A case of bisphosphonate-related osteonecrosis of the maxilla with orbital cellulitis.

Bisphosphonates are used for the treatment of bone metastases of cancer and prevention of osteoporosis. Bisphosphonate-related osteonecrosis of the jaw (BRONJ) has unclear mechanisms, but its elucidation, prevention, and treatment are essential to improve patient outcomes.An 88-year-old woman who was taking oral bisphosphonates for 4 years presented with a 5-day history of gradual orbital pain. Computed tomography (CT) revealed bilateral maxillary sinusitis and bony destruction at the base of the right maxillary sinus and inferior orbital wall. We diagnosed her with bisphosphonate-related osteonecrosis of the maxilla. In addition to intravenous antibiotic treatment, an endoscopic sinus surgery was performed. The patient's postoperative course was uneventful.To the best of our knowledge, this is the first case report of BRONJ with orbital cellulitis. This condition should be considered among patients taking bisphosphonates, who manifest with symptoms of orbital cellulitis and bone destruction on imaging.

Phellinus linteus Extract Augments the Immune Response in Mitomycin C-Induced Immunodeficient Mice.

Phellinus linteus is a fungus distributed throughout Japan, Korea and China. Boiled water-soluble extracts from P. linteus (PLW) have shown anti-tumor and immunomodulatory properties in experiments done by intraperitoneal treatment, or in in vitro cell cultures. This is the first investigation on how oral administration of PLW influences immune responses. Here, we established immunodeficient mice by mitomycin C (MMC) and then researched how PLW influenced plaque-forming cell (PFC) production and populations of cytokine [interferon- (IFNgamma-) and interleukin-4 (IL-4)]-producing T lymphocytes. PLW samples were administered orally for 19 days (1, 2 or 4 g/kg/day). PFC assay was followed using Jerne's method. IFN- and IL-4-producing T lymphocyte populations were measured by flow-activated cell sorter (FACS). These assays were conducted the day after the last oral administration. MMC groups were given MMC (1 mg/kg/day) intraperitoneally for 6 days with PLW administration. The number of PFC per 10(6) spleen cells increased significantly in the PLW (2 g/kg/day) group when compared with the MMC-control (P < 0.05) while populations of IFNgamma- and IL-4-producing T lymphocytes decreased by MMC treatment. However, the PLW group tended to increase more than the MMC-control. Our results indicated that PLW augments the immune response of the spleen in MMC-induced immunodeficient mice.

In Vitro Anti-Cytomegalovirus Activity of Kampo (Japanese Herbal) Medicine.

We examined the effect of three types of Kampo medicines on human cytomegalovirus (CMV) replication in the human embryonic fibroblast cell line, MRC-5. Treatment of cells with at least 0.01 mug/ml of Kampo medicines inhibited the cytopathic effects of CMV-infected MRC-5 cells. Moreover, Kampo medicine decreased the replication of CMV without affecting the inhibition of host cells, with a concomitant decrease in CMV DNA levels. However, Kampo medicine demonstrated no virocidal effect on cell-free CMV. Furthermore, western blotting analysis demonstrated that the Kampo medicine decreased the amount of 65 kDa late antigen expression in the infected cells. These results suggest that Kampo medicine may be sufficient to inhibit viral DNA replication and late protein synthesis, resulting in anti-CMV effects. Therefore, these three Kampo medicines have the potential of being a source of new powerful anti-CMV compounds.