日本口腔外科学会雑誌
Online ISSN : 2186-1579
Print ISSN : 0021-5163
ISSN-L : 0021-5163
35 巻, 9 号
選択された号の論文の24件中1~24を表示しています
  • 萩原 敏之, 福田 廣志, 根本 一男
    1989 年 35 巻 9 号 p. 2247-2252
    発行日: 1989/09/20
    公開日: 2011/07/25
    ジャーナル フリー
    Distributions of fibronection (Fn) in wounds produced by teeth extractions in Wistar rats were examined by immunoperoxidase labelling for Fn and the following findings were observed.
    1) Fn was found in the whole socket at 24 hours after tooth extraction.
    2) At 2-7 days after tooth extraction, Fn gradually disappeared from the outside of the socket which was replaced by fibrous tissue. In these sections, the fibroblasts invaded the central site of the socket where Fn was found.
    3) At 14 days after tooth extraction, Fn completely disappeared from the whole socket. In this section, an active new bone formation from the adjacent bone was found.
    Furthermore, we investigated the time course of rat plasma Fn level after tooth extraction. It was found that the plasma Fn level increased during the first 24 hours after tooth extraction, followed by a gradual decline from 48 hours to 7 days post-treatment.
    These findings suggest that Fn could be a useful factor in the early phase of wound healing after tooth extraction.
  • 第2報: ハムスタ-頬嚢癌形成過程における上皮細胞増殖とGGT陽性巣
    賀来 亨, 大内 知之, 中出 修, 蓑輪 泰子, 関 智香子, 阿部 英二, 菅野 秀俊, 奥山 富三, 小川 純
    1989 年 35 巻 9 号 p. 2253-2259
    発行日: 1989/09/20
    公開日: 2011/07/25
    ジャーナル フリー
    In order to investigate the relationship between GGT histochemical activity and cell proliferation during cheek pouch carcinogenesis in the hamsters, a combination of GGT histochemical and BrdU immunohistochemical analysis was performed.
    One or both cheek pouches of male golden hamsters were treated topically with 0.5% 9, 10-dimethyl-1, 2-benzanthracene (DMBA) in mineral oil over 20 weeks to produce numerous epithelial lesions at the various stages of neoplastic development. GGT histochemical activity was detected in both dysplastic and nondysplastic regions of the epithelium. GGT staining was frequently sharply demarcated from the adjacent unstained epithelium and usually extended from the basal cell layers to the superficial keratinizing layer at the early time periods of carcinogenesis. The GGT-positive areas showed the increased number and irregular distribution of BrdU-positive cells, which was not only present in the basal layer but also in 2-3 layers above it. The adjacent unstained epithelium showed a regular distribution of Brd Upositive cells limited to the basal layer. A good correlation was observed between the presence of GGT-positive areas and proliferative BrdU-positive cells, (S phase cells) during the early stage of carcinogenesis.
    Papillomas and well differentiated squamous cell carcinomas had patched GGT histochemical activity mostly in superficial keratin and dead keratinized cells. The number of BrdUpositive cells in GGT-positive areas was lower than those in the GGT-negative areas of the same papillomas. BrdU-positive cells were primarily found in the peripheral areas of the cancer nest of well differentiated squamous cell carcinomas. The cancer nest of poorly differentiated squamous cell carcinomas displayed very rarely GGT histochemical activity. BrdU positive cells were irregularly distributed throughout the cancer nest of these carcinomas. There was no correlation between GGT histochemical activity and cell proliferation in papillomas and squamous cell carcinomas during the late stage being different from that observed between GGT histochemical activity and cell proliferation in various lesions in the early stage of carcinogensis.
  • 福田 仁一, 山田 長敬, Gerd HENNING, 瀬戸 院一
    1989 年 35 巻 9 号 p. 2260-2271
    発行日: 1989/09/20
    公開日: 2011/07/25
    ジャーナル フリー
    Solcoseryl is generally known as a drug used in gastric ulcer treatment. We have investigated reossification under the influence of Solcoseryl in experimental animals in which an artificial fracture with a defined fissure width was produced.
    In this experiment, we used 40 hybrid adult dogs about 2 years old. Fracture was made between the fourth premolar of the lower right jaw and the first molar where a space of about 2 mm was opened for fixation with a plate for AO. A double blind comparison method was employed and Solcoseryl in a dose of 0.5 ml/kg was intravenously injected every day after operation. A saline solution was used as a control. The drug was administered for the postoperative periods of 1, 2, 3, 4, 5 and 6 weeks respectively. Observations were made using non-decalcified specimens doubly stained with methylene blue- basic fuchsine, and fluorescense microscopic observations were also made by labelling (Calcein blue, Xylenol orange, Calcein, Tetracycline and Alizarin complexon).
    Our conclusions are as follows:
    1. The histopathological and labelling findings in the Solcoseryl group revealed more favorable bone recovery than that in the placebo group.
    2. Differences were noted between the ossification periods in view of labelling findings.
  • 安川 和夫, 吉澤 信夫, 鈴木 政弘, 小林 千晃, 大坪 慶子, 小林 伸之, 浅野 智, 江良 謙次, 柴田 肇, 須永 芳弘, 柴田 ...
    1989 年 35 巻 9 号 p. 2272-2279
    発行日: 1989/09/20
    公開日: 2011/07/25
    ジャーナル フリー
    Flomoxef sodium (FMOX), a new oxacephem antibiotic, was preoperatively administrated by i.v. drip infusion in patients with cyst formation in the jaw. Then the concentrations of FMOX in serum, bone, cyst wall or cyst-like structure in the jaws, and its content, all collected during operation, were examined. The results were as follows.
    1. Mean concentrations of FMOX in serum, bone, cyst wall or cyst-like structure, and its content at a dose of 1g were 17.66, 3.03, 8.88, and 3.45 μg/ml.g, respectively. At a dose of 2g, those were 31.27, 6.46, 15.74 and 9.12 μg/ml.g, respectively. Mean concentrations at a dose of 2g were almost twice as high as those at a dose of 1g.
    2. Mean ratios of the antibiotic transferred into the bone, cyst wall or cyst-like structure, and its content to that in serum, were 18.39, 52.64, and 24.31%, respectively in the patients recieved 1g FMOX injection. The corresponding ratios were 20.29, 51.87, and 29.26% in those recieved 2g FMOX injection. These patients in the two dosing groups showed almost the same degree of transfer.
    3. When the degree of FMOX transfer into the cystic content was examined according to the histopathological type, it was highest in the radicular cyst, being about 3-to 4 fold these of other histological types.
  • 小川 純
    1989 年 35 巻 9 号 p. 2280-2299
    発行日: 1989/09/20
    公開日: 2011/07/25
    ジャーナル フリー
    Currently, Nd-YAG laser has been applied to the management of oral precancerous lesions, such as leukoplakia. It is not rare, however, that such lesions have ill-defined borders and there is a possibility that morphologically normal tissues adjacent to the lesions have malignant potential. The purpose of this study is to evaluate the effects of Nd-YAG laser on tissues which have malignant potential.
    Chemical carcinogen, 0.5% 9, 10 dimethyl-1, 2-benzanthracene acetone solution, was applied to the lateral borders of tongues of golden Syrian hamsters thrice weekly for 12 weeks and precancerous lesions were produced. The animals which had tumors less than 2mm in diameter on their tongues were selected for the experiment. In laser irradiation group, the lesions were excised partially by Nd-YAG laser irradiation. In blade excision group, the lesions were excised partially by biopsy forceps. In no-treatment group, the lesions were untreated. The animals in each group were sacrificed 16 weeks later and the tongues were examined histopathologically. Squamous cell carcinoma appeared in 5.0% (1/20) of the animals in no-treatment group, 28.6% (6/21) in laser irradiation group and 16.7% (4/24) in blade excision group. Histopathologically, there was a characteristic view in laser irradiation group, such as small epithelial tissues seen in the muscle layer, which had no connection with the superficial epithelium. A possibility was suggested that incomplete Nd-YAG laser irradiation on precancerous lesions promotes malignant transformation.
  • 伊東 隆利, 伊東 泰蔵, 立花 泰裕, 高木 公康, 竹田 博文, 岡田 長久, 荒木 慈子, 伊東 武嗣, 山下 佐英
    1989 年 35 巻 9 号 p. 2300-2308
    発行日: 1989/09/20
    公開日: 2011/07/25
    ジャーナル フリー
    The analysis is based on data obtained from 248 cases of oral and maxillofacial injuries treated at our hospital during the past 13 years from June 1975 to December 1988.
    1. Investigation of frequencies according to age, revealed that the two most common age groups by far were teens and twenties, accounting for 29.4% and 27.4% respectively.
    2. The ratio of male to female was 3.1 to 1.
    3. Cause of fractures was traffic accidents in most cases, accounting for 31.5%.
    4. 89.9%of patients came to hospital within 14 days after injuries.
    5. The common site of the fractures was the lower jaw in 85.2%, and combination fractures weer quite often observed on the maxilla and malar bone.
    6. Condylar fracture of the mandible accounted for 24.2%.
    7. Open reduction was applied to 60% of the cases.
    8. The period of fixation was 29-42 days in most cases.
  • 中美 俊大, 木村 博人, 鈴木 貢, 畠山 るり子, 小林 恒, 加賀谷 保, 西郷 慶悦, 小松 賢一
    1989 年 35 巻 9 号 p. 2309-2313
    発行日: 1989/09/20
    公開日: 2011/07/25
    ジャーナル フリー
    In our country, it is very rare to encounter adult patients with unoperated cleft palate. Recently, we had an opportunity to treat a 65-year-old woman with cleft palate and the postoperative course was very excellent. So far as we know in the literature this patient is the oldest unoperated case in our country. In this paper, we report the clinical course of treatment and primary plastic surgery, then discuss the problems of unoperated cleft palate patients.
  • 堀越 勝, 草間 幹夫, 岸 豊子, 宮沢 正純, 小野 富昭, 藤林 孝司, 名倉 英明, 榎本 昭二, 波利井 清紀
    1989 年 35 巻 9 号 p. 2314-2320
    発行日: 1989/09/20
    公開日: 2011/07/25
    ジャーナル フリー
    The clinical course of secondary transplanted iliac bone for reconstructive surgery of the mandible was evaluated.Secondary transplanted iliac bone after surgery of oral malignant tumor showed a satisfactory bony union by either bridge bone grafting or by elongation bone grafting and by either free bone grafting or by revascularized bone grafting.
    However, it was difficult to wear dentures on the transplanted bone because of tension of primary sutured oral mucosa.The cases with immediate reconstructive surgery of the mandible by AO plate and soft tissue by MC flap or by fore arm flap, showed some advantage for preventing facial asymmetry and for pre-prothetic surgery.
    On the other hand, limited stability of denture on the transplanted iliac bone was recognized, if there were few of resudial teeth.
    Application of osseointegrated implants for functional reconstructive surgery of the mandible may produce better results than ordinary dentures.For osseo-integrated implantation revascurarized living iliac crest grafting will be much better than non-vascurarized one because of its better nourishment.
  • 大胸筋皮弁による40症例
    大村 進, 石川 好美, 増田 元三郎, 遠藤 盛孝, 小野 繁, 藤田 浄秀
    1989 年 35 巻 9 号 p. 2321-2334
    発行日: 1989/09/20
    公開日: 2011/07/25
    ジャーナル フリー
    Forty patients who underwent transposition of pectoralis major myocutaneous flapfor the immediate reconstruction of defects after resection of head and neck cancer were reviewed. In our series, 18 patients experienced 30 complications related to flap usage. Those were 2 partial flap necrosis, 9 marginal flap necrosis, 6 suture line separations and 13 orocutaneous fistulas. Although most complications were minor and healed with local wound care, 5 orocutaneous fistulas associated with infection around the mandibular bone required removal of reconstruction plate, wire and grafted bone to achieve healing of fistulas. There were 30 patients that resulted in acceptable disability. However, 6 patients could not take peroral feedings and 4 patients could not successfully take an adequate amount of oral feedings as a result of persistent aspiration.
    There is no question that the pectoralis major myocutaneous flap has various advantages as a one-stage reconstructive technique. However, recent reports have suggested that the incidence of complications is far greater than previously considered. In our series, overall incidence (45%) was also high as described above.
    Of 40 patients, 27 received preoperative irradiation which ranged from 40 to 250 Gy and 30 patients received preoperative chemotherapy. Based on our experiences, we concluded that pathological changes of mandibular bone induced by irradiation was, at least in part, related to the postoperative infections which preceded the formation of orocutaneous fistulas.
    Recent analysis on the vascular system of the skin has revealed that there are few cutaneous branches derived from thracoacrominal artery in the chest skin. Thus, we believe this anatomical character is closely related to the high incidence of complications.
    10 patients were treated with salvage operation combined with planned perioperative irradiationand chemotherapy, It seemed likely that the immediate reconstruction with pectoralis major myocutaneous flap contributed to the development of such a combination therapy in the management of advanced head and neck cancer.
  • 野谷 健一, 山崎 裕, 水越 孝典, 戸塚 靖則, 福田 博, 進藤 正信, 安田 元昭, 飯塚 正, 雨宮 璋
    1989 年 35 巻 9 号 p. 2335-2342
    発行日: 1989/09/20
    公開日: 2011/07/25
    ジャーナル フリー
    Sixty-four-year-old male complained of the diffuse brown pigmentation of labial gingiva (3-3). The pathological diagnosis of biopsy specimen was melanosis.
    A black tuberous solid mass was found in the same site 20 months later during the follow up period. As malignant melanoma was suspected, the extirpation (partial maxillectomy) of the tumor and postoperative adjuvant immunochemotherapy (DAV, OK-432) were done.
    Six months later, metastasis was found in cervical lymph nodes. Radical neck dissection (RND) was performed and nodal involvements were pathologically recognized.
    Two years after RND, he died of pneumonia. Neither primary recurrence nor distant metastasis were observed.
  • 松富 貞男, 辻 龍雄, 早津 良和, 平山 丈二, 安山 泰春, 篠崎 文彦
    1989 年 35 巻 9 号 p. 2343-2345
    発行日: 1989/09/20
    公開日: 2011/07/25
    ジャーナル フリー
    Two patients, 67 year-old and 66 year-old males, visited our hospital because ofsudden tongue edema. Each edema seemed to be of transient. In one case, massive edema was first observed in the right half of the tongue, but next appeared in the left side. In another case, the affected site changed from the half of the tongue to the upper lip. While the etiology of Quincke's edema is not clear, these findings suggested that reversible dysfunction of vascular sympathetic nerve would be a factor influencing this etiology.
  • 本村 和弥, 山城 正宏, 岩政 輝男
    1989 年 35 巻 9 号 p. 2346-2351
    発行日: 1989/09/20
    公開日: 2011/07/25
    ジャーナル フリー
    Although odontogenic myxofibroma is generally taken as a benign, slow-glowing and nonmetastasizing mesenchymal tumor, the tumor etiology is still unknown and special attention should be paid in the treatment of this tumor because of its insidious clinical characteristics, i. e. high rate of local recurrence.
    A case of maxillary odontogenic myxofibroma that appeared in a 40-year-old female is described and the histogenesis as well as pathogeny of the lesion is discussed.
    The patient's chief complaint was a painless, slightly hard and expansive swelling of the gingiva in the left canine region of the maxilla.Radiographic examination disclosed an unilocular, well circumscribed radiolucent lesion of the maxilla and nonerupted canine. CT scanning showed a tumorous change and incisional biopsy revealed the lesion to be a myxomatous disease.
    With the patient under general anesthesia, extirpation of the tumor together with the impacted canine as well as extraction of both the central incisor and premolar on the left side of the maxilla were performed.At about 4 years postoperatively, no evidence of recurrence has appeared.
    Histopathological investigation of the tumor under light microscope revealed spindle, stellate-shaped and polyhedral cells in a fibromyxoid stroma with an occasional odontogenic epithelial island resembling an ameloblastic epithelium. No abnormal mitoses of the tumor cells were seen.
    Ultrastructurally, poorly differentiated fibroblast-like cells were noted. It is suggested that the tumor cells were derived from undifferentiated mesenchymal cells in the periodontal membrane of the impacted canine. However, it might also be possible, on the other hand, that a transformation of the fibroblast in the periodontal membrane of the impacted canine into a poorly differentiated fibroblast-like cell occurred and the transformed cell subsequently developed the odontogenic myxofibroma.
  • 安田 勝裕, 中西 淳仁, 松本 文博, 長山 勝
    1989 年 35 巻 9 号 p. 2352-2356
    発行日: 1989/09/20
    公開日: 2011/07/25
    ジャーナル フリー
    A 73-year-old female complained of pain from her right TMJ (visited our clinic) with general debility because of undernourishment. A diagnosis of TMJ arthrosis was made. Psychological factors from her past history were considered, so that occulusal and psychological therapies were given. Favorable results were obtained by the team approach of oral surgeons, prothodontists and psychiatrists.
  • 西川 英次, 寳田 博, 杵渕 孝雄, 宮澤 利明
    1989 年 35 巻 9 号 p. 2357-2363
    発行日: 1989/09/20
    公開日: 2011/07/25
    ジャーナル フリー
    A case of tuberculous lymphadenitis in the left submandibular and cervical regions is presented.
    The patient was a 25-year-old female, with a chief complaint of swelling in the left submandibular region.
    It was diagnosed clinically as tuberculous cervical lymphadenitis or malignant neoplasm.
    The extirpation of the tumor was performed under general anesthesia, because the tumor had extended rapidly.
    Histopathologic examination revealed typical tuberculous lesions in the lymphnodes and chronic sialoadenitis.
    The patient is well without recurrence 9 years after operation.
  • 古澤 栄之, 宮崎 正, 古郷 幹彦, 西尾 順太郎, 林堂 安貴, 松矢 篤三
    1989 年 35 巻 9 号 p. 2364-2366
    発行日: 1989/09/20
    公開日: 2011/07/25
    ジャーナル フリー
    A new therapy for Riga-Fede's disease is reported. It is well-known that the ulceration at the sublingual surface in infants is caused by mechanical stimulation of neonatal teeth or early eruption of anterior deciduous teeth. In many clinics tooth extraction or smo-othing incisal edge was usually performed to remove the stimulation. However, primary denti-tion and occulusion would be influenced by extraction of an anterior deciduous tooth.
    In the present case, a soft and long artificial nipple, which is generally used after cleft lip operation, was employed to modify tongue movements during feeding. This method made the tongue movement smaller, and mechanical stimulation to tongue was reduced. After two weeks the ulcer completely disappeared. This therapy seems to be of very simple, effective and conservative approach for treating Riga-Fede's disease.
  • 安井 良一, 石川 武憲, 林 綾子, 西野 宏, 前田 耕作, 深井 直樹, 下里 常弘
    1989 年 35 巻 9 号 p. 2367-2371
    発行日: 1989/09/20
    公開日: 2011/07/25
    ジャーナル フリー
    A case is reported of basal cell nevus syndrome in a 9-year-old girl, presentingmultiple jaw cysts, broad nasal base, ocular hyperterolism, incomplete osseous bridging of sella turcica and abnormal ribs. From the family investigations, it turned out that the syndrome occurred also in her mother and the mother's brother. The syndrome of these cases was familial, but chromosome aberration was not confirmed. In these three cases, common symptoms were multiple jaw cysts and abnormal rib. Such familial cases are considered rare in Japan.
  • 依田 寿幸, 神谷 祐司, 神野 洋輔, 小牧 完二, 服部 吉幸, 吉田 勝弘, 山本 信吾, 河合 幹, 内藤 宗孝
    1989 年 35 巻 9 号 p. 2372-2377
    発行日: 1989/09/20
    公開日: 2011/07/25
    ジャーナル フリー
    We investigated clinical and radiographic findings after Marsupialization for eruption of impacted tooth in dentigerous cyst of the lower premolar region in 17 children. The results were as follows.
    1. Eruption of the impacted tooth was confirmed in all cases.
    2. The impacted teeth which had a tilt over 60 degrees erupted with twist postoperatively.
    3. After marsupialization, the impacted tooth erupted faster than the normal tooth on the opposite side.
    Marsupialization of cyst is very useful for eruption of impacted teeth in children.
    Retaining the space for tooth eruption is necessary in patients whose impacted tooth locates deeply in the mandible, or occlusion is unstable.
    It is necessary to correct the impacted tooth wis much tilt in the mandible by orthodontic treatment after marsupialization.
  • 腫瘍上皮の免疫組織化学的特徴
    二宮 富久, 村瀬 範泰, 山田 和人, 東山 秀敏, 岡田 征夫, 森 昌彦
    1989 年 35 巻 9 号 p. 2378-2384
    発行日: 1989/09/20
    公開日: 2011/07/25
    ジャーナル フリー
    A case of Warthin's tumor is reported. A 62-year-old male was referred to our department with a chief complaint of a bilateral swelling in the parotid gland. He had noted bilateral nodules (benign tumor) in 1968. Thereafter, the tumor mass expanded very slowly. Superficial parotidectomy of bilateral sites was done under general anesthesia. Histopatholically, the tumor tissue was composed of epithelial cells with two layers; basal tumor cells and columnar tumor cells.
    Immunohistochemically, 11 kinds of monoclonal antibodies to keratin and S-100 α, β proteins were tested in Warthin's tumor. Keratin expressions in tumor epithelia were characte-rized by existence of three patterns: 1) immunostaining against PKK 1 and K 8.12, was positive in basal tumor cells only, 2) that against K 4.62 was found in both basal and columnar tumor cells, and 3) that against KL 1, RGE 53, K 8. 13, K8. 60, RPN 1160, RPN 1162, RPN 1164, RPN 1165 was positive only in columnar cells. S-100 α staining was positive in the tumor epithelia, whereas S-100 β slight positive or negative. Histogenesis of epithelium in Warthin's tumor was discussed with use of specific monoclonal antibodies.
  • 西村 泰一, 大坪 誠治, 嶋津 真史, 久保 孝市, 山崎 清仁, 井形 伸弘, 竹川 政範, 吉田 裕一, 末次 博史, 松田 光悦, ...
    1989 年 35 巻 9 号 p. 2385-2393
    発行日: 1989/09/20
    公開日: 2011/07/25
    ジャーナル フリー
    Twenty-eight patients with carcinoma of the tongue treated at the Department of Oral and Maxillofacial Surgery, Asahikawa Medical College from 1978 to 1986 were reviewed.
    The patients ranged in age from 33 to 80 years, and 71. 4 percent were male (20/28). The carcinoma in 26 cases originated in the lateral borders of the tongue. The histopathological diagnosis was squamous cell carcinoma in all cases. In stage grouping of the UICC (1978): 11 cases belonged to stageI, 8 to II, 5 to III, 4 to IV.
    In early cases of stage I and II, 8 cases were treated mainly by interstitial radiotherapy and 11 cases mainly by surgery. In advanced cases of stage 111 and IV, most of them received surgical treatment combined with pre-operative irradiation. The 5-year survival rate of stage I, II, III, IVwere78.9%, 85.8%, 60%and50%, respectively.
    In cases of stage 1 and 1I, the cure rate treated by surgery was clearly superior to that by radiation therapy.
    Cases with metastasis to cervical lymph nodes showed. markedly lower survival rate than those without cervical metastasis. But no case with metastasis to cervical lymph nodes treated by neck dissection died from cervical metastasis. Recurrences of primary lesions or cervical metastasis mostly occurred within 1 year after the treatment.
    This indicates that we must regularly followup the subsequent history of the patients within 1 year after the treatment.
  • 小木 信美, 片浦 俊久, 織田 元, 落合 栄樹, 栗田 賢一, 河合 幹
    1989 年 35 巻 9 号 p. 2394-2399
    発行日: 1989/09/20
    公開日: 2011/07/25
    ジャーナル フリー
    Lesch-Nyhan syndrome is a rare inborn error of purine metabolism. The incidence of this syndrome is about 1/380, 000 live births. The genetic analysis indicates that the disorder had an X-linked recessive pattern. The syndrome is clinically characterized by mental retardation, neurological disorder, self-mutilation, and hyperuricemia. Patients with this syndrome are lacking in purine salvage enzyme (HGPRT). The deficiency of this enzyme leads to excessive production of uric acid. In this paper, a case of this syndrome is described.
    A 2-year 11-month-old Japanese boy was referred for evaluation and treatment of lower lip self-biting. The child was born of a normal pregnancy and delivery. He had no neonatal complications. But his pediatrician noticed that his development was retarded physically and mentally. So, laboratory examinations were conducted. Diagnosis of Lesch-Nyhan syndrome including loss of HGPRT activity was made based on the clinical and laboratory findings. Then, treatment with allopuriol was initiated. At the age of 2, he started finger biting. Arm splints were used to reduce this self-mutilative behavior. Besides, he began chewing on his lower lip and repeatedly bit the lip causing soft tissue destruction and ulceration. His appearance had extrapyramidal signs. Fingers of both hands were mutilated and scarred. Oral examination showed the lower lip denuded with ulceration. Under local anesthesia, both deciduous central and lateral incisors were removed to prevent further lower lip tissue loss. The ulcer was healed as scarring.
    Self-mutilation is one of the most characteristic symptoms of Lesch-Nyhan syndrome. It usually starts at the age of 2. The patients compulsively bite their fingers and/or lips. Such behavior sometimes lead to extensive soft tissue destruction. However, their sensation is intact and they actually feel pain. The self-mutilation mechanism is still unknown. The behavior does not correlate with the level of uric acid and control of hyperuricemia has no favorable effect on it. Treatment of the patient from neonatal period with allopurinol cannot prevent the onset of the disease, but it can control excessive uric acid production. Physical restraints are usually used to keep patients from injury. Once patients begin to bite themselves, removal of the teeth is practically indicated.
  • 斉藤 至紀, 柏原 肇, 松川 善和, 中西 淳一, 倉阪 雅巳, 伴 宏樹, 岩城 正之, 涌本 昇, 島田 惣四郎
    1989 年 35 巻 9 号 p. 2400-2406
    発行日: 1989/09/20
    公開日: 2011/09/13
    ジャーナル フリー
    Recently, two patients came to our hospital with a chief complaint of indolent swelling of one sided submandibular gland. Clinical symptoms and examination results suggest that both patients probably had chronic sclerosing sialadenitis (Küttner's tumor).
    Case 1 (A 44-year-old male): This patient came to our hospital on January 18, 1986 with a chief complaint of indolent swelling of the left submandibular area. His face was asymmetrical and a poorly-demarcated, diffuse swelling was noted in the area from the left mandibula to the mentum. The swelling was elastic and hard; no fluctuation was palpable. Based on the results of various examinations, the patient was diagnosed as having chronic left sialadenitis. On February 12, 1986 the patient underwent complete excision of the submandibular gland under general anesthesia.
    Case 2 (A 44-year-old male): This patient came to our hospital on August 6, 1986 with chief complaints of indolent swelling of the right submandibular area and of trismus. His face was asymmetrical, and a poorly-demarcated, diffuse swelling was noted in the angle of the right jaw. The swollen area was elastic hard without fluctuation was palpable in it. In addition, the patient complained of severe salivary colic. Based on the results of various examination, this patients was diagnosed as having chronic right sialadenitis. On August, 13, 1986, the patient underwent complete excision of the right submandibular gland under general anesthesia.
    Postoperative histologic examination suggested that both of these two cases had chronic sclerosing sialadenitis (Kuttner's tumor). Their postoperative course was uneventful.
  • 中熊 太治, 斎藤 健一, 宮本 宰, 岡田 隆, 松井 義郎, 秋月 弘道, 大野 康亮, 道 健一, 山崎 亨
    1989 年 35 巻 9 号 p. 2407-2411
    発行日: 1989/09/20
    公開日: 2011/07/25
    ジャーナル フリー
    A case of a 60-year-old female with pleomorphic adenoma of the deep lobe of the parotid gland extended to the parapharyngeal space is presented.
    The clinical, pathological and radiographic features are described. Treatment and diagnosis for this neoplasm are reviewed with some literary considerations.
  • 戸田 ひとみ, 堀越 勝, 松本 堅太郎, 岩佐 俊明, 榎本 昭二
    1989 年 35 巻 9 号 p. 2412-2419
    発行日: 1989/09/20
    公開日: 2011/07/25
    ジャーナル フリー
    K-FT, a piece of drug film containing O. 025 mg of triamcinolone acetonide (TAA), was applied to 21 patients with recurrent aphtha and the clinical effect was evaluated. The results were as follows;
    1. The pain improved 2 days after K-FT administration, and by 7 days, almost disappeared. The ulcer and red halo were reduced in 2 days and by 7 days almost disappeared.
    2. About half of the patients felt no discomfort to adhere K-FT, suggesting its merit of adhesion, we, this and soft properties.
    3. K-FT was applied for more than 2 hours in 8 cases but less than 30 minutes in 8 cases.
    4. The global improvement rate was good in all cases.
    5. Side effects were not observed in any patient.
    Then tissue concentration of TAA was investigated in the tongue of rats after K-FT administration by high pressure liquid chromatography. The comparison was made between normal mucosa and aphthous mucosa experimentally caused by YaG Laser. In consequence, tissue concentration of TAA in the epithelial area almost linearly increased with time elapsed in both normal and aphthous groups. TAA was less detected in the musclaris mucosae.
  • L-システインエチル塩酸塩による検討
    藤林 孝司, 後藤 聡, 榎本 昭二
    1989 年 35 巻 9 号 p. 2420-2438
    発行日: 1989/09/20
    公開日: 2011/09/13
    ジャーナル フリー
    Twenty oral xerosis patients who visited us were treated by L-cysteine ethylester hydrochloride. The following conclusions were obtained.
    1) Ten out of the 20 patients had Sjögren's disease, and the other ten were xerostomia, diagnosed by parotid sialography, labial salivary gland biopsy, salivary gland scintigraphy, measurements of salivary secretion and immuno-serological examinations of the peripheral blood.
    2) Scores of both subjective and objective symptoms showed a decreasing trend after treatment. Improvement of each symptoms was greater in patients with xerostomia compared to Sjögren's disease patients.
    3) The amount of salivary secretion increased significantly after treatment.
    4) Two patients, whose clinical symptoms were relieved markedly, showed much improvement in salivary gland scintigraphy by comparing time-activity curves before and after administration. Both the maximum accumulation ratio and the maximum secretion ratio increased on the time-activity curve.
    5) The results of general hematology, serum biochemistry and immuno-serology did not change significantly before and after administration. However, the content of saliva-originated serum amylase in blood decreased in ten of eleven patients after treatment.
    6) The global improvement rate was markedly improved in 2 cases, improved in 5 cases, slightly improved in 9 cases and no change in 4 cases. The improvement rate over slightly improved was 90% in xerostomia, 70% in Sjögren's disease and 80% in the total cases.
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