Metastasis to the tongue seldom occurs, and lingual metastasis as an initial sign of cancer occurs even less frequently. We report a case of lung cancer in which the patient's initial symptom was related to the tongue metastasis. A 63-year-old man had a submucosal tumor on the left posterolateral aspect of the tongue and a biopsy specimen of the tongue tumor showed poorly differentiated squamous cell carcinoma. A chest X-ray showed a mass in the right lung and cytological examination of the specimen obtained by bronchial brushing showed poorly differentiated squamous cell carcinoma, whose appearance was similar to that of the tongue. Based on these findings, the tongue lesion was diagnosed a metastatic tumor from the lung cancer. The patient received radiation therapy combined with systemic chemotherapy, however, he died 5 months after the diagnosis of lung cancer. An autopsy revealed a lung cancer in the right lower lobe with metastatic tumors in the tongue, right middle lobe, left upper lobe, liver, adrenal gland, pericardium, heart, and subcutaneous tissues. No other possible primary cancer that may have been the cause of the metastases was identified.

Although oral health care has a preventive effect against ventilator-associated pneumonia (VAP), the most effective method of oral health care in this respect remains to be established. The objective of this single-center, randomized, controlled trial was to investigate the relationship between VAP and various methods of oral health care. All patients included in the study (n=142) were on mechanical ventilation with oral intubation at the intensive care unit of the Tokyo Dental College Ichikawa General Hospital. They were divided into two groups, one receiving standard oral health care (Standard group), and the other receiving oral health care using an oral moisture gel instead of water (Gel group). After removal of the intubation tube, biofilm on cuff of the tube was stained with a disclosing agent to determine the contamination level. Factors investigated included sex, age, number of remaining teeth, intubation time, fever ≥38.5°C, VAP, cuff contamination level, and time required for one oral health care session. No VAP occurred in either group during the study period. The level of cuff contamination was significantly lower in the Gel group than the Standard group, and the time required for one session of oral health care was shorter (p<0.001). Multivariate analysis revealed use of the oral moisture gel as a factor affecting cuff contamination level. Use of an oral moisture gel decreased invasion of the pharynx by bacteria and contaminants together with biofilm formation on the intubation tube cuff. These results suggest that oral health care using an oral moisture gel is effective in preventing cuff contamination.

Journal of Hard Tissue Biology 16[1] (2007) p31-35 © 2007 The Society for Hard Tissue Regenerative BiologyPrinted in Japan, All rights reserved. CODEN-JHTBFF, ISSN 1341-7649 Original 31Abstract: We encountered a patient on long-term oral corticosteroids for systemic lupus erythematosus, who did not complain of pain during caries treatment. Since the patient had no subjective sense of dental pain, all her remaining teeth became stumps, and total tooth extraction was conducted 25 years after presentation. We examined her premolar stumps histopathologically and obtained the following findings: 1. the dental pulp was narrowed in nearly all samples; 2. odontoblasts were not observable; 3. regions with dentinal tubules forming lamellae and regions with fibrotic dentinal tubules were observed. 4. fibrosis of the entire dentin was observed in some regions. 5. nerve fibers stained by anti-neurofilament protein antibody were observed in the dental pulp cavity, but the nerve fibers appeared degenerate and no nerve fiber endings were observed.

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Lap joints of an upper Al alloy (1.0-mm-thick A5052) and lower Zn-coated steel (1.2-mm-thick GA steel) were welded by a novel spot welding process for dissimilar metal lap joints using a new tool with the tip made of spherical ceramics, i.e., "Friction Anchor Welding." As a result, the Al atoms in the Al alloy diffused into the Zn-Fe layer on the GA steel, and the layer transformed into an altered layer which was mainly composed of Al-Fe intermetallic compounds. Because of this altered layer, a steel projection could not extend straight when the rotating tool was plunged through the Al alloy into the GA steel. Consequently, the height of the steel projection was small and exhibited a rugged shape while the steel projection was formed in the Al alloy. Furthermore, large amounts of Al-Fe intermetallic compounds existed near the steel projection. Additionally, Zn atoms in the Zn-Fe layer on the GA steel penetrated into the Al alloy and cracks occurred due to the Al-Zn eutectic melt. Thus, the tensile shear strength reached only about 2.7 kN/point, compared to that of the weld between A5052 and SPCC, which reached about 3.6 kN/point.