was poor.
Magnetic resonance imaging was useful as a diagnostic modality in the assessment of masseter muscle aponeuroses. Aponeuroses were distributed throughout almost the entire masseter muscle, although almost no aponeuroses were seen below the lower half of the anterior margin. This was thought to be a characteristic finding of masseter aponeuroses.
No preview · Article · Oct 1998 · Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology
[Show abstract][Hide abstract] ABSTRACT: The expression of adhesion molecules on the lymphatic endothelium of human small intestine and submandibular lymph node was studied immunohistochemically with the antibodies for selectin family and Ig superfamily members. In both small intestine and submandibular lymph node, lymphatic endothelium did not express intercellular adhesion molecule-1 and endothelial cell-selectin but expressed platelet-endothelial cell adhesion molecule-1 (PECAM-1). Though lymphatic vessels may not have a positive function in leukocyte rolling and adhesion, lymphatic endothelium may interact with leukocytes, with PECAM-1 playing a role.
[Show abstract][Hide abstract] ABSTRACT: We analyzed 44 cases of secondary cervical lymph node metastasis in patients with squamous cell carcinoma of the oral cavity and lip from 1974 through 1993. Secondary cervical lymph node metastases were found in 16.3% of N O cases. Metastasis was histologically confirmed at 47 sites. The average number of lymph node metastases was 2.2/site, and the pathological spread of metastatic nodes (level M or more) was found at 20 sites (42.6%). Extracapsular spread was seen at 22 sites (46.8%). Of the 47 sites of metastasis, 39 (83.0%) were controlled, and the overall 5-year survival rate was 61.7%.