研究者詳細 - 窪木　拓男

MISC - 窪木　拓男

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岡山大学歯学部における問題発見解決型教育法(チュートリアル教育)導入の試み

窪木拓男, 石川邦夫, 新井英雄, 吉田登志子, こうじ谷淳, 永井教之, 福井一博, 岸幹二, 滝川正春

岡山歯学会雑誌 19 ( 2 ) 2000年

口腔顔面慢性疼痛疾患としてみた顎関節症の診断と治療

窪木拓男

日本顎頭蓋機能学会誌 12 ( 1 ) 65 - 66 1999年12月

歯科治療後に発症した神経障害性疼痛の一例

窪木拓男, 井上真実, 前川賢治, 矢谷博文, 山下敦

日本顎頭蓋機能学会誌 12 ( 1 ) 60 - 60 1999年12月

新しいスプリント材料(フォトCMO-21,クラレ)の特徴

助政安伸, 山下敦, 前川賢治, 金島拓史, 窪木拓男, 矢谷博文

日本顎頭蓋機能学会誌 12 ( 1 ) 58 - 58 1999年12月

初診時アンケートにおける顎関節症患者の主訴と細病態分類形態ベースの分類による治療指針で対応できない主訴について

鈴木康司, 窪木拓男, 前川賢治, 矢谷博文, 山下敦

日本顎頭蓋機能学会誌 12 ( 1 ) 61 - 62 1999年12月

顎関節症類似の症状を呈した間代性神経障害性疼痛-血中カルバマゼピン濃度測定-(共著)

小島俊司, 窪木拓男, 古野勝志, 松香芳三, 前川賢治, 助政安伸, 上原淳二, 矢谷博文, 山下敦

日本補綴歯科学会雑誌 43 ( 6 ) 977 - 982 1999年12月

記述言語：日本語出版者・発行元：(公社)日本補綴歯科学会

53歳男,変形性顎関節炎がその疼痛の本態と考えるよりも何らかの原因で末梢神経レベルでの疼痛感作が生じ,顎関節の運動負荷がトリガーとなって著しい疼痛を引き起こしているものと考え,三叉神経痛もしくは間欠性神経障害性疼痛と診断した

DOI： 10.2186/jjps.43.977

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歯科治療に関連に発症した持続性神経障害性疼痛-非定型性歯痛-(共著)

窪木拓男, 井上真実, 古野勝志, 松香芳三, 前川賢治, 矢谷博文, 山下敦

日本補綴歯科学会雑誌 43 ( 6 ) 970 - 976 1999年12月

記述言語：日本語出版者・発行元：(公社)日本補綴歯科学会

神経障害性疼痛は神経系自体に痛みの原因があるものを指し,正常な神経系を介して末梢から侵害受容刺激が伝わることによって生ずる体性痛と区別される.即ち局所にX線学的並びに臨床的に何ら原因を見出せないにも拘わらず,患者は痛みを訴える,又,この神経障害性疼痛は間代性と持続性に分けられる.間代性のものは痛みの発作と発作の間に全く痛みを感じない静止期があるものを指し,神経痛や神経血管系疼痛等がこれに含まれる.一方,持続性のものはその痛みが異常もしくは不快な感覚を伴う持続性の疼痛を指し,帯状疱疹後疼痛,今回報告する非定型歯痛,交感神経緊張型疼痛等が含まれる.今回,歯科治療に関連して発症した口腔内の持続性神経障害性疼痛(非定型性歯痛)と思われる症例を紹介し,現在明らかな範囲でその発症メカニズム,治療法について論じた

DOI： 10.2186/jjps.43.970

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Cold pressor stimulation effect on hemodynamic changes following sustained isometric contraction in human jaw-closure muscles

Y Tsukiyama, T Kuboki, GT Clark

JOURNAL OF DENTAL RESEARCH 78 ( 11 ) 1727 - 1734 1999年11月

記述言語：英語出版者・発行元：AMER ASSOC DENTAL RESEARCH

it is postulated that an altered adrenergic response pattern may be associated with chronic muscle pain states. To evaluate this hypothesis, one must fully understand the effect of an adrenergic activation on masticatory muscle blood flow under various conditions. This study evaluated the effect of a 12 degrees C cold presser stimulation (a mild adrenergic activator), applied to-the hand-forearm area, on intramuscular hemodynamics in the-human masseter and temporalis muscles following a sustained isometric contraction. We assessed hemodynamics by measuring intramuscular hemoglobin concentration repeatedly, using a non-invasive near-infrared spectroscopy device. Measurements were taken before, during, and:after a 30-second sustained 50% maximum voluntary contraction task. Fourteen healthy subjects, seven males and seven females, with no history of muscle pain in the masticatory system participated in this study. This protocol was repeated three times, but in the second trial, the cold presser stimulation was applied to the subject during and for 5 min after the sustained contraction task. Repeated-measure analysis of variance performed on these data revealed that the peak hemoglobin concentration levels in the post-contraction recovery period were significantly reduced (between 13 and 14%) with cold presser stimulation, both in the masseter (p < 0.001) and in the temporalis (p < 0.001) muscles. The results suggest that cold presser stimulation produced a reduced intramuscular vasodilative response in these muscles during the immediate post-contraction period. One explanation for these results is that altering the local chemical environment of the muscle affects the adrenergic response pattern typically induced by a cold presser stimulation.

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Effect of cold presser stimulation (4 degrees C) on human masseter muscle haemodynamics during and after sustained isometric contraction

K Maekawa, T Kuboki, A Yamashita, GT Clark

ARCHIVES OF ORAL BIOLOGY 44 ( 11 ) 969 - 973 1999年11月

記述言語：英語出版者・発行元：PERGAMON-ELSEVIER SCIENCE LTD

The effect of cold pressor (CP) stimulation and sustained isometric contraction on the blood volume of the right masseter muscle was examined in seven healthy males, who performed 1 min of isometric jaw clenching at 50% of their maximum voluntary contraction without, with and again without a 4 degrees C CP stimulation. Total haemoglobin was measured in the masseter before, during and after the contraction task using near-infrared spectroscopy. CP stimulation during the isometric contraction diminished the magnitude of the contraction-induced decrease of blood volume when compared to the trials without CP stimulation. However, in the immediate post-contraction period (while the CP stimulation was still in place), no increase in blood volume above the usual post-contraction hyperaemia was evident. Once the CP stimulation had been removed, there was a clear decrease (faster return to baseline) in the vasodilation occurring in the post-contraction period. This diminished period of vasodilation occurred in spite of the fact that the vascular resistance (blood pressure) and heart rate were still substantially elevated by the CP effect during this same period. These data suggest that the strong CP stimulation produced a biphasic response. First. there was an early-onset strong vasodilation (during CP), which was followed by a period of diminished vasodilation, suggesting that an active, but delayed, vasoconstrictive drive may be induced by the CP stimulus. (C) 1999 Elsevier Science Ltd. All rights reserved.

DOI： 10.1016/S0003-9969(99)00093-X

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Haemodynamic responses in chronically painful, human trapezius muscle to cold pressor stimulation

CO Acero, T Kuboki, K Maekawa, A Yamashita, GT Clark

ARCHIVES OF ORAL BIOLOGY 44 ( 10 ) 805 - 812 1999年10月

記述言語：英語出版者・発行元：PERGAMON-ELSEVIER SCIENCE LTD

The aim was to compare haemodynamic responses in trapezius muscles to cold presser stimulation in individuals with localized trapezius myalgia and asymptomatic controls. Nine males with chronic localized pain in the trapezius (mean age, 23.2 years) and nine male controls (mean age, 24.6 years) who had no medical history of migraine, hypertension or sustained pain in the trapezius region were investigated. Two experimental (cold presser and mock) trials were performed in a randomly assigned sequence. In the cold presser trial the participant's left foot and ankle were immersed in 4 degrees C cold water for 2 min; the mock trial was done without that stimulus. Blood volume was continuously recorded 1 min before, 2 min during, and 5 min after cold presser stimulation using near-infrared spectroscopy. Each participant's blood-volume data were baseline-corrected and submitted to statistical analysis. Results showed that the individuals with muscle pain exhibited a significantly lower mean blood volume than the controls during cold presser stimulation (p = 0.0367). Upon withdrawal of that stimulation, the mean blood volume in both groups fell below the baseline. These results suggest that individuals with chronic regional trapezius myalgia have less capacity to vasodilate this muscle during cold presser stimulation than those without such myalgia. It is not yet known if this difference in the haemodynamic response is a cause or an effect of the myalgia. (C) 1999 Elsevier Science Ltd. All rights reserved.

DOI： 10.1016/S0003-9969(99)00082-5

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顎関節症症状の自然経過ならびに症状発現に関連するリスク要因に関する長期予後調査

神坂学, 矢谷博文, 窪木拓男, 松香芳三, 水口一

日本補綴歯科学会雑誌 43 ( 102回特別 ) 179 - 179 1999年10月

アデノウイルスを用いた顎関節への遺伝子導入の試み

縄稚久美子, 窪木拓男, 完山学, 藤沢拓生, 園山亘, 江口傑徳, 上原淳二, 矢谷博文, 山下敦

日本補綴歯科学会雑誌 43 ( 102回特別 ) 180 - 180 1999年10月

Direct adenovirus-mediated gene delivery to the temporomandibular joint in guinea-pigs

T Kuboki, T Nakanishi, M Kanyama, W Sonoyama, T Fujisawa, K Kobayashi, T Ikeda, T Kubo, A Yamashita, M Takigawa

ARCHIVES OF ORAL BIOLOGY 44 ( 9 ) 701 - 709 1999年9月

記述言語：英語出版者・発行元：PERGAMON-ELSEVIER SCIENCE LTD

Adenovirus vector system is expected to be useful for direct gene therapy for joint disease. This study first sought to confirm that foreign genes can be transferred to articular chondrocytes in primary culture. Next, recombinant adenovirus vectors harbouring beta-galactosidase gene (LacZ) was injected directly into the temporomandibular joints of Hartley guinea-pigs to clarify the in vivo transfer availability of the adenovirus vectors. Specifically, recombinant adenovirus harbouring LacZ gene (AxlCALacZ) was injected into the upper joint cavities of both mandibular joints of four male 6-week-old Hartley guinea-pigs. Either the same amount of recombinant adenovirus without LacZ gene (Axlw) suspension (placebo) or the same amount of phosphate-buffered saline solution (control) were injected into the upper joint cavities of both joints of another four male guinea-pigs. At 1, 2, 3 and 4 weeks after injection, the joints were dissected and the expression of delivered LacZ was examined by 5-bromo-4-chloro-3-indolyl-beta-D-galactopyranoside (X-gal) staining and reverse transcriptase-polymerase chain reaction (RT-PCR). To investigate the expression of transferred gene in other organs, total RNA was extracted from liver, kidney, heart and brain and the expression of LacZ mRNA and 18 S ribosomal RNA were analysed by RT-PCR. Clear expression of LacZ was observed in the articular surfaces of the temporal tubercle, articular disc and synovium of the temporomandibular joints even 4 weeks after injection in the AxlCALacZ-injected group, while no expression was detected in placebo and control groups. Histological examination confirmed that LacZ activity was clearly detected in a few cell layers of the articular surface tissues, which is much more efficient than in a previously study of the knee joint. In the other organs, expression of the delivered transgene was not observed. Based on these findings, direct gene delivery into the articular surface of the temporomandibular joint using the adenovirus vector is feasible as an effective in vivo method, (C) 1999 Elsevier Science Ltd. All rights reserved.

DOI： 10.1016/S0003-9969(99)00069-2

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Quality of life assessment of bone-anchored fixed partial denture patients with unilateral mandibular distal-extension edentulism

T Kuboki, S Okamoto, H Suzuki, M Kanyama, H Arakawa, W Sonoyama, A Yamashita

JOURNAL OF PROSTHETIC DENTISTRY 82 ( 2 ) 182 - 187 1999年8月

記述言語：英語出版者・発行元：MOSBY-YEAR BOOK INC

Statement of problem. Dental implants are expanding their use among partially edentulous patients. However, whether implants can promote the quality of life (QOL) of these patients has not been sufficiently examined.
Purpose. This study compared the QOL level among implant denture, removable partial denture, and no restoration patients with distal extension type unilateral mandibular edentulism.
Material and methods. Three groups (n = 12 each) of subjects with unilateral mandibular distal-extension edentulism who were matched for age, sex, and missing teeth were studied. The groups were (1) implant denture, (2) removable partial denture, and (3) no restoration. QOL levels of these 3 groups were compared using a self-administered questionnaire with 3 major subscales: oral condition, general condition, and dental treatment.
Results. The implant denture group showed higher oral condition related QOL score than the other groups. There was no significant difference in oral condition-related QOL scores between the removable partial denture and no restoration groups. There was no significant difference in the general condition related QOL score and dental treatment-related score among the 3 groups.
Conclusion. In unilateral mandibular distal extension edentulous patients, oral-condition-related QOL levels for dental implant patients were higher than those of removable partial denture or no restoration patients. The QOL levels of the removable partial denture patients were almost identical to those of no restoration patients.

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Haemodynamic changes in human masseter and temporalis muscles induced by different levels of isometric contraction

YJ Kim, T Kuboki, Y Tsukiyama, K Koyano, GT Clark

ARCHIVES OF ORAL BIOLOGY 44 ( 8 ) 641 - 650 1999年8月

記述言語：英語出版者・発行元：PERGAMON-ELSEVIER SCIENCE LTD

This study evaluated the influence of low contraction forces on intramuscular haemodynamics in human masseter and temporalis using near-infrared tissue spectroscopy. This method allowed the intramuscular haemoglobin (Hb) to be assessed dynamically before, during and after a 5, 15, 25 and 100% maximum voluntary contraction (MVC). Twenty volunteers, 10 males and 10 females, without pain or dysfunction in the masticatory system were included in this study. Data were recorded for 30 s before, 30 s during and 5 min after the four sustained contraction tasks. The results showed that all four levels of voluntary contraction produced a clear haemodynamic response (during and after contraction) in both muscles. For analytical purposes, the maximum Hb achieved after 100% MVC was set equal to 1.00. In the masseter the mean peak Hb during the 5, 15, 25 and 100% MVC was 0.49, 0.92, 1.30 and 1.73 while after the contractions it was 0.50, 0.65, 0.78 and 1.00, respectively. In the temporalis the peak Hb during the contractions was 0.23, 0.36, 0.48 and 0.66 and after the contractions 0.32, 0.45, 0.56 and 1.00, respectively. Repeated-measures analysis of variance revealed a significant main effect for the different contraction levels both in the masseter (during contraction, p=0.001; after contraction, p < 0.001) and the temporalis (during contraction, p=0.002; after contraction, p < 0.001). These data suggest that low levels of contraction induce a clear haemodynamic response, even at 5% effort. When compared, the masseter and anterior temporalis showed clearly different patterns for the Hb signal during the contraction (p < 0.001) as well as after it (p = 0.007). Specifically, the Hb during the contractions in the masseter appeared more stable than in the temporalis, which showed a strong return to baseline. Obviously the contracting masseter had a stronger and more sustained venous occlusion than the contracting temporalis. It is speculated that variation in architecture between the two muscles contributes to these differences in blood flow. (C) 1999 Published by Elsevier Science Ltd. All rights reserved.

DOI： 10.1016/S0003-9969(99)00059-X

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欠損歯列を有する患者に対するQOL評価質問票の信頼性・妥当性の検討(共著)

岡本壮一郎, 鈴木秀典, 完山学, 荒川光, 園山亘, 窪木拓男, 山下敦

日本補綴歯科学会雑誌 43 ( 4 ) 698 - 705 1999年8月

記述言語：日本語出版者・発行元：(公社)日本補綴歯科学会

1)各質問の再現性を検討したところ,44問中40問はその信頼性が臨床上許容範囲内であった. 2)口腔内と日常生活に関するQOL項目について因子分析を行ったところ,日常生活関連項目は,活動性,精神心理的因子に,口腔内関連項目は,嚥下,口腔清掃,発音,咀嚼・疼痛,審美性のサブスケールに分類できた. 3)口腔内や日常生活の総括スケールとそれぞれのサブスケールとの相関を検討したところ,活動性,精神心理的因子は日常生活関連のQOLを,発音,咀嚼・疼痛,審美性は口腔内関連のQOLをよく反映していた. 4)発音,審美性の口腔関連サブスケールは,欠損歯数と有意に関連があった

DOI： 10.2186/jjps.43.698

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The effects of sustained incisal clenching on the temporomandibular joint space

Y Takenami, T Kuboki, CO Acero, K Maekawa, A Yamashita, Y Azuma

DENTOMAXILLOFACIAL RADIOLOGY 28 ( 4 ) 214 - 218 1999年7月

記述言語：英語出版者・発行元：STOCKTON PRESS

Objective: To determine the effect of sustained incisal clenching on the width of the temporomandibular joint space.
Methods: Nine normal subjects clenched on an anterior appliance for 10 min at 49 N, Sagittal tomograms were obtained during comfortable closure in the intercuspal position (ICP) (ICP-Before), comfortable closure on bite force transducer without clenching (BFT-Before), start of clenching (BFT-0), end of 5 min clenching (BFT-5), end of 10 min clenching (BFT-10), comfortable closure on the bite force transducer immediately after clenching (BFT-After) and comfortable closure in ICP after clenching (ICP-After). Joint space dimensions were automatically. measured bq a computerized image analysis system.
Results: The minimum joint space dimension was significantly reduced at BFT-5 (P = 0.0381), BFT-10 (P = 0.0019) and BFT-After (P = 0.0053) in relation to BFT-Before. The condylar position was also significantly shifted upward at BFT-0 (P=0.0422), BFT-5 (P = 0.0005), BFT-10 (P = 0.0001), and BFT-After (P = 0.0003) in relation to BFT-Before.
Conclusion: Sustained incisal clenching at 49 N causes significant anterior joint space reduction. We believe this is due to marked compression of the articular cartilage and disc.

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Connective tissue growth factor induces the proliferation, migration, and tube formation of vascular endothelial cells in vitro, and angiogenesis in vivo

T Shimo, T Nakanishi, T Nishida, R Asano, M Kanyama, T Kuboki, T Tamatani, K Tezuka, M Takemura, T Matsumura, M Takigawa

JOURNAL OF BIOCHEMISTRY 126 ( 1 ) 137 - 145 1999年7月

記述言語：英語出版者・発行元：JAPANESE BIOCHEMICAL SOC

Connective tissue growth factor (CTGF) is a novel cysteine-rich, secreted protein. Recently, we found that inhibition of the endogenous expression of CTGF by its antisense oligonucleotide and antisense RNA suppresses the proliferation and migration of vascular endothelial cells. In the present study, the following observations demonstrated the angiogenic function of CTGF in vitro and in vivo: (i) purified recombinant CTGF (rCTGF) promoted the adhesion, proliferation and migration of vascular endothelial cells in a dose-dependent manner under serum-free conditions, and these effects were inhibited by anti-CTGF antibodies; (ii) rCTGF markedly induced the tube formation of vascular endothelial cells, and this effect was stronger than that of basic fibroblast growth factor or vascular endothelial growth factor; (iii) application of rCTGF to the chicken chorioallantoic membrane resulted in a gross angiogenic response, and this effect was also inhibited by anti-CTGF antibodies, (iv) rCTGF injected with collagen gel into the backs of mice induced strong angiogenesis in vivo. These findings indicate that CTGF is a novel, potent angiogenesis factor which functions in multi-stages in this process.

DOI： 10.1093/oxfordjournals.jbchem.a022414

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Effect of intravenous infusion of a beta-adrenergic blocking agent on the haemodynamic changes in human masseter muscle induced by cold-pressor stimulation

K Maekawa, T Kuboki, T Miyawaki, M Shimada, A Yamashita, GT Clark

ARCHIVES OF ORAL BIOLOGY 44 ( 6 ) 475 - 483 1999年6月

記述言語：英語出版者・発行元：PERGAMON-ELSEVIER SCIENCE LTD

Eight healthy non-smoking males (mean age: 24.1 +/- 1.1 years) without any history of chronic muscle pain and migraine participated in this study. Haemoglobin (Hb) and oxygen (O-2) saturation in the right masseter muscle were continuously recorded with a non-invasive near-infrared spectroscopic device. Heart rate and blood pressure were also recorded. The experiment had three phases: a placebo drug (physiological saline) with cold-presser trial, a 30-sec maximal voluntary clenching (MVC) trial, and a propranolol with cold-presser trial. The saline and drug trials each involved continuous recording for 1 min before, 2 min during and 5 min after the cold-presser stimulation (4 degrees C). Physiological saline (20 ml) or propranolol hydrochloride (20 ml) were infused at the rate of 2 ml/min. This infusion was begun 20 min before the baseline recording and participants did not know which solution (saline or propranolol) was being infused. For the MVC trial, each participant was asked to perform a 30-sec clench of their jaw-closing muscles. There was a rest period of 15 min between each trial. The individual Hb and O-2 data were normalized so that the baseline at the beginning of the experiment was equal to zero, and the Hb and O-2 data were normalized as a percentage of the individual's own highest absolute Hb and O-2 after and during the MVC, respectively. The results showed that the mean baseline Hb 1 min before cold-presser stimulation was significantly lower in the beta-blocker trial than in the placebo trial (p = 0.035). The mean change in Hb from baseline during cold-presser stimulation in the beta-blocker trial was also significantly less than in the placebo trial (p = 0.035). The mean Hb rebound change after the cold-presser stimulation in the beta-blocker trial was significantly higher than in the placebo trial, and no significant heart-rate differences were observed in the period after cold-presser stimulation. Overall, the mean heart rate before and during that stimulation was significantly lower in the beta-blocker trial than the placebo trial (p < 0.001). There was no significant mean blood-pressure difference between placebo and beta-blocker trials at any time. These results suggest that beta-adrenoceptor blocking decreases the blood volume in the resting masseter, suppresses the incremental blood-volume change during cold-presser stimulation. and discloses a hidden vasoconstrictive effect after that stimulation. (C) 1999 Published by Elsevier Science Ltd. All rights reserved.

DOI： 10.1016/S0003-9969(99)00028-X

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Effect of intravenous infusion of a beta-adrenergic blocking agent on the haemodynamic changes in human masseter muscle induced by cold-pressor stimulation

K Maekawa, T Kuboki, T Miyawaki, M Shimada, A Yamashita, GT Clark

ARCHIVES OF ORAL BIOLOGY 44 ( 6 ) 475 - 483 1999年6月

記述言語：英語出版者・発行元：PERGAMON-ELSEVIER SCIENCE LTD

DOI： 10.1016/S0003-9969(98)00127-7

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