We evaluated the safety and tolerability of ultra-long-term treatment with cevimeline hydrochloride hydrate in a retrospective study. One hundred eighteen patients with Sjögren's syndrome who had been treated with cevimeline hydrochloride hydrate for 2 years or more were followed for 5 years from the start of treatment to evaluate treatment outcomes, adverse drug reactions, saliva production, and symptom scores. At least 2 years after the start of treatment, none of the patient discontinued the treatment because of adverse drug reactions, no new adverse drug reactions have been reported, and no preexisting adverse drug reactions were aggravated. In 14 of 73 patients (19.2%) who had been treated with cevimeline hydrochloride hydrate for at least 5 years, blood biochemical abnormalities were observed, but these changes were all minor. Saliva production and symptom scores were evaluated in 66 patients followed up for 5 years after starting the treatment. Saliva production increased in the first 2 years of treatment, and thereafter became mostly stable. Symptom scores decreased in the first year and became mostly stable with slight changes. These results suggest the safety and efficacy of cevimeline hydrochloride hydrate may be maintained in a long-term treatment.

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Although experimental oral candidiasis was developed in a previously reported animal model using steroids, it was difficult to observe long-term changes because Candida spontaneously disappeared. Therefore, we attempted to induce Candida infection using cyclosporin A (CyA), which is an immuno-suppressant in mice, and observed the daily changes in oral mucosa. In this experimental trial, we administered CyA by cutaneous inoculation four times before and after infection with Candida albicans, and observed the oral cavity.
C. albicans-infected tongue was removed from sacrified mice and divided into two pieces; one of the pieces was examined for fungal infiltration and the other was examined for histopathological changes, such as hyphal invasion and epithelial thickness. Most fungi were detected on the fifth day after Candida inoculation before decreasing gradually, and most C. albicans had disappeared by the eleventh day. On histopathological investigation, hyphae and epithelial thickening were observed in the horny layer on the fifth day, and this epithelial thickening remained present on the eleventh day. In this mouse model of persistent oral candidiasis using immuno-suppressants, changes in the epithelium and fungal infiltration could be evaluated, thus suggesting the utility of this model.

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Purpose: In fluorescence visualization (FV) system, the instrument irradiates blue light and reflected fluorescence can be observed macroscopically. By a tumor and cell dysplasia, fluorescence decreases. It is expected to help early detection of cancer. We examined utility of FV for oral cancer and mucosal disease.
Subject: Patient in this study examination of oral cancer or oral mucosal disease in the Department of Oral and Maxillofacial Surgery, Tokyo Dental College Hospital from June, 2008 to August, 2009.
Results: Fluorescent degradation was noted in an inflammatory lesion. In addition, hyperkeratosis accepted strong fluorescence in excessive area. It was accepted fluorescent degradation in squamous cell carcinoma and in circumference.
Conclusions: The FV system can do examination of non-aggression. Utility to a screening test of oral cavity cancer and mucosal disease is suggested. However, skill is necessary for observation. We think that further examinations of an increase of the number of cases and the comparison with other diagnostic technics are necessary from now on.

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We recently experienced a case of plasmocytosis circumorificialis spreading to the lower gingiva, which we suspected to be a malignant tumor due to broad and diffuse swelling in the oral cavity, paresthesia of the lower lip, and trismus.
A male patient in his late thirties first visited on January 2007, diffuse and elastic soft swelling with rough surface of mucosa from lower gingiva to oropharynx. The lesion was clinically diagnosed as carcinoma or malignant lymphoma of the lower gingiva.
By biopsy, it was pathologically diagnosed as plasmacytosis. The lesion was disappeared 2 months after anti-inflammatory treatment.

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The patient was a 45-year-old woman with a large epulis osteoplastica at the dental bridge ((5)4(3)|). Epulis osteoplastica is a rare form of epulis. Usually, the treatment of a large epulis involves the extraction of teeth and surgical excision of the tumor. We avoided tooth extraction and the mass was excised down to the granulation tissue by curetting the alveolar bone. The excised specimen measured 32 × 31 × 24 mm (buccal epulis) and 28 × 20 × 12 mm (platal epulis). The epulis caused periodontitis, which was clinically treated after the operation. Herein, we report that the tooth can be preserved for 1 year 5 months after surgery without recurrence.

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PFAPA syndrome is characterized by periodic fever, aphthous stomatitis, pharyngitis and adenitis in young children. We report a case diagnosed as PFAPA. A 13-year-old girl presented with fever, aphthous stomatitis many times. The diagnosis of PFAPA was made on the basis of history-taking, clinical findings and laboratory examinations. A bisbenzylisoquinoline alkaloid agent, cepharanthine, was found to be effective for the treatment of this patient.

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