Japanese Journal of Oral and Maxillofacial Surgery
Online ISSN : 2186-1579
Print ISSN : 0021-5163
ISSN-L : 0021-5163
Volume 45 , Issue 11
Showing 1-18 articles out of 18 articles from the selected issue
  • Kazuhiko OKUMURA, Atsushi KONISHI, Tomomi YAMASHITA, Ken OMURA, Maki T ...
    1999 Volume 45 Issue 11 Pages 655-665
    Published: November 20, 1999
    Released: July 25, 2011
    JOURNALS FREE ACCESS
    We investigated the role of phosphatidylinositol 3-kinase (PI 3 K) in tumor cell invasion. Two cloned tumor cell lines, designated SAS-L 1 (low invasiveness) and SAS-H 1 (high invasiveness), were isolated from a human oral squamous cell carcinoma (OSCC), SAS. SAS-L 1 and SAS-H 1 cells exhibited high and low motility, respectively. To compare the function of PI 3 K between the two tumor lines, the signaling mechanism after serum stimulation was examined.
    In SAS-H 1 cells, tyrosine phosphorylation of focal adhesion kinase (p125FAK) in response to serum stimulation was markedly inhibited by both wortmannin and LY294002, a dosedependent inhibitor of PI 3 K, but inhibition was not observed in SAS-L 1 cells. Futhermore, wortmannin inhibited adhesiveness to extracellular matrices and cell motility in SAS-H 1 cells.
    PI 3 K activity induced by serum stimulation was higher in SAS-H 1 cells than in SAS-L 1 cells. Activation of PI 3 K was abolished by wortmannin or LY294002. The correlation between PI 3 K activation and invasive potential suggested that inhibition of activated PI 3 K would decrease the invasiveness of SAS-H 1 cells. Wortmannin or LY294002 inhibited invasion by SAS-H 1 cells, but not SAS-L 1 cells on endothelial monolayer invasion assay.
    Our results suggest that a PI 3 K-dependent signal transduction pathway plays an essential role in cell adhesion and cell motility of the highly-invasive OSCC cell line (SAS-H 1), which leads to the phosphorylation of p125FAK.
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  • Baosheng TAN, Masaro MATSUURA, Junichi SATO
    1999 Volume 45 Issue 11 Pages 666-676
    Published: November 20, 1999
    Released: July 25, 2011
    JOURNALS FREE ACCESS
    From 1987 through 1996, 258 parotid tumors were treated at Beijing Stomatological Hospital. In this series, 219 cases were benign and 39 were malignant. Of the benign tumors, 141 were pleomorphic adenomas, and 49 were Warthin's tumors. The other 29 cases consisted of 7 monomorphic adenomas, 6 basal cell adenomas, 6 myoepitheliomas, and 10 nonepithelial tumors.
    The clinical characteristics of patients with pleomorphic adenomas were compared with those of patients with Warthin's tumors. The average age of patients with Warthin's tumors was higher than that of patients with pleomorphic adenomas (60.1 years vs. 39.5 years). Pleomorphic adenomas were more frequent in females than in males (1.39: 1), whereas Warthin's tumors were more connor in males than in females (5.13: 1). The proportion of smokers among patients with Warthin's tumors was higher than that among patients with of pleomorphic adenomas (96.9% vs. 50.0%). These three factors differed significantly between the two types of tumors.
    The malignant tumor group included 8 mucoepidermoid carcinomas, 7 carcinomas in pleomorphic adenomas, 6 adenocarcinomas, 6 acinic cell carcinomas, 4 adenoid cystic carcinomas, and 4 papillary cyst adenocarcinomas.
    All tumors were treated by surgery. Total parotidectomy was performed for 22 of the 39 malignant tumors, superficial parotidectomy was performed for 16 cases, and deep lobectomy was performed for 1 cases. In patients with pleomorphic adenomas and Warthin's tumors, local excision of the tumors was performed for 16 cases, superficial parotidectomy for 169 cases, superficial parotidectomy with partial deep lobectomy for 4 cases and partial resection of the parotid gland including the tumor for 1 case.
    The facial nerve was exposed from the truncus to the branches in 85 cases and from the branches to the truncus in 88 cases. Weakness of the facial nerve occurred in 29 patients im-mediately after surgery, but recovered within a few weeks. No difference was noted in the occurrence of nerve disturbance between the two groups.
    Complete encapsulation of the tumor was observed in 73.8% of pleomorphic adenomas and 70.5% of Warthin's tumors, and no encapsulation was found in 1 Warthin's tumor and all 8 mucoepidermoid carcinomas. Tumor cells invaded into the capsule in 41.8% of pleomorphic adenomas. In conclusion, an adequate surgical margin is needed in parotid tumor surgery even in patients with benign tumors.
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  • Yoshinari MORIMOTO, Wataru TAKIOKA, Tsutomu SUGIURA, Masako IKEUCHI, Y ...
    1999 Volume 45 Issue 11 Pages 677-684
    Published: November 20, 1999
    Released: July 25, 2011
    JOURNALS FREE ACCESS
    Controversy surrounds the indications for surgical or non-surgical treatment of fractures of the mandibular condyle. In this study, the recovery of mandibular function in 238 patients with condylar fractures of the mandible treated surgically or non-surgically at our department between 1981 and 1996 was analyzed on the basis of impairment score to evaluate the efficacy of treatment. The results are summarized as follows:
    1. There was no statistically significant difference between the surgical and non-surgical treatment groups with regard to fracture type or location, but a slightly better outcome was obtained after surgical treatment in patients with fractures of the condylar neck and base with deviation, displacement, and dislocation. Severe dysfunction remained in patients treated nonsurgically for condylar neck and base fractures with dislocation.
    2. The recovery of mandibular function in patients with fractures of the condyle with dislocation was significantly poorer than that in patients without dislocation.
    3. Better mandibular function was obtained in the unilateral fracture group than in the bilateral fracture group.
    4. No functional problems occurred in patients 9 years of age or youngers.
    5. In patients 10 to 29 years of age, there was no difference in mandibular function according to fracture type or location between the surgical and non-surgical patients.
    6. The recovery of mandibular function in patients older than 30 years with fractures of the condylar neck and base with deviation, displacement, and dislocation was better in the surgical group than in the non-surgical group.
    Our results suggest that surgical treatment is indicated for patients older than 30 years who have fractures of the condylar neck and base wiht deviation, displacement, and dislocation.
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  • Etsuro NOZOE, Tamotsu MIMURA, Narihiro HIRAHARA, Shigefumi ASADA, Hiro ...
    1999 Volume 45 Issue 11 Pages 685-687
    Published: November 20, 1999
    Released: July 25, 2011
    JOURNALS FREE ACCESS
    A revised technique for repositioning the proximal segment in sagittal splitting ramus osteotomy (SSRO) is reported.
    A new metal wire frame was developed to measure and record the distance between the anterior margin of the ascending ramus and the maxillary teeth. The frame was made by improving the Schuchardt-Schiene metal frame, which was used in our previous study. A special forceps to accusately reposition the ascending ramus with the wire frame was also developed.
    Geometric analyses were carried out on lateral cephalograms obtained from 46 patients who underwent SSRO by our method between 1994 and 1998. The geometric differences between before and just after the operation ranged from -3.0° to 11.5°, with the mean value of 1.6°. These differences were smaller than those in our previous study.
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  • Kazutaka SUYAMA, Takemitsu MATSUO, Souichi YANAMOTO, Nobuyuki BABA, Ak ...
    1999 Volume 45 Issue 11 Pages 688-690
    Published: November 20, 1999
    Released: July 25, 2011
    JOURNALS FREE ACCESS
    Adenosquamous carcinoma is a malignant tumor initially described by Gerughty et al. in 1968. This tumor shows characteristics of both adenocarcinoma and squamous cell carcinoma and is extremely rare in the oral and maxillofacial region. We report a case of squamous cell carcinoma of the floor of the mouth showing characteristics of adenosquamous carcinoma in a metastatic lesion. The patient was a 45-year-old man, who consulted our department because of contact pain on the left side of the floor of the mouth. Examination of a biopsy specimen indicated a diagnosis of squamous cell carcinoma. The tumor was surgically removed after the patient had received preoperative arterial infusion chemotherapy with radiotherapy. Although there was no recurrence of the primary lesion, swelling of a submandibular lymph node was noted in the left side of the neck 6 months postoperatively. Therefore, total neck dissection was performed on the left side. Histopathological examination of the resected lymph node disclosed the presence of metastatic squamous cell carcinoma, which was intermixed with adenocarcinoma. The histopathological diagnosis was adenosquamous carcinoma. There were no other organs showing metastasis. However, the patient died of tumor recurrence 7 months later.
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  • Tsutomu HIRANUMA, Hideo YOSHIOKA, Takashi MIMA, Tetsuya SASABE, Takash ...
    1999 Volume 45 Issue 11 Pages 691-693
    Published: November 20, 1999
    Released: September 13, 2011
    JOURNALS FREE ACCESS
    EDTA-dependent pseudothrombocytopenia refers to a spurious low platelet count due to antibodies that cause platelet agglutination in blood anticoagulated with EDTA. Here, we report a case of EDTA-dependent pseudothrombocytopenia that occurred during postoperative follow up of a patient with lower gingival carcinoma.
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  • Kenji KAWAHARA, Yoshiro HONMA, Yoshiaki KAWAI, Naritaka MIZUTANI, Hide ...
    1999 Volume 45 Issue 11 Pages 694-696
    Published: November 20, 1999
    Released: July 25, 2011
    JOURNALS FREE ACCESS
    A case of severe thrombocytosis that occurred postoperatively in a 65-year-old man with carcinoma of the floor of the mouth is reported. The platelet count started to increase 7 days after operation, and it reached a peak (100.7×104μl) on the 15th postoperative day. The patient suffered from mild liver dysfunction with slight increases in hepatic enzymes (GOT: 64 1U, GPT: 43 Ill and γ-GTP: 398 Ill) just before the onset of thrombocytosis. Only platelets, and not other blood cell counts, were affected. The interleukin-6 (IL-6) levels in the frozen stored sera of the patient were examined retrospectively. An overt rise and fall of the serum IL-6 level, with a peak value of 135pg/ml (normal:< 5 pg/ml), were observed before the increase in the platelet count. Thus, the possible involvement of thrombocytopoietic factors such as IL-6 was considered in the pathogenesis of the present cause of thrombocytosis.
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  • Akira SATO, Tsuyoshi IIHAMA, Fumio ITO, Syuji TOYA, Akira TANAKA, Izum ...
    1999 Volume 45 Issue 11 Pages 697-699
    Published: November 20, 1999
    Released: July 25, 2011
    JOURNALS FREE ACCESS
    Acantosis nigricans is an uncommon dermatologic disorder with papillary proliferation, pigmentation, and hyperkeratosis that is associated with malignant tumors in internal organs. We report on an elderly patient who had malignant acantosis nigricans associated with oral florid papillomatosis and Leser-Trélat sign. Advanced gastric cancer was found after detecting oral papillomatosis and dermal symptoms in this patient.
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  • Koji SATOH, Yoshimi YAMAMOTO, Takaaki TSUJIKAWA, Goroh HIBI, Masahiko ...
    1999 Volume 45 Issue 11 Pages 700-702
    Published: November 20, 1999
    Released: July 25, 2011
    JOURNALS FREE ACCESS
    A 18-year-old woman was referred to the Department of Oral and Maxillofacial Surgery, Handa City Hospital because of arthralgia of the right temporomandibular joint (TMJ). The patient had a history of right TMJ clicking and limited mouth opening (30 mm). MRI disclosed anterior disc displacement without reduction of the right TMJ. Medication and pumping manipulation had little effect, followed by a gradual reduction in mouth opening. Three months later, she had a mild fever, nasal obstruction, and peripheral paresthesia. CT and MRI demonstrated tumor invasion into the nasopharynx, maxillary sinus, infratemporal fossa, and pterygoid muscles. Examination of a biopsy specimen taken from the upper pharynx revealed a hematogenic tumor. The patient was admitted to the hematology division of Fujita Health University. The diagnosis of acute lymphocytic leukemia was established by examination of the bone marrow aspirate. Induction chemotherapy was initiated according to the JAL SG ALL-93 protocol. The TMJ symptoms resolved with subsequent courses of chemotherapy. On CT and MRI, the tumor disappeared, but mouth opening was limited to 30 mm. Splint therapy and manipulation on every visit were carried out. Two months later, her maximum mouth opening increased to 42 mm. Her clinical course has been favorable without any evidence of recurrence after bone marrow transplantation.
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  • Yutaka KIMIJIMA, Masafumi MIMURA, Nobuyuki TANAKA, Shoko KIMIJIMA, ISO ...
    1999 Volume 45 Issue 11 Pages 703-705
    Published: November 20, 1999
    Released: July 25, 2011
    JOURNALS FREE ACCESS
    Amelanotic malignant melanoma rarely occurs in the oral cavity. We encountered and treated patient with a nodular amelanotic malignant melanoma arising in the maxilla. An 84-year-old woman was referred to our hospital because of a painless, pedunculated, nonpigmented tumor in the center of the anterior alveolar region of the maxilla. The clinical diagnosis was a benign tumor, and the lesion was excised. However, the histopathological diagnosis was malignant fibrous histiocytoma.
    Three months later, a small, partially pigmented tumorous lesion appeared in the same region. The tumor was resected, and minute quantities of melanin granules were observed in some tumor cells histologically. The specimen was diagnosed as amelanotic malignant melanoma. We performed immunohistochemical studies, and positive immunoreactivity for HMB-45 was found in each specimen, confirming the diagnosis.
    Although the patient subsequently underwent rotation radiotherapy to the maxilla, recurrence was found in the nasal cavity and ethmoidal sinuses 13 months after radiation therapy. The tumor grew rapidly, and the patient died 2 years 5 months after presentation.
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  • Yasufumi HORINOUCHI, Masanori SHINOHARA, Tetsuro IKEBE, Kanemitsu SHIR ...
    1999 Volume 45 Issue 11 Pages 706-708
    Published: November 20, 1999
    Released: July 25, 2011
    JOURNALS FREE ACCESS
    Ostema occurs mainly in the skull and facial bones and only rarely arises in the mandible. A rare case of a large peripheral ostema of the mandible is reported. A 46-year-old woman was referred to our hospital because of painless hard masses in the right side of the mandible. She had no symptoms except for facial asymmetry. Radiographic examination revealed two well-circumscribed, dense, radiopaque lesions in the left mandibular body and ramus. The masses, measuring 45×30 mm and 55 × 33 mm, were removed surgically via a submandibular approach under general anesthesia. The histopathological diagnosis was compact osteoma. The patient has been followed up for 5 years and has shown no tumor recurrence. This case is very rare with respect to location and size.
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  • Shuko NAKAYAMA, Akira SASAKI, Hiroshi MESE, Akiyoshi NISHIYAMA, Shoji ...
    1999 Volume 45 Issue 11 Pages 709-711
    Published: November 20, 1999
    Released: July 25, 2011
    JOURNALS FREE ACCESS
    We report a case of calcifying odontogenic cyst (COC) associated with odontoma, which occurred in the mandible of a 51-year-old woman. The lesion showed a single radiolucent area wiht an odontoma-like radiopaque mass on radiographs. It was shaped like a gourd. We classified reported cases of COC with odontoma, including our case, into two types on the basis of the relationship between the location of the cyst and odontoma. Type I is an odontoma in a cyst, and type II is an odontoma outside a cyst. Based on this classification, we analysed 27-cases of COC with odontoma reported in the Japanese literature. The analysis indicated the following results.(1) Twenty cases were classified as type I and 7 cases as type II.(2) The mean age of patients with type I was younger than that of patients with type II (3) Impacted teeth were present in 15 of 20 type I cases and 1 of 7 type II cases.(4) Type II odontomas were larger than type I, but cysts were of various sizes in both types. Our results indicate that differences in the positional relationship between COC and odontoma may be caused by patient age and growth rate of the odontoma.
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  • Isao HIRATA, Kazuhisa BESSHO, Takashi KUSUMOTO, Toshikazu SUZUKI, Tada ...
    1999 Volume 45 Issue 11 Pages 712-714
    Published: November 20, 1999
    Released: July 25, 2011
    JOURNALS FREE ACCESS
    Surgery for fibrous dysplasia of the maxillofacial region is usually performed after bone growth ceases. However, methods for determining the cessation of bone growth have not been established. We studied a case of fibrous dysplasia, using anti-recombinant human bone morphogenic protein-2 monoclonal antibody (rhBMP-2-mAb) to assess bone growth activity. The patient was a 25-year-old woman with facial deformity resulting from fibrous dysplasia of the temporal bone, sphenoid bone, maxilla, zygomatic bone, and mandible. She underwent surgery to correct the deformity. Surgical specimens were not reactive for rhBMP-2-mAb. When considered with our previous findings for fibroosseous lesions positive for rhBMP-2-mAb in areas of active bone formation, our present results indicate that the immunohistochemical staining using rhBMP-2-mAb is useful in determining the timing of surgery for fibroosseous lesions.
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  • Yoshikazu KAMINO, Hiroyuki OKADA, Noriko SAITO, Yuzuru TAKEDA, Hirotsu ...
    1999 Volume 45 Issue 11 Pages 715-717
    Published: November 20, 1999
    Released: July 25, 2011
    JOURNALS FREE ACCESS
    A case of central giant cell granuloma (CGCG) arising in the mandible of a 27-year-old woman is reported. The lesion was studied immunohistochemically. Histopathologically, CGCG had two main components, mononuclear stromal cells and multinucleated giant cells. Immunoreactivity for CD68 was moderate in most giant cells and weak to moderate in some mononuclear cells. These findings indicate that the giant cells and mononuclear cells originated from macrophages. The related literature on CGCG in Japan is also reviewed and discussed.
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  • Hidemichi YUASA, Masayuki SUGIURA, Shogo HASEGAWA, Yosuke JINNO, Kazuo ...
    1999 Volume 45 Issue 11 Pages 718-720
    Published: November 20, 1999
    Released: July 25, 2011
    JOURNALS FREE ACCESS
    A case of gigantic epulis of the mandible with pillar-shaped bone formation is reported. The patient was a 37-years-old man. He complained of a slowly growing, painless, tumor protruding from the right molar region of the mandible to the maxilla. The color of the lesion was normal. On palpation, the lesion was elastic hard with an irregular surface, but had a bony hard base. There was bone resorption of the maxilla at regions in direct contact with the tumorous mass. Radiographically, pillar-shaped bone formation was observed in the lesion. The clinical diagnosis was epulis. The epulis was excised with the patient under NLA anesthesia. The excised specimen measured 30×45×40mm. The bone in the lesion was shaped like a pillar and adhered to the mandible. The histopathologic diagnosis was epulis osteoplastica.
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  • Atsuo KAETSU, Yutaka YAMADA, Yoko OZAWA
    1999 Volume 45 Issue 11 Pages 721-723
    Published: November 20, 1999
    Released: July 25, 2011
    JOURNALS FREE ACCESS
    Multiple endocrine neoplasia (MEN) type II b is a syndrome associated with medullary thyroid carcinoma, phenochromocytoma, and multiple mucosal neuromas. We encountered a rare case of MEN type II b with a palatal cyst and an impacted supernumerary tooth. A 46-year-old man presented to Okazaki municipal hospital because of pain of the palate. He had bumpy lips, multiple diffuse tumors of the oral mucosa, and an open bite. After operation for the palatal cyst, the blood pressure fluctuated widely, ranging from 110/70 to 300/160mmHg. Further examination revealed that he had phenochromocytoma and medullary thyroid carcinoma with lymph node metastases. The palatal cyst was a nasopalatine duct cyst with an impacted supernumerary tooth. Multiple mucosal tumors were diagnosed as neuromas on examination of biopsy specimens.
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  • Tadafumi ADACHI, Yoshiteru YAMAGUCHI, Hiroshi KOHARA, Tokuzo MATSUYA, ...
    1999 Volume 45 Issue 11 Pages 724-726
    Published: November 20, 1999
    Released: July 25, 2011
    JOURNALS FREE ACCESS
    We report a case of gastrointestinal cyst of the tongue. A 10-month-old infant was referred to our hospital for examination of a large mass in the anterior two thirds of the tongue. Under general anesthesia, the lesion was removed entirely. Histologic studies showed that the cyst had an epithelial lining of gastrointestinal mucosa surrounded by smooth muscle bundles.
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  • Naoya NIIMI, Yumi TANIGUCHI, Toshio SHIGETOMI, Hideaki KAGAMI, Hideki ...
    1999 Volume 45 Issue 11 Pages 727-729
    Published: November 20, 1999
    Released: July 25, 2011
    JOURNALS FREE ACCESS
    The May-Hegglin anomaly is an extremely rare, autosomal dominant inherited disorder characterized by the triad of thrombocytopenia, giant platelets, and Döhle-like inclusion bodies in granulocytes. As a result of thrombocytopenia, a mild hemorrhagic diathesis may occur clinically, and special consideration is needed for surgical treatment. However, high-dose γ-globulin therapy, cortical steroids, and immunosuppressants are reported to be ineffective. We performed bilateral extraction of impacted wisdom teeth in a patient with May-Hegglin anomaly. Preoperative hematological examination revealed that the platelet count was 5.5×104/μl. We applied cotton type atelocollagen to the extraction cavity, and complete primary hemostasis was obtained. The patient was not given platelet transfusion. No postoperative hemorrhage occurred, and the patient's progress was good.
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