Japanese Journal of Oral and Maxillofacial Surgery
Online ISSN : 2186-1579
Print ISSN : 0021-5163
ISSN-L : 0021-5163
Volume 54, Issue 5
Displaying 1-6 of 6 articles from this issue
  • Kazuyuki SHIMADA
    2008 Volume 54 Issue 5 Pages 304-308
    Published: May 20, 2008
    Released on J-STAGE: April 22, 2011
    JOURNAL FREE ACCESS
    Radical neck dissection method systematized by Crile (1906) and establish and popularized by Martin et al. in ORL or oral surgery field. Radical neck dissction is most important treatment for head and neck cancer. But in fact, the method dissection modified by each cases such as the metastasis stage. For this reason, the anatomical knowledge especially head and neck region are very important to avoid the medical accident for QOL. In this time, the anatomical knowledge described again for neck region.
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  • A consideration for establishing diagnostic criteria
    Eiichiro ARIJI
    2008 Volume 54 Issue 5 Pages 309-315
    Published: May 20, 2008
    Released on J-STAGE: April 22, 2011
    JOURNAL FREE ACCESS
    Diagnostic imaging now plays an important role in the discrimination of metastatic lymph nodes in patients with head and neck cancers including oral squamous cell carcinomas. In these patients, computed tomography (CT) and ultrasonography (US) are frequently used in clinical situations. Various diagnostic criteria have been proposed by many authors using these two modalities. However, an ideal criterion could not always be applied to all institutions because situations would be quite different among institutions. There would be differences in performance of machine used, convenience of examination and policy foward treatment. Taking these differences into account, how do we establish a criterion? In this article, the basic concept was discussed for determination of a practical criterion.
    The criterion showing the highest accuracy is not always the best one, since sensitivity is essential for screening. The purpose should be clarified before examination. Moreover, reproducibility is as important as accuracy for diagnosis in a clinical setting. The criterion should be customized for each institution.
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  • Tsukasa KUROIWA, Nobuharu YAMAMOTO, Takeshi ONDA, Hiroki BESSYO, Takas ...
    2008 Volume 54 Issue 5 Pages 316-322
    Published: May 20, 2008
    Released on J-STAGE: April 22, 2011
    JOURNAL FREE ACCESS
    Chromosomal loss of heterozygosity (LOH) is a common mechanism for the inactivation of tumor suppressor genes in human epithelial cancers. LOH patterns can be generated through allelotyping using polymorphic microsatellite markers; however, owing to the limited number of available microsatellite markers and the requirement for large amounts of DNA, only a modest number of microsatellite markers can be screened Hybridization to single nucleotide polymorphism (SNP) arrays using Affymetartx ® GeneChip ® Mapping 10K 2.0 Array is an efficient method to detect genome-wide cancer LOH. We determined the presence of LOH in oral SCCs using these arrays.
    DNA was extracted from tissue samples obtained from 10 patients with tongue SCCs who presented at the Hospital of Tokyo Dental College. We examined the presence of LOH in 3 of the 10 patients using these arrays. At the locus that had LOH, we examined the presence of LOH using microsatellite markers.
    LOH analysis using Affymetarix ®GeneChip ® Mapping 10K Array showed LOH in all patients at the lq31.1. The LOH regions were detected and demarcated by the copy number 1 with the series of three SNP probes. LOH analysis of 1q31.1 using microsatellite markers (D1S1189, D1S2151, D1S2595) showed LOH in all 10 patients (100%).
    Our data may suggest that a putative tumor suppressor gene is located at the 1q31.1 region. Inactivation of such a gene may play a role in tongue tumorigenesis.
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  • Nobuyoshi TOMOMATSU, Narikazu EUZAWA, Yasuyuki MICHI, Kazuto EKUROHARA ...
    2008 Volume 54 Issue 5 Pages 323-333
    Published: May 20, 2008
    Released on J-STAGE: April 22, 2011
    JOURNAL FREE ACCESS
    The odontogenic keratocyst (OKC) was originally classified as a developmental cyst, and OKCs were histologically divided into orthokeratotic (O-OKCs) and parakeratotic type (P-OKCs). Clinical features differ between O-OKCs and P-OKCs. P-OKCs have a tendency to recur after surgical treatment, as compared with OOKCs. According to the revised histopathological classification of odontogenic tumors by the World Health Organization (2005), the term keratocystic odontogenic tumor (KCOT) was adopted for P-OKCs.
    In this retrospective study, we examined 186 KCOTs treated at the Maxillofacial Surgery, Tokyo Medical and Dental University Hospital from 1981 through 2005. The patients ranged in age from 7 to 85 years (mean, 32.7) and consisted of 93 males and 93 females. The most frequently involved regions were the mandibular molar region and ramus. The majority of KCOTs in the maxillary region were treated by enucleation and primary closure. The majority of KCOTs in the mandibular region were enucleated, and the wound was left open. Marginal resection was performed in the 4 patients with large lesions arising in the mandible. Recurrences occurred in 19 of 120 lesions (15.8 %) in patients who were followed for more than a year. The recurrences were found at the margins of the primary lesion in contact with the roots of teeth or at the upper margins of the mandibular ramus.
    Clinicians should consider aggressive treatment for KCOT because the recurrence rate of P-OKCs is higher than that of the other cyst types, such as O-OKCs, dentigerous cysts, and primordial cysts that were non-keratinized, and slightly keratinized stratified squamous epithelium. Thus, more aggressive treatment is needed for KCOTs as compared with other cystic lesions. However, it is difficult to make a precise diagnosis preoperatively on the basis of clinical features and X-ray imaging. Therefore, preoperative biopsy is necessary for selecting the appropriate treatment for patients with cystic lesions.
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  • Satoshi KIMIZUKA, Miwa OKADA, Hiroaki HIROTANI, Wataru HASHIMOTO, Hiro ...
    2008 Volume 54 Issue 5 Pages 334-338
    Published: May 20, 2008
    Released on J-STAGE: April 22, 2011
    JOURNAL FREE ACCESS
    Liposarcoma is a malignant tumor of the soft tissues, but it is extremely rare in the oral cavity, particularly in the tongue. The tumor typically presents as a painless, slowly enlarging mass, and wide surgical excision is important for successful management. We describe 2 patients with liposarcoma involving the tongue and buccal region, with reference to the existing literature.
    Patient 1 was a 60-year-old woman with a mass arising in the right inferior surface of the tongue. The suspected clinical diagnosis was lipoma of the tongue. Patient 2 was a 42-year-old man with swelling of the right cheek. The suspected clinical diagnosis was pleomorphic adenoma of the buccal region. Tumor excision followed by rapid intraoperative pathological examination in both patients revealed no apparent malignancy. However, the postoperative histopathological diagnosis was well-differentiated liposarcoma in patient 1 and well-differentiated type liposarcoma with metaplastic bone formation in patient 2. We thus surgically excised the tumor with a wide safety margin in patient 1 and applied postoperative radiotherapy to the buccal cheek in patient 2. Both patients remain free of reccurence and metastasis.
    These findings show that low-grade well-differentiated liposarcoma can be difficult to distinguish from other types of lipoma.
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  • Takashi SAITO, Koichi ASADA, Hiroyuki USUI, Nagataka TOYODA, Shihomi T ...
    2008 Volume 54 Issue 5 Pages 339-343
    Published: May 20, 2008
    Released on J-STAGE: April 22, 2011
    JOURNAL FREE ACCESS
    Myasthenia gravis (MG) is an autoimmune disorder characterized clinically by proximal weakness and bulbar symptoms and pathologically by damage to the post-synaptic membrane at the neuromuscular junction. We report 2 patients with MG who were given the diagnosis on the basis of jaw closing dysfunction.
    An 87-year-old woman and a 66-year-old woman had not been given a diagnosis of MG, despite the presence of ptosis. Masticatory muscle electromyograms (EMGs) clearly showed that the masseter and temporal muscles had markedly decreased voltage during closing movements. In contrast, the digastric muscle showed minimal voltage on either closing or opening the jaw. Bulbar symptoms and high titers of antibodies against acetylcholine receptor were also noted in both patients. Finally, they were given a diagnosis of MG by a neurologist on the basis of the Tensilon test.
    Oral surgeons have to consider MG in patients who have masticatory dysfunction with ocular symptoms.
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