Four-dimensional magnetic resonance imaging (4D-MRI) was used to depict a normal swallow.
At first, 2D cine MRI was performed to obtain 35 imageseach of 9 slices at a frame rate of 66 msec. For 4D MRI, the images were reconstructed to three-dimensions according to the time sequence. The sequence for MR images was fast gradient echo (multi-slice). The syn chronizedsampling method was applied using an exter naltriggering device. The subject was a normal volun teerwho had given informed consent.
The results proved that 4D-MRI for normal swallow of feredseveral benefits in depicting the closing and open ingmovement of the nasopharynx, larynx and esophagus in spite of less contrast of bolus in comparison with 2DMRI or VF. Further study on 4D-MRI will yield better information for clarifying the details of swallowing movement.

抄録全体を表示

This study was designed to evaluate the suggestion that the clinical findings and MR image findings of an teriordisc displacement with reduction cases could not reduce the disc displacement within the follow-up period.
We selected 26 joints without remarkable bone chang esin the condylar head or glenoid fossa in which reduc tiondisappeared during follow-up. Clinical evaluation focused on temporomandibular pain, trismus, and joint sound. MR imaging was targeted for configuration of articular disc, degree of disc displacement, and condylar head position.
Clinical signs observed with progression of the conditionwere disappearance of joint sound in 12/26 joints (46.1%), temporomandibular pain in 15/26 joints (57.6%), and decreased distance of opening mouth in 19/26 joints (73%). MR image findings were disc configuration changes in 12/26 joints (46.1%), increased degree of an teriordisplacement of disc in 20/26 joints (76.9%), and condylar head position changes in 9/26 joints (34.6%).
It is suggested that the advanced stage of internal de rangementis closely associated with the degree of disc displacement.

抄録全体を表示

Due to the lack of information regarding sentinel lym phoscintigraphy (SLS) in the head and neck regions using ^99m Tc phytate, the kinetics and visualization of this pharmaceutical in SLS have not been well understood. We report the results of SLS using ^99mTc phytate in pa tientswith oral squamous cell carcinoma. SLS studies were performed in eight patients with oral squamous cell carcinoma (tongue 7, and lower gingiva 1): 74 MBq of ^99mTc phytate was injected in the periphery of the tumor; after injection, static images in frontal and lateral projections of the head and neck were taken at 1, 2, 4, 6, and 24 hours with a 10-minute acquisition time. SPECT images were also studied. The intensity of accumulation in lymphatic nodes was represented by a hot node to background activity ratio (HN/BG ratio) for the region of interest. Thirty-one, 29, 30, 27, and 16 hot nodes were visualized by SLS at 1, 2, 4, 6, and 24 hours after injec tionin eight patients respectively. Nine sentinel lymph nodes were identified out of 11 hot nodes in SLS 4 hours later in three NO patients (mean: 3.0 sentinel nodes). The HN/BG ratios were 8.76±5.62, 7.07±4.38, and 3.15±1.71 at 2, 4, and 24 hours after injection in eight patients respectively. SLS using ^99mTc phytate successfully im agedsentinel nodes in patients with oral squamous cell carcinoma. The radiopharmaceutical accumulation in lymphatic nodes was higher at 2 and 4 hours than at 24 hours after injection (p<0.05).

抄録全体を表示

This study was designed to investigate the potential clinical usefulness of urinary trypsin inhibitor (UTI) in monitoring and predicting the postoperative course of patients undergoing surgery under general anesthesia. Fifeen patients with oral cavity cancer were enrolled in this study. Urine samples were collected before and af tersurgery (day 1 to day 7), and were stored at-80°C until the assay, which was conducted by one-step sand wich ELISA methods.
There were no circadian variations in UTI levels, and the normal reference range was 30.0U/mg·Cr. There were significant correlations between UTI levels and various parameters (WBC, AST, ALP, LAP and CRP).UTI levels reached maximum values at 3 days after sur gery, and decreased to the baseline by 7 days after sur gery.
These results suggested that UTI levels were in creasedin patients who were under surgical stress and were significantly correlated with various parameters. Therefore, determination of UTI levels was confirmed to be useful as a simple and noninvasive test for monitoring the postoperative course of patients undergoing surgery under general anesthesia.

抄録全体を表示

The development and progression of oral squamous cell carcinoma (OSCC) are thought to be driven by an accumulation of genetic alterations, but little is known about the specific changes that occur during the meta staticprocess. We analyzed a pair of the OSCC cell line: HSC-3 and the high-metastatic variant cell line: LMF-4, by using comparative genomic hybridization (CGH). Simultaneous hybridization analysis of HSC-3 versus LMF-4 was also performed (modified CGH). Chromo somechanges present in both cell lines were chromo some5p, 7p, 9q, 13q, 14q gains and chromosome 4q, 18q losses. Gains at chromosome 8q21-24, 9q11-21, 10q25-26, 11p, 11q13, 17q25, 18p11 were specifically detected in the LMF4 cells, suggesting that the genes associated with the development of a metastatic phenotype were located on these chromosomal regions. The combination of conventionaland modified CGH analysis facilitates the iden tificationof DNA copy number changes that might be involved in the development of a metastatic phenotype.

抄録全体を表示

It has been reported that Toll-like receptors (TLRs) play a significant role in cancer therapy as receptors of bacteria-derived anti-cancer immunotherapeutic agents such as OK-432, Mycobacterium bovis bacillus Calmette-Guerin-cell wall skeleton (BCG-CWS) and CpG-oligode oxynucleotides (ODN). In the current study, we exam inedthe expression of TLRs on 12 human head and neck cancer cell lines and their responsiveness against each TLR ligand. In the quantitative real-time polymerase chain reaction analysis, 6 TLR2-expressing cell lines, 12 TLR4-expressing cell lines, 5 cell lines expressing MD-2, a co-receptor for TLR4, and 11 TLR9-expressing cell lines were observed. Stimulation with peptidoglycan (PGN), a ligand of TLR2 that is an active component of BCG CWS, lipopolysaccaride (LPS) and OK-PSA, an active component of OK-432, that are ligands of TLR4/MD-2, or CpG-DNA, a ligand of TLR9, resulted in the activation of nuclear factor (NF)-kB in the cell lines expressing each receptor. PGN and OK-PSA induced cell-growth inhibi tionand augmented the 5-fluorouracil-induced cell death, while LPS and CpG-DNA enhanced the proliferation of the cancer cells. OK-PSA increased NF-κB activation more slowly than that by LPS. In addition, phosphoryla tionof p38 mitogen-activated protein kinase by OK-PSA was only slight as compared with that by LPS. OK-PSA also induced apoptosis of the cancer cells. It is strongly suggested that active components of OK-432 and BCG CWSmay augment anti-cancer immunity in the hosts as well as may induce growth inhibition and apoptosis of cancer cells via TLRs.

抄録全体を表示

This study evaluated a new feeding nipple designed for cleft lip and palate infants wearing a palatal obturator Hotz plate.
The new nipple made of silicon resins has a spherical top of 14 mm in diameter and a flat part in the middle to adapt to the peristaltic movement of the tongue during sucking with a crosscut opening.
Laboratory tests on the new nipple showed a correla tionbetween the compression and the strain and the simple regression coefficient was 0.062, which was higher than that of conventional ones except the Chu Chu type.
The effect of the new nipple was assessed on 23 cleftlip nd palate infants wearing a Hotz plate. After chang ingto the new nipple, 7 of 8 parents of the patients an sweredon the questionnaire that the new one was more favorable than the conventional nipple. The body weight was increased favorably during the 3 months after birth and the feeding facilities (total volume and stipulated feeding time) were observed to be satisfactory on 15 in fantsusing the new nipple.
The results was suggest that the new nipple may be more effective for the sucking of cleft lip and palate in fantswearing a palatal obturator.

抄録全体を表示

This study evaluated the side effects of prosthetic mandibular advancement (PMA) for obstructive sleep apnea syndrome (OSAS) patients.
In this study, PMA treatment was performed for 64 patients (11 females and 53 males) who were diagnosed as OSAS and referred to us by physicians. A question nairesurvey on discomfort caused by using a PMA was conducted: the patients were asked about incompatibility with a PMA, salivary secretion during sleep, occlusal alteration in the morning, pain of temporomandibular joints, and toothache.
The results obtained were as follows:
1. 84% of the patients complained of incompatibility with PMA.
2. Reduction of salivary secretion in sleep was found in 14% of the patients.
3. Although about 50% of the patients had occlusal al terationin the morning, almost of them recovered before lunch.
4. The pain of temporomandibular joints was seen in 44% of the patients.
5. Toothache, usually in frontal teeth, was recorded in 20% of the patients.
6. Seven patients out of 64 (11%) gave up the PMA treatment.

抄録全体を表示

Endogenous fungal endophthalmitis (EFE) occurs in the eye hematogenously infected by fungus derived from IVH catheters or fungal organs. We report a 68-year-old female with maxillary gingival carcinoma, who had developed EFE. Her visual acuity recovered exceedingly well by intravenous drip of Fluconazole. However, it is important for oral surgeons to have sufficient knowledge of EFE, and to cooperate with an ophthalmologist.

抄録全体を表示

Schwannoma is a benign tumor originating from Schwann's cells of the neural sheath and occurring mainly in the soft tissues of the head and neck region. This tumor rarely occurs in the oral region, and central schwannomas involving the jaw are extremely rare.
We report a rare case of schwannoma arising in the mandibular body of an elderly woman. The patient was an 86-year-old female who had no symptoms, except for painless swelling in the left side of the mandible. The tumor was located in the mandible with involvement of the inferior alveolar nerve. The tumor was surgically removed with a part of the nerve. The histopathological diagnosis was schwannoma, with evidence of both Antoni A and B tissues. There has been no evidence of recurrence in the 12 months since the operation.

抄録全体を表示

Histiocytic necrotizing lymphadenitis (HNL, Kikuchi's disease) is a lymphadenitis of unknown cause, originally described by Kikuchi and Fujimoto in 1972. Because HNL has been rarely reported in the oral region, it has occasionally been misdiagnosed as oral infected disease or another disease of the neck. A 32-year-old female suffering from two painless nodules that had appeared suddenly in the left of the posterior cervical triangle visited our department. The dimensions of the nodules were 15 mm and 10 mm in diameter. There were no systemic signs or symptoms such as fatigue and fever. From the clinical view, blood examination, CT findings and MRI findings, it was difficult to make a diagnosis. Biopsy of the larger nodule was therefore done and microscopy indicated HNL. The other nodule disappeared after 2 months with no medication. Although the nodule appeared again after 1 year and 8 months, it naturally disappeared again in a month.

抄録全体を表示

Incidence of perioperative complication and mortality rate becomes higher when coronary heart disease patients are to undergo non-cardiac surgery. We experienced an oral cancer patient who was treated by reconstruction, after asymptomatic coronary three-vessel disease was detected in the preoperative examination. Although hypertension had been pointed out by a physician for 20 years, he had left it untreated and neither the chest symptoms nor breathing difficulties had been recognized. Since abnormality in chest X-ray films and electrocardiogram had been checked, we consulted the physician and coronary heart disease was detected. For the prognosis, we consulted the physician and decided to perform coronary reconstruction with stent. Five weeks later, oral tumor resection was performed safely in close cooperation under suspending antiplatelet therapy.
The number of patients with coronary artery disease is expected to increase. Therefore we should consider not only the treatment of malignant tumor but also asymptomatic coronary disease patients to improve their long-term prognosis.

抄録全体を表示

Kaposi's sarcoma is a malignant tumor which is one of the major complications of AIDS. This disease is common in male homosexuals, and HHV-8 has been indicated to play a role in its pathogenesis.
We report a case of an HIV infected patient who was found to have Kaposis sarcoma of the hard palate. A 35-year-old male was referred to our hospital because of a mass lesion in the hard palate. This lesion was diagnosed as Kaposis sarcoma by biopsy. Laboratory tests showed that the number of CD4 was 410/ul and HIV an-tibody was positive on both particle agglutination analysis (PA) and Western blot (WB) analysis.
He received highly active antiretroviral therapy (HAART) and the use of liposomal doxorubicin. Kaposi's sarcoma disappeared after only one injection with no adverse effects including myelosuppression. There has been no recurrence during the 18 months since the last injection.

抄録全体を表示