Lemierre syndrome with blepharoptosis.

A 51-year-old woman was hospitalized with a high fever, occipital pain, blepharoptosis, and trismus. Enhanced CT showed thrombophlebitis of her left cavernous sinus, maxillary vein, and multiple pulmonary nodular lesions. (18)F-FDG PET/CT showed significant uptakes in the same lesions. Streptococcus constellatus was detected in her blood. Therefore, she was diagnosed as a Lemierre syndrome variant. After administration of antibiotics, all symptoms, inflammatory reactions, and thrombi disappeared. Since Lemierre syndrome has life-threatening potential, early diagnosis and initiation of appropriate therapy are important. In this case, (18)F-FDG PET/CT was useful to detect the focus and extent of infection.

The effect of thermal treatment on the resistance of nickel-titanium rotary files in cyclic fatigue.

OBJECTIVE: The purpose of this study was to determine the effect of various thermal treatments on the fatigue resistance of a nickel-titanium (NiTi) engine-driven endodontic file. STUDY DESIGN: Fifteen groups of 5 files each of ISO 30 and taper .04 were tested in this study. The cutting tip (5 mm from the end) of files from 14 groups were heat treated for 30 minutes in temperatures 250 degrees C, 300 degrees C, 350 degrees C, 375 degrees C, 400 degrees C, 410 degrees C, 420 degrees C, 425 degrees C, 430 degrees C, 440 degrees C, 450 degrees C, 475 degrees C, 500 degrees C, and 550 degrees C, respectively, while 1 group was used as reference. The files were placed in a device that allowed the instruments to be tested for rotating bending fatigue inside an artificial root canal. The number of rotations to breakage was recorded for each file. The mean values of all groups were statistically analyzed using 1-way analysis of variance and Student Newman Keuls multiple comparison test at alpha = .05. RESULTS: The 430 degrees C and 440 degrees C groups showed the highest values, with fatigue resistance decreasing for thermal treatment at lower and higher temperatures. This may be the result of metallurgical changes during annealing. CONCLUSION: Within the limitations of the low sample size and the specific instrument size tested, it appears that the appropriate thermal treatment may significantly increase the fatigue resistance of the NiTi file tested.

[Preoperative chemotherapy with TS-1 and low dose cisplatin for oral squamous cell carcinoma patients--a preliminary study].

We investigated the histological response and toxicities of combination chemotherapy with TS-1 and low-dose CDDP, and evaluated the usefulness of this regimen as a preoperative chemotherapy. Fourteen patients were enrolled in this study (two men and 12 women, with a mean age of 54.5 years). Patients were administered TS-1 80 mg/m2/day (days 1-14) and CDDP 5 mg/m2/day (days 1-5, 8-12) and followed by radical surgery or biopsy within 2 weeks. Ten patients completed 1 cycle of chemotherapy, two received 0.5 cycle and two others 1.5 cycle. The histological antitumor effects were evaluated with Ohboshi & Shimosato's classification using surgical or biopsy specimens of primary tumors. The response rate was 64.3% in clinical evaluation and 50.0% in histological evaluation. The number of patients who showed CR were 7/14 (50.0%) and 5/14 (35.7%) by histological and clinical evaluation, respectively. Two patients showed grade 3 neutropenia. Almost all patients revealed no or mild toxicities. TS-1 with low-dose CDDP represents a highly effective antitumor activity and mild toxicities. Especially, the CR rate was very high. These data suggested that this regimen was useful to avoid surgery or to realize minimal surgery for oral squamous cell carcinoma patients.