Search

The purpose of this study was to examine whether the width of keratinized mucosa (WKM) is associated with the health status of tissue surrounding dental implants and the contralateral teeth.Sixty patients who received implant-fixed unilateral prostheses in the premolar or molar region were recruited for the study. The following parameters were measured for each implant and contralateral tooth: WKM, gingival index (GI), probing pocket depth (PPD), bleeding on probing (BOP), pus discharge, plaque accumulation (PA), gingival recession (GR), and difficulty of brushing. The effect of the WKM on the health status of the surrounding tissue was evaluated by comparing the different WKM groups (WKM2 mm vs WKM ≥ 2 mm).Implants with a WKM2 mm demonstrated significantly greater PPD, PA, and a higher rate of BOP compared with implants with a WKM ≥2 mm. There was significantly greater GR in contralateral teeth with a WKM2 mm compared with a WKM ≥2 mm. In addition, implant sites had a higher rate of BOP compared with the contralateral teeth.Inadequate keratinized mucosa decreased cleansibility of implant sites and increased mucosal inflammation. There is a possibility that PA in implant sites caused more pronounced inflammatory response compared to contralateral tooth.

Introduction Perforation of the Schneiderian membrane is the most common complication in sinus floor augmentation (SFA). When volume of grafting is qualified to prevent enlargement of the membrane perforation, lack of bone volume may occur in optimal site. Case presentation SFA was performed in sites #24 to 26 in a 63-year-old male. However, a 10-mm size perforation of the Schneiderian membrane occurred in site #26. Although the sinus cavity was grafted with deproteinized bovine bone mineral (DBBM) after repair of membrane perforation, insufficient bone formation was observed on palatal and distal aspects of site #26 at 5 months after SFA. Although additional SFA was required for implant placement, it seemed to be difficult to elevate the membrane by a conventional lateral approach in the palatal aspect of the sinus floor (site #26). Considering the configuration of new bone formation, it was decided to perform the palatal antrostomy approach. The Schneiderian membrane was elevated without perforation, and the sinus cavity was grafted with DBBM mixed with venous blood. Two 12-mm long, 4.1-mm diameter implants were placed in sites #14 and 16. Four months after implant placement, abutment-connection surgery was successfully performed. The radiographic image indicated improved radiopacity, without obvious bone resorption in site #26. Conclusion The palatal window osteotomy technique could be considered as an alternative method for augmentation of maxillary sinus in cases where difficulty is encountered to elevate a membrane by a conventional approach (e.g., in cases in which buccal bone height is long).

Adenosquamous cell carcinoma (ASC) originating in the stomach is a relatively rare entity. ASC accounts for 0.26_??_0.53% of all resected cases of gastric cancer. Recently, we experienced a case of primary ASC of the stomach in an 81-year-old man. The patient was preoperatively diagnosed as having squamous cell carcinoma in the cardiac region of the stomach. Under the diagnosis of advanced gastric cancer, a proximal subtotal gastrectomy combined with a partial resection of the pancreas tail and a splenectomy was performed. Macroscopic finding revealed a large gastric tumor, and 3 type cancer measuring 10×10cm was identified in the upper portion of the stomach. Histologically, moderately differentiated adenocarcinoma mixed with moderately differentiated squamous cell carcinoma with keratinizing cells was recognized. Consequently, this tumor was diagnosed as ASC. In this patient, there were no ectopic squamous cells, nor undifferentiated carcinoma cells. A possible histogenesis of squamous metaplasia in pre-existing adenocarcinoma was considered in this case. Clinical staging was rated as Stage IIIA (pSI, pN0, sP0, sH0, sM0). ASC of the stomach demands extended radical operation, because there is a case that no having regional lymph-node metastasis or peritoneal dissemination even if huge tumor as this case.

Lumber hernia is so rare that only 21 cases have been seen in the Japanese literature, and none of them had recurred. This paper presents a recurrent case of idiopathic lumber hernia in the right upper lumber triangle. A 63-year-old woman was admitted to the hospital because of distended right lumber. Three months before admission she was diagnosed as lumber hernia and underwent surgery under local anesthesia. Two months later, the patient had a recurrence. This time the patient was operated on by Petit' procedure with closure of the opening of hernia. The hernia opening was walnut-sized and contained the intestine and fat. There was numness in the right gluteal part postoperatively, but it gradually disappeared. There has been no recurrence, as of 6 months after the operation. In this case the first operation under local anesthesia appeared come down to insufficient outcome. Of the domestic cases, the most common cause was idiopathic and there was no significant difference between both sexes. As to common sites of the hernia, it almost equally appears in the upper and lower triangles, but it is liable to appear in the left side in preference to right side of the area. This disease is usually operated on immediately after it is detected, because the hernia is rarely incarcerated but often enlarges.

我々は, 昭和56年から昭和62年までの7年間, 四国地区における慢性血液透析患者のうち, 824例について慢性腎不全のCa代謝異常に対する治療の状況 (主に1α-OH-D3を中心に) の変遷について調査した. さらに血液生化学検査値およびMD法についても調査し, 1α-OH-D3の臨床効果について検討した. 1. 1α-OH-D3の処方状況: 投与率は年毎に増加していたが, 投与量は低下傾向を示した. さらに投与開始時期は透析導入後早期より行われるようになってきていた. 2. 1α-OH-D3の投与開始時期別による効果の比較: 1α-OH-D3の早期投与 (透析導入後2年未満) によって血清ALPは7年間正常範囲内でコントロールされていた. 一方, 非早期投与 (透析導入後5年以上) によっても血清ALPの抑制効果は十分認められたが正常範囲までの抑制ではなかった. 3. 1α-OH-D3の投与の有無による効果の比較: 非投与群に比し投与群では, 血清ALP, 血清C-PTH, MCI値が改善されていた.以上の結果より, 血液透析患者に対する1α-OH-D3の投与は, 次第に透析導入後早期から開始される傾向にあり, 早期投与によりその有効性は高まっていると考えられた.