Kazuhiro Tominaga

An animal model for subperiosteal tissue expansion

An animal model for subperiosteal tissue expansion is described. Small tissue expanders were placed bilaterally and inflated in the buccal subperiosteal pockets of the mandible. Additionally, subcutaneous expansion was performed in the breast region. Twenty-one dogs were used in three experimental groups to evaluate the optimal size of an expander for this model, the optimal inflation regimen, and the histologic changes following subperiosteal expansion. Hemicylindrical expanders, 20 mm in width, 10 mm in height, and 30 mm in length, inflated with 1 mL saline every four days, were used for this model. It was found that the periosteum was replaced by fibrous connective tissue during expansion. Capsule formation following subperiosteal expansion was much more rapid than that following subcutaneous expansion. A greater increase in vascularity was noted in the subperiosteal expansion group and the subperiosteal control group than in the subcutaneous expansion group. In the subperiosteal expansion group, a thick fibrous capsule, with minimal inflammatory response, was observed 1 week after full inflation. Leaving the fully inflated subperiosteal expanders in place more than 1 month accelerated the resorption of the underlying bone. These results support the previously reported empirical regimens of subperiosteal tissue expansion. Furthermore, the excellence of the subperiosteal expanded bed as a recipient site for onlay grafting was confirmed.

A case of schwannoma arising from the dermal branch of the cervical nerve

A case of schwannoma arising from the dermal branch of the cervical nerve is reported. A 35-year-old man was referred to our hospital, because of a swelling on the left side of the neck. A cystic mass was discovered on CT, MRI, and ultrasound investigations. The lesion was under the sternocleidomastoid muscle, which compressed the carotid artery and internal jugular vein. Because the lesion adhered to the dermal branch of the cervical nerve, it was excised with the nerve. The pathological diagnosis was a schwannoma arising from the transverse nerve because of sensory loss after surgery. It was considered important to detect the nerve of origin intra operatively. He was well without recurrence 18 months after surgery.

Advanced osteosarcoma of maxilla for which palliative treatment was usefull. Report of a case.

高度に進展した上顎骨肉腫の1例を経験した。患者は32歳女性で, 7年前に左上顎良性骨芽細胞腫の摘出術を受けていた。初診時, 巨大な腫瘤は左顔面全体に及んでいた。生検の結果は骨肉腫であり, MTX大量療法ならびに放射線療法を行ったところ, 腫瘍は縮小し, 姑息療法として減量手術 (腫瘍切除術) を施行した。術後, 腫瘍は静止的であったが, その後右上肺野, 右脳に転移が認められるようになった。右脳転移巣に対して定位的脳放射線療法を行ったが, 呼吸不全により死の転帰をとった。剖検の結果, 右上肺野の他に, 右脳, 心臓, 舌, その他に転移巣が確認された。

Treatment to Skeletal Open Bite by Sagittal Splitting of Body of Mandible.

For correction of skeletal open bite with Angle class I, sagittal splitting of body of mandible has been performed.This surgical method can preserve the integrity of the inferior aspect of the mandibular body and alveolar crest and has obviated the necessity of bone grafting and making the precise model needed for conventional mandibular body ostectomy. In addition, the excellent interface of bone has promoted early consolidation of the proximal and distal segments.Therefore, sagittal splitting of the body of the mandible is an effective surgical procedure for skeletal open bite.

Carcinoma of the lower alveolus and gingiva of a extreme elderly woman which dramatically responded to chemotherapy with UFT alone: Report of a case.

症例は84歳女性で, 左側下顎臼歯部の腫瘤および接触痛を主訴に受診した。病理組織学的診断は中等度分化型扁平上皮癌であった。高齢者であることおよび家族の在宅治療希望のため, UFT単独投与を行ったところ, 腫瘤は徐々に消失し, 投与開始4カ月後には臨床的にも組織学的にも腫瘍の消失がみられたUFT投与開始から6カ月後, 造血機能障害のため投与を中止したが, さらに1年1カ月後まで再発がなく, 経過良好である。本報告例は, 癌の化学療法の効果判定基準でcomplete response (CR) に相当し, 高齢者歯肉癌におけるUFTの有用性を示す症例と考えられた。