RESUMO
We report on the findings of the first antimicrobial susceptibility surveillance study in Japan of isolates recovered from odontogenic infections. Of the 38 facilities where patients representing the 4 groups of odontogenic infections were seen, 102 samples were collected from cases of periodontitis (group 1), 6 samples from pericoronitis (group 2), 84 samples from jaw inflammation (group 3) and 54 samples from phlegmon of the jaw bone area (group 4) for a total of 246 samples. The positivity rates of bacterial growth on culture were 85.3%, 100%, 84% and 88.9%, respectively, for groups 1, 2, 3 and 4. Streptococcus spp. isolation rates according to odontogenic infection group were 22% (group 1), 17.7% (group 3) and 20.7% (group 4). Anaerobic isolation rates were 66.9% (group 1), 71.8% (group 3) and 68.2% (group 4). Drug susceptibility tests were performed on 726 strains excluding 121 strains that were undergrown. The breakdown of the strains subjected to testing was 186 Streptococcus spp., 179 anaerobic gram-positive cocci, 246 Prevotella spp., 27 Porphyromonas spp., and 88 Fusobacterium spp. The isolates were tested against 30 antimicrobial agents. Sensitivities to penicillins and cephems were good except for Prevotella spp. The low sensitivities of Prevotella spp is due to ß-lactamase production. Prevotella strains resistant to macrolides, quinolones, and clindamycin were found. No strains resistant to carbapenems or penems were found among all strains tested. No anaerobic bacterial strain was resistant to metronidazole. Antimicrobial susceptibility testing performed on the S. anginosus group and anaerobic bacteria, which are the major pathogens associated with odontogenic infections, showed low MIC90 values to the penicillins which are the first-line antimicrobial agents for odontogenic infections; however, for Prevotella spp., penicillins combined with ß-lactamase inhibitor showed low MIC90 values.
Assuntos
Antibacterianos , Infecções Bacterianas , Antibacterianos/farmacologia , Antibacterianos/uso terapêutico , Bactérias Anaeróbias , Infecções Bacterianas/tratamento farmacológico , Infecções Bacterianas/epidemiologia , Clindamicina/farmacologia , Clindamicina/uso terapêutico , Farmacorresistência Bacteriana , Humanos , Japão/epidemiologia , Testes de Sensibilidade Microbiana , PenicilinasRESUMO
Docetaxel, cisplatin plus fluorouracil (DCF) regimen is a useful chemotherapy, but is sometimes withdrawn due to severe adverse effects (AE). In this study, we examined whether the chronotherapy of DCF regimen could reduce the drugs-induced toxicities in clinical practice. Patients with oral squamous cell carcinoma were enrolled. Chemotherapy started at 10:30 (Morning-dosing) or 18:30 (Evening-dosing) for 5 days by a cross-over design. AE were assessed for 14 days after an initiation of each dosing. The grades of nausea, vomiting and neutropenia were smaller during Evening-dosing than during Morning-dosing. These data suggest that the chrono-chemotherapy might provide a merit for reducing the DCF regimen-related severe AE.
Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Carcinoma de Células Escamosas/tratamento farmacológico , Cisplatino/uso terapêutico , Esquema de Medicação , Neoplasias Bucais/tratamento farmacológico , Adulto , Idoso , Ritmo Circadiano/efeitos dos fármacos , Cisplatino/administração & dosagem , Estudos Cross-Over , Docetaxel/administração & dosagem , Feminino , Fluoruracila/administração & dosagem , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias Bucais/patologia , Projetos Piloto , Fatores de Tempo , Resultado do Tratamento , Adulto JovemRESUMO
In this clinical report, we present the management of a brain abscess that was presumed to be caused by radiation osteomyelitis of the mandible. The patient underwent chemoradiotherapy for oropharyngeal carcinoma on the left side at the Department of Otolaryngology of our hospital in 2000. Local recurrence or metastasis did not occur post-treatment. In January 2009, the patient was diagnosed with radiation osteomyelitis of the mandible on the left side, complicated by a pathologic fracture. In July 2011, numbness occurred in the left upper extremity and the patient was transferred to the emergency center of our hospital. A computed tomography scan showed a tumor lesion in the brain that was diagnosed as a brain abscess by magnetic resonance imaging. Neurosurgeons performed burr hole drainage of the abscess, followed by administration of antibiotics. Although impaired fine movements of the left hand remain, progress has been relatively favorable with no recurrence of osteomyelitis or brain abscess post-surgery.
Assuntos
Antibacterianos/uso terapêutico , Abscesso Encefálico/tratamento farmacológico , Quimiorradioterapia/efeitos adversos , Doenças Mandibulares/etiologia , Osteomielite/etiologia , Lesões por Radiação/tratamento farmacológico , Abscesso Encefálico/diagnóstico por imagem , Abscesso Encefálico/etiologia , Abscesso Encefálico/cirurgia , Drenagem , Humanos , Imageamento por Ressonância Magnética , Masculino , Mandíbula/efeitos da radiação , Doenças Mandibulares/diagnóstico , Pessoa de Meia-Idade , Neoplasias Orofaríngeas/terapia , Osteomielite/diagnóstico , Lesões por Radiação/diagnóstico por imagem , Lesões por Radiação/cirurgia , Tomografia Computadorizada por Raios X/efeitos adversosRESUMO
A 1-day-old male infant was referred to our department for evaluation of multiple malformations in his oral cavity. He was diagnosed duplication of the pituitary gland-plus syndrome with epignathus, cleft palate, duplication of the mandible, and a lobulated tongue. A thumb-sized mass lesion was visible on the hard palate. The duplicated mandible and lower lip was fused at the midline. The alveolar ridge was protruding through a wide-cleft soft palate involving the uvula. Further examination showed a lobulated tongue, which was seen behind the duplicated part of the mandible. Five days after birth, tracheotomy and epignathus resection were performed. At 7 months of age, the excess tissue of the duplicated mandible was resected at the area of adhesion on the lingual side, and the duplicated tongue and lip were reconstructed. A palatoplasty was performed at 20 months of age. Thereafter, the patient's progress was uneventful, with no abnormality in swallowing. No recurrence of epignathus has been observed during 2 years of follow-up.
Assuntos
Anormalidades Múltiplas/cirurgia , Fissura Palatina/cirurgia , Mandíbula/cirurgia , Neoplasias Palatinas/cirurgia , Hipófise/anormalidades , Teratoma/cirurgia , Língua/cirurgia , Pré-Escolar , Humanos , Lactente , Recém-Nascido , Lábio/anormalidades , Lábio/cirurgia , Masculino , Mandíbula/anormalidades , Palato Duro/patologia , Palato Duro/cirurgia , Palato Mole/anormalidades , Palato Mole/cirurgia , Síndrome , Língua/anormalidadesRESUMO
OBJECTIVE: The purpose of this study was to investigate the relationship between habitual chewing side and perception of the oral mucosa following reconstruction with dental implants. STUDY DESIGN: Five patients comprised 2 males and 3 females, with ameloblastoma in 2 patients, odontogenic myxoma in 2 patients, and oral squamous cell carcinoma in 1 patient. They were treated using mandibular reconstruction with bare bone graft after segmental resection of the mandible. Perception (tactile, warm, and cold) was measured at 8 points (chin, lower lip, gingiva, and lateral edge of the tongue, bilaterally). Habitual chewing side was evaluated using a computerized index, the first chewing cycle, and a question on chewing. RESULTS: Perception on resected sides was improved at all measurement points for tactile and cold sensitive evaluation, although sensitivities on the resected side remained below the normal range. In the relationship between habitual chewing side and implanted prostheses in reconstructed bone, the chewing side was the resected side in 2 of the 5 patients. When those 2 patients underwent prosthesis implantation after removal of denture, the chewing side changed from the nonresected side to the resected side. Implant prostheses on resected side were suggested to contribute to masticatory function. Perception in those patients was incomplete but was improved compared with other patients. When prosthesis implantation is performed on the reconstructed side, the resected side may become the habitual chewing side. CONCLUSIONS: Recovery of perception can influence acquisition of the habitual chewing side.
Assuntos
Transplante Ósseo/métodos , Implantes Dentários , Hábitos , Mandíbula/cirurgia , Reconstrução Mandibular/métodos , Mastigação/fisiologia , Percepção , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Neoplasias Mandibulares/diagnóstico , Neoplasias Mandibulares/cirurgia , Pessoa de Meia-Idade , Mucosa Bucal/fisiologia , Adulto JovemRESUMO
Oral lichen planus (OLP) and oral lichenoid contact lesions (OLCL) are chronic inflammatory mucocutaneous reactions with a risk of malignant transformation that alter the epithelium. OLP and OLCL have similar clinical and histopathological features and it is difficult to distinguish one from the other. Metallic restorations are suspected to generate OLCLs. Trace metal analysis of OLCL specimens may facilitate the discrimination of symptoms and identification of causative metallic restorations. The purpose of this study was to assess OLCL tissue samples for the prevalence of metallic elements derived from dental restorations, and to discriminate OLCL from OLP by using synchrotron radiation-excited X-ray fluorescence analysis (SR-XRF), particle-induced X-ray emission (PIXE), and X-ray absorption fine structure (XAFS). Typical elements of dental materials were detected in the OLCL, whereas no obvious element accumulation was detected in OLP and negative control specimens. The origin of the detected metallic elements was presumed to be dental alloys through erosion. Therefore, our findings support the feasibility of providing supporting information to distinguish OLCL from OLP by using elemental analysis.
Assuntos
Líquen Plano Bucal/metabolismo , Mucosa Bucal/metabolismo , Oligoelementos/metabolismo , Adulto , Ligas Dentárias/efeitos adversos , Feminino , Humanos , Líquen Plano Bucal/induzido quimicamente , Líquen Plano Bucal/patologia , Masculino , Mucosa Bucal/patologiaRESUMO
A case showing reinforcement of the action of warfarin and potassium in a patient administered S-1 is reported.The patient was a 71-year-old man with left upper gingival cancer.He had ventricular tachycardia (VT), hypertrophic cardiomyopathy, and a cerebellar infarction.He underwent a pacemaker implantation, and was administered warfarin.After the operation, in mid-March 2010, he was administered with S-1 and warfarin. However, the international normalized ratio of prothrombin time (PT-INR) increased to an extremely high level of 5.82, and S-1 and warfarin were stopped. They were re-administered at the end of April, and the PT-INR stabilized to approximately 2.
Assuntos
Anticoagulantes/uso terapêutico , Cardiomiopatia Hipertrófica/tratamento farmacológico , Infarto Cerebral/tratamento farmacológico , Neoplasias Bucais/tratamento farmacológico , Neoplasias de Células Escamosas/tratamento farmacológico , Taquicardia Ventricular/tratamento farmacológico , Varfarina/uso terapêutico , Idoso , Antimetabólitos Antineoplásicos/uso terapêutico , Cardiomiopatia Hipertrófica/complicações , Infarto Cerebral/complicações , Combinação de Medicamentos , Interações Medicamentosas , Humanos , Masculino , Neoplasias Bucais/complicações , Neoplasias de Células Escamosas/complicações , Ácido Oxônico/uso terapêutico , Taquicardia Ventricular/complicações , Tegafur/uso terapêuticoRESUMO
The effects of dissolved elements from metal dental restorations are a major concern in lesions of the oral mucosa, and the evaluation of accumulated metal elements, especially their distribution and chemical state, is essential for determining the precise effects of trace metals. In this study, X-ray fluorescence with synchrotron radiation (SR-XRF) and particle-induced X-ray emission (PIXE) were applied for distribution analysis of the trace metal elements contained in the oral mucosa, and the chemical states of the elements were estimated using X-ray absorption fine structure (XAFS) analysis. Appropriate combination of these analysis techniques, particularly SR-XRF and PIXE, to visualize the distributions of the elements in the oral mucosa allowed for the observation and evaluation of accumulated metal ions and debris. Importantly, the analyses in this study could be carried out using conventional histopathological specimens without damaging the specimens. Therefore, this method would be applicable for the detection of accumulated trace metal elements in biopsy specimens from the oral mucosa.
Assuntos
Mucosa Bucal/metabolismo , Espectrometria por Raios X/métodos , Oligoelementos/análise , Adulto , Feminino , Humanos , Técnicas In Vitro , Masculino , Pessoa de Meia-IdadeRESUMO
OBJECTIVE: To clarify whether intraoral ultrasonography (I-US) is effective for predicting metastasis of tongue cancer to the cervical lymph nodes. STUDY DESIGN: Participants comprised 29 patients with tongue carcinoma classified as T1-T4 using the TNM staging system. All patients underwent I-US preoperatively. Postoperatively, resected specimens were evaluated histopathologically. RESULTS: I-US found that cases with invasive depth ≥3 mm had higher potential for cervical lymph node metastasis than those with invasive depth <3 mm (P < .05). No other significant relationships were identified between observations on I-US and cervical lymph node metastasis. Cases with histopathologic blood vessel infiltration or lymph duct infiltration had a significant difference in risk of cervical lymph node metastasis. CONCLUSIONS: I-US is useful for preoperatively assessing the invasive depth of tongue carcinoma. Furthermore, observations from I-US and invasive depth of the tumor allowed presumptive diagnosis with regard to cervical lymph node metastasis.
Assuntos
Neoplasias da Língua/diagnóstico por imagem , Neoplasias da Língua/patologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Metástase Linfática/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Valor Preditivo dos Testes , UltrassonografiaRESUMO
PURPOSE: Gastrointestinal integrity and immune surveillance are affected by stress. Stress also adversely affects mucosal barrier function. ß-defensins constitute an integral component of the innate immune system as antimicrobial peptides, serving as the first line of defense against microbial pathogens at the epithelial surfaces of the upper digestive mucosa. The primary objective of this study was to determine the effects of stress on the expression profile of mouse ß-defensin-3 in the upper digestive mucosa of mice with diabetes. MATERIALS AND METHODS: We established a mouse model of restraint stress by using NSY/Hos mice with type 2 diabetes mellitus. We used real-time polymerase chain reaction, in situ hybridization, and immunohistochemistry to investigate the effects of stress and glucocorticoid administration on mouse ß-defensin-3 expression in the upper digestive mucosa of the gingiva, esophagus, and stomach. RESULTS: Mouse ß-defensin-3 mRNA expression was higher in the esophagus than in the gingiva or stomach (p<0.05). In the esophagus, mouse ß-defensin-3 mRNA expression was lower in stressed mice than in non-stressed mice (p<0.05). Furthermore, immunoreactivity to mouse ß-defensin-3 protein was lower in the esophagus of stressed mice than non-stressed mice, consistent with the results of mRNA expression analysis. Systemic glucocorticoid administration also downregulated esophageal mouse ß-defensin-3 mRNA expression. CONCLUSION: Our novel findings show that stress decreases mouse ß-defensin-3 expression in the esophagus of mice with diabetes, possibly due to increased endogenous glucocorticoid production. It appears to be highly likely that stress management may normalize mucosal antimicrobial defenses in patients with diabetes.
Assuntos
Diabetes Mellitus Tipo 2/metabolismo , Mucosa Gástrica/metabolismo , Estresse Psicológico/metabolismo , beta-Defensinas/genética , beta-Defensinas/metabolismo , Animais , Glicemia/metabolismo , Corticosterona/sangue , Diabetes Mellitus Experimental/metabolismo , Esôfago/efeitos dos fármacos , Esôfago/metabolismo , Mucosa Gástrica/efeitos dos fármacos , Regulação da Expressão Gênica/efeitos dos fármacos , Gengiva/efeitos dos fármacos , Gengiva/metabolismo , Glucocorticoides/farmacologia , Masculino , Camundongos , Reação em Cadeia da Polimerase em Tempo Real , Estômago/efeitos dos fármacos , Estresse Fisiológico/fisiologiaRESUMO
Fanconi anemia is a congenital syndrome characterized by hypoplasia of bone marrow and the development of aplastic anemia in childhood, followed by myelodysplastic syndrome and acute myelogenous leukemia in later life. We report here a patient first diagnosed with Fanconi anemia at age 10. Bone marrow transplantation was performed at age 23 and repeated after an episode of rejection at age 25. Hematologic findings returned to normal, but chronic graft-versus-host disease persisted. Esophageal cancer developed at age 35. Invasion of the bronchus and aorta by the tumor was suspected on computed tomography. Chemoradiotherapy was administered to down-stage the tumor, using low-dose cisplatin and 5-fluorouracil. After two courses of chemotherapy with cisplatin (total dose, 100 mg) and 5-fluorouracil (5000 mg) plus radiotherapy (30 Gy), Grade 3 diarrhea and bone marrow suppression developed, and treatment was discontinued. After resolution of toxicity, a good response to the neoadjuvant therapy was seen on computed tomography scan, and a subtotal esophagectomy was performed which demonstrated a complete response in the resected specimen. However, tongue cancer developed at age 40 years, and hemiglossectomy was performed. Patients with Fanconi anemia have a high risk of developing esophageal cancer while they are still young. Reduced doses of alkylating agents and radiotherapy are used in patients with Fanconi anemia. However, the optimal dosage of chemoradiotherapy and the treatment strategy for esophageal cancer in patients with Fanconi anemia remain unclear, and outcomes are generally extremely poor. In this patient, esophageal cancer associated with Fanconi anemia responded well to multidisciplinary therapy.
Assuntos
Carcinoma de Células Escamosas/terapia , Neoplasias Esofágicas/terapia , Anemia de Fanconi/complicações , Adulto , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Biópsia , Transplante de Medula Óssea , Carcinoma de Células Escamosas/diagnóstico , Carcinoma de Células Escamosas/etiologia , Carcinoma de Células Escamosas/patologia , Criança , Cisplatino/administração & dosagem , Terapia Combinada , Neoplasias Esofágicas/diagnóstico , Neoplasias Esofágicas/etiologia , Neoplasias Esofágicas/patologia , Esofagectomia , Anemia de Fanconi/terapia , Feminino , Fluoruracila/administração & dosagem , Humanos , Estadiamento de Neoplasias , Dosagem Radioterapêutica , Tomografia Computadorizada por Raios X , Neoplasias da Língua/patologia , Neoplasias da Língua/secundárioRESUMO
Six patients with advanced oral squamous cell carcinoma were treated with preoperative concurrent chemoradiotherapy. Chemotherapy consisting of CDDP(60 to 70 mg/m(2), day 1)and 5-FU(600 to 700 mg/m(2), day 1 to 5)with concurrent radiotherapy was accelerated hyperfractionation to target volume of 43-63 Gy. The clinical effect of this therapy on the primary tumor and cervical lymph node was examined in patients who visited our university hospital from 1994 to 2004. The five untreated and one recurrence patients were 3 males and 3 females. Their ages ranged from 23 to 76 years. The primary sites were the tongue in 3, lower gingiva in 2, and upper gingiva in 1 patient(s). Five cases were in advanced Stage IVA and 1 case in Stage III. The preoperative clinical responses of primary tumor: 1 case showed a complete response(CR). The response rate was 100%. We did not operate the case because of CR. Histological effect of the primary tumor(according to the grading system of Ohboshi and Shimosato): 2 patients were CR. Pathological CR rate of primary site was 33%. However, the CR rate of the metastatic lymph nodes was 0%. In terms of adverse effects, all cases developed nausea, mucositis and leucopenia. The most severe were leucopenia(Grade III), sepsis and DIC. This combination chemoradiotherapy has been proven to be very histologically effective for the primary tumor.
Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Carcinoma de Células Escamosas/tratamento farmacológico , Carcinoma de Células Escamosas/radioterapia , Cisplatino/uso terapêutico , Fluoruracila/uso terapêutico , Neoplasias Bucais/tratamento farmacológico , Neoplasias Bucais/radioterapia , Adulto , Idoso , Antígenos de Neoplasias/sangue , Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos , Biomarcadores Tumorais/sangue , Carcinoma de Células Escamosas/sangue , Carcinoma de Células Escamosas/patologia , Cisplatino/efeitos adversos , Terapia Combinada/efeitos adversos , Feminino , Fluoruracila/efeitos adversos , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias Bucais/sangue , Neoplasias Bucais/patologia , Estadiamento de Neoplasias , Prognóstico , Serpinas/sangueRESUMO
A case of epignathus combined with cleft palate, lobulated tongue, and lingual hamartoma is reported. A newborn female presented with a large skin-covered mass arising from the palate, cleft palate, and lobulated tongue with a soybean-sized lingual lesion. The palatal and lingual masses were removed on the 9th day after birth. A cystic lesion was also found on the nasal septum after removal of the palatal mass; this lesion was resected at its base. Glossoplasty was performed after excision of the lingual lesion. Histologically, the palatal mass was diagnosed as epignathus. The cystic lesion was suspected to be meningothelial tissues on the basis of hematoxylin-eosin (HE) and immunohistochemical staining: Vimentin and epithelial membrane antigen were positive, and factor VIII was negative. The mass of the tongue dorsum was diagnosed as hamartoma. No recurrence of epignathus or evidence of meningocele have been observed after 5 years of follow up.
Assuntos
Fissura Palatina/complicações , Hamartoma/complicações , Neoplasias Palatinas/complicações , Teratoma/complicações , Neoplasias da Língua/complicações , Anormalidades Múltiplas , Fissura Palatina/patologia , Feminino , Hamartoma/congênito , Hamartoma/patologia , Humanos , Recém-Nascido , Neoplasias Palatinas/congênito , Neoplasias Palatinas/patologia , Palato Duro/anormalidades , Teratoma/congênito , Teratoma/patologia , Língua/anormalidades , Neoplasias da Língua/congênito , Neoplasias da Língua/patologiaRESUMO
Human beta-defensin 3 (hBD-3), an antimicrobial peptide, is produced by various epithelial and some nonepithelial tissues. hBD-3 mRNA is widely expressed in oral tissues, including oral epithelium and the salivary glands. Although the localization of hBD-1 and hBD-2 has been well demonstrated in tissue sections, the localization pattern of hBD-3 has not yet been shown. In the present study, we investigated the expression pattern of hBD-3 mRNA by in situ hybridization using specific RNA probes; the signal for hBD-3 was detected in upper spinous and granular layers in normal oral epithelium. In cases of leukoplakia, a strong signal of hBD-3 mRNA was observed in the granular layer. In lichen planus, the signal was strongly detected in the spinous and suprabasal layers. The signals were stronger than those of either normal oral epithelium or leukoplakia. The results indicate that the localization pattern of hBD-3 is very similar to that of hBD-2. hBD-2 and hBD-3 may function together or compensate each other for expressional loss.
Assuntos
Leucoplasia Oral/metabolismo , Líquen Plano Bucal/metabolismo , Mucosa Bucal/metabolismo , RNA Mensageiro/genética , RNA Mensageiro/metabolismo , beta-Defensinas/genética , Sequência de Bases , DNA/genética , Epitélio/anatomia & histologia , Epitélio/metabolismo , Expressão Gênica , Humanos , Hibridização In Situ , Leucoplasia Oral/patologia , Líquen Plano Bucal/patologia , Mucosa Bucal/anatomia & histologiaRESUMO
We investigated the clinical and histopathologic features of 26 cases of mucocele of the glands of Blandin-Nuhn. There was a female predominance, and most patients were younger than 20 years. Fifteen patients first visited a medical doctor and 9 visited a dentist before being referred to our department. The average duration from the time the lesion was first noticed to the patient's visit was 3.6 months. All lesions were located on the ventral surface of the tongue. In 17 patients, mucoceles were seen at the tip of the tongue, whereas 9 lesions occurred more posteriorly. Lesions were situated at the midline in 19 patients and laterally in 7 patients. All lesions presented as an exophytic mass, often with a polypoid appearance. All mucoceles were histopathologically of the extravasation type, suggesting that trauma may represent a frequent initiating factor.
Assuntos
Mucocele/patologia , Doenças das Glândulas Salivares/patologia , Glândulas Salivares Menores/patologia , Doenças da Língua/patologia , Adolescente , Adulto , Fatores Etários , Criança , Pré-Escolar , Feminino , Tecido de Granulação/patologia , Humanos , Masculino , Recidiva , Fatores Sexuais , Fatores de TempoRESUMO
A 55-year-old Japanese woman presented with recurrent multiple vesicles on the soft palate. Some vesicles ruptured spontaneously but soon recurred, and the patient felt mild pain and discomfort. Histopathologically, intraepithelial mucocele with mucus retention in the salivary ducts was observed. The lesion was successfully treated with Nd: YAG Contact Laser. There has been no recurrence for 3 years.
Assuntos
Doenças da Boca/patologia , Mucocele/patologia , Palato Mole/patologia , Feminino , Humanos , Terapia a Laser , Pessoa de Meia-Idade , Doenças da Boca/cirurgia , Mucocele/cirurgia , Neodímio , Palato Mole/cirurgia , RecidivaRESUMO
Human beta defensin 2 (hBD-2) is a major antimicrobial peptide that is produced by many types of epithelial cells, and is transcriptionally inducible by various proinflammatory agents, such as cytokines and bacteria. Although in vitro studies of the hBDs in oral epithelial cells have been well documented, only little is known about the in vivo pathological state of oral epithelium. We investigated the localization of hBD-2 peptide in tissue sections of oral lichen planus, leukoplakia, candidal leukoplakia and radicular cysts using immunohistochemistry. HBD-2 was stained in both the hyperkeratinized and the granular layers in cases of lichen planus with hyperkeratosis and leukoplakia. Expression in spinous and suprabasal layers was often strong in lichen planus. There were no significant differences in the number of S-100 positive dendritic cells between the widely stained areas and those with limited staining areas in lichen planus. In cases of candidal leukoplakia, the hyphae of candida were mainly detected on the surface of keratinization, which showed only negative or faint staining for hBD-2. These results suggest that hBD-2 is vigorously induced by lichen planus-related inflammation and that it plays an important role in protection from Candida albicans infection; however, it is not a strong chemotactic attractant for Langerhans cells in pathological conditions of oral epithelium.