Oral findings in Noonan syndrome : Report of a case

Oral findings in a case of Noonan syndrome in an 8-year-old Japanese male are reported. Examination of the patient revealed a narrow, higharched palate and an anterior open bite. Cephalometric measurements showed a wide gonial angle, a large mandibular plane angle, a large Y-axis and long facial height. It is suggested that the patient had a skeletal open-bite malocclusion, which included an abnormal swallowing habit

Localization of Heat Shock Protein 27 (Hsp27) in the Rat Gingiva and its Changes with Tooth Eruption

Heat shock protein 27 kDa (Hsp27) functions as a molecular chaperon to prevent apoptosis as well as to contribute to the regulation of cell proliferation and differentiation during development. In the present study, the localization of Hsp27 in the oral epithelium of rats and its expression change during formation of the gingiva with the tooth eruption were examined immunohistochemically to elucidate the roles of Hsp27 in the oral mucosa

Japanese Lung Cancer Society Guidelines for Stage IV NSCLC With EGFR Mutations

Patients with NSCLC in East Asia, including Japan, frequently contain EGFR mutations. In 2018, we published the latest full clinical practice guidelines on the basis of those provided by the Japanese Lung Cancer Society Guidelines Committee. The purpose of this study was to update those recommendations, especially for the treatment of metastatic or recurrent EGFR-mutated NSCLC. We conducted a literature search of systematic reviews of randomized controlled and nonrandomized trials published between 2018 and 2019 that multiple physicians had reviewed independently. On the basis of those studies and the advice from the Japanese Society of Lung Cancer Expert Panel, we developed updated guidelines according to the Grading of Recommendations, Assessment, Development, and Evaluation system. We also evaluated the benefits of overall and progression-free survival, end points, toxicities, and patients’ reported outcomes. For patients with NSCLC harboring EGFR-activating mutations, the use of EGFR tyrosine kinase inhibitors (EGFR TKIs), especially osimertinib, had the best recommendation as to first-line treatment. We also recommended the combination of EGFR TKI with other agents (platinum-based chemotherapy or antiangiogenic agents); however, it can lead to toxicity. In the presence of EGFR uncommon mutations, except for an exon 20 insertion, we also recommended the EGFR TKI treatment. However, we could not provide recommendations for the treatment of EGFR mutations with immune checkpoint inhibitors, including monotherapy, and its combination with cytotoxic chemotherapy, because of the limited evidence present in the literature. The 2020 Japanese Lung Cancer Society Guidelines can help community-based physicians to determine the most appropriate treatments and adequately provide medical care to their patients

Three-dimensional analysis of the effects of the treatment on anterior crossbite in the primary dentition

We performed measurement using a 3-dimensional measurementsystem in study models of children with anterior crossbite in the primarydentition treated using a chin cap and lingual arch, and evaluated changes inthe dentition and occlusion after treatment based on measurement values andalso using wire frame models. Comparing with the situation before treatment,the overbite of anterior teeth shows improvement to become shallow and theterminal plane becomes vertical type and the occlusal plane becomes flatter.Labioclination of upper anterior teeth, linguoclination of lower anterior teethand backward movement of lower dentition are observed. Occlusal view showsthat both upper and lower dental arch become semicircular configuration. Thewidth, depth and height of the post-treatment dentition became closer to thestandard values. Chin cap and lingual arch treatment for anterior crossbiteduring early childhood is effective, and also helpful in the normal developmentof occlusion in children

A Study on Dentition and Occlusion in Children with Infraocclusal Lower First Decidous Molars

低位下顎第一乳臼歯の存在が歯列咬合関係に与える影響を検討した。対象は男児12名, 女児17名, 計29名の日本人乳児である。歯列研究用模型を用いて, 咬合関係, 歯および歯列の大きさ, 下顎歯列の彎曲について, Hellmanの歯齢別に検討を行い, 以下の結果を得た。 1. 咬合関係 前歯の咬合関係では, 反対咬合の割合が最も高かった。ⅡC期の資料のterminal planeはmesial step typeが最も多く, ⅢA期以降の資料の第一大臼歯の咬合関係はAngleのⅢ級が最も多かった。 2. 歯および歯列弓の大きさ 下顎第一乳臼歯が左右とも低位乳歯である歯列は, 上下顎ともに第二乳臼歯間の歯列弓幅径が小さく, 歯列弓長径が大きかった。 3. 下顎歯列弓の彎曲 下顎第一乳臼歯が左右とも低位乳歯である歯列の彎曲は, 左右差はなく, 左右ともに標準値より大きかった。左右どちらか一方が低位乳臼歯の歯列の彎曲は, 患側は標準値に近かったが, 健側は標準値より大きく, 左右非対称であった。また, ⅡC期よりもⅢA期の方が彎曲が大きく, 第一乳臼歯がより低位である傾向が認められた。 以上の結果より, 下顎第一乳臼歯が低位乳歯である歯列の咬合関係は, 反対咬合である割合が高く, 矢状方向からみた下顎歯列弓の彎曲が強い傾向が示された。The purpose of this study was to examine the effects of lower infraocclusal first deciduous molars on the dental occlusal relationship. The occlusal relationship, length of the dental arch, width of the dental arch, and the occlusal curvature of lower dentition were discussed in accordance with Hell-man's dental age using 29 study casts. The results of this study were as follows: 1. Concerning the anterior occlusal relationship, the anterior crossbite was found to occur with high frequently. 2. Concerning the occlusal relationship of the first molars in materials of dental age IIIA and dental age IIIB, Angle's class III was the most common. 3. For the dentition with lower infrnocclusal first deciduous molars on both sides, the width of the dental arch between the second deciduous molars was small, and the length of the dental arch was large in both maxilla and mandible. 4. The occlusal curvature of the dentition with lower infraocclusal first deciduous molars on both sides was larger than the standard value of the lower occlusal curvature of the normal occlusion. 5. The occlusal curvature of the dentition when one side has no lower infraocclusal first deciduous molar was close to the standard value. On the other hand, the side with the infraocclusal first deciduous molar was larger than the standard value and dissymmetrical with respect to the side with the infraocclusal first deciduous molar. 6. The subjects of dental age IIIA showed a larger curve than those of dental age IIC, showing a tendency of toward infraocclusal first deciduous molars

Individualized Support Based on Characteristics of Patients with Autistic Spectrum Disorder in Pediatric Practice

自閉症スペクトラム障害(Autism Spectrum Disorder以下ASD)の小児には,知的障害の有無に関わらず整理統合が困難で視覚優位である者が多い。また,ASD児の能力には個人差があるため,支援者は障害特性に配慮した個別対応が要求される。ところが,歯科診療時におけるASD児の対応法に関する情報はいまだ不十分である。 そこで,当科にて歯科診療時に行ったASD児への個別対応のうち効果的であったものを報告する。 症例1 初診時2歳11か月,男児,高機能自閉症・AD/HD(注意欠如・多動性障害) この患児は,3歳時既に全ての干仮名と数字が読めた。そこで,診療に対する混乱の除去のため,文字情報で予定を可視化した(Word Schedule)。予定の最後を「ごほうび」と記し、強化子として患児の好きなキャラクターの塗り絵を使用した。 症例2 初診時6歳11か月,男児,白閉症(知的障害を伴う) 絵カードを予定の順に並べ(予定の構造化),入室前に患児へ見せた。治療のステップが1つ終わる度に,褒め言葉と同時に○のサインボードを見せた。これは,言葉だけでなく視覚的にもできたことや褒められたことを認識できるようにするための援助である。 以上の対応により,スムーズに診療が行えた。このように,ASD児の歯科診療の際には,個々の発達レベルや行動を十分に観察した上で個別化された支援方法により対応することが有効と考えられた。Many children with autistic spectrum disorder (ASD) and with or without intellectual disability have weak central coherence and a tendency to learn in a visual manner. Because of individual differences in the developmental status of ASD children, personalized support is optimal. However, there is scant published information about methods for providing individualized support in dental practice for children with ASD. Here, we describe effective strategies for providing individualized support in dental practice for children with ASD treated at our clinic. Case 1 : Boy, aged 2 years 11 months, with high-functioning autism and AD/HD This child was able to read hiragana letters and numerals at the age of 3. Therefore, we showed him information about the clinical procedures (Word schedule) to remove emotional confusion about dental practice. We noted "reward" in red to give him a clear concept of the finish. The reward was included as a "reinforcer" and we used a drawing of his favorite cartoon character. Case 2 : Boy, aged 6 years 11 months, with autism and intellectual disability Picture cards portraying the events of the dental procedures in sequential order were shown to the child prior to and during therapy, with the picture card for each event removed when that step had been completed and a signboard with a red circle containing words of praise shown to the child. Thus, he received praise visually as well as through verbal encouragement. We also showed the child a timer that counted down the seconds until the procedure would be completed. Using these approaches, we were able to successfully facilitate dental treatments for children with ASD. It is clear that an individualized method, generated by assessing the development and behavior of each child, is advantageous for providing support of children with ASD

Expression of epidermal fatty acid binding protein (E-FABP) in septoclasts in the growth plate cartilage of mice

Subject of the dissertation is the synthesis and characterization of novel, nanoscopic transition metal colloids having reactive aluminumorganic protecting shells, and the formation of 3-D nanoparticle networks. The synthesis of aluminumorganic stabilized platinum colloids was investigated using the reaction of Pt(II)-acetylacetonate with aluminumtrimethyl. A novel di-platinum complex was identified as the key intermediate of the colloid formation. This complex decomposes in solution under formation of nanoscopic platinum particles with a mean diameter of 1.2 nm. The formation of these particles in solution was studied with Anomalous Small Angle X-ray Scattering (ASAXS). The isolated platinum colloids were characterized further with several analytic methods like Electron Microscopy (TEM) and X-ray Absorption Spectroscopy (XANES, EXAFS). The investigations showed, that the particles consist of zero-valent platinum with an aluminumorganic protecting shell containing reactive aluminum-methyl-groups. These reactive aluminum-methyl-groups are the prerequisite for the interconnection of the particles to form a 3-D nanoparticle network. For that purpose, the colloids are reacted with proton-active bifunctional "spacer-molecules". Suitable spacer molecules are diols or dicarboxylic acids which react with the aluminum-alkyl groups in the protecting shell under cleavage of methane. The structure and the electronic- and catalytic properties of the resulting Pt-nanoparticle-networks were intensively characterized. The investigations revealed, that the structure of the networks is strongly depending on the "spacer-molecule" chosen. The mean interparticle distance in the network increases with increasing length of the "spacer molecule". Variation of the "spacer molecule" also allows the pore-sizes and the specific surface areas to be tailored. Furthermore catalytic tests showed, that the Pt-nanoparticle networks are very efficient heterogeneous catalysts for the hydrogenation of alkenes