Chronic tongue ulceration resolved by sulpiride: a report of two cases.

We report two patients with chronic tongue ulceration who were successfully treated using sulpiride. The clinical diagnosis was oral candidiasis related to long-term steroid treatment. The results of the culture test and cytological examination supported this diagnosis, but antifungal treatment was ineffective and the tongue pain in these patients became more severe. Furthermore, the pain could not be relieved by nonsteroidal anti-inflammatory drugs (NSAIDs). We therefore prescribed sulpiride in addition to NSAIDs to reduce the tongue pain. A consequent improvement in both pain severity and ulceration was observed 2-3 weeks after sulpiride administration.

Disposition of TF-PEG-Liposome-BSH in tumor-bearing mice.

BNCT requires high concentration and selective delivery of (10)B to the tumor cell. To improve the drug delivery in BNCT, we conducted a study by devising TPLB. We administrated three types of boron delivery systems: BSH, PLB and TPLB, to Oral SCC bearing mice. Results confirmed that (10)B concentration is higher in the TPLB group than in the BSH group and that TPLB is significantly effective as boron delivery system.

Boron neutron capture therapy for recurrent oral cancer and metastasis of cervical lymph node.

We treated 6 patients with recurrent oral cancer and metastasis to the cervical lymph nodes after conventional treatments in 5 and non-conventional in 1 using BNCT, and herein report our results. The clinical response in our patients ranged from CR to PD. In 5 cases, spontaneous pain decreased immediately after BNCT. Three of the 6 are alive at the time of writing and we found that BNCT contributed to QOL improvement in all.

Boron neutron capture therapy for papillary cystadenocarcinoma in the upper lip: a case report.

Boron neutron capture therapy (BNCT) is a tumor-selective radiation therapy using alpha and (7)Li particles, which are produced by the reaction of neutron with boron ((10)B), and taken up by the tumor. The authors report their first experience of BNCT on a patient with no history of surgery, chemotherapy or conventional radiotherapy for papillary cystadenocarcinoma in the upper lip.

Tongue pain: burning mouth syndrome vs Candida- associated lesion.

OBJECTIVE: We investigated patients with tongue pain to examine whether the differential diagnosis of burning mouth syndrome and Candida-associated lesion was possible. PATIENTS AND METHODS: Sixty patients with tongue pain were divided into three groups according to the intensity of pain at rest and that when eating using the visual analogue scale: Group A: Functional pain group. Group B: Non-functional pain group. Group C: Mixed pain group. Antifungal treatment was scheduled for patients suspected clinically, mycologically or cytologically as having candidal infection. RESULTS: The results of the culture test and direct examination indicated that group A was different from others by its high positivity for Candida, a good response to the antifungal treatment was obtained. On the other hand, antifungal treatment was not useful in group B, and the low possibility of Candida infection in the direct examination supported the result in this group. In group C, the positivity of Candida and the effect of the antifungal treatment were between groups A and B. CONCLUSION: These results may suggest that tongue pain in group A is Candida-associated, that in group B is burning mouth syndrome-induced and that of group C is mixed conditions.

Partial atrophic tongue other than median rhomboid glossitis.

A group of 23 patients with partial atrophic change of the tongue was examined for candidiasis. All of them reported pain in the tongue on eating hot or spicy food. The intensity of the tongue pain was evaluated before and after treatment using a visual analogue scale. Of the 23 patients, 10 (43.5%) had predisposing factors for candidiasis such as diabetes mellitus and anaemia. In the culture examination, candidal species were isolated in 65.2%, all Candida albicans. Direct cytological examination performed in 10 of the 23 patients revealed fungal pseudohyphae in 8 patients. After antifungal treatment, tongue pain had disappeared or improved markedly in 82.6%. Simultaneously, the filiform papilla of the atrophic site was observed to have begun to regenerate in these patients. Candida infection should be suspected in patients with partial atrophic tongue associated with pain on eating.

Cheilitis as a variation of Candida-associated lesions.

OBJECTIVE: Occasionally, the clinical diagnosis of Candida-associated lesion is difficult because of a variety of its clinical manifestations. There have been a few reports on Candida-associated lip lesion except angular cheilitis. In this paper, we investigate the relation of Candida in persistent lesions of the lip. SUBJECTS AND METHODS: The present study includes consecutive nine patients with persistent erosive lip lesion. For each patient the age at presentation, gender, duration of the disease, other symptoms or signs, complete medical history and prior treatment or medications for the symptom were obtained. Then, mycological examination and the direct cytologic examination were performed. RESULTS: The reported average duration of the disease was 7 months. Six of nine patients had received prior treatments with topical steroids at the other clinic, which failed to resolve their symptoms. Six of nine patients had a predisposing factor for candidiasis. In the culture examination, Candida albicans were isolated in seven patients (77.8%). Five of nine patients received the direct cytologic examination, and four of them revealed pseudohyphae of fungi. The anti-fungal treatment was miconazol gel 25 mg four times per day, and average duration of the treatment was 2 weeks. The outcome was as follows: complete remission in five, remarkable response in two and no response in two. CONCLUSION: Our results suggested that one form of the varieties of Candida-associated lesions might be considered in the case of lip lesion with unknown origin that was persistent and ineffective to the topical steroids treatment.

[Treatment history of periodontal disease].

Humans began to manifest parodontal symptoms due to aggravating oral hygienic conditions since beginning to eat processed food approximately 10,000 years ago. It is believed that tooth brushing in some from began at the same time. Periodontal disease was first described 1,000 years ago in a book, in which the concept of a scaler was introduced along with techniques for removing dental calculus. Currently, scaling remains one of the major preventive and therapeutic for periodontal disease. Recently, however surgical treatment has also been employed and preventive vaccines have received intense investigation.

Magnetic resonance imaging of maxillary cancer--possibility of detecting bone destruction.

The purpose of this study was to evaluate the detectability of bone destruction of maxillary cancer with magnetic resonance imaging (MRI) using 14 cases of squamous cell carcinoma of the upper jaw. The detectability of bone destruction including the degree of spread to adjacent soft tissues was evaluated and compared to that of clinical examination, computed tomography (CT) and conventional X-ray films. MRI could show bone destruction of each bony part almost equally with CT, but differentiation among simple bone defects, bone expansion and bone destruction was difficult on MRI. The pattern of bone destruction of alveolus that could be detected on conventional X-ray examinations, could not be assessed on either CT or MRI. Soft tissue infiltration of the tumour was more clearly detected on MRI compared with CT and conventional X-ray films.

Toxicokinetics of intravenous fluoride in rats with renal damage caused by high-dose fluoride exposure.

Fluoride (F) complexes are used in some fields of industry and medicine. F excretion mainly depends on kidney function. Urinary F concentration is measured to monitor the health of workers exposed to F. The toxicokinetics of F were studied by analyzing plasma concentration of F after intravenous injection of 2.86, 5.71 and 8.57 mg/kg into male Wistar rats. A dose-response relationship was recognized between these F doses and renal tissue injury. Blood samples were removed at 0, 10, 20, and 30 min, and after 1, 2, 3, 4, 5, and 6 h after injection. Plasma concentration-vs-time profiles were evaluated by a nonlinear least-squares method for fitting data to polyexponential equations and calculation of relevant pharmacokinetic parameters. Results indicated that a two-compartment model could describe the elimination of F from plasma. The beta rate constant, total plasma clearance (C1) and first-order rate constants (K21, Kel) decreased, and the half-time of the beta-phase (t1/2beta) was significantly prolonged with increasing dose. The kidney is the main target organ for F toxicity. Acute exposure to high doses of F damages renal tissue and causes renal dysfunction. The C1 of F is mainly dependent on renal F excretion. Since severe kidney damage markedly affected the toxicokinetics of F and decreased its elimination, other nephrotoxic indicators and measurement of plasma F concentration are necessary for monitoring high-dose F exposure.

Articulatory function in patients who have undergone glossectomy with use of an artificial graft membrane.

OBJECTIVE: The purpose of this study was to investigate, by assessing speech intelligibility, the long-term usefulness of an artificial bilayer membrane as a mucosal substitute after glossectomy. STUDY DESIGN: Artificial membranes were grafted in 8 patients with intraoral defects after glossectomy. Five patients served as a control group and received only standard closure by suture after glossectomy. Speech intelligibility was evaluated by means of a standardized Japanese speech intelligibility test 6 months or more after the operation. RESULTS: The postoperative courses of all 13 patients were uneventful. Intelligibility scores of those who received grafts were better than those of the control group in the overall score, the glossal sounds score, and the rear portion sounds score. CONCLUSION: The artificial membrane was useful for the glossectomy as a long-term mucosal substitute, as well as for the short-term.

Accuracy of integration of dental casts in three-dimensional models.

PURPOSE: This study investigated errors occurring in three-dimensional (3D) models when plaster dental casts are integrated into them. MATERIALS AND METHODS: Three-dimensional milling models of three patients with a jaw deformity were fabricated using the Endoplan system (SPARC International Inc, Santa Clara, CA). After this, plaster dental casts were integrated into the 3D models using a face-bow transfer system. Two cephalograms were then compared, one obtained from the patient and the other obtained from the 3D model painted with contrast medium. RESULTS: In two cases, the reproducibility of the dental position as determined by angle analysis was within 2 degrees, and that determined by distance analysis was within 2 mm. However, errors over 4 degrees and 4.2 mm, respectively, were observed in one case. CONCLUSION: It is clinically important to confirm the accuracy of the 3D model by cephalometric analysis, and it may be necessary to reposition the dental model based on the results.

Urinary lithium: distribution shape, reference values, and evaluation of exposure by inductively coupled plasma argon-emission spectrometry.

Inductively coupled plasma argon-emission spectrometry (ICPAES) was used to evaluate the lithium content of undiluted urine samples. The method can be performed with 1 mL of urine in a single tube using a routine ICPAES analysis for rapid and convenient assessment of lithium exposure in humans. Urine samples obtained from male workers (n = 86) who had not been exposed to lithium were used for the determination of this element by ICPAES. The obtained concentrations were corrected using a specific gravity of 1.024. The particular frequency distribution resulted in a log-normal distribution diagram for anatomical spread. Geometric mean value for urinary lithium in the nonexposed male workers was 23.5 microg/L, and the confidence interval from a log-normal distribution was 11.0 to 50.5 microg/L. Taking into consideration a short biological half-life and the massive urine excretion of lithium, urinary lithium was considered to be a useful index for monitoring of exposure. Calibration curves obtained for lithium standards had good sensitivity and linearity. Good reproducibility was assessed by lithium addition to urine samples. It was concluded that the obtained lithium reference values would be useful for the early diagnosis of lithium intoxication or in the assessment of the degree of exposure to lithium in subjects at risk.

Study on urine boron reference values of Japanese men: use of confidence intervals as an indicator of exposure to boron compounds.

A simple and rapid method for the determination of urine boron by inductively-coupled plasma argon emission spectrometry (ICPAES) has been developed to establish boron exposure guidelines. After 11-fold dilution in 18.25 M omega cm ultra-pure water and vigorous shaking, urine may be directly injected into the spectrometer, providing accurate and reproducible results. We report the results obtained with urine samples obtained from a group of male Japanese electronic workers (n = 102) who had not been exposed to boron; boron concentrations were corrected with use of a specific gravity of 1.024 g/ml. The frequency distribution resulted in a log-normal distribution diagram for anatomical spread. The geometric mean values for urine boron in the non-exposed workers was 798.0 micrograms/l, while the confidence interval (C.I.) was between 398.1 and 1599.6 micrograms/l. Taking into consideration the short biological half-life of boron and its major excretion route via urine, urine was considered to be a suitable means for monitoring of exposure to this element. We conclude that the guidelines established by determining boron reference values are useful for the protection of individuals exposed to boron in their working environments.

Urinary biomarkers monitoring for experimental fluoride nephrotoxicity.

An excess of sodium fluoride (135 mg F/kg body weight) was given in a single oral dose to male Wistar rats. Effects were investigated of fluoride-induced acute kidney intoxication on the time-dependent variations of urine volume. Also, of urinary fluoride ion (F-), alpha-glutathione-S-transferase (alpha-GST), N-acetyl-beta-D-glucosaminidase (NAG), and creatinine (CR) concentrations. Fluoride administration strongly affects these urinary biochemical indices. Of the several biomarkers studied, alpha-GST is particularly useful as marker of S3 proximal tubule damage. We found that alpha-GST shows the strongest and more durable changes as a result of the large dose of F- given to the experimental animals. Our results suggest that the toxic effect of F- on the kidney may be more pronounced in the proximal tubule than the glomeruli region, and that the disorder of the proximal tubule is more serious in the S3 segment than S1 or S2 segment. Alpha-GST proved to be a useful marker for the early detection and long-term observation of proximal renal tubular injury resulting from F- intoxication. The animal model should help to establish guidelines for the treatment of industrial workers suffering from acute renal failure resulting from accidental exposure to fluoride.

Determining whether a parotid tumor is in the superficial or deep lobe using magnetic resonance imaging.

PURPOSE: This study examined the usefulness of magnetic resonance imaging (MRI) in assessing whether parotid tumors were located in the superficial or deep lobe. PATIENTS AND METHODS: Eight patients with parotid gland tumors underwent MRI using a spin echo pulse sequence. T1- and T2-weighted images were obtained. To assess tumor localization in the parotid gland, two anatomic landmarks were used: 1) a line connecting the lateral surface of posterior belly of digastric muscle and lateral surface of the cortical bone of ascending ramus (facial nerve [FN] line) and 2) the relationship to the retromandibular vein (RV). Results of all MRI examinations were compared with the surgical findings. RESULTS: Seven of eight cases were correctly diagnosed using the FN line criterion. Five of eight cases were correctly diagnosed using the RV criterion. CONCLUSION: MRI is an excellent modality to show tumor localization in the parotid gland.

Hemodialysis effect on serum boron level in the patients with long term hemodialysis.

Serum and dialysate boron levels in 17 patients with long term hemodialysis (HD) were determined by inductively coupled plasma emission spectrometry (ICPES). Serum boron level was compared with the value of age matched 467 healthy controls and the relationship between serum and dialysate boron level was analyzed. The results showed that serum boron level was significantly higher at the beginning of HD, and lower at the completion of HD in comparison with controls. Although the dialysate was contaminated with trace boron, HD resulted in an excessive decrease of serum boron, rather than boron exposure from the dialysate. Boron hemodialyzability was almost proportional to the gradient of the boron level at the beginning of HD and it could be controlled by the adjustment of the gradient. In conclusion, the serum boron level was very much disturbed in long term HD patients. If boron excess in serum at the beginning of HD, or deficiency at the completion of HD may contribute to the complications of HD patients, fine adjustment and close surveillance of the gradient should be taken into account.

A clinical study on SSP (silver spike point) electro-therapy combined with splint therapy for temporo-mandibular joint dysfunction.

When the functional limits of the muscles related to the temporo-mandibular joint and adjacent tissue exceed their anatomical capability, pain, crepitation, and functional abnormality appear as the main complaints. Although the precise nature of the condition is unknown, pain at the temporo-mandibular joint sometimes in combination with muscular tension is assumed to be due to compression of the myoneural mechanism. It is reported that occlusal lifting using a splint enables the alleviation of this muscular tension. On the other hand, there are only a few reports on the usefulness of SSP therapy for Temporo-Mandibular Joint Dysfunction. We studied the efficacy of SSP therapy combined with splint therapy in 33 patients diagnosed as having Temporo-Mandibular Joint Dysfunction who consulted our department primarily due to pain, and report our findings below. Evaluation of the results was conducted 2 weeks later. Very beneficial results were seen in 6 cases. Beneficial results were seen in 7 cases. Slightly beneficial results were seen in 18 cases, while there were no changes found in 2 cases. When combined SSP and splint therapies were conducted for Temporo-Mandibular Joint Dysfunction, favorable results were seen in about 90% of the cases.

An experimental study on mandibular movement and osteoporosis.

In order to clarify the relationship between mandibular movement and osteoporosis, the authors secured the temporo-mandibular joints of 8-week-old rats to immobilize their jaws; then conducted histologic studies chronologically, up to the fifth week. After three weeks, an expansion of the marrow cavity and a reduction of the trabecular were observed in the mandibular process and mandibular fossa. During the fifth week, an osteoporosis-like state was clearly observed. Further, an irregularity in the form of mandibular process was recognized, as well as a remarkable disturbance caused by cartilaginous ossification of the articular cartilage of the condyle.