Systemic inflammatory response syndrome (SIRS) has been regarded as potential warnings for impending postoperative complications and multiple organ failure. To confirm the availability of SIRS evaluation after oral surgery for oral cancer, correlations between SIRS and the postoperative complications were examined.
Fifty-five patients underwent the primary reconstructive surgery using free flaps in our department from January 2008 to March 2012 were included. Patients who met more than 2 diagnostic criteria for SIRS within 2 postoperative days were classified as the SIRS group. Several clinical endpoints were compared between the SIRS and non-SIRS groups.
Forty-five patients were classified as the SIRS group and 10 patients as the non-SIRS group. The incidence of complications in the SIRS was significantly higher than that in the non-SIRS. Fourteen of the 19 patients (73.7%) without any postoperative complications in the SIRS were recovered from SIRS within 3 postoperative days.
SIRS evaluation in early postoperative period could be useful to predict postoperative complications in oral cancer surgery.

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We evaluated the efficacy of pilocarpine hydrochloride and adverse drug reactions (ADRs) associated with administration of pilocarpine hydrochloride. A marketing approval has recently been granted to pilocarpine hydrochloride as a treatment for xerostomia associated with Sjögren's syndrome ("SS"). Among the patients treated with pilocarpine hydrochloride from October 2007 to March 2009, our study included 64 patients who had not previously been treated with cevimeline hydrochloride or anetholetrithione and were able to be followed for 4 weeks post-treatment. Salivary secretion and symptom scores were evaluated in 42 patients followed up for 52 weeks after starting the treatment. The results of salivary secretion (10-minute gum test) were significantly improved from baseline to 24 weeks after the initiation of treatment and thereafter. Subjective symptom scores were significantly improved from baseline to 12 weeks after the initiation of treatment and thereafter. No decrease in efficacy of pilocarpine hydrochloride due to the prolonged administration was observed in any subjects examined. ADRs occurred in 81.3% of patients. The most common ADR was heavy sweating followed by nausea and urinary frequency. Fifteen point six percent of the patient, discontinued the treatment because of adverse drug reactions such as nausea, urinary frequency or others. ADRs occurred within 4 weeks after the initiation of treatment 97.9% of patients. Nausea disappeared in 38.5% of patients by 12 weeks after the initiation of treatment. No increased incidence of ADRs due to the prolonged administration was observed in any subjects examined.

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Hemophilia A is sex-linked recessive genetic disorder which arise from deficiency or defect of blood coagulation factor VIII. Patients with hemophilia A often suffer continuous bleeding after tooth extraction. We report here two cases who suffered from hemophilia A, and we had a difficulty in hemostasis after tooth extraction though recombinant factor VIII was administered prophylactically to these patients in order to prevent abnormal bleeding.

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We report a case of sialolithiasis arising in the sublingual gland. A 72-year-old woman was referred to our hospital because of tenderness in the oral floor on the right side. An enhanced CT revealed irregularly-enhanced signals in the sublingual gland and a calcified material at the junction of the duct and the gland. With a clinical diagnosis of sialolithiasis and sialoadenitis of the sublingual gland, resection of the sublingual gland was carried out by intraoral approach under general anesthesia. Grossly, a sialolith was observed at the junction of the duct and the gland. Histologically, there were chronic inflammatory infiltrates in the parenchyma of gland and deposits of small calcified materials in the interlobular ducts. The postoperative course has been uneventful for eight years and nine months.

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Post-extraction hemorrhage is often caused by local factors, and also occasionally by hemostatic abnormality due to systemic hemorrhagic factors. In this report, we described the case of chronic disseminated intravascular coagulation (DIC) revealed by post-extraction hemorrhage. The patient was a female in her eighties. The laboratory examinations revealed the possibility of blood coagulation disorder due to chronic DIC. Although DIC was remarkably improved by continuous intravenous infusion of thrombomodulin, the underlying disease causing DIC has been unidentified. After the completion of treatment for DIC, follow-up treatment has been performed in outpatient clinic and no evidence of exacerbation of DIC has observed at the present time.

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