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Next-generation sequencing of oral squamous cell carcinoma (OSCC) has revealed TP53 as the most frequently mutated gene in OSCC mutually exclusive with human papillomavirus infection. Oral epithelial dysplasia (OED) is defined as a precancerous lesion of OSCC by the current World Health Organization (WHO) classification; therefore, it is assumed that TP53 mutations occur in early precancerous conditions such as OED. Here, we conducted an integrated analysis of TP53, including whole coding sequencing of TP53, FISH analysis of the 17p13.1 locus, and immunohistochemical analysis for p53 (p53-IHC), in 40 OED cases. We detected 20 mutations in 16 (40%) OED cases, and four cases, each harbored two mutations. FISH analysis revealed six of 24 cases (25%) had a deletion on 17p13.1, and four cases had concurrent TP53 mutations and 17p13.1 deletion (2-hit). Also, the increased frequency of TP53 mutations in higher degrees of OED implies acquisition of the mutation is a major event toward OSCC. p53-IHC revealed that overall cases could be categorized into four patterns that correlate well with the mutational status of TP53. Especially, two patterns, broad p53 expression type (pattern HI) and p53 null type (pattern LS), strongly correlated with a missense mutation and nonsense mutation, respectively. Furthermore, seven of the 40 cases progressed to SCC, and six of these seven cases presented pattern HI or LS. Therefore, patterns HI and LS have a high risk for malignant transformation if excisional treatment is not performed irrespective of the dysplasia grade. Although the current WHO classification mainly focuses on morphological criteria for the diagnosis of OED, interobserver discrepancy appears in some instances of the OED diagnosis. Our immunohistochemical analysis supports a more accurate pathological diagnosis for OED in cases of low dysplastic changes or of differential diagnosis with non-dysplastic lesions.

Background & Aims HIV-seropositivity shortens survival in patients with hepatocellular carcinoma (HCC). Whilst risk factors for HCC including Hepatitis C virus infection can influence T-cell phenotype, it is unknown whether HIV can influence functional characteristics of the T-cell infiltrate. Methods From the Liver Cancer in HIV biorepository, we derived 129 samples of transplanted (76%) or resected (20%) HCC in 8 European and North American centres. We profiled intra and peri-tumoural tissue to evaluate regulatory CD4+/FOXP3+ and immune-exhausted CD8+/PD1+ T-cells in HIV+ (n=66) and HIV- (n=63) samples. We performed targeted transcriptomics and T-cell receptor sequencing in a restricted subset of samples evaluated in relationship with HIV status. We correlated immuno-pathologic features with patients’ characteristics including markers of HIV infection. Results Of the 66 HIV+ patients, 83% were Hepatitis C virus co-infected with an undetectable HIV viral load (51%) and a median blood CD4+ cell count of 430 cells/mm3 (range 15-908). HIV+ patients were compared with HIV- controls with similar staging characteristics including Barcelona Clinic Liver Cancer (BCLC) stage A-B (86% vs. 83%, p=0.16)

Objective The present study aimed to identify the characteristics of dysgeusia caused by cancer chemotherapy. Patients and methods We investigated 181 patients with oral adverse events from cancer chemotherapy who were referred to an oral surgery clinic. Results Oral mucositis, dysgeusia and dry mouth were found in 62 (34.3%), 61 (33.7%) and 28 (15.5%) patients, respectively. Most dysgeusia was grade 1 (95.1%, P Conclusion Dysgeusia tended to occur during treatment with oxaliplatin, paclitaxel and doxorubicin, and an association with PN was also suggested.

Peripheral neuropathy is the major adverse event during administration of the taxanes, including paclitaxel and docetaxel. Among oral adverse events, oral mucositis is relatively common, but the occurrence of trigeminal nerve disorders is rare. Two cases of trigeminal nerve disorders, one involving the inferior alveolar nerve, the buccal nerve and the lingual nerve and the other the lingual nerve, caused by docetaxel are presented.

In this paper, we report two rare cases of foreign body oral injuries caused by forks inserted tightly into both sides of the lingual interdental spaces between the mandibular deciduous canines and first deciduous molars (FDMs). These pediatric cases of foreign body insertion caused not only soft tissue injuries but also the potential luxation of affected deciduous teeth, i.e., the FDMs in the present cases, during the removal of the object by force.

In horticultural crop production, accurately estimating the canopy photosynthetic rate (Ac) based on greenhouse climate conditions is of practical value for predicting and controlling crop growth and yield. We developed a method for continuously estimating Ac in a greenhouse from readily obtainable information (i.e., climatic data and canopy photographs) by combining a canopy photosynthesis model with image analysis. The canopy photosynthesis model was based on a sun/shade representation of the crop canopy combined with models of single-leaf photosynthesis, stomatal conductance, mass transfer and leaf energy balance. This combination allowed 1) the incorporation of all major climatic variables (i.e., radiation, CO2 concentration, air temperature, humidity, and wind velocity) into the Ac estimation and 2) the simultaneous estimation of Ac, canopy transpiration rate (Ec), and leaf temperature (TL). The leaf area index (Lc), which changes considerably throughout the growth period of a crop canopy, was evaluated nondestructively from the gap fractions of nadir digital photographs (i.e., the fractions of nonleaf area). The canopy photosynthesis model and image analysis results were combined and used to estimate the Ac, Ec, and TL of spinach canopies grown at ambient and elevated CO2 concentrations (c. 400 and 800 µmol mol−1, respectively). Regardless of the CO2 concentration, the estimates of Ac, Ec, and TL were in good agreement with measurements obtained with the open chamber method throughout the growth period. Analyzing the sensitivity of Ac to input variables revealed that the effects of climatic variables on Ac can vary considerably depending on the Lc and incoming radiation. The proposed method enables not only the estimation of Ac from readily obtainable information but also the quantitative evaluation of the effect of climate control on Ac in horticultural greenhouses.

The response of crops to elevated atmospheric CO2 concentrations ( C a ) is of great concern for horticultural vegetable production in greenhouse facilities, where C a levels are often artificially elevated. To elucidate the long-term effect of the elevated C a on canopy photosynthesis and growth, we conducted long-term continuous measurements of the canopy photosynthesis ( A ) and leaf area index ( L ) of hydroponically grown spinach canopies under elevated C a (approximately 800 μmol mol−1) and ambient C a (approximately 400 μmol mol−1) treatments by combining the open chamber method and image analysis of the top of view of canopies. There existed a positive feedback loop between A and L, where an increase in L caused an increase in A , which subsequently accelerated the increase in L . The enhancing effect of elevated C a on A, which was evaluated with enhancement ratios (i.e., A in the elevated C a treatment divided by A in the ambient C a treatment; A e l e v / A a m b ), showed a short-term increase under high-light conditions during the daytime and a long-term increase with canopy growth toward the harvest. The long-term increase in A e l e v / A a m b was attributed to the enhancement of A e l e v brought on by not only the short-term enhancing effect of elevated C a but also the more rapidly increasing and thus larger L in the elevated C a treatment compared with that in the ambient C a treatment. Both the long-term increase in A e l e v / A a m b and the more rapidly increasing L in the elevated C a treatment were caused by the “compound interest effect” of elevated C a , where the enhancing effects of elevated C a on A and L were gradually amplified over a long-term period through the positive feedback loop between A and L . This compound interest effect of elevated C a also caused a long-term increase in canopy nighttime respiration in proportion to daytime photosynthesis. Through these changes in the canopy-scale carbon balance, the compound interest effect detected in the elevated C a treatment likely contributed to a substantial increase in the final aboveground dry weight at the harvest time. This study highlights the importance of the long-term compound interest effect of elevated C a on canopy photosynthesis, carbon balance, and growth.

The extra-osseous/peripheral ameloblastoma (PA) is a relatively rare subtype of ameloblastoma, which develops in the soft tissues of the gingiva and oral mucosa. In this article, we describe a PA found in the gingiva of the right mandibular premolar region in a 70-year-old male. On oral examination, a firm, pedunculated mass with a granular surface and partial ulceration was found on the lingual gingiva of the right mandibular first premolar to the first molar. The pathological diagnosis of the incisional biopsy specimen was highly suspected to be PA with difficulty to differentiate from basal cell carcinoma (BCC). As the clinical history and features could not help to rule out the possibility of BCC, en bloc resection with safe margins was performed. Immunohistochemically, the tumor cells showed positivity for CK19 and p63 but Ber-EP4 was negative for tumor cells. The final histopathological diagnosis was peripheral ameloblastoma.

It is not uncommon to encounter unintentional oral self-injury in aged patients. We present a case of oral self-injury of the tongue in an 80-year-old male triggered by an unintentional self-bite wound. The cause of persistent self-injury was suspected to be Alzheimer's disease with behavioral and psychological symptoms of dementia (BPSD); treatment was complicated by anticoagulant medication. Use of yokukansan, a Japanese herbal medicine, effectively allayed the BPSD, and healing was accomplished without anticoagulant discontinuation. In this case, local treatment with restrictive oral devices was insufficient, suggesting that early concomitant pharmacological treatment for BPSD may inevitably be needed for these patients.

Objective The purpose of this study was to verify the characteristics of methotrexate (MTX)-related oral lymphoproliferative disorders (LPDs) in rheumatoid arthritis (RA) patients. Methods Twenty-eight cases of MTX-related oral LPDs with RA, which included 14 cases from English articles and 14 cases from Japanese literature, were collected. Data on demographic characteristics, clinical features, pathological diagnosis, weekly and total amount of MTX, concomitant drugs for RA, treatment, and follow-up period and outcomes were analyzed. Results Gingiva was the most frequent site (19, 67.9%), followed by tongue (4, 14.3%). Histopathologically, 15 cases (78.9%) were diffuse large B-cell lymphoma. All oral cases except for one case were Epstein–Barr virus (EBV)-positive. As an initial treatment, MTX was withdrawn for all cases including two cases of firstly decreasing the dose of MTX. Recurrence was reported in one case (4.8%). In gingival 19 cases, ulceration was found in 16 cases (84.2%), pain in 13 cases (68.4%) and alveolar bone exposure in 11 cases (57.9%). Conclusions The occurrence of MTX-related oral LPDs showed a predilection for gingiva with frequent characteristics of ulceration, pain and bone exposure. Almost all cases were EBV-positive.

Sturge-Weber syndrome (SWS) is a neurocutaneous disorder characterized by vascular malformations involving the brain, skin and occasionally the eyes. Dental and oral surgery for patients with SWS can be complicated by bleeding from angiomatoses. Here we describe extraction of a semi-impacted right maxillary wisdom tooth from a 24-year-old woman who had been diagnosed at birth with SWS with mental retardation, ocular disease and vascular malformations (Type 1). She presented with a port-wine stain on the right side of the face. Oral examination showed that the angiomatous tissue extended to the oral mucosa on the right side, but the palatal gingiva appeared intact. Referring to three-dimensional computed tomography, the tooth was extracted without complications under local anesthesia and intravenous conscious sedation using midazolam and nitrous oxide. The post-extraction course was uneventful.

Studies of cancer treatment for centenarians (those who reach 100 years old) have been relatively rare. We present a case of hard palate squamous cell carcinoma in a 106-year-old woman treated using customized mold high-dose-rate brachytherapy, with 4 years of follow-up.

We investigated the tensile properties of Fe–30Mn–(6 − x)Si–xAl (in wt.%, x = 0, 2, 3, 6) austenitic alloys precharged with hydrogen gas at 10 MPa. The Fe–30Mn–6Al alloy showed hydrogen-improved elongation through enhancement of work hardening capacity in the plastic instability condition, although the other alloys did not. This improvement in elongation is considered to be a result of a reduction in stacking fault energy because deformation twinning appeared only in the hydrogen-precharged condition.

Maxillary central incisors are most commonly luxated during oral and maxillofacial trauma in children. In this paper, we describe a rare case of intrusion of both maxillary permanent central incisors in a 10-year-old boy who was involved in a traffic accident, resulting in upward displacement of the labial alveolar cortical bone and a deformed nostril. The information obtained from the plain CT images was not adequate, and 3D-CT images were very useful for precise diagnosis. In this patient with mixed dentition, a vacuum-formed splint proved to be effective for the fixation of the luxated teeth.

Sclerotherapy with OK-432 injection has been recommended as the treatment of choice for plunging ranula because of its safety and minimal complications. However, the recurrence rate after sclerotherapy with OK-432 is variable and has been reported as 0–50%, and some reports have preferred surgical treatment despite the greater risk of potential complications. This article presents three cases of plunging ranula treated with ultrasound-guided injection of OK-432, resulting in successful regressions without major complications or recurrences. Ultrasound-guided intervention might increase the success ratio for sclerotherapy, despite the low number of patients for which it was effective in this study.

The occurrence of ocular complications in association with dental treatment is rare. In this article, we present a case of vitreous hemorrhage (VH) in a 42-year-old female with proliferative diabetic retinopathy after the extraction of maxillary left first premolar. Valsalva maneuver was suggested to be the cause of VH.

We have investigated the low temperature of Au induced lateral crystallization of electron irradiated amorphous Ge on SiO 2 /Si substrate. The reduction of the critical annealing time to cause the Au induced lateral crystallization is realized by high energy electron irradiation. In addition, the lateral crystallization region of the sample with electron irradiation has high crystalline quality as well as the sample without electron irradiation. We have speculated that the Au induced lateral crystallization of amorphous Ge on SiO 2 /Si substrate was enhanced by electron irradiation, due to the introduction of point defects into amorphous Ge able to diffuse easily of Au atoms.

Nodular fasciitis (NF) is defined as a benign and reactive fibroblastic growth extending from the superficial fascia into subcutaneous tissue or muscle. NF shows rapid growth, and pathological diagnosis can be difficult, so this entity is sometimes misdiagnosed as malignant tumor. NF can arise anywhere in the body, but occurrence in the oral region is rare and only four cases of NF involving the tongue have been reported previously. We describe herein a new case of NF in the tongue. The patient was a 37-year-old man who presented with a painless mass in the tongue that had grown rapidly over 7 days. After radiographic examination and biopsy, the mass was excised. Immunohistochemically, the specimen showed positive results for desmin and alpha smooth muscle actin, dispersive positive staining for CD-34, and weak positive results for CD-68. No signs of recurrence have been seen during the 24 months of follow-up.

Aim The aim of this study was to investigate the association between oral opportunistic infections and a recently adopted functional factor, the Functional Independence Measure (FIM), and a nutritional factor, the Geriatric Nutritional Risk Index (GNRI), in institutionalized elderly patients. Patients and methods Fifty-three patients who were admitted to a long-term nursing hospital were included in this study. The oral opportunistic pathogens (OOPs) were gathered by scratching the dorsal surface of the tongue and then were cultivated. In each patient, the FIM and GNRI score, the method of nutrition, the number of remaining teeth, and whether or not dentures were worn was examined. Results OOPs were found in 64.2% of the patients, and Pseudomonas aeruginosa was the most commonly detected OOP (43.4%). The FIM and GNRI scores of the OOP-positive patients were significantly lower than those of the OOP-negative patients, and the rate of denture wearing was also significantly lower in the OOP-positive patients. Similar results were found in P. aeruginosa-positive patients. In cases of P. aeruginosa infection, the tube-fed patients were significantly more likely to be OOP-positive than the orally fed patients. From the multivariate logistic regression model only the GNRI significantly associated with P. aeruginosa positivity. Conclusion The OOP-positive patients and P. aeruginosa-positive patients had significantly lower scores of the FIM and GNRI. But from the multivariate logistic regression model significant correlation was found between only P. aeruginosa positivity and lower scores of the GNRI.

Objective The purpose of this article is to describe implant placement in the maxilla using a modified bone-splitting procedure and also report the postoperative condition of the alveolar ridge after 2 years. Patients and methods Six patients with a maxillary ridge considered too narrow for implant placement were selected and immediate placement of eight implants was performed using a modified bone-splitting procedure. Clinical measurements for biometric analysis of alveolar ridge width were recorded with calipers at stage-one and stage-two surgery. Sequential changes in marginal bone levels around the implants and adjacent teeth were assessed radiographically. Results No major complications developed in any of the cases, and no post-insertion failures were reported. Biometrical evaluation at placement sites showed a mean gain in bone width of 2.0 mm and intraoral radiographs after 2 years of loading revealed a mean bone loss of 2.3 mm. Conclusion The bone-splitting procedure is viable for horizontal bone augmentation in an atrophic anterior maxilla. However, the present results suggest that this procedure has clinical limitations and potential prognostic risks.

Purpose Sinus lifting without graft materials allows new bone formation in the sinus, but the amount of bone formation varies. This study aimed to investigate whether nongrafted sinus lifting using a titanium bone fixation device can promote bone formation in the sinus. Materials and Methods Patients with atrophic posterior maxillae jeopardizing implant stability were included. After nongrafted sinus lifting in combination with implant placement, repositioning of the bone window and additional space-maintaining management were performed by use of the bone fixation device. The primary variables recorded retrospectively included implant survival and preoperative and postoperative alveolar crest height with and without Schneiderian membrane perforation. Independent variables included patient demographics, position and dimension of the implants, complications, and follow-up period. The t test was used for comparing differences in bone levels. The implant survival rate was estimated by uses of Kaplan-Meier statistics. Results The study included 11 patients (4 men and 7 women) and a total of 21 implants. Radiographically, new bone formation around the implant was generally observed in accordance with the implant apex. Postoperative alveolar crest height (mean, 10.9 ± 2.2 mm) was significantly higher compared with residual alveolar crest height (mean, 4.7 ± 1.4 mm), and no significant difference in bone formation was seen according to membrane perforation. The cumulative survival rate was 95.2%. Conclusions This nongrafted sinus-lifting procedure using a bone fixation device could attain predictable bone formation. Additional space-maintaining management using a bone fixation device in a nongrafted sinus lift offers a useful technique for promoting bone formation in the sinus.

Objective To elucidate the details of impalement injuries of the oral soft tissue in children caused by toothbrush, we present a clinico-statistical study of those encountered in a single institution. Patients and methods Children below 13 years old, who visited our oral surgery clinic with the complaint of an impalement injury of oral soft tissue from December of 2001 to August of 2008, were included. Results Among two hundred and thirty oral soft tissue injuries, toothbrush (73 cases) was the most frequent object, followed by a stick-like object (51 cases) and eating utensils (27 cases). In toothbrush injuries, the 1-year-olds were most affected and the frequency in boys and girls was 30 cases and 43 cases, respectively. Soft palate (31 cases) was the most frequent site, followed by buccal mucosa (17 cases) and gingiva (7 cases). All of the injuries occurred when the children were in standing position and a fall was the most frequent cause ( p Conclusion Toothbrush was the most frequent object responsible for impalement injuries. Caution must be taken while managing a toothbrush injury with a wide laceration to avoid advanced infection. To prevent toothbrush injuries, we recommend that children should use a toothbrush in sitting position.

Dissociative disorders are defined as condition that involve disruptions or breakdowns of memory, awareness, identity and/or perception. The dental treatments of the patents with dissociative disorders have often difficulties because they show uncomfortable symptoms including unconsciousness, collapse and shiver. We presented a case of dissociative disorder that was revealed by the conditions found during the dental treatment. A 51-year-old female referred to our clinic for the removal of the inflamed implant in the anterior left side of the maxilla. The implant removal had failed because she showed a collapse and an excretion of bubbly saliva form her mouth during the treatment. Under local anesthesia the implant was removed with monitoring the general condition. During the operation she showed the same symptoms but the date of the monitoring was unchanged. After the operation she examined closely in the internal medicine and was diagnosed dissociative disorder.

Acute tongue swelling may be caused by various conditions, including circulation obstruction, infection, hemorrhage, and angioneurotic edema. We present a case of extremely massive swelling of the tongue in a comatose 76-year-old woman caused by systemic edema and local congestion induced by tongue biting that severely impeded the lingual veins. The swelling was improved by setting ratchet mouth props.

The salivary duct system in the setting of chronic sialadenitis is predisposed to undergo a variety of cellular modifications. This report documents a rare type of metaplasia of a parotid benign lymphoepithelial lesion. Epimyoepithelial islands showing focal sebaceous differentiation and pure sebaceous cell nests in addition to their usual histologic appearance were noted throughout the lesion. The possible pathogenesis is discussed through a review of the literature.

An interesting case of a trauma-induced tender mass of the buccal mucosa in a 45-year-old man was presented. Following surgery, the patient was relieved from pain. Microscopically, the mature adipose tissue is unique in that it contained a single enlarged Pacinian corpuscle near the deep margin. This is the hitherto undescribed intraoral lesion of Pacinian neuroma in the herniated buccal fat pad.