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1.
J Neurooncol ; 168(3): 393-404, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38780714

RESUMO

PURPOSE: It remains unclear whether combining carmustine wafer (CW) implantation with the standard treatment for adult-type diffuse gliomas is safe and has a prognostic impact. This study aimed to investigate the prognostic value and safety of CW implantation. METHODS: Adult patients with IDH-wild-type and -mutant gliomas, grades 3-4 treated with surgical resection, radiotherapy, and temozolomide chemotherapy between 2013 and 2023 were surveyed. CWs were implanted except in cases of intraoperative wide ventricle opening or marked preoperative brain swelling. For survival analyses, a case-matched dataset based on propensity score matching (PSM), including multiple factors (patient background, diagnosis, and extent of resection) was generated. Progression-free survival (PFS), overall survival (OS), and frequency of complications of CW implantation (brain edema, infection, and cerebrospinal fluid leakage) were compared between the CW and non-use groups. RESULTS: In total, 127 patients (75 in the CW use group and 52 in the non-use group) were enrolled. Regardless of stratification, no significant differences in PFS and OS were observed between the CW use and non-use groups. The frequency of postoperative brain edema was significantly higher in the CW use group than in the non-use group. An adjusted dataset containing 41 patients in the CW use and nonuse groups was generated. Even after PSM, CW implantation had no prognostic effect. CONCLUSIONS: CW implantation with standard treatment demonstrated little beneficial effect for the present strategy of CW use.


Assuntos
Antineoplásicos Alquilantes , Neoplasias Encefálicas , Carmustina , Glioma , Pontuação de Propensão , Humanos , Masculino , Feminino , Carmustina/administração & dosagem , Carmustina/efeitos adversos , Carmustina/uso terapêutico , Glioma/tratamento farmacológico , Pessoa de Meia-Idade , Neoplasias Encefálicas/cirurgia , Antineoplásicos Alquilantes/uso terapêutico , Antineoplásicos Alquilantes/efeitos adversos , Antineoplásicos Alquilantes/administração & dosagem , Adulto , Estudos Retrospectivos , Prognóstico , Estudos de Coortes , Idoso , Implantes de Medicamento , Taxa de Sobrevida , Seguimentos
2.
J Oral Rehabil ; 51(3): 574-580, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-37964441

RESUMO

BACKGROUND: There is no clear objective indicator for selecting soft foods that are required for food bolus formation in older people with impaired oral function. OBJECTIVE: This study aimed to investigate the relationship between maximal isometric tongue pressure (MITP) and the mechanical properties of gels that can be crushed by the tongue. METHODS: This study included 65 healthy participants aged 22-96 (young group; 15 males, 15 females; older dentate group; 7 males, 8 females; older edentulous group; 10 males, 10 females). MITP was measured by the balloon-probe device. Agar gel with 10 different kinds of fracture force from 10N to 100N was used. The limit of fracture force of gels (LFFG) that were crushed by the tongue was measured by the up-and-down method. In the older edentulous group, two items were measured with and without dentures. Spearman's rank correlation coefficient was used to evaluate the relationship between MITP and LFFG in each group (p < .05). RESULTS: There were positive correlations between MITP and LFFG in all groups (overall groups: rs = .66, young group: rs = .46, older dentate group: rs = .61, older edentulous group with dentures: rs = .60, older edentulous group without dentures: rs = .47). CONCLUSION: MITP and LFFG were positively correlated in young, older dentate and older edentulous groups, suggesting that MITP has the potential to be an objective indicator of the range of mechanical properties of soft food that can be crushed by the tongue.


Assuntos
Boca Edêntula , Língua , Masculino , Feminino , Humanos , Idoso , Pressão , Géis
3.
J Oral Rehabil ; 51(8): 1413-1421, 2024 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-38661389

RESUMO

BACKGROUND: Coordination among lip, cheek and tongue movements during swallowing in patients with mandibular prognathism remains unclear. OBJECTIVES: This study aimed to identify the temporal sequences of tongue pressure and maxillofacial muscle activities during swallowing in patients with mandibular prognathism and compared characteristics with those of healthy volunteers. METHODS: Seven patients with mandibular prognathism (mandibular prognathism group) and 25 healthy volunteers with individual normal occlusion (control group) were recruited. Tongue pressures and masseter, orbicularis oris, mentalis and supra- and infrahyoid muscle activities while swallowing gel were measured simultaneously using a sensor sheet system with five measurement points and surface electromyography, respectively. Onset time, offset time and durations of tongue pressure and muscle activities were analysed. RESULTS: In the mandibular prognathism group, tongue pressure was often produced first in more peripheral parts of the palate. Offset of tongue pressure in the posteromedian and peripheral parts of the palate and maxillofacial muscle activities except for orbicularis oris were delayed. Duration of tongue pressure in the anteromedian part of the palate was significantly shorter and durations of masseter, mentalis and suprahyoid muscle activities were significantly longer. Times to onset of orbicularis oris and suprahyoid muscle activities based on first onset of tongue pressure were significantly shorter. CONCLUSION: These results suggest that patients with mandibular prognathism may exhibit specific patterns of tongue pressure production and maxillofacial muscle activities during swallowing.


Assuntos
Deglutição , Eletromiografia , Músculos Faciais , Pressão , Prognatismo , Língua , Humanos , Deglutição/fisiologia , Língua/fisiopatologia , Prognatismo/fisiopatologia , Masculino , Feminino , Músculos Faciais/fisiopatologia , Adulto Jovem , Adulto , Estudos de Casos e Controles
4.
Gerodontology ; 2024 Jun 17.
Artigo em Inglês | MEDLINE | ID: mdl-38887126

RESUMO

OBJECTS: This study aimed to determine the association between annual medical expenses and oral frailty in later-stage older adults (aged ≥ 75 years). No studies have investigated the association between medical costs and oral frailty, which would elucidate the association between oral frailty and the deterioration of mental and overall physical function. MATERIALS AND METHODS: In this cross-sectional study, 2190 adults (860 men and 1330 women aged 75-94 years) covered by the Medical System for the Elderly and residing in Tottori Prefecture, Japan, between April 2016 and March 2019, were included. Participants were classified into three groups: healthy, pre-orally frail or orally frail, based on dental health screening findings. The medical and dental expenses over the years, number of days of consultations and comorbidities were obtained from the Japanese Health Insurance Claims Database. RESULTS: The number of days of medical and dental consultations and annual medical expenses for outpatient care differed among the three study groups. A significant association was observed between oral frailty and high annual expenses for outpatient medical and dental care. Oral frailty was associated with higher medical expenses in participants with poor masticatory function. Higher and lower dental expenses were associated with subjective poor masticatory function and subjective impairment of swallowing function respectively. CONCLUSION: Medical and dental expenses for orally frail older adults are high, indicating that oral frailty may be related to the occurrence and severity of diseases other than oral health issues. Future studies should examine the mechanism by which oral weakness affects physical and mental functions.

5.
Nihon Shokakibyo Gakkai Zasshi ; 121(3): 212-220, 2024.
Artigo em Japonês | MEDLINE | ID: mdl-38462469

RESUMO

A 59-year-old man presented to our hospital with a chief complaint of epigastric pain. Pertinent history included a distal gastrectomy for gastric cancer and alcohol dependence. He underwent contrast-enhanced computed tomography (CT) and esophagogastroduodenoscopy, which led to a diagnosis of esophageal cancer (cT2N2M1, stage IVb). Subsequently, he underwent chemotherapy using 5-fluorouracil and cis-diamminedichloroplatinum and radiotherapy. A total of 44 days after treatment initiation, the patient experienced nausea and hepatobiliary enzyme elevation. CT and abdominal ultrasonography were performed, and he was diagnosed with an abdominal aortic thrombus. Intravenous heparin was administered as an anticoagulant therapy. Twenty-two days after treatment initiation, the thrombus was no longer visible on abdominal ultrasonography. The patient was then treated with warfarin. It cannot be ruled out that the patient's hepatobiliary enzyme elevation was induced by the anticancer drugs. However, enzyme elevation improved with the disappearance of the abdominal aortic thrombus, suggesting that the aortic thrombus may have contributed to the hepatobiliary enzyme elevation. No thrombus recurrence was observed until the patient's death after an initial treatment with antithrombotic agents. This case indicates that malignant tumors and chemotherapy can cause aortic thrombi, and thus, care should be exercised in monitoring this potential complication.


Assuntos
Neoplasias Esofágicas , Neoplasias Gástricas , Trombose , Humanos , Masculino , Pessoa de Meia-Idade , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Cisplatino/uso terapêutico , Neoplasias Esofágicas/diagnóstico por imagem , Neoplasias Esofágicas/tratamento farmacológico , Neoplasias Esofágicas/patologia , Neoplasias Gástricas/tratamento farmacológico , Trombose/induzido quimicamente , Trombose/diagnóstico por imagem
6.
Cancer Sci ; 114(9): 3750-3758, 2023 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-37409483

RESUMO

Magnetic hyperthermia (MHT) is a promising cancer treatment because tumor tissue can be specifically damaged by utilizing the heat generated by nano-heaters such as magnetite nanoparticles (MNPs) under an alternating magnetic field. MNPs are taken up by cancer cells, enabling intracellular MHT. Subcellular localization of MNPs can affect the efficiency of intracellular MHT. In this study, we attempted to improve the therapeutic efficacy of MHT by using mitochondria-targeting MNPs. Mitochondria-targeting MNPs were prepared by the modification of carboxyl phospholipid polymers containing triphenylphosphonium (TPP) moieties that accumulate in mitochondria. The mitochondrial localization of polymer-modified MNPs was supported by transmission electron microscopy observations of murine colon cancer CT26 cells treated with polymer-modified MNPs. In vitro and in vivo MHT using polymer-modified MNPs revealed that the therapeutic effects were enhanced by introducing TPP. Our results indicate the validity of mitochondria targeting in enhancing the therapeutic outcome of MHT. These findings will pave the way for developing a new strategy for the surface design of MNPs and therapeutic strategies for MHT.


Assuntos
Hipertermia Induzida , Nanopartículas , Humanos , Animais , Camundongos , Hipertermia Induzida/métodos , Campos Magnéticos , Mitocôndrias
7.
J Gastroenterol Hepatol ; 38(1): 94-102, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36268636

RESUMO

BACKGROUND AND AIM: Patients with incomplete gastric intestinal metaplasia (GIM) have a higher risk of gastric cancer (GC) than those with complete GIM. We aimed to clarify whether micromucosal patterns of GIM in magnifying endoscopy with narrow-band imaging (M-NBI) were useful for diagnosis of incomplete GIM. METHODS: We enrolled patients with a history of endoscopic resection of GC or detailed inspection for suspicious or definite GC. The antrum greater curvature and corpus lesser curvature were regions of interest. Areas with endoscopic findings of light blue crest and/or white opaque substance (WOS) were defined as endoscopic GIM, and subsequent M-NBI was applied. Micromucosal patterns were classified into Foveola and Groove types, and targeted biopsies were performed on GIM with each pattern. GIM was classified into complete and incomplete types using mucin (MUC)2, MUC5AC, MUC6, and CD10 immunohistochemical staining. The primary endpoint was the association between micromucosal pattern and histological subtype. The secondary endpoint was endoscopic findings associated with incomplete GIM. RESULTS: We analyzed 98 patients with 156 GIMs. Univariate analysis (odds ratio [OR] 3.4, P = 0.004), but not multivariate analysis (OR 0.87, P = 0.822), demonstrated a significant association between micromucosal pattern and subtype. The antrum (OR 3.7, P = 0.006) and WOS (OR 43, P = 0.002) were independent predictors for incomplete GIM. The WOS had 69% sensitivity and 93% specificity. CONCLUSIONS: The M-NBI micromucosal pattern is not useful for diagnosis of GIM subtype. WOS is a promising endoscopic indicator for diagnosis of incomplete GIM. (UMIN-CTR000041119).


Assuntos
Endoscopia Gastrointestinal , Imagem de Banda Estreita , Lesões Pré-Cancerosas , Neoplasias Gástricas , Humanos , Biópsia/métodos , Endoscopia Gastrointestinal/métodos , Mucosa Gástrica/diagnóstico por imagem , Mucosa Gástrica/patologia , Gastroscopia/métodos , Metaplasia/patologia , Imagem de Banda Estreita/métodos , Lesões Pré-Cancerosas/diagnóstico por imagem , Lesões Pré-Cancerosas/patologia , Neoplasias Gástricas/diagnóstico por imagem , Neoplasias Gástricas/patologia
8.
J Clin Periodontol ; 50(2): 265-275, 2023 02.
Artigo em Inglês | MEDLINE | ID: mdl-36330666

RESUMO

AIM: To investigate the association between periodontal disease and atherosclerosis and to examine whether the association is modified by hypertension status. MATERIALS AND METHODS: In this cross-sectional study, 1472 Japanese individuals aged 50-79 years who underwent a medical check-up, dental examination, and carotid ultrasonography were studied. Carotid atherosclerosis was expressed as the maximum and mean carotid intima-media thickness (max-IMT, mean-IMT) and the presence of stenosis (≥75%). Periodontal status was examined by the Community Periodontal Index (CPI, codes 0-4). The participants were divided into three groups according to the periodontal status (CPI0-2, CPI3, CPI4). RESULTS: A positive correlation was found between mean-IMT and periodontal disease after adjustment for cardiovascular risk factors in the entire cohort (mean-IMT in hypertensives: CPI0-2: 0.848 mm, CPI3: 0.857 mm, CPI4: 0.877 mm; normotensives: 0.782, 0.802, 0.826). In the entire cohort, the multivariable-adjusted odds ratio of stenosis based on mean-IMT significantly increased according to periodontal status in normotensives (odds ratio; CPI0-2: 1, CPI3: 1.39, CPI4: 2.53; p-value for trend = .004) but showed only marginal significant increase in hypertensives (1, 1.15, 1.55; p-value for trend = .063). No significant relationships were observed for max-IMT in all analyses. CONCLUSION: We observed an association between periodontal disease and atherosclerosis in normotensive and hypertensive participants.


Assuntos
Aterosclerose , Doenças das Artérias Carótidas , Hipertensão , Doenças Periodontais , Humanos , Espessura Intima-Media Carotídea , Artérias Carótidas , Constrição Patológica/complicações , População Urbana , Estudos Transversais , População do Leste Asiático , Hipertensão/complicações , Hipertensão/epidemiologia , Aterosclerose/complicações , Doenças das Artérias Carótidas/complicações , Doenças das Artérias Carótidas/diagnóstico por imagem , Doenças das Artérias Carótidas/epidemiologia , Doenças Periodontais/complicações , Doenças Periodontais/epidemiologia , Fatores de Risco
9.
Odontology ; 111(2): 451-460, 2023 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-36307615

RESUMO

The purpose of this study was to determine the influence of mandibular unilateral and bilateral distal extension partial edentulous situation and the use of removable partial dental prostheses on the force exerted on maxillary anterior teeth. A commercially available jaw model with exchangeable teeth was used. Seven experimental conditions of mandibular distal extension edentulous situation were prepared and a distal extension removable partial dental prosthesis to replace missing posterior teeth was fabricated. The occlusal force was measured by inserting an occlusal force measuring film between the maxillary and mandibular teeth of the model. An occlusal load was applied and the forces and ratios were compared using the Kruskal-Wallis test and the Mann-Whitney U test (p < 0.05). As a result, the force exerted on the maxillary anterior teeth increased significantly as the number of remaining teeth decreased in unilateral and bilateral edentulous situation. The force exerted on the maxillary anterior teeth decreased significantly with use of a removable partial dental prosthesis. It is concluded that when the number of remaining teeth decreases in mandibular unilateral and bilateral distal extension partial edentulous situation, the burden on the maxillary anterior teeth increases. Our findings suggest that for patients with mandibular distal extension partial edentulous situation, using a removable partial dental prosthesis is effective in preserving the remaining teeth by reducing excessive force.


Assuntos
Anodontia , Arcada Edêntula , Perda de Dente , Humanos , Força de Mordida , Mandíbula , Maxila , Prótese Dentária Fixada por Implante
10.
J Oral Rehabil ; 50(1): 69-75, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36309841

RESUMO

BACKGROUND: The state of food comminution caused by chewing is an important factor triggering the swallowing reflex. However, the impact of retronasal aroma released from comminuted food to the nose upon swallowing during food intake is poorly understood. OBJECTIVE: The present study investigated the relationship between aroma concentration and swallowing threshold while chewing a standardised test food. METHODS: Twenty healthy participants took part in this study. Concentration of retronasal aroma was measured over time through the nostrils using an odour sensor. The aroma concentration was measured while chewing an orange-flavoured gummy jelly until swallowing, and the number of chewing strokes was measured to determine the swallowing threshold. Next, the aroma concentration was measured while chewing the gummy jelly for 30 strokes, and 100% and 200% of swallowing threshold without swallowing. The surface area increase in the expectorated gummy jelly pieces was calculated using image analysis and defined as masticatory performance at 30 strokes. RESULTS: The average number of chewing strokes until the swallowing threshold was 45.1 ± 14.2. Higher masticatory performance was associated with a smaller number of chewing strokes at swallowing threshold, and a greater increase in surface area at the swallowing threshold. The number of chewing strokes and the aroma concentration were similar between the swallowing threshold and at the maximum aroma concentration while chewing at 200% of the swallowing threshold. CONCLUSION: The findings suggested that the swallowing threshold might be influenced by retronasal aroma concentration as well as the state of food comminution.


Assuntos
Deglutição , Humanos , Alimentos , Mastigação , Odorantes
11.
Acta Neuropathol ; 143(2): 263-281, 2022 02.
Artigo em Inglês | MEDLINE | ID: mdl-34967922

RESUMO

Oligodendrogliomas are defined at the molecular level by the presence of an IDH mutation and codeletion of chromosomal arms 1p and 19q. In the past, case reports and small studies described gliomas with sarcomatous features arising from oligodendrogliomas, so called oligosarcomas. Here, we report a series of 24 IDH-mutant oligosarcomas from 23 patients forming a distinct methylation class. The tumors were recurrences from prior oligodendrogliomas or developed de novo. Precursor tumors of 12 oligosarcomas were histologically and molecularly indistinguishable from conventional oligodendrogliomas. Oligosarcoma tumor cells were embedded in a dense network of reticulin fibers, frequently showing p53 accumulation, positivity for SMA and CALD1, loss of OLIG2 and gain of H3K27 trimethylation (H3K27me3) as compared to primary lesions. In 5 oligosarcomas no 1p/19q codeletion was detectable, although it was present in the primary lesions. Copy number neutral LOH was determined as underlying mechanism. Oligosarcomas harbored an increased chromosomal copy number variation load with frequent CDKN2A/B deletions. Proteomic profiling demonstrated oligosarcomas to be highly distinct from conventional CNS WHO grade 3 oligodendrogliomas with consistent evidence for a smooth muscle differentiation. Expression of several tumor suppressors was reduced with NF1 being lost frequently. In contrast, oncogenic YAP1 was aberrantly overexpressed in oligosarcomas. Panel sequencing revealed mutations in NF1 and TP53 along with IDH1/2 and TERT promoter mutations. Survival of patients was significantly poorer for oligosarcomas as first recurrence than for grade 3 oligodendrogliomas as first recurrence. These results establish oligosarcomas as a distinct group of IDH-mutant gliomas differing from conventional oligodendrogliomas on the histologic, epigenetic, proteomic, molecular and clinical level. The diagnosis can be based on the combined presence of (a) sarcomatous histology, (b) IDH-mutation and (c) TERT promoter mutation and/or 1p/19q codeletion, or, in unresolved cases, on its characteristic DNA methylation profile.


Assuntos
Neoplasias Encefálicas/patologia , Isocitrato Desidrogenase/genética , Oligodendroglioma/patologia , Sarcoma/patologia , Adulto , Idoso , Neoplasias Encefálicas/genética , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Mutação , Oligodendroglioma/genética , Sarcoma/genética
12.
J Neurooncol ; 159(2): 397-408, 2022 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-35779193

RESUMO

PURPOSE: IDH-wildtype (IDHwt) diffuse gliomas are treated as glioblastoma, however, some of these may show less aggressive clinical courses. The authors investigated the clinical, histopathological, and molecular characteristics of such IDHwt indolent diffuse gliomas (iDGwt), which have not been well documented in the literature. METHODS: Adult patients with IDHwt gliomas admitted between 2011 and 2020 were surveyed. In this particular study, the clinical indolence was defined mainly as having a small enhancing lesion and a stable period for more than 1 month before surgery. The current WHO diagnostic criteria were adapted for the diagnoses. Gene mutations and copy number changes in 43 representative glioma-associated genes, MGMT promoter methylation status, and survival data were compared with those of The Cancer Genome Atlas reference cohort. RESULTS: Nine out of 180 surveyed cases (5.0%) fulfilled the present criteria of the iDGwt. Considering the representative regulatory pathways, 8 (88.9%), 4 (44.4%), and 1 (11.1%) case had genetic alterations in the PI3K/MAPK, TP53, and RB pathways, respectively. The frequency of the RB pathway alteration was significantly lower than that in the reference cohort (281 of 362 cases: 77.6%). Two cases (22.2%) showing EGFR amplification met the diagnostic criteria for glioblastoma, and the frequency was significantly lower than that in the reference cohort (412 of 426 cases: 96.7%). The overall survival (median: 37.5 months) in the present series was significantly longer than that in the reference cohort (n = 426, median: 13.9 months). CONCLUSIONS: iDGwt lacked the molecular features of glioblastoma except for the PI3K/MAPK pathway alteration.


Assuntos
Neoplasias Encefálicas , Glioblastoma , Glioma , Adulto , Neoplasias Encefálicas/genética , Glioblastoma/genética , Glioma/genética , Humanos , Isocitrato Desidrogenase/genética , Estimativa de Kaplan-Meier , Mutação , Fosfatidilinositol 3-Quinases , Prognóstico
13.
Int J Clin Oncol ; 27(1): 77-94, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34637053

RESUMO

BACKGROUND: Elderly patients with primary central nervous system malignant lymphoma (EL-PCNSL) may not be given sufficient treatment due to their poor pre-treatment Karnofsky Performance Status (KPS) and comorbidities. Therefore, a retrospective, cohort study was performed to evaluate risk factors associated with a poor prognosis of EL-PCNSL in the Tohoku Brain Tumor Study Group. METHODS: Patients aged ≥ 71 years with PCNSL were enrolled from eight centers. Univariate analysis was performed with the log-rank test. A Cox proportional hazards model was used for multivariate analysis. RESULTS: Three of the total 142 cases received best supportive care (BSC). Treatment was given to 30 cases without a pathological diagnosis, 3 cases with cerebrospinal fluid (CSF) cytology, and 100 cases with a pathological diagnosis. After confirmation of no differences in progression-free survival (PFS) and overall survival (OS) between the group treated without pathology and the groups diagnosed by pathology or CSF cytology and between median age ≥ 76 years and < 76 years, a total of 133 patients were studied. The median pre-treatment KPS was 50%. Median PFS and median OS were 16 and 24 months, respectively. Risk factors associated with poor prognosis on Cox proportional hazards model analysis were pre-treatment cardiovascular disease and central nervous system disease comorbidities, post-treatment pneumonia and other infections, and the absence of radiotherapy or chemotherapy. CONCLUSIONS: Pre-treatment comorbidities and post-treatment complications would affect the prognosis. Radiation and chemotherapy were found to be effective, but no conclusions could be drawn regarding the appropriate content of chemotherapy and whether additional radiotherapy should be used.


Assuntos
Neoplasias Encefálicas , Neoplasias do Sistema Nervoso Central , Linfoma não Hodgkin , Idoso , Neoplasias Encefálicas/terapia , Sistema Nervoso Central , Neoplasias do Sistema Nervoso Central/terapia , Estudos de Coortes , Humanos , Prognóstico , Estudos Retrospectivos , Fatores de Risco
14.
Pediatr Int ; 64(1): e15328, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36331235

RESUMO

BACKGROUND: In monosymptomatic nocturnal enuresis (MNE) treatment, enuretic alarm devices are the first recommended treatment option. This study aimed to compare retrospectively the effectiveness of wearable wireless and wired alarm devices for MNE treatment in children aged 6-14 years. METHODS: All children aged 6-16 with MNE who underwent alarm therapy as outpatients were included. A wired alarm device was used from 2012 to 2015, and a wireless alarm device was used from 2016 to 2019. The primary outcomes were the dropout rates during therapy and at last follow up. The full response(14 consecutive dry nights) and the partial response rate during therapy were also assessed. RESULTS: Of the 173 patients enrolled, 75 and 98 used a wired and a wireless alarm device, respectively. The dropout rate at the last visit was significantly lower in the wireless alarm group than that in the wired alarm group (6.1% vs. 20.0%; P = 0.006). The full response(FR) rate was significantly higher in the wireless alarm group than these in the wired alarm group at 4, 12, 24 weeks (4 weeks: 11.2% vs. 1.3%, P = 0.011; 12 weeks: 31.9% vs. 13.5%, P = 0.005; 24 weeks: 72.9% vs. 39.7%, P < 0.0001). CONCLUSIONS: Wireless alarm therapy for MNE had lower attrition rates and a higher rate of FR than wired alarm therapy.


Assuntos
Enurese Noturna , Criança , Humanos , Enurese Noturna/terapia , Desamino Arginina Vasopressina , Estudos Retrospectivos , Resultado do Tratamento
15.
J Oral Rehabil ; 49(11): 1041-1048, 2022 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-36029125

RESUMO

BACKGROUND: A rise in tongue pressure coincides with an increase in the suprahyoid muscle activity. OBJECTIVES: The aim was to investigate the effects of holding a weighted plastic bottle on tongue pressure and the suprahyoid muscle activity. METHODS: Eighteen participants (8 men and 10 women; mean age 42 ± 16 years) participated in this study. All participants had no history of speech, language, hearing or swallowing disorders and no tooth loss, and they did not require dentures. Healthy participants held gauzes connected with a plastic bottle with increasing resistive loads of 0 g, 250 g, 500 g and 750 g, between their palate and tongue. The maximum tongue pressure and average tongue pressure were measured during a 5 s hold. The average tongue pressure was defined as the mean tongue pressure data in each task. The suprahyoid muscle activity was measured using the electromyogram (EMG). The root mean square of the EMG signals measured while lifting different loads and while performing the head lifting exercises was compared. All variables were examined using the Friedman's test and Wilcoxon signed-rank test. RESULTS: The maximum tongue pressure (p < .05) and average tongue pressure values (p < .05) increased gradually in the anterior-median region with increasing resistive loads, and the root mean square amplitudes for 250 g, 500 g and 750 g were not significant compared with head lifting exercises. CONCLUSION: These results indicated that plastic bottle holding could be a potential strength training tool for the tongue and the suprahyoid muscles.


Assuntos
Deglutição , Língua , Adulto , Deglutição/fisiologia , Eletromiografia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Músculos do Pescoço/fisiologia , Plásticos , Pressão , Língua/fisiologia
16.
J Oral Rehabil ; 49(12): 1144-1154, 2022 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-36161667

RESUMO

BACKGROUND: During the mixed dentition period, masticatory performance may temporarily decline as deciduous teeth are replaced by permanent teeth. This may lead to an insufficient intake of chewy foods. OBJECTIVES: This study aimed to clarify the characteristics of factors that affect masticatory performance during the dentition exchange period. METHODS: The participants were 229 students in grades 4-6 who were in the lateral dentition exchange period. Shearing performance (SP) was evaluated using gummy jelly, and mixing performance (MP) was evaluated using colour-changing gum. The chewing rate, occlusal force and area, number of teeth, Hellman's tooth age, Rohrer index, grip strength and walking speed were also evaluated. The χ2 test, Mann-Whitney test, Spearman's rank correlation coefficient and a generalised linear model were used for statistical analysis. RESULTS: SP/MP showed a significant positive correlation with occlusal force, occlusal contact area and chewing rate for gummy jelly and gum but there was a difference in the strength of the correlation between boys and girls. Chewing rate for gummy jelly and gum showed a significant relationship with both SP and MP, suggesting that masticatory performance is higher with slower chewing. Maximum occlusal force was selected as a significant independent variable for SP, and Rohrer index was selected as a significant independent variable for MP. When the occlusal force was higher and the Rohrer index was lower, the masticatory performance tended to be higher. CONCLUSIONS: Our results suggest that masticatory performance during the dentition exchange period is higher with slower chewing and a stronger occlusal force, which may be related to obesity.


Assuntos
Força de Mordida , Dentição Mista , Masculino , Feminino , Humanos , Mastigação , Alimentos , Força da Mão
17.
Gerodontology ; 39(1): 10-16, 2022 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-34726288

RESUMO

OBJECTIVE: This study aimed to verify the compatibility of masticatory performance tests using different two types of gummy jellies. BACKGROUND DATA DISCUSSING THE PRESENT STATUS OF THE FIELD: Compatibility between the glucose concentration measuring method (GC) and 10-steps visual scoring method (VS), which are masticatory performance tests for diagnosing decreased masticatory function (DMF) in oral hypofunction and the use of different types of gummy jelly, has yet to be confirmed. MATERIALS AND METHODS: The participants consisted of 134 Japanese older people (51 men and 83 women). GC, VS and the increased surface area measuring method (ISA), as an alternative analysis method for VS, were conducted to evaluate masticatory performance. Cohen's Kappa coefficient was used to verify the consistency for detecting DMF between GC and VS. Pearson's correlation coefficient was used to analyse the relationship between GC and ISA. Each masticatory performance was compared among three different groups for the number of residual teeth. Cut-off values of VS and ISA for DMF that were consistent with GC were identified. RESULTS: Glucose concentration measuring method and VS showed an excellent consistency (Kappa coefficient = 0.86). There was a high positive correlation between GC and ISA (r = .70). However, the change in masticatory performance according to the number of teeth was different between GC and VS/ISA. The cut-off values of VS and ISA were a Score of 2 and 1687 mm2 , respectively. CONCLUSION: Glucose concentration measuring method and VS/ISA remained fairly consistent for detecting DMF, which might be useful information to interconnect the various studies on masticatory performance.


Assuntos
Alimentos , Mastigação , Idoso , Feminino , Géis , Humanos , Masculino
18.
Org Biomol Chem ; 19(43): 9386-9389, 2021 11 10.
Artigo em Inglês | MEDLINE | ID: mdl-34676842

RESUMO

Here, we investigated the effect of CH3 to CF3 substitution on the membrane permeability of peptides. We synthesized a series of peptides with CF3 groups and corresponding nonfluorinated peptides and measured the membrane permeability of the peptides. As a result, we demonstrated that CH3 to CF3 substitution is useful for increasing the membrane permeability of di-/tri-peptides.


Assuntos
Peptídeos
19.
J Clin Periodontol ; 48(9): 1208-1215, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-34189741

RESUMO

AIM: We aimed to clarify the association between deterioration of periodontal status and masticatory performance in a longitudinal follow-up study of a general urban population. MATERIALS AND METHODS: This study investigated 663 participants in the Suita study with no changes in the number of functional teeth or occlusal support areas during a 5-year follow-up period. Participants were classified into three groups according to changes in periodontal status during the survey period: a recovered group; a stable group; and a deteriorated group. Rate of masticatory performance change was calculated by subtracting the value at baseline from the value at follow-up and dividing the resulting value by the baseline value. RESULTS: Median rates of masticatory performance change were -11.7% in the recovered group, -19.2% in the stable group, and -30.8% in the deteriorated group, and these values were significantly different (p < .001). Multiple regression analysis revealed periodontal status group (recovered group: reference; stable group: p = .029; deteriorated group: p = .006) as an independent variable was significantly associated with the rate of masticatory performance change. CONCLUSION: The present results suggest that deterioration of periodontal status increases the risk of age-related declines in masticatory performance.


Assuntos
Mastigação , Seguimentos , Humanos , População Urbana
20.
BMC Geriatr ; 21(1): 591, 2021 10 22.
Artigo em Inglês | MEDLINE | ID: mdl-34686146

RESUMO

BACKGROUND: Falls among older adults with a low bone density can lead to a bedridden state. Declining bone density increases the risk of falls resulting fractures in older adults. A person's physical performance is known to be closely related to bone density, and a relationship between the physical performance and the oral function is also known to exist. However, there currently is a lack of evidence regarding the relationship between bone density and the oral function. We assessed the relationship between the bone density and the both the oral function and physical performance among older adults. PATIENTS AND METHODS: 754 older adults aged 65 years or older who independently lived in rural regions and who were not taking any medications for osteoporosis participated. We checked all participants for osteoporosis using an ultrasonic bone density measuring device. Regarding the oral function, we evaluated the following factors: remaining teeth, occlusal support, masticatory performance, occlusal force, and tongue pressure. We also evaluated body mass index (BMI) and skeletal muscle mass Index as clinical characteristics. The normal walking speed, knee extension force and one-leg standing test were evaluated as physical performance. For the statistical analyses, we used the Mann-Whitney U test, chi-square test, the Kruskal-Wallis, and a multiple regression analysis. RESULTS: Eighty-one percent of the females and 58% of the males had osteoporosis or a decreased bone mass. The occlusal force, masticatory performance and the tongue pressure showed significant association with the bone density. The participants physical performance showed a significant association with their bone states except for walking speed. According to a multiple regression analysis, clinical characteristics (sex, age, BMI), one-leg standing and occlusal force showed independent associations with the bone density. It was suggested that the bone density tends to increase if the occlusal force is high and/or the one-leg standing test results are good. CONCLUSIONS: The bone density in the older adults showed a significant relationship not only with clinical characteristics or physical performance, but also with occlusal force. It may also be effective to confirm a good oral function in order to maintain healthy living for older adults.


Assuntos
Densidade Óssea , Língua , Idoso , Força de Mordida , Estudos Transversais , Feminino , Humanos , Masculino , Pressão
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