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47 巻, 11 号
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山崎 裕, 千葉 逸朗, 平井 敦子, 金田 泰幸, 野谷 健一, 福田 博, 柏崎 晴彦, 戸塚 靖則, 飯塚 正, 向後 隆男2001 年 47 巻 11 号 p. 649-655
発行日: 2001/11/20
公開日: 2011/07/25
ジャーナル フリーMutations of the p53 tumor suppressor gene have been found in about 50% of all human cancers.
The relation of p53 status to clinicopathological variables and prognosis has been evaluated; however, it remains controversial in most cancers. Recent studies suggest that malignant potential and biological properties may depend on the region of mutation. It has also been demonstrated that specific regions of mutations within the core domain of p53 protein correlate with poor prognosis in breast cancer, esophageal cancer and colon cancer. To clarify the correlation between mutations within the DNA binding surface regions of p53 and clinical outcome in patients with oral cancer, we analyzed p53 mutations in 91 fresh primary, resected specimens of oral squamous cell carcinomas (SCCs) by polymerase chain reaction-singlestrand conformation polymorphism (PCR-SSCP) and a yeast functional assay.
p53 mutations were detected in 36 of 91 (40%) cases. No correlation was found between overall mutations in the p53 gene and clinicopathological variables, clinical outcome, or survival rate. The five-year cumulative survival rate of 18 patients with tumors that had p53 mutations within DNA-binding surface regions (L2, L3, LSH) was significantly lower (52.5%) than that of the 73 other patients (p=0.004). Multivariate analysis, showed that mutations within these regions were independent prognostic factors (p<0.05, hazard ratio=2.9).
These data suggest that mutations within DNA-binding surface regions of p53 may be important prognostic factors in oral SCCs.抄録全体を表示PDF形式でダウンロード (911K) -
黒川 英雄, 武田 忍, 山下 善弘, 三浦 恵子, 高橋 哲2001 年 47 巻 11 号 p. 656-660
発行日: 2001/11/20
公開日: 2011/07/25
ジャーナル フリーThe relation between tumor depth and cervical lymph node metastasis was retrospectively investigated in 68 patients with squamous cell carcinoma of the tongue who underwent surgical treatment from 1981 through 1996.
The results were as follows:
1. There was a correlation between tumor depth and cervical lymph node metastasis in squamous cell carcinoma of the tongue.
2. The incidence of cervical lymph node metastasis increased markedly when the tumor depth was 4mm or greater and tumor diameter was 30 mm or greater.
These findings suggest that tumor depth is a risk factor for cervical lymph node metastasis in squamous cell carcinoma of the tongue.抄録全体を表示PDF形式でダウンロード (624K) -
60Co外照射との併用による治療効果を中心に木村 剛, 谷田 豊宏, 立本 行宏, 植田 栄作, 山本 哲也, 尾崎 登喜雄2001 年 47 巻 11 号 p. 661-669
発行日: 2001/11/20
公開日: 2011/07/25
ジャーナル フリーControl of metastatic lymph nodes, especially enlarged nodes with adhesion, is extremely difficult. We treated metastatic lymph nodes with adhesion by intranodal injection (INI) of anticancer agents and obtained prolonged control of metastasis. Sixteen patients with a total of 23 metastatic lymph nodes with adhesion that were not indicated for surgical removal were studied. INI of peplomycin (14.0±10.4mg), CDDP (10.0±0mg), CBDCA (60.0±37.3mg), methotrexate (28.5±27.1mg), and 5-FU (311.1±194.9mg) was given to all, 1, 10, 7, and 8 patients, respectively. External radiation with cobalt 60 (2Gy/time, 42.8±9.7Gy) was given to all but 3 patients. The results obtained were as follows:
1. Except for one patient in whom the therapeutic respones could not be evaluated, all subjects had remission of swollen lymph nodes. The remission rates ranged from 99.6% to 14.3%(average, 51.3±27.8%).
2. In three patients, metastatic lymph nodes became small enough to be surgically removed without recurrence. Of the remaining 13 patients, 11 had no re-enlargement for at least 3 months after the end of INI.
3. Three patients are still alive (observation periods, 57, 6, and 6 months). Eleven patients died of uncontrolled primary lesions, distant metastases, or metastatic lymph nodes despite treatment with INI and radiation. The remaining two patients died of cardiovascular disease and pneumonia.
4. Of the 13 patients who died, 6 (37.5% of all patients) survived for 10 months or more from the start of INI, and the remaining 7 survived for about 5 months. The mean duration of survival was 11.8±13.9 months. Finally, INI controlled metastatic lymph nodes although the therapeutic response was unclear in one patient and could not be evaluated in another.
In conclusion, INI is an useful treatment for large metastatic lymph nodes that adhere to surrounding tissue and cannot undergo lymphectomy.抄録全体を表示PDF形式でダウンロード (6732K) -
出山 文子, 由良 晋也, 泉山 ゆり, 上野 尚雄, 竹山 禎章, 馬渕 亜希子, 門脇 繁, 鄭 漢忠, 井上 農夫男, 戸塚 靖則2001 年 47 巻 11 号 p. 670-675
発行日: 2001/11/20
公開日: 2011/07/25
ジャーナル フリーTo investigate the relation between temporomandibular (TM) joint disorders and various changes associated with aging, 1092 elderly persons were examined with respect to signs and symptoms of TM disorders, age, sex, oral condition, constitution, and age-related factors, such as activities of daily living. The study group comprised persons 65 years or older who were staying at institutions for the elderly.
The data were analyzed by the logistic regression analysis, and the results were as follows:
(1) The incidence of signs and symptoms of TM disorders was higher in women than in men (odds ratio: 1.92, 95% confidence interval: 1.34 to 2.75).
(2) A significant positive correlation was found between the incidence of signs and symptoms of TM disorders and the need for assistance during eating (odds ratio: 1.49, 95% confidence interval: 1.19 to 1.89).
(3) There was a significant negative correlation between body mass index and the incidence of signs and symptoms of TM disorders (odds ratio: 0.96, 95% confidence interval: 0.93 to 0.99).抄録全体を表示PDF形式でダウンロード (848K) -
小野 貢伸, 藤田 温志, 高野 昌士, 松田 曙美, 飯塚 正, 戸塚 靖則2001 年 47 巻 11 号 p. 676-679
発行日: 2001/11/20
公開日: 2011/07/25
ジャーナル フリーMetastasis to the lateral retropharyngeal lymph nodes frequently occurs in nasopharyngeal cancers; however, it is very rare in oral carcinomas. This report describes a case of recurrent carcinoma of the lower alveolus with metastasis to retropharyngeal lymph nodes. The patient was an 84-year-old woman who underwent radical neck dissection with marginal resection of the right side of the mandible for a squamous cell carcinoma arising in the lower gingiva (T 2 N 1 M 0). Twenty-five months after the operation, she complained of a mass with ulceration in the floor of the mouth. A smear of the ulcer proved tumor recurrence. Computed tomography and magnetic resonance imaging showed that the mass invaded the tongue, with metastasis to the submental and bilateral metastases to the retropharyngeal lymph nodes. The patient and her family refused salvage treatment. She died of tumor 6 months after recurrence.抄録全体を表示PDF形式でダウンロード (6886K) -
山崎 慎司, 佐藤 敦, 友寄 泰樹, 舩山 恭子, 山口 泰, 森 士朗2001 年 47 巻 11 号 p. 680-683
発行日: 2001/11/20
公開日: 2011/07/25
ジャーナル フリーWe report a case of tuberculous lymphadenitis simultaneously detected in the metastatic cervical lymph nodes of a patient with tongue cancer. An 82-year-old woman was operated on for squamous cell carcinoma of tongue (T1 N0 M0) after chemotherapy with a combination of 5-fluorouracil and cisplatin. After 5 months follow-up, bilateral lymph node metastases were detected in the cervical region, and radical neck dissection was performed. Histopathological specimens prepared from the dissected tissue revealed metastasis of squamous cell carcinoma as well as epithelioid granuloma with Langhans' giant cells and caseous necrosis in 3 of 33 lymph nodes examined; 4 lymph nodes free from metastasis showed epithelioid granuloma. In addition to a positive response to tuberuculin antigen, the patient had a history of pulmonary tuberculosis in her late teens, and her chest X-ray film showed multiple areas of calcification at the apexes of both lungs with pleuritic thickening at the apex of the left lung. Although we found no detect evidence of mycobacterium infection on Ziehl-Neelsen staining, PCR analysis of DNA from the cervical lymph nodes, or sputum culture, we concluded this case involved tuberculous lymphadenitis of the metastatic lymph nodes on the basis of theclinicopathological findings.抄録全体を表示PDF形式でダウンロード (6613K) -
孫 安生, 高橋 克, 山村 功, 白井 陽子, 坪井 陽一, 飯塚 忠彦2001 年 47 巻 11 号 p. 684-687
発行日: 2001/11/20
公開日: 2011/07/25
ジャーナル フリーKaposi's sarcoma is one of the most common diseases in patients with AIDS, but it is rare in Japan. We describe a case of oral Kaposi's sarcoma diagnosed as epulis on the basis of clinical and pathological findings. Chang (1994) reported that Kaposi's sarcoma is associated with human herpesvirus 8 (HHV-8). We confirmed the presence of HHV-8 in this case by the nested PCR method. Moreover, the oral Kaposi's sarcoma indicated that this patient had AIDS.抄録全体を表示PDF形式でダウンロード (5787K) -
笠原 慎太郎, 瀬川 清, 工藤 啓吾, 泉沢 充, 武田 泰典2001 年 47 巻 11 号 p. 688-691
発行日: 2001/11/20
公開日: 2011/07/25
ジャーナル フリーGlandular odontogenic cyst is a rare jaw bone cyst of odontogenic origin, first described in 1988 by Gardner et al.
Radiologically, a well-defined unilocular cyst lesion is seen. Histologic features include a thin layer of epithelium with surface cilia and glandular or pseudoglandular structures.
A case of glandular odontogenic cyst of the maxilla is reported.抄録全体を表示PDF形式でダウンロード (6492K) -
寺坂 修治, 橋本 堅, 井上 正洋, 藤澤 清一2001 年 47 巻 11 号 p. 692-694
発行日: 2001/11/20
公開日: 2011/07/25
ジャーナル フリーWe report a rare case of congenital mucous cyst arising in the lower lip. An 8-month-old girl had a 10×10mm pedunculated mass in the left lower lip. The surface of the mass showed a healthy color.
The mass was softly elastic, mobile and slightly fluctuating.
The mass was removed under local anesthesia. The specimen consisted of granulation tissue and fibrous connective tissue, including inflammatory cell infiltration and capillary dilatation. No epithelium covered the lesion. On the basis of these findings, the mass was diagnosed as a mucous extravasation cyst.
It was difficult to determine the cause of the mass because it was present since birth. However, we suspected that congenital weak points in the ducts had induced mucous leakage. A review of the literature suggested that mucous cysts are caused not only by mechanical stress and closed ducts but also by congenital problems and morphological and functional disorders.抄録全体を表示PDF形式でダウンロード (3524K) -
伊賀 弘起, 日下 淳, 玉谷 哲也, 中城 公一, 吉田 秀夫, 佐藤 光信2001 年 47 巻 11 号 p. 695-698
発行日: 2001/11/20
公開日: 2011/07/25
ジャーナル フリーThe most common cause of acute idiopathic peripheral facial nerve paralysis (Bell's palsy) remains unknown. Recent studies have shown that herpes simplex virus type 1 (HSV-1) is one of the most common causes of Bell's palsy. We describe two cases of Bell's palsy that responded to treatment with the antiviral agent acyclovir. Although infectious HSV and HSV-DNA could not be detected in saliva samples obtained from either patient, serological studies indicated that the paralysis was attributed to reactivation of HSV-1. The patients were given acyclovir and prednisolone for 2 weeks. Neural symptoms resolved gradually, and facial nerve paralysis disappeared after 3 weeks.
These two cases suggest that early treatment with acyclovir and prednisolone is effective in patients with Bell's palsy.抄録全体を表示PDF形式でダウンロード (5219K) -
坂本 一郎, 朝比奈 泉, 阿部 正人, 東中川 真木子, 榎本 昭二, 岡田 憲彦2001 年 47 巻 11 号 p. 699-702
発行日: 2001/11/20
公開日: 2011/07/25
ジャーナル フリーWe report a rare case of fibrosis in the mandible that was probably caused by traumatic lesions. A 36-year-old man was referred to our clinic for evaluation and treatment of a radiolucent lesion in the right mandibular canine region. The mucosa in this region was normal. There was no cortical expansion. Computed tomography revealed a soft tissue mass at the right side of mandible. It measured 25×15×12mm and had poorly defined borders with resorption of the buccal and lingual cortical bones. Biopsy of the lesion showed inflammatory fibrous tissue. Under general anesthesia, the patient underwent extirpation of the lesion. Histopathologically, fibrous tissue consisting of interlacing collagenous fibers was noted. The course was uneventful, and bone regeneration in the bone cavity was revealed by computed tomography 1 year after surgical treatment.抄録全体を表示PDF形式でダウンロード (6979K) -
微生物学的検討木下 智, 尾上 孝利, 栗林 信仁, 中辻 智子, 覚道 健治, 白数 力也2001 年 47 巻 11 号 p. 703-706
発行日: 2001/11/20
公開日: 2011/07/25
ジャーナル フリーWe studied growth and drug susceptibility of fungi and bacteria isolated from patients with mycosis of the maxillary sinus. In culture specimens from sinusitis dentalis suspected to be caused by mycosis, Aspergillus fumigatus, Streptococcus constellatus, Peptostreptococcus anaerobius, Prevotella intermedia, and Prevotella sp. were isolated. A. fumigatus blocked the growth of the other test organisms. MICs of amphotericin B, nystatin, miconazole, and bifonazole against A. fumigatus were low. However, MICs of griseofulvin, flucytosine, and fluconazole against A. fumigatus were high. Pr. intermedia and Pr. sp. were resistant to β-lactam antibiotics and produced β-lactamases.
Our results suggest that maxillary sinus mycosis was triggered by an attack of sinusitis dentalis due to oral bacteria. Next, A. fumigatus invaded the lesion and held a dominant position in the resulting mycosis. When administering chemotherapy, attention should be paid not only to fungi and bacteria but also to sensitive fungi and bacteria and resistant strains.抄録全体を表示PDF形式でダウンロード (3038K) -
矢郷 香, 朝波 惣一郎, 岡田 豊, 安居 孝純, 木津 英樹, 笠崎 安則2001 年 47 巻 11 号 p. 707-710
発行日: 2001/11/20
公開日: 2011/07/25
ジャーナル フリーArteriovenous malformations (AVM) of the jaws are uncommon lesions in which hemorrhage is often difficult to manage.
A 16-year-old girl was referred to our hospital because of intraoral arterial bleeding on July 6, 1981. A large AVM of the maxilla was found on angiography. Transcatheter arterial embolization (TAE) was performed against the arteries supplying the maxillary lesion. However, bleeding recurred because a collateral blood supply developed. Between 1981 and 1995, TAE was carried out 8 times, but was not effective.
On June 29, 2000, direct embolization was performed. AVM was embolized by injection of n-butyl-2-cyanoacrylate (NBCA) into the nidus through the buccal gum on the left side of the maxilla. AVM was obturated, and hemorrhage was controlled.
Direct embolization of the nidus was a useful option for the treatment of recurrent AVM.抄録全体を表示PDF形式でダウンロード (6377K) -
山崎 慎司, 佐藤 敦, 高橋 俊幸, 篠原 文明, 山口 泰, 森 士朗2001 年 47 巻 11 号 p. 711-714
発行日: 2001/11/20
公開日: 2011/07/25
ジャーナル フリーWe report a case of lymphoid hyperplasia in the mental region caused by a foreign body, found to be a fragment of a tungsten carbide bur on X-ray microanalysis. A 62-year-old man visited our hospital because of a soft phyma, measuring 10mm in diameter and arising in the mental region. Although no cicatrization caused by injury was found on the phyma, the patient had a history of dental treatment to remove a crown from the lower incisor region 3 years before presentation to our clinic. Four years after presentation, extirpation of the phyma was performed. The extirpated phyma was soft and solid, and included a metallic foreign body measuring 2mm in diameter. Histopathological examination showed lymphoid hyperplasia around the foreign body. The foreign body was analyzed with the use of an electron probe microanalyzer and scanning electron microscope, with a tungsten carbide bur as a control. The morphological characteristics and composition of the metallic foreign body were found to be similar to those of the tungsten carbide bur. In conclusion, the lymphoid hyperplasia of this case was most likely caused by accidental inclusion of a tungsten carbide bur fragment under the mucosa of the oral vestibule during dental treatment.抄録全体を表示PDF形式でダウンロード (6781K)
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