RESUMEN
Pseudoankylosis of the mandible after intracranial surgical procedure has been widely reported, and is usually caused by fibrosis of the temporal muscle as a result of injury during the operation. We present an unusual case of mandibular pseudoankylosis as a result of methyl methacrylate-induced aseptic inflammatory cicatricial contracture of the temporal muscle after cranioplasty.
Asunto(s)
Anquilosis/etiología , Cementos para Huesos/efectos adversos , Cicatriz/inducido químicamente , Contractura/inducido químicamente , Enfermedades Mandibulares/etiología , Metilmetacrilato/efectos adversos , Miositis/inducido químicamente , Hueso Temporal/cirugía , Músculo Temporal/efectos de los fármacos , Adulto , Hemorragia Cerebral/cirugía , Cicatriz/patología , Tejido Conectivo/patología , Contractura/patología , Eosinófilos/patología , Humanos , Masculino , Miositis/patología , Músculo Temporal/patología , Trismo/etiologíaRESUMEN
Combination chemotherapy with THP, CDDP and 5-FU for squamous cell carcinoma of the head and neck was conducted in 13 institutions in Hyogo Prefecture as a multi-institutional cooperative study. In the initial study (Nov. 1990-Nov. 1993), THP was administered intravenously at 20 mg/m2 on day 1, CDDP at 80 mg/m2 on day 2, and 5-FU at 1,000 mg/body/day in a continuous drip infusion for 120 hours from day 2 to day 6. In the second study (May, 1996-Mar. 1998), THP was administered at 20 mg/m2 on day 1, 5-FU at 10 mg/kg/day from day 1 to day 5, and CDDP at 70 mg/m2 on day 6 in the same way as the initial study. Forty-nine patients (Stage I in 3, Stage II in 12 including 2 recurrent cases, Stage III in 6, Stage IV in 28 including 3 recurrent cases; 1 course chemotherapy in 13 and 2 or more courses in 36) were subjected as complete cases in the initial study, and 36 patients (Stage I in 5 including one recurrent case, Stage II in 11 including 1 recurrent case, Stage III in 9 including 2 recurrent cases, Stage IV in 11 including one recurrent case; 1 course in 18 and 2 or more courses in 18) in the second. The overall response rate was 65.3% (CR in 3 cases) in the initial study and 63.9% (CR in 5 cases) in the second. Primary cases showed a response rate of 65.9% (29/44) in the initial study and 71.0% (22/31) in the second, whereas recurrent cases showed a 60.0% (3/5) response rate in the initial study and a 20.0% (1/5) rate in the second. Treatment-naive patients showed a response rate of 72.7% (24/33) in the initial study and 71.0% (22/31) in the second, whereas previously treated patients showed a 50.0% (8/16) response rate in the initial study and a 20.0% (1/5) rate in the second. Adverse reactions of more than Grade 3 in the initial study were leukopenia in 18.4%, thrombocytopenia in 8.2%, decrease of hemoglobin in 6.1%, loss of hair in 6.1%, anorexia in 36.7%, nausea and vomiting in 26.5%, and diarrhea in 4.1%, whereas those of Grade 3 in the second study were decrease of hemoglobin in 2.8%, anorexia in 22.2% and nausea and vomiting in 8.3%. From these results, it is suggested that the regimen in the second study was more useful than that in the initial study.
Asunto(s)
Protocolos de Quimioterapia Combinada Antineoplásica/administración & dosificación , Carcinoma de Células Escamosas/tratamiento farmacológico , Neoplasias de Cabeza y Cuello/tratamiento farmacológico , Adulto , Anciano , Anciano de 80 o más Años , Protocolos de Quimioterapia Combinada Antineoplásica/efectos adversos , Cisplatino/administración & dosificación , Cisplatino/efectos adversos , Doxorrubicina/administración & dosificación , Doxorrubicina/efectos adversos , Doxorrubicina/análogos & derivados , Esquema de Medicación , Femenino , Fluorouracilo/administración & dosificación , Fluorouracilo/efectos adversos , Humanos , Masculino , Persona de Mediana Edad , Resultado del TratamientoRESUMEN
Nine hundred and ninety-three patients who underwent surgical removal of the mandibular third molars with oral antibiotic prophylaxis were examined to determine the incidence of postoperative deep fascial space infection and its background factors. Postoperative deep fascial space infection was observed in 8 of the patients (0.8%; 4 males and 4 females), and submandibular spaces were involved in all infected patients. Only 1 of these 8 patients was an immune compromised host. Patients aged 30 years or more had a significantly higher incidence of deep fascial space infection than those aged under 30. Five patients had partial bony impactions and 3 had complete bony impactions. However, the incidence of infection according to the molar positions was not significantly different between partial bony impaction and complete bony impaction. The 8 patients had not had pericoronitis preoperatively. The clinical courses of all were favorable after antibiotics were administered intravenously. In conclusion, the incidence of deep fascial space infection after removal of the mandibular third molars was low, at 0.8%. However, it may be desirable to remove the molars, if applicable, at a younger age because of the higher incidence of infection in patients aged over 30. The results of this study also offer information that will be useful as a basis for obtaining informed consent from patients whose mandibular third molars are to be removed.
Asunto(s)
Celulitis (Flemón)/epidemiología , Fascia/microbiología , Mandíbula/cirugía , Tercer Molar/cirugía , Infección de la Herida Quirúrgica/epidemiología , Extracción Dental , Adolescente , Adulto , Factores de Edad , Anciano , Ampicilina/administración & dosificación , Ampicilina/análogos & derivados , Ampicilina/uso terapéutico , Profilaxis Antibiótica , Asma/epidemiología , Niño , Comorbilidad , Diabetes Mellitus/epidemiología , Susceptibilidad a Enfermedades , Femenino , Hepatitis Crónica/epidemiología , Humanos , Huésped Inmunocomprometido , Incidencia , Japón/epidemiología , Masculino , Persona de Mediana Edad , Neoplasias/epidemiología , Pericoronitis/complicaciones , Pericoronitis/epidemiología , Diente Impactado/cirugíaRESUMEN
A hypertensive woman complained of a headache soon after an operation to remove a maxillary cyst. A computed tomogram showed evidence of subarachnoid haemorrhage and on angiogram an aneurysm of an anterior cerebral artery. The aneurysm was treated by clipping and the patient recovered.
Asunto(s)
Aneurisma Roto/complicaciones , Arteria Cerebral Anterior , Aneurisma Intracraneal/complicaciones , Complicaciones Posoperatorias , Hemorragia Subaracnoidea/etiología , Aneurisma Roto/cirugía , Arteria Cerebral Anterior/diagnóstico por imagen , Arteria Cerebral Anterior/cirugía , Femenino , Humanos , Hipertensión/complicaciones , Aneurisma Intracraneal/diagnóstico por imagen , Aneurisma Intracraneal/cirugía , Quistes Maxilomandibulares/cirugía , Enfermedades Maxilares/cirugía , Persona de Mediana Edad , Procedimientos Quirúrgicos Orales , Complicaciones Posoperatorias/cirugía , Radiografía , Hemorragia Subaracnoidea/cirugíaAsunto(s)
Luxaciones Articulares , Cóndilo Mandibular/lesiones , Fracturas Mandibulares , Articulación Temporomandibular/lesiones , Femenino , Fijación Interna de Fracturas/métodos , Fijación Interna de Fracturas/rehabilitación , Humanos , Lactante , Luxaciones Articulares/diagnóstico por imagen , Luxaciones Articulares/etiología , Luxaciones Articulares/rehabilitación , Luxaciones Articulares/cirugía , Fracturas Mandibulares/diagnóstico por imagen , Fracturas Mandibulares/etiología , Fracturas Mandibulares/rehabilitación , Fracturas Mandibulares/cirugía , Tomografía Computarizada por Rayos X , Fracturas Cigomáticas/diagnóstico por imagen , Fracturas Cigomáticas/etiología , Fracturas Cigomáticas/cirugíaRESUMEN
An experimental study was carried out in hamster tongue cancer induced with 9,10-dimethyl-1,2-benzanthracene (DMBA) to examine the association between the histological features and the incidence of lymph node metastases. Squamous cell carcinoma was induced in 64 of 71 hamsters exposed to DMBA 3 times weekly for a period of 10-24 weeks, and lymph node metastases were found in 8 necks. Various histological variables in the primary lesion were examined, and the mode of invasion, degree of keratinization, and stage of invasion were found to be closely related to the development of neck metastases. We then did a prospective study in 37 human patients with T1-2 tongue cancer, which also showed a close association between the incidence of neck metastases and the histological variables of mode of invasion and degree of keratinization. These experimental and clinical studies suggest that the mode of invasion and degree of keratinization may be risk factors for neck metastases that are independent of T stage, and that the indications for elective neck dissection should be re-evaluated in that light.
Asunto(s)
9,10-Dimetil-1,2-benzantraceno/efectos adversos , Carcinógenos/efectos adversos , Carcinoma de Células Escamosas/secundario , Metástasis Linfática/patología , Neoplasias de la Lengua/inducido químicamente , Animales , Biopsia , Carcinoma de Células Escamosas/inducido químicamente , Carcinoma de Células Escamosas/patología , Cricetinae , Procedimientos Quirúrgicos Electivos , Humanos , Incidencia , Queratinas , Escisión del Ganglio Linfático , Masculino , Mesocricetus , Cuello , Invasividad Neoplásica , Estadificación de Neoplasias , Estudios Prospectivos , Factores de Riesgo , Neoplasias de la Lengua/patologíaRESUMEN
Hydroxyapatite ceramics (HA) are widely used for clinical applications as a bone substitute or dental implant because they have been shown to be biocompatible and exhibit excellent osteoconductivity when grafted into the bone tissue. However, the influence of the physical properties of HA on the osteoconduction and stability remains unclear. We examined here the effect of various properties of HA granules on osteoconduction and stability using 6 types of HA granules. The HA granules were grafted into the rabbit tibia and the initial bone formation and long-term stability of the new bone were studied histologically. The following results were obtained; 1. Osteoconduction of the HA granule was influenced by the shape. Multi-nuclear granules with continuous pores ranging from 30 to 200 microns in diameter showed both excellent osteoconduction and stability. 2. Solubility behavior of HA granules, which was effected by the relative surface area sizes, also seemed to be an important factor for osteoconduction and stability. 3. Stable bi-phase ceramics with HA and beta TCP were produced at the sintering temperature of 1200 degrees C when Mg was added. The beta TCP and Mg content did not negatively influence the initial osteoconduction or long-term stability.
Asunto(s)
Sustitutos de Huesos , Huesos/fisiología , Cerámica/química , Durapatita/química , Animales , Desarrollo Óseo , Regeneración Ósea , Fenómenos Químicos , Química Física , Estabilidad de Medicamentos , Microscopía Electrónica de Rastreo , Tamaño de la Partícula , Conejos , Solubilidad , TibiaRESUMEN
PURPOSE: This retrospective study was conducted to determine the relationship between the computed tomographic findings for cervical lymph nodes (LN), histologic findings, and outcome in patients with squamous cell carcinoma of the oral cavity who underwent radical neck dissection. PATIENTS AND MATERIALS: Sixty-six patients were analyzed. Of these 66 operations, 43 were immediate therapeutic dissections in clinically N+ necks, and 23 were subsequent therapeutic dissections in patients whose necks were initially node free but progressed to positive nodes during observation. RESULTS: When the size criterion (area of the axial section) of nodal metastasis depicted on the scan of 45 mm2 was selected, almost 78% of LN were diagnosed consistent with the histologic diagnosis. As the size of the LN increased, the frequency of extranodal invasion also became higher, whereas patients with the higher histologic grades of malignancy often showed neck metastases with extranodal invasion in the early stage. Patients having LN smaller than 100 mm2, or without extranodal invasion, showed good outcome, whereas those having LN 100 mm2 or larger, with extranodal invasion, showed extremely poor outcome. CONCLUSIONS: These findings indicate that it is possible to delay neck dissection in node-free patients until neck disease is diagnosed with timely CT examination, although great caution is necessary, especially in those with a high histologic grade of malignancy.
Asunto(s)
Carcinoma de Células Escamosas/diagnóstico , Neoplasias de la Boca/diagnóstico , Tomografía Computarizada por Rayos X , Biopsia , Carcinoma de Células Escamosas/diagnóstico por imagen , Carcinoma de Células Escamosas/mortalidad , Carcinoma de Células Escamosas/patología , Carcinoma de Células Escamosas/cirugía , Humanos , Ganglios Linfáticos/diagnóstico por imagen , Ganglios Linfáticos/patología , Metástasis Linfática , Neoplasias de la Boca/diagnóstico por imagen , Neoplasias de la Boca/mortalidad , Neoplasias de la Boca/patología , Neoplasias de la Boca/cirugía , Disección del Cuello , Pronóstico , Estudios Retrospectivos , Sensibilidad y Especificidad , Tasa de Supervivencia , Tomografía Computarizada por Rayos X/métodos , Resultado del TratamientoRESUMEN
We report the case of a patient in whom oral squamous cell carcinoma and a fatal reactive form of histiocytosis were simultaneously manifested. Our conclusions indicate that such a hematophagocytic syndrome may occur in the setting of oral squamous cell carcinoma as previously described in other malignancies.
Asunto(s)
Carcinoma de Células Escamosas/patología , Sarcoma Histiocítico/patología , Neoplasias de la Boca/patología , Neoplasias Primarias Múltiples/patología , Neoplasias Inducidas por Radiación/etiología , Anciano , Carcinoma de Células Escamosas/radioterapia , Resultado Fatal , Sarcoma Histiocítico/etiología , Humanos , Masculino , Suelo de la Boca/patología , Neoplasias de la Boca/radioterapia , Radioterapia Adyuvante/efectos adversosRESUMEN
The treatment methods and prognosis were discussed in 12 patients of oral melanoma who were treated at Dept. of Oral and Maxillofacial Surgery, Kobe Univ. School of Medicine from 1975 to 1989, with a review of 96 cases published in the Japanese literature between 1984 and 1988, and the following findings were obtained. 1. Eleven our 12 cases were acral lentiginous melanoma (ALM), and one case was nodular melanoma (NM). 2. The early two cases were died of distant metastasis. Of the recent ten cases which were underwent surgical excision combined with adjuvant immunochemotherapy with DTIC, ACNU, VCR and OK-432, nine cases had good prognosis, and one case was died of local recurrence. 3. The prognosis of the reported cases was poor because of local recurrence and distant metastasis.
Asunto(s)
Melanoma/terapia , Neoplasias de la Boca/terapia , Adulto , Anciano , Anciano de 80 o más Años , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Terapia Combinada , Femenino , Humanos , Masculino , Melanoma/patología , Persona de Mediana Edad , Neoplasias de la Boca/patología , PronósticoRESUMEN
In contrast to Caucasians, Japanese people have a relatively high incidence of malignant melanoma in the oral cavity and volar-subungual skin. The classification of oral melanoma has not been established. We report 7 new cases of oral melanoma, with a review of 36 cases, published in Japan, between 1970 and 1984. Most of the cases reviewed have radial growth phases, and their gross and microscopic features seem to correspond to those of acral lentiginous melanoma of the skin. However, 1 of our cases and 3 previously reported cases of oral nodular melanoma suggest the presence of melanoma heterogeneity in the oral cavity.
Asunto(s)
Melanoma/patología , Neoplasias de la Boca/patología , Neoplasias Palatinas/patología , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Neoplasias Gingivales/patología , Humanos , Japón , Masculino , Persona de Mediana Edad , Recurrencia Local de NeoplasiaAsunto(s)
Neoplasias Encefálicas/patología , Coristoma/patología , Teratoma/patología , Diente , Niño , Humanos , Masculino , Diente/patologíaAsunto(s)
Mucosa Bucal/patología , Neoplasias de la Boca/patología , Teratoma/patología , Mejilla , Humanos , LactanteRESUMEN
Eight cases of malignant tumors of the head and neck were treated with NK 631 on a dosage schedule of 10 mg at a time 3 times weekly, by intravenous one-shot injection or intravenous drip infusion, to observe its therapeutic effects and adverse reactions. The treatment was assessed markedly effective in 3, moderately effective in 1 and ineffective in 4 of them. The treatment was also assessed moderately or markedly effective in 3 and ineffective in 2 out of squamous cell carcinoma cases. Hematologic findings, serum electrolytes and enzymologic findings were normal, but the pulmonary function examinations revealed a tendency for PaO2 to decrease slightly. In 1 case where frequent cough was observed, the cough was mitigated on withdrawal of the treatment. The adverse reactions that evolved included fever, alopecia, eruptions, nausea and vomiting, and pigmentation of the nail. To summarize these findings, the authors were impressed with NK 631 and that the agent would exert an excellent antitumor effect, compared with bleomycin, and that its effect would evolve at the early stage of its treatment. Fixed drug eruption was observed as an adverse reaction of this drug in 1 case; however, the adverse reactions of this bleomycin analog appear similar to those of its parent compound, bleomycin.