Primary intestinal-type adenocarcinoma of the buccal mucosa: A case report and literature review.

Intestinal-type adenocarcinoma of the primary salivary glands is extremely rare. So far, only 11 cases of primary intestinal-type adenocarcinoma of the oral cavity and major salivary glands have been reported. Two of those tumors arose in the floor of mouth, 7 in the tongue, and 2 in the major salivary glands. However, it has remained unclear whether these tumors are derived from mature salivary glands, and primary intestinal-type adenocarcinoma of the buccal mucosa has not been reported previously. Here, we present the first documented case of primary intestinal-type adenocarcinoma arising in a minor salivary gland of the buccal mucosa. Histopathologically, the tumor resembled a well-differentiated or mucinous colonic adenocarcinoma. Immunohistochemically, the tumor cells were diffusely positive for AE1/AE3, CAM5.2, CK7, SATB2, ß-catenin, p53, Ki-67, MUC2, and MUC5 AC. CK14 and CK20 were positive in some of the tumor cells. CDX2, CA19-9, SP-A, TTF-1, PSA, SMA, p63, and cyclin D1 were negative in the tumor cells. The tumor in the present case may have originated from salivary gland duct epithelium that underwent transformation to phenotypic intestinal-type epithelium. In this very rare case of primary intestinal-type adenocarcinoma of the buccal mucosa, we considered diagnostic markers that could be indicative of mature salivary gland origin.

Imputing Missing Values in EEG with Multivariate Autoregressive Models.

Wearable measurement for electroencephalogram (EEG) is expected to enable brain-computer interfaces, biomedical engineering, and neuroscience studies in real environments. When wearable devices are in practical use, only the user (subject) can take care of measurement, unlike laboratory- oriented experiments, where experimenters are always with the subject. As a result, measurement troubles such as artifact contamination or electrode impairment cannot be easily corrected, and EEG recordings will become incomplete, including many missing values. If the missing values are imputed (interpolated) and complete data without missing entries are available, we can employ existing signal analysis techniques that assume compete data. In this paper, we propose an EEG signal imputation method based on multivariate autoregressive (MAR) modeling and its iterative estimation and simulation, inspired by the multiple imputation procedure. We evaluated the proposed method with real data with artificial missing entries. Experimental results show that the proposed method outperforms popular baseline interpolation methods. Our iterative scheme is simple yet effective, and can be the foundation for many extensions.

Apocrine hidrocystoma of the lower lip: a case report and literature review.

The hidrocystomas (HCs) are cystic forms of sweat gland resulting from proliferation of the apocrine secretory coil or eccrine duct. Apocrine -HCs are cystic lesions that arise from the apocrine secretory coil, while eccrine -HCs represent retention cysts of the eccrine duct. The commonest site for such lesions is around the eye, and they may also occur on the ears, scalp, chest, shoulders, or feet. However, HCs of the perioral region are uncommon. The differential diagnosis with minor salivary gland cyst or cystic neoplasms often poses a problem in this site. Here we report a rare case of apocrine -HC of the right lower lip for which excisional biopsy of the lesion was performed. Histopathologically, the lesion was a unilocular cyst lined by a double-layered epithelium of the apocrine secretory type. Immunohistochemically, the secretory epithelium was positive for mammaglobin, gross cystic disease fluid protein 15 (GCDFP-15), cytokeratin 7 (CK 7) and CK18, and the myoepithelium was positive for alpha-smooth muscle actin (α-SMA) and weakly positive for S100 protein. Here we present this very rare case of apocrine -HC of the lower lip, and discussed regarding differential diagnosis with minor salivary gland cystic lesion in the lip.

A case of age-related Epstein-Barr virus (EBV)-associated B cell lymphoproliferative disorder, so-called polymorphous subtype, of the mandible, with a review of the literature.

Epstein-Barr virus (EBV) is known to be associated with the development of lymphomas in immunocompromised patients. Recently, age-related immune impairment has been recognized as a predisposing factor in the development of EBV-driven lymphoproliferative disorders (LPDs) in elderly patients without any known immunodeficiency or prior lymphoma. In approximately 70% of reported cases, the affected sites have been extranodal, such as the skin, lung, tonsil and stomach. However, age-related EBV-associated B cell (EBV + B cell) LPD is extremely rare in the oral cavity. Here we report a 71-year-old Japanese man who developed an EBV + B cell LPD resembling classical Hodgkin lymphoma (CHL)--so-called polymorphous subtype-of the mandible. Histopathologically, infiltration of large atypical lymphoid cells including Hodgkin or Reed-Sternberg-like cells into granulation tissue with marked necrosis was found in the mandibular bone. Immunohistochemical analysis revealed that the large atypical Hodgkin or Reed-Sternberg-like cells were CD3-, CD15-, CD20+, CD30+ and Epstein-Barr virus (EBV)-latent infection membrane protein-1 (LMP-1)+. In situ hybridization (ISH) demonstrated EBV-encoded small RNA (EBER) + in numerous Hodgkin or Reed-Sternberg-like cells. EBNA-2 was detected by polymerase chain reaction (PCR) using an extract from the formalin-fixed, paraffin-embedded specimen. To our knowledge, this is the first reported case of the polymorphous subtype of age-related EBV + B cell LPD affecting the mandible.

[Prolonged respiratory depression after fentanyl administration in a patient with mitochondrial encephalomyopathy].

A 21-year-old man with mitochondrial encephalomyopathy underwent surgery for removal of a maxillary cyst. During the induction of anesthesia, the patient fell into the state of apnea after intravenous administration of fentanyl 100 microgram. Trachea was successfully intubated followed by propofol 50 mg without any muscle relaxants. Anesthesia was maintained uneventfully under sevoflurane (1-2%), nitrous oxide (30%), and oxygen (70%). The respiratory depression lasted for about 120 minutes after administration of fentanyl, and was antagonized by naloxone 40 microgram. This case suggests that careful administration of fentanyl is mandatory in a patient with mitochondrial encephalomyopathy.