Screening for musculoskeletal problems in children using a questionnaire

Background

On April 1, 2016, the Ministerial ordinance was enforced, and musculoskeletal examination of the extremities was made mandatory. From 2008, the University of us started musculoskeletal direct examination. To expand the examination, from 2016, we started to use the marksheet-type questionnaire. This study aimed to report the results of a musculoskeletal examination and investigate the association between musculoskeletal examination and age/gender and reports the reliability of the collected questionnaire data.

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.     

Different localizations of drugs simultaneously administered in a strand of hair by micro‐segmental analysis

Segmental hair analysis is used to estimate the time of drug intake at monthly precision in drug‐related crimes. Previously, we advanced this analytical method to specify the day of drug intake by cutting a strand of hair into 0.4‐mm segments, which correspond to daily hair growth. Herein, we investigated the distributions of 7 compounds in a strand of hair using micro‐segmental analysis. Several strands of hair were collected 33.1?229.4 days after subjects were administered 4 pharmaceutical products that contained 10 drugs in single doses within 32 hours. The administered drugs and resulting metabolites were extracted from 0.4‐mm hair segments and quantified using liquid chromatography–tandem mass spectrometry. Acidic and neutral compounds were detected at low amounts in any of the hair segments analyzed. Epinastine, fexofenadine, dihydrocodeine, chlorpheniramine, and the chlorpheniramine metabolite, desmethylchlorpheniramine each was localized to 2 regions within a strand of hair. By contrast, methylephedrine and its metabolite, ephedrine, each was localized to only a region. Among 20 individual strands of hair associated with different subjects and head regions, few differences in the shapes of drug concentration–hair segment curves for each compound were detected. Our data indicated that 2 mechanisms for drug uptake into hair can operate depending on drug properties and that co‐administered drugs can be localized to different regions in a strand of hair. Micro‐segmental analysis may aid in the identification of the day of drug intake and help to elucidate the mechanisms of drug uptake into hair.     

Influence of tempering method on residual stress in dental porcelain.

The porcelain component of a porcelain-fused-to-metal restoration is strengthened by residual (tempering) stresses which are induced by cooling procedures followed in dental laboratories. The thermophysical properties of materials and cooling rate are the main factors which determine the residual stress. In this paper, the temperatures in the midplane of body-porcelain disks were measured from a heat-soak temperature (1000 degrees C) to room temperature during two different cooling procedures: slow cooling in air and forced-air cooling. Experimental results approximated exponential cooling wherein the cooling rates could be represented by a linear equation of temperature. Residual stresses, as affected by the tempering method and thickness of a porcelain disk, were calculated by computer simulation for regions away from the edges. The following temperature-dependent factors were incorporated into the simulation: elastic modulus, viscosity, and coefficient of thermal expansion. The cooling rate dependencies of the glass transition temperature and the temperature distribution during cooling were also included. The cooling rates used in this simulation were derived from the tempering data. The agreement between development of transient and residual stresses--calculated by computer simulation for various cooling methods, and the tendency toward failures of porcelain disks subjected to the tempering processes--was examined. Simulated residual stresses were also in good agreement with those measured by the indentation fracture method of Marshall and Lawn (1977) and Anusavice et al. (1989).     

Bone regeneration with self-assembling peptide nanofiber scaffolds in tissue engineering for osseointegration of dental implants

The aim of this study was to evaluate the correlation between the osseointegration of dental implants and tissue-engineered bone using a nanofiber scaffold, PuraMatrix (PM). The first molar and all premolars in the mandibular regions of dogs were extracted, and three bone defects were prepared with a trephine bur on both sides of the mandible after 4 weeks. The experimental groups were as follows: (1) PM, (2) PM and dog mesenchymal stem cells (dMSCs), (3) PM, dMSCs, and platelet-rich plasma, and (4) control (defect only). Implants were placed in the prepared areas 8 weeks later and were assessed by histologic and histomorphometric analyses (bone-to-implant contact [BIC]). The BICs for groups 1, 2, 3, and 4 were 40.77%, 50.35%, 55.64%, and 30.57%, respectively. The findings indicate that PM may be useful as a scaffold for bone regeneration around dental implants.     

Clinical evaluation of a low-friction attachment device during canine retraction

OBJECTIVE: The present study used a split-mouth design to compare the amount of canine movement and the retraction time between brackets with Clear Snap and brackets with stainless steel ligature wires for three different levels of retraction force. MATERIALS AND METHODS: A sample of 30 patients was used. After initial leveling, the canine was retracted using a 50-g (n = 10), 100-g (n = 10), or 150-g (n = 10) closed-coil spring. The canine on one side was chosen at random, and Clear Snap was attached to the bracket during the retraction period. The other side was used as a control. The amount of canine retraction was measured with a digital vernier caliper. Statistical analysis was performed by analysis of variance. RESULTS: The average canine retraction time was approximately 2 to 3 months less in all experimental groups (50, 100, and 150 g) compared to the control group. In the control group, 150 g resulted in a shorter duration of canine retraction compared to 50 g. There was no significant difference in the duration of canine retraction among the experimental groups. A greater amount of mean total canine movement was observed in all experimental groups compared to the control groups. CONCLUSION: A shorter duration of canine retraction time was observed with Clear Snap attached when compared with the control. The authors suggest that with the use of Clear Snap, less than 50 g of force may effectively retract a canine.     

The Japanese version of the Oral Health Impact Profile (OHIP)--validation among young and middle-aged adults

OBJECTIVE: To validate the Japanese version of the Oral Health Impact Profile (OHIP-J) for use among young and middle-aged adults. Evaluating the criterion validity was particularly important in this study. METHOD: The original Oral Health Impact Profile (OHIP) was translated into Japanese. Data from 6,079 subjects aged 20-59 were collected by means of a self-administered questionnaire and the oral condition records of a sample of workers. The survey involved items for the OHIP-J and self-rated oral health, denture wearing, number of missing teeth, work type, occupational rank, gender, and age. We adopted a self-rated oral health and number of missing teeth as validity criteria for this analysis. RESULTS: Using multiple linear regression analysis, the adjusted total OHIP-J scores for respondents who rated their oral health as poor were higher than those who did not (46.6 vs. 27.6; p<0.001). The variable of missing teeth was significantly associated with the OHIP-J total and subscale scores independent of gender, age and denture wearing (p<0.001). CONCLUSIONS: These findings suggest that the OHIP-J is suitable for assessing the oral health-related quality of life of young and middle-aged adults in Japan.     

Comparison of stability of mandibular segments following the sagittal split ramus osteotomy with poly-l-lactic acid (PLLA) screws and titanium screws fixation

The purpose of this study was to retrospectively compare the stability of the mandible following the surgical orthodontic treatment by sagittal split ramus osteotomy (SSRO) and orthodontic multi-bracket treatment using fixation methods with poly-l-lactic acid (PLLA) or titanium screws. The sample examined was 23 subjects with PLLA screws (PLLA group) and 22 subjects with titanium screws (Titan group). Lateral cephalometric radiographs were reviewed before surgery (T0), 2–3 days after surgery (T1), 1 month after surgery (T2), and after postoperative orthodontic treatment (T3) and changes in the position of bony segments were examined by cephalometric linear and angular measurements. A similar movement of the mandible following setback surgery was indicated, and statistical analysis showed no significant differences in skeletal changes between the two groups during whole postoperative periods. However, a relapse following surgical counterclockwise rotation of the distal segment in PLLA group tended to be slightly greater during T1–T2 compared with Titan group. These results suggest that a use of the PLLA screw fixation may not influence on the stability of bony segments after mandibular setback surgery by SSRO during the postoperative period, although a slight tendency for clockwise rotation of the distal segment was indicated in patients with PLLA screws. It is suggested that fixation of bony segments with PLLA screws after SSRO may be effective in properly selected cases.     

A male case with CDKL5-associated encephalopathy manifesting transient methylmalonic acidemia

Mutations in the X-linked gene CDKL5 cause early-onset epileptic encephalopathy and severe developmental delay. Because this disorder predominantly affects females, the full clinical spectrum of male patients remains elusive. We herein report a 16-year-old boy, who suffered from intractable seizures 20 days after birth. Serial electroencephalograms detected recurrent focal epileptiform discharges from age 4 months, which evolved to hypsarrhythmia later in infancy. Mass-spectrometric analyses revealed increase in urinary excretion of methylmalonic acid without perturbed concentrations of propionic acid, homocystein and methionine. Whole-exome sequencing identified a de novo, truncating mutation in CDKL5 (NM_003159.2:c.419dupA, p.Asn140Lysfs*8). Targeted sequencing excluded concomitant mutations in methylmalonic academia-associated genes. No methylmalonic acidemia has been reported in children with CDKL5 disorder. Extensive analyses on organic acid metabolism for males with CDKL5 mutations will gain more insight into their biochemical profiles in infancy.