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Published reports on nail-gun injuries to the head are rare. We describe the case of a penetrating cranio-submental injury with internal carotid arterial stenosis. A 30-year-old man sustained a penetrating head injury inflicted by a nail gun. On admission, he was conscious and had no neurological deficits. X-ray films of the skull showed that the nail had penetrated deeply into the left lacerated foramen from the submental space. CT scans showed no evidence of intracranial hemorrhage, but angiography suggested constriction of the left internal carotid artery by the nail. On the night of admission day 1, the patient had right hemiparesis with a disturbance of consciousness caused by the constriction. On 2nd day after the penetrating injury, his condition improved considerably by intravenous administration of heparin and edaravone.On the same day, the nail was easily and safely removed from the oral floor after coil embolization of the left internal carotid artery. On the 18th day, the patient was discharged with slight aphasia.

A case of Castleman's disease occurring in the buccal mucosa is described. An 84-year-old woman noticed that a mass in the left buccal mucosa that had been present for half a year. Computed tomography revealed a well-demarcated submucosal tumor, measuring 4.0 × 3.0 × 2.0 cm. The patient received no treatment at this time, and continued growth of the mass was observed. After incisional biopsy, the lesion was surgically removed. Histologically, the tumor consisted of an enlarged lymph node with conspicuous lymph follicles, in which vascular channels and deposits of eosinophilic material were noted. Laboratory examination showed an increase of serum antibody level of cytomegalovirus but of no other viruses. The patient was followed up for 1½ years, with no clinical evidence of recurrence. This is the first report of Castleman's disease presenting in an oral site. (Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2002;93:305-10)

In order to examine the functional differentiation of tumor cells of adenomatoid odontogenic tumor (AOT) as ameloblasts and to determine the participation of the extracellular matrix (ECM) in the formation of its characteristic histologic architecture, tissue samples from five cases of adenomatoid odontogenic tumor were examined by immunohistochemical staining for enamel proteins and ECM molecules. Amelogenin, enamelin, laminin, heparan sulfate proteoglycan, fibronectin, collagen type IV and type V were immunolocalized within the luminal space and along the inner rim of duct-like structures. Eosinophilic hyaline droplets within the whorled or rosette masses of tumor cells showed basically the same staining pattern as the luminal contents. High columnar tumor cells that formed duct-like structures were immunopositive for amelogenin, while the staining intensity decreased with flattening of the cells, which was a result of luminal growth. The findings suggest that the constituent cells of duct-like structures are differentiated once to ameloblasts but fail to mature further due instead to increased production of ECM molecules and due to their retention in the lumina. It is possible to regard these special structures in AOT as stromal pseudocysts.

We report a case of aspergillosis of the maxillary sinus that was suspected to be a malignant tumor.A 51-year-old woman was referred to our hospital for swelling and pain in the left cheek. Trismus was observed. Radiographs and CT scans showed opacification of the left maxillary sinus and destruction of the posterolateral bony wall.The clinical diagnosis was a malignant tumor of the left maxillary sinus. A biopsy was performed. Histopathological examination and fungal culture revealed aspergillosis.Caldwell-Luc operation was performed. After operation, amphotericin B was administered orally for three weeks.Presently, about three years after operation, this patient is well and there are no signs of recurrence.

The purpose of this study was to determine the effects of anti-Bacteroides gingivalis (Bg) and anti-Actinobacillus actinomycetemcomitans (Aa) antibodies on Bg and Aa respectively. Bg and Aa were resistant to complement-mediated bactericidal activity, and killing by PMN. However a significant reduction in CFU of Bg and Aa was found when these bacteria were incubated with the antibodies and not agitated. This would suggest that the antibody was capable of aggregating or phagocytizing, but not killing, these bacteria when complement and PMN were added. Moreover the antibodies had no effect on bacterial proliferation. Anti Aa antibody also had no effects on killing of Aa or PMN infiltration in experimentally established periodontal pockets in dogs.

ラットの歯頸部に存在し, 歯肉縁上プラーク中で優位に占める3種の細菌を6ヵ月間皮下注射した際の歯周組織病変に与える影響を検討した。免疫群 (n=10) ラットには, 3種の培養細菌 (A: Actinomyces, B: Streptococous, C: Veillonella) のホルマリン処理菌液を2週間に一度, 12回皮下注射し, 対照群 (n=8) ラットは, 未処置とした。実験開始の6ヵ月, 9ヵ月, 屠殺時の12ヵ月に血液と上顎右側口蓋側歯頸部よりプラークを採取し, 細菌学的検索に, 右側下顎はH-E染色による組織切片作製後, 組織学的検索に, 左側上下顎は歯槽骨吸収スコアー計測のための検体に供した。屠殺時採取した頸部リンパ節リンパ球の3種の細菌に対する分裂反応および血清IgG抗体価を測定した。その結果1. A菌に対する抗体価は, 免疫群で経時的に78, 208, 204EUと有意に上昇した。B菌では, 変動なく, C菌では経時的に減少した。2. 頸部リンパ節の反応は, A菌のみ免疫群で高く, 対照群との間に有意差が認められた。3. 歯頸部プラーク中における3種の細菌の割合は, 実験開始時に比べ屠殺時には免疫群, 対照群ともに減少した。4. 組織学的に接合上皮直下に, 両群とも多形核白血球, 単核球の浸潤がみられ, 上皮の根尖側移動と歯槽骨吸収が生じていた。しかし, 免疫群と対照群との間で有意差は, 認められなかった。

ワイヤー結紮で惹起したラット実験的歯周炎に対する, 薬剤による全身的免疫機能の抑制及び亢進の影響について検索した。27匹の13週齢Wistar系ラットの上顎第2臼歯にワイヤー結紮し, 粉末飼料にて12週間飼育した。屠殺時に, 血液, 頸部リンパ節, 両側上顎骨を採取した。ラットは1) 免疫抑制群 (IS, n=10) : Cyclophosphamideを15mg/ kg/weekで12週間腹腔内注射2) 免疫亢進群 (IE, n=7) : Levamisoleを1mg/kg/weekで12週間腹腔内注射3) 未処置の対照群 (C, n=10) とした。その結果, ラット口腔細菌, E. coli LPSに対する血清IgG抗体価はIS群での減少傾向, IE群での増加傾向を示した。頸部リンパ節リンパ球分裂能は, 口腔細菌, E. coli LPS及びPHA, PWM刺激によりIS群での減少傾向, IE群での増加傾向が認められた。歯槽骨吸収量及び付着の喪失量についても, IS群での増加傾向, IE群での減少傾向を示したが, C群との間に有意差が認められたのは口蓋側におけるIE群での歯槽骨吸収の抑制のみであった。また, 歯肉組織の炎症性細胞浸潤はどの群も軽度で差が認められなかった。以上より, 全身性の免疫抑制及び亢進と歯周組織の破壊には関連性がある事が示唆された。

歯周疾患罹患者におけるBlack pigmented Bacteroides (BpB) とActinobacillus actinomycetemoomitans (Aa) に対する血清及び歯肉溝滲出液 (GCF) のIgG抗体について検索した。被検者を歯周組織が健康で平均年齢41.4歳のコントロール群1 (Con. 1), 同じく24.2歳のコントロール群2 (Con. 2), 成人性歯周炎罹患者である実験群1 (Exp. 1) 及びその中で歯周初期治療を終えた実験群2 (Exp. 2) の4群に分けた。Exp. 1の血清抗Bacteroides gingivalis (Bg) 抗体価は他の3群より有意に高かったがGCF抗Bg抗体価には有意差は認められなかった。抗Bg抗体比 (GCF/血清) はExp. 1で0.28±0.05となり, Con. 1, Con. 2に比較して有意に低い値となった。BgはExp. 1のみについて検出されBpBの42.9%を占めた。またAaはいずれの群からも検出されなかった。血清抗Bg抗体価の高低とBg検出の有無を基準として付着の喪失量及びX線的骨吸収量をみると, 抗体価が低く, かつBgも検出されない群に比較して, 抗体価が高いか, あるいはBgが検出された群は有意に付着の喪失量及びX線的骨吸収量が大きかった。以上より, 歯周疾患における組織破壊にBg及び抗Bg抗体が関与していることが推測された。