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

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

Psychiatric comorbidities in patients with Atypical Odontalgia

Objective: Atypical Odontalgia (AO) is a condition characterized by tooth pain with no apparent cause. Although psychiatric comorbidity seems to be very common, it has rarely been studied. To clarify the influence of psychiatric comorbidity on the clinical features in patients with AO, we retrospectively evaluated their examination records. Methods: Clinical features and psychiatric diagnoses of 383 patients with AO were investigated by reviewing patients' medical records and referral letters. Psychiatric diagnoses were categorized according to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). We also analyzed visual analogue scale (VAS), self-rating depression scale (SDS), and the short-form McGill pain questionnaire (SF-MPQ) scores. Results: Of the 383 patients with AO, 177 (46.2%) had comorbid psychiatric disorders. The most common were depressive disorders (15.4%) and anxiety disorders (10.1%). Serious psychotic disorders such as bipolar disorder (3.0%) and schizophrenia (1.8%) were rare. Dental trigger of AO was reported in 217 (56.7%) patients. There were no significant correlations between psychiatric comorbidities and most of the demographic features. Higher VAS and SDS scores, higher frequency of sleep disturbance, and higher ratings of “Fearful” and “Punishing-cruel” descriptors of the SF-MPQ were found in patients with psychiatric comorbidity. Conclusions: About half of AO patients had comorbid psychiatric disorders. Dental procedures are not necessarily causative factors of AO. In AO patients with comorbid psychiatric disorders, pain might have a larger emotional component than a sensory one. VAS, SDS, and SF-MPQ scores might aid in the noticing of underlying comorbid psychiatric disorders in AO patients

Comorbid depressive disorders and left-side dominant occlusal discomfort in patients with phantom bite syndrome

Background: Phantom bite syndrome (PBS) is characterised by occlusal discomfort without corresponding dental abnormalities. Despite repeated, failed dental treatments, patients with PBS persist in seeking bite correction. PBS has been regarded as a mental disorder. However, we have reported that PBS patients with a dental trigger tend to have less psychiatric history than those without. Hence, the symptoms of PBS cannot be explained by a mental disorder alone, and it is unclear if mental disorders affect occlusal sensation. Objective: To elucidate the pathophysiology of PBS, we analysed the dental history, PBS symptom laterality and psychiatric history of patients. Methods: In this retrospective study, we reviewed outpatients with PBS who presented at our clinic between April 2012 and March 2017. Their medical records were reviewed for demographic data, medical history and laterality of occlusal discomfort. Results: Approximately half of the 199 enrolled patients had bilateral occlusal discomfort. In the others, the side with occlusal discomfort generally tended to be the one that had received dental treatment. There was no significant relationship between the side chiefly affected by occlusal discomfort and whether dental treatment had been received; however, the affected side differed depending on whether the patient had comorbid psychiatric disorders (P = .041). Conclusions: The distributions of the side with symptoms of PBS were different between those with and without comorbid psychiatric disorders, suggesting that psychiatric disorders might affect occlusal sensation due to a subtle dysfunction in brain areas central to sensory integration. Central dysfunction might play an important role in PBS

Retrospective chart review of oral somatic delusions

Objective: Oral cenesthopathy is characterized by foreign body sensations without medical and dental evidence for them. It is thought to be a rare disease in psychiatry, but many patients are visiting dental clinics seeking treatment to remove a foreign body. Even though the features of oral cenesthopathy might be different between a psychiatric clinic and a dental clinic, there has been no clinico-statistical study from dentists. In this study, we report a clinico-statistical study of patients with oral cenesthopathy in dentistry. Methods: This is a retrospective chart review of 606 outpatients with oral cenesthopathy in Tokyo Medical and Dental University from April 2010 through to March 2015. Results: A total of 159 male and 447 female patients were included in this study. The mean age was 62.08 years, and female patients were older than male patients. The trigger of the dental treatment and the acute phase of depression at the onset were significantly related (p=0.037). Only 128 patients (36%) had clinically significant improvement after 6 months of pharmacotherapy. No history of psychiatric disorders (odds ratio [OR] 0.479 [95% confidence interval {CI}: 0.262–0.875], p=0.017) and longer duration of illness (>18 months) (OR 2.626 [95% CI: 1.437–4.799], p=0.002) were significant factors for clinical outcomes. Conclusion: Patients with oral cenesthopathy in our clinic were predominantly elderly female patients. Dental treatment in the acute phase of depression might be a risk factor for oral cenesthopathy. Therefore, comprehending the situation of psychiatric disorder and obtaining adequate informed consent might be required to prevent the trouble concerning oral cenesthopathy

ナマズ卵レクチンのクラスター形成と細胞内輸送

Rhamnose-binding lectins are widely found in fush eggs,and Silurus asotus lectin (SAL) isolated from catfish eggs having three carbohydrate recognition domains preferentially recognizes non-reducing end Galα-linked sugar chain.In the previous study,we revealed that SRL binds to globotriaosylceramide (Gb3) by the surface plasmon resonance analysis.However,its biological effect on cultured cells is still unclear.To investigate localization and trafficking of SAL in the renel adenocarcinoma ACHN cells,which express Gb3 on the cell surface,we prepared HiLyte Fluor 555-labeled SAL (HL-SAL).When ACHN cells were treated with HL-SAL at 4℃ for 5min, and at 37℃ for 24h,HL-SAL was distributed on the cell membrane and in the intracellular compartment,respectively.To trace the trafficking route of HL-SAL from cell surface to the intracellular compartment,the images of HL-SAL-treated live cells were obtained using confocal scanning microscopy.HL-SAL was clustered on ACHN cell surface,and furthermore,partially co-localised with transferrin in intracellular compartment.These results suggest that SAL induces alteration of Gb3 distribution on the membrane and migrates from the cell surface to the intracellular vesicles

NBRP databases: databases of biological resources in Japan

The National BioResource Project (NBRP) is a Japanese project that aims to establish a system for collecting, preserving and providing bioresources for use as experimental materials for life science research. It is promoted by 27 core resource facilities, each concerned with a particular group of organisms, and by one information center. The NBRP database is a product of this project. Thirty databases and an integrated database-retrieval system (BioResource World: BRW) have been created and made available through the NBRP home page (http://www.nbrp.jp). The 30 independent databases have individual features which directly reflect the data maintained by each resource facility. The BRW is designed for users who need to search across several resources without moving from one database to another. BRW provides access to a collection of 4.5-million records on bioresources including wild species, inbred lines, mutants, genetically engineered lines, DNA clones and so on. BRW supports summary browsing, keyword searching, and searching by DNA sequences or gene ontology. The results of searches provide links to online requests for distribution of research materials. A circulation system allows users to submit details of papers published on research conducted using NBRP resources

Glycosphingolipid-enriched microdomain中でGb3と会合する分子の探索

Silurus asotus (catfish) egg lectin (SAL) is a member of rhamnose-binding lectin family, and binds to globotriaosylceramide (Gb3) localized in a glycosphingolipid-enriched microdomain (GEM) on several tumor cell lines. It is known that GEM is involved in cell adhesion and has the capability of sending signals. We report here about proteins involved in GEM associating with Gb3 and mediating signal transduction system in Burkitt\u27s lymphoma Raji cells via SAL binding to Gb3. Although Gb3 molecule was sprinkled over the surface of Raji cells, SAL uniformly bound to the Raji cell surface. Sucrose density-gradient centrifugation method and fluorescence microscopic analysis revealed that not only CD20 and CD81 but also Lyn and Csk were distributed in GEM of Raji cells. The distribution of these molecules was not altered by the treatment with SAL at 4℃ for 30 ruin. Because CD20 was not co-precipitated with the anti-Gb3 antibody, CD20 was not associated with Gb3 on Raji cells. However, there was a 47kDa protein, which was specifically co-precipitated with anti-Gb3 antibody. These results suggest that the 47kDa protein is a candidate for Gb3-associating protein in Raji cells

Learning Effectiveness in Nursing Skills Education by Designing a Flipped Classroom with ICT

PDF本研究の目的は、反転授業のデザインを基に再構築して展開した「栄養と食事」の看護技術教育の学習効果と課題を検討することである。反転授業に基づき再構築した技術学習を全て受講し、研究の同意が得られた看護学科１年生10 名を対象にグループインタビューをオンラインで実施し、質的帰納的に分析した。オンデマンド授業後に、オンライン授業と援助計画のディスカッションを経て、食事援助演習を行うという学習方法の効果について、研究に参加した学生の語りを分析した結果、122 コードから9 サブカテゴリーと3 カテゴリーが構成された。オンデマンド授業では＜今までよりも疑問を多く感じ解決したいと思う＞ことで＜既習の知識を全部活用する必要性に気づく＞ことや、＜自分のペースで繰り返す学習で理解が深まる＞ことを実感していた。オンライン授業と対面演習では＜仲間とのやり取りで疑問を解消しながら援助を想像する＞ことや、＜授業での理解を踏まえて患者への良いケアを深く思考する＞という、自らの考えを深める様子が示された。学習途上では＜議論が深まらず疑問が残り不安になる＞様子も見られたが、教員の支援や協働的な学習を経て＜患者にとって良いと思う援助方法を試行錯誤しながら探求する＞ことに至り、＜疑問を解消するためにいつもより教員に質問をする＞ことで＜演習でのやり取りを通じて援助方法に自信が持てる＞と感じていた。反転授業では学習途上において学生が抱く不安に課題があるものの、基本知識の習得と既習知識の活用に効果を発揮し、より良い援助方法を探求する機会となっていた。「栄養と食事」の技術教育は、学生自身が日常生活を手掛かりに想起しやすい援助技術であり、反転授業の展開に適していることが考えられた。Objective：We made a "Nutrition and Diet" nursing skills class with a flipped classroom design. The purpose of this study is to examine the effects and challenges of class. Methods：These are the 10 first-year nursing students who agreed to take all the Flippedclassroom classes. Group interviews were conducted online and analyzed qualitatively. This study was approved by the ethics committee of our institution. Results：The learning effects are summarized in 9categories. On demand, students had more questions than ever and wanted to solve them. Therefore, the students found it necessary to use all the knowledge they had already learned. The students also realized that they could repeat the learning at their own pace, which deepened their understanding. In class, students imagine how to help patients while answering questions through interactions with their peers. Students will think deeply about good patient care based on what they understand in class. And the students seemed to deepen their own thoughts. Students are still studying, so they are worried about not being able to have in-depth discussions with their peers.With the help of teachers and collaborative learning with their peers, they are exploring ways to make things better for patients through trial and error. Students will ask more questions than usual to the faculty to clear their doubts. So, students gain confidence in how to help by interacting with their peers in class. Conclusion：Although student anxiety is an issue for the Flipped classroom, it is effective in helping students learn the basics and use the knowledge they already have. And it is an opportunity for students to explore even better ways to help their patients. The "Nutrition and Diet" class is suitable for a Flipped Classroom because students can easily imagine it from their own daily lives.departmental bulletin pape

イイダコ(Octopus ocellatus)卵由来の赤血球凝集素について

Hemagglutinating activity was found in extract from Octopus ocellatus eggs. The hemagglutinin was partially purified by ammonium sulfate precipitation and DEAE anion exchange chromatography. DT300, a 300 mM NaCl-eluted fraction from DEAE column, possessed Ca^-dependent hemagglutinating activity on rabbit erythrocytes at concentrations from 0.47 to 30 μg/mL. Protein bands over 200 kDa were observed in DT300 on sodium dodecyl sulfate polyacrylamide gel electrophoresis. On the other hand, ruthenium red staining gave an obvious single band on a cellulose acetate membrane. The protein and carbohydrate contents of DT300 were 24% and 2%, respectively. DT300-induced hemagglutination was inhibited by fetuin, asialofetuin, heparin, and DNA but not by heparan sulfate and mono- or oligosaccharides tested. This activity was resistant to heat and protease digestion. These results indicate that the active component having C-type lectin-like activity from octopus eggs may not be composed of protein