Odontogenic deep neck space infection in a patient with hyper-IgE syndrome : a case report

Hyperimmunoglobulin E syndrome is a primary immunodeficiency state that is characterized by eczema, recurrent skin and lung infections, and markedly increased levels of IgE. Odontogenic infection can spread to vital and deep structures in such immunocompromised patients. We report a case of a 19-year-old man with hyperimmunoglobulin E syndrome presenting deep neck space infection that had spread from periapical periodontitis of the lower molars. A computed tomography scan showed an area of bony destruction in the left mandible and abscess formation in the submandibular and submental spaces. The patient was successfully treated by cervical drainage, extraction of the causative teeth, and antibiotic therapy. The present case highlights the importance of adequate treatment of dental infections in immunocompromised patients

音響効果と超音波を用いた全身麻酔前後における気道径の比較

Changes in airway dimensions can occur during general anaesthesia and surgery for a variety of reasons. This study explored factors associated with postoperative changes in airway dimensions. Patient airway volume was measured by acoustic reflectometory and neck muscle diameter by ultrasound echography in the pre- and post-anaesthetic periods in a total of 281 patients. Neck circumference was also assessed during these periods. A significant decrease in median (IQR [range]) total airway volume (from 63.8 (51.8–75.7 [14.7–103]) ml to 45.9 (33.5–57.2 [6.4–96.3]) ml, p < 0.0001), and a significant increase in muscle diameter (from 4.3 (3.3–5.6 [2.2–9.0]) mm to 5.8 (4.7–7.3 [2.8–1.3]) mm, p < 0.0001) and neck circumference (from 34.0 (32.5–37.0 [29.5–49.0]) cm to 35.0 (33.5–38.0 [30.5–50.5]) cm, p < 0.0001) were observed. It may be possible that changes in airway volume and neck circumference were influenced by surgical duration or peri-operative fluid management (ρ) = −0.31 (95% CI −0.24 to −0.01), p = 0.0301, −0.17 (−0.23 to −0.06), p = 0.0038, 0.23 (0.12–0.34), p < 0.0001, and 0.16 (0.05–0.27), p = 0.0062, respectively). The intra-oral space can significantly decrease and neck thickness increase after general anaesthesia, and might increase the risk of difficult laryngoscopy and intubation if airway management is required after extubation following general anaesthesia.博士（医学）・甲第626号・平成27年3月16日Copyright © 1999-2015 John Wiley & Sons, Inc. All Rights Reserved.© 2014 The Association of Anaesthetists of Great Britain and Irelan

成体マウス脳の成熟および未成熟オリゴデンドロサイトにおけるコルチコイステロイドレセプタ−の分布

The expression of glucocorticoid receptors (GRs) was investigated immunohistochemically in two different lineages of oligodendrocytes, using carbonic anhydrase (CA) II and neuron glial antigen (NG) 2 as markers of mature oligodendrocytes and oligodendrocyte progenitors, respectively. We focused on the gray matter regions, including CA1, CA3 and the dentate gyrus of the hippocampus, the primary somatosensory cortex barrel field and the basolateral amygdala, and the white matter regions, including the corpus callosum, external capsule and fimbria of the hippocampus. More than 80% of CAII-immunoreactive (IR) cells and more than 95% of NG2-IR cells expressed GRs in various regions of the brain. In contrast, neither CAII-IR cells nor NG2-IR cells expressed mineralocorticoid receptors (MRs) in the same regions. The intensity of GR expression was drastically reduced in CA II-IR cells and NG2-IR cells in the same regions in adrenalectomized mice. Finally, steroid receptor co-activator (SRC)-1 and p300, both of which are cofactors for GR, were expressed in the gray and white matter regions in NG2-IR cells, but not in CAII-IR cells. These results suggest that the expression of GRs in oligodendrocytes and their progenitor cells mediates several functions in vivo, including differentiation and myelination, as a major target of glucocorticoids and their cofactors.博士（医学）・甲620号・平成26年3月17日Copyright © 2014 by The Histochemical Societ

A Dilated Odontoma in the Second Molar Region of the Mandible

A case of dilated odontoma in the second molar region of the mandible was reported. The patient was a 14-year-old female. Panoramic X-ray and CT examination revealed an oval ring-shaped radiopaque lesion accompanying a radiolucent area in the center at the left second molar region of the mandible. The left second molar and all third molars were not found. The lesion was diagnosed as odontoma and extirpated under general anesthesia. The lesion was a spherical mass of 12x9mm. Histologically, the mass was composed of dentin arranged in an oval ring shape with dentinal tubules. Inside the dentin, immature enamel was present. The central area of the mass was filled with fibrous tissue with a small nest of bone and cementum. Bone tissue was also observed in contact with the immature enamel layer. These morphological and histological features are compatible with those of a dilated odontoma

“All-on-Four”コンセプトに基づいて即時荷重を適用したインプラントの力学解析

PURPOSE: The purpose of this study was to investigate the biomechanical behavior of immediately loaded implants in an edentulous mandible according to the "All-on-Four" concept. METHODS: A 3D-finite element model of an edentulous mandible was constructed. Four implants were placed between the bilateral mental foramen according to "All-on-Four" concept. A framework made of titanium or acrylic resin between the bilateral first molars was modeled. Immediate loading and a delayed loading protocol were simulated. A vertical load of 200N was applied at the cantilever or on the abutments region of the distal implants, simulating the absence of a cantilever. RESULTS: The peak principal compressive strains in the immediate loading models resulted in 24.0-35.8% and 26.4-39.0% increases compared with the delayed loading models under non-cantilever loading and cantilever loading, respectively. The loading position greatly affected the principal compressive and tensile strain values. The peak principal compressive strains in non-cantilever loading resulted in a 45.3-52.6% reduction compared with those in cantilever loading. The framework material did not influence the peak compressive and tensile strain. The maximum micromotion at the bone-implant interface in the immediate loading models was 7.5-14.4μm. CONCLUSIONS: Mandibular fixed full-arch prostheses without cantilevers may result in a favorable reduction of the peri-implant bone strain during the healing period, compared with cantilevers. The maximum micromotion was within the acceptable limits for uneventful implant osseointegration in the immediate loading models. Framework material did not play an important role in reducing the peri-implant bone strain and micromotion at the bone-implant interface.博士（医学）・乙第1398号・平成29年3月15日Copyright © 2016 Japan Prosthodontic Society. Published by Elsevier Ltd. All rights reserved

口腔癌細胞株におけるcetuximabを介した抗体依存性細胞障害(ADCC)活性と細胞表面EGFR発現との関連

BACKGROUND/AIM: Cetuximab treatment targets the epidermal growth factor receptor (EGFR) overexpressed in oral cancer. This study aimed to investigate the anti-tumour activity of cetuximab against oral cancer cell lines with respect to antibody-dependent cell-mediated cytotoxicity (ADCC), and determine the correlation between ADCC and EGFR expression. MATERIALS AND METHODS: EGFR expression in oral cancer cells was measured by quantitative flow cytometric analysis and immunohistochemistry. ADCC activity was measured by 4-h calcein release assays. RESULTS: Cetuximab-mediated ADCC against oral cancer cells was detectable at a concentration of 0.1 μg/ml. A high correlation was observed between the number of EGFR molecules on the surface of oral cancer cells and ADCC (correlation coefficient: 0.847; p=0.032). CONCLUSION: ADCC is an important mechanism underlying the therapeutic effect of cetuximab, and EGFR expression in tumour cells might serve as a predictive marker to evaluate the effect of cetuximab treatment.博士（医学）・甲第721号・令和元年9月27日Copyright© 2019, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.発行元の規定により、本文の登録不可。本文は以下のURLを参照 "http://dx.doi.org/10.21873/anticanres.13238"（※全文閲覧は学内限定

S-1投与ラットにおける味覚障害の想定される末梢メカニズム

BACKGROUND: Taste disorders are frequently observed in cancer patients undergoing chemotherapy and are serious adverse events which impair the quality of life (QoL) of the cancer patient. Nevertheless, taste disorder mechanisms in cancer patients undergoing chemotherapy have not yet been fully elucidated. The aim of this study was to reveal taste disorder-related peripheral mechanisms using the two-bottle preference test (TBPT) and histological examination of tongues by hematoxylin-eosin staining and immunohistochemistry with protein-gene product 9.5. METHODS: In the TBPT, one bottle was filled with the 0.01 mM quinine hydrochloride (quinine), as a bitter compound, and the other was filled with water. Doses of 50 and 100 mg kg-1 day-1 S-1 (tegafur/gimeracil/oteracil potassium) are lethal to Wistar rats. Therefore, doses ranging from 2-20 mg kg-1 day-1 were administered to the rats for 3 weeks. The S-1 dose of 2 mg kg-1 day-1 corresponds to the clinical dose administered to cancer patients. The part of the tongue containing the circumvallate papillae was excised the following TBPT. RESULTS: The rate of increase in terms of the average preference rate for the quinine vs. all intake (quinine plus water) was significant from the initial S-1 period to the final one, compared with that in control rats, suggesting the possibility of a worsening sensation for the bitter taste. In S-1 rats, the area of taste nerve fibers were significantly decreased and the rate of degeneration of intra-tongue ganglionic nerve cells was significantly increased. These changes were significantly correlated with the rate of increase in average preference rate of the quinine. CONCLUSION: Neuropathy of the gustatory nerve at the periphery may be involved in taste disorders induced by an anticancer drug.博士（医学）・乙1329号・平成26年3月17

Enumerated sparse extraction of important surgical planning features for mandibular reconstruction

[2020 42nd Annual International Conference of the IEEE Engineering in Medicine & Biology Society (EMBC 2020); Montreal, Quebec, Canada, 20-24 July 2020]Because implicit medical knowledge and experience are used to perform medical treatment, such decisions must be clarified when systematizing surgical procedures. We propose an algorithm that extracts low-dimensional features that are important for determining the number of fibular segments in mandibular reconstruction using the enumeration of Lasso solutions (eLasso). To perform the multi-class classification, we extend the eLasso using an importance evaluation criterion that quantifies the contribution of the extracted features. Experiment results show that the extracted 7-dimensional feature set has the same estimation performance as the set using all 49-dimensional features

Spindle Cell Hemangioma in the Mucosa of the Upper Lip: A Case Report and Review of the Literature

Spindle cell hemangioma (SCH) is a unique benign vascular lesion. We present a case of SCH in the upper lip of a 41-year-old woman. A submucosal nodular mass 30 × 20 mm in size was observed in the left upper lip. The mass developed 5 years earlier and enlarged after repeated ethanol injections. The mass was elastic firm, mobile, bluish in color, and well demarcated in magnetic resonance imaging. Under the clinical diagnosis of hemangioma, surgical excision was performed under local anesthesia. Microscopically, the lesion was composed of irregular cavernous spaces and multiple solid cellular areas. Cavernous spaces were filled with a mix of erythrocytes and organizing thrombi. The solid areas showed proliferation of spindle-shaped cells arranged haphazardly or in short interlacing fascicles. Immunohistochemically, most cells strongly reacted with vimentin. CD31, CD34, factor VIII, smooth muscle actin, and Wilms tumor-1 reacted with endothelial cells lining the cavernous spaces. The cells within solid areas consisted of mixed cell population with variable reaction for the markers except for factor VIII. From these findings, the diagnosis of SCH was made. Two years after surgery, no recurrence was noted. A review of SCH in the head and neck region is made