日本口腔外科学会雑誌
Online ISSN : 2186-1579
Print ISSN : 0021-5163
ISSN-L : 0021-5163
50 巻, 6 号
選択された号の論文の15件中1~15を表示しています
  • 根木 慎太郎
    2004 年 50 巻 6 号 p. 349-356
    発行日: 2004/06/20
    公開日: 2011/04/22
    ジャーナル フリー
    We immunohistologically studied expression levels of Ets-1, u-PA, PD-ECGF, and cyclin D1 in patients with stage I or II squamous cell carcinoma of the tongue; we then analyzed the relation between histological grade of malignancy, using the classification methods proposed by Anneroth and Yamamoto-Kohama (Y K), and subsequent cervical lymph node metastasis.
    Our study involved 31 patients with stage I or II squamous cell carcinoma of the tongue who had undergone only a partial glossectomy for primary resection. The invasive front on maximum cut sections of the resected specimens was evaluated. The results showed that 8 patients (25.8%) had subsequent metastasis to the cervical lymph nodes.
    High invasviveness, as indicated by a high grade according to Anneroth's classification and grades 3 and 4C according to the Y K classification, was associated with a high frequency of metastasis to the cervical lymph nodes. As for the relation between the expression of Ets-1, u-PA, PD-ECGF, or cyclin D1 and subsequent metastasis to the cervical lymph nodes, a trend toward a high percentage of positive cells was associated with higher histological malignancy scores. Further more, we closely analyzed cases with high grades according to Anneroth's classification or grade 4C according to the Y K classification, and found significant correlations between Ets-1 expression and subsequent metastasis. Our findings suggest that evaluating Ets-1 expression may be a useful method for predicting subsequent metastasis to the cervical lymph nodes.
  • 吉田 博昭, 福村 吉昭, 鈴木 真矢, 安原 豊人, 横田 幸治, 山口 昭彦
    2004 年 50 巻 6 号 p. 357-361
    発行日: 2004/06/20
    公開日: 2011/04/22
    ジャーナル フリー
    We treated 1472 patients who were suffering from internal derangement of the temporomandibular joint (TMJ) between April 1' 1999 and March 31' 2002. We studied the efficacy of simple mandibular manipulation therapy on the day of presentation in 154 patients (42 males and 112 females) with closed lock of the TMJ.
    The results were as follows:
    (1) At presentation, 133 (86.4 %) patients were unlocked by simple mandibular manipulation therapy.
    (2) The response rate in females and males were 88.4 % and 81.0 %, respectively.
    (3) All patients (100 %) became unlocked by the present therapy within 1 week from the onset of symptoms.
    (4) The effectiveness of the therapy was reduced if closed lock had persisted for 3 or more weeks.
  • 上田 貴史, 古郷 幹彦, 山本 友美, 大谷 朋弘, 小牧 誠史, 戸塚 靖則, 古澤 清文, 菅原 利夫, 杉原 一正, 瀬戸 院一
    2004 年 50 巻 6 号 p. 362-367
    発行日: 2004/06/20
    公開日: 2011/04/22
    ジャーナル フリー
    Infective endocarditis (IE) is the most important complication in dentistry and oral surgery. Patients with a history of congenital heart disease or valvular disease are at high risk for IE and are therefore given prophylactic treatment with antimicrobial agents. Currently, however, there is no standard treatment; prophylactic treatments vary among different institutions. The Japanese Circulation Society is planning to publish “Guidelines for the Prevention and Treatment of Infective Endocarditis.” In November 2002 the head of the National Cardiovascular Center, Dr. Kunio Miyatake, sent a questionnaire on IE to the Japanese Society of Oral and Maxillo-facial Surgeons. We obtained the cooperation of the Society's specialists and proceeded with the investigation. The results of the questionnaire, indicated that awareness of the need to prevent IE was highest postoperatively for patients with valvular disease or inoperable valvular disease, and postoperatively for congenital heart disease or inoperable congenital heart disease. Awareness of the need to prevent IE was also strong among oral surgeons treating patients who had had heart operations such as coronary artery bypass surgery and pacemaker implantation. Moreover, respondents to the questionnaire believed it was important to consider the degree of invasiveness of the specific dental treatment in patients with cardiac disease, and schemes for the prophylaxis of IE were implemented when the degree of invasiveness exceeded that of scaling. As for the antimicrobial agents given for prophylaxis, many different penicillins and cephalosporins were used. Many responses regarding dosage referred to the recommendations of the American Heart Association (AHA).
  • 吉田 雅之, 大月 佳代子, 大西 正俊
    2004 年 50 巻 6 号 p. 368-371
    発行日: 2004/06/20
    公開日: 2011/04/22
    ジャーナル フリー
    Difficulty in extracting a foreign object embedded in tissue of the oromaxillofacial region is not uncommon. Arthroscopic surgery is often used to treat conditions of the temporomandibular joints. We successfully extracted foreign objects embedded in a cul-de-sac facial gunshot wound adjacent to the temporomandibular joint, using a rigid endoscope originally designed for temporomandibular arthroscopic surgery. The procedures used are described in this report.
    The patient was a 46-year-old man who had been shot in the left side of the face. The bullet lodged in tissue medial to the left temporomandibular joint and sphenoidal sinus. Without any additional incision, a temporomandibular arthroscope was introduced from the point of entry of the bullet beneath the eye socket with the patient under general anesthesia. A total of 34 objects, including the bullet, its fragments and glass fragments from the patient's eyeglasses, were endoscopically extracted with the use of a grasping forceps. Arthroscopic monitoring permitted visual confirmation of the foreign bodies and enabled their successful extraction with minimal invasion.
  • 森 一将, 竹島 浩, 島田 藍, 福永 秀一, 嶋田 淳, 草間 薫
    2004 年 50 巻 6 号 p. 372-375
    発行日: 2004/06/20
    公開日: 2011/04/22
    ジャーナル フリー
    Botryoid odontogenic cyst was first described by Weathers and Waldron in 1973, and only a small number of cases have subsequently been reported in the literature.
    We report a case of a botryoid odontogenic cyst of the mandible in a 59-year-old woman and describe the clinical, radiographic, and histological features.
  • 三浦 正資, 岡村 和彦, 三輪 邦弘, 下田 恒久, 大関 悟, 本田 武司
    2004 年 50 巻 6 号 p. 376-379
    発行日: 2004/06/20
    公開日: 2011/04/22
    ジャーナル フリー
    We describe a 73-year-old man with a relatively large peripheral ameloblastoma arising from the anterior part of the mandibular gingiva. Clinical examination of the lesion showed a globular mass, about 40×30mm in diameter, which was elastic hard and had a wide base that closely adhered to the alveolar bone. The base partially extended to the floor of the mouth, and the remaining teeth (5-4) adjoining the mass were quite loose. An Xray film disclosed a wide area of superficial resorption in the alveolar bone surrounding the remaining teeth. A biopsy was performed, and the histological diagnosis was ameloblastoma. Based upon the diagnosis of peripheral ameloblastoma, excision of the tumor tissue was performed with the patient under general anesthesia. Pathological examination of the specimen revealed neoplastic ameloblastic cells proliferating chiefly in the submucosa. The neoplastic cells were directly contiguous with the surface squamous epithelium. Individual tumor nests consisted of peripheral layers of columnar or cuboidal cells and enclosed central areas of reticular or partially keratinized acanthomatous cells. Discrete islands and nests of tumor cells were set in a loose collagenous stroma with hyalinization. As of 4 years after the operation, no sign of recurrence has been observed.
  • 水谷 雅英, 高田 訓, 小板橋 勉, 大野 敬, 千葉 卓, 三科 正見
    2004 年 50 巻 6 号 p. 380-383
    発行日: 2004/06/20
    公開日: 2011/04/22
    ジャーナル フリー
    Cementifying fibroma and ossifying fibroma are classified together under cemento-ossifying fibroma and defined as osteogenic tumors according to the WHO histological classification in 1992. Cemento-ossifying fibroma is a relatively rare tumor, generally occurring in adult jaw bones. Few reports have described cementoossifying fibroma occurring in many places in the same jaw bone. This report describes a rare case of cementoossifying fibroma arising symmetrically in both mandibular molar regions. The patient was a 15-year-old girl, in whom tumors were detected bilaterally in the mandibular molar region at a dental clinic. Histological examination showed a basophilic calcified mass and a stroma consisting of cellular fibrous tissue. The histopathological diagnosis was cemento-ossifying fibroma.
  • 笠井 唯克, 桑島 広太郎, 田中 四郎, 毛利 謙三, 広瀬 尚志, 兼松 宣武
    2004 年 50 巻 6 号 p. 384-387
    発行日: 2004/06/20
    公開日: 2011/04/22
    ジャーナル フリー
    A 40-year-old-woman presented with swelling and pain of the right buccal mucosa. The swelling protruded intraorally. An incisional biopsy revealed pleomorphic adenoma in the pterygomandibular space. The tumor was surgically removed via a mandibular swing approach. The entire resected specimen was submitted to histopathological evaluation, which showed solid and myxomatous areas, typical of pleomorphic adenoma, throughout the tumor specimen. No recurrence was observed during 3 years of follow up.
  • 田中 潤一, 市川 秀樹, 伊藤 亜希, 相川 弦, 松崎 英雄, 吉川 京燦
    2004 年 50 巻 6 号 p. 388-391
    発行日: 2004/06/20
    公開日: 2011/04/22
    ジャーナル フリー
    We report the case of 57-year-old man with metastasis of squamous cell carcinoma to the right subdigastric lymph nodes from an unknown primary site.
    Although the first smear test of sputum was classified as V, the primary site could not be identified on further examination. Total neck dissection on the right side was performed after 2 courses of chemotherapy. Two more courses of chemotherapy were given after the operation, but radiotherapy was not performed.
    The patient is free of recurrence and metastasis about 2 and a half years after treatment.
  • 清水 麻斎子, 田島 徹, 福島 正樹, 葦沢 健, 草間 薫, 嶋田 淳
    2004 年 50 巻 6 号 p. 392-395
    発行日: 2004/06/20
    公開日: 2011/04/22
    ジャーナル フリー
    Mucoepidermoid carcinoma is a salivary gland neoplasm characterized by the coexistence of epidermoid cells, mucussecreting cells, and intermediate cells. Among the minor salivary glands, this carcinoma commonly arises in the palatal glands. In the present paper, we report a case of mucoepidermoid carcinoma with calcification that was examined microscopically. The patient was a 25-year-old man. He visited our hospital because of a swelling in the right side of the palate. The lesion had developed 6 years earlier and gradually increased in size. He was given a clinical diagnosis of palatal tumor and underwent partial resection of the maxilla under general anesthesia to excise the tumor. The tumor was diagnosed histopathologically as a mucoepidermoid carcinoma. There was an eosinophilic, homogenous substance in the interstitium of the tumor. Calcified materials with a lamellar structure were found in cysts and ducts in the tumor. Mucus and mucus-secreting cells in the tumor were deeply stained by mucicarmine, but not stained by Congo red. There has been no recurrence or metastasis of the tumor as of 12months after operation.
  • 小泉 浩一, 林堂 安貴, 吉岡 幸男, 原 潤一, 岡本 哲治
    2004 年 50 巻 6 号 p. 396-399
    発行日: 2004/06/20
    公開日: 2011/04/22
    ジャーナル フリー
    Metastatic tumors of the oral region are rare, representing about 1 % of malignant tumors in the oral cavity. In this article, we report a case of carcinoma of the sigmoid colon that metastasized to the maxillary gingiva and review of literature. A 69-year-old man underwent extraction of the right first and second molars of the maxilla, and a rapidly proliferating lesion developed at the site. The patient had previously undergone surgical excision of adenocarcinoma of the sigmoid colon. Histological examination of the oral lesion revealed adenocarcinoma similar to the previous lesion in the colon. Moreover, the serum levels of carcinoembryonic antigen (CEA) and carbohydrate antigen (CA) 19-9 were elevated. These findings suggested that the oral lesion was a metastatic adenocarcinoma from the sigmoid colon. Although computerized tomographic scans showed metastatic lesions of the liver and lung, the gingival tumor was excised to improve dysphagia induced by the rapidly growing tumor. He died of respiratory arrest 4 months after surgery.
  • 野村 公子, 石井 庄一郎, 金 曙館, 美馬 孝至, 古郷 幹彦
    2004 年 50 巻 6 号 p. 400-403
    発行日: 2004/06/20
    公開日: 2011/04/22
    ジャーナル フリー
    Tuberculosis of the parotid gland is an uncommon disease. Differential diagnosis of tuberculosis from tumors or inflammatory disease is clinically difficult and requires histopathological examination.
    We report a case of tuberculosis of the intraparotid lymph nodes. The patient was a 36-year-old woman who had swelling of the right parotid gland for 1 week. Physical examination showed an elastic soft mass, measuring approximately 18×18 mm, in the right parotid gland. She complained of tenderness of the mass.
    Magnetic resonance imaging and ultrasonography showed a tumorous lesion in the right parotid gland. Extirpation of the tumor was performed. The histopathological diagnosis was tuberculous lymphadenitis.
    The patient was treated with rifampicin, isoniazid, ethambutol hydrochloride, and pyrazinamide for 8 months. There has been no evidence of recurrence for 8 months.
  • 吉岡 泉, 冨永 和宏, 古田 功彦, 佐藤 耕一, 嶋村 知記, 福田 仁一
    2004 年 50 巻 6 号 p. 404-407
    発行日: 2004/06/20
    公開日: 2011/04/22
    ジャーナル フリー
    A case of mandibular prognathism in a 15-year-old woman with idiopathic thrombocytopenic purpura (ITP) is reported.
    In this patient, ITP had been diagnosed during preoperative orthodontic treatment. Since the preoperative laboratory data revealed a low platelet count of 5.5×104/μl, the patient was given preoperative high-dose γ-globulin therapy (400mg/kg/day) for 5 days. On the day of the operation, the platelet count had increased to 12.0×104/μl.Intraoral vertical ramus osteotomy was performed, and the amount of perioperative blood loss was 194g.After surgery, there was no abnormal bleeding, and the postoperative course was uneventful.
    High-dose γ-globulin therapy is considered a very useful and safe method for preoperative treatment of patients with ITP.
  • 澤 裕一郎, 熊澤 友子, 滝本 明, 馬杉 亮彦, 川野 大, 野村 明日香
    2004 年 50 巻 6 号 p. 408-411
    発行日: 2004/06/20
    公開日: 2011/04/22
    ジャーナル フリー
    Paralysis of the mental nerve is one of the principal complications of surgery of the mandibular canal and mental foramen region. The position of mental foramen can be clearly depicted on CT scans. The mental foramen is bilaterally located at the mandibular premolar region and appears as a dimple on the bone surface. However, several reports have described an accessory mental foramen (AMF). We examined CT pictures taken from patients with implants for missing mandibular teeth to detect variations of the AMF. The results were follows: 1) AMFs were present in 28 patients (24.6 %). 2) Unilateral AMFs were found in 24 patients, and bilateral AMFs in 4 patients. 3) Among patients with unilateral AMFs, 21 had AMFs with one foramen, and 3 had AMFs with two foramens. Among patients with bilateral AMFs, 2 patients had one foramen on each side, and 2 had two foramens on one side. 4) The position of AMF relative to that of the mental foramen was as follows: 18 foramens were superior mesial, 8 were superior distal, 6 were inferior mesial, and 5 were inferior distal.
    These results suggest that one quarter of patients with missing mandibular teeth may have AMFs around the mental foramen.
  • 中埜 秀史, 増本 一真, 内藤 克美
    2004 年 50 巻 6 号 p. 412-414
    発行日: 2004/06/20
    公開日: 2011/04/22
    ジャーナル フリー
    Two cases of accidental insertion of foreign bodies, root canal filling material and a dental cutting bar, in the maxillary sinus are described. The objects were inserted during dental treatment by the patients' primary dentists. The patients were informed of the accidental insertions before being referred to our center. The filling material and the cutting bar were both surgically removed. Recovery was uneventful in both patients.
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