Influence of experimental palatal plate on mandibular position during continuous [n] phonation and at the physiologic rest position.

The purpose of this study was to clarify the influence of an experimental palatal plate on the mandibular position during continuous [n] phonation and at the physiologic rest position. Twenty healthy dentulous volunteers (10 males and 10 females, mean age of 24.4 years) were investigated. Three kinds of experimental plate with a thickness of 3 mm, 5 mm, and 8 mm were fabricated and used for each subject. The mandibular position was recorded by a K7 kinesiograph during continuous [n] phonation and at the physiologic rest position under normal conditions and when the three kinds of plate with different thickness were worn separately. The results showed that the mean interocclusal dimensions during continuous [n] phonation were 0.5 mm vertically and 0.4 mm anteroposteriorly under the normal condition. After insertion of an experimental plate, the interocclusal distance increased a little, but the difference was not statistically significant between the normal condition and any of the three experimental conditions. No significant difference was found between the male and female groups. Furthermore, no significant difference in the interocclusal distance at the physiologic rest position was found between the above comparisons. Within the limitations of this study, we concluded that the mandibular position during continuous [n] phonation and at the physiologic rest position was not significantly influenced by the experimental plates.

[An adenocarcinoma arising from the urinary bladder 37 years after bladder augmentation using the ileum].

A 57-year-old man had undergone right nephrectomy at 10 years of age and bladder augmentation using the ileum at 20 years for treatment of urinary tract tuberculosis. He also had undergone intermittent catheterization after a traffic accident at 49 years of age. He presented at another hospital with a complaint of asymptomatic macroscopic hematuria. Cystoscopy revealed a lobulated tumor in the bladder. Transurethral resection of bladder tumor was performed, but complete resection was difficult. Histopathological examination of the specimen revealed a well differentiated adenocarcinoma. He was referred to our hospital for total cystectomy and percutaneous left nephrostomy. The tumor arose from the bladder wall near the anastomotic site between the bladder and the ileal segment. Histopathological examination revealed a well differentiated adenocarcinoma infiltrating into the muscle layer (pT2a). Postoperatively, he has been free of recurrence for one year. This is the 19th case of adenocarcinoma following bladder augmentation using the ileum reported in the Japanese literature.

Influence of experimental palatal plate on mandibular position during continuous phonation of [n].

PURPOSE: This study aimed to determine the influence of the thickness of a palatal plate on the mandibular position during continuous phonation of the sound [n]. METHODS: Eleven healthy volunteers (10 males and 1 female; 24-36 years of age, mean age 26.4 years) were recruited from dental students. They were instructed to pronounce [n] continuously under six conditions: wearing a palatal plate with a thickness of 0.3, 1.5, 3.0, 5.0, and 10.0mm, and without a plate (control). Mandibular movement during pronunciation was simultaneously recorded by a K-7 mandibular kinesiograph. Their mandibular positions in the physiologic rest position were also recorded. The distance between the incisal edge of maxillary and mandibular anterior teeth both in vertical and antero-posterior directions during continuous phonation of [n] (interocclusal distance) under all six conditions were measured and compared. RESULTS: Interocclusal distance tended to increase in both vertical and antero-posterior directions as the thickness of the palatal plates increased. There were statistically significant differences in the mandibular position both in vertical and antero-posterior directions during continuous phonation of [n] between the control condition and those wearing a palatal plate with a thickness of 10.0mm. CONCLUSION: The mandibular position determined by the phonetic method employing continuous [n] as a test pronunciation was affected by the thickness of the palatal plates inserted into the mouth. However, its influence was not significant when the thickness of the palatal plates was 5mm or less.

[Prostate cancer in a relatively young adult: a case report].

We report a case of prostate cancer in a 45-year-old. The patient was found to have an elevated prostate specific antigen (PSA) level at a general health check and was referred to our division. Serum level of PSA was 6.9 ng/ml. Digital rectal examination and magnetic resonance imaging revealed a small nodule on the right lobe. Transperineal needle biopsy of the prostate revealed adenocarcinoma at the bilateral lobe (Gleason score 3+4). Computed tomography and a bone scan showed no evidence of metastasis. The patient was diagnosed as cT2b, NO, MO, and underwent a radical prostatectomy. Patients younger than 45 with prostate cancer are rare, although the incidence of prostate cancer is increasing. Here, 25 cases previously reported in Japan in addition to the present case, are reviewed.

[A case of synchronous ipsilateral renal cell carcinoma and renal pelvic urothelial carcinoma (collision tumor): a case report].

A 54-year-old woman consulted our hospital with the complaint of microscopic hematuria and proteinuria. Abdominal computed tomographic scan revealed a tumor mass on the lower pole of the left kidney. Left radical nephrectomy was performed under the diagnosis of renal cell carcinoma. The pathological diagnosis was a collision tumor consisting of renal cell carcinoma (clear cell type, G3, INFalpha, pT1b, v -) and urothelial carcinoma of the renal pelvic (G3 >> G2, pT3, ly + , v +). Postoperative chemotherapy was not given. Convalescence was uneventful and one year after the operation she is alive with no recurrence or metastasis.

[A case of emphysematous cystitis: a case report].

A 86-year-old woman presented with asymptomatic gross hematuria,and visited our hospital, and a vesicorectal fistula was suspected from a computed tomographic (CT) scan. She had a lower abdominal mass and urinary retention on arrival. Pclvic CT demonstrated intramural gas in the urinary bladder,which suggested a diagnosis of emphysematous cystitis. Cystoscopy demonstrated reddish mucosa and gas within the bladder wall. The gross hematuria was improved and the intramural gas disappeared on a CT scan after urinary drainage and antibiotic therapy. Although emphysematous cystitis is almost always cured with conservative therapy, an accurate diagonosis and prompt treatment are required because rarely emphysematous cystitis can result in rupture of the urinary bladder and lead to septic shock.

[Prostatic duct adenocarcinoma with pagetoid spread on the glans penis: a case report].

A 75-year-old male visited our division with asymptomatic erythema on the glans penis which he first noticed six months earlier. The patient underwent total cystoprostatectomy under the diagnosis of urothelial carcinoma of the urinary bladder four years earlier. At the time, the prostatectomy specimen incidentally revealed a prostatic acinar adenocarcinoma at the bilateral peripheral zone. A skin biopsy of the erythema revealed intraepithelial Paget's cells, and the patient underwent total penectomy under the diagnosis of extramammary Paget's disease. Histopathological examination revealed continuous intraepithelial Paget's cells from the glans penis to the urethral navicular fossa, and a ductal carcinoma was detected beneath the urethral mucosa to the excisional margin. Because the Paget's cells expressed cytokeratin 20, the tumor was diagnosed as Pagetoid spread rather than Paget's disease. Re-examination of the previous prostatectomy specimen revealed prostatic duct adenocarcinoma with prostatic acinar adenocarcinoma. Therefore, the final diagnosis was prostatic duct adenocarcinoma with Pagetoid spread to the glans penis. Follow up at nine months revealed neither local recurrence, nor distant metastases, although no adjuvant therapy has been given.

[A case of CA19-9 producing transitional cell carcinoma of the ureter].

We report a case of CA19-9 producing urothelial carcinoma of the right ureter. A 61-year-old male patient who had an extremely high value of serum CA19-9 (1,185 U/ml) with right hydronephrosis was referred to us. Magnetic resonance urography and retrograde ureterography revealed a long irregular filling defect in the right distal ureter. Under the diagnosis of right ureteral tumor, we performed right total nephroureterectomy and pelvic lymphadenectomy. The tumor was histologically diagnosed as grade 1 transitional cell carcinoma and pelvic lymphnodes were positive (pT1N2M0). The tumor cells showed positive immunostaining for CA19-9. The serum CA19-9 level was normalized after the operation and successive adjuvant chemotherapy (M-VAC 2 course). No recurrence was found for 15 months after operation. In this case, the serum CA19-9 level was useful as a tumor marker.

Small GTPase Rah/Rab34 is associated with membrane ruffles and macropinosomes and promotes macropinosome formation.

Macropinocytosis is an efficient process for the uptake of nutrients and solute macromolecules into cells from the external environment. Macropinosomes, which are surrounded by actin, are formed from the cell surface membrane ruffles and migrate toward the cell center. We have cloned the entire coding sequence of a member of the Rab family small GTPases, Rah/Rab34. It lacked a consensus sequence for GTP-binding/GTPase domain. Although wild-type Rah exhibited extremely low GTPase activity in vitro, it exerted appreciable GTPase activity in vivo. In fibroblasts, Rah was colocalized with actin to the membrane ruffles and membranes of relatively large vesicles adjacent to the ruffles. These vesicles were identified as macropinosomes on the basis of several criteria. Rah and Rab5 coexisted in some, but not all, macropinosomes. Rah was predominantly associated with nascent macropinosomes, whereas Rab5 was present in endosomes at later stages. The number of macropinosomes in the cells overexpressing Rah increased about 2-fold. The formation of macropinosomes by the treatment of platelet-derived growth factor or phorbol ester was also facilitated by Rah but suppressed by a dominant-negative Rah. Rah-promoted macropinosome formation was retarded by dominant-negative mutants of Rac1 and WAVE2, which are essential for membrane ruffling. These results imply that Rah is required for efficient macropinosome formation from the membrane ruffles.