Hiroto Itoh

Chronic Paracoccidioidomycosis in Japan

Abstract We describe the case of a 36-year-old Argentinean man who developed chronic paracoccidioidomycosis, with oral and cutaneous lesions, 13 years after last living in South America. The patient had lived in Argentina until 1991 before relocating to Japan.

Systematizing mandibular reconstruction using the resin frame method

Aims: Oral tumors are the most frequent diseases that lead to mandibular defects, but because they are so rare, it is difficult to obtain the necessary large capital investment to establish and introduce a mandibular reconstruction system. therefore, we developed the resin Frame method within the current facilities that objectively increases mandibular reproducibility without requiring advanced techniques. Methods: subjects comprised 25 patients who underwent mandibular reconstruction by the resin frame method in the Department of Dentistry, Oral and Maxillofacial surgery at Jichi Medical University Hospital between October 2013 and August 2015, Junichi Hayasaka1, Shunji Sarukawa2, Hiroto Itoh3, Yoshiaki Takai4, Mikio Kusama5, Yoshiyuki Mori1, Akitoshi Katsumata6 Affiliations: 1Department of Dentistry, Oral and Maxillofacial Surgery, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke-shi, Tochigi, Japan; 2Department of Plastic Surgery, Jichi Medical University, Yakushiji, Shimotsuke-shi, Tochigi, Japan; 3Oral and Maxillofacial Surgery, Nasu Red Cross Hospital, 1081-4 Nakadawara, Otawara-shi, Tochigi, Japan; 4Department of Oral and Maxillofacial Surgery, Division of Oral Pathogenesis and Disease Control, Asahi University School of Dentistry, 1851 Hozumi, Mizuho-shi, Gifu 5010296, Japan; 5International University of Health and Welfare Hospital, Oral and Maxillofacial Surgery, 537-3 Iguchi, Nasushiobara-shi, Tochigi, Japan; 6Department of Oral Radiology, Division of Oral Pathogenesis and Disease Control, Asahi University School of Dentistry, 1851 Hozumi, Mizuho-shi, Gifu, Japan. Corresponding Author: Junichi Hayasaka, 3311-1 Yakushiji, Shimotsuke-shi, Tochigi 329-0498, Japan; Email: hayasakadds@jichi.ac.jp Received: 08 February 2018 Accepted: 15 March 2018 Published: 09 April 2018 and 25 patients who underwent the mandibular reconstruction by the conventional method between september 2007 and November 2011. All mandibles were reconstructed using fibula or iliac bones with a reconstruction plate. the computed tomography (ct) Digital Imaging and communications in Medicine (DIcOM) data before and after the operation were saved. then, the layer function was used to fuse the preand postoperative ct images. based on measured area, the concordance rate that is matching percentages between preand postoperative mandibles were calculated. We evaluated the difference between the concordance rate of the resin Frame method and the conventional method of mandibular reconstruction. results: concordance rates for the resin frame method and conventional surgery were 75.09±6.09% and 67.39±13.44%, respectively, showing a significant difference (p=0.032, p<0.05). conclusion: the resin frame method represents a mandibular reconstruction system that increases reproduction accuracy and can be implemented at current facilities using simple, objective techniques.

Limitations of Fluoro-2-deoxy-D-glucose—Positron Emission Tomography for Metastatic Neck Disease Secondary to Oral Squamous Cell Carcinoma

Abstract Objective: The objectives of this study were to evaluate the efficacy and limitations of fluoro-2-deoxy- D-glucose—positron emission tomography for metastatic neck disease secondary to oral squamous cell carcinoma. This study specifically examined the limitations of the procedure. Materials and Methods: From April 2004 to October 2007, 35 patients with oral squamous cell carcinoma underwent computed tomography, ultrasound, and fluoro-2-deoxy-D-glucose—positron emission tomography before treatment with neck dissection. After neck dissection, the results of computed tomography/ultrasound and positron emission tomography imaging were correlated with the histopathological findings of the cervical lymph nodes. Results: Positron emission tomography of the cervical lymph nodes was positive for 20 patients, 16 of who were demonstrated to have metastases on histopathological examination. Of the 4 falsepositive results, 3 were reactive lymphadenitis and 1 was sarcoidosis. Positron emission tomography was negative for 15 patients. Two of these patients had false-negative results, as metastatic disease was found at neck dissection. In 1 patient, the metastatic lymph node was largely keratinised, while micrometastasis was evident in the other patient. Pathological findings were compared with imaging results to determine the relative efficacies of positron emission tomography (accuracy, 82.9%; sensitivity, 88.8%; specificity, 76.5%), computed tomography (accuracy, 85.7%; sensitivity, 88.8%; specificity, 82.4%), and ultrasound (accuracy, 88.6%; sensitivity, 88.8%; specificity, 88.2%). There were no significant differences on statistical analysis. Conclusion: Positron emission tomography appears to have significant potential for the detection of lymph node metastasis. However, fluoro-2-deoxy-D-glucose—positron emission tomography should not be used as the sole method of imaging for initial investigation of oral squamous cell carcinoma and cervical lymph node metastasis. The surgical management of neck lymph node metastasis should not be based on fluoro-2-deoxy-D-glucose—positron emission tomography findings alone. Use of other imaging modalities in addition to fluoro-2-deoxy-D-glucose—positron emission tomography should increase the diagnostic accuracy over fluoro-2-deoxy-D-glucose—positron emission tomography alone.

Immunohistochemical Study on Superoxide Dismutases in Tongue Cancer

Abstract Objective: To analyse the relationship between the expression levels of manganese superoxide dismutase, and copper-zinc superoxide dismutase, and clinicopathological parameters in human tongue cancer. Materials and Methods: Oral biopsy specimens of 42 cases of tongue cancer were stained with antihuman manganese and copper-zinc superoxide dismutases, and the degree of staining in tumour cells was evaluated. Clinicopathological information was reviewed and the degree of tumour invasion was divided into four types. Results: The percentage of enhanced manganese superoxide dismutase expression in patients was significantly higher in patients older than 60 years than that in patients younger than 60 years. The percentage of enhanced manganese superoxide dismutase expression was higher in T4 patients versus T1 patients and in patients with lymph node metastasis versus patients without metastasis. A higher percentage of enhanced copper-zinc superoxide dismutase expression was shown in the 2+3 mode of invasion group compared with the advanced mode of invasion (4c+4d) group, and the percentage of reduced copper-zinc superoxide dismutase expression in patients in the 4c+4d group was significantly higher than that in patients in the less invasive group (2+3). The percentage of enhanced copper-zinc superoxide dismutase expression in patients without lymph node metastasis was slightly higher than that in patients with metastasis. Conclusion: These results demonstrate that expression levels of manganese and copper-zinc superoxide dismutases correlate with clinical stage, mode of invasion, and lymph node metastasis in tongue cancer.