Clinical Statistics for Dysphagia Patients ≦ 18 Years of Age in the Center of Special Needs Dentistry, April 2012-March 2013

In April 2012, the Center of Special Needs Dentistry (SND) was established at Showa University Dental Hospital to provide function training for children with eating and swallowing disorders. A statistical clinical assessment was performed on new patients ≤18 years of age who visited the Center over a 1-year period (April 2012–March 2013) to assess the conditions present at the initial visit. In all, 60 patients (29 boys, 31 girls, mean (± SD) age 4.2±4.1 years, range 0-18 years of age) were included in the study. Most patients were <1 year of age (32%) and most came from one of four cities in the Johnan area (Shinagawa City, Meguro City, Ota City and Setagaya City). The most common primary diseases at the initial visit were cerebral palsy and cleft lip and palate. The third largest patient group was of healthy children with oral function problem. Over 60% of patients attended the Center of SND because of an eating-related complaint. More than 50% of patients were obtaining nutrients via oral intake; the remaining patients were obtaining nutrients via non-oral or a combination of oral and non-oral intake. Because of the young age of the patients and the fact that most were from neighboring areas, it can be inferred that effective community health care is being provided. It is necessary for the Center of SND to continue to provide professional treatment for dysphagia and to contribute to community medicine

A Case of T/NK-Cell Post-Transplantation Lymphoproliferative Disease 7 Years after Heart Transplantation

Post-transplant lymphoproliferative diseases (PTLD) are potentially fatal complications after cardiac transplantation. Most cases are Epstein&ndash;Barr virus (EBV)-related B-cell tumors, and reduction of immunosuppression treatment as well as the use of rituximab in combination with other chemotherapy are effective. However, patients with T/NK-cell PTLD post-cardiac transplantation are rarely reported. We had a patient with a fever that lasted for three weeks, with lung infiltrations and hepatosplenomegaly, who had EBV-associated hemophagocytosis 7 years after heart transplantation and was eventually diagnosed with T/NK-cell PTLD by autopsy. Although rare diseases, regular monitoring of EBV-DNA levels might be crucial for early diagnosis and treatment of PTLD