Springer Science and Business Media LLC Acta Medica Okayama 0941-4355 33 4 2025 Characteristics of oral mucositis in patients undergoing haploidentical stem cell transplantation with posttransplant cyclophosphamide: marked difference between busulfan and melphalan regimens 252 EN Saki Ogura Division of Dental Hygienist, Okayama University Hospital Yoshihiko Soga Division of Hospital Dentistry, Okayama University Hospital Hideaki Fujiwara Department of Hematology and Oncology, Okayama University Hospital Rumi Miura Division of Dental Hygienist, Okayama University Hospital Ken-ichi Matsuoka Department of Hematology, Oncology and Respiratory Medicine, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Yoshinobu Maeda Department of Hematology, Oncology and Respiratory Medicine, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Takuo Kuboki Division of Dental Hygienist, Okayama University Hospital Purpose This study was performed to examine the effects of conditioning regimens on oral mucositis in haploidentical (haplo) donor hematopoietic stem cell transplantation (HSCT) with posttransplant cyclophosphamide (PTCy). Methods Thirty consecutive patients (male, 23; female, 7; 18–68 years, median, 59 years) undergoing haplo-HSCT with PTCy using one of three conditioning regimens―reduced intensity conditioning (RIC)-melphalan (Mel); RIC-Busulfan (Bu); and myeloablative conditioning (MAC)-Bu―were enrolled in this study. Data on the WHO grade of oral mucositis (day － 7 to + 20) were collected retrospectively. The incidences of ulcerative and severe mucositis (Grade 2–4 and Grade 3–4, respectively) were compared between the three groups. Results Ulcerative mucositis occurred in 0% (0/10) of patients in the RIC-Mel group, 57.1% (4/7) in the RIC-Bu group, and 100% (13/13) in the MAC-Bu group. The differences between the RIC-Mel and RIC-Bu groups and between the RIC-Bu and MAC-Bu groups were significant (all P < 0.05). Severe mucositis occurred in 57.1% (4/7) of patients in the RIC-Bu group and 100% (13/13) of patients in the MAC-Bu group, and the difference was significant (P < 0.05). The rates of ulcerative mucositis (≥ grade 2) and of severe mucositis (≥ grade 3) were significantly higher in the MAC-Bu group than the RIC-Bu group on days 10, 13, 15, and 16 and on days 10, 14, 15, and 16, respectively (all P < 0.05). Conclusion The risk of oral mucositis in patients undergoing haplo-HSCT with PTCy is highest with the MAC-Bu conditioning regimen, followed by RIC-Bu, and lowest with RIC-Mel. No potential conflict of interest relevant to this article was reported.

Elsevier Acta Medica Okayama 0006-4971 145 8 2025 Oral Inflammation and Microbiome Dysbiosis Exacerbate Chronic Graft-versus-host Disease 881 896 EN Yui Kambara Department of Hematology, Oncology and Respiratory Medicine, Okayama University Medical School Hideaki Fujiwara Department of Hematology and Oncology, Okayama University Hospital Akira Yamamoto Department of Hematology and Oncology, Okayama University Hospital Kazuyoshi Gotoh Department of Medical Laboratory Science, Okayama University Graduate School of Health Sciences Shuma Tsuji Department of Microbiology and Genetics, Okayama University Graduate School of Health Sciences Mari Kunihiro Department of Hematology, Oncology and Respiratory Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Tadashi Oyama Department of Hematology, Oncology and Respiratory Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Toshiki Terao Department of Hematology, Oncology and Respiratory Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Ayame Sato Division of Hospital Dentistry, Okayama University Hospital Takehiro Tanaka Department of Pathology and Oncology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Daniel Peltier Division of Pediatric Hematology, Oncology, and Stem Cell Transplantation, Department of Pediatrics, Herman B Wells Center for Pediatric Research, Simon Cancer Center, Indiana University School of Medicine Keisuke Seike Department of Hematology and Oncology, Okayama University Hospital Hisakazu Nishimori Department of Hematology and Oncology, Okayama University Hospital Noboru Asada Department of Hematology and Oncology, Okayama University Hospital Daisuke Ennishi Center for Comprehensive Genomic Medicine, Okayama University Hospital Keiko Fujii Department of Clinical Laboratory, Okayama University Hospital Nobuharu Fujii Division of Blood Transfusion, Okayama University Hospital Ken-ichi Matsuoka Department of Hematology and Oncology, Okayama University Hospital Yoshihiko Soga Division of Hospital Dentistry, Okayama University Hospital Pavan Reddy Dan L Duncan Comprehensive Cancer Center, Baylor College of Medicine Maeda Yoshinobu Department of Hematology and Oncology, Okayama University Hospital The oral microbiota, second in abundance to the gut, is implicated in chronic systemic diseases, but its specific role in graft-versus-host disease (GVHD) pathogenesis has been unclear. Our study finds that mucositis-induced oral dysbiosis in patients after hematopoietic cell transplantation (HCT) associated with increased chronic GVHD (cGVHD), even in patients receiving posttransplant cyclophosphamide. In murine HCT models, oral dysbiosis caused by bilateral molar ligatures exacerbated cGVHD and increased bacterial load in the oral cavity and gut, with Enterococcaceae significantly increasing in both organs. In this model, the migration of Enterococcaceae to cervical lymph nodes both before and after transplantation activated antigen-presenting cells, thereby promoting the expansion of donor-derived inflammatory T cells. Based on these results, we hypothesize that pathogenic bacteria increase in the oral cavity might not only exacerbate local inflammation but also enhance systemic inflammation throughout the HCT course. Additionally, these bacteria translocated to the gut and formed ectopic colonies, further amplifying systemic inflammation. Furthermore, interventions targeting the oral microbiome mitigated murine cGVHD. Collectively, our findings highlight the importance of oral dysbiosis in cGVHD and suggest that modulation of the oral microbiome during transplantation may be an effective approach for preventing or treating cGVHD. No potential conflict of interest relevant to this article was reported.

Springer Science and Business Media LLC Acta Medica Okayama 2047-0525 13 1 2024 Sensitivity and specificity of the question “do you have any concerns regarding your mouth related to undergoing surgery?” for predicting perioperative oral health problems in patients with primary esophageal and lung cancer: a retrospective observational study 36 EN Aiko Yoshitomi Division of Hospital Dentistry, Okayama University Hospital Yoshihiko Soga Division of Hospital Dentistry, Okayama University Hospital Reiko Yamanaka-Kohno Division of Hospital Dentistry, Okayama University Hospital Hiroshi Morimatsu Perioperative Management Center, Okayama University Hospital Background Perioperative oral management contributes to the prevention of dental/systemic complications. However, a professional dental checkup before surgery is generally not performed and relies on the patient’s answer to a simple question by medical professionals other than dentists: “Do you have any concerns regarding your mouth related to undergoing surgery?” Here, we evaluated the sensitivity and specificity of this question for predicting perioperative oral health problems in patients with primary esophageal and primary lung cancer. Methods We performed an oral cavity check in all patients before scheduled surgery for primary esophageal and lung cancer. A total of 183 patients were enrolled (M, 112; F, 71; 24–88 years, median, 69 years), consisting of 61 with primary esophageal cancer (M, 46; F, 15; 24–85 years, median, 69 years) and 122 with primary lung cancer (M, 66; F; 56; 33–88 years, median, 69 years). All subjects provided a response to this question, and an oral cavity check was performed by dentists. The sensitivity and specificity of this question for detecting oral health problems were evaluated retrospectively. Results Overall sensitivity and specificity for detecting oral health problems were 0.263 and 0.898, respectively. There were no significant differences by sex or disease (primary esophageal or lung cancer). Conclusion This simple question has low sensitivity but high specificity for detecting oral health problems. Although challenging to detect surgical patients with oral health problems by simply asking questions, the results indicated that patients with oral complaints are more likely to have problems during surgery. No potential conflict of interest relevant to this article was reported.

日本口腔内科学会 Acta Medica Okayama 2186-6147 28 2 2022 「MASCC/ISOO 口腔粘膜障害のマネジメントに関する臨床ガイドライン（2019-2020改訂版）」公式日本語訳概要の解釈について 41 49 EN Yoshihiko SOGA Division of Hospital Dentistry, Okayama University Hospital がん治療における化学療法、口腔を照射野に含む放射線療法、および造血幹細胞移植では、有害事象として口腔粘膜障害がしばしば発生する。がん支持療法の国際学会であるMultinational Association of Supportive Care in Cancer および International Society for Oral Oncology (MASCC/ISOO)は、システマティックレビューの手法により、2019年から2020年にかけて、「MASCC/ISOO 口腔粘膜障害のマネジメントに関する臨床ガイドライン」の改訂版を発表した。さらに、総括の概要について、日本語の公式翻訳版も発表された。しかし、国際的なガイドラインであるが故に、日本での非承認薬あるいは適応外使用について言及されている内容が多い。また、総括の概要で、原文に由来する意図が伝わりにくい箇所がある。本稿では、改訂されたガイドラインの内容について紹介するとともに、上述した問題点を念頭に、ガイドラインの総括の概要に記載された内容について詳述した。 No potential conflict of interest relevant to this article was reported.

Springer Science and Business Media LLC Acta Medica Okayama 0015-5632 63 5 2018 Unusual oral mucosal microbiota after hematopoietic cell transplantation with glycopeptide antibiotics: potential association with pathophysiology of oral mucositis 587 597 EN Misato Muro Division of Hospital Dentistry, Okayama University Hospital Yoshihiko Soga Division of Hospital Dentistry, Okayama University Hospital Tomoko Higuchi Division of Hospital Dentistry, Okayama University Hospital Kota Kataoka Department of Preventive Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Daisuke Ekuni Department of Preventive Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Yoshinobu Maeda Department of Hematology, Oncology and Respiratory Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Manabu Morita Department of Preventive Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Severe oral mucositis occurs frequently in patients receiving hematopoietic stem cell transplantation (HCT). Oral mucosal bacteria can be associated with progression of oral mucositis, and systemic infection may occur via ulcerative oral mucositis. However, little information is available regarding the oral microbiota after HCT. Here, PCR-denaturing gradient gel electrophoresis (DGGE) was performed to characterize the oral mucosal microbiota, which can be affected by antibiotics, before and after HCT. Sixty reduced-intensity HCT patients were enrolled. Three patients with the least antibiotic use (quinolone prophylaxis and/or β-lactam monotherapy group) and three patients with the most antibiotic use (β-lactam-glycopeptide combination therapy group) were selected. Bacterial DNA samples obtained from the oral mucosa before and after HCT were subjected to PCR-DGGE. The trajectory of oral mucositis was evaluated. The oral mucosal microbiota in the β-lactam-glycopeptide combination therapy group was different from that in the quinolone prophylaxis and/or β-lactam monotherapy group, and Staphylococcus spp. and Enterococcus spp. were identified. Lautropia mirabilis was dominant in one patient. Ulcerative oral mucositis was observed only in the β-lactam-glycopeptide combination therapy group. In conclusion, especially with the use of strong antibiotics, such as glycopeptides, the oral mucosal microbiota differed completely from that under normal conditions, and consisted of Staphylococcus spp., Enterococcus spp., and unexpectedly L. mirabilis. The normal oral microbiota consists not only of bacteria, but these unexpected bacteria could be involved in the pathophysiology as well as systemic infection via oral mucositis. Our results can be used as the basis for future studies in larger patient populations. No potential conflict of interest relevant to this article was reported.

Springer Science and Business Media LLC Acta Medica Okayama 2196-3002 6 2 2019 Recent Changes and Improvements in Multidisciplinary Perioperative Management From a Nutritional Perspective: Dental Specialty Should Be Considered Important 70 75 EN Yoshihiko Soga Divison of Hospital Dentistry, Okayama University Hospital Yasuhiro Shirakawa Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Toshiyoshi Fujiwara Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Takako Ashiwa Division of Nursing, Okayama University Hospital Hiroshi Morimatsu Perioperative Management Center, Okayama University Hospital, Purpose of review Recently, multidisciplinary strategies on accelerated recovery postoperatively have been provided, and management of the perioperative period has changed and improved dramatically. We summarize the enhanced recovery after surgery (ERAS®) protocol and its outcomes from a nutritional perspective. We established the perioperative management center (PERiO), much of whose work contents conform to ERAS®, but intensive dental staff involvement is characteristic. We also summarize its outcomes. Recent findings ERAS® is a multimodal perioperative care pathway designed to achieve early recovery for patients undergoing a major surgery. Nutrition is a key pillar for patient-care. Throughout the perioperative period, oral nutrition is suggested as well as possible. Good outcomes have been reported by a meta-analysis of randomized controlled trials. However, dental staff are not regarded as part of the professional team. PERiO reported good outcomes of care bundles and suggested the importance of dental staff contribution. The Japanese social insurance system began to cover involvements of dental staff for perioperative oral management since 2012. Analysis of the nationwide administrative claims database in Japan concluded that preoperative oral care by a dentist significantly reduced postoperative complications in patients undergoing cancer surgery. Summary Currently, dental staff are not regarded as key professionals of ERAS®, although dental staff can contribute to good outcomes in the perioperative period and PERiO, and consequently the Japanese universal health insurance coverage system covering involvements of dental staff for perioperative oral management showed good outcomes. Therefore, further clinical studies involving the dental specialty should be considered important for perioperative management from nutritional perspectives. No potential conflict of interest relevant to this article was reported.

Wiley Acta Medica Okayama 0022-3492 79 1 2008 Appearance of Multidrug-Resistant Opportunistic Bacteria on the Gingiva During Leukemia Treatment 181 186 EN Yoshihiko Soga Department of Pathophysiology – Periodontal Science, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Takashi Saito Department of Hematology, Oncology and Respiratory Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Fusanori Nishimura Department of Pathophysiology – Periodontal Science, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Fumihiko Ishimaru Department of Hematology, Oncology and Respiratory Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Junji Mineshiba Department of Pathophysiology – Periodontal Science, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Fumi Mineshiba Department of Pathophysiology – Periodontal Science, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Hirokazu Takaya Department of Pathophysiology – Periodontal Science, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Hideaki Sato Department of Pathophysiology – Periodontal Science, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Chieko Kudo Department of Pathophysiology – Periodontal Science, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Susumu Kokeguchi Department of Global Health and Environmental Sciences – Oral Microbiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Nobuharu Fujii Department of Hematology, Oncology and Respiratory Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Mitsune Tanimoto Department of Hematology, Oncology and Respiratory Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Shogo Takashiba Department of Pathophysiology – Periodontal Science, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Background: Dentists generally recognize the importance of periodontal treatment inpatients with leukemia, with the most attention paid to preventing the development of odontogenic infection. For physicians, the worst type of infection is one caused by multidrug-resistant bacteria. Here, we report a patient with an abnormal increase in multidrug-resistant opportunistic bacteria in the gingiva during hematopoietic cell transplantation (HCT). Methods: A 53-year-old woman receiving HCT for leukemia had an insufficient blood cell count for invasive periodontal treatment before HCT. Even brushing caused difficulties with hemostasis. Therefore, frequent pocket irrigation and local minocycline administration were performed. Results: The multidrug-resistant opportunistic bacterium Stenotrophomonas maltophilia was detected first in phlegm 2 days before HCT, and it was detected in a gingival smear and a blood sample 7 and I I days after HCT, respectively. The patient developed sepsis on day I I and died 14 days after HCT. Frequent irrigation and local antibiotic application were ineffective against S. maltophilia on the gingiva. Inflammatory gingiva without scaling and root planing showed bleeding tendency, and this interfered with the eradication of this bacterium. Conclusions: The gingiva in patients undergoing leukemia treatment acts as sites of proliferation and reservoirs for multidrug-resistant opportunistic bacteria. Severe systemic infection by multidrug-resistant bacteria in such patients with leukemia also may involve the gingiva. To prevent abnormal increases in such bacteria on the gingiva, scaling and/or root planing before chemotherapy, which reduces bleeding on brushing during the neutropenic period caused by chemotherapy, may contribute to infection control in such patients, although it was impossible in this case. No potential conflict of interest relevant to this article was reported.

the Allergy and Immunology Society of Thailand Acta Medica Okayama 0125-877X 31 4 2013 Cytokine expression in human dermal fibroblasts stimulated with eosinophil cationic protein measured by protein array 271 276 EN Takamaro Sato Yoshihiko Soga Tomoko Yamaguchi Michio Meguro Hiroshi Maeda Joji Tada Takayuki Otani Masaharu Seno Shogo Takashiba [Background] : Eosinophil cationic protein (ECP) was reported previously to be involved in allergic inflammation with cytotoxic activity. On the other hand, recent studies showed that ECP did not induce cell death but inhibited the growth of cancer-derived cells. Our previous study indicated that human ECP enhanced differentiation of rat neonatal cardiomyocytes and stress fiber formation in Balb/c 3T3 mouse fibroblasts, while the effects of human ECP on human fibroblasts are unknown. [Objective] : The present study was performed to determine the effects of human ECP on cytokine expression in human fibroblasts by protein array. [Methods] : The effects of recombinant human ECP (rhECP) on normal human dermal fibroblasts (NHDF) were examined by assaying cell growth. Furthermore, cytokine expression of NHDF stimulated by ECP, which could influence cell growth, was evaluated by protein array. [Results] : ECP was not cytotoxic but enhanced the growth of NHDF. The peak rhECP concentration that enhanced the cell counts by 1.56-fold was 100 ng/mL, which was significantly different from cultures without ECP stimulation (ANOVA/Scheffe’s test, P < 0.05). Array analyses indicated that ciliary neurotrophic factor (CNTF), neutrophilactivating peptide (NAP)-2, and neurotrophin (NT)-3 were significantly upregulated in NHDF stimulated with 100 ng/mL ECP compared to those without stimulation. [Conclusion] : ECP is not cytotoxic but enhances the growth of NHDF. CNTF, NAP-2, and NT-3 were suggested to be involved in enhancing the growth of NHDF. These findings will contribute to determination of the role of ECP in allergic inflammation. (Asian Pac J Allergy Immunol 2013;31:271-6) No potential conflict of interest relevant to this article was reported.

Springer-Verlag Acta Medica Okayama 0941-4355 21 2 2013 Antibiotic sensitivity of bacteria on the oral mucosa after hematopoietic cell transplantation 367 368 EN Yoshihiko Soga Yoshinobu Maeda Mitsune Tanimoto Takayuki Ebinuma Hiroshi Maeda Shogo Takashiba No potential conflict of interest relevant to this article was reported.

The Japanese Society of Internal Medicine Acta Medica Okayama 0918-2918 54 14 2015 Detection of Identical Isolates of Enterococcus faecalis from the Blood and Oral Mucosa in a Patient with Infective Endocarditis 1809 1814 EN Akemi Okui Yoshihiko Soga Susumu Kokeguchi Motoko Nose Reiko Yamanaka Nobuchika Kusano Manabu Morita The detection of infective endocarditis (IE) of oral origin has been previously discussed. However, there are few reports confirming this infection using molecular biological techniques. We herein describe the case of a 67-year-old man who developed IE. Blood culture samples and strains obtained from the gingival and buccal mucosa showed 100% identity to Enterococcus faecalis JCM 5803 on sequencing of 16S rRNA gene fragments. A random amplification of polymorphic DNA (RAPD) analysis showed the same pattern for these samples, thus confirming the identity of E. faecalis isolates in the blood and oral mucosa. Our observations provide novel information regarding the level of identity between IE pathogens and oral bacteria. No potential conflict of interest relevant to this article was reported.

Springer Berlin Heidelberg Acta Medica Okayama 0941-4355 22 6 2014 Distribution of oral mucosal bacteria with mecA in patients undergoing hematopoietic cell transplantation 1679 1683 EN Takayuki Ebinuma Yoshihiko Soga Takamaro Sato Kazuyuki Matsunaga Chieko Kudo Hiroshi Maeda Yoshinobu Maeda Mitsune Tanimoto Shogo Takashiba [Purpose] We recently reported frequent detection of antibiotic-resistant bacteria on the oral mucosa during the period of hematopoietic cell transplantation (HCT) and suggested an association between oral mucositis and antibiotic-resistant bacterial infection. Methicillin-resistant Staphylococcus spp. were frequently detected, and the oral cavity may be a reservoir of the gene mediating methicillin resistance, mecA. Here, we examined the frequency of mecA carriers in patients undergoing HCT. [Methods] Fifty-nine patients (male (M) = 37, female (F) = 22, 47.3 ± 11.0 years) receiving HCT were enrolled in this study. Buccal swab samples were obtained four times from day －7 to day +20 (once/week), and mecA was detected by PCR. Fifty-two subjects without systemic disease, who completed dental treatment, especially periodontal treatment (M = 21, F = 31, 55.4 ± 14.2 years), were also enrolled as controls and checked for mecA on the oral mucosa. [Results] Seventy-six percent (45/59) of the HCT patients carried mecA at least once in the study period (days －7 to +20), while no control subjects had mecA. The frequency of mecA carriers was 19.2 % from days －7 to －1, while it was significantly increased on days +7 to +13 and +14 to +20, with frequencies of 60.9 and 63.2 %, respectively (P < 0.01, ANOVA). [Conclusions] mecA was detected in oral mucosa of patients undergoing HCT. The high detection frequency of staphylococci resistant to penicillin and beta-lactams in our recent report was supported. No potential conflict of interest relevant to this article was reported.

Okayama University Medical School Acta Medica Okayama 0386-300X 68 6 2014 Management of Lacerated and Swollen Tongue after Convulsive Seizure with a Mouth Protector: Interprofessional Collaboration Including Dentists in Intensive Care 375 378 EN Reiko Yamanaka Yoshihiko Soga Yoshie Moriya Akemi Okui Tetsuo Takeuchi Kenji Sato Hiroshi Morimatsu Manabu Morita Case Report 10.18926/AMO/53027 We encountered a 74-year-old male patient with tongue laceration after convulsive seizures under intensive care. The tongue showed severe swelling, and the right ventral surface had been lacerated by his isolated and pointed right lower canine. Our university hospital has established a perioperative management center, and is promoting interprofessional collaboration, including dentists, in perioperative management. Dentists collaborating in the perioperative management center took dental impressions, with the support of anesthesiologists who opened the patientʼs jaw under propofol sedation, to produce a mouth protector. By raising the patientʼs bite, the completed mouth protector prevented the isolated tooth from contacting the tongue and protected the lacerated wound. Use of the mouth protector prevented the lacerated tongue from coming into contact with the pointed tooth, and the tongue healed gradually. These findings underscore that interprofessional collaboration including dentists can improve the quality of medical care. No potential conflict of interest relevant to this article was reported.

ヒョーロン・パブリッシャーズ Acta Medica Okayama 0289-0909 72 6 2012 文献と臨床の橋わたし　がん化学療法を受けている患者に対する口腔内管理の意義 147 149 EN No potential conflict of interest relevant to this article was reported.

ヒョーロン・パブリッシャーズ Acta Medica Okayama 0289-0909 73 5 2013 もし、周術期口腔機能管理の依頼があったら?　周術期医療に歯科の専門性はどう役立つか? 154 157 EN No potential conflict of interest relevant to this article was reported.

クインテッセンス出版 Acta Medica Okayama 0911-9574 34 11 2010 医療の"いま"を伝える　周術期における医科-歯科連携　病院医療への歯科衛生士の参画 70 74 EN No potential conflict of interest relevant to this article was reported.

医学出版 Acta Medica Okayama 2 13 2010 特集糖尿病第6の合併症：歯周病歯周病と糖尿病の相互作用のメカニズム 33 42 EN No potential conflict of interest relevant to this article was reported.

岡山歯学会 Acta Medica Okayama 0913-3941 32 2 2013 岡山大学病院歯科系診療科等が医科系診療科等から受けた院内紹介とそれに対する初動対応　―平成22年度と23年度を対象とした実態調査― 57 63 EN Reiko Yamanaka Emiko Udaka Aiko Yoshitomi Eriko Matsumoto Yoshihiko Soga Manabu Morita No potential conflict of interest relevant to this article was reported.

Acta Medica Okayama 1618-1247 100 2 2012 Histological and immunohistochemical features of gingival enlargement in a patient with AML 254 257 EN Norihiro Sonoi Yoshihiko Soga Hiroshi Maeda Koichi Ichimura Tadashi Yoshino Kazutoshi Aoyama Nobuharu Fujii Yoshinobu Maeda Mitsune Tanimoto Richard Logan Judith Raber-Durlacher Shogo Takashiba Here, we discuss the pathophysiology of leukemia-associated gingival enlargement based on a case of acute myelomonocytic leukemia (AML-M4) with typical gingival enlargement. Uniquely, this patient was well enough to allow full periodontal examination and incisional gingival biopsy to be performed both before and after chemotherapy. The patient was a 39-year-old Japanese woman with AML-M4 showing gingival enlargement. Histological and immunohistochemical features of gingiva and bacterial counts in the periodontal pockets were examined before and after chemotherapy. The results were as follows: (1) infiltration of myelomonocytic blasts in enlarged gingiva; (2) resolution of gingival enlargement with complete remission of AML by anticancer chemotherapy; and (3) the numbers of bacteria in the periodontal pockets were not high and were not altered before or after chemotherapy. In patients with AML-M4, remarkable mucosal enlargement is not generally observed in the body except in the gingiva. We hypothesized that antigens derived from periodontal bacteria, even if they are not present in large numbers, could act as chemoattractants for myelomonocytic leukemic cells. No potential conflict of interest relevant to this article was reported.

電通サドラー・アンド・ヘネシー株式会社 Acta Medica Okayama 20 2010 移植後合併症の看護ポイント─GVHD③ 口腔GVHD 2 3 EN No potential conflict of interest relevant to this article was reported.

岡山歯学会 Acta Medica Okayama 0913-3941 28 1 2009 岡山大学病院周術期管理センター(歯科部門)設立後5ヵ月間の活動内容および今後の展開 37 42 EN Reiko Yamanaka Yoshihiko Soga Kumiko Nawachi Yoshinobu Yanagi Naoki Kodama Takashi Nakata Rumi Miura Misao Hagawa Tetsuo Takeuchi Mieko Yamane Manabu Morita Shogo Takashiba Jun-ichi Asami Shogo Minagi Masahiro Yoshiyama Tsutomu Shimono Takuo Kuboki Akira Sasaki Kiyoshi Morita No potential conflict of interest relevant to this article was reported.

岡山歯学会 Acta Medica Okayama 0913-3941 31 2 2012 岡山大学病院歯科系診療科等が医科系診療科等から受けた院内紹介とそれに対する初動対応 ― 平成22年度を対象とした実態調査― 67 71 EN Yoshihiko Soga Emiko Kurashige Reiko Yamanaka Aiko Yoshitomi Manabu Morita No potential conflict of interest relevant to this article was reported.

Acta Medica Okayama 0941-4355 19 7 2011 Bacterial substitution of coagulase-negative staphylococci for streptococci on the oral mucosa after hematopoietic cell transplantation 995 1000 EN Yoshihiko Soga Yoshinobu Maeda Fumihiko Ishimaru Mitsune Tanimoto Hiroshi Maeda Fusanori Nishimura Shogo Takashiba Coagulase-negative staphylococci (CoNS) are frequently isolated from blood cultures of hematopoietic cell transplantation (HCT) patients. Generally, the use of central venous catheters is recognized as a significant risk factor for CoNS infection, while the impact of CoNS infection from oral ulcerative mucositis, which occurs frequently in HCT, may be underestimated. Here, we examined the bacteria on the buccal mucosa after HCT. Sixty-one patients were examined for bacteria on the buccal mucosa routinely once a week from 1 week before to 3 weeks after allogeneic HCT. Subjects were divided into groups with short and long periods of antibiotic use, and differences in bacterial substitution were evaluated. The relationships between type of HCT (conventional HCT or RIST) and bacterial substitution were also evaluated. The changes in detection frequencies of CoNS and alpha-streptococci from before to 3 weeks after HCT were significant (P < 0.05, chi (2) test): 14.5-53.3% and 92.7-53.1%, respectively. Significant bacterial substitution of CoNS for streptococci was observed in the long-term antibiotic use group (P < 0.05, chi (2) test), but also occurred in cases with short-term or no antibiotic use. No relationships between type of HCT (conventional HCT or RIST) were observed. Bacterial substitution of CoNS for streptococci occurred frequently on the buccal mucosa after HCT. In addition to antibiotic use, environmental factors may be involved in bacterial substitution. It is important to consider the presence of oral mucositis in CoNS infection after HCT. No potential conflict of interest relevant to this article was reported.

Acta Medica Okayama 0941-4355 18 3 2010 Total bacterial counts on oral mucosa after using a commercial saliva substitute in patients undergoing hematopoietic cell transplantation 395 398 EN Yuko Sugiura Yoshihiko Soga Kokoro Yamabe Soichiro Tsutani Ichiro Tanimoto Hiroshi Maeda Susumu Kokeguchi Nobuharu Fujii Fumihiko Ishimaru Mitsune Tanimoto Fusanori Nishimura Shogo Takashiba The commercial saliva substitute OralbalanceA (R) has been reported to alleviate symptoms of postradiotherapy xerostomia in head and neck cancer patients. OralbalanceA (R) may also be effective for xerostomia in patients undergoing hematopoietic cell transplantation (HCT) with high-dose chemotherapy and total-body irradiation. However, HCT patients are in a severely compromised condition, and saliva substitute must not promote infection. We reported previously that OralbalanceA (R) has antimicrobial effects against microbial species detected during HCT in vitro. This study was performed to determine the in vivo effects of OralbalanceA (R) on oral mucosal total bacterial counts in patients undergoing HCT. A total of 18 neutropenic patients undergoing HCT were enrolled in this study. Before and after 1 week of OralbalanceA (R) use, bacterial samples were obtained from patients by wiping an area of I center dot 1 cm on the buccal mucosa with sterilized cotton swabs. Total bacterial counts of the obtained samples were examined by quantitative polymerase chain reaction amplification of the bacterial 16S ribosomal RNA gene. As controls, bacterial samples were also obtained from ten healthy subjects, and total bacterial counts were examined. No significant increase in bacterial count was observed with use of OralbalanceA (R). None of the patients showed bacterial counts above the range found in healthy controls after using OralbalanceA (R). In neutropenic patients undergoing HCT, OralbalanceA (R) did not increase the total counts of oral mucosal bacteria beyond the range found in healthy controls. Oral care using OralbalanceA (R) may alleviate the symptoms induced by hyposalivation without promoting infection. No potential conflict of interest relevant to this article was reported.

Acta Medica Okayama 0941-4355 18 1 2010 Oral mucositis in patients receiving reduced-intensity regimens for allogeneic hematopoietic cell transplantation: comparison with conventional regimen 115 119 EN Kanayo Takahashi Yoshihiko Soga Yumeno Murayama Mika Udagawa Hitomi Nishimoto Yuko Sugiura Yoshinobu Maeda Mitsune Tanimoto Shogo Takashiba Severe oral mucositis induced by allogeneic hematopoietic cell transplantation (HCT) is associated with intolerable pain and risk of systemic bacteremia infection. Differences between conventional HCT and reduced-intensity regimens for allogeneic HCT (RIST) may influence the occurrence and severity of oral mucositis. Here, we evaluated oral mucositis in patients undergoing RIST and compared the results with those in conventional allogeneic HCT patients to facilitate predictive measures for mucositis. A total of 127 consecutive patients undergoing HCT (conventional, 63; RIST, 64) were included in this study. Severity of oral mucositis during HCT period was evaluated daily. Differences in severity of mucositis among HCT types were analyzed. Use of morphine to control pain due to oral mucositis was evaluated in each HCT method. The severity of oral mucositis was reduced in patients undergoing RIST. Worsening of oral mucositis was delayed in patients receiving RIST. Use of morphine to control pain due to oral mucositis was significantly decreased in patients undergoing RIST compared with those receiving conventional allogeneic HCT. The severity of oral mucositis was reduced and the peak day of oral mucositis was delayed in RIST patients compared with those receiving conventional HCT. No potential conflict of interest relevant to this article was reported.

Acta Medica Okayama 0941-4355 17 5 2009 Febrile neutropenia and periodontitis: lessons from a case periodontal treatment in the intervals between chemotherapy cycles for leukemia reduced febrile neutropenia 581 587 EN Yoshihiko Soga Yoshiko Yamasuji Chieko Kudo Kaori Matsuura-Yoshimoto Kokoro Yamabe Yuko Sugiura Yoshinobu Maeda Fumihiko Ishimaru Mitsune Tanimoto Fusanori Nishimura Shogo Takashiba Oral and systemic infections arising from the oral cavity are significant problems in clinical management of patients undergoing leukemia treatment. However, there is significant disparity in the reported incidences of development of periodontal infections. Evidence is limited to those showing the systemic influence of periodontal infection in neutropenic patients. This study indicated an association between febrile neutropenia (FN) and periodontitis in a case in which periodontal treatment in the intervals between chemotherapy cycles reduced FN in subsequent courses of chemotherapy and hematopoietic transplantation (HCT). Periodontal treatment was performed in a 61-year-old man with advanced periodontitis, who received HCT following three cycles of chemotherapy. After recovery from neutropenia induced by initial chemotherapy, periodontal treatment was performed in each chemotherapy interval period. Following extraction of teeth with severe advanced periodontitis, all teeth were subjected to periodontal pocket curettage and root planning, which are common periodontal treatments to reduce periodontal pockets harboring anaerobic periodontal bacteria, before HCT. Periodontal treatment successfully reduced periodontal pockets from 4.1 +/- 1.5 mm to 3.0 +/- 0.6 mm, which was almost within the healthy range (< 3.0 mm), before HCT. The frequency of FN decreased significantly with increasing cycles of chemotherapy, and decreases in FN corresponded to progress of periodontal treatment. Blood cultures obtained a total of 12 times throughout leukemia treatment were all negative. The observations reported here indicate the importance of periodontal treatment in clinical management of patients undergoing leukemia treatment to prevent FN, although all blood cultures were negative. No potential conflict of interest relevant to this article was reported.

Acta Medica Okayama 1340-7988 19 3 2012 気管挿管における口腔内偶発症防止対策の必要性 431 432 EN No potential conflict of interest relevant to this article was reported.

Acta Medica Okayama 0941-4355 16 10 2008 Evaluation of xerostomia in hematopoietic cell transplantation by a simple capacitance method device 1197 1200 EN Yuko Sugiura Yoshihiko Soga Sachiko Nishide Kotoe Kono Kanayo Takahashi Nobuharu Fujii Fumihiko Ishimaru Mitsune Tanimoto Fusanori Nishimura Shogo Takashiba Goals Hematopoietic cell transplantation (HCT) may lead to the development of xerostomia. However, there have been few reports of xerostomia in HCT patients based on objective data. We investigated moisture in the oral mucosa in patients undergoing HCT by the capacitance method using a convenient device, Moisture Checker for Mucus (R) (MCM; Life Co., Ltd., Saitama, Japan). Subjects and methods Thirty-six patients undergoing HCT at Okayama University Hospital of Medicine and Dentistry (Male=22, Female=14; age=41.6 +/- 16.2 years old) were enrolled in this study. Moisture in the oral mucosa was measured by MCM in accordance with the manufacturer's instructions. The results were obtained as MCM values (%), which are the weight percentage of water content in the oral mucosal epithelium. As controls, moisture of the oral mucosa was also examined in healthy volunteers (Male=27, Female=35; age=43.0 +/- 14.6 years old). Main results Throughout the examination period, MCM values were significantly lower in patients who underwent HCT than in controls. The degree of mucosal moisture in HCT patients showed wide interindividual differences. Conclusion The degree of mucosal moisture in HCT patients was low and showed wide interindividual differences. Evaluation of xerostomia using such a device may contribute to appropriate oral care with saliva substitute. No potential conflict of interest relevant to this article was reported.

Acta Medica Okayama 0941-4355 19 2 2011 Progress of oral care and reduction of oral mucositis-a pilot study in a hematopoietic stem cell transplantation ward 303 307 EN Yoshihiko Soga Yuko Sugiura Kanayo Takahashi Hitomi Nishimoto Yoshinobu Maeda Mitsune Tanimoto Shogo Takashiba Oral mucositis is a common symptomatic complication associated with hematopoietic stem cell transplantation (HCT). We use simple strategies aimed to reduce oral mucositis by keeping the oral cavity clean and moist. Here, we report on the progress of oral care and the changes in the degree of oral mucositis. The purpose of this pilot study is to evaluate the effects of our strategies on the prevalence and the severity of oral mucositis. Fifty-three consecutive patients from 2003 to 2006 administered with conventional allogeneic HCT were enrolled in this study. The degree of oral mucositis was evaluated daily in all patients. Our oral care program was divided into two periods: "examination and trial period (2003 and 2004)" and "intensive oral care period (2005 and 2006)." In the latter, an oral care regimen was carried out systematically by a multidisciplinary team. Using our oral care strategies, the prevalence of ulcerative oral mucositis was decreased significantly. The rate was reduced from 76% (10 of 13) of patients with ulcerative oral mucositis in 2003 to only 20% (3 of 15) in 2006. Our pilot study suggests that oral mucositis in HCT patients can be alleviated by simple strategies aimed at keeping the oral cavity clean and moist. No potential conflict of interest relevant to this article was reported.

Acta Medica Okayama 0941-4355 16 4 2008 Antimicrobial effects of the saliva substitute, Oralbalance (R), against microorganisms from oral mucosa in the hematopoietic cell transplantation period 421 424 EN Yuko Sugiura Yoshihiko Soga Ichiro Tanimoto Susumu Kokeguchi Sachiko Nishide Kotoe Kono Kanayo Takahashi Nobuharu Fujii Fumihiko Ishimaru Mitsune Tanimoto Kokoro Yamabe Soichiro Tsutani Fusanori Nishimura Shogo Takashiba Goals The commercially available saliva substitute Oralbalance (R) has been reported to alleviate symptoms of post-radiotherapy xerostomia in head and neck cancer patients. Oralbalance (R) may also be effective for xerostomia in patients undergoing hematopoietic cell transplantation (HCT) with high-dose chemotherapy and total-body irradiation. However, HCT patients are severely compromised, and saliva substitute must therefore not promote infection. This study was performed to determine the effects of Oralbalance (R) on microbial species identified during HCT. Patients and methods Microbial identification of oral mucosa was performed in 28 patients undergoing HCT. The antimicrobial effects of Oralbalance (R) against bacteria and fungi detected in the HCT period were examined in vitro. Briefly, bacteria and fungi were spread on agar plates, and 0.1g of Oralbalance (R) gel was applied (about phi 1cm). After incubation at 37 degrees C for 24h, the presence of a transparent zone of inhibition around Oralbalance (R) was observed. Main results Not only bacterial species constituting normal flora of the oral mucosa but also those not usually constituting normal flora, e.g., coagulase-negative Staphylococcus, were detected. A transparent zone was observed around Oralbalance (R) in all bacterial species examined. No transparent zone was observed for Candida albicans, but growth was inhibited in the area where Oralbalance (R) was applied. Conclusions Oralbalance (R) does not facilitate increases in microorganisms in the HCT period. Oral care with Oralbalance (R) does not promote infection in patients undergoing HCT. No potential conflict of interest relevant to this article was reported.

Acta Medica Okayama 1601-5029 9 2 2011 Discovery of a patient with strongly suspected bullous pemphigoid in a ward by oral health care providers 159 162 EN N Kanda Y Soga M Meguro A Tanabe Y Yagi Y Himuro Y Fujiwara S Takashiba N Kobayashi Objectives: Oral health care providers may discover systemic diseases incidentally from signs observed in the oral cavity. Here, we report a case in which oral health care providers in a hospital discovered a patient with strongly suspected bullous pemphigoid (BP), which is a relatively rare but important disease, in a ward. Methods: The patient was a 78-year-old Japanese woman admitted to our hospital because of severe Alzheimer's disease. We discovered recurrent ulcers in the oral mucosa and skin when performing oral care in her ward. Biopsy could not be performed safely because of involuntary biting. We performed blood tests for anti-BP180-NC16a antibody, which is autoantibody specific for BP. Results: The patient had a very high anti-BP180-NC16a antibody titre. We consulted a dermatologist regarding her clinical course and the clinical features of the oral mucosa and skin along with blood test results. BP was very strongly suspected. Discussion: In cases in which oral health care providers suspect their patients may have BP, appropriate examination and provision of information to the doctor are important. Oral health care providers should have knowledge about systemic diseases, the signs of which appear in oral cavity to avoid missing important systemic diseases. No potential conflict of interest relevant to this article was reported.

日本口腔リハビリテーション学会 Acta Medica Okayama 24 1 2011 病院医療支援を目的とした口腔の管理学および専門診療分野の必要性―周術期医療への歯科的介入を例として― 1 10 EN Yoshihiko Soga No potential conflict of interest relevant to this article was reported.

Acta Medica Okayama 2002 TNF-αおよびIL-1β遺伝子の一塩基多型の研究 -日本人歯周炎の重症化との関連性- EN No potential conflict of interest relevant to this article was reported.