日本口腔外科学会雑誌
Online ISSN : 2186-1579
Print ISSN : 0021-5163
ISSN-L : 0021-5163
42 巻, 6 号
選択された号の論文の16件中1~16を表示しています
  • 特に骨移植前後におけるリンパ球混合培養反応について
    小林 千晃, 柴田 考典, 江良 謙次, 吉澤 信夫, 仙道 富士郎
    1996 年 42 巻 6 号 p. 537-549
    発行日: 1996/06/20
    公開日: 2011/07/25
    ジャーナル フリー
    This is the first paper to describe the use of a one-way mixed lymphocyte reaction (MLR) for the immunological evaluation of various types of allogeneic cortical bone grafts, i. e., fresh, frozen, and freeze-dried, to the mandibles of dogs. A total of 35 mongrel dogs (26 males/9 females) were used for this one-way MLR evaluation. The experimental design included the evaluation of three types of allogeneic cortical bone-grafts: fresh bones (Group 1), frozen bones (Group 2), and freeze-dried bones (Group 3).
    Of the 35 dogs, 10 (6 males/4 females) were used as bone donors and 25 (20 males/5 females) as bone graft recipients. The one-way MLR was used to evaluate immunological differences between the donors and the recipients and the degree of transplant rejection.
    The MLR results are summalized below:
    1) Of the 3 groups, the fresh cortical bone grafts showed the highest stimulation index (S. I.) value;
    2) Of the 3 cultures examined, the freeze-dried cortical bone graft cultures showed the highest S. I. value for the longest period, whereas in the fresh bone graft cultures the S. I. value was maintained for the shortest period.
    Based on these findings, it was concluded that freeze-dried cortical allogeneic bone grafts elicit the lowest cell-mediated immunity.
  • 光本 和世
    1996 年 42 巻 6 号 p. 550-555
    発行日: 1996/06/20
    公開日: 2011/07/25
    ジャーナル フリー
    It is widely accepted that the ability of osteoblastic cells to attach to titanium plates is influenced by many factors. In this study, the author examined whether the initial attachment of osteoblastic cells (MC 3 T 3 -E 1 cells) to titanium plates was affected by the stage of cell differentiation and by pretreatment with transforming growth factor-β(TGF-β).
    The cells were divided into four groups according to the stage of culture: stage I (proliferating stage), stage II (preconfluent stage), stage III (confluent stage), and stage IV (nodule-forming stage). Cell attachment was then estimated by crystal violet staining.
    The results revealed that cell attachment increased with the advancement of stage. At the final stage (stage IV), however, cell attachment decreased. TGF-β increased cell attachment through de novo protein synthesis. When the effect of TGF-β was compared between stage II and stage DI, the cells at stage II were more responsive to TGF-β than those at stage M. These results suggest that the affinity of MC 3 T 3 -E 1 cells to titanium plates may differ according to the stage of differentiation and that this affinity may be modulated by TGF-β.
  • 文 樹民, 辻 龍雄, 李 辛薇, 三村 由香, 石丸 孝則, 早津 良和, 篠崎 文彦
    1996 年 42 巻 6 号 p. 556-559
    発行日: 1996/06/20
    公開日: 2011/07/25
    ジャーナル フリー
    Numerical aberrations of chromosomes 3 and 17 were studied by FISH using centromere-specific DNA probes in formalin-fixed, paraffin-embedded materials consisting 8 pleomorphic adenomas (PA), 4 carcinomas in pleomorphic adenoma (CIPA), and 4 normal submandibular glands. Two hybridized signals, or disomy, were detected in 92.6± 2.6% of interphase cells from normal salivary glands for chromosome 3 and in 89.8±2.2% of these cells for chromosome 17. On the other hand, nuclei with three or more hybridization signals, indicating polysomic cells, were detected in 2.6±1.7% of normal salivary gland cells, 15.5±6.3% of PA cells, and 37.6±5.1% of CIPA cells for chromosome 3, and in 1.1 ± 0.8% of normal cells, 10.3±6.8% of PA, and 17.7±18.6% of CIPA for chromosome 17. Nuclei with a single hybridization signal, indicating monosomy, were detected in 4.8±3.6% of normal salivary gland cells, 11.2±7.5% of PA, and 7.8±3.1% of CIPA for chromosome 3, and in 9.1±1.4% of normal cells, 30.3±25.3% of PA, and 30.0±24.6% of CIPA for chromosome 17. Nuclei with a single hybridization signal were more frequent for chromosome 17 than for chromosome 3, but there was no significant difference between PA and CIPA. These results suggest that polysomy of chromosomes 3 and 17 increases with the process of tumorigenesis. In contrast, monosomy of chromosome 17 seems to be an early event in salivary gland tumors.
  • 小村 健, 和田 重人, 小野 貢伸, 嶋田 文之
    1996 年 42 巻 6 号 p. 560-565
    発行日: 1996/06/20
    公開日: 2011/07/25
    ジャーナル フリー
    In squamous cell carcinomas of the oral cavity, spinal accessory lymph node (SALN) metastasis develops infrequently, and the prognosis of the patients with SALN metastasis is extremely poor.
    In this paper, patients with SALN metastasis of squamous cell carcinomas of the oral cavity were studied retrospectively. The SALN metastasis was histopathologically confirmed in 9 (5.0%) of 179 patients who underwent radical or modified radical neck dissection. The primary sites of their tumors were the tongue in 6 patients, the lower gingiva in 2, and the buccal mucosa in 1. The risk of SALN metastasis was related to the tumor spread into the oropharynx and the differentiation of the tumor, but not related to the T stage. In the patients with SALN metastasis, the mean total number of involved nodes on the affected side of the neck was 9.4. All of these patients had metastases in multiple groups of neck lymph nodes, and the majority had metastases in the upper and middle jugular groups of nodes. The mean number of involved SALNs was 2.0, and the mean size of these nodes was 0.52 cm in diameter.
    The outcome of treatment in the patients with SALN metastasis was poor: 1 patient was alive with no evidence of disease, and 8 patients died of disease with an average duration of survival of 8.0 months after neck dissection.
    To improve the prognosis of patients with SALN metastasis, both postoperative irradiation to the neck and intensive adjuvant chemotherapy should be employed.
  • 中島 博, 松浦 正朗, 岡田 とし江
    1996 年 42 巻 6 号 p. 566-580
    発行日: 1996/06/20
    公開日: 2011/09/13
    ジャーナル フリー
    This study was designed to investigate masticatory disturbances in patients with occupational maxillofacial injuries. During the 3 -year 3 -month period from April 1992 through June 1995, 51 patients were examined on the basis of (1) dental findings, (2) mandibular mobility, (3) electromyograms (EMG), (4) occlusal findings by Dental Prescale®, and (5) masticatory efficiency rate calculated from the results of a questionnaire that assessed the ability to chew 173 foods.
    The following results were obtained:
    1. Masticatory efficiency rate could be estimated on the basis of occlusal variables assessed with Dental Prescale®. The most important occlusal variable with this method was maximal force.
    2. At a value of 40% or more, masticatory efficiency rate was correlated with dental findings and mandibular mobility.
    3. In this same group of patients, masticatory efficiency rate was correlated with electromyographic findings (silent period rate, etc.).
    4. Variables of the occlusion evaluated with Dental Prescale® were positively correlated with masticatory efficiency rate.
    5. In patients with a masticatory efficiency rate of 40% or more, masticatory disturbances could be generally estimated from masticatory efficiency rate.
    6. Many patients with a masticatory efficiency rate of less than 40% had lack of consistency between objective and subjective findings. Masticatory disturbances could therefore not be evaluated correctly by analyzing items (1) to (5) in this group of patients.
  • 市川 健司, 大多和 亜希, 小川 俊夫, 宮内 忍, 吉賀 浩二, 高田 和彰
    1996 年 42 巻 6 号 p. 581-586
    発行日: 1996/06/20
    公開日: 2011/07/25
    ジャーナル フリー
    The condylar process of the mandible is one of the most common sites involved inmaxillofacial fractures. Recently, many cases of condylar fractures were reported in which open reduction was the procedure of choice. However, there has been controversy concerning the indications of surgical and nonsurgical treatment for fractures of the condylar process. In our department, closed reduction is generally used to manage condylar fractures since various complications may occur after open reduction of the temporomandibular region. To evaluate the clinical results of nonsurgical treatment, patients with condylar fractures treated between 1984 and 1995 were reviewed.
    During the study period, 203 fractures were found in 156 patients with a mean age of 29.7 years. Males outnumbered females by two-fold. Traffic accidents were the major cause of injury; about half of the patients had been involved in such accidents. The overwhelming majority of cases (151 cases, 96.8%) were nonsurgically treated, primarily by maxillomandibular fixation followed by functional rehabilitation (100 cases).
    Ninty-two patients were recalled after more than 6 months. There was no functional problem in 86.2% of the fractures with no or slight displacement, whereas some problems occurred in patients with dislocation of the condylar head from the glenoid fossa. As comparedwith adult patients, those aged under 20 years, even with severe dislocation, showed relatively good results not only functionally but also morphologically. However, most remaining problems were not severe, and only a few patients experienced difficulties in their daily lives.
  • 武 宜昭, 梅田 正博, 横尾 聡, 奥 尚久, 藤岡 学, 川越 弘就, 寺延 治, 中西 孝一, 島田 桂吉
    1996 年 42 巻 6 号 p. 587-589
    発行日: 1996/06/20
    公開日: 2011/07/25
    ジャーナル フリー
    Lymph node metastasis of oral cancer occurs usually in the cervical region, and rarely in other regions. We report here four patients with squamous cell carcinoma of the maxilla who had lymph node metastases in the buccal or parotid lymph nodes.
    The primary site was the maxillary gingiva in two patients and the maxillary sinus in two. The metastatic site was the buccal lymph nodes in three and parotid lymph nodes in one. These four patients underwent surgical excision of the matastatic tumor, which resulted in local cure, but two died of distant metastasis.
    The incidence of metastasis to regions other than the cervical lymph nodes was 6.5% in all patients with squamous cell carcinoma of the maxilla treated at our Department, but it rose to 28.6% when limited to pN (+) patients. These findings emphasize the importance of paying attention to the buccal and parotid lymph nodes in patients with maxillary cancer.
  • 吉川 文弘, 岩井 聡一, 椿本 有利子, 加藤 逸郎, 大前 政利, 土居 敏英, 作田 正義
    1996 年 42 巻 6 号 p. 590-592
    発行日: 1996/06/20
    公開日: 2011/07/25
    ジャーナル フリー
    Pleomorphic adenoma is the most common tumor of the salivary gland. Usually, it grows slowly and has a good prognosis. However, some pleomorphic adenoma. generally referred to as malignant pleomorphic adenoma (carcinoma in pleomorphic adenoma) show invasive growth or distant metastasis. We examined clinical features in 69 patients who were given a diagnosis and treated at our clinic during the past 16 years. The 69 patients included 63 patients with pleomorphic adenoma and 6 patients with malignant pleomorphic adenoma. The 63 cases of pleomorphic adenoma occurred in 21 males and 42 females. The ratio of males to females was 1: 2, indicating a higher prevalence in females than males. The 6 cases of malignant pleomorphic adenoma occurred in 4 males and 2 females. The diagnosis was carcinoma in pleomorphic adenoma in 4 cases and so-calld malignant pleomorphic adenoma in the other 2 cases. Five of these patients were treated at our clinic; surgery was performed in all 5 patients. The 5 -year survial rate was 80%.
  • 足立 雅利, 長谷川 功, 田中 正司, 鈴木 宗一, 佐藤 田鶴子, 野中 博子
    1996 年 42 巻 6 号 p. 593-595
    発行日: 1996/06/20
    公開日: 2011/07/25
    ジャーナル フリー
    Acinic cell carcinoma is a rare tumor that generally arises from the parotid gland. The differential diagnosis of this carcinoma from other diseases of the parotid gland is difficult preoperatively. The authors report their experience with a 25-year-old woman with an acinic cell carcinoma arising from the right parotid gland. She presented with a mass situated anterior to the right ear. The mass measured 38×28mm. An exploratory puncture was performed, and the serous contents of the mass were aspirated. CT revealed a cystoid lesion that was considered to be nononcogenic. It was diagnosed to be a parotid gland cyst and excised. However, histopathological examination revealed an acinic cell carcinoma. The patient is being followed up, and there have been no signs of recurrence.
  • 門久 美紀子, 右山 裕則, 佐藤 秀人, 高橋 弘, 藤田 修一, 岡邊 治男
    1996 年 42 巻 6 号 p. 596-598
    発行日: 1996/06/20
    公開日: 2011/07/25
    ジャーナル フリー
    Malignant schwannoma is a rare tumor among all soft tissue sarcomas. The head and neck is an uncommon site for this tumor. It is difficult to diagnose malignantschwannoma both clinically and histologically.
    We report a case of malignant schwannoma that occurred in the buccal submucosa. The patient was a 40-year-old woman who complained of swelling of the right buccal region. The diagnosis on a preoperative biopsy was fibrosarcoma. However, the postoperative diagnosis on immunohistochemical examination was malignant schwannoma.
  • 顔面正中面の自動設定法の開発
    野口 信宏, 後藤 昌昭, 香月 武
    1996 年 42 巻 6 号 p. 599-601
    発行日: 1996/06/20
    公開日: 2011/07/25
    ジャーナル フリー
    Many methods have been developed to evaluate facial asymmetry. To evaluate asymmetry, definition of the symmetrical plane of the face is essential. The planes used in previous studies depended almost entirely on landmarks designated by the operator. In this study, an objective symmetrical plane was defined automatically as a midsagittal plane that was derived by calculating three-dimensional data of the face.
    The facial surface was scanned using a rapid noncontact measuring system. The original image and mirror image were matched using the least squares method in an area measuring 70×70mm around the soft tissue nasion. An, objective symmetrical plane was thus calculated.
    Facial midsagittal planes defined by this method were acceptable to our subjective impression, and the results showed only little difference among operators or after repeated determination.
  • 中井 英貴, 新美 敦, 野阪 泰弘, 沢井 俊宏, 渡邊 和代, 小関 健司, 本田 雅規, 藤本 雄大, 上田 実
    1996 年 42 巻 6 号 p. 602-604
    発行日: 1996/06/20
    公開日: 2011/07/25
    ジャーナル フリー
    Orbital defects associated with malignant tumor surgery or trauma can be socially disabling because of cosmetic factors. We used osseointegrated implants to support orbital epitheses in 6 patients. In this paper we showed the effectiveness of this treatment and examined the following points:
    1. Period of treatment.
    2. Success rate of implants placed in irradiated bone.
    3. Placement site of implants.
    4. Skin reactions around abutments.
    5. Retention and fixation of epitheses.
  • 竹部 幹浩, 山田 容三, 井上 雄, 千葉 博茂, 斎藤 文男
    1996 年 42 巻 6 号 p. 605-607
    発行日: 1996/06/20
    公開日: 2011/07/25
    ジャーナル フリー
    We report a patient in whom transcatheter arterial embolization (TAE) was performed to control arterial bleeding caused by rupture of a traumatic aneurysmal maxillary artery. A 29-year-old man sustained multiple midface and mandibular fractures in a traffic accident, and an aneurysm developed in the maxillary artery (sphenopalatine artery). Subsequently, arterial bleeding was caused by its rupture. TAE was performed using a standard right transfemoral Seldinger technique under local anesthesia, and a platinum microcoil (coiled diameter: 2mm, length in introducer: 40mm) was positioned at the origin of the sphenopalatine artery. The method used was selective arterial embolization by digital subtraction angiography.
    Reliable hemostasis was obtained with minimal invasiveness. This technique has contributed significantly to the management of arterial bleeding caused by rupture of a traumatic aneurysmal maxillary artery. Thus far, no further problems have been encountered.
  • 高木 公康, 渡邉 諭, 西村 賢二, 伊東 隆利, 向井 洋, 篠原 直幸
    1996 年 42 巻 6 号 p. 608-610
    発行日: 1996/06/20
    公開日: 2011/07/25
    ジャーナル フリー
    Ankylosis of the temporomandibular joint can be classified into intra-articular and extra-articular ankylosis. We report a rare case of extra-articular ankylosis caused by extensive adhesion of the alveolar process at the left side of maxilla and mandible.
    A 66-year-old woman visited our clinic with a chief complaint of trismus. She suffered from a feverish disease around the age of 3-4 years, which caused erosion and ulceration of the oral mucosa resulting in the massive adhesion of the alveolar process. At the age of about 50, she completely lost mobility of the mandible.
    Under general anesthesia, the region of the alveolar process with adhesion was resected. One month and a half later, vestibuloplasty was performed. As of 4 years 6 months postoperatively, there is no evidence of recurrence.
  • 山口 昭彦, 別所 和久, 西田 光男, 白井 泰彦, 古原 優樹, 飯塚 忠彦
    1996 年 42 巻 6 号 p. 611-613
    発行日: 1996/06/20
    公開日: 2011/07/25
    ジャーナル フリー
    Osteopetrosis is a rare disorder characterized by symmetrical systemic sclerosisof skeletal bone. Osteomyelitis of the jaws is a frequent complication in the oral and maxillofacial region. We report here a case of osteomyelitis of the mandible that occurred 2 years after tooth extraction in a patient with osteopetrosis. The osteomyelitis was successfully treated by removal of the necrotic bone and granulation tissue, hyperbaric oxygen therapy, and antibiotic therapy.
  • 井辺 弘樹, 原田 昌和, 片井 敦雄, 田中 智之, 和田 健, 坂本 忠幸
    1996 年 42 巻 6 号 p. 614-616
    発行日: 1996/06/20
    公開日: 2011/07/25
    ジャーナル フリー
    Primary cutaneous nocardiosis of the face is a rare diease in Japan. A 58-year-old woman visited our department due to post-traumatic facial swelling. Clinical exaination revealed a 2×3 cm induration with skin redness and a few small whitish pustules at the right side of the mental region. Nocardia brasiliensis was isolated from aspirated pus. Although N. brasiliensis was resistant to many antibiotics on sensitivity testing, the lesions disappeared relatively soon after the oral administration of sulfamethoxazole-trimethoprim combination therapy followed by minocyclin.
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