著者
小島 拓 芳澤 享子 小野 由起子 倉部 華奈 加納 浩之 齊藤 力 小林 正治
出版者
特定非営利活動法人 日本顎変形症学会
雑誌
日本顎変形症学会雑誌 (ISSN:09167048)
巻号頁・発行日
vol.25, no.3, pp.234-240, 2015-08-15 (Released:2015-09-12)
参考文献数
21
被引用文献数
2

We present three cases in whom mental disorders appeared after orthognathic surgery.The first case was a 35-year-old female who had a history of depression. After the operation, a manic state appeared and she was diagnosed with bipolar disorder. Her medicine was changed from an antidepressant to a mood stabilizer, after which her mental condition stabilized.The second case was a 34-year-old male. He could not accept the appearance of his postoperative face, and it took about three months for him to finally accept his new appearance.The final case was a 37-year-old female. She could not accept the appearance of her postoperative face because it was not what she had expected. She began to complain about her face and became depressive, and was finally diagnosed with major depressive disorder. After administration of an antidepressant, her mental condition gradually improved.We must take into consideration the possibility that patients will develop mental disorders after orthognathic surgery, and adequate explanation and patient assessment before the operation are therefore important.
著者
小島 拓 長谷部 大地 加藤 祐介 倉部 華奈 船山 昭典 新美 奏恵 加納 浩之 齊藤 力 小林 正治
出版者
特定非営利活動法人 日本顎変形症学会
雑誌
日本顎変形症学会雑誌 (ISSN:09167048)
巻号頁・発行日
vol.26, no.3, pp.237-242, 2016-08-15 (Released:2016-09-14)
参考文献数
22
被引用文献数
2 2

Peripheral facial nerve palsy following orthognathic surgery is a rare complication. We discuss the incidence of this complication, its possible causes, subsequent treatment and ultimate outcomes.A total of 910 patients underwent orthognathic surgery in our department during the period from 2001 to 2015. Five (0.55%) of those patients had peripheral facial nerve palsy postoperatively. The postoperative day when facial nerve palsy occurred ranged from day 1 to day 13. All of the cases were unilateral and included lip motility disturbance, difficulty in closing the eyes and inability to wrinkle the forehead. All of the patients received medication with an adrenocortical steroid and vitamin B12. Stellate ganglion block and physical therapy were also used for the patients who had moderate to severe facial nerve palsy. Complete recovery was achieved in all but one of the patients, in whom slight palsy remained. There were several possible causes of facial nerve palsy including abnormal bleeding, postoperative swelling, and handling of operating instruments.In conclusion, peripheral facial nerve palsy after orthognathic surgery is relatively rare. If it occurs, however, complete recovery can be expected in most cases.
著者
小林 正治 玉乃井 英嗣 井上 智晴 益山 新樹
出版者
天然有機化合物討論会実行委員会
雑誌
天然有機化合物討論会講演要旨集 55 (ISSN:24331856)
巻号頁・発行日
pp.PosterP-13, 2013 (Released:2018-03-09)

1. はじめに 食用キノコであるヤマブシタケには,アルツハイマー型老年期認知症の中核・周辺症状を改善する効果があることが臨床試験によって認められており[1],最近では,生もの,乾燥体,粉末,錠剤などの様々な形体で健康食品として販売されている。ヤマブシタケの機能性を司る因子の一つとして,子実体に含まれるヘリセノン類の関与が指摘されている。ヘリセノン類は1991年に発見された天然由来としては初の神経成長因子(NGF)合成促進物質であり,間接的にニューロンの分化・成熟・機能維持を助けることにより脳の老化を予防すると考えられている[2]。ヘリセノン類には多数の同族体が存在し,NGF合成促進活性だけでなく血小板凝集抑制活性[3]や小胞体ストレスによる細胞死の抑制活性[4]などの多彩な生物活性が知られている。しかしながら,これらの生物活性は個別の化合物に対して局所的に調べられたものであり,多様な構造を持つヘリセノン類の包括的な構造活性相関については明らかにされていない。活性試験についても,天然物サンプルの量的供給が隘路となり,in vivoでの毒性試験や薬物動態試験まで十分に検討されていない。以上の背景を踏まえ,本研究では,多様な構造を持つヘリセノン類の体系的な構造活性相関と創薬・治療学的応用を目指し,全合成研究を行った。2. 合成計画 ヘリセノン類は大別して,側鎖の5’位が酸化されているものと酸化されていない図1.ヘリセノン関連天然物の体系的全合成戦略(☆は本研究で合成完了した化合物)ものに分けられ,芳香環右辺や左辺側鎖の構造の違いによって系統化できる(図1)。私たちは,側鎖とコアのカップリングによって生成するフタリド1を共通中間体として,非天然型の誘導体も含めて網羅的に合成するルートを計画した。3. コア部の短段階合成[5] ヘリセノン類を効率的に合成するために重要となるのは,多様な官能基を直截的かつ位置選択的に導入することである。私たちは,不飽和エステル3とアセト酢酸エチルのMichael-Claisen反応によりジケトン5を合成し,臭化銅(II)によるワンポット多官能基化反応を経てコア部6を直截的に合成した(図2)。5→6の多官能基化反応では,酸性度の高いジケトンのα位が選択的に臭素化された後 (中間体i),メタノールの付加,HBrの脱離,芳香環化,ラクトン化が連続的に起こり所望のフタリドが生成したと考えられる。以上のように,市販のカルボン酸2から4工程でコア部を合成するルートを見出した5。図2.コア部の短段階合成4. ヘリセノンJおよびヘリセンA-Cの全合成5 続いて,側鎖とのカップリングを検討した。7aは2つのオルト位に電子供与性置換基を持つ反応性の低いアリールブロミドであったが,条件の最適化を行った結果,CsF存在下,(Ph3P)2PdCl2を触媒として80~85 °Cでカップリングを行うことで,目的の1bが単離収率60-87%で生成した(図3)。なお,本過程では7aから誘導したアリール銅試薬のゲラニルブロミドに対する置換反応も検討した(View PDFfor the rest of the abstract.)
著者
金丸 祥平 新垣 晋 芳澤 享子 西山 秀昌 程 珺 小林 正治
出版者
社団法人 日本口腔外科学会
雑誌
日本口腔外科学会雑誌 (ISSN:00215163)
巻号頁・発行日
vol.64, no.7, pp.423-428, 2018-07-20 (Released:2018-09-20)
参考文献数
21

Sarcomatous transformation of fibrous dysplasia (FD) is an extremely rare event. We report a case of low-grade central osteosarcoma (LGCO), which arose secondarily from FD of the mandible. A 35-year-old woman, who had regularly been followed up for a 19-year period for a diagnosis of FD, presented with a painful swelling in right mandibular body. On computed tomographic images, the right mental area was prominently expanded with the eroded cortex, and its inner part was entirely filled with an inhomogeneously enhanced lesion. Since a biopsy specimen taken from the anterior lesion was diagnosed to be LGCO, a segmental mandibulectomy and reconstruction with a fibula free flap was performed. There has been no sign of recurrence or metastasis as of 7 years after surgery. It is important to make a diagnosis and a treatment plan in patients with FD because malignant transformation of FD occurs rather infrequently.
著者
倉部 華奈 隅田 好美 小島 拓 加藤 祐介 齋藤 功 小林 正治
出版者
公益社団法人 日本口腔外科学会
雑誌
日本口腔外科学会雑誌 (ISSN:00215163)
巻号頁・発行日
vol.66, no.4, pp.178-187, 2020-04-20 (Released:2020-06-22)
参考文献数
23

Patients with jaw deformities frequently have psychological and social problems. There have been many reports on psychological status and satisfaction following orthognathic surgery as determined by quantitative methods. However, only limited information can be obtained by using a quantitative method because the patient’s psychological problems are complex. On the other hand, qualitative studies are suitable for clarifying the hypothetical construction of the phenomenon and patients’ experiences and processes. The purpose of this study was to examine the process by which patient’s psychological and social problems change from pre-treatment to post-treatment. The subjects were 6 female patients who had undergone orthognathic surgery 18 months ago. We conducted semi-structured interviews and performed analysis by a grounded theory approach. The patient’s anxiety started from the period of adolescence and was affected by the patient’s friends. Information on orthognathic surgery gave the patients hope and reduced their anxiety. The processes of psychological and social changes during and after treatment were affected by friends, family, and patients with the same disease. Patients had feelings of accomplishment, happiness, and confidence because they overcame various hardships, and they acquired active attitudes in social life.
著者
片桐 渉 小林 正治 佐々木 朗 須佐美 隆史 須田 直人 田中 栄二 近津 大地 冨永 和宏 森山 啓司 山城 隆 齋藤 功 高橋 哲
出版者
特定非営利活動法人 日本顎変形症学会
雑誌
日本顎変形症学会雑誌 (ISSN:09167048)
巻号頁・発行日
vol.30, no.3, pp.213-225, 2020 (Released:2020-09-11)
参考文献数
21
被引用文献数
2 2

The Japanese Society for Jaw Deformities performed a nationwide survey from 2006 to 2007 and the results were reported in 2008. In the last 10 years, new surgical procedures and medical devices have been developed and brought major changes to surgical orthodontic treatment. Accordingly, we need to assess the current status of surgical orthodontic treatment.A nationwide survey of surgical orthodontic treatment between April 2017 and March 2018 was carried out and 99 surgical facilities and 64 orthodontic facilities were enrolled in the survey. The number of patients who received orthognathic surgery was 3,405, about 69% of whom were diagnosed with mandibular protrusion. Before the surgery, 3D-simulation was performed for about 40% of patients at both surgical and orthodontic facilities. Computer-aided design and computer-aided manufacturing (CAD/CAM) wafers were used at 12.1% of surgical facilities and at 17.7% of orthodontic facilities. Sagittal split ramus osteotomy (SSRO) was performed in 2,768 patients (85.5%) and Le FortⅠosteotomy in 1,829 patients (56.5%). Blood loss during the surgery was reduced compared with that in the previous survey. Autologous blood transfusion tended to be performed in cases as necessary such as surgery for maxilla and anemia of the patient. Duration of intermaxillary fixation and hospital stay were also shortened. This survey revealed the current status of surgical orthodontic treatment in Japan in comparison with the previous survey.
著者
小林 正治 小田 陽平 長谷部 大地 加藤 健介 新美 奏恵 中里 隆之 泉 直也 高田 佳之 福田 純一 高木 律男 齊藤 力
出版者
特定非営利活動法人 日本顎変形症学会
雑誌
日本顎変形症学会雑誌 (ISSN:09167048)
巻号頁・発行日
vol.16, no.3, pp.153-160, 2006-08-15 (Released:2011-02-09)
参考文献数
16
被引用文献数
2 11

To assess whether patients were satisfied with the results of treatment, questionnaires were sent to 291 patients who had undergone orthognathic surgery for correction of jaw deformities and 133 questionnaires were returned with valid answers. The chief problem of 94 (71%) of these patients was appearance. Dysfunctions such as masticatory disturbance and speech difficulties were the primary reason for which 38 (29%) of the patients sought treatment. Seventy-five percent of the patients answered that they were satisfied with the results in regard to their chief problems. A favorable change in appearance was recognized by 125 patients, whereas five patients noticed no major changes and three patients were displeased with their postoperative faces. The patients'evaluations of their appearance seemed to be influenced by the responses of other peoPle to the surgical-results, and objective improvements did not always satisfy their expectations. Improvements in masticatory function and speech were recognized by 92 and 54 patients, respectively. Eighty patients had TMJ signs and symptoms such as click and/or pain before treatment, which disappeared in 53 (66%) of the symptomatic patients after the surgery. On the other hand, TMJ signs and symptoms appeared postoperatively in 7 (15%) of 47 patients without those before treatment. Psychologically, 42 patients noted favorable changes in personality after the surgery. Eight patients with mandibular set back noted the onset or worsening of snoring after the surgery.
著者
伊藤 亜希 小林 正治 松崎 英雄 田中 潤一 大畠 仁 高野 伸夫 齊藤 力
出版者
特定非営利活動法人 日本顎変形症学会
雑誌
日本顎変形症学会雑誌 (ISSN:09167048)
巻号頁・発行日
vol.17, no.4, pp.229-237, 2007-12-15 (Released:2011-02-09)
参考文献数
29
被引用文献数
3 7

This study investigated the relation between personality characteristics and types of jaw deformities and evaluated the influence of orthognathic surgery on personality characteristics.The subjects consisted of 52 patients (16 males and 36 females) in whom jaw deformities were surgically corrected and the mean age at surgery was 26.3 years. They were divided into four groups based on the types of jaw deformities such as mandibular protrusion with or without maxillary retrusion, mandibular retrusion with or without maxillary protrusion, open bite and asymmetry.Personality characteristics were analyzed using Minnesota Multiple Personality Inventory (MMPI) and Rosenberg's Self-Esteem Scale before and six months after surgery, and the Kruskal Wallis test and t-test were used for statistical analyses.Preoperative MMPI scores were not significantly different from normal values of their generation as a whole, but the distribution of Depression Scale and Self-Esteem Scale scores among the four groups were significantly different. The Depression Scale score in the asymmetry group was higher than those in the other groups and the Self-Esteem Scale score in the asymmetry group was lower than those in the other groups. After surgery, the Depression Score decreased in the asymmetry group and the Self-Esteem Scale score increased in all groups except the open bite group.In conclusion, it is considered that patients with asymmetry are likely to have an inferiority complex and orthognathic surgery for such patients has a favorable effect on personality characteristics because the deformity and the change of full-face appearance are easily recognized by themselves.
著者
高橋 功次朗 丹原 惇 森田 修一 小林 正治 池田 順行 林 孝文 齋藤 功
出版者
特定非営利活動法人 日本顎変形症学会
雑誌
日本顎変形症学会雑誌
巻号頁・発行日
vol.27, no.1, pp.1-7, 2017

Cephalometric prediction is still widely used for treatment planning in surgical orthodontic patients. However, there have been few reports on the relationship between mandibular midline changes by orthognathic surgery and the amount of bilateral setback movement on lateral cephalograms. The aim of this study was to clarify the relationships between the difference in mandibular setback amount for deviated and non-deviated sides and the amount of middle region displacement on cephalometric prediction in patients with mandibular prognathism and deviation.<br>The subjects comprised 15 patients diagnosed as mandibular prognathism with skeletal deviation at the orthodontic clinic, Niigata University Medical and Dental Hospital. All patients underwent only mandibular setback surgery involving midline correction by sagittal split ramus osteotomy(SSRO). Frontal and lateral cephalograms taken just before and immediately after orthognathic surgery were used for measurements. X-Y coordinates were constructed using the occlusal plane on the preoperative lateral cephalogram for the X coordinate and the perpendicular line drawn intersecting the X line at the Sella for the Y coordinate. The amount of posterior movement of the distal segment and middle region displacement were determined by superimposition of pre-and postoperative lateral cephalograms. The postoperative midline changes were measured linearly using a study model taken at just before orthognathic surgery. We examined the relationship between the average amount of operative movement for deviated and non-deviated sides and the amount of anteroposterior changes of the incisal region. The relationship between the difference in operative movement for deviated and non-deviated sides and postoperative midline changes was also examined.<br>Significant correlations were found between the bilateral difference of operative movement and the amount of anteroposterior changes of the incisal region. A significant correlation was also revealed between the bilateral difference of operative movement and horizontal middle region. In addition, a significant regression formula was obtained as β=0.65α+1.17(α: bilateral difference of mandibular posterior movement (mm), β: lateral movement of mandibular midline(mm))by regression analysis.<br>The present results suggest that, in cases with skeletal deviation, it is possible to regard the average value of anteroposterior movement of distal segments on both sides as a predictive factor for the posterior position of the incisal region. Also, the results suggest that the amount of midline correction can be predicted from the bilateral difference of operative movement. Since there is diversity and much variation in the movement of distal segments, it is not easy to predict the amount of midline displacement during orthognathic surgery. However, this regression formula may be useful for orthodontists and surgeons to plan surgical orthodontic treatment.
著者
小林 正治 平間 正博
出版者
The Society of Synthetic Organic Chemistry, Japan
雑誌
有機合成化学協会誌 (ISSN:00379980)
巻号頁・発行日
vol.62, no.3, pp.184-193, 2004-03-01 (Released:2009-11-13)
参考文献数
25
被引用文献数
3 4

A novel nine-membered enediyne antibiotic N 1999-A 2 was chemically synthesized and its absolute stereochemistry was determined. Chemical evidence of the thiol-triggered activation as well as the DNA cleavage profiles of N 1999-A 2 and its stereoisomers proved that the configuration of the C 11-naphthoate moiety played a dominant role in governing not only the orientation of the thiol attack but also the specificity of DNA cleavage.