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

Isolation and characterization of a new DUR3-like gene, PyDUR3.3, from the marine macroalga Pyropia yezoensis (Rhodophyta)

DUR3 proteins mediate high-affinity transport of exogenous and endogenous urea. Although two DUR3-like genes (PyDUR3.1/3.2) have been identified in Pyropia yezoensis, a BLAST search using these sequences against the P. yezoensis EST database suggested the existence of another DUR3-like gene (PyDUR3.3). In this study, the PyDUR3.3 gene was isolated and characterized and compared to PyDUR3.1/3.2 genes. The predicted length of PyDUR3.3 was 679 amino acids, which included 15 transmembrane domains. An amino acid sequence alignment of algal, plant, and yeast DUR3 proteins showed that PyDUR3.3 was more similar to PyDUR3.2 than to other DUR3 proteins, including PyDUR3.1. Exon–intron structures of PyDUR3.3 and PyDUR3.2 were also closely related to each other, which clearly differed from that of PyDUR3.1. Expression analysis showed that PyDUR3.3 mRNA levels were extremely high in sporophytes, regardless of the nutrient condition, compared to gametophytes. On the other hand, expression of PyDUR3.2 and PyDUR3.1 was high in the gametophytes and sporophytes, respectively, and was induced by nutrient starvation. These results suggest that expression of PyDUR3.3/3.2/3.1 depends on the life history phase as well as the nutrient conditions, and that PyDUR3.3 and PyDUR3.2 are paralogues specifically differentiated in function and life history phase

関節リウマチ関連間質性肺疾患マウスの肺におけるニンテダニブが引き起こす遺伝子発現変化

令和4年

Solitary Spinal Epidural Metastasis from Gastric Cancer

Solitary epidural space metastasis of a malignant tumor is rare. We encountered a 79-year-old male patient with solitary metastatic epidural tumor who developed paraplegia and dysuria. The patient had undergone total gastrectomy for gastric cancer followed by chemotherapy 8 months priorly. The whole body was examined for suspected metastatic spinal tumor, but no metastases of the spine or important organs were observed, and a solitary mass was present in the thoracic spinal epidural space. The mass was excised for diagnosis and treatment and was histopathologically diagnosed as metastasis from gastric cancer. No solitary metastatic epidural tumor from gastric cancer has been reported in English. Among the Japanese, 3 cases have been reported, in which the outcome was poor in all cases and no definite diagnosis could be made before surgery in any case. Our patient developed concomitant pneumonia after surgery and died shortly after the surgery. When a patient has a past medical history of malignant tumor, the possibility of a solitary metastatic tumor in the epidural space should be considered

Additional file 1: Figure S1. of Deltopectoral flap revisited for reconstruction surgery in patients with advanced thyroid cancer: a case report

Touch-up surgery for the scar contracture. a: Multiple z-plasty was designed for the scar contracture on the left neck. b: The scar contracture was released after removal of the scar and incisions of the flaps. Each small flap was elevated over the superficial fascia. c: The wound was closed with some trimming of the flap edges. d: Local finding 1 year after multiple z-plasty. The scar contracture was released almost completely although hypertrophic scar was formed again. (ZIP 12226 kb

Additional file 2: Figure S2. of Deltopectoral flap revisited for reconstruction surgery in patients with advanced thyroid cancer: a case report

Preoperative reconstructed 3D–CT angiography. a: The left anterior oblique view shows the origin of the left internal thoracic artery (ITA) while the right ITA is observed clearly in the picture. b: In the right anterior oblique view, the arising portion of the right ITA can be seen just behind the yellowish shadow of the tumor in the right neck. The right ITA is clearly seen in this view. (ZIP 1109 kb

IGF-II Producing Hepatocellular Carcinoma Treated with Sorafenib: Metabolic Complications and a Foresight to Molecular Targeting Therapy to the IGF Signal

Hypoglycemia is a rare paraneoplastic manifestation of patients with neoplasms. Hypoglycemia can be induced by several causes, including an aberrant increase of hypoglycemic agents and adrenal insufficiency. Sorafenib is the first agent to demonstrate a survival benefit in the treatment of advanced hepatocellular carcinoma (HCC). This small molecule inhibits serine/threonine kinase RAF in tumor cells and tyrosine kinases VEGFR/PDGFR in tumor vasculature and decreases tumor growth and angiogenesis. In this paper, we report a case of HCC who was treated with sorafenib and showed severe hypoglycemia. This hypoglycemia might be induced by two causes, both adrenal insufficiency as an adverse effect of sorafenib and activation of the insulin-like growth factor (IGF) signal by excessive secretion of incompletely processed precursors of IGF-II. Although the IGF signal is suggested to be involved in aberrant growth of HCC in some cases, there is no other report showing the influence of sorafenib on HCC with active IGF signal. Unfortunately, the effect of sorafenib was limited in the present case. However, emerging drugs that directly inhibit the IGF signal can be expected to be highly effective in the treatment of HCC with hypoglycemia