Jouji Nomura

Destructive calcium pyrophosphate dihydrate temporo-mandibular arthropathy (pseudogout)

A case of a 57-year-old man with destructive calcium pyrophosphate dihydrate (CPPD) arthropathy (pseudogout) together with pseudotumor formation in the temporomandibular joint (TMJ).

Magnetic resonance imaging of synovial proliferation in temporomandibular disorders with pain.

Objective: The objective of this study was to assess the clinical significance of synovial proliferation in patients with painful temporomandibular disorders based on magnetic resonance imaging findings. Methods: The current study was conducted in 100 joints of 100 patients with unilateral painful temporomandibular disorders. One hundred joints on the contralateral side of patients with unilateral disease were used as nonpain group. Areas in the articular space that showed a low signal intensity on T1-weighted imaging, a high signal intensity on T2-weighted imaging, and high signal intensity on gadolinium-enhanced fat-suppressed T1-weighted imaging were judged to be regions of synovial proliferation. Results: Synovial proliferation alone was observed in 8.0% of the pain group, but in none of the nonpain group. Synovial proliferation + effusion was observed in 33.0% of the pain group and in 7.0% of the nonpain group. Effusion alone was observed in 7.0% of the pain group and in 3.0% of the nonpain group. The mean visual analog scale value of pain was in the order of synovial proliferation alone > synovial proliferation + effusion > effusion alone. The incidence rates of anterior displacement of the disk were 100% for synovial proliferation alone, 93.9% for synovial proliferation + effusion, 57.1% for effusion alone, and 57.7% for “without synovial proliferation/effusion.” Conclusions: Strong correlations were observed between synovial proliferation, pain, and disk displacement. It is considered that evaluating effusion alone provides only limited information on the disease state in painful temporomandibular disorders. Thus, it is essential to include enhanced T1-weighted imaging as a means to judge the disease state as well as to assess disease progression.

Inflammatory pseudotumor in the submandibular region: Clinicopathologic study and review of the literature

A rare case of right submandibular inflammatory pseudotumor in a 63-year-old man is reported. The tumor appeared as a symptomless swelling in the submandibular region and resembled a malignant neoplasm on computed tomographic and magnetic resonance images. Surgical resection was required. The pertinent English and Japanese literature is reviewed, and histologic and electron microscopic findings are discussed.

Acanthosis nigricans with oral lesions and a malignant visceral tumor: A case report

Abstract Acanthosis nigricans (AN) is a disease characterized by papillary proliferation of the mucosa and skin, hyperkeratosis, and pigmentation. It is classified as malignant, benign, or pseudo types.1−5 In the malignant type, mucosal and dermal signs precede or accompany malignant visceral tumors.2,4,5 Thus, recognition of AN may possibly facilitate the diagnosis of the malignancy. However, AN is rarely reported in the oral region. This article reports a case of AN with oral papillomatous lesions and a ma ant visceral tumor.

Aggressive infantile fibromatosis of the submandibular region

Aggressive infantile fibromatosis is an unusual, tumor-like, proliferative lesion which grows infiltratively. The clinical and histological features of aggressive infantile fibromatosis in the submandibular region of a 3-year-old girl are reported.

Synergistic Increase in Osteosarcoma Cell Sensitivity to Photodynamic Therapy with Aminolevulinic Acid Hexyl Ester in the Presence of Hyperthermia

OBJECTIVE We observed that two osteosarcoma cell lines from the same tumor displayed marked differences in their sensitivities to photodynamic therapy (PDT) with aminolevulinic acid hexyl ester (hALA-PDT). We investigated why these two closely related lines had different hALA-PDT sensitivities and whether the PDT phototoxicity of the less sensitive cell line could be increased by a simultaneous application of hyperthermia (HT). METHODS Flow cytometry was used to evaluate the intracellular accumulation of protoporphyrin IX (PpIX), a metabolic product of aminolevulinic acid, in two human mandibular osteosarcoma cell lines (HOSM-1 and HOSM-2) treated with HT, hALA-PDT, or hALA-PDT combined with HT (PDT + HT). With hALA-PDT, cells treated with 0.2 mM hALA were irradiated with a light dose of 10-80 J/cm(2) from a near-infrared irradiator. With PDT + HT, the cells were treated as for hALA-PDT except that the temperature was raised to 43.5 degrees C during irradiation. RESULTS At 6 h after hALA treatment, HOSM-2 cells carried about 1.53-fold more PpIX than HOSM-1 cells. With hALA-PDT, the survival rate for HOSM-1 cells treated with 80 J/cm(2) irradiation was 35.7%, while that for HOSM-2 cells treated with 40-80 J/cm(2) was below 12%. With PDT + HT, the survival rate for HOSM-1 and HOSM-2 cells treated with 80 J/cm(2) irradiation was 14.1% and 10.7%, respectively. CONCLUSION A combination therapy comprising hALA-PDT + HT treatment may be very useful for the treatment of tumors containing cells that are insensitive to hALA-PDT, such as the HOSM-1 cell line described in this study.

Hyperthermia enhances the antitumor effect of photodynamic therapy with ALA hexyl ester in a squamous cell carcinoma tumor model

BACKGROUND Photodynamic therapy (PDT) using 5-aminolevulinic acid is considered to be ineffective in the treatment of tumors with progression to the deep layer. Therefore, for such tumors, a method is required which can enhance the effectiveness of this therapy. We examined the anti tumor effect of the combination of PDT with 5-aminolevulinic acid hexyl ester (hALA) and hyperthermia (HT) in a squamous cell carcinoma (SCC) tumor model. METHODS A tumor model was prepared by subcutaneously implanting SCC into nude mice, and treated with HT, PDT with hALA (hALA-PDT), or hALA-PDT combined with HT (PDT+HT). The treatment was performed by remodeled near infra-red irradiator which allows the generation of two types of rays for PDT and HT. With HT, the tumor was irradiated for raising the temperature with a light dose of 437.5 J/cm(2). With hALA-PDT, the tumor treated with 250 mg/kg hALA was irradiated with a light dose of 50 J/cm(2). With PDT+HT, the tumor was treated as for hALA-PDT except that the temperature was raised during irradiation with a light dose of 437.5 J/cm(2) (including light dose of 50 J/cm(2) for PDT). RESULTS The tumor growth rates on Day 12 were 97.10% in HT, 67.55% in hALA-PDT and 33.90% in PDT+HT, and PDT+HT showed significant inhibitory effects on tumor growth, although the anti-tumoral effects of HT and hALA-PDT were not seen. CONCLUSION hALA-PDT combined with HT demonstrated a significant inhibitory effect on the tumor growth of squamous cell carcinoma showing a progression in the deep layer. This suggests that this therapy is useful for tumors showing progression to the deep layer, which hALA-PDT alone is generally ineffective in treating.

Efficacy of Combined Photodynamic and Hyperthermic Therapy with a New Light Source in an in Vivo Osteosarcoma Tumor Model

OBJECTIVE In this study, we investigated the efficacy of Super Lizer (SL) as a new light source in photodynamic therapy (PDT) with hyperthermia in an in vivo osteosarcoma tumor model. MATERIALS AND METHODS Nude mice in three study groups (PDT only, PDT with hyperthermia in low energy, and PDT with hyperthermia in high energy) and three control groups (no treatment, photosensitizer only, and hyperthermia only) were implanted subcutaneously with human osteosarcoma cells and injected with a photosensitizing hematoporphyrin derivative (HPD) at a total dose of 10 mg/kg, in all study groups and in control group 2. At 72 h after light treatment, mice were sacrificed. RESULTS The tumor volume growth rates in the heat-only (1.50) and PDT-only (1.40) groups were significantly lower than the growth rate in the no-treatment group (1.82). Further, the tumor volume growth rate in the PDT with hyperthermia in high-energy group (1.19) was significantly lower than in the heat- or PDT-only groups. CONCLUSION Although non-laser PDT, including SL-PDT, may be beneficial only in the treatment of superficial tumors because of limited light penetration, PDT combined with hyperthermia may extend the utility of PDT in antitumor treatment. The use of SL as a new light source in PDT may significantly advance antitumor therapy due to its simplicity, ease, and cost benefit.

A case of desmoplastic ameloblastoma occupying maxillary sinus.

We report a rare case of desmoplastic ameloblastoma lesion that filled the entire maxillary sinus. The patient visited our hospital with a chief complaint of swelling around the upper left premolars. A panoramic X-ray captured an image of a mixture of ill-defined radiolucency and radiopacity from the swollen area to the maxillary sinus. Computed tomography (CT) and Magnetic resononce imaging (MRI) showed that the lesion occupied almost the entire left maxillary sinus and had entered the nasal cavity. A pathologic diagnosis of ameloblastoma was made after biopsy, and the tumor was removed and the marginal bone curetted under general anesthesia. A CT scan at 4 months postoperatively indicated the presence of residual and recurrent tumor in the area of the upper left lateral incisor, and removal and curettage were performed again. Recurrence may be detected relatively easily based on radiographic characteristics, and therefore follow-up with an X-ray examination such as a CT scan is important.

Kinky hair disease with multiple eruption cysts: A case report

A rare case of kinky hair disease with multiple eruption cysts is described. Dental abnormalities include eruption cysts, delayed tooth eruption, prognathia, open bite, generalized gingival swelling, and high arched palate.