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Toshihiro Imamura,Shunsuke Uesugi,Takashi Ono 대한치과교정학회 2020 대한치과교정학회지 Vol.50 No.3
Root resorption can be caused by several factors, including contact with the cortical bone. Here we report a case involving a 21-year-old female with Angle Class II, division 1 malocclusion who exhibited significant root resorption in the maxillary right central incisor after orthodontic treatment. The patient presented with significant left-sided deviation of the maxillary incisors due to lingual dislocation of the left lateral incisor and a Class II molar relationship. Cephalometric analysis demonstrated a Class I skeletal relationship (A pointnasion- B point, 2.5o) and proclined maxillary anterior teeth (upper incisor to sella-nasion plane angle, 113.4o). The primary treatment objectives were the achievement of stable occlusion with midline agreement between the maxillary and mandibular dentitions and appropriate maxillary anterior tooth axes and molar relationship. A panoramic radiograph obtained after active treatment showed significant root resorption in the maxillary right central incisor; therefore, we performed cone-beam computed tomography, which confirmed root resorption along the cortical bone around the incisive canal. The findings from this case, where different degrees of root resorption were observed despite comparable degrees of orthodontic movement in the bilateral maxillary central incisors, suggest that the incisive canal could be an inducing factor for root resorption. However, further investigation is necessary to confirm this assumption.
Kazutomo Yamasaki,Takashi Hisabe,Kenshi Yao,Hiroshi Ishihara,Kentaro Imamura,Tatsuhisa Yasaka,Hiroshi Tanabe,Akinori Iwashita,Toshiharu Ueki 대한소화기내시경학회 2021 Clinical Endoscopy Vol.54 No.4
Background/Aims: A white substance that is opaque to endoscopic light is sometimes observed in the epithelium during narrowbandimaging with magnifying endoscopy of gastric or colorectal epithelial neoplasms. This prospective observational study aimedto determine whether the morphology of the white opaque substance (WOS) allows differential diagnosis between colorectaladenoma and carcinoma. Methods: A consecutive series of patients with colorectal adenomas or early carcinomas who underwent endoscopic resectionor surgical excision were studied. The morphology of the WOS was determined based on endoscopic images before thehistopathological diagnosis was performed. The primary outcome was the diagnostic performance of an irregular WOS as a markerof colorectal carcinoma. Results: The study analyzed 125 lesions. A total of 33 lesions showed an irregular WOS, and 92 lesions showed a regular WOS. Among the 33 lesions found to show an irregular WOS, 30 were carcinomas. Among the 92 lesions showing a regular WOS, 79 wereadenomas. With irregular WOS as a marker of carcinoma, the diagnostic accuracy was 87%, sensitivity was 91%, and specificity was86%. Conclusions: This study demonstrated the potential usefulness of the morphology of the WOS as a marker for the differentialdiagnosis between adenoma and carcinoma in cases of colorectal epithelial neoplasms.
Shunsuke Uesugi,Toshihiro Imamura,Satoshi Kokai,Takashi Ono 대한치과교정학회 2018 대한치과교정학회지 Vol.48 No.3
For patients with bimaxillary protrusion, significant retraction and intrusion of the anterior teeth are sometimes essential to improve the facial profile. However, severe root resorption of the maxillary incisors occasionally occurs after treatment because of various factors. For instance, it has been reported that approximation or invasion of the incisive canal by the anterior tooth roots during retraction may cause apical root damage. Thus, determination of the position of the maxillary incisors is key for orthodontic diagnosis and treatment planning in such cases. Cone-beam computed tomography (CBCT) may be useful for simulating the post-treatment position of the maxillary incisors and surrounding structures in order to ensure safe teeth movement. Here, we present a case of Class II malocclusion with bimaxillary protrusion, wherein apical root damage due to treatment was minimized by pretreatment evaluation of the anatomical structures and simulation of the maxillary central incisor movement using CBCT. Considerable retraction and intrusion of the maxillary incisors, which resulted in a significant improvement in the facial profile and smile, were achieved without severe root resorption. Our findings suggest that CBCT-based diagnosis and treatment simulation may facilitate safe and dynamic orthodontic tooth movement, particularly in patients requiring maximum anterior tooth retraction.
Hirokazu Saito,Yoshihiro Kadono,Takashi Shono,Kentaro Kamikawa,Atsushi Urata,Jiro Nasu,Haruo Imamura,Ikuo Matsushita,Tatsuyuki Kakuma,Shuji Tada 대한소화기내시경학회 2022 Clinical Endoscopy Vol.55 No.2
Background/Aims: Difficult biliary cannulation is an important risk factor for post-endoscopic retrograde cholangiopancreatography(ERCP) pancreatitis (PEP). Therefore, this study aimed to identify the factors that predict difficult cannulation for common bile ductstones (CBDS) to reduce the risk for PEP. Methods: This multicenter retrospective study included 1,406 consecutive patients with native papillae who underwent ERCP forCBDS. Factors predicting difficult cannulation for CBDS were identified using univariate and multivariate analyses. Results: Univariate analysis showed that six factors significantly predicted difficult cannulation: ERCP performed by non-expertendoscopists, low-volume center, absence of acute cholangitis, normal serum bilirubin, intradiverticular papilla, and type of majorduodenal papilla. Multivariate analysis identified ERCP performed by non-expert endoscopists (odds ratio [OR], 2.5; p<0.001),low-volume center (OR, 1.6; p<0.001), intradiverticular papilla (OR, 1.3; p=0.007), normal serum bilirubin (OR, 1.3; p=0.038), andabsence of acute cholangitis (OR, 1.3; p=0.049) as factors significantly predicting difficult cannulation for CBDS. Conclusions: Initial cannulation by an experienced endoscopist, early rescue cannulation, or early takeover by an experiencedendoscopist should be considered when performing ERCP for CBDS in the presence of factors predicting difficult cannulation.
Shaoqi Duan,Nobuko Imamura,Takashi Kondo,Hirosato Kanda,Yoko Kogure,Takuya Okugawa,Masashi Fukushima,Toshihiko Tomita,Tadayuki Oshima,Hirokazu Fukui,Koichi Noguchi,Yi Dai,Hiroto Miwa 대한소화기 기능성질환∙운동학회 2022 Journal of Neurogastroenterology and Motility (JNM Vol.28 No.2
Background/AimsHerbal medicine is an important complementary therapy for functional dyspepsia (FD). However, its effect against gastric hypersensitivity in patients with FD has rarely been evaluated. Yokukansan (YKS), a traditional Japanese herbal medicine, is effective against neuropathic and inflammatory pain. This study aims to use a maternal separation (MS) stress-induced FD model to investigate the effects of YKS against gastric hypersensitivity, gastric motility, and duodenal micro-inflammation. MethodsThe MS stress model was established by separating newborn Sprague-Dawley rats from their mothers for 2 hours a day from postnatal days 1 to 10. At the age of 7-8 weeks, the rats were treated with YKS at a dose of 5 mL/kg (1 g/kg) for 7 consecutive days. After YKS treatment, electromyographic activity in the acromiotrapezius muscle by gastric distention and the gastric-emptying rate were assessed. Immunohistochemical analysis of eosinophils in the duodenum and phosphorylated extracellular signal-regulated kinase (p-ERK) 1/2 in the spinal cord was performed. ResultsYKS treatment suppressed MS stress-induced gastric hypersensitivity and decreased the elevated levels of p-ERK1/2 in the spinal cord. In the gastroduodenal tract, YKS inhibited eosinophil-associated micro-inflammation but did not improve gastric dysmotility. ConclusionsYKS treatment improved gastric hypersensitivity by alleviating eosinophil-associated micro-inflammation in the gastroduodenal tract. This treatment may be considered an effective therapeutic option for epigastric pain and micro-inflammation in patients with FD.
Kenta Chuman,Kenshi Yao,Takao Kanemitsu,Takashi Nagahama,Masaki Miyaoka,Haruhiko Takahashi,Kentaro Imamura,Rino Hasegawa,Toshiharu Ueki,Hiroshi Tanabe,Seiji Haraoka,Akinori Iwashita 대한소화기내시경학회 2021 Clinical Endoscopy Vol.54 No.2
Background/Aims: The objective of this study was to elucidate the histological structure of the absent microsurface patterns (MSPs)that were visualized by magnifying endoscopy with narrow-band imaging (M-NBI). Methods: The study included consecutive gastric epithelial neoplasias for which M-NBI findings and histological findings couldbe compared on a one-to-one basis. The lesions were classified as absent MSPs and present MSPs based on the findings obtainedusing M-NBI. Of the histopathological findings for each lesion that corresponded to M-NBI findings, crypt opening densities, cryptlengths, crypt opening diameters, intercrypt distances, and crypt angles were measured and compared. Results: Thirty-six lesions were included in the analysis; of these, 17 lesions exhibited absent MSP and 19 lesions exhibited presentMSP. Comparing the histological measurements for absent MSPs vs. present MSPs, median crypt opening density was 0.9 cryptopenings/mm vs. 4.8 crypt openings/mm (p<0.001), respectively. The median crypt length, median crypt opening diameter, medianintercrypt distance, and median crypt angle were 80.0 μm vs. 160 μm (p<0.001), 40.0 μm vs. 44.2 μm (p=0.09), 572.5 μm vs. 166.7μm (p<0.001), and 21.6 degrees vs. 15.5 degrees (p<0.001), respectively. Conclusions: Histological findings showed that lesions exhibiting absent MSPs had lower crypt opening density, shorter crypt length,greater intercrypt distance, and larger crypt angle.