Intraoral ultrasonography of tongue mass lesions

Objectives: To demonstrate the usefulness of intraoral ultrasonography (IOUS) for tongue mass lesions, we analyzed surgery cases excluding squamous-cell carcinoma and leukoplakia and compared IOUS and pathological findings. Methods: We used the hospital information system and Radiology Information System to evaluate the IOUS and pathological findings of patients who underwent surgeries for tongue masses in the past 11 years. Results: Surgeries for the tongues were performed in 268 cases. Imaging examinations were carried out in 52 (19.4%) cases including 42 (15.7%) cases by IOUS. The pathological results of the surgeries were as follows: 36 cases were inflammatory lesions, 74 cases were tumours, 131 cases were hyperplasia, 8 cases were cystic lesions and 19 cases were other miscellaneous lesions. On the other hand, the number of patients who received IOUS in the same period was 87, and 42 of them had surgeries. In 32 out of the 42 (76.2%) cases, pre-operative IOUS features matched with pathological results. Most of the haemangiomas and lipomas could be diagnosed by IOUS alone. Conclusions: IOUS of the tongue revealed the nature of the lesions including the border, size, location, depth, the presence or absence of a capsule and the internal structure including vascularity of the mass. The ultrasonographic findings well reflected the histological findings. IOUS is a simple and useful technique that provides additional information beyond inspection, clarifying the internal structure, blood flow and relationships with the adjacent tissues. In this article, we indicated 11 representative cases (fibrous polyp, haemangioma, pyogenic granuloma, lipoma, liposarcoma, chondroma, lymphangioma, schwannoma, neurofibroma, pleomorphic adenoma and amyloidosis) to show the usefulness of IOUS

Distribution of oral mucosal bacteria with mecA in patients undergoing hematopoietic cell transplantation

[Purpose] We recently reported frequent detection of antibiotic-resistant bacteria on the oral mucosa during the period of hematopoietic cell transplantation (HCT) and suggested an association between oral mucositis and antibiotic-resistant bacterial infection. Methicillin-resistant Staphylococcus spp. were frequently detected, and the oral cavity may be a reservoir of the gene mediating methicillin resistance, mecA. Here, we examined the frequency of mecA carriers in patients undergoing HCT. [Methods] Fifty-nine patients (male (M) = 37, female (F) = 22, 47.3 ± 11.0 years) receiving HCT were enrolled in this study. Buccal swab samples were obtained four times from day −7 to day +20 (once/week), and mecA was detected by PCR. Fifty-two subjects without systemic disease, who completed dental treatment, especially periodontal treatment (M = 21, F = 31, 55.4 ± 14.2 years), were also enrolled as controls and checked for mecA on the oral mucosa. [Results] Seventy-six percent (45/59) of the HCT patients carried mecA at least once in the study period (days −7 to +20), while no control subjects had mecA. The frequency of mecA carriers was 19.2 % from days −7 to −1, while it was significantly increased on days +7 to +13 and +14 to +20, with frequencies of 60.9 and 63.2 %, respectively (P < 0.01, ANOVA). [Conclusions] mecA was detected in oral mucosa of patients undergoing HCT. The high detection frequency of staphylococci resistant to penicillin and beta-lactams in our recent report was supported

Salivary Biomarkers May Be Useful to Assess Stress State in Patients with Lung Cancer Undergoing Chemotherapy

ABSTRAC

Febrile neutropenia and periodontitis: lessons from a case periodontal treatment in the intervals between chemotherapy cycles for leukemia reduced febrile neutropenia

Oral and systemic infections arising from the oral cavity are significant problems in clinical management of patients undergoing leukemia treatment. However, there is significant disparity in the reported incidences of development of periodontal infections. Evidence is limited to those showing the systemic influence of periodontal infection in neutropenic patients. This study indicated an association between febrile neutropenia (FN) and periodontitis in a case in which periodontal treatment in the intervals between chemotherapy cycles reduced FN in subsequent courses of chemotherapy and hematopoietic transplantation (HCT). Periodontal treatment was performed in a 61-year-old man with advanced periodontitis, who received HCT following three cycles of chemotherapy. After recovery from neutropenia induced by initial chemotherapy, periodontal treatment was performed in each chemotherapy interval period. Following extraction of teeth with severe advanced periodontitis, all teeth were subjected to periodontal pocket curettage and root planning, which are common periodontal treatments to reduce periodontal pockets harboring anaerobic periodontal bacteria, before HCT. Periodontal treatment successfully reduced periodontal pockets from 4.1 +/- 1.5 mm to 3.0 +/- 0.6 mm, which was almost within the healthy range (< 3.0 mm), before HCT. The frequency of FN decreased significantly with increasing cycles of chemotherapy, and decreases in FN corresponded to progress of periodontal treatment. Blood cultures obtained a total of 12 times throughout leukemia treatment were all negative. The observations reported here indicate the importance of periodontal treatment in clinical management of patients undergoing leukemia treatment to prevent FN, although all blood cultures were negative

ネパール デタールムラ ジュウミン ノ ケンコウ チョウサ ト シシュウ シッカン リカン ジョウキョウ ナラビニ シシュウビョウゲンサイキン ニ カンスル チョウサ

ネパール中央部カスキ郡・デタール村住民の生活習慣を含めた健康調査、歯科検診、歯周病原細菌に関して 調査し、以下の結果を得た。 １．う蝕罹患状況・未処置かつ重症化したう蝕歯をもつ者が多い。一人平均う蝕本数が加齢とともに増加していた。う蝕処置 をしている者が少なく、抜去している歯が多かった。 ２．歯周疾患罹患状況・歯周組織検査ではCPI：0（健全）の者はどの年代でも少なく、加齢に伴い重症化していた。・喫煙者と非喫煙者の比較では、CPI値が喫煙者の方が高く、喫煙と歯周病の関連性が示唆された。・ブラッシングの回数は2回者が最も多く、回数が多い者ほどCPI値は低値を示した。 ３．唾液潜血反応検査と歯周病原細菌検査・唾液潜血反応陽性者は95％だった。また、ブラッシング時出血自覚症状の有無と唾液潜血反応の結果は、ほぼ一致した。・歯肉に炎症ある者にPorphyromonas gingivalis （ Pg 菌）に対する血漿抗体価陽性の傾向が認められ、唾液潜血反応結果では潜血反応陽性者の Pg 菌に対する血漿抗体価は陰性の傾向が認められた。このことから、この地域の歯周病罹患率ならびにう蝕罹患率は高く、重症化していることが示唆された。A health check including an interview about life habits, dental checkup and investigation of periodontopathic bacteria of periodontal disease among the residents of Dhital village, Kaski District,Nepal was conducted. The results are as follows: １．Prevalence of dental caries・There were many residents who had serious tooth decay resulting from lerving it untreated.The average number of tooth decay has increased with aging.There were not many people who treated their tooth decay,and many of their teeth were extracted. ２．Prevalence of periodontal disease・The survey of periodontal tissue showed that there were only a few people with CPI:0（healthy periodontal tissue）in every generation,and prevalence rate was rising with aging.・The comparison between smokers and non-smokers showed that the average CPI values of　smokers were higher than that of non-smokers, and it suggested a correlation between smoking and progression of periodontal disease.・There were a large number of people who brushed their teeth twice a day. The more examination they brushed their teeth, the lower the value of average CPI became. ３．Salivary occult blood test and periodontopathic bacteria test・Positive persons of occdlt blood examination were 95%. The presence of the subjective symptom with respect to bleeding during brushing teeth almost agreed with the result of the salivary occult blood test.・A positive trend for plasma antibody value against Porphyromonas gingivalis was found among the people with gingival inflammation. As a result of reaction against salivary occult blood, there was a negative trend for the plasma antibody value against Porphyromonas gingivalis . From there results,it was suggested that among people living in thie district, prevalence of both periodontal disease and tooth decay were high,and their conditions were serious

Alveolar rhabdomyosarcoma in the skin of the abdominal wall in an elderly patient: A case report

Alveolar rhabdomyosarcoma (ARMS) is a type of primitive round cell tumor that mainly develops in adolescents and young adults. Immunohistochemically, the expression of myogenic markers is a key clue for pathological diagnosis, and an aberrant expression of neuroendocrine markers and/or cytokeratin has also been reported. Therefore, an unusual clinical course complicated with aberrant neuroendocrine expression may make the diagnosis of ARMS difficult. In this report, we present a case of ARMS that developed in the skin of the abdominal wall in an elderly patient; the tumor cells expressed neuroendocrine markers. ARMS should be considered as a differential diagnosis of primitive round cell tumors in elderly patients and it is essential to confirm concurrent myogenic differentiation and PAX3/PAX7–FOXO1 fusion gene expression to make a pathological diagnosis. Keywords: Alveolar rhabdomyosarcoma, Primitive round cell tumor, Neuroendocrine marker, PAX3/PAX7–FOXO1 fusion gene, High-sensitivity RT-PC

Predictive factors for tooth loss during supportive periodontal therapy in patients with severe periodontitis: a Japanese multicenter study

Abstract Background Supportive periodontal therapy (SPT) must take individual patient risk factors into account. We conducted a multicenter joint retrospective cohort study to investigate the value of modified periodontal risk assessment (MPRA) and therapy-resistant periodontitis (TRP) assessment as predictive factors for tooth loss due to periodontal disease in patients with severe periodontitis during SPT. Methods The subjects were 82 patients from 11 dental institutions who were diagnosed with severe periodontitis and continued SPT for at least 1 year (mean follow-up = 4.9 years) between 1981 and 2008. The outcome was tooth loss due to periodontal disease during SPT. The Cox proportional hazards model was used to analyze sex, age, diabetes status, smoking history, number of periodontal pockets measuring ≥6 mm, rate of bleeding on probing, bone loss/age ratio, number of teeth lost, MPRA, and TRP assessment as explanatory variables. Results Univariate analysis showed that loss of ≥8 teeth by the start of SPT [hazard ratio (HR) 2.86], MPRA score indicating moderate risk (HR 8.73) or high risk (HR 11.04), and TRP assessment as poor responsiveness to treatment (HR 2.79) were significantly associated with tooth loss (p < 0.05). In a model in which the explanatory variables of an association that was statistically significant were added simultaneously, the HR for poor responsiveness to treatment and ≥8 teeth lost was significant at 20.17 compared with patients whose TRP assessment indicated that they responded favorably to treatment and who had lost <8 teeth by the start of SPT. Conclusion MPRA and TRP assessment may be useful predictive factors for tooth loss due to periodontal disease during SPT in Japanese patients with severe periodontitis. Additionally, considering the number of teeth lost by the start of SPT in TRP assessment may improve its predictive accuracy