Successful hyperbaric oxygen therapy for laryngeal radionecrosis after chemoradiotherapy for mesopharyngeal cancer: case report and literature review.

Laryngeal radionecrosis is one of the most troublesome late complications of radiotherapy, because it is frequently resistant to treatment and laryngectomy is required in the worst case. Here, we report a case of laryngeal radionecrosis, successfully treated by use of hyperbaric oxygen (HBO) therapy, in which laryngectomy was avoided. A 67-year-old male received radical chemoradiotherapy (CRT) for mesopharyngeal cancer, which included radiotherapy with a total dose of 71.4 Gy/38 Fr and chemotherapy with CDDP + S-1. He developed dyspnea and throat pain 9 months after completion of CRT. Laryngoscopy revealed vocal cord impairment because of severe laryngeal edema. He was diagnosed as having laryngeal radionecrosis and initially received conservative therapy combined with antibiotics, steroids, and prostaglandins. Because his dyspnea was persistent despite this treatment, HBO therapy was administered 20 times, and resulted in complete remission of the dyspnea. HBO therapy, therefore, is regarded as an effective conservative therapeutic option for laryngeal radionecrosis.

Reevaluation of human leukocyte antigen DR-DQ haplotype and genotype in type 1 diabetes in the Japanese population.

AIM: This study aims at clarifying the human leukocyte antigen haplotypes and genotypes conferring susceptibility or resistance to type 1 diabetes in the Japanese population. METHODS: The frequencies of human leukocyte antigen DR-DQ haplotypes and genotypes were compared between 83 type 1 diabetic patients, except for fulminant type 1 diabetes, and control subjects in the Japanese population. The patients were divided by onset age into four groups (ages 5-14, 15-29, 30-49, and 50-71 years); the haplotype frequency was compared between each group. RESULTS: The frequencies of DRB1*0405-DQB1*0401 (DR4), DRB1*0802-DQB1*0302 (DR8), DRB1*0901-DQB1*0303 (DR9), and DRB1*1302-DQB1* 0604 (DR13) haplotypes were significantly higher in the patients than in the control subjects. The frequencies of DRB1* 1501-DQB1*0602 and DRB1*1502-DQB1*0601 haplotypes were significantly lower in the patients than in the controls. The frequencies of DR4/8, DR4/13, DR9/9, and DR9/13 genotypes were significantly higher in the patients than in the control subjects. The DR13 haplotype was the most frequent haplotype in the age group 30-49 years, whereas the other haplotypes but DR13 were the most frequent in the other age groups. CONCLUSION: DR4, DR8, DR9, and DR13 haplotypes confer susceptibility to type 1 diabetes in Japanese patients.

Central acinic cell carcinoma of the mandible. Case report.

Central acinic cell carcinoma (of the mandible) is rare, and, to our knowledge, only seven cases of this disease have been reported in the literature. A case in a 67-year-old Japanese woman is presented. Clinical examination revealed a 10.0x6.0mm mass located on the buccal aspect of the gingiva of the second molar in the left mandible. Radiographic examination revealed a radiolucency from the second to the third molar of the left mandible. Computed tomography disclosed destruction of the lingual cortical bone of the third molar region. The preliminary diagnosis was of odontogenic tumour. The patient was admitted, and removal of the tumour and of the involved teeth were carried out. Histological examination disclosed the diagnosis of acinic cell carcinoma. Subsequently, the tumour area was widely excised from the second premolar region to the coronoid process, and radical neck dissection was performed. A lymph node metastasis was found in the submandibular region. No recurrence or metastasis was observed during the 34-month follow-up.