Wernicke's encephalopathy after chemoradiotherapy for tongue cancer: Report of a case

A case of acute Wernicke's encephalopathy induced by thiamine deficiency due to malnutrition subsequent to chemoradiotherapy for tongue cancer is presented. A 63-year-old male patient had severe oral mucositis and mental stress in a long-term hospitalization for chemoradiotherapy of tongue cancer. After discharge from hospital, he had alcoholism and malnutrition. Three months later, disturbance of consciousness and ataxia followed by memory disturbance appeared. Laboratory examination revealed low serum level of thiamine. The symptoms, laboratory data, and magnetic resonance imaging suggested acute Wernicke's encephalopathy. The patient was intravenously administered thiamine and received nutritional control, thereby the symptoms were improved.     

In vivo monitoring of the bone healing process around different titanium alloy implant surfaces placed into fresh extraction sockets

Objectives

Increasing surface roughness and coating with tricalcium phosphate of titanium and titanium alloy implants has been proposed to provide better rates of osseointegration. However, how these changes in surface topography and chemistry influence the osseointegration process of immediate implants placed in fresh extraction sockets is unclear. This study investigated the influence of three clinically employed implant surfaces on the early bone healing events in vivo.

Methods

Machined smooth implants were milled from grade 5 Ti6Al4V titanium. Surfaces were moderately roughened by grit blasting, which were then coated with tricalcium phosphate. Implants were placed into freshly extracted incisor sockets of mandibles of normal Wistar rats and left for 1, 3 and 9 weeks. Healing bone tissue around the implants was examined by histochemistry and immunocytochemistry to localise PCNA proliferative cells, and osteoblast differentiation markers osteopontin and osteocalcin. Positive synthesising cells were counted using image analysis.

Results

Histology indicated no differences in the amount or pattern of bone formation within the healing tissue surrounding the different implant surfaces. Bone healing occurred predominantly on exposed bone surfaces (distance osteogenesis) and not on the implant surface (contact osteogenesis). No differences were observed in the number or timing of PCNA, osteopontin and osteocalcin positive cells within the bone healing tissue around each of the implant analysed.

Conclusion

For immediately placed implants, the surface modifications investigated appeared to have little influence on the activity of bone forming cells surrounding the implant, probably due to the high level of distance osteogenesis seen within this scenario.

Clinical significance

For immediate placement of implants into fresh extraction sockets, titanium implants with roughened surfaces and coating with tricalcium phosphate have negligible influence in accelerating the early bone healing events of osseointegration.     

The interrelationship between an anthropophobic tendency and narcissistic personality in adolescence

This study investigates the interrelationship between an anthropophobic tendency and narcissistic personality in adolescence. Previous research has proposed that anthropophobia and narcissistic personality disorders can be classified into subtypes. In recent studies, Okano (1998) suggested that the relationship between an anthropophobic tendency and narcissistic personality should be explained in terms of two dimensions (two-dimension model), instead of one dimension (one-dimension model). Questionnaires were administered to 305 adolescents who were enrolled in a university. In analysis 1, the relationship between an anthropophobic tendency and narcissistic personality, which are both within normal limits of anthropophobia and narcissism in adolescence, was examined with a two-dimension model. In analysis 2, the characteristics of self-consciousness and adaptiveness in adolescence, which were classified using a two-dimension model, were examined. The results were as follows: (1) an anthropophobic tendency and narcissistic personality could be explained with a two-dimension model; and (2) the characteristics of five subtypes were revealed in detail.