Distribution of Cefroxadine was examined in Oral tissue of mice by agar well method. After oral administration of Cefroxadine 200μg/g in mice, the tissue concentration reached a peak in 15 or 30 minutes. The tissues in order of concentration were the serum, mouth floor, tongue, mandibular bone·femur, and submandibular gland.
This study was performed to obtain the index for the clinical malignancy of oral cancers as well as that for the potential of malignant change in oral precancerous lesions by analysing the nuclear DNA content and nuclear area and examining the relationship of these parameters to the clinical and pathological findings. Subjects enrolled in this study were consisted of 57 cases of oral squamous cell carcinoma, 13 cases of leukoplakia, 10 cases of verrucous hyperplasia and 6 cases of normal oral mucosa. Cell samples were obtained by smear and imprint in general but isolated from thick paraffin sections of biopsy specimens in some cases as occasion demanded. The nuclear DNA content and nuclear area were simultaneously determined by Vickers M 86 scanning microdensitometer after Feulgen staining. The nuclear DNA content of epithelial cells was calculated referring that of lymphocyte as control to be 2.0 C. The results were summarized as follows: 1. The DNA histogram revealed that the normal oral mucosa had a high, distinct peak at 1.5-2.0 C. Cells over 4.0 C were not observed. The nuclear area was approximately 40μ2. 2. In the case of squamous cell carcinoma, the variations of nuclear DNA content and nuclear area became larger with the increased values of them, however, the variation by individual cases was also large. Patients with rapid progress of tumorigenesis and high degree of histological atypia had increased average values of nuclear DNA content and its variance, high frequency of cells over 4.0 C, and enhanced variance of nuclear area. In addition, patients with 2 peaks or more in the DNA histogram or those with high correlation of nuclear DNA content to nuclear area were apt to have poor prognosis. 3. The nuclear DNA content and nuclear area in cells from cases of papilloma or leukoplakia with simple hyperkeratinization were the same as normal mucosa or else increased slightly. However, the average nuclear DNA content and its variance, frequency of cells more than 4.0 C, distributions of nuclear DNA content and nuclear area in cells from suspected malignant verrucous lesion and leukoplakia accompanying carcinogenesis in part resembled to those of squamous cell carcinoma. From these findings mentioned above, determinations of the nuclear DNA content and nuclear area of cells from oral cancers and oral precancerous lesions seem to have an important significance in the evaluation of clinical malignancy and malignant potential.
A ultrasonic study was performed in 71 patients with various jaw diseases (benign and malignant tumors, cysts, fractures) using 3.5-MHz electronic scan and 5-MHz or 7.5-MHz arc scan in immersion method. The results are summarized below. Ultrasonograms can delineate not only soft tissues (skin, subcutaneous tissue, muscle tissue) but also jaw bones; however, only strong echoes from the surface can be obtained in the case of jaw. The inside of bone is delineated in jaw diseases with destructed or thinned cortical bones. These internal echoes can be classified into three types as follows. 1. Cystic pattern: Anechoic pattern 2. Solid pattern: Echoic pattern 3. Mixed pattern: Anechoic and echoic patterns Benign bone tumors and cysts in general demonstrated a bulging cortical margin distinct from the surrounding tissues. The internal echoes usually varied in cases of benign bone tumors, but those of bone cysts were of cystic pattern except for a solid pattern observed in one case due to the acoustic structure of the cyst contents. Most of malignant tumors showed a solid pattern with irregular and/ or unclear margin. When a tumor invaded the surrounding tissues, the pattern there become hypoechogenic. In the case of fracture, a displacement and separation of bone fragment was noted while the surrounding tissues showed a hypoechoic pattern with slightly well defined margin due to the degeneration of tissue. The postoperative course was objectively followed with time lapse by serial ultrasonic examination. The ultrasonic examination is a valuable additional tool, providing important informations on jaw diseases.
Sialography is an indispensable clinical examination of the salivary glands. It is however not yet elucidated enough on what kind of histopathological change in the salivary glands sialogram is based. In this study, the histopathology of submandibular gland was examined by sialogram in 25 cases of submandibular sialolithiasis. The result thus obtained is summarized as follows. Some abnormal findings were obtained in all sialograms of the duct system and glandular parenchyma. These abnormal sialograms were divided into four types according to the nature of duct and parenchyma. Dilated duct was due to the irregularity and enlargement of duct cavity. The irregularity or leakage of duct wall contour was attributable to the changes of duct epithelium. Each glandular parenchyma of the four types of abnormal sialogram previously classified was compared to the corresponding histopathological findings. Type I. The picture of glandular parenchyma was mainly consisted of maculor pattern. Histological changes of the duct and parenchyma were relatively mild. Acinus cells disappeared in some places around the duct and were replaced by lymphocytic cluster. Type II. Leakage of the glandular parenchyma was frequently observed in the surroundings of peripheral duct. Lack of the duct wall, thinning, proliferation and/ or irregularity of the duct epithelium were seen. Acinus cells extensively disappeared and were replaced by inflammatory granulation tissue in general. Type III. Leakage of the duct and parenchyma was remarkableand histopathological changes of the duct system were more severe than those of Type II. Acinus cells also extensively disappeared and were replaced by inflammatory glanulation tissue and fibrous tissue. Type IV. Lack of the glandular parenchyma was extensively observed, while acinus cells almost disappeared and were replaced by the proliferated connective tissue in principle.
The inhibitory effect of ethanol fraction in the supernatant of F. nucleatum KO-31 culture on cancer cells was examined by in vitro-in vivo method. When 4 mg/ml of ethanol fraction was given to mice previously transplanted 4.0×107 cells/ ml of Ehrlich ascites, a remarkable antitumor activity was observed with T/C (%) of 197.0% or more. Following the administration of ethanol fraction at an increased dose of 12 mg/ ml to mice bearing 4.0 ×107 cells/ ml of Sarcoma 180, an antitumor activity was also noted with T/C (%) of 154.5% or more. On the other hand, whether or not this experiment produced any cytomorphological changes was examined under light microscope. Control cells pre-cultured for 180 min were all round or elliptrical having large nucleus, distinct nucleoli, and a small number of lipid granules in cytoplasma, while a vacuolation and destruction of cells were observed in ethanol fraction treated cells in addition to the degeneration and disappearance of cell membrane and extracellular outflow of protoplasma. A direct antitumor action was demonstrated to exist in the supernatant of F. nucleatum KO-31 culture not only from the basic experiment but also from the light microscopic observation.
Key words are very useful for examining scientific articles. Because technical terms to be used in the title of these articles may be chosen as the key words with high potential, they must be used in correct and universal ways. The present study was designed to analyse technical terms used in the title of 1, 491 clinical reports which had presented in the Japanese Journal of Oral and Maxillofacial Surgery from the standpoint of information science. The resultc are summarized below. 1) The kind of technical terms used in the original form of articles reviewed counted 1, 885 in total and its frequency summed to 4, 811. 2) About 75% of these technical terms were used only once in their title of article. 3) Approximately half of the only once-used terms were possible to revise into synonyms or compound words of more frequently used terms. 4) When technical terms were classified according to the use, some characteristics were found in each group. 5) It was known that, in controlling these technical terms, much attention should be paid to less-frequently used terms, synonyms and compound words. From these results, rules in selecting key words were further discussed.
The clinical efficacy of Cefaclor (CCL), a new oral antibiotic of the Cephem group, was investigated at a daily dose of 750mg, which was administered in three equally divided doses, in 34 cases of infections in the field of dental stomatology. Attention was also paid to its possible side effects. In addition, sensitivity to and MIC of the drug were examined for bacteria isolated from suppurative foci. The following results were obtained: 1) The treated cases consisted of 25 with acute, purulent periostitis of the jaw, 4 with acute, suppurative inflammation of the floor of the mouth, 2 with abscess of the cheek, 2 with parulis, and one with dental peritonsillar abscess. CCL wasevaluated to be clinically effective in 81.8% on the 5th day and in 93.9%. 2) From suppurative foci 39 strains of 7 species of bacteria were isolated: 22 strains were α-Streptococcus, 10 Neisseria, and 7 others. The sensitivity test with 1 concentration disc demonstrated that almost all strains were strongly sensitive to CCL. 3) The MIC of CCL was determined for the bacteria isolated and identified. It was 0.39 to 6.25μg/ml for α-Streptococcus and 6.25μg/ml or lower for Neisseria. Thus, CCL was inferior to ABPC in this regard, but inhibited bacterial growth at a lower concentration than CEX. 4) The only clinical side effect seen was slight diarrhea in one case. No large differences were found between the data of the blood tests before and after CCL treatment. These results suggest that CCL is an effective and safe drug against infections in the field of dental stomatology and is an advantageous antibiotic in dental practice.
Monostotic fibrous dysplasia is a benign disease, which may appear in a single bone and is mainly consisted of fibrous changes in the bone marrow, however, the presence or absence of tumorigenesis in this disease is now more passively discussed than passed days because of problems existing in the differentiation from related bone diseases or in the method of operation. In addition, this disease is also interested because of its less occurrence in the jaw and oral regions. Recently, we experienced this disease appearing in the left mandibula and examined in detail. The result will be described below with some considerations. A 57 year-old woman came to our hospital with a main complaint of swelling in the left mandibular molar. Her face was slightly asymmetric. X-ray films showed an opaque, well defined and thumb-tip sized mass in the left mandibular osseous body. These findings first suggested an ossifying fibroma but the diagnosis of fibrous dysplasia was finally made based on the histopathological findings. The infrared spectrometric analysis revealed the chemical components to be 31% Ca3 (PO4) 2 and 69% MgNH4 PO4·6H2O. In addition, the crystal structure was analysed by X-ray diffraction, resulted in the identification of hydroxyapatite with less crystalline property.
Pemphigus vulgaris is a chronic, erosive and bullous disease of skin and mucous membranes characterized by histologic features showing acantholysis and degeneration of the epithelial cells. The authors have experienced one case of pemphigus vulgaris which accompained symptoms of formation of bullae and erosion on the palate and buccal mucosa in a 52 year-old woman, and reported on it with some comments based on the literature. This lesion was diagnosed as pemphigus vulgaris by clinical features, Nikolsky's sign, Tzanck test and histopathological examination. In the treatment, Paramethazone·8mg/ day, Pantocin·600 mg/ day and Vitamin B1 were administered. There was no lesion recurrence in the course of about 4 years.
A case of cat scratch disease (C. S. D.) in a 7-year-old girl is presented in this paper. The patient showed swelling in left cheek and submandlar area starting 1 week previously. Also, a scratch on medial angle of eye by kitten was found. Investigation including Hanger-Rose Test and histopathological examination gave a diagnosis C. S. D. The diagnotic and treatment course are discussed.
Sometimes in the treatment of the carcinoma in the oral and maxillo-facial region, cases requiring extensive lips resection are experienced. Accordingly, due consideration must be given to aesthetic and functional aspects, two important factors in reconstructive surgery following the resection. Recently, we have achieved quite satisfactory results with the nasolabial flap, one of the local dermal flaps, in postoperative reconstructive surgery for two cases of upper lip defects in the treatment of the carcinoma. The first case was 33 year-old male patient with mucoepidermoid carcinoma. The second case was a 77 year-old female patient with basal cell carcinoma.
We report on two branchiogenic cyst cases on the side of the neck. The first case was a 27 year-old male in whom the cyst developed on the upper left side of the neck. As CT, ultrasonic diagnosis and aspiration biopsy revealed nonatypical, flat eratinized cells, a diagnosis of branchiogenic cyst was made. Then the cyst was surgically excised. From histopathological findings that the inner wall was covered with stratified squamous epithelium and well-developed specific lymphatic tissue was observed in the lower layer of the epithelium, a definite diagnosis of branchogenic cyst was made. According to Bailey's classification, the cyst belonged to Type III, and the epithelial cord which extended toward the oropharynx. These findings suggested that the cyst originated from the second branchial cleft. The second case was a 52 year-old male with a cyst on the upper right side of the neck. A diagnosis of branchiogenic cyst was made by biopsy and the cyst was excised. According to Bailey's classification, it belonged to Type I. From the viewpoint of embryology, it was suspected to originate from the second branchial cleft. The embryologic mechanism, clinical findings and histopathological findings on these two cases were examined and the literatures are reviewed.
Pleomorphic adenoma is said to frequently occur in the parotid gland but in general is relatively rare in the other salivary gland. However, the site of appearance and its frequency vary in the literatures concerned and the occurrence from the small salivary gland is reported to be very high in Japan. Recently, we experienced a case of benign pleomorphic adenoma of the left submandibular gland in origin in a 44 year old woman. The patient was aware of swelling of the left submandibular gland for 5 years without any treatment but recently visited our department because of increased radiating pain. Atpalpation, an immobile, elastically hard tumor of a pigeon egg size with clearly cut off margin was felt on the left submandibular gland. After the diagnosis of salivary gland tumor, the tumor including submandibular gland was removed. On the eighth months after operation, prognosis is favorable but the course will be further observed considering possible recurrence and malignant changes.
Wathin's tumor is a comparatively rare epithelial benign tumor of the salivary glands. The tumor hasbeen known to represent 5% to 10% of all salivary gland tumors. It occurs most frequently in the region of the parotid gland. Recently, we experienced a case of Warthin's tumor. The patient, 55 year-old man, visited our clinic with the chief complaint of a painless mass below the right parotid gland. The mass was well-defined, movable, firm, resilient in consistency, and not adherent to the surrounding tissues. Clinical diagnosis was a benign tumor inferior to the right parotid gland. The tumor was surgically removed. The remo ved tumor was encapsulated by a fibrosis connective tissue. It was 20×20×25mm in size, reddish brown in color and weighed 7.2g. Microscopically, the tumor had epithelial component and lymphoid component. The epithelium consisted of cells arranged in double layers around cystic spaces. The inner layer was composed of tall columnar cells with acidophilic cytoplasm, the outer layer was composed of cuboidal cells. The stroma had lymphoid tissue which demonstrated germinal cells. As a consequence histopathologic diagnosis was Warthin's tumor. The post-operative course was uneventful and no recurrence was observed. Additionally, we discussed 154 cases of Warthin's tumor reported in our country. 136 Warthin's tumors located in the region of the parotid gland, comprised 88.3%. Bilateral lesions were found to occur in 9.1% of the 154 cases. Age distribution ranged from 6 to 82 years old, the greatest frequency was between the fifth and sixth decades. There were 127 males and 27 females, a ratio of about 5:1. The symptom duration was usually within 5 years.Most of the masses ranged from the size of the first joint of adult Japanese male thumb to the size of a chicken egg. The doctrine that the tumor of originates from heterotropic salivary gland ducts in lymph nodes has been supported by many investigators.
A submandibular phyma requiring biopsy for its differential diagnosis was reported. A twelve year-old girl came to our department with a main complaint of swelling in the right submandibular region first noticed about 3 month previously. A round phyma about 35 mm in diameter with relatively well defined margin was noted at the first examination. The phyma was mobile and elastic-soft without tenderness and adhesion to the skin. The submandibular salivary gland was slightly displaced upward in the sialogram, however, it was revealed that the lesion was not directly involved in the gland. The ultrasonic findings suggested that the lesion had a cystic character. A tentative puncture was not effective for diagnosis. The lesion was finally extracted and confirmed to be of mucocele. Thus, the clinical diagnosis of submandibular phyma seems not always easy in the absence of biopsy.
Typical Sturge-Weber syndrome of a 27 year-old female was reported. She had vascular nevus on the right side of her face, right maxillary hemangioma, epilepsy, intercranial calcification, paralysis on the left side of her extremitie 1 and glaucoma. Hemangioma on the right maxilla associated with this syndrome was treated successfully with carbon dioxide laser. The tumor was cut by focused beam and small blee ding vessels were sealed off by defocused beam. Bleeding was minimal. Postoperative healing was excellent, but left maxillary central incisor was damaged by carbon dioxide beam. We considered that vascular-rich lesions were effectively extirpated with carbon dioxidelaser. But the manipulation of the apparatus was a little difficult in molar region cases, therefore, without careful operation, surrounding tissue might be damaged.