Kosei Kubota

Professional oral health care reduces oral mucositis pain in patients treated by superselective intra-arterial chemotherapy concurrent with radiotherapy for oral cancer

PurposeOral mucositis (OM) is a painful complication of radiation therapy (RT) for head and neck cancer. OM can compromise nutrition, require opioid analgesics and hospitalization for pain control, and lead to interruption of treatment. Severe oral mucositis appears inevitable in superselective intra-arterial chemotherapy concurrent with radiotherapy (SSIACRT), requiring management of OM for the patient. The objective of this study was to assess the utility of professional oral health care (POHC) for the management of OM in patients undergoing SSIACRT.MethodsThirty-three patients were enrolled in this study. The first 17 patients underwent SSIACRT before we created an oral management team, and thus did not receive POHC. The remaining 16 patients received POHC. Fever duration, duration of oral feeding difficulty, opioid usage, duration of opioid administration, duration of hospitalization, and number of hospital days from the end of irradiation to discharge were compared between these two groups.ResultsMedian total dose of morphine during SSIACRT, median number of hospital days from end of irradiation to discharge, and duration of hospitalization all differed significantly between groups (P < 0.05). Duration of opioid administration, fever duration, and duration of oral feeding difficulty did not differ significantly between groups.ConclusionsThese findings indicate that POHC may reduce opioid use and shorten the hospital stay. Such results might be obtained through infection control by POHC. This report appears to be the first study to evaluate the efficiency of POHC in SSIACRT for oral cancer from the perspective of mucositis pain and opioid use.

Expression of interferon‐stimulated gene 20 in vascular endothelial cells

ISG20 is an ribonuclease specific for single‐stranded RNA and considered to play a role in innate immunity against virus infections. We herein show that both poly IC, an authentic double‐stranded RNA, and IFN‐γ induced ISG20 expression in cultured HUVEC. Poly IC‐induced ISG20 expression was inhibited by LY294002, an inhibitor of PI3K, or by RNA interference against IFN regulatory factor three. ISG20 expression was not induced by IFN‐β, loxoribine or CpG oligonucleotide. These results suggest that ISG20 induction by poly IC may not be dependent on the IRF‐3‐mediated type I IFN induction pathway in HUVEC. ISG20 may be involved in innate immunity against viral infection in vascular endothelial cells.

Comparison of sialolithiasis in pediatric and adult patients

Abstract Aims To compare the clinical characteristics of sialolithiasis between pediatric and adult patients. Settings and Design Subject characteristics, clinical manifestations, salivary calculi characteristics, and treatment modalities and outcomes from medical records were retrospectively compared between pediatric and adult patients with sialolithiasis visiting the Department of Oral and Maxillofacial Surgery, Hirosaki University Hospital, between 2005 and 2014. Subjects We included 5 pediatric (all boys) and 45 adult (20 men; 25 women) patients. Results Most patients had submandibular swelling. The calculi were located on the right in 100.0% of pediatric patients and 57.8% of adult patients. Moreover, 20.0% of pediatric patients and 35.6% of adult patients exhibited sialoliths in the glands. Calculi were Conclusions A large number of relatively small and distal sialoliths in pediatric patients was removed using intraoral retrieval under local anesthesia. This difference in the choice of treatment between pediatric and adult sialolithiasis may be attributed to the size and palpability of the calculi.

Impalement of an unusual foreign body on the temporomandibular joint causing severe trismus.

A penetrating injury by a foreign body is comparatively common in the oral and maxillofacial region. On the other hand, injury to the temporomandibular joint (TMJ) by a foreign object is very rare. The TMJ is an anatomically narrow space surrounded by hard bony processes. An unusual case of trauma with severe trismus caused by a foreign body that impaled the TMJ is reported. A 55-year-old man presented with a 5 × 1-cm laceration to the right cheek caused by a flying object propelled during the use of a lawn mower. The edge of the foreign body had a metallic wire, which became imbedded in the wound. His jaw opening was severely limited. Computed tomography revealed that the foreign body was 3 mm in diameter and was impaled on the articular capsule. The object was successfully removed, and the wound and interior of the TMJ were irrigated. Rehabilitation of mouth opening was started on postoperative day 3. On day 9, mouth opening had improved to 35 mm, and he was discharged. After 1 year, mouth opening was 45 mm with no sign of any TMJ disorders.