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The search for hepatitis C virus (HCV) in body fluids other than blood is important when assessing possible nonparenteral routes of viral transmission. However, the role of oral fluids in HCV transmission remains controversial. Here we quantitatively determined HCV RNA in saliva and gingival crevicular fluid (GCF) of anti-HCV-positive patients. Most patients (14 of 18; 78%) whose saliva specimens were negative had HCV RNA in their GCF. Most patients (20 of 26; 77%) had higher HCV RNA levels in their GCF than in their saliva. Although there was not a statistically significant correlation between the serum viral load and HCV level in saliva or GCF, patients with low serum HCV loads were less likely to have detectable HCV in their saliva. These findings have important implications for medical personnel and suggest that epidemiological studies designed to understand the significance of the oral route of transmission of HCV are warranted.

Necrotizing sialometaplasia (NS) is a benign disease of the mucous-secreting glands that most commonly occurs in the palatal mucosa. It was first described by Abrams et al. in 1973 as an inflammatory disease characterized by coagulative necrosis of the minor salivary glands, marked squamous metaplasia of glandular acini and ducts, and even pseudoepitheliomatous hyperplasia. Etiologically, NS is thought to be caused by ischemia due to local tissue injury. We describe two cases of necrotizing sialometaplasia in a patient with bulimia and self-induced vomiting. The etiologic factors of NS are discussed. Initially, NS may be triggered by physical trauma with ischemia. Gastric juice irritation and side effects of drugs are considered to contribute to the development of NS.

Article, Analytical sciences. 17(9): 1055-1058 (2001)

The potentiometric response behavior of an electrode, which consists of a non-plasticized carboxyl-modified polyacrylamide polymer (PAA) coupled to benzo-12-crown-4 (PAA–B12C4) to Li+, Mg2+, and Ca2+ in such aprotic solvents as acetonitrile (AN), propylene carbonate (PC), and γ-butyrolactone (GBL), were examined. The electrode showed a Nernstian response to Li+ and Ca2+ in AN, and Li+, Mg2+, and Ca2+ in PC and a near-Nernstian response to Mg2+ in GBL. From the response to Ca2+ it could be confirmed that the membrane potential was mainly established at the polymer membrane–solution interface. The electrode was applied to a study of their complexing with such other basic aprotic solvent molecules (D) as N,N-dimethylformamide, dimethyl sulfoxide, and hexamethylphosphoric triamide. The successive complex formation constants (βi) and Gibbs energies of transfer (ΔGtr(j)) of Li+ in AN and Mg2+ in PC in relation to such D were obtained.

1991年から1994年の期間に癌研究会附属病院頭頸科で根治的治療を行なった中咽頭扁平上皮癌は207例であった。このうち121例には一次治療として放射線治療を中心とした保存的治療が行なわれた。一次治療後の局所再発は52例 (43.0%) にみられた。最終的な局所制御率はT1: 100%, T2: 77.7%, T3: 60.6%, T4: 11.1%で, 全体では69.5%であった。手術を中心とした外科的治療を行なった86例の局所制御率は74.2%であった。放射線治療後の再発はT3, T4の症例に頻度が高かったが, T2でも側壁型の下方進展型, 前壁型の喉頭蓋谷への進展が著明な症例にしばしばみられ, 上壁型ではT1, T2の表在性の腫瘍でも再発しやすい傾向があった。Stage 別の疾患特異的5年生存率は stage I: 88.9%, II: 82.2%, III: 73.1%, IV: 36.1%で全体では59.1%であった。

Using the Satoh-Heimdahl method, we inoculaed Streptococcus milleri NCTC 7331 and Bacteroides fragilis NCTC 9343 into the mandibles of NZW rabbits to prepare a model of infection. We compared the tissue penetration of clarithromycin (CAM), a newly developed macrolide antibiotic, after oral administration in this animal model and in normal rabbits, which served as control. Concentrations of CAM in oral-cavity fluids and sites, including serum, tongue, gingiva, submandibular gland, parotid gland, submandibular lymph node, mandible, maxilla, and pus, were determined by bioassay.(14C) CAM (20mg/kg) was administered into the auricular veins of infected and normal animals. Macroautoradiograms were taken 5 minutes after the intravenous injection of CAM. The following results ware obtained:1) In the infected group, peak serum levels of CAM (0.32μg/ml) were obtained 0.75 hour after oral adminstration. Peak tissue levels of CAM (0.68-2.39μg/g) were attained 0.5-1 hour after treatment. The ratio of the peak oral tissue level to the peak serum level ranged from 2.31 to 7.47. One hour after treatment, the peak level of CAM in pus (0.1μg/ml) was obtained, and the ratio of the peak pus: serum level was 0.31.2) In the normal group, peak serum levels of CAM (0.16μg/ml) were obtained 0.5 hour after treatment. Peak tissue levels of CAM (0.19-1.05μg/g) were obtained 0.5-2 hours after treatment. The ratio of the peak oral tissue level to the peak serum level ranged from 1.19 to 6.56.3) In the infected group, macroautoradiograms disclosed an area with comparatively high radioactivity exceeding the blood CAM level, particularly around the focus of infection.4) The results of bioassay showed, high radioactivity primarily in submandibular gland tissue and in the submandibular lymph nodes in both the infected group and the normal group.In general, the tissue levels of macrolides are higher than their blood levels. The results of the present experiment with CAM are consistent with this finding. High concentration of CAM were selectively distributed around sites of infection in the jaw bones; CAM can therefore exert its inherent antibiotic effect.

We describe a case of intravascular fasciitis. A 24-year-old Japanese man visited this hospital in November 1994 because of swelling of the upper lip. Ultrasound examination showed a hypoechoic mass, measuring 10 mm in diameter, with slightly illdefined margins in the upper lip. The mass was ellipsoid and flat, and its inner echo level was heterogerous. Under local anesthesia, the patient underwent resection of the mass. On the basis of these clinical and histopathological findings, we made a diagnosis of intravascular fasciitis of the upper lip. The patient made steady progress after the operation.

Lipoma is generally regarded as a benign nonepithelial tumor consisting of mature adipose cells. Although lipoma is said to develop everywhere adipose tissues physiologically exist, it frequently develops in the subcutaneous tissues of extremities and trunk. Therefore the incidence of lipoma of mouth is relatively low. The author experienced a case of lipoma which developed in the buccal mucosa and reported the treatment course. The patient was a 70-year-old female who presented herself in the department of oral surgery with a chief complaint of a mass in the right buccal mucosa. She was treated in the outpatient clinic and underwent tumorectomy under local anesthesia. According to the histopathological findings, the lipoma was a subepithelial tumor with well-defined margins comprising uncapsulated mature fat particles. The connective tissue components were interspersed with part of the lipoma. In view of these findings, the author made a diagnosis of simple lipoma. The patient showed no signs of recurrence and made steady progress after the surgery.

We report a case of sialadenoma papilliferum of the oral floor. A 68-years-old woman visited our hospital in December 1993 complaining of a mass of the right side of the oral floor. A ball-like protrusion, measuring 6 × 6 × 5 mm, with sharp margins was found at the right side of the oral floor. The lesion was suspected to be a papilloma, and tumorectomy was performed under local anesthesia. Pathohistologic examination revealed a papillary sialadenoma, first reported by Abrams. The patient has done well since the operation. Tumors of the oral floor have not previously been reported in the literature.

Recently, we encounted a case of lymphoepithelial cyst with calcification which developed on the floor of the oral cavity. Here, we report the clinical course of this patient. On February 17, 1995, a 24-year-old woman presented at our department because of a mass on the right side of the floor of the oral cavity. Examination revealed an elastic hard mass of 5×5×3 mm in size, which had well-defined margins and a smooth surface mucosa. The mass, which caused neither spontaneous pain nor tenderness, was regarded as a movable tumor because of the absence of adhesion to the surrounding tissues. We performed a tumorectomy under local anesthesia. The pathological diagnosis was a lymphoepithelial cyst with calcification. Five months have passed since the operation. There are no signs of recurrence, and the patient's postoperative course is satisfactory.

We performed preoperative combined therapy using nedaplatin (CDGP) and radiation in 12 patients with squamous cell carcinoma originating from the oral cavity and maxillary sinus, and examined for any adverse events that may have occurred during this therapeutic regimen. Regarding the irradiation, external irradiation utilizing a 6 MV linac (linear accelerator) at a dose of 2.0 Gy/day was performed 5 times a week, with the target total radiation dose set at 40 Gy. In addition, CDGP was intravenously administered 30 minutes before irradiation at a dose of 5 mg/m2/day. Mucositis was observed in all 12 subjects, however, the severity was observed to be grade 1-2 with no major differences in comparison to the patients given standard radiation monotherapy. Two subjects developed grade 3 leucopenia and were thus given granulocyte colony stimulating factor (G-CSF). In addition, grade 2 and grade 3 thrombocytopenia were both observed in one subject each. The subject with grade 3 thrombocytopenia required a platelet transfusion during surgery. No marked changes in serum creatinine levels were noted. These findings are therefore considered to provide evidence supporting the safety of this combination therapy.