Cell adhesion and migration are basic biological processes. To evaluate the characteristics of oral wound healing, differences among cells derived from various tissues and the influence of saliva on cell-specific properties were investigated. Three human cell lines were used: gingival fibroblasts, embryonic palatal messenchyme (HEPM) and skin fibroblasts. To estimate cell adhesion, the cells were plated on dishes. Following incubation, the cells were rinsed to remove unattached cells. The cell adhesion rate was calculated by dividing the number cells remaining on the dishes by the number of plated cells. To estimate cell migration, the cells were plated on the dishes marked with two reference points. Photographs of the plated cells were taken via a phase contrast microscope. In the photographs, the distance each cell had migrated from the reference points was measured. The following results were obtained: 1. The three cell lines differed in their migration and adhesion abilities. Skin fibroblasts had higher migration and adhesion properties than the other cells derived from oral tissue.HEPM migrated less than gingival fibroblasts. 2. Fibronectin enhanced cell adhesion and migration. This result was in agreement with previous reports. 3. Coating the dishes with whole saliva inhibited cell adhesion and migration. 4. Adding whole saliva to the medium also inhibited cell adhesion and migration.
Histochemical properties of mucosubstances derived from human normal submandibular glands of 20 autopsied cases were investigated by staining with 9 different kinds of lectins including ConA, UEA-I, GS-I, GS-II, BPA, DBA and WGA. Immunohistochemical staining with anti-lysozyme antibody was also carried out to identify serous cells. Furthermore, prior to lectin binding, oxidation with periodic acid followed by reduction with sodium borohydride was performed in order to compare the tissue-specific staining properties of simple lectin stain with those after chemical modification. GS-II exclusively reacted with mucous cells and staining was enhanced by oxidation. SBA and DBA lectins also bound remarkably to mucous cells after chemical modification. No lectins reacted only with serous cells, and only UEA-I showed obvious signs of reaction with serous cells even after 10-min oxidation, while the other lectins exhibited minimal binding. DBA and BPA lectins were characterized by the existence of site-specific staining in intercalated duct cells. SBA showed strong binding with cells of the striated ducts and interlobular ducts. In addition, the existence of cells possessing mixed characteristics of serous and mucous cells was suggested in the acini, since glycoproteins and lysozymes were present in the same cytoplasm. These results indicated that cell-species of the human submandibular glands could be differentiated by staining techniques employing appropriate combinations of lectins and chemical modification. These techniques may be useful in studying the mechanisms of cell differentiation and tumorgenesis.
Thermochemotherapy with cis-diamminedichloroplatinum II (CDDP) was investigated by measurement of the tumor growth curve, histological examination and measurement of intratumor concentrations of CDDP. BALB/c mice with Meth-A fibrosarcomas were used in these studies. Hyperthermia was carried out at 43°C for a 30-minute period using a halogen lamp. Intratumor temperature was measured with a thermistor placed in the center of the tumor. Tumor growth was delayed after treatment in the animals receiving heat with CDDP and in those receiving heat alone. However, in the animals receiving CDDP alone (5mg/kg intraperitoneal infusion), this effect was not observed. In the animals receiving heat with CDDP, histological examination revealed vacuolation, pyknotic degeneration, and karyorrhexis of tumor cells. With heat alone, the major histological changes to the tumor cells were pyknosis, karyorrhexis, and karyolysis. Therefore, vacuolation can be considered to be a characteristic effect of CDDP administration. Vacuolation was observed earlier in the animals receiving heat with CDDP than in those receiving CDDP alone. We therefore conclude that heating tends to promote the antitumor effect of CDDP. A higher concentration of CDDP was observed from 6 hours to 72 hours after administration in animals receiving heat with CDDP than in those given CDDP alone. When combined with hyperthermia, CDDP tended to remain in the tumor longer than when administered alone.
Temporomandibular arthrosis allegedly results from the intricate involvement of several factors. However, the relationship between the development of mandibular deformity and temporomandibular arthrosis has been a topic of increasing attention. Briefly presented here is a case of mandibular deformity diagnosed among patients examined at our department for the chief complaints of temporomandibular arthrosis and malocclusion. The mandibular deformity was surgically treated, and the discs of the temopromandibular joint (TMJ) were fixed by arthroscopic suturing causing the temporomandibular arthrosis to disappear. The patient was a 25-year-old female examined by our department for the chief complaints of bilateral pain in the TMJ, clicking of the left TMJ, and malocclusion. Mandibular defromity and malocclusion were present, and double-contrast CT scan of the TMJ led us to suspect discus articularis dislocation. The therapy we instituted consisted of occlusal rectification by sagittal splitting of the mandible and arthroscopic suturing and fixation of the right disc. Eleven months postoperatively, facial symmetry has been restored, occlusion improved, and temporomandibular arthrosis alleviated.
To investigate the efficacy of aciclovir for herpetic gingivostomatitis, changes in local lesions and fluctuations in local virus titer were compared between a treated group of patients given oral aciclovir (4 patients, 7 sites, 36 specimens) and a control group of patients not given aciclovir (3 patients, 5 sites, 15 specimens). Specimens were able to be taken from the same site for several days in succession in all patients. The results demonstrated improvement in clinical symptoms in the treated group from day 2 of treatment. Likewise, a tendency towards cure of local symptoms was noted remarkably earlier in the treated group than in the control group. In addition, assessment of the virus titer of specimens taken daily from the same site revealed that the virus was not isolated from local specimens as early as after 1 day of treatment up to 3 days of treatment in the oral aciclovir group. The results indicated that oral aciclovir is therapeutically effective for herpes simplex virus and that the drug should be administered for at least 3 days.
The increasing incidence of multiple cancer in recent years has emphasized the importance of active and multimodal treatment for this disease. We have recently experienced a patient undergoing surgical treatment performed for oropharyngeal cancer and transcatheter arterial embolization for hepatic cancer in whom 2 years have passed postoperatively without any signs of recurrence or metastasis of either the oral or hepatic tumor. The case is described in this report. The patient was a 61-year-old male who had chronic hepatitis. On February 6, 1990, he initially presented at our clinic with the main complaints of redness of the oral mucosa and pain during eating. His oral lesion was definitivery diagnosed as squamous cell carcinoma of the left lateral oropharynx and tongue by incisional biopsy, and he was admitted to our hospital on February 20 of the same year. Concurrent hepatic cancer was suspected based on the results of in-depth preoperative general examinations. On May 16, laparoscopy was performed at the same time as surgical treatment for the oral cancer, and the hepatic lesion was diagnosed as primary hepatocellular carcinoma. On May 17, transcatheter arterial embolization was performed for hepatic cancer, and on July 14, he was discharged after postoperative adjuvant radiotherapy of the oral primary region and neck.
A 51-year-old woman developed a serious gas producing phlegmon which extended from the right cheek to the chest. Necrotizing soft tissue infection infiltrated to components below and above the affected fascia. Crepitation was evident beneath the skin and the foul smelling gas was noted. Antibiotic treatment was initiated intravenously. Excision of the involved fascia and adjacent soft tissues was carried out repeatedly. The patient recovered from this severe condition including DIC after 30 days of intensive care. The dermal defects were reconstructed 60 days after the onset of the disease. Bacteriological examinations did not reveal the presence of any anaerobes including clostridium. We finally diagnosed this case to be non-clostridial cellulitis associated with mixed bacterial infection.
A rare case of multiple odontomas of the mandible occurring in a 10-year-old boy is presented. The patient was referred to our clinic due to the absence of the right mandibular molars. Radiographic examination revealed three combined radiolucent-radiopaque lesions of the mandible, resembling complex odontomas. All three lesions were removed with the patient under general anesthesia. Histopathologic findings were consistent with multiple complex odontomas with ossifying fibroma. There were no signs of recurrence upon reexamination of the patient three years postoperatively.
A rare case of extramedullary plasmacytoma arising from mandibular gingiva is presented. A 33-year-old man with localized swelling in the gingiva of the mandibular incisor region was referred for consultation. The swelling was diagnosed as plasmacytoma by biopsy, and therefore the patient underwent a series of clinical examinations. The examinations failied to establish a diagnosis of multiple myeloma. The lesion was resected with part of the mandibular bone, because radiographs indicated resorption of the bone adjacent to the gingival lesion. PAP method, which is an immunohistochemical technique for staining, revealed that the tumor was an Ig-λ type of extramedullary plasmacytoma. Recurrence and metastasis of the tumor have not been noted during a 2-year follow-up period after resection.
We analyzed cases of benign odontogenic tumors treated in our department between 1977 and 1991 to derive the clinical implications. Seventy-three cases were retrospectively evaluated. Analysis of the series yielded the following results.(1) Odontogenic tumors most commonly appeared in the first and second decades of life.(2) Radiographic findings were helpful, but often lead to misdiagnoses.(3) Some cases of ameloblastoma with thick encapsulation in patients aged less than 20 years showed favorable postoperative course even after enucleation, whereas most cases demonstrated aggressive behavior.(4) Since some tumors, particularly odontoma, occasionally associated with other lesions, tentative surgical procedures and precise histopathologic diagnoses are mandatory.
The Mucorales are widespread in nature, subsisting on decaying vegetation and diverse organic materials. Although they and their spores show minimal intrinsic pathogenicity in normal persons, they can initiate aggressive and fulminant infection under certain clinical conditions such as diabetes mellitus, leukemia, or metabolic or immunologic deficiencies1). Here, we report a suspected case of mucormycosis of the maxillary sinus who was cured by chemotherapy, necrotomy and good control of diabetes mellitus, although side effects occurred with Amphotericin-B.
A case of chronic myelocytic leukemia with tumor formation in the mandible is presented. A 24-year-old female was referred to our department during hematological remission of chronic myelocytic leukemia because she complained of swelling of the mandibular region after suffering a contusion. The swelling was diagnosed to be caused by massive infiltration of leukemic cells by biopsy. Although the swelling macroscopically disappeared after chemotherapy for leukemia, the tumor was confirmed to persist by CT. She died about seven month after her first visit in spite of treatment.
A 21-year-old male was shot with a handgun in the mandible, chest, inguinal region, and upper limbs. Upon admission to the emergency room, vital signs were relatively stable. X-ray examination of the head and neck region apparently revealed that the right side of the mandible was fractured and that the bullet-shaped radiopaque object was lodged in the tongue. However, because the radiopaque object in the tongue was found intraoperatively to be a full cast crown on the mandibular firstmolar, the initial clinical impression of the route that the bullet passed through the body proved to be mistaken. The comminuted mandibular fracture was reduced and stabilized with a miniplate under general anesthesia. Five months later, after an abscess appeared in the right submandibular region, the remaining bullet fragments were surgically removed. The postoperative course was uneventful. The unique characteristics of gunshot wounds shoud be carefully considered at initial assessment.
This paper reports a case of habitual temporomandibular dislocation which was surgically treated using a T-type titanium miniplate. A 53-year-old man visited our hospital presenting with recurrent frontal dislocation of both temporomandibular joints and he had severe mental retardation. Following a standard preauricular approach to the zygomatic arch, a bent T-type titanium miniplate was applied to limit the movement of the condylar process. The plate was fixed to the zygomatic arch with three 2-mm titanium screws. Routine follow-up, 1year and 6months after surgery, showed no clinical evidence of recurrent dislocation. This method seems to be very useful for patients with mental disturbances, because it is easy to perform and requires no intermaxillary fixation postoperatively.
A case of osseous choristoma in the radical region of the tongue (in the vicinity of the foramen caecum) in a 53-year-old female is described. This lesion was 8×6mm in size and removed under general anesthesia. Microscopic examination revealed the tumor to be composed of dense lamellar bone with haversian canals, surrounded by thin fibrous connective tissue with stratified squamous epithelium of the lingnal surface.
Verruciform xanthoma is a rare lesion clinically manifested as a gum tumor with a papillary or granular surface. Histopathologically, it is characterized by extreme elongation of epithelial rete pegs and swollen foamy cells in the connective tissue between the rete pegs. A case study is presented of verruciform xanthoma on the gingiva of the lower jaw of a 53-year-old male. The disease had been detected 15 years earler. Histopathological, immunochemical and electron microscopic findings are discussed. It is speculated that this lesion may be due to local chronic inflammation, with foamy cells being derived from histiocytes.