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http://hdl.handle.net/2115/45744
2024-03-29T02:27:27Z当初は舌痛症が疑われたが,長期経過の後にガンマナイフが奏功した高齢女性の典型的三叉神経痛の1例
http://hdl.handle.net/2115/90523
Title: 当初は舌痛症が疑われたが,長期経過の後にガンマナイフが奏功した高齢女性の典型的三叉神経痛の1例
Authors: 松田, 捺美; 平良, 賢周; 新井, 絵理; 尾崎, 公哉; 山野, 茂; 渡邊, 裕; 山崎, 裕
Abstract: 我々は当初,舌痛症が疑われたが再燃を繰り返すうちに神経痛様の症状を呈するようになり,三叉神経痛と診断され,最終的にはガンマナイフが施行された症例を経験したので報告する.
患者は76歳女性で,初診時,舌の痛みは安静時の痛みで,左舌縁を触診するとかえって痛みは軽快した.舌痛に対してラフチジンが著効したが,再燃を繰り返した.7 年後,会話の始めに,左下顎全体に走行する発作性の鈍痛が出現するようになった.前三叉神経痛(Pretrigeminal neuralgia)の可能性を考慮し,カルバマゼピンを100 mg/日から投与開始した.これにより一時は痛みが完全に消退したが,数か月後には再燃したため,三叉神経痛を疑い脳神経外科に対診した.同科のMR画像で左三叉神経起始部を動脈が圧迫する所見が認められ,臨床症状,カルバマゼピンの効果から,典型的三叉神経痛と診断された.痛みはカルバマゼピンで一時的には良好にコントロールされたが,4年後には400mg/日の投与でもコントロール困難になった.87歳と高齢であったため,手術の適応はなくガンマナイフが施行された.その後約2年経過した現在,合併症はなくカルバマゼピン200 mgの服用下で痛みは良好にコントロールされている.; We describe a patient with suspected burning mouth syndrome, who experienced repeated flare-ups and subsequently developed neuralgia-like symptoms, which led to diagnosis of trigeminal neuralgia. The patient eventually underwent gamma knife surgery.
A 76-year-old woman underwent physical examination, which showed tongue pain at rest; pain was less severe upon palpation of the left lingual border. Administration of raftidine led to remarkable improvement in her tongue pain; however, she had recurrent flare-ups. She developed paroxysmal dull pain that radiated across the entire left mandible at the onset of conversations, 7 years later and received carbamazepine (100 mg) for suspected pre-trigeminal neuralgia. Her pain disappeared completely temporarily; however, she experienced flare-ups a few months later. She consulted a neurosurgeon for a high index of clinical suspicion for trigeminal neuralgia. Based on MRI findings, which showed arterial compression of the left trigeminal nerve origin, clinical sympt oms, and the response to carbamazepine, we diagnosed trigeminal neuralgia. The pain was temporarily well controlled with carbamazepine therapy; however, pain persisted even with carbamazepine administration (400mg a day), 4 years later. Surgery was contraindicated owing to her advanced age (87years), and she underwent gamma knife surgery. The patient has shown no complications, and her pain is well controlled with carbamazepine (200mg), 2years postoperatively.2023-09-14T15:00:00Z松田, 捺美平良, 賢周新井, 絵理尾崎, 公哉山野, 茂渡邊, 裕山崎, 裕 我々は当初,舌痛症が疑われたが再燃を繰り返すうちに神経痛様の症状を呈するようになり,三叉神経痛と診断され,最終的にはガンマナイフが施行された症例を経験したので報告する.
患者は76歳女性で,初診時,舌の痛みは安静時の痛みで,左舌縁を触診するとかえって痛みは軽快した.舌痛に対してラフチジンが著効したが,再燃を繰り返した.7 年後,会話の始めに,左下顎全体に走行する発作性の鈍痛が出現するようになった.前三叉神経痛(Pretrigeminal neuralgia)の可能性を考慮し,カルバマゼピンを100 mg/日から投与開始した.これにより一時は痛みが完全に消退したが,数か月後には再燃したため,三叉神経痛を疑い脳神経外科に対診した.同科のMR画像で左三叉神経起始部を動脈が圧迫する所見が認められ,臨床症状,カルバマゼピンの効果から,典型的三叉神経痛と診断された.痛みはカルバマゼピンで一時的には良好にコントロールされたが,4年後には400mg/日の投与でもコントロール困難になった.87歳と高齢であったため,手術の適応はなくガンマナイフが施行された.その後約2年経過した現在,合併症はなくカルバマゼピン200 mgの服用下で痛みは良好にコントロールされている.
We describe a patient with suspected burning mouth syndrome, who experienced repeated flare-ups and subsequently developed neuralgia-like symptoms, which led to diagnosis of trigeminal neuralgia. The patient eventually underwent gamma knife surgery.
A 76-year-old woman underwent physical examination, which showed tongue pain at rest; pain was less severe upon palpation of the left lingual border. Administration of raftidine led to remarkable improvement in her tongue pain; however, she had recurrent flare-ups. She developed paroxysmal dull pain that radiated across the entire left mandible at the onset of conversations, 7 years later and received carbamazepine (100 mg) for suspected pre-trigeminal neuralgia. Her pain disappeared completely temporarily; however, she experienced flare-ups a few months later. She consulted a neurosurgeon for a high index of clinical suspicion for trigeminal neuralgia. Based on MRI findings, which showed arterial compression of the left trigeminal nerve origin, clinical sympt oms, and the response to carbamazepine, we diagnosed trigeminal neuralgia. The pain was temporarily well controlled with carbamazepine therapy; however, pain persisted even with carbamazepine administration (400mg a day), 4 years later. Surgery was contraindicated owing to her advanced age (87years), and she underwent gamma knife surgery. The patient has shown no complications, and her pain is well controlled with carbamazepine (200mg), 2years postoperatively.頚椎症由来と考えられた三叉神経障害の1例
http://hdl.handle.net/2115/90522
Title: 頚椎症由来と考えられた三叉神経障害の1例
Authors: 佐藤, 栄作; 榊原, 典幸; 水野, 貴行; 加藤, 卓己; 平郡, 唯衣; 鈴鹿, 正顕; 箕輪, 和行
Abstract: 頚椎症は頚肩部や四肢に痺れなどの症状を生じることが一般的であり,顎顔面領域に症状を呈することは
稀である.今回我々は,頚椎症由来と思われた両側三叉神経障害の1例を経験したので,若干の文献的考察を加えてその概要を報告する.
患者は68歳女性で,オトガイ部皮膚の痺れを主訴に当科を受診,両側オトガイ神経支配領域の皮膚に安静時のビリビリとした異常感覚を認めた.当科受診の1 か月前より特に誘引なく主訴を自覚しており,1 日数回の頻度で症状が出現していた.既往歴は左側腎癌術後,右側乳癌術後,骨粗鬆症でビスホスホネート製剤注射中,慢性腎不全で血液透析中であった.
腎癌,乳癌の転移性腫瘍,造血器悪性腫瘍,薬剤関連顎骨壊死,脳病変などを疑い精査を行ったが,いずれも原因の特定には至らず,MRIの撮像範囲内に偶然C 4 / 5 椎間関節の変性変化(変形した椎間板や肥厚した靭帯による脊髄の圧迫所見)を認め,整形外科にコンサルトしたところ,頚椎症の診断となった.趣味である麻雀,オセロなどによる頚部前屈姿勢の時間が長かったため,姿勢の指導で保存的に経過観察したところ,両側オトガイ神経支配領域の異常感覚は消失した.症状改善後1年6か月を経過した現在まで再燃を認めていない.
顎顔面領域の感覚障害を認めた場合,まれではあるが,頚椎症の可能性も考慮する必要があると考えられた.; Cervical spondylosis generally causes symptoms such as numbness in the neck, shoulders and extremities, but rarely presents in the maxillofacial region.
We experienced a case of bilateral trigeminal neuropathy thought to be caused by cervical spondylosis. We report the outline of this case with some literature considerations.
The patient was a 68-year-old woman who visited our department with a chief complaint of numbness in the skin of the chin. Abnormal sensation at rest was observed in the skin of the area innervated by mental nerves on both sides. The patient had been aware of the chief complaint for one month without any particular trigger, and the symptoms appeared several times a day. Her medical history included surgery for left renal cancer, surgery for right breast cancer and was undergoing bisphosphonate injections for osteoporosis and hemodialysis for chronic renal failure.
We suspected metastatic tumor of renal and breast cancer, hematopoietic malignant tumor, medication-related osteonecrosis of the jaw and brain lesions. A detailed examination was performed but the cause could not be determined. A degenerative change in the C4/5 facet joint was incidentally observed within the imaging range of MRI and an orthopedic surgeon diagnosed cervical spondylosis. The patient spent a lot of time in a forward-bent neck posture due to her hobbies such as Mahjong and Othello. Dysesthesia in the bilateral mental innervation areas disappeared as a result of conservative follow-up with posture guidance. One year and 6 mo nths after symptom improvement, no recurrence has been observed.
Although rare, cervical spondylosis should also be considered when sensory disturbance is observed in the maxillofacial region.2023-09-14T15:00:00Z佐藤, 栄作榊原, 典幸水野, 貴行加藤, 卓己平郡, 唯衣鈴鹿, 正顕箕輪, 和行頚椎症は頚肩部や四肢に痺れなどの症状を生じることが一般的であり,顎顔面領域に症状を呈することは
稀である.今回我々は,頚椎症由来と思われた両側三叉神経障害の1例を経験したので,若干の文献的考察を加えてその概要を報告する.
患者は68歳女性で,オトガイ部皮膚の痺れを主訴に当科を受診,両側オトガイ神経支配領域の皮膚に安静時のビリビリとした異常感覚を認めた.当科受診の1 か月前より特に誘引なく主訴を自覚しており,1 日数回の頻度で症状が出現していた.既往歴は左側腎癌術後,右側乳癌術後,骨粗鬆症でビスホスホネート製剤注射中,慢性腎不全で血液透析中であった.
腎癌,乳癌の転移性腫瘍,造血器悪性腫瘍,薬剤関連顎骨壊死,脳病変などを疑い精査を行ったが,いずれも原因の特定には至らず,MRIの撮像範囲内に偶然C 4 / 5 椎間関節の変性変化(変形した椎間板や肥厚した靭帯による脊髄の圧迫所見)を認め,整形外科にコンサルトしたところ,頚椎症の診断となった.趣味である麻雀,オセロなどによる頚部前屈姿勢の時間が長かったため,姿勢の指導で保存的に経過観察したところ,両側オトガイ神経支配領域の異常感覚は消失した.症状改善後1年6か月を経過した現在まで再燃を認めていない.
顎顔面領域の感覚障害を認めた場合,まれではあるが,頚椎症の可能性も考慮する必要があると考えられた.
Cervical spondylosis generally causes symptoms such as numbness in the neck, shoulders and extremities, but rarely presents in the maxillofacial region.
We experienced a case of bilateral trigeminal neuropathy thought to be caused by cervical spondylosis. We report the outline of this case with some literature considerations.
The patient was a 68-year-old woman who visited our department with a chief complaint of numbness in the skin of the chin. Abnormal sensation at rest was observed in the skin of the area innervated by mental nerves on both sides. The patient had been aware of the chief complaint for one month without any particular trigger, and the symptoms appeared several times a day. Her medical history included surgery for left renal cancer, surgery for right breast cancer and was undergoing bisphosphonate injections for osteoporosis and hemodialysis for chronic renal failure.
We suspected metastatic tumor of renal and breast cancer, hematopoietic malignant tumor, medication-related osteonecrosis of the jaw and brain lesions. A detailed examination was performed but the cause could not be determined. A degenerative change in the C4/5 facet joint was incidentally observed within the imaging range of MRI and an orthopedic surgeon diagnosed cervical spondylosis. The patient spent a lot of time in a forward-bent neck posture due to her hobbies such as Mahjong and Othello. Dysesthesia in the bilateral mental innervation areas disappeared as a result of conservative follow-up with posture guidance. One year and 6 mo nths after symptom improvement, no recurrence has been observed.
Although rare, cervical spondylosis should also be considered when sensory disturbance is observed in the maxillofacial region.両側陳旧性顎関節脱臼に対し関節隆起切除術と関節包周囲の癒着剥離術を行い整復した1例
http://hdl.handle.net/2115/90521
Title: 両側陳旧性顎関節脱臼に対し関節隆起切除術と関節包周囲の癒着剥離術を行い整復した1例
Authors: 格口, 渉; 中道, 祥之; 笠原, 和恵; 堀川, 雅昭; 長, 太一; 松下, 和裕; 大廣, 洋一
Abstract: 顎関節脱臼が陳旧化した場合,観血的整復術が必要となることが多い.症例は,84歳女性で,アルツハイマー型認知症の既往があった.他院手術での経口挿管時に脱臼し,整復されないまま2か月経過後に,北海道中央労災病院口腔外科・顎顔面外科を受診した.局所麻酔下では徒手整復できず,観血的に整復する方針とした.脱臼から約3か月経過後,全身麻酔下に顎関節を開放し,加えて関節隆起切除術を試行したが整復できず,関節包周囲の癒着組織剥離術を追加することで,整復し得た.術後,わずかな臼歯部開咬がみられたが,術後5日目には義歯を装着し咬頭嵌合位が得られた.術後12か月経過後も再脱臼なく,咬合状態は良好である.整復が困難な陳旧性顎関節脱臼症例においては,関節隆起切除術に加え,関節包周囲の癒着組織剥離術を施行することが必要と思われた.; Open reduction is performed frequently for chronic long-standing dislocation of the temporomandibular joint (TMJ) owing to difficulty with closed reduction. This case report presents a case of an 84-year-old woman with a medical history of Alzheimer’s disease who was referred to our hospital for treatment of TMJ dislocation attributed to tracheal intubation upon general anesthesia 2 months ago. Closed reduction with local anesthesia was unsuccessful; thus, open reduction with general anesthesia was performed 3 months later. Reduction was successful upon performing eminectomy and adhesiolysis around the articular capsule. Open bite was observed until 5 days after the surgery. No recurrence of the dislocation was observed at 1 year following her surgery. Thus, eminectomy and adhesiolysis around the articular capsule could be considered for challenging cases of chronic TMJ dislocation.2023-09-14T15:00:00Z格口, 渉中道, 祥之笠原, 和恵堀川, 雅昭長, 太一松下, 和裕大廣, 洋一顎関節脱臼が陳旧化した場合,観血的整復術が必要となることが多い.症例は,84歳女性で,アルツハイマー型認知症の既往があった.他院手術での経口挿管時に脱臼し,整復されないまま2か月経過後に,北海道中央労災病院口腔外科・顎顔面外科を受診した.局所麻酔下では徒手整復できず,観血的に整復する方針とした.脱臼から約3か月経過後,全身麻酔下に顎関節を開放し,加えて関節隆起切除術を試行したが整復できず,関節包周囲の癒着組織剥離術を追加することで,整復し得た.術後,わずかな臼歯部開咬がみられたが,術後5日目には義歯を装着し咬頭嵌合位が得られた.術後12か月経過後も再脱臼なく,咬合状態は良好である.整復が困難な陳旧性顎関節脱臼症例においては,関節隆起切除術に加え,関節包周囲の癒着組織剥離術を施行することが必要と思われた.
Open reduction is performed frequently for chronic long-standing dislocation of the temporomandibular joint (TMJ) owing to difficulty with closed reduction. This case report presents a case of an 84-year-old woman with a medical history of Alzheimer’s disease who was referred to our hospital for treatment of TMJ dislocation attributed to tracheal intubation upon general anesthesia 2 months ago. Closed reduction with local anesthesia was unsuccessful; thus, open reduction with general anesthesia was performed 3 months later. Reduction was successful upon performing eminectomy and adhesiolysis around the articular capsule. Open bite was observed until 5 days after the surgery. No recurrence of the dislocation was observed at 1 year following her surgery. Thus, eminectomy and adhesiolysis around the articular capsule could be considered for challenging cases of chronic TMJ dislocation.長時間連続の律動性咀嚼筋筋活動を認めた覚醒時ブラキシズムの一例
http://hdl.handle.net/2115/90520
Title: 長時間連続の律動性咀嚼筋筋活動を認めた覚醒時ブラキシズムの一例
Authors: 山田, 恭子; 山口, 泰彦
Abstract: 【目的】持続時間の短いphasic波形が連なる律動性咀嚼筋筋活動(rhythmic masticatory muscle activity,RMMA)はグラインディングタイプの睡眠時ブラキシズム(sleep bruxism,SB)の筋電図において特徴的とされるが,しかし,日中覚醒時ブラキシズム(awake bruxism,AB)においてSBのような連続性のRMMAが見られることについての報告はなかった.我々は,ABにおいて長時間連続するRMMAを示した症例を経験したので報告する.
【症例】患者は初診時60歳代の女性.前医にて左側顎関節症(非復位性顎関節円板障害)治療後に全顎的な補綴治療が必要な状態であったが,転居のため紹介にて本院に転院し,全顎的に補綴治療を受けた.定期経過観察中の初診7 年後に1|2 の動揺と3 のファイバーポストコアの破折が発現し,③ 2 ① ブリッジと上下顎義歯を新製した.新製後は睡眠時にも臼歯部の咬合支持が必要と考え,睡眠時の義歯装着にて対応していた.しかし,その後も上顎前歯部の動揺が完全には治まらず,初診9 年後にSBとの関連を疑い夜間は義歯だけではなく床付きアプライアンスの装着を検討することとし,事前にSB診断のために睡眠時咬筋筋電図検査を行った.また,ABの可能性も考えられたため,就寝前と起床後の覚醒時間帯も測定した.
【結果】睡眠時はSBのエピソード数は3.7回/hと少なく,睡眠時ブラキサーの基準値以下であった.一方,覚醒時は54.1回/hと多く,しかも波形の大部分が典型的なRMMAであった.
【結論】 睡眠時の咀嚼筋筋活動は正常範囲でも,日中覚醒時に著しい筋活動を示す患者が存在すること,また,日中覚醒時でも長時間連続のRMMAを呈す場合があり得ることが示された.; Purpose: Rhythmic masticatory muscle activity (RMMA), a series of phasic bursts with short duration , is anelectromyographic (EMG) characteristic of grinding-type sleep bruxism (SB). There have been no reports of long-lasting RMMA regarding awake bruxism (AB), like SB. In this article, we present an AB case with a long-lasting RMMA.
Case: This paper reports a case of a woman in her 60s with previously treated temporomandibular disorder (TMD) on the left side (anterior displacement of the temporomandibular joint [TMJ] disc without reduction) who visited our clinic for her relocation and underwent full mouth reconstruction. At a routine follow-up 7 years after the first visit, the anterior maxillary teeth were increasingly mobile, and the fiber post-core of the right maxillary canine tooth, an abutment of a fixed bridge, was found fractured. Subsequently, a maxillary fixed bridge and upper and lower partial dentures were remade. She was instructed to wear the dentures to maintain the occlusal support of the molars during sleep, besides during the daytime. However, even after following the instruction, the mobility of the anterior maxillary teeth persisted. Since SB was suspected 9 years after her first visit, we planned the night-time use of an oral appliance with a denture-type structure in the missing tooth area. A masseteric EMG was recorded to diagnose the SB presence precisely before applying the oral appliance. Since the possibility of AB was also considered, EMG during daytime wakefulness before going to bed and getting up was also measured besides during sleep.
Results: The number of episodes, i.e., groups of EMG waveforms during sleep, was 3.7/h, which was small and within the normal range. Conversely, the number of episodes during wakeful ness was 54.1/h, which was exceptionally high, and most of the waveforms were typical RMMA.
Conclusion: Based on the clinical experience of this patient, some patients can show a significantly large amount of masticatory muscle activity during the daytime even though masticatory muscle activity is within the normal range during sleep. In addition, it was indicated that long-lasting RMMA can occur in AB during the day.2023-09-14T15:00:00Z山田, 恭子山口, 泰彦【目的】持続時間の短いphasic波形が連なる律動性咀嚼筋筋活動(rhythmic masticatory muscle activity,RMMA)はグラインディングタイプの睡眠時ブラキシズム(sleep bruxism,SB)の筋電図において特徴的とされるが,しかし,日中覚醒時ブラキシズム(awake bruxism,AB)においてSBのような連続性のRMMAが見られることについての報告はなかった.我々は,ABにおいて長時間連続するRMMAを示した症例を経験したので報告する.
【症例】患者は初診時60歳代の女性.前医にて左側顎関節症(非復位性顎関節円板障害)治療後に全顎的な補綴治療が必要な状態であったが,転居のため紹介にて本院に転院し,全顎的に補綴治療を受けた.定期経過観察中の初診7 年後に1|2 の動揺と3 のファイバーポストコアの破折が発現し,③ 2 ① ブリッジと上下顎義歯を新製した.新製後は睡眠時にも臼歯部の咬合支持が必要と考え,睡眠時の義歯装着にて対応していた.しかし,その後も上顎前歯部の動揺が完全には治まらず,初診9 年後にSBとの関連を疑い夜間は義歯だけではなく床付きアプライアンスの装着を検討することとし,事前にSB診断のために睡眠時咬筋筋電図検査を行った.また,ABの可能性も考えられたため,就寝前と起床後の覚醒時間帯も測定した.
【結果】睡眠時はSBのエピソード数は3.7回/hと少なく,睡眠時ブラキサーの基準値以下であった.一方,覚醒時は54.1回/hと多く,しかも波形の大部分が典型的なRMMAであった.
【結論】 睡眠時の咀嚼筋筋活動は正常範囲でも,日中覚醒時に著しい筋活動を示す患者が存在すること,また,日中覚醒時でも長時間連続のRMMAを呈す場合があり得ることが示された.
Purpose: Rhythmic masticatory muscle activity (RMMA), a series of phasic bursts with short duration , is anelectromyographic (EMG) characteristic of grinding-type sleep bruxism (SB). There have been no reports of long-lasting RMMA regarding awake bruxism (AB), like SB. In this article, we present an AB case with a long-lasting RMMA.
Case: This paper reports a case of a woman in her 60s with previously treated temporomandibular disorder (TMD) on the left side (anterior displacement of the temporomandibular joint [TMJ] disc without reduction) who visited our clinic for her relocation and underwent full mouth reconstruction. At a routine follow-up 7 years after the first visit, the anterior maxillary teeth were increasingly mobile, and the fiber post-core of the right maxillary canine tooth, an abutment of a fixed bridge, was found fractured. Subsequently, a maxillary fixed bridge and upper and lower partial dentures were remade. She was instructed to wear the dentures to maintain the occlusal support of the molars during sleep, besides during the daytime. However, even after following the instruction, the mobility of the anterior maxillary teeth persisted. Since SB was suspected 9 years after her first visit, we planned the night-time use of an oral appliance with a denture-type structure in the missing tooth area. A masseteric EMG was recorded to diagnose the SB presence precisely before applying the oral appliance. Since the possibility of AB was also considered, EMG during daytime wakefulness before going to bed and getting up was also measured besides during sleep.
Results: The number of episodes, i.e., groups of EMG waveforms during sleep, was 3.7/h, which was small and within the normal range. Conversely, the number of episodes during wakeful ness was 54.1/h, which was exceptionally high, and most of the waveforms were typical RMMA.
Conclusion: Based on the clinical experience of this patient, some patients can show a significantly large amount of masticatory muscle activity during the daytime even though masticatory muscle activity is within the normal range during sleep. In addition, it was indicated that long-lasting RMMA can occur in AB during the day.上行結腸癌を合併したPlummer-Vinson症候群の1例
http://hdl.handle.net/2115/90519
Title: 上行結腸癌を合併したPlummer-Vinson症候群の1例
Authors: 宗片, 勇史; 坂田, 健一郎; 白川, 輝; 佐藤, 淳; 佐藤, 千晴; 村井, 知佳; 大賀, 則孝; 北川, 善政
Abstract: 【目的】鉄欠乏性貧血は,鉄不足により血色素産生が阻害され,小球性低色素性貧血を示す疾患である.口腔粘膜の萎縮や再生不良による舌炎や口角炎が生じるが,これに嚥下障害を伴った場合Plummer-Vinson症候群と呼ばれる.鉄欠乏性貧血の診断に関して,末梢血液検査では,小球性低色素性貧血(MCV 80以下,MCHC 30以下)を示しヘモグロビン値(Hb)が低下し,生化学的検査では,血清鉄(Fe)60 μg/dL以下,血清フェリチン値の低下,総鉄結合能(TIBC)および不飽和鉄結合能(UIBC)が増加する.今回,味覚異常を主訴として嚥下困難感,舌の疼痛に加えて鉄欠乏性貧血を合併した患者に対して,鉄補充療法により各症状が著明に改善し,鉄欠乏性貧血の原因として上行結腸癌を認めた症例を経験したので報告する.
【症例】70歳,女性.味覚異常と嚥下困難感を主訴に来院した.眼瞼結膜蒼白,舌乳頭の一部萎縮を認め,初診時の血液検査の結果は,MCV 69 f l,MCHC 24.6 pg,Fe 6 μg/dL,Hb 4.1 g/dL,TIBC 445 μg/dL,UIBC 437 μg/dLであった.Plummer-Vinson症候群の診断のもと,クエン酸第一鉄ナトリウムおよびピロリン酸第二鉄により鉄補充療法を行い,経時的に血液検査を実施した.
【経過】鉄補充療法開始2 か月後,眼瞼結膜の充血,舌乳頭の回復,口腔内症状の改善が認められた.また,血液検査にてFeおよびHbの上昇,TIBCおよびUIBCの減少が認められた.その後,消化器内科にて鉄欠乏性貧血の原因に関して精査を行った結果,上行結腸癌が認められた.
【結論】Plummer-Vinson症候群に対し適切に鉄補充療法を行うことで,早期に口腔内症状および血液検査値の改善が認められるが,長期的な改善を認めない難治性の症例に対しては,鉄欠乏性貧血に関して積極的な原因精査の必要があると示唆された.; Iron deficiency anemia is the most common type of anemia in Jap an, and iron deficiency inhibits blood pigment production, resulting in microcytic hypochromic anemia. Glossitis and angular cheilitis occur owing to the atrophy of the oral mucosa and poor regeneration of the mucosal epithelium. When this is accompanied by dysphagia, it is called Plummer‒Vinson syndrome. Regarding the diagnosis of the iron deficiency anemia, peripheral blood tests reveal microcytic hypopigmented anemia (MCV, ≤80 ; MCHC, ≤30), and the hemoglobin level (Hb) decreases. Biochemical tests reveal a decreased serum iron (Fe) level of <60 μg/dL, decreased serum ferritin levels, and increased total iron binding capacity (TIBC) and unsaturated iron-binding capacity (UIBC). We report a case of Plummer‒Vinson syndrome with the considerable improvement of oral symptoms by iron replacement therapy, and ascending colon cancer was found to be the cause of the iron deficiency anemia.
A 70-year-old woman complained of abnormal taste. Her eyelid co njunctiva was pale, and her oral cavity showed a partial atrophy of the tongue papillae. Blood test results at h er first visit were as follows: MCV, 69; MCHC, 24.6; Fe, 6 μg/dL; Hb, 4.1 g/dL; TIBC, 445 μg/dL; and UIBC, 437 μg/dL. With the Plummer‒Vinson syndrome diagnosis, the iron replacement therapy with sodium ferrous citrate (Feromia®) and ferric pyrophosphate (Incremin®) was started and blood tests were performed over time. Two months after starting the iron replacement therapy, the hyperemia of the palpebral conjunctiva, recovery of the tongue papillae, and imp rovement of oral symptoms were observed. Blood test results are as follows: Fe, 99 μg/dL; Hb, 10 g/dL; TIB C, 329 μg/dL; and UIBC, 230 μg/dL. Incr eased Fe and Hb levels and decreased TIBC and UIBC levels were observed. Thereafter, ascending colon cancer was confirmed based on the results of a detailed examination of the cause of the iron deficiency anemia at the Department of Gastroenterology.
These results suggest that the appropriate iron replacement the rapy for Plummer‒Vinson syndrome improves oral symptoms and blood test results at an early stage. Moreover, the active examination of the cause of the iron deficiency anemia was suggested to be necessary for refractory cases not showing long-term improvement.2023-09-14T15:00:00Z宗片, 勇史坂田, 健一郎白川, 輝佐藤, 淳佐藤, 千晴村井, 知佳大賀, 則孝北川, 善政【目的】鉄欠乏性貧血は,鉄不足により血色素産生が阻害され,小球性低色素性貧血を示す疾患である.口腔粘膜の萎縮や再生不良による舌炎や口角炎が生じるが,これに嚥下障害を伴った場合Plummer-Vinson症候群と呼ばれる.鉄欠乏性貧血の診断に関して,末梢血液検査では,小球性低色素性貧血(MCV 80以下,MCHC 30以下)を示しヘモグロビン値(Hb)が低下し,生化学的検査では,血清鉄(Fe)60 μg/dL以下,血清フェリチン値の低下,総鉄結合能(TIBC)および不飽和鉄結合能(UIBC)が増加する.今回,味覚異常を主訴として嚥下困難感,舌の疼痛に加えて鉄欠乏性貧血を合併した患者に対して,鉄補充療法により各症状が著明に改善し,鉄欠乏性貧血の原因として上行結腸癌を認めた症例を経験したので報告する.
【症例】70歳,女性.味覚異常と嚥下困難感を主訴に来院した.眼瞼結膜蒼白,舌乳頭の一部萎縮を認め,初診時の血液検査の結果は,MCV 69 f l,MCHC 24.6 pg,Fe 6 μg/dL,Hb 4.1 g/dL,TIBC 445 μg/dL,UIBC 437 μg/dLであった.Plummer-Vinson症候群の診断のもと,クエン酸第一鉄ナトリウムおよびピロリン酸第二鉄により鉄補充療法を行い,経時的に血液検査を実施した.
【経過】鉄補充療法開始2 か月後,眼瞼結膜の充血,舌乳頭の回復,口腔内症状の改善が認められた.また,血液検査にてFeおよびHbの上昇,TIBCおよびUIBCの減少が認められた.その後,消化器内科にて鉄欠乏性貧血の原因に関して精査を行った結果,上行結腸癌が認められた.
【結論】Plummer-Vinson症候群に対し適切に鉄補充療法を行うことで,早期に口腔内症状および血液検査値の改善が認められるが,長期的な改善を認めない難治性の症例に対しては,鉄欠乏性貧血に関して積極的な原因精査の必要があると示唆された.
Iron deficiency anemia is the most common type of anemia in Jap an, and iron deficiency inhibits blood pigment production, resulting in microcytic hypochromic anemia. Glossitis and angular cheilitis occur owing to the atrophy of the oral mucosa and poor regeneration of the mucosal epithelium. When this is accompanied by dysphagia, it is called Plummer‒Vinson syndrome. Regarding the diagnosis of the iron deficiency anemia, peripheral blood tests reveal microcytic hypopigmented anemia (MCV, ≤80 ; MCHC, ≤30), and the hemoglobin level (Hb) decreases. Biochemical tests reveal a decreased serum iron (Fe) level of <60 μg/dL, decreased serum ferritin levels, and increased total iron binding capacity (TIBC) and unsaturated iron-binding capacity (UIBC). We report a case of Plummer‒Vinson syndrome with the considerable improvement of oral symptoms by iron replacement therapy, and ascending colon cancer was found to be the cause of the iron deficiency anemia.
A 70-year-old woman complained of abnormal taste. Her eyelid co njunctiva was pale, and her oral cavity showed a partial atrophy of the tongue papillae. Blood test results at h er first visit were as follows: MCV, 69; MCHC, 24.6; Fe, 6 μg/dL; Hb, 4.1 g/dL; TIBC, 445 μg/dL; and UIBC, 437 μg/dL. With the Plummer‒Vinson syndrome diagnosis, the iron replacement therapy with sodium ferrous citrate (Feromia®) and ferric pyrophosphate (Incremin®) was started and blood tests were performed over time. Two months after starting the iron replacement therapy, the hyperemia of the palpebral conjunctiva, recovery of the tongue papillae, and imp rovement of oral symptoms were observed. Blood test results are as follows: Fe, 99 μg/dL; Hb, 10 g/dL; TIB C, 329 μg/dL; and UIBC, 230 μg/dL. Incr eased Fe and Hb levels and decreased TIBC and UIBC levels were observed. Thereafter, ascending colon cancer was confirmed based on the results of a detailed examination of the cause of the iron deficiency anemia at the Department of Gastroenterology.
These results suggest that the appropriate iron replacement the rapy for Plummer‒Vinson syndrome improves oral symptoms and blood test results at an early stage. Moreover, the active examination of the cause of the iron deficiency anemia was suggested to be necessary for refractory cases not showing long-term improvement.下顎エナメル上皮腫に反復処置法を適応し,腫瘍による歯根吸収を伴う歯を無治療で温存した1例
http://hdl.handle.net/2115/90517
Title: 下顎エナメル上皮腫に反復処置法を適応し,腫瘍による歯根吸収を伴う歯を無治療で温存した1例
Authors: 足利, 雄一; 篠原, 早紀; 関口, 珠希; 格口, 渉; 大廣, 洋一
Abstract: 反復処置法は、顎骨の良性腫瘍または嚢胞に対して適用され、顎骨の形態回復ならびに口腔の機能温存に優れた治療である。顎骨良性腫瘍ではしばしば歯根の吸収を伴う。再発を防ぐため、一般的に病変に含まれる歯は抜歯や歯根端切除が施行される.生活歯の場合は歯の保存が可能であったとしても歯髄壊死が起こる可能性が高いことから根管治療がおこなわれる.今回,下顎エナメル上皮腫に対し反復処置法を用いて治療を行い,腫瘍により歯根が吸収された歯を無治療で温存できた症例を経験したのでその概要を報告する.
症例は19歳女性で,右側下顎体部の腫脹と軽度の鈍痛を主訴に当科を受診した.パノラマX線写真およびCTで右側下顎第1大臼歯から右側下顎枝にかけて右側下顎第1,第2大臼歯の歯根吸収を伴う境界明瞭な多房性のX線透過性病変を認めた.生検によりエナメル上皮腫の診断を得て,反復処置法による治療を行った.右側下顎第1,第2大臼歯を抜歯することなく温存に努めたところ,経過観察開始から6年後に電気歯髄診で反応がみられるようになり,歯髄に対する治療を行うことなく温存が可能であった. 10年の経過観察期間中,再発を認めず経過良好である.; The dredging method has shown excellent results in treating benign tumors or cysts, restoring the morphology of the jawbone, and preserving oral function. Benign jawbone tumors are often associated with root resorption of the involved teeth. To avoid recurrence, the teeth involved in the lesion are usually extracted, or even if the tooth can be saved, endodontic treatment or apicoectomy is performed because of the high probability of pulp necrosis. We report a case in which a tooth with a resorbed root due to a tumor was successfully preserved without treatment after applying the dredging method to a mandibular ameloblastoma.
A 19-year-old woman presented to our department with a complaint of swelling and mild dull pain in the right mandibular region. Panoramic radiographs and computed tomography revealed a well-defined multilocular radiolucent lesion in the ascending ramus of the mandible with the root resorptions of the mandibular first and second molars. A biopsy was performed, and a histopathological analysis led to t he diagnosis of ameloblastoma. The patient was treated with the dredging method. The involved molars were preserved wi thout treatments. Nine years after the initial treatment, the mandibular first and second molars responded normally to the electric pulp test. No recurrence or complications were observed during a 10-year follow-up period, and the teeth were preserved and functional in their place.2023-09-14T15:00:00Z足利, 雄一篠原, 早紀関口, 珠希格口, 渉大廣, 洋一反復処置法は、顎骨の良性腫瘍または嚢胞に対して適用され、顎骨の形態回復ならびに口腔の機能温存に優れた治療である。顎骨良性腫瘍ではしばしば歯根の吸収を伴う。再発を防ぐため、一般的に病変に含まれる歯は抜歯や歯根端切除が施行される.生活歯の場合は歯の保存が可能であったとしても歯髄壊死が起こる可能性が高いことから根管治療がおこなわれる.今回,下顎エナメル上皮腫に対し反復処置法を用いて治療を行い,腫瘍により歯根が吸収された歯を無治療で温存できた症例を経験したのでその概要を報告する.
症例は19歳女性で,右側下顎体部の腫脹と軽度の鈍痛を主訴に当科を受診した.パノラマX線写真およびCTで右側下顎第1大臼歯から右側下顎枝にかけて右側下顎第1,第2大臼歯の歯根吸収を伴う境界明瞭な多房性のX線透過性病変を認めた.生検によりエナメル上皮腫の診断を得て,反復処置法による治療を行った.右側下顎第1,第2大臼歯を抜歯することなく温存に努めたところ,経過観察開始から6年後に電気歯髄診で反応がみられるようになり,歯髄に対する治療を行うことなく温存が可能であった. 10年の経過観察期間中,再発を認めず経過良好である.
The dredging method has shown excellent results in treating benign tumors or cysts, restoring the morphology of the jawbone, and preserving oral function. Benign jawbone tumors are often associated with root resorption of the involved teeth. To avoid recurrence, the teeth involved in the lesion are usually extracted, or even if the tooth can be saved, endodontic treatment or apicoectomy is performed because of the high probability of pulp necrosis. We report a case in which a tooth with a resorbed root due to a tumor was successfully preserved without treatment after applying the dredging method to a mandibular ameloblastoma.
A 19-year-old woman presented to our department with a complaint of swelling and mild dull pain in the right mandibular region. Panoramic radiographs and computed tomography revealed a well-defined multilocular radiolucent lesion in the ascending ramus of the mandible with the root resorptions of the mandibular first and second molars. A biopsy was performed, and a histopathological analysis led to t he diagnosis of ameloblastoma. The patient was treated with the dredging method. The involved molars were preserved wi thout treatments. Nine years after the initial treatment, the mandibular first and second molars responded normally to the electric pulp test. No recurrence or complications were observed during a 10-year follow-up period, and the teeth were preserved and functional in their place.Pre-operative virtual planning followed by fabrication of patient-specific guiding instruments for mandibular deformity after fibula free flap reconstruction
http://hdl.handle.net/2115/90512
Title: Pre-operative virtual planning followed by fabrication of patient-specific guiding instruments for mandibular deformity after fibula free flap reconstruction
Authors: Ashikaga, Yuichi; Shinohara, Saki; Nakano, Shintaro; Ogawa, Naohiro; Matsuyama, Daigo; Murakami, Hirotake; Kuribayashi, Kazuyo; Ohiro, Yoichi
Abstract: Corrective osteotomy for secondary mandibular reconstruction is complex, and it is extremely difficult to achieve desirable three-dimensional positioning. The authors present a case for repositioning the mandibular segments of mandibular deformity after fibula free flap reconstruction using computer-assisted surgical simulation and patient-specific guiding instruments. A 69-year-old man developed severe mandibular deviation after segmental mandibulectomy and reconstruction with fibula free flap for basal cell carcinoma of the mental region. A virtual osteotomy was performed between the mandible and fibula on a 3D virtual model using simulation software. The proximal mandibular segments were placed in the ideal position using a 3D virtual model. The original contour of the mandible before the primary resection was used as a reference for repositioning. Patient-specific guiding instruments were fabricated for the pre-osteotomy and intraoperative positioning of the osteotomized mandible, enabling bone fragments to be repositioned and fixed using the pre-operative plan. Post-operative CT showed that the mandibular segments were precisely repositioned. In this case, virtual planning and patient-specific guiding instruments were useful in corrective surgery for mandibular deformity after fibula free flap reconstruction.2023-09-14T15:00:00ZAshikaga, YuichiShinohara, SakiNakano, ShintaroOgawa, NaohiroMatsuyama, DaigoMurakami, HirotakeKuribayashi, KazuyoOhiro, YoichiCorrective osteotomy for secondary mandibular reconstruction is complex, and it is extremely difficult to achieve desirable three-dimensional positioning. The authors present a case for repositioning the mandibular segments of mandibular deformity after fibula free flap reconstruction using computer-assisted surgical simulation and patient-specific guiding instruments. A 69-year-old man developed severe mandibular deviation after segmental mandibulectomy and reconstruction with fibula free flap for basal cell carcinoma of the mental region. A virtual osteotomy was performed between the mandible and fibula on a 3D virtual model using simulation software. The proximal mandibular segments were placed in the ideal position using a 3D virtual model. The original contour of the mandible before the primary resection was used as a reference for repositioning. Patient-specific guiding instruments were fabricated for the pre-osteotomy and intraoperative positioning of the osteotomized mandible, enabling bone fragments to be repositioned and fixed using the pre-operative plan. Post-operative CT showed that the mandibular segments were precisely repositioned. In this case, virtual planning and patient-specific guiding instruments were useful in corrective surgery for mandibular deformity after fibula free flap reconstruction.咬合力測定装置の測定値と咬筋筋電図波形振幅の関係:異なる咬合力測定システムの比較
http://hdl.handle.net/2115/90509
Title: 咬合力測定装置の測定値と咬筋筋電図波形振幅の関係:異なる咬合力測定システムの比較
Authors: 中島, 利徳; 山口, 泰彦; 高橋, 奏多; 前田, 正名; 石丸, 智也
Abstract: Purpose: This study aimed to investigate the relationship between amplitude of masseteric electromyogram (EMG) and measured values of T-scan system (TS) which can measure dynamic occlusal force but whose measured values are not expressed in a specific unit of force, and the relationship bet ween the masseteric EMG amplitude and bite force value expressed in Newton units measured using the Dental Prescale (PS).
Methods: A total of 18 healthy participants were included. EMG and bite force were measured simultaneously as the participants’ jaws occluded at 10 levels of strength, including the maximum voluntary contraction force.
Measurements were taken twice on different days. EMG electrodes were attached to the masseter muscle region on the main masticatory side and maintained for TS and PS measurements on the same day.
Regarding EMG measurements, the maximum amplitude of each waveform was measured. Regression analysis was performed with the measured values for TS and PS as objective variables and EMG amplitudes as explanatory variables.
In addition, the ratio of the regression coefficients for TS and PS (TS/PS) was calculated.
Results: Both PS value and EMG amplitudes and TS value and EMG amplitudes showed a linear and significant correlation. The average correlation coefficients of PS and EMG values measured first and second were 0.91 and 0.88, respectively. Those for TS measured first and second were 0.90 and 0.85, respectively. For both PS and TS, no significant difference(PS:P=0.20,TS:P=0.35)was observed in the regression coefficients of the measured occlusal force values and EMG amplitudes between the 1st and 2nd measurements. However, considerable variabilities were observed both between days and between participants.
A significant correlation was found between the regression coefficient of the occlusal force measured using PS and the EMG amplitude between the 1st and 2nd measurements. However no significant correlation was found in the TS measurements.
The median values of the ratio of regression coefficients (TS/PS) for all participants in the 1st and 2nd measurements were 5.67 and 6.84, respectively. Although there was no significant difference(P=0.37) between the 1st and 2nd measurements, variability was observed between the days. In addition, the variations among participants were large.
Conclusion: The measurement values using TS and PS correlated with the EMG amplitude. The finding suggests the possibility of linking the occlusal force displays of the TS an d PS via electromyogram amplitude values. However, the ratio of regression coefficients between measurement values using PS and EMG amplitudes and TS and EMG amplitudes in the linear regression equations was not constant owing to large inter-individual variations and day-to-day variabilities.
It is suggested that it is necessary to improve the analysis methods and parameters that link the occlusal force displays of the TS and PS.2023-09-14T15:00:00Z中島, 利徳山口, 泰彦高橋, 奏多前田, 正名石丸, 智也Purpose: This study aimed to investigate the relationship between amplitude of masseteric electromyogram (EMG) and measured values of T-scan system (TS) which can measure dynamic occlusal force but whose measured values are not expressed in a specific unit of force, and the relationship bet ween the masseteric EMG amplitude and bite force value expressed in Newton units measured using the Dental Prescale (PS).
Methods: A total of 18 healthy participants were included. EMG and bite force were measured simultaneously as the participants’ jaws occluded at 10 levels of strength, including the maximum voluntary contraction force.
Measurements were taken twice on different days. EMG electrodes were attached to the masseter muscle region on the main masticatory side and maintained for TS and PS measurements on the same day.
Regarding EMG measurements, the maximum amplitude of each waveform was measured. Regression analysis was performed with the measured values for TS and PS as objective variables and EMG amplitudes as explanatory variables.
In addition, the ratio of the regression coefficients for TS and PS (TS/PS) was calculated.
Results: Both PS value and EMG amplitudes and TS value and EMG amplitudes showed a linear and significant correlation. The average correlation coefficients of PS and EMG values measured first and second were 0.91 and 0.88, respectively. Those for TS measured first and second were 0.90 and 0.85, respectively. For both PS and TS, no significant difference(PS:P=0.20,TS:P=0.35)was observed in the regression coefficients of the measured occlusal force values and EMG amplitudes between the 1st and 2nd measurements. However, considerable variabilities were observed both between days and between participants.
A significant correlation was found between the regression coefficient of the occlusal force measured using PS and the EMG amplitude between the 1st and 2nd measurements. However no significant correlation was found in the TS measurements.
The median values of the ratio of regression coefficients (TS/PS) for all participants in the 1st and 2nd measurements were 5.67 and 6.84, respectively. Although there was no significant difference(P=0.37) between the 1st and 2nd measurements, variability was observed between the days. In addition, the variations among participants were large.
Conclusion: The measurement values using TS and PS correlated with the EMG amplitude. The finding suggests the possibility of linking the occlusal force displays of the TS an d PS via electromyogram amplitude values. However, the ratio of regression coefficients between measurement values using PS and EMG amplitudes and TS and EMG amplitudes in the linear regression equations was not constant owing to large inter-individual variations and day-to-day variabilities.
It is suggested that it is necessary to improve the analysis methods and parameters that link the occlusal force displays of the TS and PS.19F-NMR測定によるリポソームを生体膜モデルとしたイソフルランの作用部位の研究
http://hdl.handle.net/2115/90506
Title: 19F-NMR測定によるリポソームを生体膜モデルとしたイソフルランの作用部位の研究
Authors: 本間, 将一; 平沖, 敏文; 渋谷, 真希子; 鈴木, 邦明; 藤澤, 俊明
Abstract: [Objectives] To investigate the interaction of a general anesthetic with biological membranes, we measured 19F nuclear magnetic resonance (NMR) spectra of isoflurane on the isoflurane-multilamellar liposome (MLV) system. The paramagnetic effect of the spin-probe was examined to obtain the spatial structure between isoflurane and spin-probe in the MLV.
[Methods] We made the MLV solution including spin probe, 5- or 16-doxyl stearic acid (5- or16-DSA), added isoflurane to the MLV solution and obtained chemical shifts, the spin-lattice relaxation time (T1) and the spin-spin relaxation time (T2) of isoflurane on the spectra at 7T.
[Results and Discussion] The addition of isoflurane did not change the chemical shifts and the T1, but line widths became slightly broad and the T2 decreased remarkably, suggesting that isoflurane affects a chemical-exchange process between free and bound isoflurane on MLV. T1 and the T2 furthermore decreased in the presence of 5-DSA or 16-DSA due to the paramagnetic interaction between 19F nuclei of isoflurane and the electron of the spin-probe. T1 and T2 with 5-DSA were shorter than those of 16-DSA. These results suggest that the di stance between isoflurane and 5-DSA in MLV is closer than that of 16-DSA, and that isoflurane molecules locate in the outer surface of MLV.2023-09-14T15:00:00Z本間, 将一平沖, 敏文渋谷, 真希子鈴木, 邦明藤澤, 俊明[Objectives] To investigate the interaction of a general anesthetic with biological membranes, we measured 19F nuclear magnetic resonance (NMR) spectra of isoflurane on the isoflurane-multilamellar liposome (MLV) system. The paramagnetic effect of the spin-probe was examined to obtain the spatial structure between isoflurane and spin-probe in the MLV.
[Methods] We made the MLV solution including spin probe, 5- or 16-doxyl stearic acid (5- or16-DSA), added isoflurane to the MLV solution and obtained chemical shifts, the spin-lattice relaxation time (T1) and the spin-spin relaxation time (T2) of isoflurane on the spectra at 7T.
[Results and Discussion] The addition of isoflurane did not change the chemical shifts and the T1, but line widths became slightly broad and the T2 decreased remarkably, suggesting that isoflurane affects a chemical-exchange process between free and bound isoflurane on MLV. T1 and the T2 furthermore decreased in the presence of 5-DSA or 16-DSA due to the paramagnetic interaction between 19F nuclei of isoflurane and the electron of the spin-probe. T1 and T2 with 5-DSA were shorter than those of 16-DSA. These results suggest that the di stance between isoflurane and 5-DSA in MLV is closer than that of 16-DSA, and that isoflurane molecules locate in the outer surface of MLV.Na,K-ATPase活性のフッ素による阻害
http://hdl.handle.net/2115/90490
Title: Na,K-ATPase活性のフッ素による阻害
Authors: 沖野, 雄一郎; 出山, 義昭; 吉村, 善隆; 鈴木, 邦明; 本多, 丘人
Abstract: Fluoride (F) has been widely applied for the prevention of dental caries, but the range of application is limited because of acute toxicity. Moreover, the detailed toxicity mechanism is unclear. In this study, we consider that Na,K-ATPase from a rat brain is the target of acute toxicity of F, and we investigate the effects of F on Na,K-ATPase activities and the amount of phosphorylated intermediate (EP). F inhibited Na,K-ATPase activity, Na-ATPase activity, and K-pNPPase activity depending on the concentrations investigated. It was also found that aluminum (Al) increased the inhibition of ATPase activity by fluoride depending on the Al concentration and the optimum concentration was 100 μM Al. Activities were recovered to some extent by dilution, but not in the presence of both F and Al. This Al action required Mg2+, and the effect of Mg2+ could be replaced with Mn2+ or Ca2+. The amount of EP decreased depending on F concentrations investigated and Al further enhanced the inhibit ion of EP formation. However, while the activity was inhibited almost completely, about half of the EP formation remained. Deferoxamine decreased the effect of Al. These results suggest the following. F inhibited Na,K-ATPase activity by decreasing EP formation depending on its concentration, and Al increased the affinity of F for Na,K-ATPase. There are two inhibition mechanisms by F; inhibition of Na,K-ATPase activity by F alone is reversible, but the inhibition in the presence of F, Al, and divalent metals is irreversible.2023-09-14T15:00:00Z沖野, 雄一郎出山, 義昭吉村, 善隆鈴木, 邦明本多, 丘人Fluoride (F) has been widely applied for the prevention of dental caries, but the range of application is limited because of acute toxicity. Moreover, the detailed toxicity mechanism is unclear. In this study, we consider that Na,K-ATPase from a rat brain is the target of acute toxicity of F, and we investigate the effects of F on Na,K-ATPase activities and the amount of phosphorylated intermediate (EP). F inhibited Na,K-ATPase activity, Na-ATPase activity, and K-pNPPase activity depending on the concentrations investigated. It was also found that aluminum (Al) increased the inhibition of ATPase activity by fluoride depending on the Al concentration and the optimum concentration was 100 μM Al. Activities were recovered to some extent by dilution, but not in the presence of both F and Al. This Al action required Mg2+, and the effect of Mg2+ could be replaced with Mn2+ or Ca2+. The amount of EP decreased depending on F concentrations investigated and Al further enhanced the inhibit ion of EP formation. However, while the activity was inhibited almost completely, about half of the EP formation remained. Deferoxamine decreased the effect of Al. These results suggest the following. F inhibited Na,K-ATPase activity by decreasing EP formation depending on its concentration, and Al increased the affinity of F for Na,K-ATPase. There are two inhibition mechanisms by F; inhibition of Na,K-ATPase activity by F alone is reversible, but the inhibition in the presence of F, Al, and divalent metals is irreversible.