担当区分：筆頭著者,　最終著者,　責任著者   記述言語：日本語   掲載種別：研究論文（学術雑誌）   出版者・発行元：(一社)日本老年歯科医学会  

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Wiley  

BACKGROUND: Oral mucositis is one of the main areas of research in supportive and palliative care of cancer patients. However, the methodology of prospective clinical trials on oral mucositis has not been established, despite its uniqueness. Here, we propose a novel research policy on oral mucositis, including an implementable set of recommendations for researchers conducting clinical trials. METHODS: The first draft was developed by an expert panel of six specialists from the Japanese Supportive, Palliative, and Psychosocial Care Study Group. A provisional draft was developed after review by the following medical societies: the Japanese Association of Supportive Care in Cancer, the Japanese Association of Oral Supportive Care in Cancer, the Japanese Cancer Association, and the receipt of public comments. RESULTS: The research policy on oral mucositis mainly consists of the following components: (i) definition of oral mucositis; (ii) characteristics of oral mucositis; (iii) characteristics of oral mucositis research; (iv) target population for oral mucositis research; (v) endpoints and assessment measures in oral mucositis; (vi) eligibility criteria; (vii) research design; (viii) minimally recommended intervention in oral mucositis research as a supplement. The final policy (Ver1.0) was completed on August 16, 2021. CONCLUSIONS: This policy may serve as a significant reference for planning and conducting clinical trials for the management of oral mucositis.

DOI： 10.1002/cam4.4811

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その他リンク： https://onlinelibrary.wiley.com/doi/full-xml/10.1002/cam4.4811

担当区分：最終著者   記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Springer Science and Business Media LLC  

Objectives An increasing number of patients visiting the dental office have a growing need for perioperative oral management (POM) to prevent postoperative complications. Therefore, it is necessary to determine which patients should receive preferential POM. This study investigated the dental status of patients scheduled to undergo surgery and addressed the priority for POM. Methods This retrospective study included a total of 150 patients who were scheduled to undergo surgery at the Department of Respiratory Surgery (DRS), Department of Neurological Surgery (DNS), Department of Gynecological Surgery (DGS), Department of Breast and Endocrine Surgery (DBES), and Department of Esophageal Surgery (DES) managed by the Perioperative Management Center of Okayama University Hospital. We compared the general and dental status of patients among the five groups. Results The DES group had significantly fewer teeth than the DBES group (p = 0.012), more severe periodontitis than both the DBES (p = 0.005) and DNS groups (p = 0.020), and poorer molar occlusal support status than both the DBES (p = 0.002) and DGS groups (p = 0.041). The DES group exhibited a significantly higher median age (p = 0.002), a higher ratio of males (p < 0.001), a higher prevalence of malignant tumors (p < 0.001), and higher proportions of smokers (p < 0.001) and drinkers (p < 0.001) than the other groups. Conclusion Patients who underwent surgery at the DES had more dental problems than other surgery patients. Accordingly, these patients should be given the highest priority for POM triage.

DOI： 10.1007/s11748-021-01757-4

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その他リンク： https://link.springer.com/article/10.1007/s11748-021-01757-4/fulltext.html

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Springer Science and Business Media LLC  

BACKGROUND: Multidisciplinary team (MDT) approach has become a standard for perioperative patient care, including in esophageal cancer. In our institution, the Perioperative Management Center (PERiO) has been doing an MDT approach for patients undergoing esophageal cancer surgery since 2009. On the other hand, neoadjuvant therapy has also been becoming standard for many malignancies, including esophageal cancer. In Japan, neoadjuvant chemotherapy (NAC) for esophageal cancer is standard now. However, there have been no reports about when is the best time to start the MDT approach for patients with neoadjuvant therapy. In this study, the best start time for the MDT approach for esophageal cancer patients with NAC was examined from the perspective of adverse events during chemotherapy and perioperative period. METHODS: All cases underwent thoracoscopic esophagectomy in the prone position (TEPP) after NAC. The PERiO Intervention group that started before NAC (n = 100) was compared with the PERiO Intervention group that started after NAC (n = 77). Eventually, 54 paired cases were matched by propensity score matching. RESULTS: The adverse event rate during chemotherapy, especially oral complications, was significantly decreased in the PERiO Intervention started before the NAC group (P = 0.007). Furthermore, weight loss during the period from chemotherapy to surgery was significantly reduced in the group that started before NAC (P = 0.033). CONCLUSION: The MDT approach should be started before NAC in patients undergoing esophageal cancer surgery to prevent adverse events during chemotherapy and provide safe perioperative conditions.

DOI： 10.1007/s10388-021-00844-y

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その他リンク： https://link.springer.com/article/10.1007/s10388-021-00844-y/fulltext.html

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：OXFORD UNIV PRESS  

The aim of this study was to compare the estimated public medical care cost of measures to address metallic dental restorations (MDRs) for head and neck radiotherapy using high-energy mega-voltage X-rays. This was considered a first step to clarify which MDR measure was more cost-effective. We estimated the medical care cost of radiotherapy for two representative MDR measures: (i) with MDR removal or (ii) without MDR removal (non-MDR removal) using magnetic resonance imaging and a spacer. A total of 5520 patients received head and neck radiation therapy in 2018. The mean number of MDRs per person was 4.1 dental crowns and 1.3 dental bridges. The mean cost per person was estimated to be 121 720 yen for MDR removal and 54 940 yen for non-MDR removal. Therefore, the difference in total public medical care cost between MDR removal and non-MDR removal was estimated to be 303 268 800 yen. Our results suggested that non-MDR removal would be more cost-effective than MDR removal for head and neck radiotherapy. In the future, a national survey and cost-effectiveness analysis via a multicenter study are necessary; these investigations should include various outcomes such as the rate of local control, status of oral mucositis, frequency of hospital visits and efforts of the medical professionals.

DOI： 10.1093/jrr/rrab003

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掲載種別：研究論文（学術雑誌）  

Background: Mucositis is a significant toxicity of cancer therapy with numerous systemic sequelae. The goal of this systematic review was to update the Multinational Association of Supportive Care in Cancer and International Society of Oral Oncology (MASCC/ISOO) Clinical Practice Guidelines for the management of mucositis. Methods: The literature was reviewed systematically to identify interventions for mucositis. Studies were rated according to the presence of major and minor flaws according to previously published criteria. The body of evidence for each intervention and in each treatment setting was assigned a level of evidence based on previously published criteria. Guidelines were developed based on the level of evidence, with 3 possible guideline determinations: recommendation, suggestion, or no guideline possible. Results: The guideline covers evidence from 1197 publications related to oral or gastrointestinal mucositis. Thirteen new guidelines were developed for or against the use of various interventions in specific treatment settings, and 11 previous guidelines were confirmed after aa review of new evidence. Thirteen previously established guidelines were carried over because there was no new evidence for these interventions. Conclusions: The updated MASCC/ISOO Clinical Practice Guidelines for mucositis provide professional health caregivers with a clinical setting-specific, evidence-based tool to help with the management of mucositis in patients who have cancer.

DOI： 10.1002/cncr.33100

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：SPRINGER  

PURPOSE: To update the clinical practice guidelines for the use of growth factors and cytokines for the prevention and/or treatment of oral mucositis (OM). METHODS: A systematic review was conducted by the Mucositis Study Group of the Multinational Association of Supportive Care in Cancer/International Society of Oral Oncology (MASCC/ISOO). The body of evidence for each intervention, in each cancer treatment setting, was assigned an evidence level. The findings were added to the database used to develop the 2014 MASCC/ISOO clinical practice guidelines. Based on the evidence level, the following guidelines were determined: recommendation, suggestion, and no guideline possible. RESULTS: A total of 15 new papers were identified within the scope of this section and were merged with 51 papers that were reviewed in the previous guidelines update. Of these, 14, 5, 13, 2, and 1 were randomized controlled trials about KGF-1, G-CSF, GM-CSF, EGF, and erythropoietin, respectively. For the remaining agents there were no new RCTs. The previous recommendation for intravenous KGF-1 in patients undergoing autologous hematopoietic stem cell transplantation (HSCT) conditioned with high-dose chemotherapy and TBI-based regimens is confirmed. The previous suggestion against the use of topical GM-CSF for the prevention of OM in the setting of high-dose chemotherapy followed by autologous or allogeneic stem cell transplantation remains unchanged. CONCLUSIONS: Of the growth factors and cytokines studied for the management of OM, the evidence supports a recommendation in favor of KGF-1 and a suggestion against GM-CSF in certain clinical settings.

DOI： 10.1007/s00520-019-05170-9

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担当区分：筆頭著者,　責任著者   記述言語：英語   掲載種別：研究論文（学術雑誌）  

Purpose of Review: Recently, multidisciplinary strategies on accelerated recovery postoperatively have been provided, and management of the perioperative period has changed and improved dramatically. We summarize the enhanced recovery after surgery (ERAS®) protocol and its outcomes from a nutritional perspective. We established the perioperative management center (PERiO), much of whose work contents conform to ERAS®, but intensive dental staff involvement is characteristic. We also summarize its outcomes. Recent Findings: ERAS® is a multimodal perioperative care pathway designed to achieve early recovery for patients undergoing major surgery. Nutrition is a key pillar for patient care. Throughout the perioperative period, oral nutrition is suggested as well as possible. Good outcomes have been reported by a meta-analysis of randomized controlled trials. However, the dental staff are not regarded as part of the professional team. PERiO reported good outcomes of care bundles and suggested the importance of dental staff contribution. The Japanese social insurance system began to cover involvements of the dental staff for perioperative oral management since 2012. Analysis of the nationwide administrative claims database in Japan concluded that preoperative oral care by a dentist significantly reduced postoperative complications in patients undergoing cancer surgery. Summary: Currently, the dental staff are not regarded as key professionals of ERAS®, although the dental staff can contribute to good outcomes in the perioperative period and PERiO, and consequently, the Japanese universal health insurance coverage system covering involvements of the dental staff for perioperative oral management showed good outcomes. Therefore, further clinical studies involving dental specialty should be considered important for perioperative management from nutritional perspectives.

DOI： 10.1007/s40496-019-0217-3

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：OKAYAMA UNIV MED SCHOOL  

Preoperative oral care is helpful to prevent postoperative complications in patients who are undergoing esophagectomy. Here, we report the case of an 81-year-old Japanese man with an upper limb disability caused by post-polio syndrome who was receiving neoadjuvant chemotherapy for esophageal cancer. He had poor oral health status and developed oral complications as a side effect of chemotherapy. He could not brush his teeth by himself. However, infection control by oral care provided by an interprofessional collaboration successfully improved his oral hygiene, and his follow-up involved no severe complications. Interprofessional collaboration is useful especially for patients with upper limb disability.

DOI： 10.18926/AMO/56461

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担当区分：最終著者,　責任著者   記述言語：日本語   出版者・発行元：(一社)日本造血細胞移植学会  

口腔粘膜障害の創部保護を行い、疼痛を緩和する医療機器「エピシル口腔用液」(ソレイジア・ファーマ株式会社、東京)が2018年4月に保険適用された。しかし、本邦で本機器の疼痛緩和効果および使用感等についての報告はない。そこで本院で造血細胞移植を受け、口腔粘膜障害の疼痛を訴えた4名の患者を対象とし、症例研究を行った。使用後5分において、4人のうち3人でペインスコアが減少し、その後30分から120分にかけて口腔内疼痛は概ね同等で推移した。2名が味覚の変化および刺激感について、1名が不快感について「少し気になる」と回答したが、使用後2時間の評価時間の後、全員が継続使用を希望した。有害事象および機器としての不具合の発生はなかった。エピシル口腔用液は、造血細胞移植患者を対象として、疼痛をはじめとする口腔粘膜障害による不快感を緩和することを示唆した。(UMIN-CTR ID:UMIN000029244)(著者抄録)

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その他リンク： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2019&ichushi_jid=J06229&link_issn=&doc_id=20190123510006&doc_link_id=%2Fej9johct%2F2019%2F000801%2F006%2F0036-0042%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fej9johct%2F2019%2F000801%2F006%2F0036-0042%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

担当区分：筆頭著者,　最終著者,　責任著者   記述言語：日本語   出版者・発行元：(一社)日本口腔腫瘍学会  

厚生労働省は、県内のがん診療の連携協力体制の整備やがんに関する相談支援情報の提供にあたって中心的な役割を果たす都道府県がん診療連携拠点病院を指定している。大学病院がこの指定を受けている場合、医育機関という本来の役割から、多職種連携でがん支持療法を担う人材育成という役割も果たす必要がある。岡山大学病院は2011年に、がんの支持療法を歯科の専門性をもって行うことを一つの目的とした専門診療部(医療支援歯科治療部)を開設した。そして、多くのがん手術療法、放射線療法、化学療法などにおいて、がん口腔支持療法を積極的に展開している。この治療部は、学部教育あるいは歯科医師臨床研修においてがん口腔支持療法の担い手を養成する絶好の場となり得る。そこで、2012年度から、研修歯科医が多職種連携医療の中における歯科医師の役割について学び、実践するための研修プログラムを開始した。本院で展開される様々な多職種連携医療に研修歯科医師をその一員として可能な範囲で参画させている。さらに、歯学部6年次生を対象に、診療参加型臨床実習でも1週間の実習期間を必修とした。がん口腔支持療法の分野は医療に必須な分野として引き続き発展が必要である。技術的な面のさらなる研鑽は言うに及ばず、全身的な医科的な知識の習得、がんを抱える患者を心理面でサポートできる能力、他職種との人間関係の構築能力、そして患者の死生観に至るような哲学的な理解も必要とされる。このことは、がん医療のみならず、本邦が課題とする健康長寿社会の実現に貢献する歯科医療人に共通して必要な素養である。歯科医療の幅を広げる若手歯科医師の育成が必要である。(著者抄録)

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その他リンク： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2018&ichushi_jid=J02382&link_issn=&doc_id=20180921320002&doc_link_id=%2Fdy8ortum%2F2018%2F003003%2F003%2F0085-0097%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fdy8ortum%2F2018%2F003003%2F003%2F0085-0097%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

記述言語：日本語   出版者・発行元：岐阜大学医学教育開発研究センター  

岡山大学歯学部は、平成26年に岡山大学が採択された文部科学省課題解決型高度医療人材養成プログラム選定事業「健康寿命社会を担う歯科医学教育改革-死生学や地域包括ケアモデルを導入した医科歯科連携教育体制の構築-」の中で、岡山大学病院で展開されているチーム医療の現場を体験する「高度医療支援・周術期口腔機能管理実習」を必須科目として開講している。本実習は、単なる知識の習得ではなく、チーム医療の現場で専門性をもって積極的に対応できる歯科医療人養成を目的としており、現在は岡山大学の学生だけでなく、上記事業の連携大学からの学生受け入れも行っている。本実習は、チーム医療の現場を実際に経験させるだけでなく、学生にがん手術予定の患者及び患者家族をエスコートするという役割を与えたことで、学習内容が印象に残り、医療職としてのプロフェッショナリズムを育む可能性があることが示唆された。(著者抄録)

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担当区分：責任著者   記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Mosby Inc.  

Objective: Intravenous zoledronic acid (ZA) is often replaced with subcutaneous denosumab in patients with bone metastatic cancer. Despite their different pharmacologic mechanisms of action, both denosumab and ZA are effective in bone metastasis but cause osteonecrosis of the jaw (ONJ) as a side effect. ZA persists in the body almost indefinitely, whereas denosumab does not persist for long periods. This study evaluated the risks of developing ONJ when replacing ZA with denosumab. Study Design: In total, 161 Japanese patients administered ZA for bone metastatic cancer were enrolled in this single-center, retrospective, observational study. The risk of developing ONJ was evaluated by logistic regression analysis using the following factors: age, gender, cancer type, angiogenesis inhibitors, steroids, and replacement of ZA with denosumab. Results: Seventeen patients (10.6%) developed ONJ. Multiple regression analysis indicated a significant difference in rate of ONJ associated with replacement of ZA with denosumab (odds ratio = 3.81
95% confidence interval 1.04-13.97
P =.043). Conclusions: Replacing ZA with denosumab is a risk factor for the development of ONJ. Both binding of bisphosphonate to bone and receptor activator of nuclear factor-κ B ligand inhibition could additively increase the risk of ONJ. We bring the replacement of ZA with denosumab to the attention of clinical oncologists.

DOI： 10.1016/j.oooo.2018.02.010

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担当区分：責任著者   記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Springer Netherlands  

Severe oral mucositis occurs frequently in patients receiving hematopoietic stem cell transplantation (HCT). Oral mucosal bacteria can be associated with progression of oral mucositis, and systemic infection may occur via ulcerative oral mucositis. However, little information is available regarding the oral microbiota after HCT. Here, PCR-denaturing gradient gel electrophoresis (DGGE) was performed to characterize the oral mucosal microbiota, which can be affected by antibiotics, before and after HCT. Sixty reduced-intensity HCT patients were enrolled. Three patients with the least antibiotic use (quinolone prophylaxis and/or β-lactam monotherapy group) and three patients with the most antibiotic use (β-lactam-glycopeptide combination therapy group) were selected. Bacterial DNA samples obtained from the oral mucosa before and after HCT were subjected to PCR-DGGE. The trajectory of oral mucositis was evaluated. The oral mucosal microbiota in the β-lactam-glycopeptide combination therapy group was different from that in the quinolone prophylaxis and/or β-lactam monotherapy group, and Staphylococcus spp. and Enterococcus spp. were identified. Lautropia mirabilis was dominant in one patient. Ulcerative oral mucositis was observed only in the β-lactam-glycopeptide combination therapy group. In conclusion, especially with the use of strong antibiotics, such as glycopeptides, the oral mucosal microbiota differed completely from that under normal conditions and consisted of Staphylococcus spp., Enterococcus spp., and unexpectedly L. mirabilis. The normal oral microbiota consists not only of bacteria, but these unexpected bacteria could be involved in the pathophysiology as well as systemic infection via oral mucositis. Our results can be used as the basis for future studies in larger patient populations.

DOI： 10.1007/s12223-018-0596-1

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：WILEY  

Objective: This study was performed to determine the prevalence of oral health conditions unnoticed by doctors and ward staff that may increase risk of incidents and/or accidents in hospitalised patients with moderate-severe dementia.
Background data discussing the present status of the field: Dementia patients may not recognise risks in the mouth, such as tooth mobility or ill-fitting dental prostheses and/or dentures. In addition to the risk of choking, injury by sharp edges of collapsed teeth or prosthodontics could pose risks. However, many previous publications were limited to case reports or series.
Materials and methods: Ninety-two consecutive hospitalised dementia patients (M: 52, F: 40, median age: 82.5 years, range: 62-99 years, from 2011 to 2014), referred for dentistry for dysphagia rehabilitation, were enrolled in this study. Participants referred for dental treatment with dental problems detected by ward staff were excluded. All participants had a Global Clinical Dementia Rating Score &gt;2. Their dental records were evaluated retrospectively for issues that may cause incidents and/or accidents.
Results: Problems in the mouth, for example tooth stumps, dental caries, and ill-fitting dentures, were detected in 51.1% of participants (47/92). Furthermore, 23.9% (22/92) showed risk factors that could lead to incidents and/or accidents, for example falling out of teeth and/or prosthodontics or injury by sharp edges of teeth and/or prosthodontics.
Conclusions: Hospitalised moderate-severe dementia patients had a high prevalence of oral health conditions unnoticed by doctors and ward staff that may increase risk of incidents and/or accidents.

DOI： 10.1111/ger.12235

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掲載種別：研究論文（学術雑誌）  

DOI： 10.15344/2456-4443/2017/115

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：JAPAN NEUROSURGICAL SOC  

Perioperative management is critical for positive neurosurgical outcomes. In order to maintain safe and authentic perioperative management, a perioperative management center (PERIO) was introduced to patients of our Neurosurgery Department beginning in June 2014. PERIO involves a multidisciplinary team consisting of anesthesiologists, dentists/dental hygienists/technicians, nurses, physical therapists, pharmacists, and nutritionists. After neurosurgeons decide on the course of surgery, a preoperative evaluation consisting of blood sampling, electrocardiogram, chest X-ray, and lung function test was performed. The patients then visited the PERIO clinic 7-14 days before surgery. One or two days before surgery, the patients without particular issues enter the hospital and receive a mouth cleaning one day before surgery. After surgery, postoperative support involving eating/swallowing evaluation, rehabilitation, and pain control is provided. The differences in duration from admission to surgery, cancellation of surgery, and postoperative complications between PERIO and non-PERIO groups were examined. Eighty-five patients were enrolled in the PERIO group and 131 patients in the non-PERIO group. The duration from admission to surgery was significantly decreased in the PERIO group (3.6 +/- 0.3 days), compared to that in the non-PERIO group (4.7 +/- 0.2 days). There was one cancelled surgery in the PERIO group and six in the non-PERIO group. Postoperative complications and the overall hospital stay did not differ between the two groups. The PERIO system decreased the duration from admission to surgery, and it is useful in providing high-quality medical service, although the system should be improved so as not to increase the burden on medical staff.

DOI： 10.2176/nmc.oa.2016-0085

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：PHARMACEUTICAL SOC JAPAN  

Zoledronic acid and denosumab are two antiresorptive drugs currently in use for treating osteoporosis. They have different mechanisms of action, but both have been shown to delay the onset of skeletal-related events in patients with advanced cancer. However, medication-related osteonecrosis of the jaw (MRONJ) has been reported in cancer patients treated with zoledronic acid or denosumab. We studied 155 patients with several types of advanced cancer who were treated with zoledronic acid or denosumab in our hospital during the period from April 2010 through March 2013. Thirteen of these 155 patients (8.4%) developed MRONJ. MRONJ development was significantly associated with the number of zoledronic acid or denosumab infusions (p&lt;0.001) and the duration of zoledronic acid or denosumab therapy (p&lt;0.001). Logistic regression analysis showed that diabetes [odds ratio (OR)=6.699, 95% confidence interval (CI), 1.435-31.277, p=0.016], anemia [OR=14.559, 95% CI, 2.161-98.069, p=0.006], and pus discharge [OR=6.491, 95% CI, 1.514-27.835, p=0.012] significantly increased the risk of developing MRONJ. However, the risk of MRONJ was significantly lower [OR=0.137, 95% CI, 0.020-0.944, p=0.043] when patients received periodical dentistry maintenance. Diabetes, anemia, and pus discharge may also play roles in its development. These findings suggest that the active inclusion of dentistry maintenance in bisphosphonate or denosumab treatment of cancer patients can reduce MRONJ development.

DOI： 10.1248/bpb.b15-00385

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Basic Oral Care for hematology-oncology patients and hematopoietic stem cell transplantation recipients: A Position paper from the joint task force of the Multinational Association of Supportive Care in Cancer / International Society of Oral Oncology (MASCC/ISOO) and the European Group for Blood and Marrow Transplantation (EBMT)

DOI： 10.1007/s00520-014-2378-x

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担当区分：責任著者   記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：JAPAN SOC INTERNAL MEDICINE  

The detection of infective endocarditis (IE) of oral origin has been previously discussed. However, there are few reports confirming this infection using molecular biological techniques. We herein describe the case of a 67-year-old man who developed IE. Blood culture samples and strains obtained from the gingival and buccal mucosa showed 100% identity to Enterococcus faecalis JCM 5803 on sequencing of 16S rRNA gene fragments. A random amplification of polymorphic DNA (RAPD) analysis showed the same pattern for these samples, thus confirming the identity of E. faecalis isolates in the blood and oral mucosa. Our observations provide novel information regarding the level of identity between IE pathogens and oral bacteria.

DOI： 10.2169/internalmedicine.54.3223

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記述言語：英語  

DOI： 10.1007/s00520-014-2432-8

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：OKAYAMA UNIV MED SCHOOL  

We encountered a 74-year-old male patient with tongue laceration after convulsive seizures under intensive care. The tongue showed severe swelling, and the right ventral surface had been lacerated by his isolated and pointed right lower canine. Our university hospital has established a perioperative management center, and is promoting interprofessional collaboration, including dentists, in perioperative management. Dentists collaborating in the perioperative management center took dental impressions, with the support of anesthesiologists who opened the patient's jaw under propofol sedation, to produce a mouth protector. By raising the patient's bite, the completed mouth protector prevented the isolated tooth from contacting the tongue and protected the lacerated wound. Use of the mouth protector prevented the lacerated tongue from coming into contact with the pointed tooth, and the tongue healed gradually. These findings underscore that interprofessional collaboration including dentists can improve the quality of medical care.

DOI： 10.18926/AMO/53027

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担当区分：責任著者   記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：SPRINGER  

We recently reported frequent detection of antibiotic-resistant bacteria on the oral mucosa during the period of hematopoietic cell transplantation (HCT) and suggested an association between oral mucositis and antibiotic-resistant bacterial infection. Methicillin-resistant Staphylococcus spp. were frequently detected, and the oral cavity may be a reservoir of the gene mediating methicillin resistance, mecA. Here, we examined the frequency of mecA carriers in patients undergoing HCT.
Fifty-nine patients (male (M) = 37, female (F) = 22, 47.3 +/- 11.0 years) receiving HCT were enrolled in this study. Buccal swab samples were obtained four times from day -7 to day +20 (once/week), and mecA was detected by PCR. Fifty-two subjects without systemic disease, who completed dental treatment, especially periodontal treatment (M = 21, F = 31, 55.4 +/- 14.2 years), were also enrolled as controls and checked for mecA on the oral mucosa.
Seventy-six percent (45/59) of the HCT patients carried mecA at least once in the study period (days -7 to +20), while no control subjects had mecA. The frequency of mecA carriers was 19.2 % from days -7 to -1, while it was significantly increased on days +7 to +13 and +14 to +20, with frequencies of 60.9 and 63.2 %, respectively (P &lt; 0.01, ANOVA).
mecA was detected in oral mucosa of patients undergoing HCT. The high detection frequency of staphylococci resistant to penicillin and beta-lactams in our recent report was supported.

DOI： 10.1007/s00520-014-2151-1

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BACKGROUND Mucositis is a highly significant, and sometimes dose-limiting, toxicity of cancer therapy. The goal of this systematic review was to update the Multinational Association of Supportive Care in Cancer and International Society of Oral Oncology (MASCC/ISOO) Clinical Practice Guidelines for mucositis. METHODS A literature search was conducted to identify eligible published articles, based on predefined inclusion/exclusion criteria. Each article was independently reviewed by 2 reviewers. Studies were rated according to the presence of major and minor flaws as per previously published criteria. The body of evidence for each intervention, in each treatment setting, was assigned a level of evidence, based on previously published criteria. Guidelines were developed based on the level of evidence, with 3 possible guideline determinations: recommendation, suggestion, or no guideline possible. RESULTS The literature search identified 8279 papers, 1032 of which were retrieved for detailed evaluation based on titles and abstracts. Of these, 570 qualified for final inclusion in the systematic reviews. Sixteen new guidelines were developed for or against the use of various interventions in specific treatment settings. In total, the MASCC/ISOO Mucositis Guidelines now include 32 guidelines: 22 for oral mucositis and 10 for gastrointestinal mucositis. This article describes these updated guidelines. CONCLUSIONS The updated MASCC/ISOO Clinical Practice Guidelines for mucositis will help clinicians provide evidence-based management of mucositis secondary to cancer therapy.

DOI： 10.1002/cncr.28592

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担当区分：責任著者   記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：ALLERGY IMMUNOL SOC THAILAND,  

Background: Eosinophil cationic protein (ECP) was reported previously to be involved in allergic inflammation with cytotoxic activity. On the other hand, recent studies showed that ECP did not induce cell death but inhibited the growth of cancer-derived cells. Our previous study indicated that human ECP enhanced differentiation of rat neonatal cardiomyocytes and stress fiber formation in Balb/c 3T3 mouse fibroblasts, while the effects of human ECP on human fibroblasts are unknown.
Objective: The present study was performed to determine the effects of human ECP on cytokine expression in human fibroblasts by protein array.
Methods: The effects of recombinant human ECP (rhECP) on normal human dermal fibroblasts (NHDF) were examined by assaying cell growth. Furthermore, cytokine expression of NHDF stimulated by ECP, which could influence cell growth, was evaluated by protein array.
Results: ECP was not cytotoxic but enhanced the growth of NHDF. The peak rhECP concentration that enhanced the cell counts by 1.56-fold was 100 ng/mL, which was significantly different from cultures without ECP stimulation (ANOVA/ Scheffe's test, P &lt; 0.05). Array analyses indicated that ciliary neurotrophic factor (CNTF), neutrophil-activating peptide (NAP)-2, and neurotrophin (NT)-3 were significantly upregulated in NHDF stimulated with 100 ng/mL ECP compared to those without stimulation.
Conclusion: ECP is not cytotoxic but enhances the growth of NHDF. CNTF, NAP-2, and NT-3 were suggested to be involved in enhancing the growth of NHDF. These findings will contribute to determination of the role of ECP in allergic inflammation.

DOI： 10.12932/AP0287.31.4.2013

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担当区分：責任著者   記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：QUINTESSENCE PUBLISHING CO INC  

Occlusal support may be an important factor affecting nutritional support after major surgery. This report presents a patient who gained body weight after receiving a new prosthesis. The patient was an 82-year-old man with thoracic esophageal carcinoma. He did not have occlusal support because of multiple caries lesions. His body weight slowly increased after surgery, but almost stopped in the period of 54 to 68 days after surgery. After treatment with dentures (day 72 postsurgery), body weight gain was observed again, although his medical treatment had not changed. An appropriate prosthesis could contribute to perioperative nutrition support and may lead to earlier recovery after surgery.

DOI： 10.11607/ijp.3622

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担当区分：筆頭著者,　責任著者   記述言語：英語   出版者・発行元：SPRINGER  

DOI： 10.1007/s00520-012-1602-9

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記述言語：英語   出版者・発行元：SPRINGER  

The aim of this project was to review the literature and define clinical practice guidelines for the use of cytokines and growth factor agents for the prevention or treatment of oral mucositis induced by cancer chemotherapy or radiotherapy.
A systematic review was conducted by the Mucositis Study Group of the Multinational Association of Supportive Care in Cancer/International Society for Oral Oncology (MASCC/ISOO). The body of evidence for each intervention, in each cancer treatment setting, was assigned an evidence level. Based on the evidence level, one of the following three guideline determinations was possible: Recommendation, Suggestion, No guideline possible.
Sixty-four clinical studies across 11 interventions were evaluated. A recommendation was made for the use of recombinant human KGF-1 (palifermin) at a dose of 60 mu g/kg per day for 3 days prior to conditioning treatment and for 3 days post-transplant for prevention of oral mucositis in patients receiving high-dose chemotherapy and total body irradiation followed by autologous stem cell transplantation for hematological malignancies. A suggestion was made against using granulocyte macrophage colony-stimulating factor mouthwash for the prevention of oral mucositis in the setting of high-dose chemotherapy followed by autologous or allogeneic stem cell transplantation. No guideline was possible for any other cytokine or growth factor agents due to inconclusive evidence.
Of the cytokine and growth factor agents studied for oral mucositis, the evidence only supports use of palifermin in the specific population listed above. Additional well-designed research is needed on other cytokine and growth factor interventions and in other cancer treatment settings.

DOI： 10.1007/s00520-012-1594-5

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記述言語：日本語   出版者・発行元：(NPO)日本歯周病学会  

頭頸部癌は他部位の癌と異なり、細菌の多い口腔が領域に含まれるのが特徴である。したがって、細菌感染による合併症の発症リスクが高い。頭頸部癌治療に対する口腔ケアは合併症の予防・軽減に有効である。岡山大学病院予防歯科では、多職種がチーム医療を展開する頭頸部がんセンターが設立されている。同院予防歯科では周術期および退院後の継続的な口腔ケアを担当している。その中から2症例を紹介した。

DOI： 10.2329/perio.55.262

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その他リンク： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2013&ichushi_jid=J01095&link_issn=&doc_id=20130913350004&doc_link_id=%2Fcp9perlo%2F2013%2F005503%2F005%2F0262-0268%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fcp9perlo%2F2013%2F005503%2F005%2F0262-0268%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

記述言語：日本語   出版者・発行元：岡山歯学会  

過去1年間に岡山大学病院歯科系診療科等の初診患者を対象に、医科系診療科等からの院内紹介に対する初動対応状況を調査した。その結果、院内紹介件数は、平成22年度1,377件(全初診患者の14.3%)、平成23年度1,452件(全初診患者の14.2%)であった。紹介先は平成23年度に新設された医療支援歯科治療部とスペシャルニーズ歯科センター宛が209件(年間院内紹介件数の9.6%)で、歯科側の受け入れは一元化され受入れ体制ができつつあることが分かった。

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その他リンク： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2013&ichushi_jid=J02040&link_issn=&doc_id=20140122210004&doc_link_id=http%3A%2F%2Fousar.lib.okayama-u.ac.jp%2F52867&url=http%3A%2F%2Fousar.lib.okayama-u.ac.jp%2F52867&type=%89%AA%8ER%91%E5%8Aw%81F%89%AA%8ER%91%E5%8Aw%8Aw%8Fp%90%AC%89%CA%83%8A%83%7C%83W%83g%83%8A&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F80034_3.gif

担当区分：責任著者   記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：SPRINGER  

Here, we discuss the pathophysiology of leukemia-associated gingival enlargement based on a case of acute myelomonocytic leukemia (AML-M4) with typical gingival enlargement. Uniquely, this patient was well enough to allow full periodontal examination and incisional gingival biopsy to be performed both before and after chemotherapy. The patient was a 39-year-old Japanese woman with AML-M4 showing gingival enlargement. Histological and immunohistochemical features of gingiva and bacterial counts in the periodontal pockets were examined before and after chemotherapy. The results were as follows: (1) infiltration of myelomonocytic blasts in enlarged gingiva; (2) resolution of gingival enlargement with complete remission of AML by anticancer chemotherapy; and (3) the numbers of bacteria in the periodontal pockets were not high and were not altered before or after chemotherapy. In patients with AML-M4, remarkable mucosal enlargement is not generally observed in the body except in the gingiva. We hypothesized that antigens derived from periodontal bacteria, even if they are not present in large numbers, could act as chemoattractants for myelomonocytic leukemic cells.

DOI： 10.1007/s10266-011-0051-0

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：SAGE PUBLICATIONS LTD  

Chronic low-grade infection has been suggested to be associated with metabolic disorder such as diabetes. However, the molecular mechanism underlying this important association is largely unknown. The only clue established so far is that many subjects exhibit elevated levels of C-reactive protein as measured by highly sensitive assay. Here, we hypothesized that adipocyte-macrophage interaction plays a key role in amplifying such low grade infection to the level of influencing metabolic disorders. The presence of macrophages in abdominal adipose tissues was investigated by immunohistochemistry. To see whether molecules associated with acute phase protein, LPS signaling, and persistent recruitment of monocytes, are produced at higher amounts in adipocytes co-cultured with macrophages stimulated with low concentration of LPS (1 ng/ml), we measured serum amyloid A (SAA), LPS binding protein (LBP), soluble CD14 (sCD14), and RANTES levels in culture supernatant of co-cultures. Lastly, we investigated in vivo effect of low-grade LPS infusion on the production of these molecules using obese model mice. The macrophages were certainly identified in abdominal adipose tissues. Investigated molecules, especially LBP, SAA, and RANTES were produced at higher amounts in co-cultures stimulated with LPS compared with the cells without LPS. The ob/ob, and high-fat diet-induced obesity mice produced higher amounts of LBP, SAA, and RANTES one day after LPS infusion (1 ng/ml/g body weight) compared with ob/- and normal-fat fed control mice. Thus, adipocytes and infiltrated macrophages, and their interaction with low endotoxin stimulation appear to play an important role in amplifying and maintaining LPS-induced low-grade inflammation.

DOI： 10.1177/1753425910393370

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記述言語：日本語   出版者・発行元：(一社)日本集中治療医学会  

2008年9月〜2009年8月の1年間に著者らの施設の周術期管理センターを受診した163症例に歯科医師の術前診査を推奨した。今回、そのうち同意した158例(男性87例、女性71例、年齢22〜86歳、中央値64歳)を対象に後方視的に検討した。1)158例中46例に処置が必要と判断され、手術時に歯の脱落の危険がある27例に対してマウスプロテクタを作製した。また、作製の型取りで歯の脱落の危険があった2例には当該歯の抜歯後に残存歯の保護のためマウスプロテクタを作製した。一方、歯の脱落の危険はないが、充填物や冠の脱落防止または破損防止が必要と判断された29例に対してもマウスプロテクタが作製された。2)手術時の口腔内偶発症の発生例は認められなかった。ただ、プロテクタの適合が悪く挿管中に度々外れ、麻酔管理に支障を来した症例が2例あったが、使用材料の改良により以後の発生は認められていない。

DOI： 10.3918/jsicm.19.431

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その他リンク： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2012&ichushi_jid=J02874&link_issn=&doc_id=20120801480033&doc_link_id=10.3918%2Fjsicm.19.431&url=https%3A%2F%2Fdoi.org%2F10.3918%2Fjsicm.19.431&type=J-STAGE&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00007_3.gif

担当区分：筆頭著者,　最終著者,　責任著者   記述言語：日本語   出版者・発行元：日本口腔リハビリテーション学会  

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その他リンク： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2011&ichushi_jid=J05979&link_issn=&doc_id=20120427340001&doc_link_id=http%3A%2F%2Fousar.lib.okayama-u.ac.jp%2F48950&url=http%3A%2F%2Fousar.lib.okayama-u.ac.jp%2F48950&type=%89%AA%8ER%91%E5%8Aw%81F%89%AA%8ER%91%E5%8Aw%8Aw%8Fp%90%AC%89%CA%83%8A%83%7C%83W%83g%83%8A&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F80034_3.gif

記述言語：日本語   出版者・発行元：(一社)日本歯科医学教育学会  

質が高く、安心・安全な医療を実現していくために、チーム医療の促進は重要な課題であり、チーム医療を担う医療人の育成が必要とされている。岡山大学病院歯科医師臨床研修では、平成23年度から周術期管理センターを研修の場とする「チーム医療研修プログラム」を開始した。本報告では、研修歯科医のプログラムに対する関心とチーム医療に関する理解に与えた効果をアンケート調査によって検討することを目的とした。対象は平成23年度本学病院研修歯科医44名とし、医師、看護師、薬剤師、理学療法士、管理栄養士など多職種によって行われる周術期管理チーム医療を体験させた。受講前には本プログラムに対する期待度を、受講後には満足度、有意義度について質問し、研修歯科医のプログラムに対する関心度を評価した。また、プログラム受講前後に周術期チーム医療に関する用語や職種について質問し、チーム医療に関する理解度を評価した。90.9%の研修歯科医がプログラムに対して期待し、受講後は88.6%が満足だった、84.1%が有意義だったと回答した。さらに、周術期管理に関する用語について主観的理解度が向上し、チーム医療にかかわる職種についての理解が深まった。歯科医師臨床研修におけるチーム医療教育の方法として、周術期管理チーム医療の現場に実際に関与させるプログラムは、研修歯科医の関心が高く、研修歯科医の周術期管理チーム医療に対する理解を深めることが示唆された。(著者抄録)

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担当区分：筆頭著者   記述言語：日本語   出版者・発行元：岡山歯学会  

平成22年度に歯科系診療科等が医科系診療科等から受けた院内紹介について報告した。歯科系診療科等で初診料を算定した患者数は9606件で、そのうち院内紹介が1377件であった。紹介元は周術期管理センター279件、耳鼻咽喉科140件、心臓血管外科87件、循環器内科81件など計27診療科であった。紹介の際の宛先は、具体的な診療科名を挙げず、電子カルテの院内紹介テンプレートで「歯科(紹介)」を選択するケースが418件と最も多く、具体的名を挙げたのは周術期管理センター(歯科部門)、口腔外科(再建系)、第1総合診療室の順に多かった。具体名なく紹介された患者418名の初動対応状況は、曜日割の院内紹介受入当番診療科が初期対応を行ったのが216件、総合診療室(予診室)で適切な専門診療科が検討され振分されたのが104件であった。

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担当区分：筆頭著者,　責任著者   記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：SPRINGER  

Coagulase-negative staphylococci (CoNS) are frequently isolated from blood cultures of hematopoietic cell transplantation (HCT) patients. Generally, the use of central venous catheters is recognized as a significant risk factor for CoNS infection, while the impact of CoNS infection from oral ulcerative mucositis, which occurs frequently in HCT, may be underestimated. Here, we examined the bacteria on the buccal mucosa after HCT.
Sixty-one patients were examined for bacteria on the buccal mucosa routinely once a week from 1 week before to 3 weeks after allogeneic HCT. Subjects were divided into groups with short and long periods of antibiotic use, and differences in bacterial substitution were evaluated. The relationships between type of HCT (conventional HCT or RIST) and bacterial substitution were also evaluated.
The changes in detection frequencies of CoNS and alpha-streptococci from before to 3 weeks after HCT were significant (P &lt; 0.05, chi (2) test): 14.5-53.3% and 92.7-53.1%, respectively. Significant bacterial substitution of CoNS for streptococci was observed in the long-term antibiotic use group (P &lt; 0.05, chi (2) test), but also occurred in cases with short-term or no antibiotic use. No relationships between type of HCT (conventional HCT or RIST) were observed.
Bacterial substitution of CoNS for streptococci occurred frequently on the buccal mucosa after HCT. In addition to antibiotic use, environmental factors may be involved in bacterial substitution. It is important to consider the presence of oral mucositis in CoNS infection after HCT.

DOI： 10.1007/s00520-010-0923-9

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：WILEY-BLACKWELL  

Objectives: Oral health care providers may discover systemic diseases incidentally from signs observed in the oral cavity. Here, we report a case in which oral health care providers in a hospital discovered a patient with strongly suspected bullous pemphigoid (BP), which is a relatively rare but important disease, in a ward. Methods: The patient was a 78-year-old Japanese woman admitted to our hospital because of severe Alzheimer&apos;s disease. We discovered recurrent ulcers in the oral mucosa and skin when performing oral care in her ward. Biopsy could not be performed safely because of involuntary biting. We performed blood tests for anti-BP180-NC16a antibody, which is autoantibody specific for BP. Results: The patient had a very high anti-BP180-NC16a antibody titre. We consulted a dermatologist regarding her clinical course and the clinical features of the oral mucosa and skin along with blood test results. BP was very strongly suspected. Discussion: In cases in which oral health care providers suspect their patients may have BP, appropriate examination and provision of information to the doctor are important. Oral health care providers should have knowledge about systemic diseases, the signs of which appear in oral cavity to avoid missing important systemic diseases.

DOI： 10.1111/j.1601-5037.2010.00448.x

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担当区分：筆頭著者,　責任著者   記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：SPRINGER  

Oral mucositis is a common symptomatic complication associated with hematopoietic stem cell transplantation (HCT). We use simple strategies aimed to reduce oral mucositis by keeping the oral cavity clean and moist. Here, we report on the progress of oral care and the changes in the degree of oral mucositis. The purpose of this pilot study is to evaluate the effects of our strategies on the prevalence and the severity of oral mucositis.
Fifty-three consecutive patients from 2003 to 2006 administered with conventional allogeneic HCT were enrolled in this study. The degree of oral mucositis was evaluated daily in all patients. Our oral care program was divided into two periods: "examination and trial period (2003 and 2004)" and "intensive oral care period (2005 and 2006)." In the latter, an oral care regimen was carried out systematically by a multidisciplinary team.
Using our oral care strategies, the prevalence of ulcerative oral mucositis was decreased significantly. The rate was reduced from 76% (10 of 13) of patients with ulcerative oral mucositis in 2003 to only 20% (3 of 15) in 2006.
Our pilot study suggests that oral mucositis in HCT patients can be alleviated by simple strategies aimed at keeping the oral cavity clean and moist.

DOI： 10.1007/s00520-010-1002-y

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：WILEY-BLACKWELL PUBLISHING, INC  

P&gt;Methanobrevibacter oralis is an archaeal species frequently isolated from sites of severe periodontitis. However, its pathogenic roles remain unclear. Here, we aimed to isolate group II chaperonin from M. oralis and examine its antigenicity. The genes encoding two chaperonin subunits (Cpn-1 and Cpn-2) were cloned from M. oralis using polymerase chain reaction and genome walking procedures. Recombinant proteins Cpn-1 and Cpn-2 were generated, and the reactivities of sera from patients with periodontitis were examined by Western immunoblotting. The open reading frames of Cpn-1 and Cpn-2 genes consisted of 1641 and 1614 base pairs, respectively. Putative ATP-binding domains conserved among the chaperonin family were observed in both genes. The deduced amino acid sequences of the two genes showed 28.8-40.0% identity to each of the subunits of human CCT (CCT1-8). Thirty and 29 of 36 patients&apos; sera reacted with the recombinant Cpn-1 and recombinant Cpn-2, respectively. Western immunoblotting using antiserum against human CCT subunits indicated that anti-CCT3 and anti-CCT8 antibodies recognized recombinant Cpn-1. In addition, anti-CCT1, CCT3, CCT6, and CCT8 antibodies recognized an antigen of approximately 60 kDa in M. oralis. The results suggested that the chaperonin subunits of M. oralis were antigenic molecules that were recognized by periodontitis patients and that may cross-react with human chaperonin CCT.

DOI： 10.1111/j.2041-1014.2009.00548.x

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担当区分：責任著者   記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：SPRINGER  

The commercial saliva substitute OralbalanceA (R) has been reported to alleviate symptoms of postradiotherapy xerostomia in head and neck cancer patients. OralbalanceA (R) may also be effective for xerostomia in patients undergoing hematopoietic cell transplantation (HCT) with high-dose chemotherapy and total-body irradiation. However, HCT patients are in a severely compromised condition, and saliva substitute must not promote infection. We reported previously that OralbalanceA (R) has antimicrobial effects against microbial species detected during HCT in vitro. This study was performed to determine the in vivo effects of OralbalanceA (R) on oral mucosal total bacterial counts in patients undergoing HCT.
A total of 18 neutropenic patients undergoing HCT were enrolled in this study. Before and after 1 week of OralbalanceA (R) use, bacterial samples were obtained from patients by wiping an area of I center dot 1 cm on the buccal mucosa with sterilized cotton swabs. Total bacterial counts of the obtained samples were examined by quantitative polymerase chain reaction amplification of the bacterial 16S ribosomal RNA gene. As controls, bacterial samples were also obtained from ten healthy subjects, and total bacterial counts were examined.
No significant increase in bacterial count was observed with use of OralbalanceA (R). None of the patients showed bacterial counts above the range found in healthy controls after using OralbalanceA (R).
In neutropenic patients undergoing HCT, OralbalanceA (R) did not increase the total counts of oral mucosal bacteria beyond the range found in healthy controls. Oral care using OralbalanceA (R) may alleviate the symptoms induced by hyposalivation without promoting infection.

DOI： 10.1007/s00520-009-0789-x

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：SPRINGER  

Severe oral mucositis induced by allogeneic hematopoietic cell transplantation (HCT) is associated with intolerable pain and risk of systemic bacteremia infection. Differences between conventional HCT and reduced-intensity regimens for allogeneic HCT (RIST) may influence the occurrence and severity of oral mucositis. Here, we evaluated oral mucositis in patients undergoing RIST and compared the results with those in conventional allogeneic HCT patients to facilitate predictive measures for mucositis.
A total of 127 consecutive patients undergoing HCT (conventional, 63; RIST, 64) were included in this study. Severity of oral mucositis during HCT period was evaluated daily. Differences in severity of mucositis among HCT types were analyzed. Use of morphine to control pain due to oral mucositis was evaluated in each HCT method.
The severity of oral mucositis was reduced in patients undergoing RIST. Worsening of oral mucositis was delayed in patients receiving RIST. Use of morphine to control pain due to oral mucositis was significantly decreased in patients undergoing RIST compared with those receiving conventional allogeneic HCT.
The severity of oral mucositis was reduced and the peak day of oral mucositis was delayed in RIST patients compared with those receiving conventional HCT.

DOI： 10.1007/s00520-009-0637-z

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担当区分：筆頭著者   記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：SPRINGER  

Oral and systemic infections arising from the oral cavity are significant problems in clinical management of patients undergoing leukemia treatment. However, there is significant disparity in the reported incidences of development of periodontal infections. Evidence is limited to those showing the systemic influence of periodontal infection in neutropenic patients. This study indicated an association between febrile neutropenia (FN) and periodontitis in a case in which periodontal treatment in the intervals between chemotherapy cycles reduced FN in subsequent courses of chemotherapy and hematopoietic transplantation (HCT).
Periodontal treatment was performed in a 61-year-old man with advanced periodontitis, who received HCT following three cycles of chemotherapy. After recovery from neutropenia induced by initial chemotherapy, periodontal treatment was performed in each chemotherapy interval period. Following extraction of teeth with severe advanced periodontitis, all teeth were subjected to periodontal pocket curettage and root planning, which are common periodontal treatments to reduce periodontal pockets harboring anaerobic periodontal bacteria, before HCT.
Periodontal treatment successfully reduced periodontal pockets from 4.1 +/- 1.5 mm to 3.0 +/- 0.6 mm, which was almost within the healthy range (&lt; 3.0 mm), before HCT. The frequency of FN decreased significantly with increasing cycles of chemotherapy, and decreases in FN corresponded to progress of periodontal treatment. Blood cultures obtained a total of 12 times throughout leukemia treatment were all negative.
The observations reported here indicate the importance of periodontal treatment in clinical management of patients undergoing leukemia treatment to prevent FN, although all blood cultures were negative.

DOI： 10.1007/s00520-008-0532-z

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：AMER ACAD PERIODONTOLOGY  

Background: A genome-association study is a powerful toot for analyzing small gene effects in complex diseases such as chronic periodontitis (CP), although the cost of analysis is prohibitive. We designed a study using the DNA pooling method, which could be a breakthrough in lowering such costs. This study was conducted to assess the genetic association in severe CP in a Japanese population.
Methods: We adopted a DNA pooling method by genotyping 454 densely spaced microsatellite (MS) markers in chromosome 19 as a pilot study, with the possibility of future use in a whole-genome study. This can reduce the high cost and technical burden, which is generally unavoidable in a genomic association study. Pooled DNA samples from 300 case subjects, 300 control subjects, and 200 systemically healthy subjects were screened by genotyping MS markers. The case-control association in the candidate region was analyzed by individual typing of MS and single nucleotide polymorphisms (SNPs).
Results: The single MS marker allele 17 of 1902G31 was isolated in association with severe CP (P = 0.0012 for 2 x 2; P&lt;0.046 for 2 x m, where m refers to the number of polymorphic alleles observed in a population). No other SNP or MS polymorphism hypothesized to affect biologic functions in the critical region was found in the linkage disequilibrium block analysis.
Conclusions: We efficiently isolated the susceptible locus for severe CP in chromosome 19 and identified a useful marker to evaluate the risk for disease. This approach can be applied to a whole-genome study in severe CP. J Periodontol 2009;80:663-671.

DOI： 10.1902/jop.2009.080516

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記述言語：日本語   出版者・発行元：岡山歯学会  

現在までの介入患者数を調べ、歯科に期待されている周術期医療のニーズを明らかにした。すなわち、プラークフリーの実施状況およびマウスプロテクターの作製状況を調べ、超急性期病院である大学病院における医科・歯科連携のニーズを明らかにした。5ヵ月間に、岡山大学病院周術期管理センターを受診した65例を対象とした。周術期管理センター(歯科部門)受診者数は62例、周術期管理センター本部受診者数65例の95.4%であった。プラークフリー受診者数は月毎に増加し、延べ66例となった。延べ人数となっているのは、複数回手術を受けた患者の場合、その都度プラークフリーを受けているためである。マウスプロテクターを必要とした患者は合計7例であり、その理由は、動揺歯の固定の他、高額私費補綴物の保護、充填物や歯質の破損の防止等、様々であった。

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その他リンク： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2009&ichushi_jid=J02040&link_issn=&doc_id=20090730120005&doc_link_id=http%3A%2F%2Fousar.lib.okayama-u.ac.jp%2F52024&url=http%3A%2F%2Fousar.lib.okayama-u.ac.jp%2F52024&type=%89%AA%8ER%91%E5%8Aw%81F%89%AA%8ER%91%E5%8Aw%8Aw%8Fp%90%AC%89%CA%83%8A%83%7C%83W%83g%83%8A&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F80034_3.gif

記述言語：英語   出版者・発行元：The Japanese Society of Inflammation and Regeneration  

Periodontal disease has been recognized as local infectious disease, which becomes major cause of tooth loss in the adults. However, it is now being re-recognized as low-grade inflammatory disease exhibiting negative impact on the host. It is believed that severer form of periodontal disease is often seen in diabetic and/or obese subjects. This may be associated with chronic immuno-activation due to hyperadipocytokinemia as well as hyperglycemia. Severe periodontal inflammation, in turn, acts to evoke insulin resistance and to accelerate atherosclerotic changes. Therefore, the disease may accelerate the fatigue of pancreatic β-cells as well as vascular inflammation. Overall, the disease may promotes the aging itself. Because of these unwanted negative effects of the disease, it is very important to understand the molecular mechanisms as to why such small, local inflammation due to oral infectious disease is intensified to the levels of influencing our systemic health. Here in this mini-review, we discuss about the negative effects of periodontal disease on acceleration of aging.

DOI： 10.2492/inflammregen.29.186

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その他リンク： https://jlc.jst.go.jp/DN/JALC/00333171026?from=CiNii

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：NATURE PUBLISHING GROUP  

Recent studies have suggested that macrophages were integrated into adipose tissues to interact with adipocytes, thereby exacerbating inflammatory responses. Furthermore, both adipocytes and macrophages appear to express toll-like receptor-4 (TLR-4), and free fatty acids may stimulate cells through TLR-4. Herein, we analyzed genes differentially expressed in adipocytes when co-cultured with macrophages in the presence of a ligand for TLR-4, bacterial lipopolysaccharide (LPS). RAW264.7, a murine macrophage cell line and differentiated 3T3-L1 adipocytes were co-cultured using a transwell system. Genes differentially expressed in adipocytes were analyzed by the DNA microarray method following 4, 8, 12 and 24 h stimulation with 1 ng ml(-1) of Escherichia coli LPS. Randomly selected genes with high expressions were confirmed by quantitative methods at both the gene and the protein level. Co-culture of macrophages and adipocytes with a low LPS concentration (1 ng ml(-1)) markedly upregulated gene expressions associated with inflammation and/or angiogenesis, such as those of interleukin-6 (IL-6), MCP-1, RANTES and CXCL1/KC, in adipocytes. Furthermore, several genes associated with insulin resistance were differentially expressed. Upregulations of genes encoding MCP-1, RANTES and CXC/KC were confirmed by quantitative methods. These results suggest that ligands for TLR-4 stimulate both adipocytes and macrophages to upregulate the expressions of many genes associated with inflammation and/or angiogenesis.

DOI： 10.1038/ijo.2008.153

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：SPRINGER  

Goals Hematopoietic cell transplantation (HCT) may lead to the development of xerostomia. However, there have been few reports of xerostomia in HCT patients based on objective data. We investigated moisture in the oral mucosa in patients undergoing HCT by the capacitance method using a convenient device, Moisture Checker for Mucus (R) (MCM; Life Co., Ltd., Saitama, Japan).
Subjects and methods Thirty-six patients undergoing HCT at Okayama University Hospital of Medicine and Dentistry (Male=22, Female=14; age=41.6 +/- 16.2 years old) were enrolled in this study. Moisture in the oral mucosa was measured by MCM in accordance with the manufacturer&apos;s instructions. The results were obtained as MCM values (%), which are the weight percentage of water content in the oral mucosal epithelium. As controls, moisture of the oral mucosa was also examined in healthy volunteers (Male=27, Female=35; age=43.0 +/- 14.6 years old).
Main results Throughout the examination period, MCM values were significantly lower in patients who underwent HCT than in controls. The degree of mucosal moisture in HCT patients showed wide interindividual differences.
Conclusion The degree of mucosal moisture in HCT patients was low and showed wide interindividual differences. Evaluation of xerostomia using such a device may contribute to appropriate oral care with saliva substitute.

DOI： 10.1007/s00520-008-0470-9

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：BLACKWELL PUBLISHING  

Objectives: The expression of interleukin (IL)-12R beta 2 molecule is a crucial regulatory factor in the T-helper type (Th) 1 differentiation of T cells. To elucidate the role of the cell-mediated immune (CMI) response in the pathogenesis of periodontitis, Japanese periodontal patients were subjected to single nucleotide polymorphism (SNP) analyses of the 5' flanking region of IL12RB2, whose variants are frequently detected in lepromatous leprosy patients, in which the very weak cellular immune response is caused by low expression of IL-12R beta 2.
Material and Methods: The gene polymorphisms of the 5' flanking region of IL12RB2 were examined in subjects with several types of periodontal disease and in healthy controls. Serum immunoglobulin (Ig) G antibody titres against periodontopathic bacteria were measured and compared in periodontal patients with and without variant alleles of IL12RB2.
Results: The frequencies of variant alleles of IL12RB2 were significantly higher in aggressive periodontitis patients as compared with healthy controls or chronic periodontitis patients. Serum IgG titres against all periodontal bacteria examined in subjects carrying variant alleles were higher than those in subjects without variant alleles.
Conclusion: IL-12R beta 2 SNPs could be useful as genetic markers to access the susceptibility of the general population to periodontal disease. Low CMI responses or high humoral responses are associated with the pathogenesis of inflammatory periodontal diseases.

DOI： 10.1111/j.1600-051X.2008.01208.x

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：SPRINGER  

Goals The commercially available saliva substitute Oralbalance (R) has been reported to alleviate symptoms of post-radiotherapy xerostomia in head and neck cancer patients. Oralbalance (R) may also be effective for xerostomia in patients undergoing hematopoietic cell transplantation (HCT) with high-dose chemotherapy and total-body irradiation. However, HCT patients are severely compromised, and saliva substitute must therefore not promote infection. This study was performed to determine the effects of Oralbalance (R) on microbial species identified during HCT.
Patients and methods Microbial identification of oral mucosa was performed in 28 patients undergoing HCT. The antimicrobial effects of Oralbalance (R) against bacteria and fungi detected in the HCT period were examined in vitro. Briefly, bacteria and fungi were spread on agar plates, and 0.1g of Oralbalance (R) gel was applied (about phi 1cm). After incubation at 37 degrees C for 24h, the presence of a transparent zone of inhibition around Oralbalance (R) was observed.
Main results Not only bacterial species constituting normal flora of the oral mucosa but also those not usually constituting normal flora, e.g., coagulase-negative Staphylococcus, were detected. A transparent zone was observed around Oralbalance (R) in all bacterial species examined. No transparent zone was observed for Candida albicans, but growth was inhibited in the area where Oralbalance (R) was applied.
Conclusions Oralbalance (R) does not facilitate increases in microorganisms in the HCT period. Oral care with Oralbalance (R) does not promote infection in patients undergoing HCT.

DOI： 10.1007/s00520-007-0391-z

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：AMER ACAD PERIODONTOLOGY  

Background: Dentists generally recognize the importance of periodontal treatment inpatients with leukemia, with the most attention paid to preventing the development of odontogenic infection. For physicians, the worst type of infection is one caused by multidrug-resistant bacteria. Here, we report a patient with an abnormal increase in multidrug-resistant opportunistic bacteria in the gingiva during hematopoietic cell transplantation (HCT).
Methods: A 53-year-old woman receiving HCT for leukemia had an insufficient blood cell count for invasive periodontal treatment before HCT. Even brushing caused difficulties with hemostasis. Therefore, frequent pocket irrigation and local minocycline administration were performed.
Results: The multidrug-resistant opportunistic bacterium Stenotrophomonas maltophilia was detected first in phlegm 2 days before HCT, and it was detected in a gingival smear and a blood sample 7 and I I days after HCT, respectively. The patient developed sepsis on day I I and died 14 days after HCT. Frequent irrigation and local antibiotic application were ineffective against S. maltophilia on the gingiva. Inflammatory gingiva without scaling and root planing showed bleeding tendency, and this interfered with the eradication of this bacterium.
Conclusions: The gingiva in patients undergoing leukemia treatment acts as sites of proliferation and reservoirs for multidrug-resistant opportunistic bacteria. Severe systemic infection by multidrug-resistant bacteria in such patients with leukemia also may involve the gingiva. To prevent abnormal increases in such bacteria on the gingiva, scaling and/or root planing before chemotherapy, which reduces bleeding on brushing during the neutropenic period caused by chemotherapy, may contribute to infection control in such patients, although it was impossible in this case.

DOI： 10.1902/jop.2008.070205

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記述言語：日本語   出版者・発行元：(NPO)日本歯科保存学会  

薬物誘発性歯肉増殖症は,カルシウム拮抗剤,抗てんかん剤あるいは免疫抑制剤の服用者の一部に認められる副作用である.歯肉増殖症の発症機構についてこれまでにさまざまな報告がなされてきたが,近年,歯肉増殖症は歯肉線維芽細胞におけるα2インテグリン発現の抑制とコラーゲンファゴサイトーシスの抑制を介したコラーゲン線維の蓄積により発症することが示された.しかしながら,歯肉増殖症の発症率が報告により異なっている原因については不明である.いくつかの疾患において,その発症に関与する遺伝的素因として一塩基多型が知られている.筆者らは,α2インテグリン+807C/T遺伝子多型が歯肉増殖症の発症と関連することを示したが,この遺伝子多型はアミノ酸変異を生じないため発症との直接の関与は考えられず,+807の近傍のほかの一塩基多型との協調関与の可能性が考えられた.そこで本研究では,歯肉増殖症の発症と+807遺伝子多型と連鎖不平衡の関係にあるα2インテグリン+1648G/A遺伝子多型との関連について検討を行った.被験者は,徳島大学病院および新潟大学病院に通院するカルシウム拮抗剤,フェニトイン,あるいはサイクロスポリン服用患者98名を対象とした.歯肉増殖はMcGawらの基準に基づき判定した.末梢血サンプルは増殖症患者45名(増殖症群)と非増殖症患者53名(非増殖症群)から採取した.血液からゲノムDNAを抽出し,α2インテグリン+1648遺伝子部位についてシークエンス分析を行った.その結果,α2インテグリン+1648G/Aの遺伝子型分布は,GGが増殖症群と非増殖症群でそれぞれ95.6%と88.7%と著しく高く,GAはそれぞれ4.4%と9.4%,そしてAAは非増殖症群の1例のみであった.また,アレル頻度については+1646Gアレルが増殖症群と非増殖症群でそれぞれ97.8%と94.7%で,+1648Aアレルがそれぞれ2.2%と5.3%であり,両群間には有意な差は認められなかった.これらの結果は,薬物誘発性歯肉増殖症の発症はヒトα2インテグリン+1648G/A遺伝子多型と相関しないことを示している.しかしながら,歯肉増殖症はα2インテグリン+807C/T遺伝子多型と+1648G/A以外のその他の遺伝子多型との協調を介して発症することも考えられる.(著者抄録)

DOI： 10.11471/shikahozon.51.464

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その他リンク： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2008&ichushi_jid=J01092&link_issn=&doc_id=20080908300010&doc_link_id=%2Fdo1conde%2F2008%2F005104%2F010%2F0464-0471%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fdo1conde%2F2008%2F005104%2F010%2F0464-0471%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

記述言語：日本語   出版者・発行元：特定非営利活動法人 日本歯周病学会  

DOI： 10.14833/amjsp.2008s.0.114.0

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：NATURE PUBLISHING GROUP  

Objective: Recent studies suggested macrophages were integrated in adipose tissues, interacting with adipocytes, thereby exacerbating inflammatory responses. Persistent low-grade infection by gram-negative bacteria appears to promote atherogenesis. We hypothesized a ligand for toll-like receptor 4 (TLR4), bacterial lipopolysaccharide (LPS), would further exaggerate macrophage-adipocyte interaction.
Research Methods and Procedures: RAW264.7 macrophage cell line and differentiated 3T3-L1 preadipocytes were co-cultured using transwell system. As a control, each cell was cultured independently. After incubation of the cells with or without Escherichia coli LPS, tumor necrosis factor (TNF)-alpha and interleukin (IL)-6 production was evaluated.
Results: Co-culture of macrophages and adipocytes with low concentration of Escherichia coli LPS (1 ng/mL) markedly up-regulated IL-6 production (nearly 100-fold higher than that of adipocyte culture alone, p &lt; 0.01), whereas TNF-alpha production was not significantly influenced. This increase was partially inhibited by anti-TNF-alpha neutralizing antibody. Recombinant TNF-a and LPS synergistically upregulated IL-6 production in adipocytes. However, this increase did not reach the level of production observed in co-cultures stimulated with LPS.
Discussion: A ligand for TLR-4 stimulates macrophages to produce TNF-alpha. TNF-alpha, thus produced, cooperatively upregulates IL-6 production with other soluble factors secreted either from adipocytes or macrophages in these cells. Markedly up-regulated IL-6 would greatly influence the pathophysiology of diabetes and its vascular complications.

DOI： 10.1038/oby.2007.305

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：BLACKWELL PUBLISHING  

DOI： 10.1111/j.1600-0757.2006.00171.x

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：SAGE PUBLICATIONS LTD  

Diabetic subjects are susceptible to atherosclerosis. It has been postulated that inflammation plays a crucial role in atherogenesis. Since previous studies suggested persistent low-grade infection by Gram-negative bacteria such as Chlamydia spp. and/or periodontal infection is associated with increased atherogenesis among diabetic subjects, we hypothesized that macrophages under hyperglycemia respond to lipopolysaccharide (LPS) challenge in a more exaggerated manner than under normal glucose conditions. Therefore, we examined cytokine productivity and associated signal transduction molecules in LPS-stimulated the monocytic cell line THP-1, under conditions of hyperglycemia. Differentiated THP-1 cells were cultured under normal and high glucose conditions without fetal bovine serum, and were stimulated with Escherichia coli LPS in the presence of LPS binding protein. Following stimulation, activated signal transduction molecules were detected by protein rnicroarray and confirmed thereafter. Results indicated that c-jun N-terminal kinase (INK) was highly-phosphorylated at high glucose concentrations, and this was confirmed by Western-immunoblotting. Tumor necrosis factor-alpha and monocyte chemo-attractant protein-1 production were significantly enhanced under these conditions. SP600125, a selective inhibitor of JNK, dose-dependently suppressed the production of these cytokine. Therefore, we suggest that this may be one of the mechanisms by which sub-clinical infection by Gram-negative bacteria promotes atherosclerosis in diabetic subjects.

DOI： 10.1177/0968051907082608

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：GEORG THIEME VERLAG KG  

Recent studies have suggested that the periodontal disease, chronic sub-clinical inflammation, is associated with atherosclerosis, although "cause or effect" relationship is still unclear. The aim of this study was to assess the association between the degree of periodontal infection and lipid profiles in diabetic subjects. Additionally, the association of such sub-clinical inflammation with HMG-CoA reductase gene expression was evaluated. One hundred and thirty-one non-obese relatively well-controlled Japanese type 2 diabetic patients were enrolled for the study. Although no significant association was observed between serum triglycerides, HLD-cholesterol and antibody titer to Porphyromonas gingivalis (Pg), the most predominant periodontal pathogen in adults, LDL-cholesterol was significantly associated with antibody titer to Pg. Concomitantly, the same works out to be true for total cholesterol. To understand the possible mechanisms underlying this association, we evaluated 3-hydroxy-3-methylglutaryl-CoA (HMG-CoA) reductase gene expression in cultured HepG2 cells stimulated by either bacterial lipopolysaccharide (LPS) or inflammatory cytokines. Although Pg and E. coli LPS had no effect on HMG-CoA reductase gene expression, both tumor necrosis factor-a and interleukin-6 (IL-6), especially IL-6 at low concentration, markedly up-regulated HMG-CoA reductase gene expression. It can be concluded that Pg infection is associated with increased LDL-cholesterol in diabetic subjects, which may be accompanied by increased cholesterol synthesis by inflammatory cytokines.

DOI： 10.1055/s-2006-949525

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記述言語：日本語   出版者・発行元：(NPO)日本歯科保存学会  

血液疾患患者122名を対象に、歯周病原性細菌として代表的なP.gingivalisに対する血清IgG抗体価と歯周病の程度との間に関連がみられるか検討した。結果、多様な血液像(白血球減少など)を呈する血液疾患患者においても健常者と同様に歯周病の程度が重いほどIgG抗体価は高値であった。

DOI： 10.11471/shikahozon.49.731

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その他リンク： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2006&ichushi_jid=J01092&link_issn=&doc_id=20070117080006&doc_link_id=%2Fdo1conde%2F2006%2F004906%2F006%2F0731-0738%26dl%3D0&url=http%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fdo1conde%2F2006%2F004906%2F006%2F0731-0738%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：INT AMER ASSOC DENTAL RESEARCHI A D R/A A D R  

alpha 2 integrin on fibroblasts is reported to play an important role in the induction of drug- induced gingival overgrowth, which is characterized by excessive accumulation of type I collagen in gingival connective tissue. Silent polymorphism 807 T/ C within the alpha 2 integrin gene is associated with high/ low alpha 2 integrin expression. The aim of this study was to test the hypothesis that expression of alpha 2 integrin 807 T/ C polymorphism correlates with drug- induced gingival overgrowth. A case- control study comparing 136 subjects taking calcium channel blockers ( 72 with vs. 64 without drug- induced gingival overgrowth) demonstrated that the frequency of the + 807 C allele was significantly higher in the case group than in the controls ( odds ratio, 3.61; 95% confidence interval, 2.14 - 6.10; P &lt; 0.05). The present findings suggest that the alpha 2 + 807 C allele is one of the genetic risk factors for drug- induced gingival overgrowth.

DOI： 10.1177/154405910508401217

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：INT AMER ASSOC DENTAL RESEARCHI A D R/A A D R  

An elevated level of C-reactive protein (CRP) predicts the future development of coronary heart disease. Periodontitis appears to up-regulate CRP. CRP is produced by hepatocytes in response to interleukin-6 (IL-6). A major source of IL-6 in obese subjects is adipocytes. We hypothesized that lipopolysaccharide (LPS) from periodontal pathogens stimulated adipocytes to produce IL-6, and that the production was suppressed by the drugs targeted against insulin resistance, thiazolidinedione ( pioglitazone), since this agent potentially showed an anti-inflammatory effect. Mouse 3T3-L1 adipocytes were stimulated with E. coli, P. gingivalis, and F. nucleatum LPS. The IL-6 concentration in culture supernatants was measured. All LPS stimulated adipocytes to produce IL-6. Although pioglitazone changed adipocyte appearance from large to small, and completely suppressed P. gingivalis and F. nucleatum LPS-induced IL-6 production, E. coli LPS-induced IL-6 production was not efficiently blocked. Thus, pioglitazone completely blocked periodontal-bacteria-derived LPS-induced IL-6 production in adipocytes, a major inducer of CRP.

DOI： 10.1177/154405910508400306

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：BLACKWELL MUNKSGAARD  

Leprosy is characterized by a wide spectrum of clinical features depending on the individual differences in Th1-type immunity. The objective of this study was to evaluate whether monocyte activation by stimulus via class II HLA molecules would be correlated with the differences in cellular immune responses among diverse clinical forms of leprosy. IL-1beta and IL-12 productivity in monocyte preparations obtained from PBMCs was estimated in patients with lepromatous- and tuberculoid-type leprosy. We found that monocytes from lepromatous patients produced significantly higher (about 4-fold higher) amounts of IL-12 as compared to in patients with tuberculoid type of leprosy when class II HLA molecules were cross-linked with anti-HLA class II antibodies, whereas almost equal amounts of IL-1beta were produced from each monocyte preparation by stimulus via class II HLA molecules regardless of the clinical form of leprosy. These results suggest that monocyte activation differs between lepromatous and tuberculoid patients in terms of IL-12 secretion, which might be related to individual differences in the cellular immune responses according to the clinical type of leprosy.

DOI： 10.1111/j.1600-0463.2004.apm11204-0507.x

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：GEORG THIEME VERLAG KG  

The aim of the present study was to investigate the relationship between periodontal bacteria infection (Porphyromonas gingivalis, Actinobacillus actinomycetemcomitans, Prevotella intermedius) and C-reactive protein (CRP) and albuminuria in non-obese Japanese type 2 diabetic patients. One hundred and thirty-four non-obese Japanese type 2 diabetic patients without evidence of current acute illness including clinically significant acute infectious disease were enrolled into the study. The degree of periodontal bacterial infection was evaluated using IgG titer against Porphyromonas gingivalis, Actinobacillus actinomycetemcomitans, or Prevotella intermedius. The bacterial sonic extracts were used as antigens. High-sensitivity CRP (hCRP), glucose, glycosylated hemoglobin (HbA(1c)), and lipids were also measured after an overnight fast. Urinary albumin excretion rate as a ratio of urinary albumin and urinary creatinine was assessed in a morning spot urine sample using a commercial enzymatic immunoassay. The prevalence of Porphyromonas gingivalis infection was 52.2 % and that of Actinobacillus actinomycetemcomitans and Prevotella intermedius was 7.5 and 14.2 %, respectively. IgG titer against Porphyromonas gingivalis significantly correlated with CRP (r = 0.225, p &lt; 0.001) and albuminuria (r = 0.185, p &lt; 0.05), while IgG titer against Actinobacillus actinomycetemcomitans or Prevotella intermedius was not associated with either parameter. These results suggest that among periodontal bacteria, Porphyromonas gingivalis infection is associated with atherosclerosis in non-obese Japanese type 2 diabetic patients.

DOI： 10.1055/s-2004-814221

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：PERGAMON-ELSEVIER SCIENCE LTD  

Previous studies suggested that the onset of phenytoin-induced gingival overgrowth depended on serum phenytoin concentration. Cytochrome P450 2C (CYP2C) plays an important role in phenytoin metabolism. Recently, single nucleotide polymorphisms in the coding region of CYP 2C influencing phenytoin metabolism were identified. The purpose of the present study was to see if CYP 2C polymorphisms might relate to the onset and severity of phenytoin-induced gingival overgrowth. Twenty-eight epileptic patients taking phenytoin aged 15 to 75 (mean age: 42.2 years old, 20 males and 8 females) and 56 unrelated healthy subjects aged 30 to 48 (mean age: 36.8 years old, 48 males and 8 females) were examined for CYP 2C polymorphisms. All epileptic subjects were examined for the degree of gingival overgrowth, daily phenytoin dose and serum phenytoin concentration. The results indicated about 7% of the subjects including epileptic and healthy subjects examined were positive for CYP 2C9*3. However, the degree of gingival overgrowth did not directly correlate with CYP 2C polymorphisms. Nevertheless, the subjects with severer gingival overgrowth exhibited significantly higher serum phenytoin concentration, indicating that phenytoin metabolism is an important determinant for the severity of the disease. Additionally, CYP 2C9*3 carriers exhibited significantly higher serum drug concentration to drug dose. Therefore, we concluded although the gene analysis is not directly related to diagnose the disease itself, it can be utilized in estimating serum phenytoin concentration from drug dose, which in turn serves to predict the future development and clinical course of the disease. (C) 2003 Elsevier Inc. All rights reserved.

DOI： 10.1016/j.lfs.2003.07.018

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：AMER ACAD PERIODONTOLOGY  

Background: Elevated levels of C-reactive protein (CRP) and decreased plasma adiponectin are associated with increased risk of atherosclerosis. Furthermore, recent observations suggested that adiponectin and tumor necrosis factor-alpha (TNF-alpha) suppressed each other's production. Since periodontal disease has been suggested to act as a risk factor for atherosclerosis, we examined the effects of antimicrobial periodontal treatment on CRP, adiponectin, and TNF-a levels.
Methods: Fifteen chronic periodontitis patients with various systemic conditions at high risk for atherosclerosis were enrolled in the study. Patients were non-surgically treated with topical application of antibiotics and mechanical debridement of calculus once a week for 1 month. Before and after therapy, CRP, adiponectin, and TNF-alpha levels were measured.
Results: Both CRP and TNF-alpha levels were significantly decreased after treatment (P &lt;0.01 and P &lt;0.03, respectively), while adiponectin levels did not change significantly.
Conclusions: Periodontal treatment is effective in reducing CRP and TNF-alpha, while adiponectin does not appear to be influenced by periodontal treatment. Elevated levels of CRP and TNF-alpha may be associated with increased risk for future development of atherosclerosis in periodontitis patients.

DOI： 10.1902/jop.2003.74.8.1231

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：BLACKWELL MUNKSGAARD  

Objectives: Tumour necrosis factor-alpha (TNF-alpha ) and interleukin-1beta (IL-1beta ) participate in the establishment of inflammatory lesions in periodontitis. High production of these cytokines may relate to the severity of periodontitis. There have already been several studies examining the association between periodontitis and single nucleotide polymorphisms (SNPs) that affect cytokine productivity. Recently, new SNPs of TNF-alpha , -1031, -863 and -857, variants of which are observed in a relatively large proportion in Japanese, have been identified. The variant alleles of these SNPs have been suggested to be related to high TNF-alpha production. For a better understanding of the genetic factors associated with the severity of periodontitis, further analysis including these newly identified SNPs is essential. In addition, previous reports on TNF-alpha or IL-1beta SNPs associated with periodontitis were mainly for Caucasian populations. Therefore, the aim of this study is to examine the association between severe periodontitis in Japanese and the following SNPs: five in the TNF-alpha gene promoter (-1031, -863, -857, -308, -238) and three in the IL-1beta gene (-511, -31, +3953).
Material and Methods: A total of 128 Japanese individuals were enrolled in this study. They were 64 patients with severe adult periodontitis and 64 healthy subjects. TNF-alpha and IL-1beta SNPs were genotyped by polymerase chain reaction-restriction fragment length polymorphism for all subjects. TNF-alpha and IL-1beta production from LPS-stimulated monocytes/macrophages was also measured for 15 healthy male subjects.
Results: TNF-alpha production in TNF-alpha -1031/-863 (linkage disequilibrated) or -857 SNP variant allele carriers tended to be elevated, and the frequency of subjects who carried at least one variant allele in TNF-alpha -1031, -863 or -857 SNPs among severe periodontitis patients was significantly higher than in healthy subjects.
Conclusion: Since the frequency of subjects who carried at least one variant allele in TNF-alpha -1031, -863 or -857 SNPs was higher in periodontitis patients than in healthy subjects, TNF-alpha -1031, -863 and -857 SNPs appear to be associated with severe adult periodontitis in Japanese populations.

DOI： 10.1034/j.1600-051X.2003.00287.x

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：W B SAUNDERS CO  

The aim of the present study was to investigate whether non-obese Japanese type 2 diabetic patients with porphyromonas gingivalis infection have atherosclerotic vascular diseases. A total of 134 non-obese Japanese type 2 diabetic patients (96 men and 38 women, aged 36 to 84 years, body mass index [BMI] 20.1 to 26.9 kg/m(2)) were studied. In conjunction with BMI, glycosylated hemoglobin (HbA(1c)), fasting glucose, and serum lipids (triglycerides, total cholesterol, high-density lipoprotein [HDL] cholesterol, low-density lipoprotein [LDL] cholesterol) were measured. LDL cholesterol was calculated using the Friedewald formula. Using high-resolution B-mode ultrasound scan, we measured intimal medial thickness (IMT) in plaque-free segments of bilateral common carotid arteries, and the mean of IMT in 2 vessels was used for the analysis. Furthermore, we calculated the degree of stenosis in plaque segments of bilateral common carotid arteries. The degree of carotid atherosclerosis was expressed as a percentage ratio between the area of plaque and that of the lumen using the formula (Lumen Area Residual - Lumen Area)/Lumem Area x 100. Both the areas were automatically measured by the system on a frozen transverse scanning plane at the site of maximal narrowing. When 2 or more plaques were present in the vessel, only that causing the greatest degree of stenosis was considered for analysis. Values represent mean+/-SEM unless otherwise stated. Immunoglobulin G (IgG) titer against porphyromonas gingivalis was 245 +/- 65 (mean +/- 2 SD) in nondiabetic healthy subjects. In contrast, there was a wide variation in IgG titer against porphyromonas gingivalis in type 2 diabetic patients studied (range, 16 to 26,800). Thus, we classified our type 2 diabetic patients into 2 subpopulations according to the value of mean +/- 2 SD (= 310) of nondiabetic healthy subjects: one with high IgG titer against porphyromonas gingivalis (&gt;310) (1,422 :t 408) and the other with normal IgG titer against porphyromonas gingivalis (&lt;310) (152 +/- 10, P = .002). The populations did not differ with respect to age, sex, BMI, fasting glucose, HbA(1c) serum triglycerides, total, HDL, and LDL cholesterol levels. Although the mean IMT in plaque-free segments was not different between the 2 groups (0.73 +/-0.03 v 0.68 +/- 0.02 mm, P = .098), the degree of stenosis in plaque segments was significantly higher in the high IgG titer group (12.0% +/- 2.2%) than in normal one (5.5% +/- 1.4%, P = .009). From these results, it can be concluded that porphyromonas gingivalis infection, although still a subclinical infection, is associated with atherosclerotic vascular disease in non-obese Japanese type 2 diabetic patients. Copyright 2003, Elsevier Science (USA). All rights reserved.

DOI： 10.1053/meta.2003.50001

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：AMER ACAD PERIODONTOLOGY  

It is generally accepted that obesity is associated with many other multiple-risk factor syndromes such as hypertension, hyperlipidemia, type 2 diabetes mellitus, and periodontal disease. The number of obese people is increasing rapidly in both western and eastern countries. Adipocytes in the adipose tissues of obese people produce large quantities of biologically active molecules such as leptin, an important molecule regulating energy expenditure and body weight. Therefore, adipocyte-derived active molecules, named adipocytokines, are candidate molecules accounting for the close association between obesity and other multiple-risk factor syndromes. The proinflammatory cytokine tumor necrosis factor-alpha (TNF-alpha) is produced by adipocytes, and its blood concentration is elevated in obese patients and declines with weight loss. Studies have demonstrated that TNF-alpha. suppresses insulin action via its specific receptor; hence, it exacerbates insulin resistance. In addition to adipocytes, monocytes/macrophages produce large quantities of TNF-alpha. Thus, TNF-alpha, produced from monocytic cells due to inflammatory diseases, may have an additive influence on insulin sensitivity to adipocyte-derived TNF-alpha. Here, we hypothesized that 1) TNF-alpha produced by the adipose tissues of obese patients acts as a risk factor for periodontal inflammation, and 2) TNF-alpha produced due to periodontal inflammation may be an additional important factor influencing insulin sensitivity in both obese and type 2 diabetic patients. We believe that this interaction is a possible mechanism accounting for a 2-way relationship between type 2 diabetes and periodontal disease.

DOI： 10.1902/jop.2003.74.1.97

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記述言語：日本語   出版者・発行元：(NPO)日本歯科保存学会  

慢性関節リウマチ(RA)患者の歯周治療を取り上げ,歯周治療がRAの臨床データへ及ぼす影響について考察した.50歳女.下顎右側第二大臼歯に自発痛及び咬合痛を自覚し,修復処置をうけた.その後,症状があまり改善しないため受診した.又,患者はRAの治療のため本歯周治療に伴い,歯周病原性細菌に対する血清IgG抗体価が低下した.血清IgG抗体価の低下に呼応して,TNF-αとCRP値が著明に低下した.よって,RAを伴う重度歯周炎に対して徹底した歯周処置を行うことによって,末梢血レベルでの炎症マーカーを改善することができる可能性が示唆された

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その他リンク： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2003&ichushi_jid=J01092&link_issn=&doc_id=20030303170014&doc_link_id=%2Fdo1conde%2F2003%2F004601%2F014%2F0110-0117%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fdo1conde%2F2003%2F004601%2F014%2F0110-0117%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：AMER DIABETES ASSOC  

DOI： 10.2337/diacare.25.10.1888

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記述言語：日本語   出版者・発行元：岡山歯学会  

日本人重度歯周炎患者と健常者各64名を対象に,TNF-α及びIL-1β遺伝子におけるSNPsのアリル分布を比較検討した.その結果,TNF-α及びIL-1β遺伝子に存在するSNPsの個々のアリル分布は,重度歯周炎患者群と健常者群の間で有意差を認めなかった.TNF-α遺伝子-1031,-863,-857 SNPs及びIL-1β遺伝子-511,-31 SNPsのアリル2キャリアは,重度歯周炎患者群,健常者群に拘らず日本人に広く分布した.又,TNF-α遺伝子-1031,-863,-857 SNPs及びIL-1β遺伝子-511/-31 SNPsのアリル間では,TNF-αあるいはIL-1βの産生性に有意差はみられなかった.TNF-α遺伝子-1031,-863,-857 SNPsのいずれかがアリル2である者の割合は,重度歯周炎患者群が健常者群と比べ高い値を示した

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総ページ数：冊   記述言語：日本語

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記述言語：日本語   出版者・発行元：(株)北隆館  

食道がん患者への歯科的支援には、術前補助化学(放射線)療法開始前からの口腔衛生管理、義歯などによる咬合支持(噛み合わせ)の回復、摂食嚥下機能の評価、訓練指導などがある。食道がん患者への歯科的支援により、術前補助化学(放射線)療法中の口腔粘膜炎を軽症化し、誤嚥性肺炎などの術後合併症を軽減し、経口栄養摂取を促進することは、術後の良好な経過に貢献する可能性がある。さらには、喫煙など食道がんと歯科疾患に共通のリスクファクターに対して行う歯科的なアプローチは、食道がん発症予防に寄与する可能性がある。(著者抄録)

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記述言語：日本語   出版者・発行元：大道学館出版部  

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記述言語：日本語   出版者・発行元：(株)ヒョーロン・パブリッシャーズ  

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記述言語：日本語   出版者・発行元：医歯薬出版(株)  

ややもすると口腔ケアの論点は口腔内の保清の方法とその効果になりがちであるが、周術期の口腔内管理では口腔衛生管理はもちろんのこと、適切な歯科治療やさらには摂食・嚥下機能評価および訓練といった、多角的かつ包括的な観点も必要であり、歯科医師および歯科衛生士の専門性はよりよい周術期管理に役立つと考えられる。周術期の感染予防の観点からみた場合、歯性感染巣の除去や口腔衛生状態を良好に保つことは、口腔近傍の手術における手術部位感染対策や術後肺炎対策へ直接的に寄与する。さらに、咀嚼機能の改善による経口栄養摂取の促進は、栄養状態の改善により間接的に感染予防へつながりうるものと考えられる。摂食・嚥下機能評価および訓練は、(1)誤嚥性肺炎対策という直接的な感染予防と、(2)経口栄養摂取の促進による栄養状態の改善、という間接的な感染予防の両者の意義をもつととらえられる。平成24年度(2012)の診療報酬改定で、周術期における口腔機能の管理などに診療報酬が新設された。口腔内の適切な管理による、よりよい周術期医療の創造への動きが今後加速すると考えられる。周術期における口腔ケアは、口腔衛生管理はもちろんのこと、周術期管理にあたり口腔を全身の一臓器としてとらえ、多角的な観点から最善な状態に整えることへ、その意味合いを変えていきそうである。(著者抄録)

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その他リンク： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2012&ichushi_jid=J00060&link_issn=&doc_id=20121122020001&doc_link_id=%2Faa7ayuma%2F2012%2F024308%2F002%2F0651-0655%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Faa7ayuma%2F2012%2F024308%2F002%2F0651-0655%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

記述言語：日本語   出版者・発行元：(株)照林社  

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記述言語：日本語   出版者・発行元：(株)ヒョーロン・パブリッシャーズ  

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その他リンク： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2012&ichushi_jid=J01091&link_issn=&doc_id=20120531280020&doc_link_id=http%3A%2F%2Fousar.lib.okayama-u.ac.jp%2F52877&url=http%3A%2F%2Fousar.lib.okayama-u.ac.jp%2F52877&type=%89%AA%8ER%91%E5%8Aw%81F%89%AA%8ER%91%E5%8Aw%8Aw%8Fp%90%AC%89%CA%83%8A%83%7C%83W%83g%83%8A&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F80034_3.gif

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記述言語：日本語   出版者・発行元：(株)メディカルレビュー社  

近年、歯周病は単に口腔局所の感染症としてのみではなく、生体における軽微な慢性炎症性疾患として捉えられるようになった。糖尿病患者は健常者と比較して、種々の機序で細菌感染に対して過剰に反応し、結果的に歯周病は重症化する。一方、このようにして重症化した歯周病、あるいはそれによって惹起される慢性炎症は、逆に糖尿病をさらに悪化させる。本稿では、歯周病と糖尿病との双方向性の関連について、筆者らが行ってきた研究成果を中心に、その想定メカニズムを紹介する。(著者抄録)

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記述言語：日本語   出版者・発行元：(一社)日本口腔ケア学会  

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記述言語：日本語   出版者・発行元：医歯薬出版(株)  

近年、糖尿病の合併症として歯周病の病態がしだいに解明されてきた。また、内臓脂肪蓄積-炎症論を軸としたメタボリック・シンドロームに対する病態解明が進み、歯周病は糖尿病単独の合併症というよりも、肥満が密接に関連したメタボリック・シンドロームの合併症としてとらえられるようになった。また、逆に歯周病が軽微な慢性炎症として、糖尿病やメタボリック・シンドロームの病態に影響を及ぼすことが明らかにされつつある。歯周病が糖尿病の病態を修飾する機序について、炎症論を軸として著者らの研究を中心に述べる。著者らは、糖尿病患者における歯周病感染がインスリン抵抗性の亢進、CRPの上昇、頸動脈の内膜中膜複合体の肥厚あるいはアルブミン尿に関係することを明らかにした。これらはいずれも虚血性心疾患に対する危険因子であり、歯周病が動脈硬化の進行促進因子となる可能性を示すものである。これらの知見を踏まえ、今後の歯周医学の展望について論じる。(著者抄録)

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その他リンク： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2010&ichushi_jid=J00060&link_issn=&doc_id=20100115070002&doc_link_id=%2Faa7ayuma%2F2010%2F023203%2F003%2F0167-0171%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Faa7ayuma%2F2010%2F023203%2F003%2F0167-0171%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

記述言語：日本語   出版者・発行元：クインテッセンス出版(株)  

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記述言語：日本語   出版者・発行元：(株)医学出版  

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記述言語：日本語   出版者・発行元：クインテッセンス出版(株)  

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記述言語：日本語   出版者・発行元：日総研出版  

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記述言語：日本語   出版者・発行元：(株)日本看護協会出版会  

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記述言語：日本語   出版者・発行元：(株)日本看護協会出版会  

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記述言語：日本語   出版者・発行元：(株)日本看護協会出版会  

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その他リンク： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2009&ichushi_jid=J01949&link_issn=&doc_id=20091014370016&doc_link_id=%2Fag0ngtdi%2F2009%2F002412%2F014%2F0052-0055%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fag0ngtdi%2F2009%2F002412%2F014%2F0052-0055%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

記述言語：日本語   出版者・発行元：(株)日本看護協会出版会  

J-GLOBAL

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その他リンク： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2009&ichushi_jid=J01949&link_issn=&doc_id=20091014370017&doc_link_id=%2Fag0ngtdi%2F2009%2F002412%2F015%2F0056-0059%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fag0ngtdi%2F2009%2F002412%2F015%2F0056-0059%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

記述言語：日本語   出版者・発行元：医歯薬出版(株)  

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記述言語：日本語   出版者・発行元：医歯薬出版(株)  

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記述言語：英語   掲載種別：研究発表ペーパー・要旨（国際会議）   出版者・発行元：INT AMER ASSOC DENTAL RESEARCHI A D R/A A D R  

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記述言語：英語   掲載種別：研究発表ペーパー・要旨（国際会議）   出版者・発行元：INT AMER ASSOC DENTAL RESEARCHI A D R/A A D R  

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記述言語：英語   掲載種別：研究発表ペーパー・要旨（国際会議）   出版者・発行元：INT AMER ASSOC DENTAL RESEARCHI A D R/A A D R  

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記述言語：英語   掲載種別：研究発表ペーパー・要旨（国際会議）   出版者・発行元：INT AMER ASSOC DENTAL RESEARCHI A D R/A A D R  

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開催年月日： 2022年6月18日 - 2022年6月19日

記述言語：日本語   会議種別：シンポジウム・ワークショップ パネル（指名）  

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開催年月日： 2022年6月10日 - 2022年6月12日

記述言語：日本語   会議種別：シンポジウム・ワークショップ パネル（指名）  

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開催年月日： 2022年4月28日 - 2022年5月13日

記述言語：日本語   会議種別：ポスター発表  

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開催年月日： 2021年

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開催年月日： 2020年8月10日

記述言語：日本語  

開催地：誌上開催（新型コロナウイルス感染拡大のため）  

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開催年月日： 2020年8月10日

記述言語：日本語  

開催地：誌上開催（新型コロナウイルス感染拡大のため）  

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開催年月日： 2020年8月10日

記述言語：日本語  

開催地：誌上開催（新型コロナウイルス感染拡大のため）  

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開催年月日： 2020年8月9日 - 2020年8月10日

記述言語：日本語   会議種別：シンポジウム・ワークショップ パネル（指名）  

開催地：web開催  

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開催年月日： 2020年8月

記述言語：日本語  

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開催年月日： 2020年2月19日 - 2020年2月21日

記述言語：日本語   会議種別：ポスター発表  

開催地：名古屋市・ウインクあいち  

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開催年月日： 2020年2月9日

記述言語：日本語   会議種別：シンポジウム・ワークショップ パネル（指名）  

開催地：千葉県浦安市・明海大学浦安キャンパス  

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開催年月日： 2020年

記述言語：日本語  

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開催年月日： 2020年

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開催年月日： 2020年

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開催年月日： 2019年12月15日

記述言語：日本語   会議種別：口頭発表（一般）  

開催地：岡山大学歯学部棟  

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開催年月日： 2019年11月30日 - 2019年12月1日

記述言語：日本語   会議種別：ポスター発表  

開催地：国立がん研究センター  

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開催年月日： 2019年11月30日 - 2019年12月1日

記述言語：日本語   会議種別：ポスター発表  

開催地：国立がん研究センター  

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開催年月日： 2019年11月30日 - 2019年12月1日

記述言語：日本語   会議種別：ポスター発表  

開催地：国立がん研究センター  

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開催年月日： 2019年11月30日 - 2019年12月1日

記述言語：日本語   会議種別：ポスター発表  

開催地：国立がん研究センター  

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開催年月日： 2019年11月23日 - 2019年11月24日

記述言語：日本語   会議種別：口頭発表（一般）  

開催地：米子市文化ホール  

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開催年月日： 2019年9月14日 - 2019年9月16日

記述言語：日本語   会議種別：ポスター発表  

開催地：ウインクあいち  

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開催年月日： 2019年9月14日 - 2019年9月16日

記述言語：日本語   会議種別：口頭発表（一般）  

開催地：ウインクあいち  

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開催年月日： 2019年9月14日 - 2019年9月16日

記述言語：日本語   会議種別：ポスター発表  

開催地：ウインクあいち  

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開催年月日： 2019年9月14日 - 2019年9月16日

記述言語：日本語   会議種別：ポスター発表  

開催地：ウインクあいち  

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開催年月日： 2019年9月14日 - 2019年9月16日

記述言語：日本語   会議種別：ポスター発表  

開催地：ウインクあいち  

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開催年月日： 2019年9月6日 - 2019年9月7日

記述言語：日本語   会議種別：シンポジウム・ワークショップ パネル（指名）  

開催地：リンクステーションホール青森（青森市文化会館）  

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開催年月日： 2019年8月

記述言語：日本語  

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開催年月日： 2019年8月

記述言語：日本語  

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開催年月日： 2019年8月

記述言語：日本語  

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開催年月日： 2019年6月21日 - 2019年6月23日

記述言語：英語   会議種別：ポスター発表  

開催地：San Francisco, CA USA  

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開催年月日： 2019年3月7日 - 2019年3月9日

記述言語：日本語   会議種別：ポスター発表  

開催地：大阪国際会議場  

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開催年月日： 2018年12月1日 - 2018年12月2日

記述言語：日本語   会議種別：口頭発表（一般）  

開催地：新潟市，新潟大学医学部学士会 有壬記念会館  

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開催年月日： 2018年12月1日 - 2018年12月2日

記述言語：日本語   会議種別：ポスター発表  

開催地：新潟市，新潟大学医学部学士会 有壬記念会館  

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開催年月日： 2018年12月1日 - 2018年12月2日

記述言語：日本語   会議種別：ポスター発表  

開催地：新潟市，新潟大学医学部学士会 有壬記念会館  

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開催年月日： 2018年12月1日 - 2018年12月2日

記述言語：日本語   会議種別：口頭発表（一般）  

開催地：新潟市，新潟大学医学部学士会 有壬記念会館  

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開催年月日： 2018年12月1日 - 2018年12月2日

記述言語：日本語   会議種別：ポスター発表  

開催地：新潟市，新潟大学医学部学士会 有壬記念会館  

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開催年月日： 2018年12月1日 - 2018年12月2日

記述言語：日本語   会議種別：ポスター発表  

開催地：新潟市，新潟大学医学部学士会 有壬記念会館  

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開催年月日： 2018年12月1日 - 2018年12月2日

記述言語：日本語   会議種別：口頭発表（一般）  

開催地：新潟市，新潟大学医学部学士会 有壬記念会館  

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開催年月日： 2018年11月23日 - 2018年11月25日

記述言語：日本語   会議種別：口頭発表（招待・特別）  

開催地：神戸市・神戸国際展示場、神戸国際会議場、神戸ポートピアホテル  

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開催年月日： 2018年11月2日 - 2018年11月4日

記述言語：英語   会議種別：ポスター発表  

開催地：Taipei, Taiwan  

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開催年月日： 2018年9月16日 - 2018年9月17日

記述言語：日本語   会議種別：口頭発表（一般）  

開催地：福岡市・福岡国際会議場  

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開催年月日： 2018年9月16日 - 2018年9月17日

記述言語：日本語   会議種別：ポスター発表  

開催地：福岡市・福岡国際会議場  

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開催年月日： 2018年8月

記述言語：日本語  

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開催年月日： 2018年8月

記述言語：日本語  

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開催年月日： 2018年7月27日 - 2018年7月28日

記述言語：日本語   会議種別：ポスター発表  

開催地：福島県郡山市・奥羽大学  

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開催年月日： 2018年7月19日 - 2018年7月21日

記述言語：日本語   会議種別：口頭発表（一般）  

開催地：神戸市・神戸国際会議場・神戸国際展示場  

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開催年月日： 2018年7月19日 - 2018年7月21日

記述言語：日本語   会議種別：ポスター発表  

開催地：神戸市・神戸国際会議場・神戸国際展示場  

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開催年月日： 2018年7月14日 - 2018年7月15日

記述言語：日本語   会議種別：ポスター発表  

開催地：金沢市・石川県立音楽堂，ANAクラウンプラザホテル金沢，ホテル日航金沢  

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開催年月日： 2018年7月

記述言語：日本語  

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開催年月日： 2018年7月

記述言語：日本語  

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開催年月日： 2018年7月

記述言語：日本語  

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開催年月日： 2018年6月28日 - 2018年6月30日

記述言語：英語   会議種別：ポスター発表  

開催地：Vienna, Austria  

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開催年月日： 2018年5月11日 - 2018年5月13日

記述言語：日本語   会議種別：シンポジウム・ワークショップ パネル（指名）  

開催地：名古屋市・ウインクあいち（愛知県産業労働センター）  

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開催年月日： 2018年1月25日 - 2018年1月26日

記述言語：日本語   会議種別：シンポジウム・ワークショップ パネル（指名）  

開催地：新潟市・新潟グランドホテル  

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開催年月日： 2017年11月25日 - 2017年11月26日

記述言語：日本語   会議種別：ポスター発表  

開催地：岡山市・岡山大学創立五十周年記念館  

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開催年月日： 2017年11月25日 - 2017年11月26日

記述言語：日本語   会議種別：ポスター発表  

開催地：岡山市・岡山大学創立五十周年記念館  

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開催年月日： 2017年11月25日 - 2017年11月26日

記述言語：日本語   会議種別：ポスター発表  

開催地：岡山市・岡山大学創立五十周年記念館  

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開催年月日： 2017年11月25日 - 2017年11月26日

記述言語：日本語   会議種別：ポスター発表  

開催地：岡山市・岡山大学創立五十周年記念館  

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開催年月日： 2017年11月25日 - 2017年11月26日

記述言語：日本語   会議種別：シンポジウム・ワークショップ パネル（指名）  

開催地：岡山市・岡山大学創立五十周年記念館  

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開催年月日： 2017年11月10日 - 2017年11月11日

記述言語：日本語   会議種別：ポスター発表  

開催地：札幌市・北海道大学歯学部講堂  

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開催年月日： 2017年11月10日 - 2017年11月11日

記述言語：日本語   会議種別：ポスター発表  

開催地：札幌市・北海道大学歯学部講堂  

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開催年月日： 2017年9月16日 - 2017年9月18日

記述言語：日本語   会議種別：口頭発表（一般）  

開催地：東京都品川区・きゅりあん（品川区立総合区民会館）  

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開催年月日： 2017年9月16日 - 2017年9月18日

記述言語：日本語   会議種別：口頭発表（一般）  

開催地：東京都品川区・きゅりあん（品川区立総合区民会館）  

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開催年月日： 2017年9月16日 - 2017年9月18日

記述言語：日本語   会議種別：ポスター発表  

開催地：東京都品川区・きゅりあん（品川区立総合区民会館）  

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開催年月日： 2017年7月28日 - 2017年7月29日

記述言語：日本語   会議種別：口頭発表（一般）  

開催地：松本市・松本市中央公民館（Mウィング文化センター）  

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開催年月日： 2017年7月28日 - 2017年7月29日

記述言語：日本語   会議種別：ポスター発表  

開催地：松本市・松本市中央公民館（Mウィング文化センター）  

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開催年月日： 2017年7月27日 - 2017年7月29日

記述言語：日本語   会議種別：シンポジウム・ワークショップ パネル（指名）  

開催地：神戸市・神戸国際会議場，国際展示場  

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開催年月日： 2017年7月27日 - 2017年7月29日

記述言語：日本語   会議種別：シンポジウム・ワークショップ パネル（指名）  

開催地：神戸市・神戸国際会議場，国際展示場  

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開催年月日： 2017年6月22日 - 2017年6月24日

記述言語：英語   会議種別：ポスター発表  

開催地：Washington DC, USA  

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開催年月日： 2017年4月26日 - 2017年4月28日

記述言語：日本語   会議種別：シンポジウム・ワークショップ パネル（公募）  

開催地：松山市，ひめぎんホール（愛媛県県民文化会館）  

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開催年月日： 2017年3月22日 - 2017年3月25日

記述言語：英語   会議種別：ポスター発表