コウクウ シュウヘン ノ キンマクゲキ

The fascial spaces in the maxillofacial and anterior neck regions are divided into three groups: superficial, intra-layer, and deep, named according to their positional relation to the superficial layer of the cervical fascia (SL). The spaces 1) to 8) described below are distributed around the oral cavity, 1) to 4) and 5) to 8) of which are included in the superficial and intra-layer groups, respectively. 1) The buccal and infraorbital spaces. The former lies between the superficial fascia of face and the buccinator, which is posteriorly continuous to the buccal fat pad. The latter lies between the levator labii superioris and the levator anguli oris. 2) The buccal fat pad. It sandwiches the ramus of mandible from the front and lies superficial to the fascia covering the lateral and medial pterygoidei and the temporalis. 3) The peritonsillar space. It is adjacent to the prestyloid space with the superior constrictor located in between. 4) The sublingual space. It lies in the floor of mouth. It is separated from the submandibular and submental spaces by the mylohyoid, and communicates with them through slits between muscle bundles of the mylohyoid or over its posterior free border. The spaces 1) to 4) are adjacent to the oral cavity and may be involved in spread of odontogenic infection. 5) The submental space. It lies in the median region bounded by the two anterior bellies of digastric muscles and the hyoid bone. Its roof and bottom are composed of SL and the mylohyoid, respectively. It posteriorly communicates with the submandibular space. 6) The submandibular space. It is enveloped by SL and located in the submandibular region bounded by the digastric and mandible. It communicates with the pterygomandibular and poststyloid spaces via the route of the lingual and mylohyoid nerves and that of the facial artery and vein, respectively. 7) The pterygomandibular space. It and the prestyloid space lie between SL and the cranial base. It is a fatty space between the medial and lateral pterygoidei. It is anteriorly adjacent to the buccal fat pad, and posteriorly communicates with the parotid space via the route of the maxillary artery and vein. 8) The prestyloid space. It lies medial to the pterygomandibular space with the medial pterygoideus located in between, and communicates with the pterygomandibular space beneath the foramen ovale. It is posteriorly adjacent to the parotid space, and further communicates with the poststyloid and retropharyngeal spaces of the deep group

Effects of SLIT with JCP tablets

Objective : We examined the effects of SLIT with tablets containing JCP antigens on nasal symptoms and sleep disturbance in patients with Japanese cedar pollinosis during pollen dispersal season. Methods : A total of 128 patients with Japanese cedar pollinosis were categorized into four groups : 19 one-year SLIT with tablets group, 16 two-year SLIT with drops group, 19 antihistamine group, and 74 untreated group. The scores of nasal symptoms and sleep disturbance were evaluated based on the Japanese guidelines for allergic rhinitis and the Athens Insomnia Scale. Results : The scores of nasal symptoms and sleep disturbance at the peak cedar pollen period in the two-year SLIT with drop group and the one-year SLIT with tablets group were significantly lower than those in untreated group. Additionally, these scores were significantly lower in the one-year SLIT with tablets group than those in the antihistamine group. Conclusion : It is suggested that SLIT with JCP tablets improved both nasal symptoms and sleep disturbances at peak pollen period in patients with Japanese cedar pollinosis. SLIT with JCP tablets for one year was more effective than SLIT with JCP drops for two years and prophylactic treatment with antihistamines

Efficacy of dual sublingual immunotherapy with Japanese cedar pollen and house dust mite allergens in patients with allergic rhinitis sensitized to multiple allergens

Objective: In the present study, we examined the effects of dual sublingual immunotherapy (SLIT) with Japanese cedar pollen (JCP) and house dust mite (HDM) allergens on nasal symptoms during the peak pollen period (PPP) and in late fall (LF) in patients with allergic rhinitis (AR) sensitized to both JCP and HDM. We then compared the efficacy of dual-SLIT with JCP and HDM to that of mono-SLIT with JCP at PPP. Methods: Twenty-five bisensitized patients with AR who showed positive serum specific immunoglobulin E (IgE) against both JCP and HDM were enrolled. In dual-SLIT, 16 patients received JCP drops/tablets and HDM tablets concurrently. In mono-SLIT with JCP, nine patients received JCP drops/tablets. Nasal symptoms were scored on a 0–4 point scale. Results: The nasal scores at PPP and in LF in the bisensitized patients with AR who received dual-SLIT with JCP and HDM in 2019 were significantly lower than those in the same patients who received antihistamines only in 2018. The decrease in scores of nasal obstruction at PPP from 2018 to 2019 in patients who received dual-SLIT was significantly greater than those in patients who received mono-SLIT with JCP. Dual-SLIT was well tolerated and only had mild adverse effects. Conclusion: These findings suggest that dual-SLIT suppressed both JCP-induced seasonal and HDM-induced perennial nasal symptoms in bisensitized patients with AR. Dual-SLIT was more effective in suppressing nasal obstruction at PPP than mono-SLIT with JCP with limitation of baseline characteristics not to be controlled between the two groups, suggesting that dual-SLIT suppressed HDM-induced priming effects, thus resulting in further suppression of nasal obstruction at PPP. Level of Evidence: 3b, a case-controlled stud

Measurement of the zygomatic bone and pilot hole technique for safer installation of zygomaticus implants

The zygomaticus implant (Brånemark system, Nobel Biocare, Gotebörg, Sweden) was developed for patients with severe bone resorption of the posterior maxilla, which may eliminate or minimize the need for bone grafting. Although the zygomaticus implant has had a remarkable success rate in a difficult patient population, the method requires an advanced surgical technique and carries increased risk of complications, such as the perforation of the orbital floor or infratemporal fossa. Although it is important to have a detailed understanding of the anatomy of the zygomatic bone when performing the installation, there have been few anatomic studies on the zygomatic bone for installation of zygomaticus implants. In this study, we measured the height and thickness of the zygomatic bone for the installation. The thickness at a 90-degree angle point, where the upper margin of the zygomatic arch and the temporal margin of the frontal process of the zygomatic bone intersect and where the apex of the implant penetrates, according to the original method, was 1.8 ± 0.4 mm, which gradually increased inferiorly and anteriorly. In conclusion, the penetration point of the apex of the zygomaticus implant should be located more inferoanterior to the 90-degree angle point, as the thickness of the 90-degree angle point is thinner than the diameter of the implant. Based on these results, we have proposed a newer and safer installation method for the zygomaticus implant using a drill guide, which can be easily made

Courses of the Human Sublingual Artery

The purpose of the present study was to classify the courses of the human sublingual artery. For this purpose, the arteries supplying the floor of the mouth and the tongue were gross anatomically investigated, using 101 sides of 53 cadavers. The courses were divided into three categories: those passing medial or lateral to the hyoglossus (Categories M and L) and that piercing the mylohyoid (Category P), which were subdivided into five types. Category M had one type regarded as the usual type in which the lingual artery took the usual pattern of distribution. Categories L and P, in which the sublingual artery arose from the facial or submental artery, had the respective two types and were collectively regarded as the unusual type. Sixty-one and 36 of the 101 sides were of the usual and unusual types, respectively, the latter of which included 17 of Category L and 19 of Category P. The remaining four were variations of the lingual artery itself. On examining the types by gender, the usual type was more often found in females (75.6%), whereas the unusual type was more often found in males (48.1%). Bilateral occurrence of the same type was often found in both the usual type (77.4%) and the unusual type (65.0%). Existence of the sublingual artery branch significantly increased the thicknesses of the submental arteries. The classification proposed here will conceivably contribute to safer dental implant surgery and more accurate interpretation of angiographic images of arteries in the floor of the mouth

Narrow-band UVB suppresses nasal symptom and H1R mRNA

Background: Phototherapy with narrow-band ultraviolet B (narrow-band UVB) is clinically effective treatment for atopic dermatitis. In the present study, we examined the effects of intranasal irradiation with narrow-band UVB on nasal symptom, upregulation of histamine H1 receptor (H1R) gene expression and induction of DNA damage in the nasal mucosa of allergic rhinitis (AR) model rat. Methods: AR model rats were intranasally irradiated with 310 nm of narrow-band UVB. Nasal mucosal levels of H1R mRNA were measured using real-time quantitative reverse transcriptase (RT)-PCR. DNA damage was evaluated using cyclobutane pyrimidine dimer (CPD) immunostaining. Results: In toluene 2, 4-diisocyanate (TDI)-sensitized rats, TDI provoked sneezes and H1R gene expression in the nasal mucosa. Intranasal pre-irradiation with 310 nm narrow-band UVB at doses of 600 and 1400, but not 200 mJ/cm2 significantly inhibited the number of sneezes and upregulation of H1R gene expression provoked by TDI. CPD-positive cells appeared in the nasal mucosa after intranasal narrow-band UVB irradiation at a dose of 1400, but not 200 and 600 mJ/cm2. The suppression of TDI-provoked sneezes and upregulation of H1R gene expression lasted 24 h, but not 48 h, after narrow-band UVB irradiation with a dose of 600 mJ/cm2. Conclusions: Intranasal pre-irradiation with narrow-band UVB dose-dependently inhibited sneezes and upregulation of H1R gene expression of the nasal mucosa in AR model rats, suggesting that the inhibition of nasal upregulation of H1R gene expression suppressed nasal symptom. The suppression after narrow-band UVB irradiation at a dose of 600 mJ/cm2 was reversible without induction of DNA damage. These findings indicated that low-dose narrow-band UVB phototherapy could be effectively and safely used for AR treatment in a clinical setting

INCS suppresses H1R gene expression

The purpose of this study is to examine the effect of intranasal corticosteroid (INCS) administration on histamine H1 receptor (H1R) gene expression in the nasal mucosa of healthy participants and the effects of dexamethasone on basal and histamine-induced H1R mRNA expression, and histamine-induced phosphorylation of extracellular signal-regulated kinase (ERK) in HeLa cells. Sixteen healthy participants were given INCS once daily for a week. After pretreatment of dexamethasone, HeLa cells were treated with histamine. Levels of H1R mRNA and phosphorylation of ERK were measured using real time PCR and immunoblot analysis, respectively. Levels of H1R mRNA in the nasal mucosa of healthy participants receiving INCS was significantly decreased. Dexamethasone suppressed basal levels of H1R mRNA, and histamine-induced up-regulation of H1R mRNA and ERK phosphorylation in HeLa cells. These data suggested that corticosteroid inhibited both basal transcription and histamine-induced transcriptional activation of H1R through its suppression of ERK phosphorylation in the signaling pathway involved in H1R gene transcription. It is further suggested that pre-seasonal prophylactic administration of INCS suppresses both basal and pollen-induced upregulation of H1R gene expression in the nasal mucosa of patients with pollinosis, leading to prevention of the exacerbation of nasal symptoms during peak pollen season

FIR Ceramics Promote the Formation of Bone

Far infrared ray (FIR) energy radiated by the natural ceramics (Rhyolite) cooled FIR ceramics activates water molecules and blood circulation to stimulate skin and other tissues. The aim of our study is to make clear whether the FIR ceramics radiating FIR energy affect or not on the new bone formation in vivo and in vitro. Methods: MC3T3-E1 cells were cultured in FIR CO2 incubator. The cell proliferation and the gene expression were analyzed by using WST-8 assay kit, RT-PCR and micro array analysis. The enzyme activities were analyzed by using the apiRZYM kit. Furthermore, titanium and natural FIR ceramics compounds were implanted under the periosteium of rat skull bone by injection method. Four weeks later, the samples were examined by the light microscope and micro CT analyses. Results: Proliferation of MC3T3-E1 cell was and DNA concentrations were inhibited by FIR energy radiation. The ALP activities were accelerated and the area of calcification nodules increased on 4 weeks. The RT-PCR data showed that the gene Runx2, Osterix, BSP, OCN, Col1a1 and OPN expression of MC3T3-E1 osteoblast like cells was activated. Bone mineral density (BMD mg/cm²) of implanted sites of T50-F50, T25-F75 and F100 groups was significantly enhanced after 4 weeks compared with control groups. This data shows FIR energy radiation by the natural FIR ceramics promoted bone-forming activity of osteoblasts. Significance: This study suggested that new bioactive ceramics such us natural FIR ceramics was useful for some clinically applications to repair bone defects for example of dental implant surgery

Muscle mass, quality, and strength; physical function and activity; and metabolic status in cachectic patients with head and neck cancer

Background & aims: Cancer cachexia is commonly associated with poor prognosis in patients with head and neck cancer (HNC). However, its pathophysiology and treatment are not well established. The current study aimed to assess the muscle mass/quality/strength, physical function and activity, resting energy expenditure (REE), and respiratory quotient (RQ) in cachectic patients with HNC. Methods: This prospective cross-sectional study analyzed 64 patients with HNC. Body composition was measured via direct segmental multifrequency bioelectrical impedance analysis, and muscle quality was assessed using echo intensity on ultrasonography images. Muscle strength was investigated utilizing handgrip strength and isometric knee extension force (IKEF). Physical function was evaluated using the 10-mwalking speed test and the five times sit-to-stand (5-STS) test. Physical activity was examined using a wearable triaxial accelerometer. REE and RQ were measured via indirect calorimetry. These parameters were compared between the cachectic and noncachectic groups. Results: In total, 23 (36%) patients were diagnosed with cachexia. The cachectic group had a significantly lower muscle mass than the noncachectic group. Nevertheless, there was no significant difference in terms of fat between the two groups. The cachectic group had a higher quadriceps echo intensity and a lower handgrip strength and IKEF than the noncachectic group. Moreover, they had a significantly slower normal and maximum walking speed and 5 STS speed. The number of steps, total activity time, and time of activity (<3 Mets) did not significantly differ between the two groups. The cachectic group had a shorter time of activity (≥3 Mets) than the noncachectic group. Furthermore, the cachectic group had a significantly higher REE/body weight and REE/fat free mass and a significantly lower RQ than the noncachectic group. Conclusions: The cachectic group had a lower muscle mass/quality/strength and physical function and activity and a higher REE than the noncachectic group. Thus, REE and physical activity should be evaluated to determine energy requirements. The RQ was lower in the cachectic group than that in the noncachectic group, indicating changes in energy substrate. Further studies must be conducted to examine effective nutritional and exercise interventions for patients with cancer cachexia