シカ シンシン イガク ノ ショウカイ : カンカク イジョウ オ ウッタエル カンジャ ノ シカ チリョウ

This paper summarizes the clinical instruction lecture that was held at the meeting of Shikoku Shigakukai on March 22, 2012. A psychosomatic disorder is usually defined as follows. 1) It is a disorder that is manifested in the patient's body (somatic), 2) the psychosocial factor is connected to the development of symptoms and its progress, and 3) the patient experiences an organic or functional problem. This definition excludes the physical disability that are experienced along with mental disorder, such as neurosis, depression and schizophrenia. In the field of clinical dentistry, however, the definition of psychosomatic disorder usually covers a wider range of symptoms than the definition cited above. That is, when patients who suffer from mental disorders such as neurosis, depression and schizophrenia complain of a symptom on the mouth or a maxiro-facial region that is different from common dental problems, then their symptoms are considered "so-called dental-psychosomatic disorder", and generally become the target of treatment. In the lecture, seven cases of this author's patients were introduced and added some considerations. These patients suffered from the "so-called dental-psychosomatic disorder"

ガク カンセツショウ カラ シカ シンシンショウ ソシテ コレカラ

The following presentation was prepared based on my experience of treating approximately 1,000 temporomandibular joint disorder (TMD) patients over the past 15 years. In one study, I researched the relationship between systemic joint laxity and dislocation of the disc, and concluded that a) temporomandibular joint is not just a joint in one's jaw but is an important component of one's entire body and that b) it reflects how a patient's other parts of the body functions. Another study was conducted on the relationship between the signs and symptoms of TMD and personality types. The research results revealed that a) those with unstable emotional state tend to suffer from TMD and that b) those who suffer from TMD tend to have unstable emotional state. This finding confirmed the body-mind connectedness; one's mind and body influence each other, and it is impossible to separat e one from the other. The other study on menopausal female patients who suffer from TMD revealed that a) it is necessary to involve psychosomatic medicine to the treatment of TMD patients and that b) many patients benefit from interdisciplinary treatment from the perspectives of psychiatry, psychosomatic internal medicine and obstetrics and gynecology

ガク カンセツショウ カンジャ ニオケル MR ガゾウ ショケン ト リンショウ ショケン ノ ヒカク ケントウ

Two hundred eighteen (28.4%) of 768 patients with temporomandibular disorders (TMD), who visited the Clinic for Temporomandibular Disorders, Tokushima University Medical and Dental Hospital during the period of January 2006 through December 2007, were examined using magnetic resonance (MR) imaging. The present study assessed clinico-statistically the correlation between MR images and the clinical findings of 157 patients with complete registered data in our TMD reporting system. The following findings were obtained: 1. MR imaging showed anterior disk displacement in 125 joints (67.9%), rotational disk displacement in 45 joints (24.5%), and sideways disk displacement in 13 joints (7.1%). 2. Joint effusion (JE) was found in 42.7% of 157 patients; 48.0% in females and 23.5% in males. In addition, anterior or rotational disk displacement was observed in 97% of patients with JE. Furthermore, condyle bone change was significantly higher in joints with than without JE. 3. The appearance of JE was significantly higher on the symptomatic side than the asymptomatic side, but tenderness of the temporomandibular joint (TMJ) area or the value of the visual analog scale (VAS) regarding pain and problems in daily life was not related to the presence of JE

チイキ コウレイシャ トノ フクシ タイケン ガクシュウ ノ キョウイク コウカ ト チイキ コウケン ジギョウ トシテノ ヒョウカ

本研究の目的は，地域高齢者との福祉体験学習における学生への教育効果と、地域貢献事業としての評価をすることである。徳島大学歯学部では，医療人を志すものとしての自覚を持つことを目的とした取り組みを県内16カ所の施設で合計28回実施した。これは，学生が口腔保健指導「お口の健康長寿教室」において，高齢者を対象とした口腔機能訓練の補助者として体験学習するものである。学習後のレポートから， 到達目標とした地域貢献の在り方や歯科専門職としての役割を認識する学生が多くを占めた。一方，地域貢献事業として評価するため，参加職員への調査を行った結果，利用者への役立ちに加え，多くの施設職員の理解も深まったとのアンケート結果が得られた。以上から，本取り組みは学生への教育目標「医療人としての自覚を持つ」に沿った成果が得られており，また，施設職員の口腔機能向上プ口グラムへの盤解の深まりから，今後の継続が期待される。The purose of this study is to evaluate the educational effect by the welfare-experience learning program with aged people in community，and to evaluate this program as the regional contribution. This program is to aim at having a consciousness of becoming the dental professional in the University of Tokushima，Faculty of Dentistry，and they were carried out with 16 institutions (a total of 28 times).This program makes students accompany the oral health guidance"long-life oral healthy classroom"，and they carried out the experience study as on auxiliary person of the variaus functional oral-training for elderly people.By the investigation of the student's report, there are students who recognized the achievement objectives which are roles of the way concerning regional contribution as dental professionals in community. On the other hand，the questionnaire to the participating persoonnel was conducted in order to evalaote this program as the regional contrtbution. As a result，this program is useful to elderly people and the understanding of institution personnel is also deepened this practice. As mentioned above，the result of having is suitable for the educational goal "to have a consciousness of becoming the dental professional". Furthermore，this program was considered that future continuation is also expected by deepening of an understanding to the personnel's functional oral-training program

Electromagnetic Structure and Electron Acceleration in Shock-Shock Interaction

International audienceA shock-shock interaction is investigated by using a one-dimensional full particle-in-cell simulation. The simulation reproduces the collision of two symmetrical high Mach number quasi-perpendicular shocks. The basic structure of the shocks and ion dynamics is similar to that obtained by previous hybrid simulations. The new aspects obtained here are as follows. Electrons are already strongly accelerated before the two shocks collide through multiple reflection. The reflected electrons self-generate waves upstream between the two shocks before they collide. The waves far upstream are generated through the right-hand resonant instability with the anomalous Doppler effect. The waves generated near the shock are due to firehose instability and have much larger amplitudes than those due to the resonant instability. The high-energy electrons are efficiently scattered by the waves so that some of them gain large pitch angles. Those electrons can be easily reflected at the shock of the other side. The accelerated electrons form a power-law energy spectrum. Due to the accelerated electrons, the pressure of upstream electrons increases with time. This appears to cause the deceleration of the approaching shock speed. The accelerated electrons having sufficiently large Larmor radii are further accelerated through the similar mechanism working for ions when the two shocks are colliding