Shumei Murakami

Spatial relationships between the mandibular central incisor and associated alveolar bone in adults with mandibular prognathism.

OBJECTIVE To examine if there was any correlation between the labio-lingual inclinations of the mandibular central incisor and the associated alveolar bone, and to investigate the labio-lingual position of the mandibular central incisor root apex in the associated cancellous bone in adults with untreated mandibular prognathism. MATERIALS AND METHODS High-resolution computed tomography images of the mandible were recorded in 20 adult patients with mandibular prognathism. The labio-lingual inclinations of a central incisor and its associated alveolar bone, the thickness of the associated cancellous bone, and the distance from the central incisor root apex to the inner contour of both the labial and lingual cortical plates were measured. Correlations and differences between the measured variables were tested for statistical significance. RESULTS The labio-lingual inclination of the central incisor significantly correlated with the labio-lingual inclination of the associated alveolar bone, the thickness of cancellous bone, and the distance from the central incisor root apex to the inner contour of the lingual cortical bone. The distance from the central incisor root apex to the inner contour of the labial cortical plate of bone was significantly smaller than that to the lingual cortical plate. CONCLUSIONS In adults with untreated mandibular prognathism, when the mandibular central incisor was more lingually inclined, the associated alveolar bone was also more lingually inclined and thinner. The mandibular central incisor root apex was closer to the inner contour of the labial cortical bone than to the lingual cortical bone.

Dual Segmental Distraction Osteogenesis of the Midface in a Patient With Apert Syndrome

Objective To present orthodontic treatment combined with dual segmental distraction osteogenesis in a patient with Apert syndrome. Patient A 15-year-old boy exhibited severe midfacial hypoplasia with retruded and hypoplastic maxilla and anterior open bite. The patient was treated with a rigid external distraction II system for distraction osteogenesis, a preadjusted edgewise appliance, and a modified maxillary protraction headgear. The concave profile with midfacial hypoplasia was improved. A tight occlusal relationship between maxillary and mandibular teeth was achieved. Postoperative treatment results have been stable for 1 year.

Late complications after high-dose-rate interstitial brachytherapy for tongue cancer

ObjectivesTo analyze the treatment results and late complications of high-dose-rate (HDR) interstitial brachytherapy (ISBT) for early (T1N0, T2N0) mobile tongue cancer using the microSelectron-HDR.MethodsFrom January 1993 through April 2001, a total of 72 patients with early squamous cell carcinomas of the mobile tongue were treated with microSelectron-HDR interstitial brachytherapy at the Department of Radiology, Osaka University Hospital. Of the patients, 18% were treated with a combination of prior external radiation and HDR-ISBT, and 82% were treated with HDR-ISBT alone. For HDR-ISBT alone, all cases were treated with a total dose of 54 Gy/9 fractions every 5 days or 60 Gy/10 fractions every 8 days. In combined therapy with an external dose of 30 to 40 Gy, HDR-ISBT was given at a total dose of 42–50 Gy. The Brinkman and alcohol indexes were used to analyze the incidence of late complications after HDR-ISBT.ResultsThe 2- and 5-year local control rates were 85% and 82%, respectively. Fifteen of 72 patients (21%) treated with HDR-ISBT had late complications. Ten of 15 patients (67%) with late complications had a Brinkman index exceeding 600.ConclusionsHDR-ISBT is useful and easily applied under local anesthesia to early or superficial lesions of the mobile tongue. However, we found an increase in late complications, such as soft-tissue ulcers and bone exposure, after irradiation of tongue cancer with 60 Gy HDR-ISBT in patients with a Brinkman index greater than 600.

Osteosarcoma in the maxilla : a case report

We encountered a case of osteosarcoma in the maxilla of a 20-year-old man, who complained of gingival swelling of the left maxillary molar. Limited bone destruction was detected on conventional radiography, including panoramic radiography, whereas a more extensive lesion was seen on computed tomography (CT), and new bone formation was clearly seen in the three-dimensional CT image. CT was superior to conventional radiography, including panoramic radiography, for detecting the extent of bone destruction and new bone formation in the lesion, allowing more accurate evaluation of the osteosarcoma.

A Phantom Study On Component Segregation for MR Images Using ICA

RATIONALE AND OBJECTIVES A phantom set was devised to evaluate capability of independent component analysis (ICA) as an image filter for magnetic resonance (MR) images to segregate components. MATERIALS AND METHODS Four components (free water [FW], olive oil [OL], 2% and 4% agar gels [2A and 4A, respectively]) were arranged in a phantom set. Seven MR images were obtained with different echo time and repetition time. ICA was performed on 23 combinations of four components. A segregation rate higher than 70% was defined as effective. RESULTS Four-component segregation was obtained in 5 of 23 combinations. The best result showed a mean of 87% across the four components. For each component, there were 20 of 23 for FW, 22 for OL, 9 for 2A, and 16 for 4A. CONCLUSIONS The results demonstrated ICA works as an image filter and provides new contrast images that unambiguously segregate components in MR images. For practical application, the best performance should be obtained when T(1)W, T(2)W, and proton density images are included in the dataset for ICA.

First brachial cleft cyst in the parotid area

A first brachial cleft cyst was detected in the parotid area of a 66-year-old Japanese man complaining of swelling in the left upper neck. Although the lesion was suggestive of a cyst, based on computed tomography and magnetic resonance imaging, the lesion was misdiagnosed as a benign tumor, because it was thought to localize to the parotid and most lesions occurring in the parotid gland are tumors. The histopathological diagnosis was a first brachial cleft cyst or a so-called lymphoepithelial cyst. This case demonstrates that it may be difficult to differentiate a cyst from a benign tumor in the parotid area.

A primordial cyst without keratinization in the maxillary molar region: a case report

In this article we report a case of a 54-year-old man with a primordial cyst in the left maxillary molar region. We performed conventional radiographs and computed tomography (CT) without contrast enhancement, but it was difficult to determine whether the lesion was a tumor or a cyst. CT images with contrast medium showed a cyst, not a tumor. Histopathologically, the cyst wall was composed of fibrous connective tissue lined by nonkeratinized squamous epithelium. Based on its clinical, radiological, and histopathological findings, this lesion was diagnosed as a primordial cyst. This case indicated that enhanced CT imaging is useful for differentiating between cysts and benign tumors and that there are no specific differences in the radiological appearance between primordial cysts and odontogenic keratocysts