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健常若年日本人成人の頸部リンパ節の超音波像：年齢，性別および体格との関係
Get PDF松本歯科大学博士（歯学）2013甲第149号application/pdf口腔がんの頸部リンパ節転移の精査に有用である超音波検査では、リンパ節の形態を示す短長径や短長径比の計測、リンパ節内部の血流パターンや血流量から異常リンパ節の有無や評価を行う。その場合、頸部リンパ節の形態や血流は年齢，性別および体格の影響を受ける可能性があるが、これらの関与について検討した報告は殆どない。本研究では健常若年日本人成人を対象に，年齢，性別および体格指数（BMI）と頸部リンパ節の形態、内部血流パターンの関係について検討を行うという目的は明確である。研究は規定されたリンパ節の測定法を根拠に目的、測定バイアスまで考慮した方法、高度な統計解析法を十分に考えて計画がなされており、かつ、周到な準備の下に論理的に施行され、実証性も良いと考えられる。 結果では、リンパ節の短径は上頸部で年齢とBMI，顎下部で性別（女性）とBMI，オトガイ下部でBMIと有意な関連があり、いずれの領域でもBMIの増加により短長径比は有意に増加し、かつ女性は男性より有意に増加することを明確に示した。また、リンパ節の血流型では上頸部はBMIが増加すると無血流型になる傾向があり，オトガイ下部では有意に放散型になること、顎下部では女性の場合に有意に無血流型になることを明らかにし、明確である。 考察・結論では本研究結果について適切に論文を引用して年齢，性別、BMIと頸部リンパ節の形態や血流との関連を考察しており、超音波検査時の異常リンパ節の評価の際には，性別およびBMIを考慮して検査を行うべきであるとの結論かつ新知見を明確に導いている。 さらに、本研究結果は頸部リンパ節の超音波検査時の重要な基本情報であり、今後、口腔がんの好発年齢である高齢者での検討を行うことで、さらに有用な成果が得られることが期待されるという研究の発展性を示している。以上から学位に相応しい内容であると判断する。doctoral thesi
Roles of Cathelicidin-related Antimicrobial Peptide in Murine Osteoclastogenesis
Get PDF松本歯科大学博士（歯学）2013甲第157号application/pdfCathelicidin-related antimicrobial peptide (CRAMP) not only kills bacteria but also binds to lipopolysaccharide (LPS) to neutralize its activity. CRAMP is highly expressed in bone marrow and its expression is reported to be up-regulated by inflammatory and infectious stimuli. Here, we examined the role of CRAMP in murine osteoclastogenesis. Osteoclasts were formed in co-cultures of osteoblasts and bone marrow cells in response to 1a,25-dihydroxyvitamin D3 [1a,25(OH)2D3], prostaglandin E2(PGE2), and Toll-like receptor (TLR) ligands such as LPS and flagellin through the induction of receptor activator of nuclear factor-jB ligand(RANKL) expression in osteoblasts. CRAMP inhibited the osteoclastogenesis in co-cultures treated with LPS and flagellin, but not in those treated with 1a,25(OH)2D3 or PGE2. Although bone marrow macrophages(BMMs) highly expressed formyl peptide receptor 2 (a receptor of CRAMP), CRAMP showed no inhibitory effect on osteoclastogenesis in BMM cultures treated with RANKL. CRAMP suppressed both LPS- and flagellin-induced RANKL expression in osteoblasts and tumour necrosis factor-a (TNF-a) expression in BMMs, suggesting that CRAMP neutralizes the actions of LPS and flagellin. LPS and flagellin enhanced the expression of CRAMP mRNA in osteoblasts. Extracellularly added CRAMP suppressed LPS- and flagellin-induced CRAMP expression. These results suggest that the production of CRAMP promoted by LPS and flagellin is inhibited by CRAMP released by osteoblasts through a feedback regulation. Even though CRAMP itself has no effect on osteoclastogenesis in mice, we propose that CRAMP is an osteoblast-derived protector in bacterial infection-induced osteoclastic bone resorption.thesi
Molecular analysis of potassium ion channel genes in sudden death cases among patients administered psychotropic drug therapy: Are polymorphisms in LQT genes a potential risk factor?（向精神薬服用患者の突然死症例におけるカリウムイオンチャネルに関する分子生物学的解析：QT 延長症候群関連遺伝子の多型が危険因子となり得るか?）
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Clinical significance of carotid artery calcification seen on panoramic radiographs.
Get PDFapplication/pdfAmong patients who visited our hospital with a chief complaint of disorders involving the oromandibular region, with suspected carotid artery calcification based on panoramic radiography, and who underwent computed tomography for a detailed examination of these disorders, there were four patients in whom a definitive diagnosis of carotid artery calcification was made. We herein provide an overview of these cases, along with a brief
review of the relevant literature. When imaging findings suggestive of carotid artery calcification are obtained on panoramic radiographs, dentists can request detailed examinations and treatment at specialized medical institutions in the early stage by providing patients with information about the risks of atherosclerotic diseases. Early detection and treatment may reduce the severity or risks of complications and damage caused by atherosclerotic diseases, as well as possibly contributing to improved quality of life. In this study, we evaluated carotid artery calcification visible on panoramic radiographs. However, it seems that further detailed analysis is needed to examine the association between carotid artery calcification and a past history of risk factors for arteriosclerosis.journal articl
Formative Factors of Membranous Substances on Dorsum of Tongue, Teeth, Buccal Mucosa in Elderly Persons Requiring Nursing Care
Get PDFapplication/pdf要介護者の口腔粘膜にみられる付着物は，痰，痂皮，剥離上皮と呼ばれているが，上皮成分を主体とした付着物を剥離上皮膜と定義づけ，本研究にて，要介護高齢者の口腔内に形成された剥離上皮膜を部位別に形成要因を検討した。調査対象者は，入院中の患者のうち65 歳以上の要介護高齢者70 名であった（81.1±7.7 歳）。入院記録より年齢，疾患，常用薬，寝たきり度を調査し，意識レベル，発語の可否，介助磨きの頻度は担当看護師から聴取した。歯科医師が口腔内診査を行い，膜状物質の形成の有無，Gingival Index などを評価した。形成された膜状物質は，歯科医師がピンセットで採取した。粘膜保湿度（舌背部，舌下粘膜）は，粘膜湿潤度試験紙（キソウエット®）により10秒法で評価した。採取された膜状物質は，通法に従ってパラフィン切片を作製し，HE 染色とサイトケラチン1 による免疫染色で重層扁平上皮か否かについて確認し，重層扁平上皮由来の角質変性物が認められたものを剥離上皮膜と判断した。剥離上皮膜形成の有無を従属変数として，患者背景・口腔内の14 項目，疾患の15 項目，常用薬の32項目，合計61項目を独立変数として部位ごとで決定木分析を行った。すべての部位で剥離上皮膜の形成に最優先される要因は「摂食状況」であり，経口摂取者には，剥離上皮膜がみられなかった。第2 位は舌背部で舌背湿潤度，頰部で開口，歯面の第3 位が開口であり，口腔粘膜の乾燥を示唆する結果であった。以上，剥離上皮膜の形成要因には口腔乾燥があり，保湿の維持が剥離上皮膜の予防につながると考えられた。journal articl
Experimental model of occlusal trauma in mouse periodontal tissues.
Get PDFapplication/pdfThe aim of this study was to establish a model, which can be used to investigate the response of periodontal tissues to excessive occlusal loading in mice by observing histopathological changes. The experiment was performed on ten 7-week-old ddY male mice. Under general anesthesia by intraperitoneal injection
pentobarbital sodium, a micro-plus-screwpin (head part, 1.7mm in diameter, thickness 0.5mm thickness) was screwed into the pulp cavity of the upper-left-first molar. R_mCT images of the experimental site indicated the occlusal contact position between the upper- and lower-left-first molars during the experimental periods. A micro-plus-screwpin was maintained at a constant position on the occlusal surface throughout the experimental period. Histopathological changes of the periodontal ligament at the furcation lesion of the lower-left-first molar and its surrounding periodontal tissues were observed under a light microscope. The densities of deeply dyeing cells in hematoxylin staining with a round-shaped nucleus were increased in the periodontal ligament, with a peak effect of day 4. Multinucleated giant cells appeared in the central lesion of the periodontal ligament on day 7. The distribution of resorption on the surface of both of the cementum and the alveolar bone was accompanied by multinucleated giant cells, which expanded rapidly from day 7 to day 14. These results showed that histopathological changes of periodontal tissues to excessive occlusal load were observed at the furcation area of molar teeth. The present method confirmed the effectiveness of the experimental model to examine the occlusal trauma on periodontal tissues produced by excessive occlusal load.journal articl