Pilocarpine hydrochloride (Salagen^®) is currently indicated for the treatment of xerostomia caused by Sjögren syndrome (SS). However, administration of this drug is frequently discontinued because of adverse effects. In this study, we examined the compliance and clinical efficacy of the gradually-increasing administration of pilocarpine. Twenty-six SS patients (2 men, 25 women, mean age 64 years, range 40-85) received 7.5mg pilocarpine per day for the first 4 weeks, and then 15mg pilocarpine per day for further 8 weeks. Nineteen patients (73.1%) completed administration for total 12 weeks, and 7 patients failed it (3 patients stopped administration until the 4th week, and 4 patients after the 4th week). When calculated with 23 patients whose daily dose increased to 15mg, the completion rate was 82.6%. Saxon test and questionnaires revealed an increase in saliva-flow rate in 88.9% of 19 patients and improvements of subjective and objective symptoms in over 50%. The results suggested that 15mg of pilocarpine was well tolerated in patients who underwent the gradually-increasing administration.

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We report a case of acute promyelocytic leukemia with gingival hemorrhage that resulted in a rapid fatal outcome. The patient was a 61-year-old man who had visited our hospital because the bleeding persisted.Blood tests revealed that, while the white blood cell count was within the normal range, red blood cell count, hemoglobin, hematocrit, platelet count, and blood clotting ability were all decreased. LDH was elevated. After referral to an internist, the patient was given a diagnosis of acute promyelocytic leukemia. However, he was transferred by ambulance to the ICU of another hospital after suffering from cerebral hemorrhage at mid night on the day of the initial examination and died five days later.

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Plasma cell granuloma (PCG) is a reactive lesion, not a neoplastic lesion, and most commonly develops in the lung. PCG in the oral cavity is rare. We report a case of gingival PCG. The patient was a 65-year-old man who presented complaining of gingival swelling. A raised lesion was seen on the lingual side of the right mandibular first and second molar region, with the surface showing a granular appearance. The lesion was surgically resected and histopathological diagnosis was gingival hyperplasia with inflammatory cell infiltration. The patient stopped going to hospital after treatment. Two years later, he re-visited with gingival pain. A mass lesion at the same location on the right mandible was observed, appearing as an exophytic lobular shaped pedunculated mass. Surgical removal including periosteum was again performed. Histopathologically, the lesion was diagnosed as PCG. Massive plasma cell infiltration was observed, but these plasma cells did not show monoclonality. Postoperative progress was good, and no abnormalities have been seen as of 6 months postoperatively.

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Lymphoepithelial cysts occasionally develop in the oral cavity, especially the sublingual area or floor of the mouth. We report a case of a lymphoepithelial cyst which developed in the lower right oral vestibule.
The patient was a 79-year-old male who noticed a swelling in the right lower oral vestibule. The tumor was border clear, elastic soft. We excised the swelling with surrounding tissue in the local anesthesia. Histopathological diagnosis was a lymphoepithelial cyst.

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