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Infective endocarditis (IE) is one of the most common diseases occurring in patients with valvular heart disease (VHD). One of the causes of IE is bacteremia caused by oral jaw infections, including medication‐related osteonecrosis of the jaw (MRONJ) and oral surgery. We performed an extensive surgery for MRONJ prior to aortic valve replacement with severe aortic stenosis (SAS) for IE prevention. In patients with SAS and MRONJ who are being suggested a surgery on standby for VHD, a prior extensive surgery for MRONJ should be considered to prevent the risk of IE.

Background Use of the Glatzel mirror for measuring expiratory nasal flow in preschool children has the disadvantage of vagueness, and the mirror may induce fear and inhibition of interest in those children. In response to these limitations, we developed a new device with dual cameras for measuring expiratory nasal flow in 2 to 6 year old children. The aim of this study is to compare the Glatzel mirror and the new device, in terms of accurate assessment of expiratory nasal flow, children's feelings, and correlation to each child's profile. Methods This study evaluated 20 cleft lip and palate patients and 21 healthy children aged between 2 and 6 (under 7) years. After consent was granted, a 4-week screening period was undertaken followed by inspection at weeks 8, 16, 24, and 32. Each inspection was conducted while the children were asked to pronounce various sounds and comprised three stages: i) use of the Glatzel mirror, ii) subjective visual assessment using the new device, and iii) image recording by dual cameras of the new device. Questionnaires for the new device were administered at the initial and final inspections. To contrast the results between the Glatzel mirror and the new device, the numbers that indicated values of subjective visual assessment and camera assessment greater than the assessment values of the Glatzel mirror were compared. For measuring the children's responses to the new device compared with those to the Glatzel mirror, the answers to the questionnaires were compared. For the comparison of the children's profiles (age and sex) and feelings, the numbers of subjects who could use the new device were measured. Results The camera assessment of the new device indicated significantly greater values than that of the Glatzel mirror (P < 0.05). The feelings of the subjects to the new device mostly improved as the study progressed. Subjects aged 3 years and older were generally able to use the new device from the initial inspection. For both sexes, as the inspection progressed, the number occasions of successful use increased. Conclusion This study demonstrated the superiority of the new device with dual cameras to the Glatzel mirror in terms of functionality and attitude of children.

As society ages and inspection technology develops, the incidence of secondary malignancies has increased. Esophageal and gastric cancers are common for primary tumors of oral secondary malignancies, but, on the otherhand, ML (malignant lymphomas) are rare. We report here two cases of mandibular SCC (squamous cell carcinoma) complicated with ML as metachronous secondary malignancies. In both cases, oral SCCs were aggressive and the clinical courses were rapid. Case 1 was a 62-year-old man who had a past history of CLL (chronic lymphocytic leukemia) /SLL (small lymphocytic lymphoma) and developed oral SCC. Though he had a surgical resection after chemoradiotherapy, SCC recurred just two months post operation. Case 2 was an 83-year-old man who developed oral SCC during treatment for Epstein-Barr Virus(EBV)-positive DLBCL (diffuse large B-celllymphoma) of the elderly. He discontinued chemotherapy and he had an operation for oral SCC. Etoposide was resumed for exacerbation of EBV-positive DLBCL of the elderly ; he is alive without any relapse of oral SCC. Aggressive clinical features of secondary oral malignancies are considered to be closely related to a long-term immunosuppressive state due to ML and chemotherapy.

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