Primary cutaneous anaplastic large cell lymphoma occurring in an atopic dermatitis patient: a case report with review of the literature with emphasis on their association

Although the risk of malignant lymphoma in patients with atopic dermatitis (AD) remains controversial, an increased risk of malignant T-cell lymphoma in patients with AD has been reported. Primary cutaneous anaplastic large cell lymphoma (C-ALCL) is a relatively common distinct clinicopathological entity. However, occurrence of C-ALCL in patients with AD has been rarely reported. Herein, we describe the 5^th reported case of C-ALCL occurring in a patient with AD and review the clinicopathological features. A 30-year-old Japanese male with a long-standing history of AD presented with a gradually enlarged nodular lesion in the right abdominal wall, which had spontaneously regressed without therapy. Two years later, multiple nodular lesions appeared in his trunk, and swelling of multiple lymph nodes was also detected. Histopathological studies demonstrated diffuse proliferation of large-sized lymphocytes with large convoluted nuclei containing conspicuous nucleoli and relatively rich cytoplasm in the skin and lymph node. Immunohistochemically, these lymphocytes were positive for CD30, CD8, and MUM1, and negative for CD3, CD4, and ALK1. Accordingly, a diagnosis of primary C-ALCL was made. The patient died of disease after various courses of chemotherapy. Our clinicopathological review revealed that the prognosis of C-ALCL occurring in patients with AD is poor because two of 5 patients died of disease. Therefore, albeit extremely rare, AD patients with C-ALCL should be monitored closely, and additional clinicopathological studies are needed to clarify the pathogenesis of C-ALCL occurring in patients with AD.     

The effect of oral appliances that advanced the mandible forward and limited mouth opening in patients with obstructive sleep apnea: A systematic review and meta‐analysis of randomised controlled trials

Oral appliances (OAs) have demonstrated efficacy in treating obstructive sleep apnea (OSA), but many different OA devices are available. The Japanese Academy of Dental Sleep Medicine supported the use of OAs that advanced the mandible forward and limited mouth opening and suggested an evaluation of their effects in comparison with untreated or CPAP. A systematic search was undertaken in 16 April 2012. The outcome measures of interest were as follows: Apnea Hypopnea Index (AHI), lowest SpO₂, arousal index, Epworth Sleepiness Scale (ESS), the SF‐36 Health Survey. We performed this meta‐analysis using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) system. Five studies remained eligible after applying the exclusion criteria. Comparing OA and control appliance, OA significantly reduced the weighted mean difference (WMD) in both AHI and the arousal index (favouring OA, AHI: ?7·05 events h^?1; 95% CI, ?12·07 to ?2·03; P = 0·006, arousal index: ?6·95 events h^?1; 95% CI, ?11·75 to ?2·15; P = 0·005). OAs were significantly less effective at reducing the WMD in AHI and improving lowest SpO₂ and SF‐36 than CPAP, (favouring OA, AHI: 6·11 events h^?1; 95% CI, 3·24 to 8·98; P = 0·0001, lowest SpO₂: ?2·52%; 95% CI, ?4·81 to ?0·23; P = 0·03, SF‐36: ?1·80; 95% CI, ?3·17 to ?042; P = 0·01). Apnea Hypopnea Index and arousal index were significantly improved by OA relative to the untreated disease. Apnea Hypopnea Index, lowest SpO₂ and SF‐36 were significantly better with CPAP than with OA. The results of this study suggested that OAs improve OSA compared with untreated. CPAP appears to be more effective in improving OSA than OAs.     

Biotin and carnitine deficiency due to hypoallergenic formula nutrition in infants with milk allergy

Amino acid formulas and hydrolyzed formulas given to infants in Japan with milk allergies theoretically contain little, if any, biotin and carnitine. We assessed biotin and carnitine insufficiency in six infants with milk allergy who were fed amino acid formulas and/or hydrolyzed formulas, by measuring urine 3‐hydroxyisovaleric acid (3‐HIA) and serum free carnitine (C0), respectively. All patients presented with elevated urine 3‐HIA and lowered serum C0 compared with post‐menstrual age‐matched infants who were fed breast milk or standard infant formulas. Supplementation with biotin and l ‐carnitine immediately improved the insufficiency. Care should be taken to avoid biotin and carnitine deficiency in allergic infants fed amino acid or hydrolyzed formulas.     

The corrosion behavior of Nd2Fe14B and SmCo5 magnets.

Rare earth magnets have corrosive problems associated with their use in prostheses in various fields including orthodontics. The purpose of this study is to investigate the corrosion behavior of an Nd2Fe14B magnet and a SmCo5 magnet in an oral environment. The relations among the attractive force changes, the released elements, the weight changes and the anodic polarization measurements of the magnets were examined under immersions in 1% NaCl, 1% lactic acid, 0.05% HCl, 0.1% Na2S and Greenwood's artificial saliva at 37 degrees C for forty-two days. The results showed that the rare earth magnets underwent high corrosive assaults and large attractive force reductions by the immersions in 1% lactic acid and 0.05% HCl. The problem of corrosion of the magnets could be overcome by sealing them within laser-welded stainless steel capsules.     

Machinability evaluation of titanium alloys (Part 2)--Analyses of cutting force and spindle motor current

To establish a method of determining the machinability of dental materials for CAD/CAM systems, the machinability of titanium, two titanium alloys (Ti-6Al-4V and Ti-6Al-7Nb), and free-cutting brass was evaluated through cutting force and spindle motor current. The metals were slotted using a milling machine and square end mills at four cutting conditions. Both the static and dynamic components of the cutting force represented well the machinability of the metals tested: the machinability of Ti-6Al-4V and Ti-6Al-7Nb was worse than that of titanium, while that of free-cutting brass was better. On the other hand, the results indicated that the spindle motor current was not sensitive enough to detect the material difference among the titanium and its alloys.     

Construction of data base for designing removable partial dentures. 1. Retainer and abutment selection

In designing removable partial dentures (R.P.D.) for edentulous patients, variety of designs are selected with considering the condition of residual teeth, alveolar ridge, occlusion and other factors. We have been trying to develop the computer consultation system for designing R.P.D. (so called "expert system") to rationalize the processes of R.P.D. design. In developing and expanding this system, the construction and enlargement of the rulebase and database are indispensable. In this report, we analyzed R.P.D. designs in student's clinic ('83-'85), in order to find the logic for design (rulebase) and to construct databases. Following results were obtained. 1) Wire clasps were most frequently used in Kennedy classification I, II in maxilla. Double clasps were mostly used in Kennedy class I, II in mandible. Akers' clasps were mostly used in class III. 2) Canine, first and second premolar were more frequently selected for abutment than other teeth.