Fork injuries with the tines inserted bilaterally between the mandibular interdental spaces

In this paper, we report two rare cases of foreign body oral injuries caused by forks inserted tightly into both sides of the lingual interdental spaces between the mandibular deciduous canines and first deciduous molars (FDMs). These pediatric cases of foreign body insertion caused not only soft tissue injuries but also the potential luxation of affected deciduous teeth, i.e., the FDMs in the present cases, during the removal of the object by force.     

Dietary habits in Japanese patients with psoriasis and psoriatic arthritis: Low intake of meat in psoriasis and high intake of vitamin A in psoriatic arthritis

Psoriasis is characterized by T‐helper 17 cell‐dominant abnormal immunity, and hyperproliferation and abnormal differentiation of epidermal keratinocytes. Some patients are associated with arthritis. Dietary habits can modulate the pathogenesis of psoriasis. Previous studies in Western countries showed higher body mass indices, higher intake of fat and lower intake of fish or vegetables in psoriatic patients compared with the reference groups. We evaluated dietary habits in adult Japanese psoriatic patients, using a validated brief‐type self‐administered dietary history questionnaire, and compared the results to those of age‐ and sex‐matched healthy controls. The results in psoriatic patients with arthritis were compared with those in the patients without. Japanese psoriatic patients showed higher body mass indices, higher intake of fish/shellfish, pulses, sugar/sweeteners, vitamin B₁₂ and vitamin D, and lower intake of meat, compared with those of healthy controls. The logistic regression analysis showed that psoriasis was associated with high body mass index and low intake of meat. The intake of confection in patients with high Psoriasis Area and Severity Index was higher than that in those with low index. The intake of β‐carotene, vitamin A and green/yellow vegetables in psoriatic patients with arthritis were higher than those in the patients without. The dietary habits in Japanese psoriatic patients are rather different from those in Western patients. This is the first study showing the differences in dietary habits between psoriatic patients with arthritis and those without. Further studies should elucidate the relationships of these results with skin and joint lesions in psoriatic patients.     

Wound,pressure ulcer and burn guidelines – 4: Guidelines for the management of connective tissue disease/vasculitis-associated skin ulcers

The Japanese Dermatological Association prepared guidelines focused on the treatment of skin ulcers associated with connective tissue disease/vasculitis practical in clinical settings of dermatological care. Skin ulcers associated with connective tissue diseases or vasculitis occur on the background of a wide variety of diseases including, typically, systemic sclerosis but also systemic lupus erythematosus (SLE), dermatomyositis, rheumatoid arthritis (RA), various vasculitides and antiphospholipid antibody syndrome (APS). Therefore, in preparing the present guidelines, we considered diagnostic/therapeutic approaches appropriate for each of these disorders to be necessary and developed algorithms and clinical questions for systemic sclerosis, SLE, dermatomyositis, RA, vasculitis and APS.     

An analysis of qualitative and mixed methods abstracts from Japanese,UK and US primary care conferences

Background

As research in family medicine covers varied topics, multiple methodologies such as qualitative research (QR) and mixed methods research (MMR) are crucial. However, we do not know about the difference in the proportion of QR or MMR between Japan, the UK and the US. This knowledge is needed to shape future research within countries with developing primary care such as Japan and other Asian countries. This study aims to describe the use of QR and MMR in Japanese primary care and compare this to the UK and US; then to make informed recommendations for primary care research.

Methods

A repeated cross-sectional study (2012–2016) based on the abstracts submitted to the annual conferences of the Japanese Primary Care Association in Japan, the Royal College of General Practitioners in the UK, and the North American Primary Care Research Group in the US and other North American countries. The proportions of QR/MMR among all the posters and paper presentations for each of these three conferences were assessed. Also examined were trends and types of qualitative techniques for all three countries and participants/settings for Japan.

Results

There were 1080 abstracts for Japan, 575 for UK and 3614 for US conferences. QR/MMR proportions were 7.5%, 15.1% and 28.1%, respectively. Japan’s proportion was lower than that of UK and US (p?<?0.001). The proportion was increasing over time for the UK (p?=?0.02). Steps for coding and analyses was most popular for Japan, thematic analysis for the UK and grounded theory for the US. Primary care doctors and hospitals were the commonest contexts for Japan.

Conclusions

QR and MMR were not as popular in primary care in Japan compared to the UK and the US, whereas their use was increasing in the UK. Approaches, participants and settings may differ among these countries. Education and promotion of QR/MMR and multi-disciplinary collaborations need to be recommended in Japan with developing primary care.

     

Pacinian neuroma in adipose herniation of the buccal mucosa

An interesting case of a trauma-induced tender mass of the buccal mucosa in a 45-year-old man was presented. Following surgery, the patient was relieved from pain. Microscopically, the mature adipose tissue is unique in that it contained a single enlarged Pacinian corpuscle near the deep margin. This is the hitherto undescribed intraoral lesion of Pacinian neuroma in the herniated buccal fat pad.     

Effects of a mandibular lateral shift on the condyle and mandibular bone in growing rats

OBJECTIVE: To examine the effects of mandibular lateral shift on the growth and morphology of the condyle and mandibular bone in growing rats. MATERIALS AND METHODS: A maxillary resin plate was designed to displace 4-week-old rat mandibles 2 mm to the left during closure. The plate was cemented, and the rats were killed after 2, 4, 8, or 12 weeks. Gross dimensions of the condylar head were measured. Radiographic films of the mandibles were exposed, and selected measurements were made. The newly formed bone in the condyle was evaluated with periodic acid and Schiff's reagent (PAS) staining. RESULTS: The length of the condylar head was greater on the ipsilateral side compared with the contralateral side. The experimental rats developed an asymmetric mandible, shorter in horizontal dimension but longer in the vertical dimension on the ipsilateral side. The mandibular growth direction was also affected, with the mandible on the ipsilateral side growing in a more anterior and superior direction. The amount of newly formed bone was greater in the superior subchondral region but lower in the posterior subchondral region on the ipsilateral side compared with the contralateral side. CONCLUSIONS: Mechanical stimuli delivered by a functional shift produce a series of morphological and histological responses in the condyle and lead to condylar and mandibular asymmetry in rats.     

Tourette's syndrome with rapid deterioration by self-mutilation of the upper lip

A case of Tourette's syndrome is presented in a thirteen-year-old boy with obsessive-compulsive symptoms including self-mutilation of the upper lip. His upper lip injury was caused by complication of picking with fingernail, and self-biting with the lower anterior teeth. It became rapidly worse and the median part of the upper lip collapsed. But the placement of an acrylic splint was able to prevent further damage of the upper lip.