Three-dimensional human placenta-like bud synthesized from induced pluripotent stem cells

Placental dysfunction is related to the pathogenesis of preeclampsia and fetal growth restriction, but there is no effective treatment for it. Recently, various functional three-dimensional organs have been generated from human induced-pluripotent cells (iPSCs), and the transplantation of these iPSCs-derived organs has alleviated liver failure or diabetes mellitus in mouse models. Here we successfully generated a three-dimensional placental organ bud from human iPSCs. The iPSCs differentiated into various lineages of trophoblasts such as cytotrophoblast-like, syncytiotrophoblast-like, and extravillous trophoblast-like cells, forming organized layers in the bud. Placental buds were transplanted to the murine uterus, where 22% of the buds were successfully engrafted. These iPSC-derived placental organ buds could serve as a new model for the study of placental function and pathology

Pharmacotherapeutic outcomes in atypical odontalgia : determinants of pain relief

Objectives: There has been considerable research which has focused on clarifying the origin of pain in patients with atypical odontalgia (AO), also known as “idiopathic toothache”, and on identifying effective treatment, but there has been limited success so far. In this study, we assessed the outcomes of treatment and attempted to identify factors that could account for pain remission in patients with AO. Patients and methods: Data for 165 patients diagnosed with AO from June 2015 to August 2017 were retrospectively reviewed. The patients’ sex, age, duration of pain, and psychiatric history were collected, along with information on pain intensity, depressive status, and catastrophizing scores. Responses at 4 and 16 weeks from the start of treatment were observed. The associations between potentially associated factors and outcome were investigated using Bayesian model averaging. Results: A 30% reduction in pain was reported by 38 patients (46.3%) at 4 weeks and by 54 patients (65.9%) at 16 weeks. The pain intensity decreased as the depression and catastrophizing score improved; all of the changes were statistically significant (P<0.001). Four elements, that is, patient sex, depression score at baseline, pain score at 4 weeks, and change in the catastrophizing score, explained 52.5% of the variation in final outcome between individual patients. Conclusion: Our findings confirm the efficacy of tricyclic antidepressants (TCAs) as a treatment for AO and indicate that other medications, especially aripiprazole used in combination with a TCA, may be useful. A considerable number of patients, especially women, those with lower levels of depression at baseline, and those who responded to 4 weeks of treatment, achieved pain relief

Expectant management of a herniated amniotic sac presenting as silent uterine rupture: a case report and literature review.

Foetal membranes bulging into the abdominal cavity is a unique initial manifestation of silent or complete uterine rupture during pregnancy. Since silent uterine rupture has potential risk for complete uterine rupture, which leads to acute life-threatening complications for both the mother and baby, it is difficult to determine whether to manage expectantly or surgically, including repair of the uterine wall or termination of the pregnancy, especially in the early second trimester. We present here a case of a herniated amniotic sac with overstretched uterine wall of the fundus presenting as silent uterine rupture, which was incidentally detected on routine ultrasonography at 18 weeks' gestation in a 38-year-old primigravida with a history of myomectomy for diffuse uterine leiomyomatosis. Magnetic resonance imaging examination revealed that the myometrium thickness was fully maintained at the site of the foetal membranes ballooning. The pregnancy was therefore managed expectantly and continued to successful delivery at 30 weeks' gestation. The precise assessment of the uterine wall may be essential to manage a herniated amniotic sac presenting as silent uterine rupture and to optimise the outcome of the pregnancy. We review all cases of a herniated amniotic sac out of focally overstretched uterine wall before 34 weeks' gestation

知の拠点としての図書館におけるアクティブラーニングに向けて ―本学附属図書館にて展開すべき「学び」とは―

What kind of“ learning” should be developed in our university library? The library is considered“ a knowledge- center.” It is also recognized as a space for active learning, apart from classroom interaction- by the community, Japanese educators, and the Ministry of Education, Culture, Sports, Science and Technology. The university library aims to provide effective methods for learning-in both typical and modern style materials and techniques-to encourage students to spend more time studying on their leisure time in a fun and interactive way. At present, our university strives to conduct an educational program and informative research which would encourage the students to be more independent. Therefore, we have developed and structured a library wherein students could work on their school requirements by themselves with ease and easy access. We aim to provide a place that can be mutually shared by both students and instructors, which would later yield to a more intellectual learning. We value education, and we believe that the best way to contribute to our university is to provide our students and teachers an appropriate area where they can further enhance their wisdom and knowledge, through various forms of media. This essay will provide detailed concepts for each floor at the time of development（ as of November 2013）. The library remains a solemn environment to allow the people to concentrate and focus on what they are studying on. It also has an area that would involve activities and workshops, suited for lively group learning and PBL. Up until now, our library did not have such activity-creating concepts. This change is foreseen as a vital diversity for learning. In order to reform this, we conducted a student survey to find out what more can be offered for the betterment of our students’ education. As a result, the majority of the students wanted to have a more“ feminine space”. This implies their demand that they be given a learning space which could be styled in a more fashionable, adult-like way, be equipped with the latest information tools, be more spacious and organized, be more interactive, and for it to still have a quiet environment for those who would want to study on their own. The students want to be given a space where they can discuss matters with each other. They also suggested on having a lounge area where they can listen to music, and have their snacks and drinks. Their belongings are also one of their major concerns, so they would like to be given room to place their belongings somewhere close to them, as not to bother other library enthusiasts. These opinions among the student body was then evaluated and discussed among the staff and faculty members of the university these improvements were necessary to provide a more interesting library which would encourage students to use more often than that of the past. We, the instructors of the university, also aim to make our students inquisitive, logical, and analytical, in every possible way. With this library development, we envision a more comfortable space for learning for both the students and the instructors. These changes are not merely for the purpose of dealing with the students’ pleas, but because we strongly believe that such vital changes were necessary to create a more improved educational outcome in accordance to the pursuit of excellence the students and instructors can contribute to the university, and vice versa. Through this project, instructors and students will be able to work face-to-face. The instructors will then learn what the students want. The students will be able to develop the required skills needed for their education and research. This is one learning area our university should develop

Burning Mouth Syndrome and Atypical Odontalgia

Objective: This study aimed (1) to investigate the differences in clinical characteristics of patients between 2 groups, those who have atypical odontalgia (AO) only and those who have AO with burning mouth syndrome (BMS), and (2) to assess the influence of psychiatric comorbidity factors on patients' experiences. Method: Medical records and psychiatric referral forms of patients visiting the Psychosomatic Dentistry Clinic of Tokyo Medical and Dental University between 2013 and 2016 were reviewed. The final sample included 2 groups of 355 patients: those who have AO only (n = 272) and those who have AO with BMS (AO-BMS; n = 83). Clinicodemographic variables (gender, age, comorbid psychiatric disorders, and history of headache or sleep disturbances) and pain variables (duration of illness, pain intensity, and severity of accompanying depression) were collected. Initial pain assessment was done using the Short-Form McGill Pain Questionnaire, and depressive state was determined using the Zung Self-Rating Depression Scale. Results: The average age, female ratio, and sleep disturbance prevalence in the AO-only group were significantly lower than those in AO-BMS group. AO-BMS patients rated overall pain score and present pain intensity significantly higher than did the AO-only patients (P = 0.033 and P = 0.034, respectively), emphasizing sharp (P = 0.049), hot-burning (P = 0.000), and splitting (P = 0.003) characteristics of pain. Patients having comorbid psychiatric disorders had a higher proportion of sleep disturbance in both groups and a higher proportion of depressive state in the AO-only group. Conclusions: AO-BMS patients have different epidemiological characteristics, sleep quality, and pain experiences compared to AO-only patients. The presence of psychiatric comorbidities in both groups may exacerbate sleep quality. We suggest that BMS as a comorbid oral disorder in AO patients contributes to a more intensively painful experience