論文 - 莇生田　整治

Clinical value of 3D SPECT/CT imaging for assessing jaw bone invasion in oral cancer patients

Miyashita H., Nakahara T., Asoda S., Kameyama K., Kawaida M., Enomoto R., Shiba H., Jinzaki M., Kawana H., Nakagawa T.

Journal of Cranio-Maxillofacial Surgery （Journal of Cranio-Maxillofacial Surgery）  47 （ 7 ） 1139 - 1146 2019年07月

ISSN  10105182

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© 2019 European Association for Cranio-Maxillo-Facial Surgery Purpose: This study compared the diagnostic accuracy of jaw bone invasion (JBI) of oral cancer observed with three-dimensional (3D) SPECT/CT, CT, and MRI, and evaluated the clinical advantages of 3D SPECT/CT compared to conventional two-dimensional (2D) SPECT/CT. Materials and methods: From April 2014 to January 2018, consecutive 16 oral cancer patients with suspected JBI, who had preoperatively undergone the imaging tests, were retrospectively enrolled. The likelihood of JBI was independently scored by a radiologist and oral surgeon. Using 2D or 3D SPECT/CT images, 20 oral surgeons delineated virtual surgical areas on 3D-printed jaws for 3 cases in which the extent of JBI was fully pathologically confirmed. The surgeons completed questionnaires regarding surgical planning and explanations for patients using Likert scales. Results: JBI was found in 9 patients including 5 (56%) with initial bone invasion. 3D SPECT/CT showed very high negative predictive value (100%) and inter-observer agreement (kappa = 0.917). 3D SPECT/CT was more sensitive than CT and MRI when inconclusive findings for JBI were considered negative. Compared to 2D SPECT/CT, 3D SPECT/CT had greater clinical advantages such as surgical planning and explanation to patients (p < 0.005). Conclusion: 3D SPECT/CT is useful not only for detecting JBI but also for surgical planning.

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Acute odontogenic infection combined with crowned dens syndrome: A case report

Soma T., Asoda S., Kimura M., Munakata K., Miyashita H., Nakagawa T., Kawana H.

Journal of Medical Case Reports （Journal of Medical Case Reports）  13 （ 1 ）  2019年05月

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© 2019 The Author(s). Background: Calcium pyrophosphate dihydrate crystal deposition disease is a condition in which calcium pyrophosphate dihydrate crystal is deposited in joint cartilage and ligaments. Calcium pyrophosphate dihydrate crystal deposition disease that involves calcification around the odontoid process of the second cervical vertebra is called crowned dens syndrome. Crowned dens syndrome is accompanied by fever in addition to acute and intense neck, posterior head, and temporal pain; thus, distinguishing crowned dens syndrome may be difficult in the presence of odontogenic infection. To the best of our knowledge, this is the first report describing a patient with crowned dens syndrome with coexisting odontogenic infection. Case presentation: A 75-year-old Japanese woman was examined in the Emergency Department of this hospital due to a chief complaint of worsened buccal swelling on the left side. An odontogenic infection was considered, and she underwent her first examination. She presented with a body temperature of 37.4 °C, marked swelling and tenderness of her left lower eyelid through to her left cheek, and pain on the left temporal area. Blood tests revealed a leukocyte count of 6700/μL and a C-reactive protein level of 7.15 mg/dL. There was swelling and pain around the gingiva and acute purulent apical periodontitis of left maxillary second premolar. Cellulitis of the left cheek was diagnosed. After performing drainage of the pus, antibiotic treatment was initiated. Although her clinical symptoms improved, blood tests on day 9 of hospitalization revealed a leukocyte count of 6500/μL and a C-reactive protein level of 25.62 mg/dL, which were indicative of worsening symptoms. Computed tomography was performed to evaluate remote infection and images revealed a calcification around the odontoid process of her second cervical vertebra. When she was referred to the Orthopedic Surgery Department, pseudogout of the cervical spine was diagnosed. Subsequently, oral acetaminophen was initiated, and both her leukocyte count and C-reactive protein improved markedly. Conclusions: In the presence of persistent fever and abnormally high leukocyte and C-reactive protein indicative of an inflammatory reaction, coexistence of pseudogout should be considered. In particular, when symptoms of temporal pain are present, the possibility of pseudogout of the cervical spine must be considered in the differential diagnosis.

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A case of spindle cell/pleomorphic lipoma on inferior border of the mandible

Munakata K., Asoda S., Usuda S., Miyashita H., Soma T., Hasegawa T., Ogawa C., Ohyama S., Yamauchi T., Kawaida M., Kameyama K., Nakagawa T., Kawana H.

Journal of Oral and Maxillofacial Surgery, Medicine, and Pathology （Journal of Oral and Maxillofacial Surgery, Medicine, and Pathology）  2019年

ISSN  22125558

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© 2019 Asian AOMS(+) ASOMP(+) JSOP(+) JSOMS(+) JSOM(+) and JAMI Spindle cell lipomas and pleomorphic lipomas are uncommon and distinct variants of benign lipomas. Although spindle cell lipomas and pleomorphic lipomas were originally considered different entities, the recent WHO classification defines them as spindle cell/pleomorphic lipoma (SCL/PL). This is because of their similar clinical features and the existence of intermediate histopathological features between them. A 77-year-old male presented to our clinic with a painless swelling on the left inferior border of the mandible. Computed tomography revealed a clearly defined mass in the subcutaneous lesion. With a histopathological diagnosis of myxolipoma, demonstrated by biopsy, excisional surgery was performed under general anesthesia. The histopathology revealed SCL/PL with the presence of spindle cells and mature adipocytes. No tumor recurrence had been noted at two year after surgery.

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The effect of improving oral hygiene through professional oral care to reduce the incidence of pneumonia post-esophagectomy in esophageal cancer

Yamada Y., Yurikusa T., Furukawa K., Tsubosa Y., Niihara M., Mori K., Asoda S., Kawana H., Kitagawa Y., Nakagawa T.

Keio Journal of Medicine （Keio Journal of Medicine）  68 （ 1 ） 17 - 25 2019年

ISSN  00229717

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© 2018 by The Keio Journal of Medicine. Radical esophagectomy for thoracic esophageal cancer is invasive and frequently results in postoperative pulmonary complications. Postoperative pneumonia is the most common such complication and affects hospital mortality and survival rates. Oral care has been very effective in reducing pneumonia. In Japan, preoperative professional oral care is highly recommended. However, there are few studies on the effect of preoperative improvements in oral hygiene as a result of intervention on the incidence of postoperative pneumonia. The primary end-point of this retrospective study was the incidence of postoperative pneumonia after radical esophagectomy. The oral health levels of 46 patients were individually categorized, and then patients were grouped according to whether they maintained or improved their oral hygiene. At the first dental examination, oral health levels were classified as good in 22 patients and bad in 24. Of the 46 patients studied, 39 patients maintained or improved their oral hygiene (good control group), whereas 7 showed no improvement (bad control group). Postoperative pneumonia occurred in eight patients: four in the good control group and four in the bad control group. Statistical analysis with postoperative pneumonia as a dependent variable showed a significant effect of oral hygiene improvement on the incidence of pneumonia. Logistic regression analysis with this factor as an independent variable demonstrated that the risk of postoperative pneumonia was reduced in the good control group (OR 0.086, 95% CI 0.014-0.529). Therefore, preoperative professional oral care may improve oral hygiene and oral health, which may in turn reduce the incidence of postoperative pneumonia.

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Clinical investigation of α1-antitrypsin and lactoferrin in gingival sulcus fluid from elderly patients—A preliminary report

Uchiyama K., Kotani K., Kato T., Asoda S.

Oral Science International （Oral Science International）  2019年

ISSN  13488643

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© 2019 The Authors. Oral Science International published by John Wiley & Sons Australia, Ltd on behalf of JapaneseStomatological Society. Objectives: To compare levels of α1-antitrypsin (AT) and lactoferrin (LF) in gingival crevicular fluid (GCF) and on the tongue and determine whether MATATACORO® (MA-T), a stabilized chlorine dioxide solution, affects GCF AT and LF levels. Methodology: The α1-antitrypsin and lactoferrin levels in GCF and on the tongue were measured for 18 elderly patients (mean age: 83 years) and correlations were analyzed. AT and LF levels in GCF were assessed before and 1 hr after treatment with MA-T. Results: The α1-antitrypsin and lactoferrin levels were lower on the tongue than in GCF (median 0.6, 0.4 μg/mL vs median 2.4, 3.6 μg/mL). The respective AT and LF levels in GCF and on the tongue were positively correlated (AT: r =.43, LF: r =.69). GCF AT and LF levels were reduced following MA-T treatment (AT: median 3.6 and 1.9 μg/mL and LF: 2.3 and 0.4 μg/mL pre- and post-treatment, respectively; both P <.01). Conclusion: The α1-antitrypsin and lactoferrin levels in GCF were higher than those on the tongue, but AT and LF were detectable for both sampling types. The reduction in GCF AT and LF levels after MA-T treatment suggests that MA-T could be used to control periodontal inflammation.

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Targeting the Tumor Stroma for Oral Cancer Therapy

Takehito Ouchi, Satoru Morikawa, Seiji Asoda

Modern Research in Dentistry 2019年

共著, 査読有り

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口腔に初発症状を認めた骨髄肉腫の1例

矢島祥助, 安居孝純, 軽部健史, 佐藤仁, 莇生田整治, 鬼澤勝弘

日本口腔外科学会雑誌 （日本口腔外科学会）  65 （ 3 ） 229 - 233 2019年

研究論文（学術雑誌）, 共著, 査読有り

未萌出小臼歯の中心結節破折に継発した蜂窩織炎の1例

軽部健史, 臼田慎, 遠藤友樹, 莇生田整治, 宮下英高, 安井佑太, 鬼澤勝弘, 安居孝純, 矢郷香, 木津英樹

日本小児口腔外科学会雑誌 （日本小児口腔外科学会）  29 （ 3 ） 260 - 265 2019年

研究論文（学術雑誌）, 共著, 査読有り

本態性血小板血症患者に発生した口底癌の1例

長谷川稔洋, 宗像花楠子, 小川千晴, 家崎憲博, 莇生田整治, 宮下英高, 相馬智也, 福田仁, 吉田俊一, 内田育宏, 寺尾保信, 大山定男

日本口腔腫瘍学会雑誌 （日本口腔腫瘍学会）  30 （ 4 ） 159 - 166 2018年12月

研究論文（学術雑誌）, 共著, 査読有り

A case of platelet transfusion refractoriness occurring after platelet transfusion for tooth extraction in myelodysplastic syndromes patient

Soma T., Asoda S., Iwasaki R., Miyashita H., Inoue M., Yamada Y., Uchiyama K., Nakagawa T., Kawana H.

Journal of Oral and Maxillofacial Surgery, Medicine, and Pathology （Journal of Oral and Maxillofacial Surgery, Medicine, and Pathology）  30 （ 6 ） 496 - 499 2018年11月

ISSN  22125558

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© 2018 Asian AOMS(+) ASOMP(+) JSOP(+) JSOMS(+) JSOM(+) and JAMI Myelodysplastic syndrome is an acquired hematopoietic disorder showing symptoms of pre-leukemia and refractory anemia. In the tooth extraction process of such cases, bleeding tendency due to pancytopenia, infection etc., becomes a problem. As such, a cautious approach is required. We have confirmed platelet transfusion refractoriness prior to tooth extraction in a myelodysplastic syndrome patient, and hereby report a case of tooth extraction following human leukocyte antigen (HLA)-compatible concentrated platelet transfusion. The patient was a 55-year-old female who was examined at our department due to a request for the extraction of tooth No. 36. Following consultation at the Hematology Department, platelet transfusion was performed as a pretreatment upon hospitalization. Increased body temperature, chills, shivers, and feelings of discomfort in the pharynx were observed. A close examination was performed due to a lack of increase in platelet count, and revealed platelet transfusion refractoriness caused by anti-HLA antibodies. Therefore, the patient was re-hospitalized and transfused with a platelet concentrate-HLA preparation. One hour later, an increase in platelet count was confirmed and the tooth extraction was performed. There was no evidence of bleeding or infection following extraction, and the prognosis was good.

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Recurrent Spindle Cell Carcinoma Shows Features of Mesenchymal Stem Cells

Ouchi T., Morikawa S., Shibata S., Takahashi M., Yoshikawa M., Soma T., Miyashita H., Muraoka W., Kameyama K., Kawana H., Arima Y., Saya H., Okano H., Nakagawa T., Asoda S.

Journal of Dental Research （Journal of Dental Research）  97 （ 7 ） 779 - 786 2018年07月

研究論文（学術雑誌）, 共著, 査読有り,  ISSN  00220345

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© 2018, International & American Associations for Dental Research. This study investigated a case of spindle cell carcinoma (SpCC) in tongue pathological lesions. The patient experienced a local recurrence and distant metastasis after surgical intervention. Although standard chemotherapy was administered, a granulomatous mass continued to develop. This aggressive growth led to survival of the tumor. Secondary debulking surgery was performed to improve the patient’s quality of life at the request of the patient. Using a tissue sample derived from the secondary debulking surgery, we performed an analysis of the tumor’s cell surface antigens, differentiation potential, metastatic ability, and inhibition potential by anticancer reagents. In vitro analysis revealed that the cell population grown under adherent culture conditions expressed the mesenchymal stem cell (MSC) markers CD73, CD90, and CD105. The cell line established from this SpCC contained colony-forming unit fibroblasts (CFU-Fs) and exhibited multipotent differentiation into several mesenchymal lineages, including bone, cartilage, and fat. The SpCC cells also displayed vigorous mobilization. These characteristics suggested that they had the differentiation potential of mesenchymal cells, especially MSCs, rather than that of epithelial cells. The surgical specimen analyzed in this study resisted the molecular target reagent cetuximab, which is an epidermal growth factor receptor inhibitor. This clinical insight revealed that chemotherapy-resistant SpCC cells have different characteristics compared to most other cancer cells, which are sensitive to cetuximab. Our cell death assay revealed that SpCC cell death was induced by the anticancer drug imatinib, which is known to inhibit protein tyrosine kinase activity of ABL, platelet-derived growth factor receptor α (PDGFRα), and KIT. Here, we report recurrent SpCC with characteristics of MSCs and potential for treatment with imatinib.

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Treatment of severe generalized chronic periodontitis in a patient with Behçet’s disease: A case report

Morikawa S., Ouchi T., Asoda S., Horie N., Tsunoda K., Kawana H., Nakagawa T.

Journal of International Medical Research （Journal of International Medical Research）  46 （ 5 ） 2037 - 2045 2018年05月

ISSN  03000605

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© 2018, © The Author(s) 2018. Behçet’s disease is a systemic disorder of unknown etiology. It involves multiple organ systems and is characterized by recurring episodes of oral ulcers as well as ocular, genital, and skin lesions. Oral ulcers can affect tooth brushing and impair proper oral hygiene. As a result, a dental biofilm accumulates, and the condition of the teeth and periodontal tissue deteriorates. The aim of this case report is to highlight the efficacy of periodontal treatment for patients with Behçet’s disease. A 51-year-old man with Behçet’s disease presented with generalized severe periodontitis. After basic treatment of the periodontal tissues, periodontal surgery was performed at several sites with bony defects. However, the patient developed severe stomatitis in the oral mucosa and gingiva after periodontal surgery. Administration of the antimicrobial agent cefdinir had little effect on recovery; however, subsequent administration of sitafloxacin resulted in significant improvement of the stomatitis. This case demonstrates that periodontal therapy is very useful for alleviating the oral signs and symptoms of Behçet’s disease. Systemic antibiotic treatment with sitafloxacin (but not cefdinir) and mechanical debridement were effective in preventing the recurrence of aphthous ulcer outbreaks after periodontal surgery.

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Large odontogenic mixofibroma of the mandible excised without visible scar: A case report

Sato H., Asoda S., Muraoka W., Yoshikawa M., Yasui T., Horie N., Onizawa K., Nakagawa T., Kawana H.

Journal of Oral and Maxillofacial Surgery, Medicine, and Pathology （Journal of Oral and Maxillofacial Surgery, Medicine, and Pathology）  30 （ 3 ） 272 - 277 2018年05月

ISSN  22125558

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© 2018 Asian AOMS(+) ASOMP(+) JSOP(+) JSOMS(+) JSOM(+) and JAMI Combination of a pre-auricular-temporal approach and zygomatic osteotomy is a useful surgical approach for major temporomandibular joint tumours; however, additional approaches may be required to remove tumours expanding under the basal part of the condyle. We describe a patient with a large odontogenic myxofibroma of the basal part of condyle that was excised by a combination of pre-auricular-temporal approach with resection of the zygomatic arch and transoral approach. A 22-year-old man was referred to our department with a painless swelling in the left preauricular area. There was a palpable mass around his left condyle. Computed tomography revealed an infiltrative mass that had expanded to the vicinity of the impacted third molar root apex. The patient had strong cosmetic requirements, and we therefore adopted a combination of pre-auricular-temporal approach with zygomatic osteotomy and transoral approach for resection of the tumour. There was minimal intraoperative bleeding, and no sensory loss in the area innervated by the facial nerve. Histopathological analysis of the excised tumour revealed odontogenic myxofibroma. The scar was located in an inconspicuous area that could be hidden by his hair and in the oral cavity. There were no signs of recurrence or neoplastic transformation 7 years after surgical intervention.

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上顎歯肉に発生した非AIDS関連カポジ肉腫の1例

小川千晴, 大山定男, 内田育宏, 吉田俊一, 莇生田整治, 船田信顕

日本口腔外科学会雑誌 64 （ 4 ） 219 - 224 2018年

研究論文（学術雑誌）, 共著, 査読有り

Oral and maxillofacial tissue penetration of sitafloxacin following oral administration of a single 100 mg dose

Asoda S, Iwsaki R, Morita M, Horie N, Onizawa K, Uchiyama K, Kawana H, Nakagawa T

Oral Science International 14 （ 2 ） 40 - 42 2017年07月

研究論文（学術雑誌）, 共著, 査読有り

The onset risk of carcinoma in patients continuing tacrolimus topical treatment for oral lichen planus: A case report

Morita M, Asoda S, Tsunoda K, Soma T, Nakagawa T, Shirakawa M, Shoji H, Yagishita H, Nishikawa T, Kawana H

Odontology 105 （ 2 ） 262 - 266 2017年04月

研究論文（学術雑誌）, 査読有り

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Abstract
Oral lichen planus is a chronic inflammatory mucocutaneous disease. Topical use of steroids and other immuno-modulating therapies have been tried for this intractable condition. Nowadays, tacrolimus ointment is used more commonly as a choice for treatment. However, a number of discussions have taken place after tacrolimus was reported to be carcinogenic. This report describes a patient who applied tacrolimus ointment to the lower lip after being diagnosed with oral lichen planus in 2008, and whose lesion developed squamous cell carcinoma in 2010. Since the relationship between tacrolimus and cancer development has been reported in only a few cases, including this case report, the clinician must be careful selecting tacrolimus as a second-line treatment for oral lichen planus.

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国際頭痛分類第3版beta版による三叉神経痛（典型的三叉神経痛と有痛性三叉神経ニューロパチー）の臨床統計的検討

臼田頌，村岡渡，西須大徳，佐藤仁，吉川桃子，莇生田整治，河奈裕正，中川種昭，和嶋浩一

日本口腔顔面痛学会雑誌 10 （ 1 ） 23 - 30 2017年

研究論文（学術雑誌）, 共著, 査読有り

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小児の下顎骨に生じた歯原性粘液線維腫の1例

佐藤仁, 安居孝純, 軽部健史, 莇生田整治, 河奈裕正, 鬼澤勝弘

日本口腔外科学会雑誌 63 （ 9 ） 467 - 471 2017年

研究論文（学術雑誌）, 共著, 査読有り

口腔癌患者に対するTPF 3剤併用化学療法時におけるAprepitantおよびFosaprepitantの制吐効果に関する検討

内山公男, 山田学, 椎葉勇介, 笠崎真吾, 須賀賢一郎, 岩渕博史, 莇生田整治, 上原慶太

癌と化学療法 44 （ 7 ） 585 - 589 2017年

顎関節に発生したびまん型腱滑膜巨細胞腫の1例

大山定男, 小川千晴, 内田育宏, 吉田俊一, 莇生田整治, 船田信顕

日本口腔外科学会雑誌 （日本口腔外科学会）  63 （ 4 ） 204 - 209 2017年

研究論文（学術雑誌）, 共著, 査読有り