Hypopituitarism manifesting after invasive dental treatment in a patient with carcinoma of the tongue: a case report

BACKGROUND

The symptoms of hypopituitarism are not usually discussed in the clinical setting of oral surgery.

CASE PRESENTATION

We herein report a case of hypopituitarism that became evident after biopsy and extraction of several teeth in a 68-year-old man with tongue cancer. Three days after biopsy, the patient developed nausea and vomiting, and his serum sodium had fallen to 124 mEq/L. His serum cortisol concentration was low. Although the plasma concentration of adrenocorticotropic hormone (ACTH) was within the normal range, ACTH stimulation testing showed a lack of cortisol response. Given these findings, we suspected secondary adrenal insufficiency. To investigate the cause of secondary adrenal insufficiency, MRI of the head was performed, which revealed pituitary gland atrophy. The results of pituitary anterior lobe hormone-stimulation tests were compatible with hypopituitarism. Thirty days after biopsy, partial tongue resection was successfully performed under general anesthesia with perioperative hydrocortisone supplementation.

CONCLUSIONS

We must be aware of various signs of hypopituitarism when we perform invasive dental treatment.

A pilot study of the clinical evidence for the methodology for prevention of oral mucositis during cancer chemotherapy by measuring salivary excretion of 5-fluorouracil

Objective to re-examine measures to prevent oral mucositis caused by drugs in head and neck cancer patients during cancer treatment by measuring salivary excretion of 5-fluorouracil. Saliva, blood, and urine were simultaneously collected from oral cancer patients and breast cancer patient at the point in time of before, during, and after the administration of 5-FU, then the 5-FU levels of the samples were quantitatively analysed using LC-MS/MS. In all patients, the 5-FU levels in saliva and serum peaked at 30 min to 3 h after the start of 5-FU treatment, and high levels were maintained throughout the administration of the drug. With regard to urinary 5-FU levels, they remained high from 3 to 120 h after the start of 5-FU treatment. After the completion of 5-FU treatment, even though it not appeared in the patients’ serum and urine promptly, 5-FU was detected in saliva at 12 h after the completion of 5-FU treatment in one oral cancer patient and at 48 h after the completion of 5-FU treatment in the breast cancer patient. It was suggested that the level of hydration after the completion of chemotherapy may be involved in the differences in 5-FU excretion.

Selective extraction of Pd(ii) by p-tert-butylcalix[4]arenedicarboxylic acid

p-tert-Butylcalix[4]arenedicarboxylic acid, in which two distal hydroxy groups of p-tert-butylcalix[4]arene are replaced with carboxy groups, shows extraction selectivity toward Pd²⁺ ions by the formation of a 2 : 2 (M/L) complex.

Neon and CO2 adsorption on open carbon nanohorns

We present the results of a thermodynamics and kinetics study of the adsorption of neon and carbon dioxide on aggregates of chemically opened carbon nanohorns. Both the equilibrium adsorption characteristics, as well as the dependence of the kinetic behavior on sorbent loading, are different for these two adsorbates. For neon the adsorption isotherms display two steps before reaching the saturated vapor pressure, corresponding to adsorption on strong and on weak binding sites; the isosteric heat of adsorption is a decreasing function of sorbent loading (this quantity varies by about a factor of 2 on the range of loadings studied), and the speed of the adsorption kinetics increases with increasing loading. By contrast, for carbon dioxide there are no substeps in the adsorption isotherms; the isosteric heat is a nonmonotonic function of loading, the value of the isosteric heat never differs from the bulk heat of sublimation by more than 15%, and the kinetic behavior is opposite to that of neon, with equilibration times increasing for higher sorbent loadings. We explain the difference in the equilibrium properties observed for neon and carbon dioxide in terms of differences in the relative strengths of adsorbate-adsorbate to adsorbate-sorbent interaction for these species.

Mechanism of the dependence of hepatitis B virus genotype G on co-infection with other genotypes for viral replication

Hepatitis B virus (HBV) is classified into several genotypes. Genotype G (HBV/G) is characterised by worldwide dispersion, low intragenotypic diversity and a peculiar sequence of the precore and core region (stop codon and 36-nucleotide insertion). As a rule, HBV/G is detected in co-infection with another genotype, most frequently HBV/A2. In a previous in vivo study, viral replication of HBV/G was significantly enhanced by co-infection with HBV/A2. However, the mechanism by which co-infection with HBV/A2 enhances HBV/G replication is not fully understood. In this study, we employed 1.24-fold HBV/A2 clones that selectively expressed each viral protein and revealed that the core protein expressing construct significantly enhanced the replication of HBV/G in Huh7 cells. The introduction of the HBV/A2 core promoter or core protein or both genomic regions into the HBV/G genome showed that both the core promoter and core protein are required for efficient HBV/G replication. The effect of genotype on the interaction between foreign core protein and HBV/G showed that HBV/A2 was the strongest enhancer of HBV/G replication. Furthermore, Western blot analysis of Dane particles isolated from cultures of Huh7 cells co-transfected by HBV/G and a cytomegalovirus (CMV) promoter-driven HBV/A2 core protein expression construct indicated that HBV/G employed HBV/A2 core protein during particle assembly. In conclusion, HBV/G could take advantage of core proteins from other genotypes during co-infection to replicate efficiently and to effectively package HBV DNA into virions.

Surfactant-mediated gene transfer for animal cells

A commercially available cationic surfactant, dimethyl-dioctadecyl ammonium bromide (DDAB), was used for making lipid vesicles. DDAB easily dissolved in water at 60 °C and formed lipid vesicles at room temperature. The lipid vesicles showed very low cytotoxicity compared with other cationic surfactants. After the lipid vesicles were mixed with plasmid DNA solution, the solution was added to mammalian cells. The addition of a nonionic surfactant (Tween 80) to the cationic lipid vesicles at the weight ratio of 1:1 enhanced transfection efficiency. Adding more or less than the optimal amounts of DNA and lipid vesicles resulted in decreased transfection efficiency. With the optimal amounts of DNA (pCMVβ) and lipid vesicles, about 90-95% of CHO-K1 and BHK-21C13 cells transiently expressed β-galactosidase activity 24 h after transfection. By this procedure, stable transformants around 10(5) cells corresponding to 10% efficiency could be obtained by one batch transfection.

Intermittent addition of HGF and TGF-beta1 in rat primary hepatocyte culture

The effects of hepatocyte growth factor (HGF) and transforming growth factor-beta (TGF-beta) on two morphological states of hepatocytes in monolayer and spheroid cultures, were examined in terms of their mitogenic ability and albumin expression. In monolayer culture on collagen-coated dishes, the increase in DNA content in the presence of HGF was observed when HGF was added within two days of cell isolation, whereas no increase in DNA was observed when HGF was added four days of cell isolation. DNA content increased even after four days, when HGF was added intermittently. On the other hand, spheroid formation was promoted on Primaria(R) dishes in HGF-free culture, whereas it was inhibited following the addition of HGF. No increase in DNA content was observed in spheroid cultures even in the presence of HGF throughout the culture period. The albumin production ability rapidly decreased in monolayer culture, but the decline was attenuated following the addition of HGF during the course of culture. A high albumin production ability was maintained independent of HGF supplementation in spheroid culture. Both DNA content and albumin production decreased rapidly following the addition of TGF-beta1 in monolayer culture, and this decline was also attenuated following the addition of HGF to the medium.

[Clinicopathological study of calcifying cystic odontogenic tumors]

Calcifying cystic odontogenic tumors are benign tumors, characterized by the presence of ghost cells and calcified materials. We evaluated clinical characteristics of calcifying cystic odontogenic tumors in 21 cases at the Maxillofacial Surgery, Tokyo Medical and Dental University Hospital, between January 1979 and December 2006. Of the 21 lesions that were studied, 12 were observed in male patients, and 9 in female patients. The median age was 13.0 years (range, 4-69 years). Of the 21 lesions, 11 were located in the maxilla (intraosseous), 9 in the mandible (intraosseous), and 1 in the lower gingiva (extraosseous). Radiographically, 18 lesions appeared as unilocular radiolucencies, and 2 lesions as multilocular radiolucencies. Impacted teeth were observed in 15 cases. In 20 cases, the lesions were treated by enucleation. The follow-up duration ranged from 2 years, 5 months to 28 years, 8 months, and in 1 case, the lesion recurred and showed a malignant transformation 2 years 10 months after the treatment. Histopathologically, the lining epithelium consisted of cuboidal or columnar odontogenic cells. Ghost cells were frequently calcified, and the tissue was hardened. In 14 cases, the tumor was associated with odontoma.

The effects of cell adhesion on the growth and protein productivity of animal cells

We investigated the effect of cell adhesion on cellgrowth and productivity of recombinant protein inChinese hamster ovary (CHO) cells. Cells cultured innormal tissue culture dishes attached to the dishsurfaces and grew as a monolayer, while cells culturedin non-treated dishes proliferated in suspension assingle cells without adhering to the dish surfaces. On an agarose-coated dish surface, cell aggregatesformed without attaching to the dish. Growth rates inboth suspension cultures were slightly lower thanthose in monolayer culture. Cell cycle analysisindicated that the duration of the G(1) phase insuspension cultures was longer than that in monolayerculture, suggesting that attachment to the substratummainly affected the transition from the G(1) to theS phase. Consistent with this, CDK inhibitor p27,that inhibits the G(1)S transition, was induced inthe cells cultured in suspension.To assess the productivity of recombinant proteins,CHO cells were transfected with a plasmid containingmurine interferon gamma (mIFN-gamma) under thecontrol of the cytomegalovirus promoter. Insuspension culture, mIFN-gamma productivity wasslightly lower than that in the monolayer culture. When protein kinase C was activated by phorbol ester,mIFN-gamma production was enhanced in both themonolayer and suspension cultures. However, theproductivity in the suspension culture was lower thanthat in the adherent culture even in the presence ofhigh concentrations of phorbol ester. These resultssuggested that cell adhesion to the substratum affectsvarious features of CHO cells.

Structures and Properties of C60 & C70 Thin Films Fabricated by Organic MBE

The C60/C70 thin film crystals have been fabricated on the (001) surface of alkali halide substrates, KC1, KBr, and NaCl, and their structures have been studied. The crystal structure analyses by TEM show that the hexagonal closed packing (hep) with lattice parameters of a=10.0 Å and c=16.3 Å and the face-centered cubic (fee) with a=14.2 Å coexist in the C60 thin film crystals. The C70 thin film crystals show an expanded lattice constant of a=10.5 Å from the view perpendicular to the stacking plane. The ratio of hep to fee is dependent on the kind of the substrates and on the substrate temperatures during the crystal growth. The observed reversible change in the Raman spectrum of the C60 thin films implies a rotational molecular motion in the thin film crystals.

Phase II feasibility study of adjuvant S-1 plus docetaxel for stage III gastric cancer patients after curative D2 gastrectomy (OGSG 0604)

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Background: Although an adjuvant chemotherapy with S-1 has become the standard treatment for stage II-III gastric cancer (GC) patients (pts) after curative D2 gastrectomy in Japan, the survival benefit for stage III pts obtained by S-1 is considered to be modest. S-1 plus docetaxel has shown a good response rate of 56% with prolonged median overall survival (OS) of 14.3 months in pts with advanced GC. This phase II study evaluated the feasibility and safety of adjuvant S-1 plus docetaxel for stage III GC pts after R0 resection. Methods: Patients with curatively resected pathological stage III GC receiving D2 dissection, age 20–80 years, performance status < 1, no prior adjuvant treatment, adequate organ function, and informed consent were given S-1 (80 mg/m2/day) orally for consecutive 2 weeks plus docetaxel (40 mg/m2) intravenously on day 1, repeated every 3 weeks. The treatment was started within 45 days after gastrectomy, and repeated for 4 cycles, followed by S-1 monotherapy until 1 year after surgery. Study endpoints included feasibility of the 4 cycles of S-1 plus docetaxel as primary, and safety, progression free survival (PFS), and OS as secondary. Sample size was set to be 50, which was determined to reject the feasibility of 50% under the expectation of 75% with power of 90% and two-sided α of 5%. Results: Fifty-three pts, 42 males and 11 females with a median age of 65 years, were enrolled between 5/2007 and 8/2008. Pathological stages included IIIA in 36 pts and IIIB in 17 pts. Planned 4 cycles of treatment were delivered to 41 out of 53 pts, with the feasibility of 77.4% (95% CI 63.8–87.7%, P<0.001). Reasons for discontinuation were recurrent cancer in 1 pt, adverse events in 10, and miscellaneous in 1, respectively. Grade 4 neutropenia was observed in 28% of pts with grade 3 febrile neutropenia in 9%. Non-hematological toxicities of grade 3 or more involved fatigue in 6%, anorexia in 9%, and nausea in 6%. No treatment-related deaths occurred. Conclusions: Adjuvant S-1 plus docetaxel was well-tolerated and showed good compliance. Although follow-up is ongoing on survival, this regimen could be a candidate of future phase III trial seeking for the optimal adjuvant chemotherapy for stage III GC pts after curative D2 gastrectomy.

No significant financial relationships to disclose.

Amplification of competitive telomere sequence in living animal cells induces chromatin instability

We have reported the establishment of new episomal-type expression vector the copy number of which can be readily regulated by a temperature shift. In this study, we attempt to apply this vector for the functional analysis of the noncoding regions of DNA. A plasmid containing a 0.45 kb-telomere repeat sequence was constructed and transfected into simian CV-1 cells, leading to successful establishment of cell lines in which episomal telomere sequence could be amplified by temperature shift. When the episomal telomere sequence was amplified, the cells stopped proliferating at the G(2)/M phase of the cell cycle and exhibited a large size with flattened morphology and several small nucleus-like particles. These cells expressed Cdk inhibitor p21 and beta-galactosidase, which are expressed in some senescent cells. Microscopic analysis revealed frequent end-to-end attachments of chromosomes, which resulted in a variety of aberrant chromosome configurations. None of these characteristics was observed in nontransfected and control plasmid-transfected CV-1 cells at any cultivation temperature. These results indicate the usefulness of our vector system in analyzing telomeric DNA.

Changes in the Fluorescence Spectrum of Individual Single-Wall Carbon Nanotubes Induced by Light-Assisted Oxidation with Hydroperoxide

Through fluorescence-spectrum measurements, we investigated the effects of light-assisted oxidation with H2O2 (LAOx) on single-wall carbon nanotubes (SWNTs) that were individually dispersed in an aqueous solution of surfactant. The intensities of the fluorescence spectra were decreased remarkably by the LAOx when the light's wavelength was 400-500 nm and a little when 600-700 nm. The spectrum intensity did not recover even when the pH was restored to an original value of 6.5. The spectra changed little when the LAOx wavelength was 500-600 nm or the light was not irradiated. In addition, the effect of LAOx on SWNTs was related to the diameters of SWNTs. We inferred that these phenomena reflected that H2O2 was dissociated by absorbing the fluorescence light emitted from optically excited SWNTs, which, in turn, accelerated the burning out of SWNTs.

Isolating Single-Wall Carbon Nanohorns as Small Aggregates through a Dispersion Method

An approach to isolating small aggregates of single-wall carbon nanohorns (SWNHs) is presented. SWNHs are ultrasonically treated in an aqueous solution of surfactant, resulting in dispersion of SWNH aggregates. Subsequent centrifuging enables the separation of small aggregates from larger aggregates or agglomerations and removal of graphitic particles (GG balls), the main impurity. The SWNHs obtained in this way were purified and formed small aggregates, thus exhibiting characteristics superior to those of SWNHs before treatment. We believe that the ability to isolate small SWNH aggregates in an aqueous solution should contribute to their application in the fields of biological sensing and drug delivery systems.

Growth induction of rat primary hepatocytes using antisense oligonucleotides

We examined growth control of adult and fetal hepatocytes by regulating the expression of cell-cycle-related proteins using antisense S-oligonucleotides to tumor suppressors retinoblastoma (RB) protein and p53, and cyclin-dependent kinase (CDK) inhibitors p21 and p27. The protein expression in both adult and fetal hepatocytes was significantly suppressed with the addition of corresponding antisense oligonucleotides at a concentration of 2.5 microM. For the evaluation of growth, 3H-thymidine incorporation and DNA content were measured and the results demonstrated that all the antisense oligonucleotides had growth-promoting effects and the promoting potential was equivalent or slightly greater than that with the addition of hepatocyte growth factor (HGF) (10 ng/ml). The growth-promoting effect of the antisense oligonucleotides was enhanced by HGF in both adult and fetal hepatocyte cultures, and the effects on hepatocyte growth were also observed in a suspension culture.

Integrase-mediated nonviral gene transfection with enhanced integration efficiency

Retroviruses efficiently integrate their genome into the host chromosome. Two elements of the retrovirus genome are needed for the integration: long terminal repeats (LTRs) and integrase protein. We attempted to incorporate the retrovirus integration machinery in lipid vesicle-mediated gene transfection with the aim of achieving efficient stable transfection in a nonviral gene transfection system. A DNA fragment, in which a neomycin-resistant gene was flanked between partial LTR sequences derived from the Rous sarcoma virus (RSV), was constructed. This DNA fragment was transfected together with purified recombinant RSV integrase or integrase expression vectors by means of lipid vesicle-mediated gene transfection. The integrase-mediated transfection enhanced the stable transfection efficiency. The length and the end structure of the LTR sequences were important in achieving high efficiency. Under optimal conditions, the stable transfection efficiency showed a 16-fold improvement over that without integrase.

Dissociation of Electrolytes in a Nano-aqueous System within Single-Wall Carbon Nanotubes

Research on material incorporation within single-wall carbon nanotubes (SWNTs) through aqueous solutions of various electrolytes is performed for the purpose of providing a foundation for future application of SWNTs to, for example, drug delivery systems. We have determined that the optical spectra of SWNTs were significantly affected when SWNTs that had opened holes or removed caps were treated through immersion in an aqueous solution of electrolytes, followed by drying at room temperature; however, the spectra of SWNTs without opened holes or removed caps were not subjected to such treatment. We infer that when the sucked solutions remained inside the tubes, even after drying (the nano-aqueous system), the electrolyte was dissociated into ions, which was likely to change the electronic states of SWNTs. On the other hand, when the SWNTs were well-dried under vacuum, no remarkable changes in their optical spectra were observed.

Fe-sapphire and C-Fe-sapphire interactions and their effect on the growth of single-walled carbon nanotubes by chemical vapor deposition

We previously reported that the quantity of single-walled carbon nanotubes grown on Fe-coated sapphire by chemical vapor deposition depended on the crystallographic faces of sapphires. In this report, we show that the interaction of Fe, sapphire, and carbon depended on the sapphire faces. We deduce that the quantity of Fe available to catalyze the growth of single-walled carbon nanotubes was suppressed by the formation of Fe-Al alloys and whether the Fe-Al alloys were formed on Fe-coated sapphire or not depended on the sapphire-surface structure.