Mycoplasma salivariumにおけるヌクレアーゼの存在とその特性

Mycoplasmas depend on the host cells for various nutrients such as nucleic acid precursors and steroids. It has been mentioned that the acquisition of the nucleotides from the host cells is probably mediated through their own nucleases. However, in Mycoplasma salivarium, the existence of nuclease has not yet been known. In this study, we examined the nuclease activity in M. salivarium, and analyzed the properties of the enzyme. The Triton X-114 solubilized supernatant (Tx) obtained from lysate of M. salivarium was used for the enzymatic analysis. The nuclease activity was detected as a specific band of 25kDa by SDS-PAGE and the following in-gel digestion (SDS-PAGE nuclease assay). The nuclease activity of Tx was strictly dependent on Ca^. The nuclease was heat-stable, and the optimum pH was in the range of 7-9. The nuclease showed a low substrate specificity. From these findings, it was revealed that M. salivarium has a novel type of 25kDa and Ca^ dependent nuclease. Moreover, we examined whether Tx could cleave the chromatin DNA in the nuclei originated from eukaryote cells. Consequently, Tx cleaved the DNA of HS-72 B cell nuclei in vitro. From these results, it has been suggested that M. salivarium in the host cells, obtains nucleotides by the digestion of DNA and RNA from the host cells with their own nuclease, and these cleavage results in injury in host cells and the following various pathogenesis of the oral region

Bone graft on the labial symphysis for the skeletal Class III case

通常臨床歯科医学における骨移植は,その病理学的形態より3壁性骨欠損を有する歯周病患者に対して広く行われている。今回,下顎前歯部(下顎結合部)唇側面歯槽骨の開窓や限局性穿孔は存在するが,歯肉退縮を生じていない骨格型III級不正咬合患者へ顎矯正手術と同時に自家骨移植を付加的に行った。初診時のセファログラム所見より高く幅の狭い下顎結合部とこの薄い骨に直立している下顎前歯が確認された。また,術前矯正歯科治療中,下顎前歯はその捻転の解消と頬舌的な移動が行われた。手術時には下顎前歯部の開窓や限局性穿孔が確認された。下顎前歯部(下顎結合部)唇側面に自己海面骨を移植することによって歯槽骨の開窓や限局性穿孔は覆われた。結果的にセファログラム上での経過所見より,その後4年10か月間移植骨の残留が認められ,さらに臨床的に咬合が安定し通常後戻りしやすいとされる下顎前歯捻転の後戻りも認められず良好な結果を得たので報告した。Bone graft in clinical dentistry prevails in periodontal patients who have three wall infrabony defect around the tooth because of its pathological morphology. In this case report, bone graft on the labial bone surface of the lower incisors (mandibular symphysis) was applied as an auxiliary procedure at the same time of orthognathic surgery to a patient who had fenestrations and circumscribed holes without gingival recession and skeletal Class III malocclusion. The initial lateral cephalometric radiograph revealed a narrow and high symphysis, with an incisor position straight above the thin bone. During the pre-surgical orthodontic treatment, the incisors had been derotated and moved in the minimal labiolingual direction. Some fenestrations and circumscribed holes were found during orthognathic surgery. Through the bone allograft, the labial bone surface of the lower incisors (mandibular symphysis) with fenestrations and circumscribed holes were covered with the patient\u27s cancellous bone. Consequently, a series of the lateral cephalometric radiographs revealed that the grafted bone was kept for four years and ten months after surgery with stable occlusion and no rotational relapse on the lower incisors where it is usually easy to relapse clinically

筋突起切離術により治療した下顎骨筋突起過形成による開口障害の一例

This report describes a case of hyperplasia of the mandibular coronoid process treated by coronoidotomy. A 26-year-old man visited our clinic complaining of restricted mouth opening. Panoramic radiography revealed marked hyperplasia of the right mandibular coronoid process. Three-dimensional CT showed that the coronoid process touched the temporal surface of the zygomatic bone at the maximal mouth opening position. His maximum mouth opening range was 27mm. The coronoid process was amputated about 8mm in width, and mouth opening training was done for a year after the surgery. Although the coronoid process and mandibular ramus reunited, the maximum mouth opening range was maintained at 40mm 13 months after the surgery

小唾液腺腫瘍の臨床病理学的検討

Minor salivary gland tumors were clinicopathologically evaluated. Between 1990 and 2000, 31 patients with minor salivary gland tumors (10 males and 21 females between 12 and 75 years of age, mean age : 49.9 years) were treated in our department. Minor salivary gland tumors most frequently occurred in the palate in 19 patients, followed by 5 in the buccal mucosa, 4 in the lips, and 1 in the oropharynx. Histopathological examinations revealed 20 benign and 11 malignant tumors. Pleomorphic adenoma accounted for the majority (19 cases) of the benign tumors. Malignant tumors consisted of 3 mucoepidermoid carcinomas, 3 adenoid cystic carcinomas, 1 adenocarcinoma, 1 acinic cell carcinoma, 1 salivary duct carcinoma, 1 tubular adenocarcinoma, and 1 basal cell adenocarcinoma. All cases of benign tumors were successfully treated by extirpation without tumor recurrence. Of the 11 cases of malignant tumors, 7 were treated by surgery alone, 1 was treated by surgery after chemotherapy, and 3 were treated by surgery after chemotherapy and radiotherapy. Primary lesions recurred in 2 of these patients. The outcomes of patients with malignant tumors were as follows : 6 patients survived without other complications, 3 died of uncontrollable tumors, and 2 died of other diseases. Of the 3 patients who died of uncontrollable tumors, 2 died of primary lesions and 1 died of cervical lymph node metastasis

上顎歯肉癌のリンパ節転移に関する臨床病理学的検討

We analyzed clinicopathologically patients with upper gingival carcinoma, especially those with cervical lymph node metastasis. This study included 35 patients who had undergone treatment for upper gingival carcinoma from 1975 to 2001. Clinically suspected node positive (N(+)) cases were appeared in 7 of the cases (20.0%). The TNM classification (UICC) was T4N1 and T4N2 in 3 each patients, with all patients classified as M0. Histopathologically confirmed node positive (pN(+)) cases appeared in 4 of 7 N(+) cases and 4 cases of secondary metastasis, for a total of 8 cases. A high prevalence of pN(+) cases were found among the endophytic, and 4C types. Regarding treatment modality, preoperative chemotherapy was administered to 30 of the cases. Chemotherapy was administered intra-venously in 8 cases and intra-arterially in 13 cases. Among patients treated intra-venously, there were no cases demonstrating neck metastasis ; however, among those treated intra-arterially, there was secondary metastasis in 3 cases. The 5-year cumulative survival rate was 81.3% overall and 62.5% among the pN(+) cases. Uncontrolled sites in pN(+) cases consisted of cervical lymph node metastasis in one case, and distant metastasis in another case

下顎枝矢状分割術における生体内吸収性ポリ-L-乳酸骨接合ミニプレート固定の術後安定性について

左右非対称のない下顎前突症患者に対する下顎枝矢状分割術において,ポリ-L-乳酸製(PLLA)ミニプレート固定法による術後の顎態の安定性について検討を行った.両側下顎枝矢状分割術(SSRO)を施行し,下顎骨の後退量に左右差のない患者40名(男性17名,女性23名)を対象とした.これらの骨固定に際し,PLLAミニプレートを使用した患者22名(男性9名,女性13名)をPLLAプレート群とし,チタンミニプレートを使用した患者18名(男性8名,女性10名)をチタンプレート群とした.手術直前,手術後1か月,手術後1年に撮影した側面頭部X線規格写真の分析を行い,顎態の安定性について検討した.その結果,手術後1年ではPLLAプレート群およびチタンプレート群両群の男女ともに著しい後戻り様変化は認めなかった.このことから,SSROを用いた左右差のない下顎後退術に対するPLLAミニプレート固定は,術後顎態の安定性の観点からはチタンミニプレート固定と比較して何ら問題点はなく,プレートの除去手術が回避できる点で有益であると考えられる.アレルギーの有無や,顎骨の移動量等を総合的に判断し,PLLAミニプレートかチタンミニプレートを選択することができると考えられる.We studied the postsurgical stability of the mandible using biodegradable Poly-L-lactide bone mini plate fixation undergone sagittal split ramus osteotomy. The forty patients with mandibular prognathism without facial asymmetry (17 males and 23 females) operated from March 2003 to March 2009, were divided into two groups based on the types of osteosynthesis used. 22 patients (9 males and 13 females) using the PLLA mini-plate (PLLA plate group), and 18 patients (8 males and 10 females) using the titanium mini-plate (titanium plate group) were examined. Lateral cephalograms were taken immediately before the surgery, one month, and one year after surgery. Changes in position of the mandible were examined. As a result of this study, remarkable relapses were not recognized at one year after operation for males and females in both groups. It is thought the PLLA mini-plate fixation to the mandible without facial asymmetry setback doesn\u27t present as many problems from the viewpoint of postsurgical stability compared with the titanium mini-plate fixation, and it is profitable that we avoided the plate removal operation. We can select the PLLA or the titanium mini-plate from a comprehensive standpoint

複数の埋伏過剰歯を伴った石灰化嚢胞性歯原性腫瘍の1例

石灰化嚢胞性歯原性腫瘍(以下CCOT)は病理組織学的に,裏装上皮内にghost cellの出現とそれらの石灰化を特徴とし,また,歯牙腫をはじめとする歯原性腫瘍を合併することがある.さらに,CCOT症例の半数前後は埋伏歯を伴うことが知られているが,複数の埋伏過剰歯を伴うことは稀である。今回われわれは,歯牙腫と8本の埋伏過剰歯を伴ったCCOTの1例を経験したので,その概要を報告する.症例は40歳代の男性で,近歯科医院を受診した際にX線検査にて右側上顎洞部に嚢胞様透過像が認められ,精査・加療目的に当科紹介となった.初診時,上顎右側側切歯から右側第一大臼歯部の頬側歯肉に弾性軟の腫脹を認め,波動が触知された.CTにて,右側上顎洞および鼻腔の下部に境界明瞭で単胞性の嚢胞様病変を認め,病変内部に大小の石灰化像および歯牙様石灰化像を認めた.全身麻酔下にて摘出術および対孔形成術を施行した.摘出組織ではCCOTとともに歯牙腫ならびに8本の埋伏歯を認めた.病理組織学的に上皮層内にghost cellとその石灰化がみられた.文献的に本症例のように複数の埋伏過剰歯を伴ったCCOTはきわめてまれであった.It is well known that an associated impacted tooth is seen in about half of cases with calcifying cystic odontogenic tumor (CCOT), but CCOT with two or more impacted teeth is extremely rare. This paper reports a case of CCOT with 8 impacted, supernumerary teeth. The patient is an adult male with swelling of right maxilla. X-ray examination showed a cystic lesion with calcification and with numerous impacted, supernumerary teeth. A clinical diagnosis of CCOT with odontoma was made. And surgical excised of the lesion was performed. Macroscopically, surgically excised specimen showed eight supernumerary teeth with formal and/or unformal shape were involved in the lesion, but these teeth were not enclosed by fibrous capsule. The lesion was diagnosed finally as CCOT with odontoma and with eight impacted, supernumerary teeth by pathological examination. The review of the literature yielded CCOT with more than 3 associated supernumerary has not been documental

チタンメッシュトレーとPCBMによる下顎骨再建を施行した類腱型エナメル上皮腫の1例

類腱型のエナメル上皮腫(desmoplastic ameloblastoma:DA)は,エナメル上皮腫の一亜型で,豊富な膠原線維の増生からなる間質と石鹸泡状のエックス線透過像を特徴とする.DAは,X線学的に境界不明瞭で,腫瘍周囲の被膜がないため切除範囲の設定が困難で,典型的なエナメル上皮腫と比較して,再発の割合が高いと考えられている.2006年9月,58歳の男性が,下顎右側臼歯部歯肉の腫脹と顎骨の膨隆にて近医より当科を紹介受診した.画像所見において,腫瘍の境界は不明瞭で,腫瘍は下顎骨下縁にまで及んでいた.生検の結果,組織学的に類腱型のエナメル上皮腫と診断された.下顎区域切除術ならびにチタンメッシュトレーと腸骨からのPCBMによる下顎骨再建を施行した.術後4年経過した現在,再発はみられていない.Desmoplastic ameloblastoma (DA) is a variant of ameloblastoma, characterized by foamy radiolucency and desmoplastic stroma. The recurrence rate of DA is thought to be higher than that of usual ameloblastoma because the fibrous capsule surrounding the tumour is not present and decision of the resection area is difficult, corresponding to the radiographically poorly-defined tumour margin. A 58-year-old man was referred to our clinic in September 2006 because of swelling of the mandible on the right side. Radiography indicated a poorly-defined lesion that expanded to the inferior border of the mandible. We carried out a biopsy and a diagnosis of DA was made histopathologically. Then, we carried out segmental mandibulectomy and mandibular reconstruction using a titanium mesh tray and PCBM from iliac bone. No signs of recurrence have been seen for 4 years after surgery