日本口腔外科学会雑誌
Online ISSN : 2186-1579
Print ISSN : 0021-5163
ISSN-L : 0021-5163
47 巻, 7 号
選択された号の論文の17件中1~17を表示しています
  • 山崎 裕, 千葉 逸朗, 平井 敦子, 佐藤 千晴, 榊原 典幸, 野谷 健一, 福田 博, 柏崎 晴彦, 鄭 漢忠, 戸塚 靖則
    2001 年 47 巻 7 号 p. 389-399
    発行日: 2001/07/20
    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 patterns of tumor-associated p53 mutations are known to be dependent on the primary site and on environmental carcinogens. These characteristics imply molecular linkage between- a particular cancer and specific exogenous or endogenous carcinogens. To clarify the characteristics of the p53 mutational spectrum in oral squamous cell carcinomas (SCCs), we examined p53 mutations in 124 freshly resected specimens of primary oral SCCs by polymerase chain reaction-single-strand conformation polymorphism (PCRSSCP) and direct sequencing.
    p53 mutations were detected in 53 of 124 (43%) cases. Mutations were equally distributed through exons 5 to 8 and were found in codons 135, 176, 193, and 306 in addition to codons 175, 245, 248, and 273, which are known hotspots. In particular, codon 176 could be a mutational hotspot in oral SCCs. We found that 28% of the mutations were G: C→A: T transitions at the CpG site, which has been implicated in endogenous processes, including methylation and deamination of cytosine. In contrast, only 13% of the mutations were G: C→T: A transversions, which have been implicated in association with exogenous carcinogens. G: C→A: T transitions at non-CpG sites and G: C→T: A transversions occurred preferentially on the nontranscribed coding strand of the p53 gene. Therefore, these mutations may arise from bulky chemical DNA adducts. The present study did not support an association between the nature of p53 mutations and tobacco smoking or alcohol intake.
    These data suggest that oral carcinogenesis involving p53 mutations is mainly caused by endogenous processes, however, such carcinogenesis may be partially caused by exogenous carcinogens other than tobacco and alcohol.
  • 田村 英俊, 佐々木 研一, 綿引 隆一郎, 小倉 基
    2001 年 47 巻 7 号 p. 400-404
    発行日: 2001/07/20
    公開日: 2011/07/25
    ジャーナル フリー
    Three-dimensional (3D) analysis of the temporomandibular joint (TMJ) compartment is necessary for diagnosis of internal derangement of the TMJ. We performed contrast-enhanced 3 D-computed tomography (C-3 DCT) in the upper joint compartment of 41 TMJs of 36 patients. C-3 DCT accurately diagnosed adhesion of the upper joint compartment and perforation of the disc in all cases. C-3 DCT facilitates diagnosis by providing a three-dimensional presentation of the entire TMJ compartment, promoting informed consent and understanding by patients. Furthermore, C-3 DCT is a useful diagnostic imaging technique befor arthroscopic surgery of the TMJ.
  • 佐藤 美樹, 佐藤 孝幸, 天笠 光雄
    2001 年 47 巻 7 号 p. 405-407
    発行日: 2001/07/20
    公開日: 2011/07/25
    ジャーナル フリー
    A radicular cyst is the most common odontogenic jaw cyst in adults. However, this cyst rarely occurs in children. Radicular cysts originating from deciduous teeth are particularly rare. We clinically analyzed 9 radicular cysts arising in deciduous teeth that were diagnosed by pathological examination at our department between 1971 and 1998. The ratio of boys to girls was 1.25: 1. The average age on presentation of this cyst was 9.9 years, with a range of 7 to 12 years. Extraction of the affected tooth and marsupialization of the cyst was performed to treat most of the deciduous teeth. The prognosis of all patients was favorable, and no recurrence has occurred.
  • 岩本 修, 津山 治己, 木原 俊之, 古賀 千尋, 楠川 仁悟, 亀山 忠光
    2001 年 47 巻 7 号 p. 408-411
    発行日: 2001/07/20
    公開日: 2011/07/25
    ジャーナル フリー
    We report a case of Cowden's disease with verrucous carcinoma of the buccal mucosa. Pathognomonic symptoms of Cowden's disease include multiple hamartomas of many organs, papillomatosis on the oral mucosa, and discrete papules on the face or limb extremities. These sympotoms often complicate malignant tumor. A 58-year-old woman was referred to our hospital because of a mass in the right buccal mucosa. Upper gastrointestinal endoscopy on preoperative examination showed multiple polyps of the esophagus and stomach. Furthermore, there were papillomatous lesions on the oral mucosa and small papules on the dorsum of the hand and on the face. These symptoms were consistent with the diagnostic criteria for Cowden's disease. The mass in the buccal mucosa was resected, and the histological diagnosis was verrucous carcinoma. The findings suggested that Cowden's disease was associated with oral cancer in this case.
  • 原田 直, 杉山 勝, 蜂須賀 永三, 佐藤 淳, 小川 郁子, 石川 武憲
    2001 年 47 巻 7 号 p. 412-415
    発行日: 2001/07/20
    公開日: 2011/07/25
    ジャーナル フリー
    We describe an unusual case of polymorphous low-grade adenocarcinoma arising from the inner side of the upper lip of a 48-year-old woman. This tumor was firstly reported by Evans and Batsakis (1984) and was adopted as a new entity in the subclassification of adenocarcinoma by the World Health Organization Classification (1991). The clinical course and histopathological and immunohistochemical characteristics are described with a literature review concerning this case. Histologic features include a variety of growth patterns, such as ductal, trabecular, and solid structures. Immunohistochemical analyses showed positive stainings for cytokeratin, vimentin, and S-100 protein. In addition, a few cells forming ductal structures also stained positively for epithelial membrane antigen.
  • 野原 幹司, 舘村 卓, 藤田 義典, 平田 創一郎, 和田 健
    2001 年 47 巻 7 号 p. 416-419
    発行日: 2001/07/20
    公開日: 2011/07/25
    ジャーナル フリー
    We describe the postoperative course of a patient with carcinoma in the oral floor and the tongue, in whom chronic postoperative aspiration successfully responded to intermittent oro-esophageal (IOE) tube feeding with deglutition training. The patient had a poor swallowing reflex, resulting in an immobile pharynx, although postoperative wound healing progressed normally. Initially, a tracheotomy tube to prevent aspiration and a nasogastric (NG) tube for feeding were provided, but swallowing was not restored. A therapeutic program to stimulate swallowing in the pharyngeal stage was established. The program included deglutition training to avoid aspiration and IOE tube feeding to avoid use of the NG tube. Six weeks after initiation of the program, abnormal aspiration of saliva decreased, and the tracheotomy tube was removed. After 8 weeks, the patient was able to orally insert the IOE tube and to take to the required volume of nutrition. The NG tube was therefore discarded. After 5 months, videofluorography confirmed that the patient could swallow safely without aspiration, showing reflexive movement of the pharynx. This clinical experience suggests that swallowing function might be negatively affected not only by surgical invasion but also by long-term placement of an NG tube and a tracheotomy tube. In patients who have aspiration associated with placement of NG and tracheotomy tubes, deglutition training and IOE tube feeding may help to restore swallowing function.
  • 森川 秀広, 森 士朗, 佐藤 敦, 松田 耕策, 一迫 玲, 越後 成志
    2001 年 47 巻 7 号 p. 420-423
    発行日: 2001/07/20
    公開日: 2011/07/25
    ジャーナル フリー
    We report a case of lymphadenitis type toxoplasmosis in the submandibular and cervical lymph nodes of a 53-year-old man with squamous cell carcinoma of the upper gingiva at the right side of the upper incisor region. The size of the tumor was 18×14mm. The patient had swelling of multiple lymph nodes in both sides of the submandibular region and the right side of the cervical region. Tumor resection with neck dissection was performed after chemotherapy with a combination of 5-fluorouracil and cisplatin. Histopathological specimens prepared from the dissected lymph nodes showed no metastatic lesions, but the lymph node specimens had increased numbers of lymphoid follicles, monocytoid B lymphocyte aggregation in the sinus or parafollicular area, and epithelioid cell clusters, especially in the germinal centers. Since these findings strongly suggested toxoplasmic lymphadenitis, serological examination was performed, and an increased level of serum toxoplasmic antibody was detected. In conclusion, we diagnosed this case as toxoplasmic lymphadenitis in the regional lymph nodes associated with squamous cell carcinoma of the upper gingiva.
  • 伊介 昭弘, 林 勝彦, 杉崎 正志, 田辺 晴康
    2001 年 47 巻 7 号 p. 424-427
    発行日: 2001/07/20
    公開日: 2011/07/25
    ジャーナル フリー
    We report a case of peripheral squamous odontogenic tumor, which is a rare benign odontogenic tumor. The patient was a 30-year-old man who presented with a painless swelling in the gingiva of the anterior teeth of the mandible. The mass was hemispherical and dark brown. No abnormality was found in the surrounding tissue. There were no findings on dental radiographs or computed tomographic scans.
    Under local anesthesia, the mass, including the periosteum, was enucleated. The underlying bone had not been resorbed. The removed specimen measured 10×8×4mm and was elastic hard.
    Histologically, the specimen was composed of numerous nests of well-differentiated squamous epithelium in fibrous connective tissue. Each of the epithelial nests had a peripheral layer of cuboidal or squamous cells. There was occasional microcystic generation and calcification. No dysplasia was present. Based on these findings, the lesion was diagnosed as a peripheral squamous odontogenic tumor. Healing was uneventful, and there has been no evidence of recurrence as of 1 year postoperatively.
  • 藤本 佐千恵, 早津 良和, 水柿 雄三, 篠崎 文彦
    2001 年 47 巻 7 号 p. 428-431
    発行日: 2001/07/20
    公開日: 2011/07/25
    ジャーナル フリー
    Myoepithelioma is a rare tumor accounting for less than 1% of all salivary gland tumors. Clinically, myoepitheliomas present as slow-growing, painless masses and cannot be distinguished from pleomorphic adenomas.
    We report a case of myoepithelioma of the palate. The patient was a 35-year-old man who had a painless mass on the palate. On magnetic resonance imaging, the mass showed slight high signal intensity on T 1-weighted images enhanced by gadolinium-DTPA and high signal intensity on T 2-weighted images. The tumor was surgically removed under general anesthesia. The tumor was well encapsulated by a fibrous membrane. Histologically, the tumor was composed mainly of plasmacytoid cells with eccentric nuclei. Immunohistochemical studies revealed positive reactions for S-100 protein and cytokeratin in the tumor cells. Postoperative observation has revealed no recurrence, as of 1 and a half year after the operation.
  • 西村 明洋, 植野 茂, 大杉 泰敏, 杉本 圭介, 白数 力也
    2001 年 47 巻 7 号 p. 432-435
    発行日: 2001/07/20
    公開日: 2011/07/25
    ジャーナル フリー
    We describe our experience with two cases of ossifying fibroma of the mandible that were associated with cystic cavities in the tumor tissue. These cavities included serous fluid and partly lacked a soft tissue lining with the surrounding bone. Clinical and macroscopic findings in these cases resembled those of simple bone cyst.
  • 高橋 悦子, 高橋 雄三, 亀卦川 昭宗, 戸田 ひとみ, 榎本 昭二, 茅野 照雄
    2001 年 47 巻 7 号 p. 436-439
    発行日: 2001/07/20
    公開日: 2011/07/25
    ジャーナル フリー
    We describe a case of amyloidosis of the tongue that developed after long-term hemodialysis (HD) therapy. A 70-year-old man was referred to our department because of spontaneous pain of the left border of the tongue. Firm and waxy white-yellow multinodular lesions were present. Biopsy of a painful lesion histopathologically revealed amyloidosis of the tongue. The patient had been given a diagnosis of chronic renal failure in 1968 and had received HD therapy since 1974. He had suffered from carpal tunnel syndrome (CTS) on the right side in 1986 and on the left side in 1988. He also had dysfunction of both shoulder joints in 1991; amyloid deposits were removed surgically. The serum beta 2-microglobulin level was elevated. This case was therefore diagnosed as HD-associated amyloidosis (HDaA) involving the tongue. Beta 2-microglobulin is a normally occurring protein that is not removed by HD and accumulates in the plasma. It forms amyloid deposits, particularly in the bones and joints and is often associated with CTS with joint dysfunction. Tongue involvement is rare. HDaA is one of the complications of long-term HD. Renal transplantation is the only radical treatment available for HDaA. Because patients with HDaA are increasing, amyloid deposits in oral tissue are likely to be encountered.
  • 萬野 幸代, 櫻井 一成, 西村 則彦, 森寺 邦康, 高岡 一樹, 浦出 雅裕
    2001 年 47 巻 7 号 p. 440-442
    発行日: 2001/07/20
    公開日: 2011/07/25
    ジャーナル フリー
    Sarcoidosis is a systemic granulomatous lesion of uncertain etiology. It occurs most frequently with bilateral hilar lymphadenopathy and skin or eye lesions. Oral sarcoidosis is rare, especially in the tongue. We report on a patient with tongue lesion diagnosed as sarcoidosis.
  • 伊東 大典, 井本 衣美, 堀口 英之, 竹味 利晃, 立川 哲彦, 南雲 正男
    2001 年 47 巻 7 号 p. 443-446
    発行日: 2001/07/20
    公開日: 2011/07/25
    ジャーナル フリー
    Castleman's disease is a rare, benign lymphoproliferative disorder of unknown origin. The mediastinum is most commonly affected by this disease, followed by the cervical lymph nodes. We report a rare case of Castleman's disease arising in the buccal region. An 81-year-old woman was referred to our hospital in 1989 for further examination and treatment of a slowly-growing left buccal mass. A chicken egg-sized, relatively well-defined painless mass was found in the left buccal region. Smaller stellite masses were also palpable. Computed tomography (CT) revealed a homogenouslyenhanced soft tissue mass in the left buccal region, with expansion to the left infratemporal fossa and pterygomandibular space. The left parotid gland was not involved. A biopsy specimen of the lesion displayed features of Castleman's disease. Immunoserological analyses showed a markedly elevated IgM level. Radiotherapy followed by surgical resection of the lesion was performed. Postoperative follow-up has revealed no signs of recurrence.
  • 田中 徳昭, 飯田 征二, 古郷 幹彦, 石井 庄一郎, 妹尾 日登美, 占部 一彦, 松矢 篤三
    2001 年 47 巻 7 号 p. 447-450
    発行日: 2001/07/20
    公開日: 2011/09/13
    ジャーナル フリー
    CATCH 22 syndrome, defined by Wilson in 1993, is associated with cardiac defects, abnormal face, thymic hypoplasia, cleft palate, and hypocalcemia resulting from microdeletions of chromosome 22q11. We report three cases of CATCH 22 syndrome with cleft palate. All patients had a small mouth, bloated eye lids, and a low nasal bridge. Ocular hypertelorism and short palpebral fissures were found in two patients. Two had tetralogy of fallot, and none had thymic hypoplasia. Palatoplasty was performed in all three patients.
  • 園山 智生, 近藤 壽郎, 高田 典彦, 今村 栄作, 瀬戸 皖一
    2001 年 47 巻 7 号 p. 451-454
    発行日: 2001/07/20
    公開日: 2011/07/25
    ジャーナル フリー
    We describe a case of Tourette's disorder in a 7-year-old boy. Symptoms of Tourette's disorder include tic disorders, multiple tics, and voice tics; these sympotoms persist for more than 1 year. Tic disorders are attributed to psychological stress in the household environment.
    Generally, tics appear in childhood and induce self mutilation. Our patient had severe bite wounds in the tongue caused by self mutilation. These symptoms were suggested to be caused by a poor relation with his mother. We were nearly satisfied with the outcome of our symptomatic treatment. However, continuous treatment by a psychiatrist or other specialist is considered necessary.
  • 莇生田 整治, 鬼澤 勝弘, 岩渕 博史, 朝波 惣一郎
    2001 年 47 巻 7 号 p. 455-458
    発行日: 2001/07/20
    公開日: 2011/07/25
    ジャーナル フリー
    We report a rare case of congenital teeth with an eruption cyst. A newborn infant was referred to our department by her pediatrician because of a small swelling on the mandibular gingiva. On oral examination, a dome-like lesion arose on the crest of the anterior mandibular alveolus. Measuring 14mm in diameter, the swelling was fluctuant and apparently filled with fluid. The lesion seemed to contain two white substances. Marsupialization was performed under local anesthesia. We found that the lesion contained two congenital teeth. The partially formed crowns of these teeth were removed. There have been no signs of recurrence in the approximately 1 year since the operation.
  • 堅田 裕, 石川 好美, 小泉 文, 榎本 雅宏, 川田 賢介
    2001 年 47 巻 7 号 p. 459-461
    発行日: 2001/07/20
    公開日: 2011/07/25
    ジャーナル フリー
    Epidermoid cyst is not very rare in the head and neck region. It is generally found in the floor of the mouth, but occasionally occurs in unusual locations. We report a very rare case that occurred in tha lateral deep spaces.
    A 15-year-old girl was referred for examination of a soft, painless mass in the submandibular region. Intraoral examination revealed swelling of the right tonsil. A computed tomographic scan and magnetic resonance imaging revealed a large cystic lesion in the parapharyngeal space and the submandibular space. Excision of the cyst was performed by a submandibular approach. The pathological diagnosis was an epidermoid cyst lined by keratinized squamous epithelium. Two years after the operation, no signs of recurrence or functional disturbance were detected
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