Updated on 2023/10/24

写真a

 
INOUE Makoto
 
Organization
Academic Assembly Institute of Medicine and Dentistry SHIGAKU KEIRETU Professor
Faculty of Dentistry Department of Dentistry Professor
Graduate School of Medical and Dental Sciences Oral Life Science Oral Biological Science Professor
Title
Professor
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Degree

  • 博士(歯学) ( 1998.3   新潟大学 )

Research Interests

  • physiology

  • neurophysiology

  • mastication

  • oral physiology

  • dysphagia

  • swallow

Research Areas

  • Life Science / Social dentistry

  • Life Science / Clinical pharmacy

  • Life Science / Physiology

  • Life Science / Oral biological science

Research History (researchmap)

  • - 新潟大学大学院医歯学総合研究科 教授

    2008

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  • Niigata University   Graduate School of Medical and Dental Sciences

    2006 - 2008

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  • Niigata University   Medical and Dental Hospital

    2004 - 2006

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  • Niigata University   Faculty of Dentistry

    1998 - 2004

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Research History

  • Niigata University   Graduate School of Medical and Dental Sciences Oral Life Science Oral Biological Science   Professor

    2008.4

  • Niigata University   Faculty of Dentistry School of Dentistry   Professor

    2008.4

  • Niigata University   Graduate School of Medical and Dental Sciences Oral Life Science   Associate Professor

    2006.10 - 2008.3

Education

  • Niigata University   歯学研究科

    - 1998

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    Country: Japan

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  • Niigata University   Graduate School, Division of Dental Research

    - 1998

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Professional Memberships

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Studying abroad experiences

  • Umea University   Research fellow

    2004.2 - 2004.4

  • 英国レスター大学(Leicester University, UK)   研究員(Research fellow)

    1999.12 - 2001.11

 

Papers

  • Modulation of reflex responses of the anterior and posterior bellies of the digastric muscle in freely moving rats. International journal

    Titi Chotirungsan, Yuhei Tsutsui, Nobuaki Saka, Satomi Kawada, Nozomi Dewa, Taku Suzuki, Jin Magara, Takanori Tsujimura, Makoto Inoue

    Journal of oral rehabilitation   2023.6

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    BACKGROUND: Chewing and licking are primarily activated by central pattern generator (CPG) neuronal circuits in the brainstem and when activated trigger repetitive rhythmic orofacial movements such as chewing, licking and swallowing. These CPGs are reported to modulate orofacial reflex responses in functions such as chewing. OBJECTIVE: This study explored the modulation of reflex responses in the anterior and posterior bellies (ant-Dig and post-Dig, respectively) of the digastric muscle evoked by low-intensity trigeminal stimulation in conscious rats. METHODS: The ant-Dig and post-Dig reflexes were evoked by using low-intensity electrical stimulation applied to either the right or left inferior alveolar nerve. Peak-to-peak amplitudes and onset latencies were measured. RESULTS: No difference was observed between threshold and onset latency for evoking ant-Dig and post-Dig reflexes, suggesting that the latter was also evoked disynaptically. The peak-to-peak amplitude of both reflexes was significantly reduced during chewing, licking and swallowing as compared to resting period and was lowest during the jaw-closing phase of chewing and licking. Onset latency was significantly largest during the jaw-closing phase. Inhibitory level was similar between the ant-Dig and post-Dig reflex responses and between the ipsilateral and contralateral sides. CONCLUSION: These results suggest that both the ant-Dig and post-Dig reflex responses were significantly inhibited, probably due to CPG activation during feeding behaviours to maintain coordination of jaw and hyoid movements and hence ensure smooth feeding mechanics.

    DOI: 10.1111/joor.13537

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  • Atropine facilitates water-evoked swallows via central muscarinic receptors in anesthetized rats. International journal

    Yuta Nakajima, Takanori Tsujimura, Yuhei Tsutsui, Titi Chotirungsan, Satomi Kawada, Nozomi Dewa, Jin Magara, Makoto Inoue

    American journal of physiology. Gastrointestinal and liver physiology   2023.5

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    Anticholinergic medication causes impaired swallowing with hyposalivation. However, the underlying mechanisms by which these drugs modulate the swallowing reflex remain unclear. This study investigated the effects of the muscarinic acetylcholine receptor (mAChR) non-specific antagonist atropine on the initiation of swallowing. Experiments were performed on 124 urethane-anesthetized rats. A swallow was evoked by either topical laryngeal application of a small amount of distilled water (DW), saline, citric acid, or capsaicin; upper airway distention with a continuous airflow; electrical stimulation of the superior laryngeal nerve (SLN); or focal microinjection of NMDAinto the lateral region of the nucleus of the solitary tract (L-nTS). Swallows were identified by electromyographic bursts of the suprahyoid and thyrohyoid muscles. Either atropine, the peripheral mAChR antagonist methylatropine, or antagonists of mAChR subtypes M1-M5 were intravenously delivered. Atropine at a dose of 1 mg/kg increased the number of DW-evoked swallows compared with baseline and did not affect the number of swallows evoked by saline, citric acid, capsaicin, or upper airway distention. Methylatropine and M1-M5 antagonists did not significantly change the number of DW-evoked swallows. Bilateral SLN transection completely abolished DW-evoked swallows, and atropine decreased the swallowing threshold of SLN electrical stimulation. Finally, microinjection of NMDA receptor antagonist AP-5 into the L-nTS inhibited DW-evoked swallows, and atropine facilitated the initiation of swallowing evoked by NMDA microinjection into this region. These results suggest that atropine facilitates DW-evoked swallows via central mAChR actions.

    DOI: 10.1152/ajpgi.00039.2023

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  • Effects of Head and Neck Alignment and Pharyngeal Anatomy on Epiglottic Inversion During Swallowing in Dysphagic Patients. International journal

    Taku Suzuki, Haruka Hino, Jin Magara, Takanori Tsujimura, Kayoko Ito, Makoto Inoue

    Dysphagia   2023.5

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    The effects of head and neck alignment and pharyngeal anatomy on epiglottic inversion remain unclear. This study investigated the factors involved in epiglottic inversion, including head and neck alignment and pharyngeal anatomy, in patients with dysphagia. Patients with a chief complaint of dysphagia and who underwent videofluoroscopic swallowing study at our hospital from January to July 2022 were enrolled. They were divided into three groups based on the degree of epiglottic inversion as the complete-inversion (CI), partial-inversion (PI), and non-inversion group (NI) groups. Data were compared among the three groups; a total of 113 patients were analyzed. The median age was 72.0 (IQR: 62.0-76.0) years; 41 (36.3%) and 72 (63.7%) were women and men, respectively. There were in 45 (39.8%) patients in the CI, 39 (34.5%) in the PI, and 29 (25.7%) in the NI groups, respectively. Single-variable analysis revealed significant relation to epiglottic inversion of Food Intake LEVEL Scale score, penetration-aspiration score with 3-mL thin liquid bolus, epiglottic vallecula and pyriform sinus residue, hyoid position and displacement during swallowing, pharyngeal inlet angle (PIA), epiglottis to posterior pharyngeal wall distance, and body mass index. Logistic regression analysis with complete epiglottic inversion as the dependent variable revealed the X coordinate at maximum hyoid elevation position during swallowing and PIA as significant explanatory variables. These results suggest that epiglottic inversion is constrained in patients with dysphagia who have poor head and neck alignment or posture and a narrow pharyngeal cavity just before swallowing.

    DOI: 10.1007/s00455-023-10579-w

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  • 唾液分泌量の低下が咀嚼嚥下運動に与える影響

    後藤 理恵, 落合 勇人, Kulvanich Sirima, 辻村 恭憲, 真柄 仁, 竹井 亮, 高橋 肇, 井上 誠

    日本顎口腔機能学会雑誌   28 ( 2 )   78 - 79   2023.3

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    Language:Japanese   Publisher:日本顎口腔機能学会  

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  • Characteristics of medication-induced xerostomia and effect of treatment. International journal

    Kayoko Ito, Naoko Izumi, Saori Funayama, Kaname Nohno, Kouji Katsura, Noboru Kaneko, Makoto Inoue

    PloS one   18 ( 1 )   e0280224   2023

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    OBJECTIVE: Side-effects of medications cause xerostomia. There have been cases where a medication has been discontinued owing to its severe side-effects. Therefore, the xerostomia must be treated to ensure that the primary disease is managed effectively. This study analyzed the actual status of patients with medication-induced xerostomia and investigates factors associated with its improvement. METHODS: This study assessed 490 patients diagnosed with medication-induced xerostomia who had an unstimulated salivary flow of ≤0.1 mL/min and received treatment for xerostomia at a xerostomia clinic. Patient age, sex, medical history, medications used, disease duration of xerostomia, and psychological disorders were recorded. The anticholinergic burden was assessed using the Anticholinergic Cognitive Burden scale. The unstimulated salivary flow was measured by the spitting method. According to their symptoms and diagnoses, the patients were introduced to oral lubricants, instructed on how to perform massage, and prescribed Japanese herbal medicines, and sialogogues. Factors associated with the subjective improvement of xerostomia and objective changes in the salivary flow rate were recorded at six months. RESULTS: Xerostomia improved in 338 patients (75.3%). The improvement rate was significantly lower in patients with psychiatric disorders (63.6%) (P = 0.009). The improvement rate decreased as more anticholinergics were used (P = 0.018). However, xerostomia improved in approximately 60% of patients receiving three or more anticholinergics. The unstimulated salivary flow increased significantly more in patients who reported an improvement of xerostomia (0.033±0.053 mL/min) than in those who reported no improvement (0.013±0.02 mL/min) (P = 0.025). CONCLUSION: Xerostomia treatment improved oral dryness in 75.3% of patients receiving xerogenic medications in this study. If xerostomia due to side-effects of medications can be improved by treatment, it will greatly contribute to the quality of life of patients with xerogenic medications and may reduce the number of patients who discontinue medications.

    DOI: 10.1371/journal.pone.0280224

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  • 「食の支援ステーション」来訪者の介護食品ニーズに関する調査

    出羽 希, 伊藤 加代子, 坂井 遥, 落合 勇人, 秋元 幸平, 井上 誠

    日本摂食・嚥下リハビリテーション学会雑誌   26 ( 3 )   S247 - S247   2022.12

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  • 聴覚障害患者にタブレット端末を使用して摂食嚥下リハビリテーションを実施した1例

    山田 真子, 井上 誠, 辻村 恭憲, 渡邊 賢礼, 那小屋 公太, 落合 勇人

    日本摂食・嚥下リハビリテーション学会雑誌   26 ( 3 )   S263 - S263   2022.12

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  • 唾液分泌低下がパンの咀嚼嚥下動態に与える影響

    落合 勇人, 板 離子, 小貫 和佳奈, Kulvanich Sirima, 真柄 仁, 辻村 恭憲, 井上 誠

    日本摂食・嚥下リハビリテーション学会雑誌   26 ( 3 )   S161 - S161   2022.12

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  • Functional evaluation of jaw and suprahyoid muscle activities during chewing

    Anna Sasa, Sirima Kulvanich, Naohito Hao, Reiko Ita, Masahiro Watanabe, Taku Suzuki, Jin Magara, Takanori Tsujimura, Makoto Inoue

    Journal of Oral Rehabilitation   2022.9

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    Publishing type:Research paper (scientific journal)   Publisher:Wiley  

    DOI: 10.1111/joor.13373

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  • Inhibition of Water-Evoked Swallowing During Noxious Mechanical Stimulation of Tongue in Anesthetized Rats. International journal

    Takanori Tsujimura, Yuta Nakajima, Titi Chotirungsan, Satomi Kawada, Yuhei Tsutsui, Midori Yoshihara, Taku Suzuki, Kouta Nagoya, Jin Magara, Makoto Inoue

    Dysphagia   38 ( 3 )   965 - 972   2022.9

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    Dysphagia is sometimes accompanied by pain. Because orofacial structures subserve mastication and swallowing, orofacial pain might impair both functions. Tongue biting can occur not only accidentally while eating but also in some pathological conditions. However, it remains unclear whether noxious mechanical stimulation of the tongue affects swallowing. To explore this question, we evaluated the effects of lingual pinch stimulation on the initiation of swallowing evoked by distilled water (DW) infusion with a flow rate of 5.0 µL/s for 20 s into the pharyngolaryngeal region in anesthetized rats. The swallowing reflex was identified by electromyographic (EMG) bursts in the suprahyoid muscles which include the anterior belly of the digastric muscle, mylohyoid and geniohyoid muscles, and laryngeal elevation by visual inspection. The number of DW-evoked swallows during pinch stimulation was significantly smaller than that in a control condition or during pressure stimulation. The onset latency of the first swallow during pinch stimulation was significantly longer than that in the control condition. DW-evoked swallowing was almost abolished following bilateral transection of the superior laryngeal nerve (SLN) compared with the control condition, suggesting that the SLN plays a crucial role in the initiation of DW-evoked swallowing. Finally, electrophysiological data indicated that some SLN-responsive neurons in the nucleus tractus solitarii (nTS) exhibited delayed latency from a single SLN stimulation during lingual pinch stimulation. These results suggest that noxious mechanical stimulation of the tongue inhibits the initiation of swallowing and modulates neuronal activity in the nTS.

    DOI: 10.1007/s00455-022-10522-5

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  • Evaluating the effect of management on patients with oral hypofunction: A longitudinal study. International journal

    Wakana Onuki, Jin Magara, Kayoko Ito, Reiko Ita, Satomi Kawada, Yuhei Tsutsui, Yuta Nakajima, Haruka Sakai, Takanori Tsujimura, Makoto Inoue

    Gerodontology   2022.9

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    INTRODUCTION: Declining oral function may affect subsequent physical frailty in the older population. The aim of this longitudinal study was to summarise data on patients who underwent functional oral examination and evaluate the impact of management on patients with oral hypofunction (OHF). METHODS: Dental outpatients aged over 65 years at their initial visit to the Niigata University Hospital received detailed assessment of seven oral function items to diagnose oral hypofunction using diagnostic criteria defined by the Japanese Society of Gerodontology. Patients with OHF at the first assessment received management including oral health guidance for low function and dental treatment. They were re-evaluated approximately 6 months later and the two assessments were compared. According to the results of the second assessment, the patients were divided into two groups: OHF improved and OHF re-diagnosed. RESULTS: Of the 273 patients who underwent the first assessment, 86 (31.5%) were diagnosed with OHF and received management. Of those, 42 (48.8%) completed the second assessment. Comparing the first and second assessment, significant improvement was observed in oral hygiene, occlusal force, tongue-lip motor function of /pa/, mastication and swallowing. The change in values from the first assessment demonstrated a significant difference between the OHF improved and re-diagnosed groups only in occlusal force. CONCLUSION: Management for patients with OHF can contribute to the improvement of poor oral function, and an increase in occlusal force was notable in the recovery from OHF.

    DOI: 10.1111/ger.12655

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  • 唾液分泌抑制がもたらす固形食品摂取時の咀嚼嚥下運動への影響

    落合 勇人, 小貫 和佳奈, 高田 夏佳, 伊藤 加代子, 真柄 仁, 辻村 恭憲, 井上 誠

    老年歯科医学   37 ( 2 )   123 - 124   2022.9

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  • 唾液分泌抑制がもたらす固形食品摂取時の咀嚼嚥下運動への影響

    落合 勇人, 小貫 和佳奈, 高田 夏佳, 伊藤 加代子, 真柄 仁, 辻村 恭憲, 井上 誠

    日本老年歯科医学会総会・学術大会プログラム・抄録集   33回   O11 - 03   2022.6

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  • Chewing modulates the human cortical swallowing motor pathways

    Jin Magara, Wakana Onuki, Reiko Ita, Takanori Tsujimura, Makoto Inoue

    Physiology & Behavior   249   113763 - 113763   2022.5

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    Publishing type:Research paper (scientific journal)   Publisher:Elsevier BV  

    DOI: 10.1016/j.physbeh.2022.113763

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  • Impact of oral function on regaining oral intake and adjusting diet forms for acute stroke patients. International journal

    Sirima Kulvanich, Haruka Sakai, Riho Takanami, Mako Yamada, Anna Sasa, Kayoko Ito, Takanori Tsujimura, Jin Magara, Makoto Inoue

    Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association   31 ( 5 )   106401 - 106401   2022.5

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    BACKGROUND: Outcome prediction for dysphagia recovery is essential for rehabilitation treatment planning. Several studies have reported various predictors for resuming oral feeding after post-stroke dysphagia. However, evidence on oral health and function, a crucial part of feeding, has rarely been reported. Therefore, the goal of this study was to identify the oral status-related factors that could predict oral intake resumption in acute stroke patients. METHODS: 80 acute stroke patients with dysphagia were included. Clinical data, including the changes of general condition, oral and swallowing functions, were collected once a week until discharge. Patients were divided into two groups based on the outcome of the food intake level scale at discharge, and data were compared between the groups. RESULTS: 60 patients had regained complete oral intake before discharge. Multiple logistic regression showed that posterior tongue pressure could significantly predict complete oral intake recovery. Tongue pressure and modified water swallowing test score also significantly influenced diet forms. In addition, Spearman correlation analysis showed that improvement of other oral status-related factors, such as oral moisture and dentition status, also indicated the improvement of diet forms and swallowing function during the hospital stay. CONCLUSION: Tongue pressure measurement could be a useful oral status-related indicator for predicting complete oral intake and adjusting diet forms for acute stroke patients during hospitalization. Acute stroke patients should receive proper oral status evaluation and implementation to enhance functional recovery.

    DOI: 10.1016/j.jstrokecerebrovasdis.2022.106401

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  • Cause of Impairments of Bolus Transport and Epiglottis Inversion. International journal

    Taku Suzuki, Sirima Kulvanich, Takanori Tsujimura, Jin Magara, Yasushi Ohnishi, Makoto Inoue

    Dysphagia   2022.2

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    DOI: 10.1007/s00455-022-10421-9

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  • Cause of Impairments of Bolus Transport and Epiglottis Inversion

    Taku Suzuki, Sirima Kulvanich, Takanori Tsujimura, Jin Magara, Yasushi Ohnishi, Makoto Inoue

    Dysphagia   2022.2

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    Publishing type:Research paper (scientific journal)   Publisher:Springer Science and Business Media LLC  

    DOI: 10.1007/s00455-022-10421-9

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    Other Link: https://link.springer.com/article/10.1007/s00455-022-10421-9/fulltext.html

  • Functional Role of Suprahyoid Muscles in Bolus Formation During Mastication. International journal

    Anna Sasa, Sirima Kulvanich, Naohito Hao, Reiko Ita, Masahiro Watanabe, Taku Suzuki, Jin Magara, Takanori Tsujimura, Makoto Inoue

    Frontiers in physiology   13   881891 - 881891   2022

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    It still remains unclear how the suprahyoid muscles function in bolus formation during mastication. This study aimed to investigate the contributory role of the suprahyoid muscles during mastication. A total of 20 healthy young volunteers were asked to perform tongue pressure generation tasks and unilateral mastication tasks using peanuts and two different types of rice crackers. Surface electromyographic (EMG) activity of the masseter and suprahyoid muscles and mandibular kinematics were recorded. Suprahyoid activity increased with increasing tongue pressure. Masticatory duration until the first deglutition differed significantly among the different foods; the harder the food, the longer the duration. This was also the case in masseter activity per masticatory cycle. Masticatory rate and suprahyoid activity per masticatory cycle were significantly higher during soft rice cracker mastication. Masseter activity was higher on the masticatory side than on the non-masticatory side, however, there was no difference in suprahyoid activity between the sides. Suprahyoid activity and jaw gape showed significant positive correlation in the early stage on both the masticatory and non-masticatory sides. The suprahyoid muscles functioned dominantly for jaw-opening during peanut mastication, and for bolus formation, especially in the late stage during soft rice cracker mastication. Bolus formation was performed dominantly on the masticatory side during rice cracker mastication. These findings clearly demonstrate a functional role of the suprahyoid muscles during mastication of solid foods from assessments using both EMG activity and mandibular kinematic recordings.

    DOI: 10.3389/fphys.2022.881891

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  • 頸部食道癌再発に対する遊離空腸を用いた再建術後に認められた嚥下障害の一例

    落合 勇人, 渡邊 賢礼, 那小屋 公太, 山田 真子, 井上 誠

    日本摂食・嚥下リハビリテーション学会雑誌   25 ( 3 )   S125 - S125   2021.12

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  • 口腔乾燥がもたらす摂食嚥下運動への影響

    後藤 理恵, 落合 勇人, Kulvanich Sirima, 辻村 恭憲, 真柄 仁, 竹井 亮, 高橋 肇, 井上 誠

    日本摂食・嚥下リハビリテーション学会雑誌   25 ( 3 )   S84 - S84   2021.12

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  • 口腔機能低下症の評価および管理指導についての検討

    板 離子, 小貫 和佳奈, 真柄 仁, 辻村 恭憲, 伊藤 加代子, 那小屋 公太, 羽尾 直仁, 坂井 遥, 中嶋 優太, 井上 誠

    日本口腔リハビリテーション学会雑誌   34 ( 1 )   68 - 69   2021.12

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  • 口腔機能低下症診断のためのカットオフ値と検査項目の一考察

    小貫 和佳奈, 板 離子, 真柄 仁, 辻村 恭憲, 伊藤 加代子, 那小屋 公太, 羽尾 直仁, 坂井 遥, 中嶋 優太, 井上 誠

    日本口腔リハビリテーション学会雑誌   34 ( 1 )   68 - 68   2021.12

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  • 急性期の延髄外側症候群の嚥下障害に対し、頸部回旋を併用したバルーン単純引き抜き法を行った一例

    筒井 雄平, 真柄 仁, 小貫 和佳奈, 坂 暢晃, 坂井 遥, 井上 誠

    新潟歯学会雑誌   51 ( 2 )   89 - 94   2021.12

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    症例は75歳女性。初診より2日前に階段の昇降や嚥下の困難感を自覚、翌日に症状悪化しN病院脳神経内科へ緊急搬送、頭部MRIで右延髄背外側および右小脳半球に梗塞巣が認められた。摂食嚥下機能評価およびリハビリテーション目的に当科初診となった。2病日目に実施した摂食嚥下機能評価では、右側口唇の感覚運動不良、同側軟口蓋挙上不良および反射の消失、気息性嗄声を認め、改訂水飲みテストは3b点だった。3病日目に嚥下内視鏡検査を実施し、左側臥位・頸部右回旋にてゼリー(学会分類2013、0j)摂取が可能なことを確認して、直接訓練を開始した。4病日目より頸部回旋を併用したバルーン単純引き抜き法を開始、姿勢調整下での直接訓練を継続した。17病日目には咽頭残留量の改善を認め、また、嚥下造影検査では姿勢調整下での食塊通過、およびバルーン引き抜き時に頸部回旋側の対側への通過が確認できた。21病日目にリハビリテーション目的に転院となり、上記訓練の継続を紹介状に記載、介入終了となった。急性期の延髄外側症候群に伴う球麻痺症例において、誤嚥性肺炎の予防や早期機能回復を目標に、姿勢制御下で咽頭残留を軽減しながら安全に訓練を実施できた。またバルーン単純引き抜き法に頸部回旋を併用することで、有効な訓練効果が得られる可能性が考えられた。(著者抄録)

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  • 頸部食道癌再発に対する遊離空腸を用いた再建術後に認められた嚥下障害の一例

    落合 勇人, 渡邊 賢礼, 那小屋 公太, 山田 真子, 井上 誠

    日本摂食・嚥下リハビリテーション学会雑誌   25 ( 3 )   S125 - S125   2021.12

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  • 口腔乾燥がもたらす摂食嚥下運動への影響

    後藤 理恵, 落合 勇人, Kulvanich Sirima, 辻村 恭憲, 真柄 仁, 竹井 亮, 高橋 肇, 井上 誠

    日本摂食・嚥下リハビリテーション学会雑誌   25 ( 3 )   S84 - S84   2021.12

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  • Survey of oral hypofunction in older outpatients at a dental hospital. International journal

    Wakana Onuki, Jin Magara, Takanori Tsujimura, Kayoko Ito, Haruka Sakai, Sirima Kulvanich, Yuta Nakajima, Nobuaki Saka, Makoto Inoue

    Journal of oral rehabilitation   48 ( 10 )   1173 - 1182   2021.10

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    BACKGROUND: Oral hypofunction is defined as the reversible stage preceding oral dysfunction. However, its assessment and management need further examination and consideration. OBJECTIVE: The present study aimed to examine the current state of oral hypofunction among outpatients at the university hospital. METHODS: New outpatients underwent medical interviews and detailed assessment of oral hypofunction at their initial visit to our dental department. Oral hypofunction was diagnosed if the results of three of the following seven assessment items were below cut-off values: poor oral hygiene, oral dryness, reduced occlusal force, decreased tongue-lip motor function, decreased tongue pressure, decreased masticatory function and deterioration of swallowing function. The relationships between factors used to diagnose oral hypofunction as well as the distributions of assessment values were clarified. RESULTS: Seventy-five of 209 patients (35.9%) were finally diagnosed with oral hypofunction. Diagnosis of oral hypofunction was significantly related to patient age, Eichner index, a chief complaint of dental or periodontal disease or ill-fitting dentures and a history of neurodegenerative disease. The lowest quintile values for poor oral hygiene, oral dryness and decreased masticatory performance were all above current cut-off values. Reduced occlusal force contributed strongly to the diagnosis of oral hypofunction. CONCLUSION: Oral hypofunction in dental outpatients at a university hospital was associated with patient age, medical history and chief complaint at presentation. Diagnosis of oral hypofunction can be closely related to reduced occlusal force. The validity of cut-off values for assessments of oral hypofunction needs further consideration.

    DOI: 10.1111/joor.13237

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  • Antitussive effects of NaV 1.7 blockade in Guinea pigs. International journal

    Li Yu, Kojun Tsuji, Izumi Ujihara, Qi Liu, Nikoleta Pavelkova, Takanori Tsujimura, Makoto Inoue, Sonya Meeker, Eric Nisenbaum, Jeff S McDermott, Jeff Krajewski, Bradley J Undem, Marian Kollarik, Brendan J Canning

    European journal of pharmacology   907   174192 - 174192   2021.9

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    Our previous studies implicated the voltage-gated sodium channel subtype NaV 1.7 in the transmission of action potentials by the vagal afferent nerves regulating cough and thus identified this channel as a rational therapeutic target for antitussive therapy. But it is presently unclear whether a systemically administered small molecule inhibitor of NaV 1.7 conductance can achieve therapeutic benefit in the absence of side effects on cardiovascular function, gastrointestinal motility or respiration. To this end, we have evaluated the antitussive effects of the NaV 1.7 selective blocker Compound 801 administered systemically in awake guinea pigs or administered topically in anesthetized guinea pigs. We also evaluated the antitussive effects of ambroxol, a low affinity NaV blocker modestly selective for tetrodotoxin resistant NaV subtypes. Both Compound 801 and ambroxol dose-dependently inhibited action potential conduction in guinea pig vagus nerves (assessed by compound potential), with ambroxol nearly 100-fold less potent than the NaV 1.7 selective Compound 801 in this and other NaV 1.7-dependent guinea pig and human tissue-based assays. Both drugs also inhibited citric acid evoked coughing in awake or anesthetized guinea pigs, with potencies supportive of an NaV 1.7-dependent mechanism. Notably, however, the antitussive effects of systemically administered Compound 801 were accompanied by hypotension and respiratory depression. Given the antitussive effects of topically administered Compound 801, we speculate that the likely insurmountable side effects on blood pressure and respiratory drive associated with systemic dosing make topical formulations a viable and perhaps unavoidable therapeutic strategy for targeting NaV 1.7 in cough.

    DOI: 10.1016/j.ejphar.2021.174192

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  • Factors associated with xerostomia in perimenopausal women

    Chizuko Shinohara, Kayoko Ito, Kiyoshi Takamatsu, Mariko Ogawa, Yuka Kajii, Kaname Nohno, Aki Sugano, Saori Funayama, Akira Katakura, Takeshi Nomura, Makoto Inoue

    Journal of Obstetrics and Gynaecology Research   2021.8

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    DOI: 10.1111/jog.14963

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  • 原疾患の管理が安定後も合併症の問題により、嚥下障害の対応に難渋した皮膚筋炎の一例

    落合 勇人, 辻村 恭憲, 渡邊 賢礼, 那小屋 公太, 高波 里帆, 山田 真子, 井上 誠

    新潟歯学会雑誌   51 ( 1 )   45 - 50   2021.8

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    皮膚筋炎は自己免疫疾患のひとつであり、合併症としてしばしば嚥下障害を呈する。多くの場合は、原疾患の治癒とともに嚥下障害も改善することが報告されているが、治療が長期化し嚥下障害が遷延する報告も見受けられる。我々は、皮膚筋炎の活動性が安定後も関連する合併症等の影響により治療が難渋した症例を経験したため報告する。患者は73歳、男性。X-10年に皮膚筋炎の診断を受け、外来通院にてフォローを行っていたが再燃し、当院入院となった。四肢筋力低下、嚥下困難感を主訴に当科紹介となった。入院当初の嚥下造影検査では液体誤嚥や固形物の咽頭残留を伴う咽頭期障害が顕著であった。原疾患に対してステロイドパルス療法、低栄養改善のために経鼻経管栄養を開始した後に、少量のゼリーを用いた直接訓練を進めた。皮膚筋炎の活動性が安定した後も嚥下障害は残存し、さらに原疾患の合併症として蠕動運動障害や腸管気腫を発症したことで経管栄養の調整及び嚥下訓練は難渋した。その後、代償的嚥下法を獲得し、自宅退院後もごく少量の楽しみ程度の経口摂取が継続可能となった。皮膚筋炎では、関連する消化器や呼吸器等の合併症、低栄養が嚥下障害の予後に関連すると思われる。リハビリテーションの実施にあたっては、全身状態の変化に留意し、難治例には残存機能を生かした訓練を行う必要があることが考えられた。(著者抄録)

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  • Menopausal symptoms are associated with oral sensory complaints in perimenopausal women: an observational study. International journal

    Tomoharu Taga, Kayoko Ito, Kiyoshi Takamatsu, Mariko Ogawa, Saori Funayama, Makoto Inoue

    BMC women's health   21 ( 1 )   262 - 262   2021.6

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    BACKGROUND: Perimenopausal women experience a wide variety of systemic symptoms: hot flashes, sweating, mental health concerns and various oral sensory complaints (OSC). OSC in perimenopausal women include xerostomia, taste disturbance and burning mouth. However, the factors associated with these OSC have not been identified. The purpose of this investigation was to elucidate the factors associated with OSC in perimenopausal women. METHODS: The study cohort comprised 43 perimenopausal women aged 45-55 years. Data on medical history, medications, menstrual status, menopausal symptoms, quality of life, xerostomia, taste disturbance and burning mouth were collected. Volumes of unstimulated and stimulated saliva were measured. Tongue coating was evaluated according to a tongue coating index. Univariate analysis was performed to identify factors significantly associated with having xerostomia, taste disturbance, burning mouth and more than two OSC (2OSC). Next, the factors strongly associated with these symptoms were examined by logistic regression analysis. RESULTS: The number of menopausal symptoms was significantly higher, and volume of unstimulated saliva was significantly lower in participants with xerostomia, taste disturbance, burning mouth or 2OSC than in those without these characteristics. Agents targeting the central nervous system were more frequently taken by participants with burning mouth and 2OSC than by those without these characteristics. According to logistic regression analysis, the number of menopausal symptoms was an explanatory variable for xerostomia, taste disturbance, burning mouth and 2OSC. CONCLUSIONS: Our findings suggested that OSC associated with the number of menopausal symptoms. Management of menopausal symptoms may decrease OSC, leading to improved quality of life of perimenopausal women.

    DOI: 10.1186/s12905-021-01401-6

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  • Relationships Between Survival and Oral Status, Swallowing Function, and Oral Intake Level in Older Patients with Aspiration Pneumonia. International journal

    Taku Suzuki, Takanori Tsujimura, Jin Magara, Naohito Hao, Naru Shiraishi, Kazuya Maekawa, Kazuo Matsushima, Makoto Inoue

    Dysphagia   37 ( 3 )   558 - 566   2021.4

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    The factors affecting the survival of patients with aspiration pneumonia (AP) remain unclear. This study aimed to determine whether factors, including oral status, swallowing function, and oral intake level, were related to survival outcomes in older patients hospitalized for AP. The study enrolled patients with AP who were admitted to our hospital between February 2017 and November 2019. Patients were divided into two groups based on the 90-day mortality after the first swallowing function evaluation: survivors and deceased. The data were compared between the two groups. A total of 29 patients were diagnosed with AP. Of these patients, 13 died within 90 days. The numbers of patients who could not use removable dentures and required sputum suctioning and had cough reflex at rest were significantly higher in the deceased than in the survivors. The salivary pooling and pharyngeal clearance scores evaluated by videoendoscopy, International Dysphagia Diet Standardisation Initiative Functional Diet Scale score determined after swallowing function evaluation, and consciousness level were significantly worse in the deceased than in the survivors. There were significant differences in patients' oral status, swallowing function, oral intake level, and consciousness level between the survivors and deceased.

    DOI: 10.1007/s00455-021-10306-3

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  • 【産婦人科医も知っておきたい歯科の知識】閉経に伴う口腔愁訴とそれらに対するHRTの効果

    伊藤 加代子, 井上 誠

    産科と婦人科   88 ( 4 )   487 - 491   2021.4

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    更年期世代の女性には、のぼせや発汗などのいわゆる更年期症状のほか、口腔乾燥感、味覚異常、舌痛症、顎関節痛などの口腔に関する愁訴が多く認められ、QOLが著しく低下することが多い。口腔に愁訴がある場合、適切な診療科に紹介することにより、症状が改善する可能性がある。また、ホルモン補充療法が有効であるという報告もあるが、効果については見解の一致をみていないのが現状である。(著者抄録)

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  • A精神科病院の病棟内食堂で食事摂取可能な入院患者における誤嚥性肺炎リスクの影響要因と予防に向けた支援

    清野 由美子, 小山 諭, 井上 誠, 鈴木 拓, 吉原 翠, 渋木 瞳, 笹 杏奈, 鈴見 梨紗, 坂井 遥

    日本摂食・嚥下リハビリテーション学会雑誌   25 ( 1 )   33 - 43   2021.4

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    【目的】精神科病院の病棟内食堂で食事摂取可能な入院患者における誤嚥性肺炎リスクの影響要因を明らかにし、誤嚥性肺炎予防に向けた支援への示唆を得るために調査研究を行った。【方法】対象者は、A精神科病院入院患者約400名のうち、病棟内食堂で食事摂取可能な20歳以上85歳未満の者100名とした。対象者を誤嚥性肺炎リスク評価により高・中・低リスクに分け、その群のそれぞれの基本属性、日常生活の状況、食事摂取の状況、栄養状態(Body Mass Index:BMI、Geriatric Nutritional Risk Index:GNRI)、血液生化学所見(Total Protein:TP、Albumin:Alb、Hemoglobin:Hb、Hematocrit:Ht、White Blood Cell:WBC)を調査し、統計学的に検討した。【結果】対象者のうち、高リスク群0名、中等度リスク群24名、低リスク群76名であった。群間比較において、年齢は、中等度リスク群で有意に高値であった。BMI、GNRI、Ht、Hb、Peak Expiratory Flow:PEF、Repetitive Saliva Swallowing Test:RSSTは、中等度リスク群で有意に低値であった。Spearmanの順位相関係数では、年齢、BMI、GNRI、Alb、Ht、Hb、PEF、RSSTにおいて相関を認めた。二項ロジスティック回帰分析において、BMI、PEF、RSSTが独立変数として得られた。【結論】精神科病院の病棟内食堂で食事摂取可能な入院患者における誤嚥性肺炎リスクの影響要因は、BMI、PEF、RSSTの低下であることが示唆された。誤嚥性肺炎予防に向けた支援として、栄養状態や呼吸機能、嚥下機能の維持・改善を目指す取り組みが必要と考える。(著者抄録)

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  • Changes of bolus properties and the triggering of swallowing in healthy humans. International journal

    Izumi Kochi, Eri Takei, Rumiko Maeda, Kayoko Ito, Jin Magara, Takanori Tsujimura, Sirima Kulvanich, Makoto Inoue

    Journal of oral rehabilitation   48 ( 5 )   592 - 600   2021.1

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    There is wide variation in chewing behaviours, even among healthy humans. Further, the way in which humans determine swallowing initiation when chewing solid foods remains unclear. The current study sought to investigate how the bolus properties change over time during chewing, and to clarify which factors affect chewing and swallowing behaviours, including swallowing initiation, in healthy humans. Twenty-four healthy volunteers were instructed to chew 8 g of steamed rice and spit it out at 50%, 100% and 150% of their own chewing duration, defined as the time of chewing from onset of the first chewing cycle to onset of the first swallow. Chewing and swallowing behaviours were monitored and determined by visual inspection of video recordings. The physical properties such as hardness, cohesiveness and adhesiveness as well as water content of the bolus were measured. In each subject, maximum bite force, tongue pressure and stimulated salivary flow rate were also measured. Hardness gradually decreased, and the cohesiveness and water content of the bolus did not change up to 50% of chewing duration, followed by a slight but significant increase. The adhesiveness of the bolus rapidly decreased at the beginning of chewing. Chewing duration was significantly related to stimulated salivary flow rate; greater salivary flow rate was associated with shorter chewing duration. Variation of chewing duration and swallowing initiation was not dependent on bolus properties during the chewing of steamed rice, but mainly depended on the surface lubrication of the bolus.

    DOI: 10.1111/joor.13151

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  • Impact of Oral and Swallowing Function on the Feeding Status of Older Adults in Nursing Homes. International journal

    Sirima Kulvanich, Kayoko Ito, Eri Takei, Haruka Sakai, Risa Suzumi, Jin Magara, Takanori Tsujimura, Makoto Inoue

    Gerontology   67 ( 2 )   1 - 9   2021.1

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    BACKGROUND: To date, there have been few guidelines proposed for adjustment of the food consistency, particularly to match the oral function of older adults, which will guide clinicians and caregivers in appropriately modifying food. OBJECTIVE: We investigated how oral, swallowing, and cognitive conditions of older adults who required daily nursing care in a nursing home were associated with different dietary food consistencies. METHODS: Clinical examinations to record dentition status, swallowing, and cognitive functions were performed, and the feeding status, including the food consistencies and need for assistance at lunchtime, was evaluated in 37 older residents in nursing homes. The swallowing function was assessed by performing a modified water-swallowing test, and food swallowing was tested using pudding and rice crackers. The χ2 test was used to determine the relationships among the parameters. RESULTS: No participants were able to take cooked rice, nor regular and soft side dishes. There was no significant relationship between dentition status and feeding status. Of the participants, 95% ate pudding without any problems and 49% ate rice crackers without any signs of swallowing difficulty such as coughing or stopping chewing. There was a significant relationship between the food test score using a rice cracker and the level of food consistencies, and between the same test score and the level of mealtime assistance, whereby the better the score of the food test using a rice cracker, the better was the level of food consistencies including use of a thickening agent and the better was the level of mealtime assistance. CONCLUSION: The results strongly suggest that the food test using a rice cracker was associated with the level of food consistency and mealtime assistance for older adults in nursing homes.

    DOI: 10.1159/000511912

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  • Coordination of Respiration, Swallowing, and Chewing in Healthy Young Adults. International journal

    Naohito Hao, Anna Sasa, Sirima Kulvanich, Yuta Nakajima, Kouta Nagoya, Jin Magara, Takanori Tsujimura, Makoto Inoue

    Frontiers in physiology   12   696071 - 696071   2021

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    Examining the coordination of respiration and swallowing is important for elucidating the mechanisms underlying these functions and assessing how respiration is linked to swallowing impairment in dysphagic patients. In this study, we assessed the coordination of respiration and swallowing to clarify how voluntary swallowing is coordinated with respiration and how mastication modulates the coordination of respiration and swallowing in healthy humans. Twenty-one healthy volunteers participated in three experiments. The participants were asked to swallow 3 ml of water with or without a cue, to drink 100 ml of water using a cup without breathing between swallows, and to eat a 4-g portion of corned beef. The major coordination pattern of respiration and swallowing was expiration-swallow-expiration (EE type) while swallowing 3 ml of water either with or without a cue, swallowing 100 ml of water, and chewing. Although cueing did not affect swallowing movements, the expiratory time was lengthened with the cue. During 100-ml water swallowing, the respiratory cycle time and expiratory time immediately before swallowing were significantly shorter compared with during and after swallowing, whereas the inspiratory time did not differ throughout the recording period. During chewing, the respiratory cycle time was decreased in a time-dependent manner, probably because of metabolic demand. The coordination of the two functions is maintained not only in voluntary swallowing but also in involuntary swallowing during chewing. Understanding the mechanisms underlying respiration and swallowing is important for evaluating how coordination affects physiological swallowing in dysphagic patients.

    DOI: 10.3389/fphys.2021.696071

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  • 術後早期より摂食嚥下リハビリテーションを実施した三叉神経鞘腫の1例

    高波 里帆, 中嶋 優太, Kulvanich Sirima, 渡邊 賢礼, 那小屋 公太, 井上 誠

    新潟歯学会雑誌   50 ( 2 )   93 - 97   2020.12

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    三叉神経鞘腫とは、三叉神経根や末梢神経のシュワン細胞に発症する比較的稀な良性腫瘍の1つである。今回、三叉神経鞘腫摘出手術後に摂食嚥下障害を認めた症例を経験したのでここに報告する。症例は44歳女性。右巨大三叉神経鞘腫に対する腫瘍摘出術が施行され、術後2日目に摂食嚥下機能評価目的に当科初診となった。初診時、球麻痺症状としての顔面神経麻痺、舌の運動時の偏位や抵抗力の減弱、開鼻声を伴う左カーテン徴候、軟口蓋右側で感覚の低下や軟口蓋反射・咽頭絞扼反射の消失を認めた。反復唾液嚥下テストは1回、改訂水飲みテストは4点(嚥下後の呼吸良好、ムセなし)であり、嚥下内視鏡検査時には発声時の不完全な声門閉鎖が観察された。また、右側からの食塊口唇漏出、液体摂取時の嚥下反射惹起遅延、緩慢な咀嚼を認めた。食事再開は可能と判断し、半固形食、液体とろみ付与の食事形態で経口摂取再開とした。その後、嚥下訓練、咀嚼訓練を継続し、術後18日目の自宅退院時には食形態が軟飯・軟菜食までに回復した。退院後の術後34日目の再評価時、一部の球麻痺症状は残存したものの、反復唾液嚥下テスト5回、改訂水飲みテストは5点と改善を認めた。急性期病院においては在院日数の短縮が求められるため、本症例のように術後間もなくからの介入により退院まで円滑に摂食嚥下リハビリテーションを実施できたことが、自宅でも十分に生活できる程度の摂食嚥下機能の回復を促進し、生活の質の回復に寄与したものと考えられた。(著者抄録)

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  • 新潟大学医歯学総合病院歯科における口腔機能低下症の評価と検討

    小貫 和佳奈, 真柄 仁, 辻村 恭憲, 伊藤 加代子, 渡邊 賢礼, 那小屋 公太, 船山 さおり, 羽尾 直仁, 井上 誠

    新潟歯学会雑誌   50 ( 2 )   112 - 113   2020.12

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  • 新潟大学医歯学総合病院歯科における口腔機能低下症の患者統計

    小貫 和佳奈, 真柄 仁, 辻村 恭憲, 伊藤 加代子, 渡邊 賢礼, 那小屋 公太, 船山 さおり, 羽尾 直仁, 坂井 遥, 中嶋 優太, 井上 誠

    日本口腔リハビリテーション学会雑誌   33 ( 1 )   73 - 73   2020.12

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  • 急性期摂食嚥下障害患者の経口摂取と口腔機能との関係

    坂井 遥, 笹 杏奈, 伊藤 加代子, 井上 誠

    日本口腔リハビリテーション学会雑誌   33 ( 1 )   69 - 69   2020.12

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  • 健常若年者における呼吸と嚥下の協調

    羽尾 直仁, 笹 杏奈, 辻村 恭憲, 那小屋 公太, 中嶋 優太, 坂 暢晃, 後藤 理恵, 真柄 仁, 井上 誠

    新潟歯学会雑誌   50 ( 2 )   122 - 122   2020.12

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  • 健常者における呼吸と嚥下の協調

    羽尾 直仁, 笹 杏奈, 辻村 恭憲, 那小屋 公太, 中嶋 優太, 真柄 仁, 井上 誠

    日本口腔リハビリテーション学会雑誌   33 ( 1 )   69 - 70   2020.12

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  • Involvement of capsaicin-sensitive nerves in the initiation of swallowing evoked by carbonated water in anesthetized rats. International journal

    Kojun Tsuji, Takanori Tsujimura, Shogo Sakai, Taku Suzuki, Midori Yoshihara, Kouta Nagoya, Jin Magara, Yoshihide Satoh, Makoto Inoue

    American journal of physiology. Gastrointestinal and liver physiology   319 ( 5 )   G564-G572   2020.11

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    Capsaicin powerfully evokes the swallowing reflex and is a known therapeutic agent for improving dysphagia and preventing aspiration pneumonia. However, the role of capsaicin-sensitive nerves in the initiation of swallowing evoked by various natural stimuli remains unclear. To explore this question, we blocked laryngeal capsaicin-sensitive nerves following the coapplication of QX-314 and capsaicin (QX/Cap), and investigated the effects on swallowing evoked by mechanical and chemical stimulation in anesthetized rats. Swallows were evoked by capsaicin, carbonated water (CW), distilled water (DW), and punctate mechanical stimulation using von Frey filaments applied topically to the larynx. Swallows were documented by recording electromyographic activation of the suprahyoid and thyrohyoid muscles. The initiation of swallowing by capsaicin was strongly suppressed at 5 min following QX/Cap treatment and returned in a time-dependent manner. CW-evoked swallows at 5 min following QX/Cap treatment were significantly diminished compared with before and 30 min after treatment. In contrast, DW-evoked and mechanically evoked swallows were unchanged by QX/Cap treatment. Furthermore, CW-evoked swallows were virtually abolished by transection of the superior laryngeal nerves and significantly decreased by the topical application of acid-sensing ion channel-3 (ASIC3) inhibitor APETx2, but they were not affected by the nonselective transient receptor potential channel inhibitor ruthenium red or the ASIC1 inhibitor mambalgin-1. Taken together, we speculate that capsaicin-sensitive nerves play an important role in the initiation of CW-evoked swallows.NEW & NOTEWORTHY The initiation of swallowing evoked by laryngeal capsaicin and carbonated water application was diminished by the coapplication of QX-314 and capsaicin. Carbonated water-evoked swallows were also abolished by transection of the superior laryngeal nerves and were inhibited by the acid-sensing ion channel-3 inhibitor. Capsaicin-sensitive nerves are involved in the initiation of carbonated water-evoked swallows.

    DOI: 10.1152/ajpgi.00233.2020

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  • Age-related changes in functional adaptation to bolus characteristics during chewing. International journal

    Eri Takei, Sirima Kulvanich, Takanori Tsujimura, Jin Magara, Kayoko Ito, Ryo Takei, Hideaki Washio, Hitoshi Arao, Makoto Inoue

    Physiology & behavior   225   113102 - 113102   2020.10

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    We investigated how the physical properties of food affect chewing kinematics, and examined the effects of aging on behavior. Twenty young and 21 older volunteers were asked to freely chew rice crackers and spit the food out at their average chewing duration. We compared chewing characteristics among the conditions (age × rice cracker), and examined the area of rectified masseter and suprahyoid electromyographic bursts per chewing cycle. We also evaluated temporal changes in those values. In addition, the bolus properties at the end of chewing were compared. The harder/larger the rice cracker, the longer the chewing duration and the greater the number of chewing cycles. These values also increased with age. Chewing cycle time was not affected by age and rice cracker properties, except in one condition: for the rice cracker with the lowest hardness and density, the chewing cycle time was longer than for the other rice crackers. Chewing cycle time decreased at the middle stage of chewing, followed by an increase, with increasing suprahyoid electromyographic activity at the late stage. The physical properties of the bolus at the end of chewing did not differ between age groups, and depended on the initial properties. The water absorption rate of the bolus was significantly greater for the rice cracker with the lowest hardness and density compared with other rice crackers. The results demonstrated that not only hardness, but also other factors, such as density, significantly affected chewing behaviors.

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  • Prevalence of xerostomia with or without overactive bladder symptoms. International journal

    Kayoko Ito, Makoto Inoue, Hisae Nishii, Tetsuro Matsumoto

    Lower urinary tract symptoms   13 ( 2 )   224 - 229   2020.10

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    Overactive bladder (OAB) occurs idiopathic or secondary to a neurological cause. In addition, OAB may also occur due to xerostomia, because it causes excessive drinking of water. If xerostomia is one of the causes of OAB, treating xerostomia may be effective. This study aimed to investigate the prevalence of xerostomia with or without overactive bladder symptoms. A web-based questionnaire was administered to investigate the prevalence of xerostomia with or without overactive bladder symptoms. The survey included questions concerning age, gender, medical history, medications, OAB symptoms by the Overactive Bladder Symptom Score (OABSS), and xerostomia by the Dry Mouth Scale (DMS). From the analysis, a total of 21 (13.0%) participants were identified as having OAB. The prevalence of xerostomia was six (28.6%) in the OAB group and 14 (10.0%) in the non-OAB group. OABSS and DMS were significantly higher in the OAB group than in the non-OAB group. Urgency score and urgency incontinence score of OABSS were substantially higher in xerostomia participants than non-xerostomia participants. The adjusted odds ratio of OAB showed DMS total score, xerostomia symptoms, accompanying symptoms, and other symptoms that were all significantly associated with OAB. These results suggested that OAB subjects, even untreated subjects, had xerostomia. It may be beneficial for clinicians to perform dry mouth management in parallel with careful choice pharmacotherapy for the wellness of OAB patients.

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  • 麻酔下ラットにおけるAMPA受容体ポジティブアロステリックモジュレーターによる嚥下誘発への効果

    吉原 翠, 那小屋 公太, 辻村 恭憲, 井上 誠

    Journal of Oral Biosciences Supplement   2020   342 - 342   2020.9

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  • 慢性閉塞性肺疾患(COPD)に起因する嚥下機能低下の生理学的検証

    那小屋 公太, 辻村 恭憲, 吉原 翠, 井上 誠

    Journal of Oral Biosciences Supplement   2020   343 - 343   2020.9

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  • 麻酔下ラットにおける喉頭TRPV1持続活性化による嚥下誘発への影響

    吉原 翠, 那小屋 公太, 真柄 仁, 辻村 恭憲, 井上 誠

    日本顎口腔機能学会雑誌   26 ( 1 )   22 - 23   2020.9

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  • Sustained laryngeal transient receptor potential vanilloid 1 activation inhibits mechanically-induced swallowing in anesthetized rats. Reviewed International journal

    Midori Yoshihara, Takanori Tsujimura, Taku Suzuki, Kouta Nagoya, Naru Shiraishi, Jin Magara, Miho Terunuma, Makoto Inoue

    American journal of physiology. Gastrointestinal and liver physiology   319 ( 3 )   G412-G419   2020.8

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    A major component of gastric acid is hydrochloric acid (HCl), which can activate transient receptor potential vanilloid 1 (TRPV1). In the present study, we investigated how sustained laryngeal TRPV1 activation affects the frequency of the swallowing reflex. Experiments were carried out on 85 male Sprague-Dawley rats. The effects of short and sustained application of chemicals (3 µl of 0.1 N HCl or capsaicin) on the frequency of swallowing and of time-dependent changes in the occurrence of swallowing evoked by supralaryngeal nerve stimulation were determined. To evaluate vascular permeability of the larynx, Evans blue dye was intravenously injected after 5 or 60 min of sustained TRPV1 activation. SB366791 (a TRPV1 inhibitor) and Cap/QX-314 (a TRPV1-expressed neuronal inhibitor) significantly inhibited HCl/capsaicin-induced swallowing, but air flow-induced swallowing was not affected. Although the number of air flow-induced swallows induced by capsaicin stimulation was not affected within 5 min, but significantly reduced by 60-min capsaicin or HCl application. The swallowing threshold associated with supralaryngeal nerve stimulation did not significantly change throughout the recording period. Evans blue dye concentrations in the larynx were significantly higher at 60 min in the 10-5 M capsaicin group than in the other groups. Our results suggest that sustained TPRV1 activation not only desensitizes TRPV1, but also inactivates mechanoreceptors, which may be attributed to increases in vascular permeability and edema, as part of an inflammatory process.

    DOI: 10.1152/ajpgi.00082.2020

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  • Lasting modulation of human cortical swallowing motor pathways following thermal tongue stimulation. Reviewed International journal

    Jin Magara, Masahiro Watanabe, Takanori Tsujimura, Shaheen Hamdy, Makoto Inoue

    Neurogastroenterology and motility : the official journal of the European Gastrointestinal Motility Society   33 ( 1 )   e13938   2020.7

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    BACKGROUND: Thermal tactile oropharyngeal stimulation has been clinically used to facilitate swallowing initiation in dysphagic patients. We previously demonstrated that thermal stimulation applied to the oral cavity provokes an immediate excitability in pharyngeal motor cortex. The aim of the current study was to investigate whether thermal stimulation can produce longer lasting effects on the corticopharyngeal neural pathway. METHODS: Healthy volunteers (n = 8/12) underwent baseline pharyngeal motor evoked potential (PMEP) measurements evoked by transcranial magnetic stimulation. In the first experiment, subjects received thermal stimulation alternating 30 seconds of 15 and 36°C applied to the tongue surface for either 10 minutes, 5 minutes, or sham. In the second experiment, one of three intermittent thermal stimulus patterns was delivered: cold (alternating 30 seconds of 15 and 36°C), warm (continuous 36°C), or hot (alternating 30 seconds of 45 and 36°C) for 10 minutes. In both experiments, PMEP were remeasured every 15 minutes up to 60 minutes following thermal stimulation. KEY RESULTS: Repeated measures ANOVA for each stimulus time in the first experiment showed a significant increased change in PMEP amplitude at 30 minutes following only 10-minute stimulation compared with sham (P < .05). In the second experiment, we found that cold stimulation was more effective than the other stimulation (P < .05) at increasing PMEP amplitudes. CONCLUSIONS AND INFERENCES: Ten-minute cold stimulation on the tongue can induce a delayed (30 minutes) increase in pharyngeal cortical excitability, providing a clinically useful therapeutic window for its application in dysphagic patients.

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  • Inter-individual variation of bolus properties in triggering swallowing during chewing in healthy humans. Reviewed International journal

    Rumiko Maeda, Eri Takei, Kayoko Ito, Jin Magara, Takanori Tsujimura, Makoto Inoue

    Journal of oral rehabilitation   47 ( 9 )   1161 - 1170   2020.7

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    BACKGROUND: There is a wide variation of chewing behaviors even in healthy humans. The present study was aimed to clarify how the rheological properties of the bolus during chewing is different among individuals. We also investigated if the swallowing threshold was consistent among the individuals and if the difference in the bolus properties at the swallowing affected swallowing movement. METHODS: Twenty-nine healthy volunteers were asked to ingest 8 g of steamed rice. Based on the chewing duration defined by the time until first swallow, participants were asked to chew the food, then either spit it out, or swallow it, at 50%, 100% and 150% of chewing duration. In seven volunteers, the maximum bite force was measured. RESULTS: The hardness of the bolus gradually decreased throughout recording. Although the chewing duration varied widely, there was a significant negative correlation between time and hardness, regardless of the difference in individual chewing duration. The cohesiveness of the bolus was unchanged at the 100% time point, followed by a slight but significant increase. There was no significant correlation between the chewing duration and adhesiveness of the bolus. Swallowing-related bursts of Supra and Infra EMGs were not related to the chewing duration or bolus properties, and chewing duration did not affect swallowing function. CONCLUSION: The current results suggest that the bolus properties such as the hardness and cohesiveness during chewing is just dependent on the chewing duration and the difference in the bolus properties does not affect the swallowing initiation and movement.

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  • Effects of Carbonation and Temperature on Voluntary Swallowing in Healthy Humans. Reviewed International journal

    Chikako Takeuchi, Eri Takei, Kayoko Ito, Sirima Kulvanich, Jin Magara, Takanori Tsujimura, Makoto Inoue

    Dysphagia   36 ( 3 )   384 - 392   2020.6

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    We investigated how swallowing behaviors are affected by the temperature and carbonation of water in healthy humans. Twenty-nine healthy volunteers were instructed to drink as much natural water, carbonated water, or cider as they wanted, and we recorded the volume of solution swallowed and electromyographic (EMG) activity of the masseter and suprahyoid muscles. Sensory tests regarding the ease of holding the solution in the mouth and ease of swallowing were also performed. The volume of carbonated water swallowed was significantly lower than that of natural water and cider. The ease of holding and swallowing the solution significantly differed between solution types such that natural water was the easiest solution to hold and swallow, followed by cider and then carbonated water in both tests. EMG activity was also affected by the solution type. Masseter EMG activity was significantly lower when swallowing natural water compared with carbonated water. Suprahyoid EMG activity was significantly lower when swallowing natural water compared with carbonated water and cider. The volume of solution swallowed was significantly correlated with the ease of holding and swallowing the solution, but not with masseter or suprahyoid EMG activities. The ease of holding and swallowing the solution significantly affected masseter and suprahyoid EMG activities. The results suggested that when participants experienced difficulty holding and swallowing the solution, masseter and suprahyoid EMG activity increased. Considering our findings that mechanical stimulation with bubbles decreased the volume of solution swallowed and increased EMG activities, carbonated water swallowing may be useful in treating deglutition disorders.

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  • Endurance measurement of hyoid muscle activity and hyoid-laryngeal position during tongue lift movement. Reviewed International journal

    Yukako Sunada, Jin Magara, Takanori Tsujimura, Kazuhiro Ono, Makoto Inoue

    Journal of oral rehabilitation   47 ( 8 )   967 - 976   2020.4

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    BACKGROUND: Tongue lift movement (TLM) is used as a therapy to improve tongue pressure against the hard palate for dysphagic patients. OBJECTIVE: The present study aimed to characterize the time-dependent endurance changes in hyoid muscle activity and hyoid-laryngeal displacement during TLM in different ways. METHODS: Sixteen young healthy volunteers were instructed to perform TLM at maximum effort (100%) against the anterior and posterior parts of the hard palate using a balloon-type tongue pressure instrument, followed by a 10-second recording during anterior 80% TLM, anterior 100% TLM, posterior 80% TLM and posterior 100% TLM with visual feedback. Electromyography (EMG) of suprahyoid (S-Hyo) and infrahyoid (I-Hyo) muscles and videofluorography were simultaneously recorded. To evaluate temporal changes, the recording period was divided into three substages: early, middle and late. Tongue pressure, integrated EMG (iEMG), power frequency of EMG burst and hyoid-laryngeal position were compared among the conditions (80% vs 100%, anterior vs posterior and early vs middle vs late). RESULTS: Tongue pressure was stably maintained for 10 seconds in all conditions. S-Hyo iEMG and I-Hyo iEMG were significantly greater at 100% than at 80%, while no significant difference was observed between positions. S-Hyo iEMG and I-Hyo iEMG significantly increased at the late stage, while power frequency of EMG burst gradually decreased. Significant temporal changes in laryngeal elevation were observed only in posterior 100% TLM. CONCLUSION: The current results suggested that isometric posterior TLM may be more useful compared with anterior TLM in clinical situations for dysphagic patients to elevate the hyolaryngeal complex.

    DOI: 10.1111/joor.12988

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  • Evaluation of hyoid movement during swallowing using a bend sensor. Reviewed International journal

    Kazuhiro Murakami, Yoshitomo Minagi, Kazuhiro Hori, Fumiko Uehara, Simonne E Salazar, Makoto Inoue, Yoshinobu Maeda, Kazunori Ikebe, Takahiro Ono

    Journal of oral rehabilitation   47 ( 3 )   339 - 345   2020.3

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    BACKGROUND: Movement of the hyoid and laryngeal complex is critical for preventing aspiration, as well as smooth bolus passage through the pharynx. We have developed a non-invasive system for measuring laryngeal movement during swallowing with a bend sensor and have already reported the time coordination between the signal waveform from the sensor and hyoid movement. OBJECTIVE: The aim of this study was to clarify the quantitative association between the output value of the sensor and hyoid movement during swallowing. METHODS: A small bend sensor was fixed on the skin surface along the midline of the neck of 13 healthy men (mean age, 30.8 ± 4.5 years). Laryngeal and hyoid movements during swallowing of 5 mL of water were recorded synchronously by the bend sensor and videofluorography. The relationship between the bend sensor output value (LM value) and hyoid position (x- and y-axis displacements) by videofluorography from the onset to the offset of the signal waveform was analysed for all tasks and for each task using Pearson's correlation coefficients. RESULTS: There was a positive correlation between the LM value and hyoid position for all tasks (x-axis displacement: r = .647, y-axis displacement: r = .233). In particular, there was a moderate to high correlation between the LM value and x-axis displacement for each task (.453 ≤ r ≤ .934). CONCLUSION: The LM value can be a quantitative parameter of anterior hyoid movement during swallowing that might be associated with bolus flow and upper oesophageal sphincter opening.

    DOI: 10.1111/joor.12906

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  • Properties of hyoid muscle contraction during tongue lift measurement. Reviewed International journal

    Naomi Koshi, Jin Magara, Shogo Sakai, Takanori Tsujimura, Kazuhiro Ono, Makoto Inoue

    Journal of oral rehabilitation   47 ( 3 )   332 - 338   2020.3

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    BACKGROUND: Tongue lift movement (TLM) task is considered a treatment strategy in dysphagic patients. However, there is no evidence of effect of sustained tongue movements on the related muscle contraction. OBJECTIVES: The present study aimed to characterise the properties and time-dependent changes of the electromyographic (EMG) features of suprahyoid muscles during TLM. METHODS: Twenty young healthy volunteers were instructed to perform TLM at maximum effort in either the anterior or the posterior position, during measurement of tongue pressure for 7 s. Supra- (S-hyo) and infra-hyoid (I-hyo) EMGs were recorded. The area and power frequency of EMG burst and the area under the curve of tongue pressure were compared among the conditions: trials (1st, 2nd vs 3rd trials); anterior vs posterior TLM; and early vs late 3 s of each trial. RESULTS: There was no difference in the tongue pressure among trials or between the early and late 3 s. Anterior tongue pressure was significantly higher than posterior tongue pressure (P < .001). The area of I-hyo EMG burst was significantly larger (P = .044), and the power frequency of I-hyo EMG burst was significantly smaller (P = .042) during posterior TLM than anterior TLM. A significant difference in the power frequency of both EMG bursts was observed between early and late stages during both anterior (P < .05) and posterior (P < .01) TLM. CONCLUSION: Hyoid muscles may compensate for rapid fatigue of the tongue muscle to maintain tongue pressure by changing their activity pattern during tongue pressure generation.

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  • Comparison of physical properties of voluntary coughing, huffing and swallowing in healthy subjects. International journal

    Akiko Yawata, Takanori Tsujimura, Ryosuke Takeishi, Jin Magara, Li Yu, Makoto Inoue

    PloS one   15 ( 12 )   e0242810   2020

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    Coughing, huffing and swallowing protect the airway from aspiration. This study was conducted to compare the physical properties of voluntary coughing, huffing and swallowing in healthy subjects. Ten healthy men were asked to huff, cough and swallow repeatedly. Electromyograms (EMGs) were recorded from the left side of the external oblique (EO), sternocleidomastoid, suprahyoid (SH) and thyrohyoid muscles. Airflow was recorded using a face mask with two-way non-rebreathing valves. The expiratory velocity of huffing and coughing and the SH EMG of all actions presented high intraclass correlation coefficients (> 0.8). The inspiratory and expiratory velocities did not differ significantly between coughing and huffing. The expiratory acceleration of coughing was significantly higher than that of huffing, whereas the expiratory volume of coughing was significantly smaller than that of huffing. The EO EMG of coughing and huffing were significantly larger than that of swallowing. The EO EMG activity during the expiratory phase was significantly higher than that of the other phases of both coughing and huffing. The SH EMG of coughing and huffing were significantly smaller than that of swallowing. Correlation analysis revealed that the expiratory velocity of coughing was strongly positively correlated with that of huffing. The expiratory volume of huffing was significantly positively correlated with hand grip strength. These results suggest that EO and SH muscle activities during huffing or coughing differ those during swallowing, and huffing and coughing may work similarly in expiratory function.

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  • Evaluation of the association between orofacial pain and dysphagia.

    Takanori Tsujimura, Makoto Inoue

    Journal of oral science   62 ( 2 )   156 - 159   2020

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    Swallowing has a vital function in airway protection and is the next step after mastication. Swallowing impairment, which is known as dysphagia, is frequently accompanied by pain. Previous clinical studies have shown that orofacial pain affects swallowing function. Thus, it was hypothesized that orofacial noxious inputs may modulate swallowing function. Previous studies using anesthetized animals has proposed that the facial skin-nucleus tractus solitarii (NTS), masseter muscle-NTS, lingual muscle-NTS, and lingual muscle-paratrigeminal nucleus-NTS pathways may be involved in the inhibition of swallowing caused by facial, masseter, and lingual pain. Moreover, the activation of gamma-aminobutyric acidergic NTS neurons is involved in the inhibition of the swallowing reflex following trigeminal noxious inputs. This review focused on the recent management of dysphagia, neural mechanisms of swallowing, and relationship between orofacial pain and swallowing function. This and other future studies in this field can provide a better understanding of both normal and impaired swallowing and can help develop a new approach to treat patients with dysphagia and orofacial pain.

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  • 種々のとろみ水やゼリー食品が嚥下動態に与える影響

    小貫 和佳奈, 竹井 絵理, 渡邊 賢礼, 井上 誠

    日本摂食・嚥下リハビリテーション学会雑誌   23 ( 3 )   S358 - S358   2019.12

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  • 新潟大学医歯学総合病院における医療連携口腔管理チームの取り組みについて

    黒川 亮, 那小屋 公太, 井上 誠, 高木 律男

    日本口腔リハビリテーション学会雑誌   32 ( 1 )   66 - 66   2019.12

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  • 米飯摂取時の咀嚼時間の個人差に関する検討

    高地 いづみ, 竹井 絵理, 真柄 仁, 辻村 恭憲, 前田 留美子, 井上 誠

    新潟歯学会雑誌   49 ( 2 )   78 - 78   2019.12

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  • 舌挙上運動時における舌骨筋の機能特性

    古志 奈緒美, 真柄 仁, 辻村 恭憲, 小野 和宏, 井上 誠

    新潟歯学会雑誌   49 ( 2 )   77 - 77   2019.12

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  • 誤嚥性肺炎入院患者における摂食嚥下機能評価項目の検討

    建部 一毅, 真柄 仁, 井上 誠

    日本口腔リハビリテーション学会雑誌   32 ( 1 )   61 - 62   2019.12

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  • 皮膚筋炎に起因した嚥下障害に対し摂食嚥下リハビリテーションを行った2症例

    石澤 尚子, 真柄 仁, 渡邊 賢礼, 笹 杏奈, 井上 誠

    日本口腔リハビリテーション学会雑誌   32 ( 1 )   70 - 71   2019.12

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  • 誤嚥性肺炎クリニカルパス策定に向けた摂食嚥下機能評価項目の検討

    真柄 仁, 井上 誠

    老年歯科医学   34 ( 2 )   185 - 185   2019.9

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  • 米菓摂取時の咀嚼特性と食塊物性

    竹井 絵理, 真柄 仁, 辻村 恭憲, 井上 誠

    日本顎口腔機能学会雑誌   26 ( 1 )   26 - 27   2019.9

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  • 食道癌術後に嚥下障害・嗄声を認め長期的介入が奏功した一症例

    笹 杏奈, 渡邊 賢礼, 井上 誠

    言語聴覚研究   16 ( 3 )   219 - 219   2019.9

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  • Qualitative analysis of the vocabulary used in work logs of a preventive programme for elderly oral function and nutrition. Reviewed International journal

    Kayoko Ito, Ayako Edahiro, Yoshihiko Watanabe, Yuki Ohara, Yoshiko Motohashi, Shiho Morishita, Keiko Motokawa, Yutaka Watanabe, Hirohiko Hirano, Makoto Inoue

    Journal of oral rehabilitation   46 ( 8 )   723 - 729   2019.8

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    BACKGROUND: In Japan, day care services for elders include programmes aimed at improving nutrition and oral and motor functions. Few studies have qualitatively assessed these interventions. OBJECTIVE: To qualitatively search for the characteristic words used in the work logs of a preventive programme on oral function and nutrition for elders by intervention period and intervention type. METHODS: We included 83 participants (81.3 ± 8.2 years) from four day care services in Japan and divided them into the following groups randomly: those who received oral function intervention only, nutritional intervention only and those who received combined oral function plus nutritional intervention. The interventions were conducted twice per month for 24 months. Data from handwritten work logs were entered into a computer as text files. Monitoring of frequently appearing words, co-occurrence analysis and cross-tabulation by intervention period and intervention types was conducted using text mining analysis. RESULTS: Correspondence analysis revealed that the words used during 1-6 months and 7-12 months were similar in participants' subjective content, and those used in objective content in 13-18 months and 19-24 months were similar. These results indicate that subjective improvements increased after 13 months, and it was maintained within 24 months. The combined intervention type is ideal for oral and nutrition problems. CONCLUSION: Because this text mining approach revealed the changes in the words used and could be used to monitor any subjective improvement, this approach may help evaluate the effects of preventive care.

    DOI: 10.1111/joor.12804

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  • Involvement of the epithelial sodium channel in initiation of mechanically evoked swallows in anaesthetized rats Reviewed

    Takanori Tsujimura, Rumi Ueha, Midori Yoshihara, Eri Takei, Kouta Nagoya, Naru Shiraishi, Jin Magara, Makoto Inoue

    Journal of Physiology   597 ( 11 )   2949 - 2963   2019.6

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    © 2019 The Authors. The Journal of Physiology © 2019 The Physiological Society Key points: Afferents carried by the superior laryngeal nerve play a primary role in the initiation of laryngeal mechanically evoked swallows in anaesthetized rats. Amiloride and its analogues inhibit swallowing evoked by mechanical stimulation, but not swallowing evoked by chemical and electrical stimulation. The epithelial sodium channel is probably involved in the initiation of laryngeal mechanically evoked swallows. Abstract: The swallowing reflex plays a critical role in airway protection. Because impaired laryngeal mechanosensation is associated with food bolus aspiration, it is important to know how the laryngeal sensory system regulates swallowing initiation. This study was performed to clarify the neuronal mechanism of mechanically evoked swallows. Urethane-anaesthetized Sprague–Dawley male rats were used. A swallow was identified by activation of the suprahyoid and thyrohyoid muscles on electromyography. The swallowing threshold was measured by von Frey filament and electrical stimulation of the larynx. The number of swallows induced by upper airway distension and capsaicin application (0.03 nmol, 3 μl) to the vocal folds was counted. The effects of topical application (0.3–30 nmol, 3 μl) of the epithelial sodium channel (ENaC) blocker amiloride and its analogues (benzamil and dimethylamiloride), acid-sensing ion channel (ASIC) inhibitors (mambalgine-1 and diminazene) and gadolinium to the laryngeal mucosa on swallowing initiation were evaluated. A nerve transection study indicated that afferents carried by the superior laryngeal nerve play a primary role in the initiation of laryngeal mechanically evoked swallows. The mechanical threshold of swallowing was increased in a dose-dependent manner by amiloride and its analogues and gadolinium, but not by ASIC inhibitors. The number of swallows by upper airway distension was significantly decreased by benzamil application. However, the initiation of swallows evoked by capsaicin and electrical stimulation was not affected by benzamil application. We speculate that the ENaC is involved in the initiation of laryngeal mechanically evoked swallows.

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  • 誤嚥性肺炎クリニカルパス策定に向けた摂食嚥下機能評価項目の検討

    真柄 仁, 井上 誠

    日本老年歯科医学会総会・学術大会プログラム・抄録集   30回   O2 - 29   2019.6

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  • Cerebellar repetitive transcranial magnetic stimulation restores pharyngeal brain activity and swallowing behaviour after disruption by a cortical virtual lesion. Reviewed International journal

    Ayodele Sasegbon, Masahiro Watanabe, Andre Simons, Emilia Michou, Dipesh H Vasant, Jin Magara, Philip M Bath, John Rothwell, Makoto Inoue, Shaheen Hamdy

    The Journal of physiology   597 ( 9 )   2533 - 2546   2019.5

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    KEY POINTS: Despite evidence that the human cerebellum has an important role in swallowing neurophysiology, the effects of cerebellar stimulation on swallowing in the disrupted brain have not been explored. In this study, for the first time, the application of cerebellar neurostimulation is characterized in a human model of disrupted swallowing (using a cortical virtual lesion). It is demonstrated that cerebellar stimulation can reverse the suppressed activity in the cortical swallowing system and restore swallowing function in a challenging behavioural task, suggesting the findings may have important therapeutic implications. ABSTRACT: Repetitive transcranial magnetic stimulation (rTMS) can alter neuronal activity within the brain with therapeutic potential. Low frequency stimulation to the 'dominant' cortical swallowing projection induces a 'virtual-lesion' transiently suppressing cortical excitability and disrupting swallowing behaviour. Here, we compared the ability of ipsi-lesional, contra-lesional and sham cerebellar rTMS to reverse the effects of a 'virtual-lesion' in health. Two groups of healthy participants (n = 15/group) were intubated with pharyngeal catheters. Baseline pharyngeal motor evoked potentials (PMEPs) and swallowing performance (reaction task) were measured. Participants received 10 min of 1 Hz rTMS to the pharyngeal motor cortex which elicited the largest PMEPs to suppress cortical activity and disrupt swallowing behaviour. Over six visits, participants were randomized to receive 250 pulses of 10 Hz cerebellar rTMS to the ipsi-lesional side, contra-lesional side or sham while assessing PMEP amplitude or swallowing performance for an hour afterwards. Compared to sham, active cerebellar rTMS, whether administered ipsi-lesionally (P = 0.011) or contra-lesionally (P = 0.005), reversed the inhibitory effects of the cortical 'virtual-lesion' on PMEPs and swallowing accuracy (ipsi-lesional, P < 0.001, contra-lesional, P < 0.001). Cerebellar rTMS was able to reverse the disruptive effects of a 'virtual lesion'. These findings provide evidence for developing cerebellar rTMS into a treatment for post-stroke dysphagia.

    DOI: 10.1113/JP277545

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  • 延髄外側症候群の嚥下障害に対し可撤性補綴装置を装着した一症例

    真柄 仁, 井上 誠

    日本補綴歯科学会誌   11 ( 特別号 )   155 - 155   2019.5

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  • Effect of attention on chewing and swallowing behaviors in healthy humans. Reviewed International journal

    Hirokazu Ashiga, Eri Takei, Jin Magara, Ryosuke Takeishi, Takanori Tsujimura, Kouta Nagoya, Makoto Inoue

    Scientific reports   9 ( 1 )   6013 - 6013   2019.4

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    We examined how attention alters chewing and swallowing behaviors. Twenty-one healthy volunteers were asked to freely eat 8 g of steamed rice in three separate trials, and we obtained the average number of chewing cycles (N) and chewing duration (T) prior to the first swallow in each trial. We also conducted an N-limited test, in which participants chewed the food while independently counting the number of chewing cycles and swallowed the food when they reached N, and a T-limited test, in which they chewed the food for T sec and then swallowed. We recorded electromyograms (EMGs) from masseter and suprahyoid muscles and collected videoendoscopic images. In the N-limited test, chewing speed decreased, masseter muscle activity (area under the curve of the rectified EMG burst) per cycle increased, and suprahyoid muscle activity per cycle decreased. In the T-limited test, the chewing speed increased, muscle activities per cycle decreased, and the number of cycles increased. The occurrence frequency of bolus propulsion into the pharynx before swallowing was smaller in the N- and T-limited tests than in the free chewing test. Further, the whiteout time was longer in the T-limited test than in the free chewing test. Attentional chewing changes not only chewing but also swallowing behavior.

    DOI: 10.1038/s41598-019-42422-4

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  • 味覚外来患者統計および亜鉛補充療法の効果 Reviewed

    船山さおり, 伊藤加代子, 濃野 要, 井上 誠

    口腔・咽頭科   32 ( 1 )   42 - 47   2019.3

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  • 舌挙上運動時における舌骨喉頭位と舌骨筋活動の評価

    砂田 悠香子, 真柄 仁, 竹石 龍右, 辻村 恭憲, 井上 誠

    新潟歯学会雑誌   48 ( 2 )   116 - 116   2018.12

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  • 介護食品および介護食器具等に関する情報提供

    伊藤 加代子, 辻村 恭憲, 真柄 仁, 井上 誠

    日本口腔リハビリテーション学会雑誌   31 ( 1 )   56 - 56   2018.12

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  • 身体的フレイル患者に対する歩行機能訓練は口腔・嚥下機能を改善するか?

    渋木 瞳, 真柄 仁, 井上 誠

    新潟歯学会雑誌   48 ( 2 )   118 - 118   2018.12

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  • 米菓摂取時の筋活動と食塊物性

    竹井 絵理, 竹井 亮, 鷲尾 英明, 真柄 仁, 辻村 恭憲, 井上 誠

    日本咀嚼学会雑誌   28 ( 2 )   82 - 82   2018.11

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  • Cold thermal oral stimulation produces immediate excitability in human pharyngeal motor cortex Reviewed

    J. Magara, M. Watanabe, T. Tsujimura, S. Hamdy, M. Inoue

    Neurogastroenterology & Motility   e13384   2018.10

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    DOI: 10.1111/nmo.13384

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  • 更年期の婦人科受診患者におけるQuality of lifeに影響する因子の検討

    篠原 千鶴子, 伊藤 加代子, 高松 潔, 小川 真里子, 濃野 要, 船山 さおり, 片倉 朗, 野村 武史, 井上 誠

    日本女性医学学会雑誌   26 ( Suppl. )   152 - 152   2018.10

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  • Effect of peripherally and cortically evoked swallows on jaw reflex responses in anesthetized rabbits. Reviewed International journal

    Taku Suzuki, Midori Yoshihara, Shogo Sakai, Kojun Tsuji, Kouta Nagoya, Jin Magara, Takanori Tsujimura, Makoto Inoue

    Brain research   1694   19 - 28   2018.9

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    This study aimed to investigate whether the jaw-opening (JOR) and jaw-closing reflexes (JCR) are modulated during not only peripherally, but also centrally, evoked swallowing. Experiments were carried out on 24 adult male Japanese white rabbits. JORs were evoked by trigeminal stimulation at 1 Hz for 30 s. In the middle 10 s, either the superior laryngeal nerve (SLN) or cortical swallowing area (Cx) was simultaneously stimulated to evoke swallowing. The peak-to-peak JOR amplitude was reduced during the middle and late 10-s periods (i.e., during and after SLN or Cx stimulation), and the reduction was dependent on the current intensity of SLN/Cx stimulation: greater SLN/Cx stimulus current resulted in greater JOR inhibition. The reduction rate was significantly greater during Cx stimulation than during SLN stimulation. The amplitude returned to baseline 2 min after 10-s SLN/Cx stimulation. The effect of co-stimulation of SLN and Cx was significantly greater than that of SLN stimulation alone. There were no significant differences in any parameters of the JCR between conditions. These results clearly showed that JOR responses were significantly suppressed, not only during peripherally evoked swallowing but also during centrally evoked swallowing, and that the inhibitory effect is likely to be larger during centrally compared with peripherally evoked swallowing. The functional implications of these results are discussed.

    DOI: 10.1016/j.brainres.2018.05.002

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  • 若手の口腔生理学研究最前線 嚥下反射の誘発に関わる末梢の受容機構

    吉原 翠, 鈴木 拓, 那小屋 公太, 辻村 恭憲, 井上 誠

    Journal of Oral Biosciences Supplement   2018   98 - 98   2018.9

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  • 米飯摂取時の食塊物性と筋活動特性

    竹井 絵理, 前田 留美子, 真柄 仁, 辻村 恭憲, 竹石 龍右, 井上 誠

    日本顎口腔機能学会雑誌   25 ( 1 )   32 - 33   2018.9

  • 聴神経腫瘍術後に脳幹・小脳出血を合併し摂食嚥下障害を認めた1症例

    笹 杏奈, 辻 光順, 渡邊 賢礼, 那小屋 公太, 伊藤 加代子, 真柄 仁, 辻村 恭憲, 井上 誠

    新潟歯学会雑誌   48 ( 1 )   37 - 41   2018.6

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    聴神経腫瘍術後に嚥下障害を認めた一例を報告する。症例は56歳女性。2017年2月に小脳・脳幹を圧迫する聴神経鞘腫に対する摘出術施行、術後左小脳出血及び延髄から橋にかけて低吸収域を認めたため、脳内血腫除去および減圧開頭術が施行された。術後11日目に嚥下機能評価目的に当科初診となった。小脳前庭症状としての姿勢保持困難と失調性構音障害、球麻痺症状としての顔面神経麻痺、舌運動減弱、開鼻声を伴う右カーテン徴候を認めた。反復唾液嚥下テストは2回、改訂水飲みテストおよびとろみ付液体3ccでのテストでは3a点(嚥下後湿性音あり)であった。嚥下内視鏡検査時、安静時より咽頭内分泌物貯留、左側披裂・声帯は傍正中位固定で声門閉鎖不良、ホワイトアウトは減弱しており、とろみ付液体摂取時の食道流入不良、鼻咽腔逆流を認めた。さらに、残留物は不顕性誤嚥をしていた。重度摂食嚥下障害の診断にて、口腔ケア・間接訓練から介入を開始した。耐久性が改善した術後19日目以降は間接訓練の負荷を増やし、少量のとろみ付液体を用いた直接訓練も開始した。術後35日目に実施した嚥下造影検査では、依然として嚥下後の咽頭残留量が多く食事開始にはいたらなかった。転院を前に術後55日目に実施した最終評価では、幻暈などの前庭症状は改善していたものの球麻痺症状に大きな変化は認められなかった。最終的に食事開始までは至らなかったものの、訓練の効果による咽頭残留の軽減と姿勢調整を行うことで安全な経口摂取方法の提案ができた。(著者抄録)

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  • 舌癌術後の摂食嚥下障害に対し間接訓練ならびに直接訓練を実施した1症例

    小貫 和佳奈, 笹 杏奈, 辻 光順, 渡邊 賢礼, 白石 成, 伊藤 加代子, 真柄 仁, 辻村 恭憲, 井上 誠

    新潟歯学会雑誌   48 ( 1 )   43 - 48   2018.6

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    頭頸部癌術後は、高頻度に摂食嚥下障害を生じる。今回、舌癌術後に摂食嚥下障害を生じ、リハビリテーションによる食形態や姿勢の調整によって経口摂取が可能となった症例を経験したので報告する。症例は68歳の男性。舌亜全摘術、両側頸部郭清術、腹直筋皮弁再建術、気管切開術、胃瘻造設術後、放射線治療開始と同時にN大学医歯学総合病院摂食嚥下機能回復部に紹介受診となった。初診時、頸部拘縮、舌切除による創部瘢痕化を伴う口腔移送不良・鼻咽腔閉鎖不全・咽頭収縮不全を認めた。嚥下内視鏡検査と嚥下造影検査により、リクライニング60度、左側臥位・右側頸部回旋位にてとろみ付液体2ccの食道流入が可能なことを確認して、毎日の間接訓練および代償法を用いた直接訓練を開始した。術後放射線治療の影響による口腔粘膜炎は自制内であり、訓練手技を獲得して耐久性が向上した介入29日目より食事開始、介入35日目には口腔移送改善を目的として舌接触補助床を用いた訓練を開始したものの、違和感や嘔気が強く常時使用にはいたらなかった。今後は、経口摂取のみでの栄養確保、歯科補綴学的アプローチによる口腔準備期の改善も可能であると考えている。(著者抄録)

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  • 神経筋変性疾患患者における舌圧と嚥下機能の評価

    真柄 仁, 白石 成, 井上 誠

    日本補綴歯科学会誌   10 ( 特別号 )   258 - 258   2018.6

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  • 咀嚼がもたらす摂食嚥下機能への影響

    井上 誠, 辻村 恭憲, 真柄 仁

    日本老年歯科医学会総会・学術大会プログラム・抄録集   29回   [O1 - 6]   2018.6

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  • Involvement of hypoglossal and recurrent laryngeal nerves on swallowing pressure. Reviewed International journal

    Takanori Tsujimura, Taku Suzuki, Midori Yoshihara, Shogo Sakai, Naomi Koshi, Hirokazu Ashiga, Naru Shiraishi, Kojun Tsuji, Jin Magara, Makoto Inoue

    Journal of applied physiology (Bethesda, Md. : 1985)   124 ( 5 )   1148 - 1154   2018.5

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    Swallowing pressure generation is important to ensure safe transport of an ingested bolus without aspiration or leaving residue in the pharynx. To clarify the mechanism, we measured swallowing pressure at the oropharynx (OP), upper esophageal sphincter (UES), and cervical esophagus (CE) using a specially designed manometric catheter in anesthetized rats. A swallow, evoked by punctate mechanical stimulation to the larynx, was identified by recording activation of the suprahyoid and thyrohyoid muscles using electromyography (EMG). Areas under the curve of the swallowing pressure at the OP, UES, and CE from two trials indicated high intrasubject reproducibility. Effects of transecting the hypoglossal nerve (12N) and recurrent laryngeal nerve (RLN) on swallowing were investigated. Following bilateral hypoglossal nerve transection (Bi-12Nx), OP pressure was significantly decreased, and time intervals between peaks of thyrohyoid EMG bursts and OP pressure were significantly shorter. Decreased OP pressure and shortened times between peaks of thyrohyoid EMG bursts and OP pressure following Bi-12Nx were significantly increased and longer, respectively, after covering the hard and soft palates with acrylic material. UES pressure was significantly decreased after bilateral RLN transection compared with that before transection. These results suggest that the 12N and RLN play crucial roles in OP and UES pressure during swallowing, respectively. We speculate that covering the palates with a palatal augmentation prosthesis may reverse the reduced swallowing pressure in patients with 12N or tongue damage by the changes of the sensory information and of the contact between the tongue and a palates. NEW & NOTEWORTHY Hypoglossal nerve transection reduced swallowing pressure at the oropharynx. Covering the hard and soft palates with acrylic material may reverse the reduced swallowing function caused by hypoglossal nerve damage. Recurrent laryngeal nerve transection reduced upper esophageal sphincter negative pressure during swallowing.

    DOI: 10.1152/japplphysiol.00944.2017

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  • 咀嚼の意識化による咀嚼および嚥下の変調について

    阿志賀 大和, 鈴木 拓, 真柄 仁, 竹石 龍右, 辻村 恭憲, 井上 誠

    日本顎口腔機能学会雑誌   24 ( 2 )   128 - 129   2018.3

  • 米飯咀嚼時の食塊形成と嚥下誘発の関係

    前田 留美子, 竹井 絵理, 真柄 仁, 辻村 恭憲, 竹石 龍右, 井上 誠

    日本顎口腔機能学会雑誌   24 ( 2 )   130 - 131   2018.3

  • Differential Response Pattern of Oropharyngeal Pressure by Bolus and Dry Swallows Reviewed

    Mana Hasegawa, Masayuki Kurose, Keiichiro Okamoto, Yoshiaki Yamada, Takanori Tsujimura, Makoto Inoue, Taisuke Sato, Takatsune Narumi, Noritaka Fujii, Kensuke Yamamura

    Dysphagia   33 ( 1 )   83 - 90   2018.2

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    The aim of this study was to determine if bolus and dry swallow showed similar pressure changes in the oropharynx using our newly developed device. A unique character of it includes that baropressure can be measured with the sensor being placed in the balloon and can assess the swallowing mechanics in terms of pressure changes in the oropharynx with less influences of direct contacts of boluses and oropharyngeal structures during swallow indirectly. Fifteen healthy subjects swallowed saliva (dry), 15 ml of water, 45 ml of water, and 15 ml of two different types of food in terms of viscosity (potage soup-type and mayonnaise-type foods). Suprahyoid muscle activity was recorded simultaneously. Three parameters, area under the curve (AUC), peak amplitude, and duration of pressure, were analyzed from each swallow. Almost all of the bolus swallowing events had biphasic baropressure responses consisting of an early phase and late phase (99%), whereas 90% of the saliva swallowing events had a single phase. AUC, peak, and duration displayed greater effects during the late phase than during the early phase. Baropressure of the early phase, but not of the late phase, significantly increased with increasing volume
    however, small but significant viscosity effects on pressure were seen during both phases. Peak pressure of the late phase was preceded by maximum muscle activity, whereas that of the early phase was seen when muscle activity displayed a peak response. These findings indicated that our device with the ability to measure baropressure has the potential to provide additional parameter to assess the swallow physiology, and biphasic baropressure responses in the early and late phases could reflect functional aspects of the swallowing reflexes.

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  • 身体的フレイル患者における歩行機能と口腔機能との関連

    井上 誠, 保田 麻里, 真柄 仁

    8020: はち・まる・にい・まる   ( 17 )   136 - 137   2018.2

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    退院時に独歩をめざす「DOPPOプロジェクト」への参加意思があるN病院入院患者32名を対象とし、リハビリ開始時に口腔・嚥下機能の評価と身体機能評価を行い、相互の関連性について検討した。口腔機能の評価項目は[咬合力][グミ咀嚼能力][舌圧][口唇閉鎖力]、嚥下機能の評価項目は[3オンス水飲みテスト][反射唾液嚥下テスト(RSST)]とした。身体機能の評価項目は[握力][下肢伸展力][SPPB][10m歩行時の速度および歩数][6分間歩行距離]とした。検討の結果、口腔機能と身体機能との関連性については、多くの項目間で有意な相関が認められた。嚥下機能が低下している群(15名)と非低下群に分けて身体機能各項目の群間比較を行ったところ、低下群は[SPPB]が有意に低く、[10m歩行時の歩数]が有意に多かった。歩行速度が<0.8m/sの16名を"歩行速度低下群"、他の16名を"非低下群"として口腔・嚥下機能各項目の群間比較を行ったところ、低下群は[咬合力][グミ咀嚼能力][舌圧][RSST]が有意に低値であった。

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  • Immediate effect of laryngeal surface electrical stimulation on swallowing performance. Reviewed International journal

    Keizo Takahashi, Kazuhiro Hori, Hirokazu Hayashi, Masako Fujiu-Kurachi, Takahiro Ono, Takanori Tsujimura, Jin Magara, Makoto Inoue

    Journal of applied physiology (Bethesda, Md. : 1985)   124 ( 1 )   10 - 15   2018.1

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    Surface electrical stimulation of the laryngeal region is used to improve swallowing in dysphagic patients. However, little is known about how electrical stimulation affects tongue movements and related functions. We investigated the effect of electrical stimulation on tongue pressure and hyoid movement, as well as suprahyoid and infrahyoid muscle activity, in 18 healthy young participants. Electrical stimulation (0.2-ms duration, 80 Hz, 80% of each participant's maximal tolerance) of the laryngeal region was applied. Each subject swallowed 5 ml of barium sulfate liquid 36 times at 10-s intervals. During the middle 2 min, electrical stimulation was delivered. Tongue pressure, electromyographic activity of the suprahyoid and infrahyoid muscles, and videofluorographic images were simultaneously recorded. Tongue pressure during stimulation was significantly lower than before or after stimulation and was significantly greater after stimulation than at baseline. Suprahyoid activity after stimulation was larger than at baseline, while infrahyoid muscle activity did not change. During stimulation, the position of the hyoid at rest was descended, the highest hyoid position was significantly inferior, and the vertical movement was greater than before or after stimulation. After stimulation, the positions of the hyoid at rest and at the maximum elevation were more superior than before stimulation. The deviation of the highest positions of the hyoid before and after stimulation corresponded to the differences in tongue pressures at those times. These results suggest that surface electrical stimulation applied to the laryngeal region during swallowing may facilitate subsequent hyoid movement and tongue pressure generation after stimulation. NEW & NOTEWORTHY Surface electrical stimulation applied to the laryngeal region during swallowing may facilitate subsequent hyoid movement and tongue pressure generation after stimulation. Tongue muscles may contribute to overshot recovery more than hyoid muscles.

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  • 口腔乾燥症診断チャートの開発 Reviewed

    伊藤加代子, 船山さおり, 勝良剛詞, 金子 昇, 濃野 要, 池 真樹子, 井上 誠

    日摂食リハ会誌   22 ( 2 )   153 - 160   2018

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  • Effects of pharyngeal electrical stimulation on swallowing performance. Reviewed International journal

    Ryosuke Takeishi, Jin Magara, Masahiro Watanabe, Takanori Tsujimura, Hirokazu Hayashi, Kazuhiro Hori, Makoto Inoue

    PloS one   13 ( 1 )   e0190608   2018

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    Pharyngeal electrical stimulation (PEStim) has been found to facilitate voluntary swallowing. This study investigated how PEStim contributed to modulation of swallowing function in 15 healthy humans. In the involuntary swallowing test, water was injected onto the pharynx at 0.05 ml/s and the onset latency of the first swallow was measured. In the voluntary swallowing test, subjects swallowed their own saliva as quickly as possible for 30 s and the number of swallows was counted. Voluntary and involuntary swallowing was evaluated before (baseline), immediately after, and every 10 min after 10-min PEStim for 60 min. A voluntary swallowing test with simultaneous 30-s PEStim was also conducted before and 60 min after 10-min PEStim. The number of voluntary swallows with simultaneous PEStim significantly increased over 60 min after 10-min PEStim compared with the baseline. The onset latency of the first swallow in the involuntary swallowing test was not affected by 10-min PEStim. The results suggest that PEStim may have a long-term facilitatory effect on the initiation of voluntary swallowing in healthy humans, but not on peripherally-evoked swallowing. The physiological implications of this modulation are discussed.

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  • 咀嚼時米飯の物性変化は嚥下誘発をどのように決定するか

    前田 留美子, 竹井 絵理, 真柄 仁, 辻村 恭憲, 竹石 龍右, 井上 誠

    新潟歯学会雑誌   47 ( 2 )   114 - 114   2017.12

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  • 頸部壊死性筋膜炎により残遺した嚥下障害に対し、外科的治療と摂食嚥下リハビリテーションによる介入が奏功した一例

    辻 光順, 渡邊 賢礼, 真柄 仁, 井上 誠

    日本口腔リハビリテーション学会雑誌   30 ( 1 )   99 - 100   2017.12

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  • 咀嚼の意識化による摂食嚥下運動の変化

    阿志賀 大和, 鈴木 拓, 真柄 仁, 竹石 龍右, 辻村 恭憲, 井上 誠

    新潟歯学会雑誌   47 ( 2 )   114 - 114   2017.12

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  • Effect of body posture on chewing behaviours in healthy volunteers Reviewed

    T. Iizumi, J. Magara, T. Tsujimura, M. Inoue

    JOURNAL OF ORAL REHABILITATION   44 ( 11 )   835 - 842   2017.11

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    Mastication is essential to the eating process and forms an important part of feeding behaviour. Many factors related to the food bolus, such as bolus texture and size, are known to influence mastication. The aim of this study was to determine the effects of body posture on (i) chewing duration prior to the first swallow and (ii) patterns of mastication-related EMG activity. We asked 10 healthy adults to chew 8g of steamed rice with barium sulphate while we recorded masseter, suprahyoid and infrahyoid muscle activity and simultaneously collected videofluorographic images. Participants chewed in either an upright or reclining position. Chewing duration, which was defined as the time from the start of mastication to the first swallow, was not different between the positions. However, the variability of chewing duration was larger in the upright versus reclining position, and the chewing duration in the reclining position was distributed around 15s. Masseter activity gradually decreased in a time-dependent manner and was significantly larger at the early versus late stage of mastication. Suprahyoid activity was significantly larger at the early versus middle stage of mastication in the upright position only. Finally, masseter activity per second was negatively correlated with changes in chewing duration, that is, the larger the increase in chewing duration in the reclining position, the more the decrease in masseter activity per second. These results suggest that position-dependent changes in chewing behaviours, as described by chewing duration and EMG activity, may vary among participants.

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  • Sagittal Plane Kinematics of the Jaw and Hyolingual Apparatus During Swallowing in Macaca mulatta Reviewed

    Yuki Nakamura, Jose Iriarte-Diaz, Fritzie Arce-McShane, Courtney P. Orsbon, Kevin A. Brown, McKenna Eastment, Limor Avivi-Arber, Barry J. Sessle, Makoto Inoue, Nicholas G. Hatsopoulos, Callum F. Ross, Kazutaka Takahashi

    DYSPHAGIA   32 ( 5 )   663 - 677   2017.10

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    Studies of mechanisms of feeding behavior are important in a society where aging- and disease-related feeding disorders are increasingly prevalent. It is important to evaluate the clinical relevance of animal models of the disease and the control. Our present study quantifies macaque hyolingual and jaw kinematics around swallowing cycles to determine the extent to which macaque swallowing resembles that of humans. One female and one male adult Macaca mulatta were trained to feed in a primate chair. Videofluoroscopy was used to record kinematics in a sagittal view during natural feeding on solid food, and the kinematics of the hyoid bone, thyroid cartilage, mandibular jaw, and anterior-, middle-, and posterior-tongue. Jaw gape cycles were defined by consecutive maximum gapes, and the kinematics of the swallow cycles were compared with those of the two consecutive non-swallow cycles preceding and succeeding the swallow cycles. Although there are size differences between macaques and humans, and macaques have shorter durations of jaw gape cycles and hyoid and thyroid upward movements, there are several important similarities between our macaque data and human data reported in the literature: (1) The durations of jaw gape cycles during swallow cycles are longer than those of non-swallow cycles as a result of an increased duration of the jaw-opening phase; (2) Hyoid and thyroid upward movement is linked with a posterior tongue movement and is faster during swallow than non-swallow cycles; (3) Tongue elevation propagates from anterior to posterior during swallow and non-swallow cycles. These findings suggest that macaques can be a useful experimental model for human swallowing studies.

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  • 転写因子Phox2bを発現する三叉神経運動核背側網様体ニューロンの生理学的および形態学的解析

    那小屋 公太, 中村 史朗, 中山 希世美, 望月 文子, 吉田 篤, 井上 誠, 井上 富雄

    日本顎口腔機能学会雑誌   24 ( 1 )   50 - 51   2017.9

  • 嚥下が顎反射に与える影響

    鈴木 拓, 吉原 翠, 辻 光順, 真柄 仁, 辻村 恭憲, 井上 誠

    Journal of Oral Biosciences Supplement   2017   263 - 263   2017.9

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  • 舌圧測定時における舌骨筋群の筋電図学的分析

    古志 奈緒美, 真柄 仁, 酒井 翔悟, 鈴木 拓, 辻村 恭憲, 井上 誠

    日本顎口腔機能学会雑誌   24 ( 1 )   34 - 35   2017.9

  • 口腔への温度刺激がもたらす嚥下機能への影響

    吉原 翠, 竹内 千華子, 竹石 龍右, 伊藤 加代子, 真柄 仁, 辻村 恭憲, 井上 誠

    日本顎口腔機能学会雑誌   24 ( 1 )   40 - 41   2017.9

  • 口腔内への温度刺激がもたらす咽頭皮質延髄路の変調

    真柄 仁, 渡邊 賢礼, 酒井 翔悟, 鈴木 拓, 辻村 恭憲, 井上 誠

    嚥下医学   6 ( 2 )   246 - 246   2017.9

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  • 健常成人の舌挙上運動時における舌骨筋群の筋活動動態の検討

    古志 奈緒美, 真柄 仁, 酒井 翔梧, 鈴木 拓, 辻村 恭憲, 井上 誠

    言語聴覚研究   14 ( 3 )   265 - 265   2017.9

  • Central inhibition of initiation of swallowing by systemic administration of diazepam and baclofen in anaesthetized rats Reviewed

    Takanori Tsujimura, Shogo Sakai, Taku Suzuki, Izumi Ujihara, Kojun Tsuji, Jin Magara, Brendan J. Canning, Makoto Inoue

    AMERICAN JOURNAL OF PHYSIOLOGY-GASTROINTESTINAL AND LIVER PHYSIOLOGY   312 ( 5 )   G498 - G507   2017.5

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    Dysphagia is caused not only by neurological and/or structural damage but also by medication. We hypothesized memantine, dextromethorphan, diazepam, and baclofen, all commonly used drugs with central sites of action, may regulate swallowing function. Swallows were evoked by upper airway (UA)/pharyngeal distension, punctate mechanical stimulation using a von Frey filament, capsaicin or distilled water (DW) applied topically to the vocal folds, and electrical stimulation of a superior laryngeal nerve (SLN) in anesthetized rats and were documented by recording electromyographic activation of the suprahyoid and thyrohyoid muscles and by visualizing laryngeal elevation. The effects of intraperitoneal or topical administration of each drug on swallowing function were studied. Systemic administration of diazepam and baclofen, but not memantine or dextromethorphan, inhibited swallowing evoked by mechanical, chemical, and electrical stimulation. Both benzodiazepines and GABA(A) receptor antagonists diminished the inhibitory effects of diazepam, whereas a GABA(B) receptor antagonist diminished the effects of baclofen. Topically applied diazepam or baclofen had no effect on swallowing. These data indicate that diazepam and baclofen act centrally to inhibit swallowing in anesthetized rats.
    NEW & NOTEWORTHY Systemic administration of diazepam and baclofen, but not memantine or dextromethorphan, inhibited swallowing evoked by mechanical, chemical, and electrical stimulation. Both benzodiazepines and GABAA receptor antagonists diminished the inhibitory effects of diazepam, whereas a GABAB receptor antagonist diminished the effects of baclofen. Topical applied diazepam or baclofen was without effect on swallowing. Diazepam and baclofen act centrally to inhibit swallowing in anesthetized rats.

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  • Factors associated with mucosal dryness in multiple regions and skin: A web-based study in women Reviewed

    Kayoko Ito, Kiyoshi Takamatsu, Kaname Nohno, Aki Sugano, Saori Funayama, Kouji Katsura, Noboru Kaneko, Mariko Ogawa, Jukka H. Meurman, Makoto Inoue

    JOURNAL OF OBSTETRICS AND GYNAECOLOGY RESEARCH   43 ( 5 )   880 - 886   2017.5

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    Aim: We hypothesized that feeling mucosal dryness in one body region and the skin may be associated with dryness in other regions and that there are common background factors for dryness. In an earlier web-based survey, we reported prevalence figures of dry eyes, nose, mouth, skin, and vagina. In the present study, additional analyses were made to investigate the factors associated with dryness in each region, and simultaneous dryness in multiple regions.
    Methods: A web-based questionnaire was completed by 310 Japanese women. The questions included dryness of the eyes, nose, mouth, vagina, and skin. Menopausal and other symptoms were also addressed. Multiple logistic regression modeling was performed to identify factors associated with dryness in each region and in multiple dry regions.
    Results: Dry eyes were associated with dryness in the nose and with headache; dry nose was associated with dryness in the vagina and eyes; dry mouth was associated with sticky mouth symptom and dryness of the nose; dry skin was associated with use of xerogenic medications and vaginal discharge; and dryness of the vagina was associated with vaginal itchiness and dry nose. Vaginal discharge (odds ratio, 9.64; 95% confidence interval, 3.15-29.51) and sticky mouth (odds ratio, 6.35; 95% confidence interval, 1.29-31.29) were further associated with dryness in multiple regions.
    Conclusion: The present results confirmed our study hypothesis by showing that dryness in one region was clearly associated with that in another or in multiple regions. The result implies the need for holistic diagnosis and counseling for patients with dryness complaints.

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  • 小脳高頻度磁気刺激はヒト摂食機能の回復をもたらすか

    渡邊 賢礼, 真柄 仁, 井上 誠

    日本顎口腔機能学会雑誌   23 ( 2 )   122 - 123   2017.3

  • 嚥下時の顎反射の変調

    鈴木 拓, 酒井 翔悟, 辻 光順, 真柄 仁, 辻村 恭憲, 井上 誠

    日本顎口腔機能学会雑誌   23 ( 2 )   128 - 129   2017.3

  • Impact of oral ingestion on oral health condition in dysphagic inpatients Reviewed

    Tejima Y, Ito K, Magara J, Tsujimura T, Inoue M

    Oral Health and Dental Management   16 ( 1 )   1 - 9   2017

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  • Physical fitness and oral function in community-dwelling older people: a pilot study Reviewed

    Hiromi Izuno, Kazuhiro Hori, Misao Sawada, Masayo Fukuda, Chikako Hatayama, Kayoko Ito, Yoshio Nomura, Makoto Inoue

    GERODONTOLOGY   33 ( 4 )   470 - 479   2016.12

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    ObjectiveThe aim of the present study was to quantify the relation between physical fitness and oral function, including tongue and lip movements.
    BackgroundPhysical fitness and oral function influence quality of life and activities of daily living in older individuals. Occlusal contact and mastication performance are associated with physical fitness, but the association between tongue and lip movements and physical fitness is unclear.
    Material and methodsSixty-six independent community-dwelling older individuals (24 men, 42 women; mean age, 70.35.9years) participated in this study. Measures of physical fitness were the one-leg standing time with eyes open, the functional reach test, anteflexion, the timed up and go test, and grip strength. Measures of oral function were tongue pressure, lip pressure, tongue movement from side to side, the repetitive saliva-swallowing test (RSST), oral diadochokinesis and masticatory efficiency. Multiple regression analysis was used to quantify the relation between physical fitness and oral function.
    ResultsAfter adjustment for age, sex, BMI, exercise habits and number of remaining teeth, the tongue movement from side to side and/or oral diadochokinesis were chosen as significant factors in each physical fitness measurement. Furthermore, the lip pressure and masticatory efficiency were associated with handgrip strength.
    ConclusionOral function, including tongue and lip movements, was associated with physical fitness in older people in this study. Tongue dexterity as characterised by tongue movement from side to side and oral diadochokinesis particularly associated with physical fitness.

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  • Physical fitness and oral function in community-dwelling older people: a pilot study. Reviewed International journal

    Hiromi Izuno, Kazuhiro Hori, Misao Sawada, Masayo Fukuda, Chikako Hatayama, Kayoko Ito, Yoshio Nomura, Makoto Inoue

    Gerodontology   33 ( 4 )   470 - 479   2016.12

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    OBJECTIVE: The aim of the present study was to quantify the relation between physical fitness and oral function, including tongue and lip movements. BACKGROUND: Physical fitness and oral function influence quality of life and activities of daily living in older individuals. Occlusal contact and mastication performance are associated with physical fitness, but the association between tongue and lip movements and physical fitness is unclear. MATERIAL AND METHODS: Sixty-six independent community-dwelling older individuals (24 men, 42 women; mean age, 70.3 ± 5.9 years) participated in this study. Measures of physical fitness were the one-leg standing time with eyes open, the functional reach test, anteflexion, the timed up and go test, and grip strength. Measures of oral function were tongue pressure, lip pressure, tongue movement from side to side, the repetitive saliva-swallowing test (RSST), oral diadochokinesis and masticatory efficiency. Multiple regression analysis was used to quantify the relation between physical fitness and oral function. RESULTS: After adjustment for age, sex, BMI, exercise habits and number of remaining teeth, the tongue movement from side to side and/or oral diadochokinesis were chosen as significant factors in each physical fitness measurement. Furthermore, the lip pressure and masticatory efficiency were associated with handgrip strength. CONCLUSION: Oral function, including tongue and lip movements, was associated with physical fitness in older people in this study. Tongue dexterity as characterised by tongue movement from side to side and oral diadochokinesis particularly associated with physical fitness.

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  • 種々の条件刺激がもたらす嚥下機能の変化

    大平 匡徹, 田村 浩平, 渡邊 昌崇, 真柄 仁, 辻村 恭憲, 井上 誠

    日本摂食・嚥下リハビリテーション学会雑誌   20 ( 3 )   S209 - S209   2016.12

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  • 婦人科受診患者における口腔乾燥をもたらす因子に関する検討

    篠原 千鶴子, 伊藤 加代子, 高松 潔, 小川 真里子, 濃野 要, 船山 さおり, 片倉 朗, 野村 武史, 井上 誠

    日本女性医学学会雑誌   24 ( Suppl. )   112 - 112   2016.10

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  • 新潟大学くちのかわき外来における転帰に関する検討

    伊藤 加代子, 船山 さおり, 金子 昇, 濃野 要, 高野 綾子, 池 真樹子, 井上 誠

    老年歯科医学   31 ( 2 )   272 - 273   2016.9

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  • Mechanisms and prevention of sudden death in multiple system atrophy Reviewed

    Takayoshi Shimohata, Naotaka Aizawa, Hideaki Nakayama, Hiroshige Taniguchi, Yasuyoshi Ohshima, Hitoshi Okumura, Tetsuya Takahashi, Akio Yokoseki, Makoto Inoue, Masatoyo Nishizawa

    PARKINSONISM & RELATED DISORDERS   30   1 - 6   2016.9

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    Background: Sudden death in multiple system atrophy (MSA) usually occurs during sleep and was therefore attributed to suffocation resulting from vocal cord abductor paralysis, a characteristic laryngeal finding of MSA. This led to the use of tracheostomy and noninvasive positive pressure ventilation (NPPV) for the prevention of sudden death. However, neither method has been able to prevent sudden death, and both have occasionally precipitated treatment-related complications, including central sleep apneas and exacerbation of floppy epiglottis. Therefore, it is important to determine the mechanisms and prevention of sudden death in MSA.
    Methods: We reviewed the literature on the mechanisms and prevention of sudden death in patients with MSA.
    Results: Sudden death in MSA is hypothesized to be a consequence of disordered central respiration, suffocation caused by sputum and food, upper airway obstruction from NPPV acting on a floppy epiglottis, cardiac autonomic disturbance, or a combination of these factors.
    Conclusion: Various factors may be involved in the mechanism of sudden death in MSA. A multidisciplinary approach 'is needed to prevent sudden death, and this requires an organized system of several medical specialties. Neurologists require a cooperative network that includes experts in otorhinolaryngology, sleep medicine, dysphagia rehabilitation, and cardiology. (C ) 2016 Elsevier Ltd. All rights reserved.

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  • Exploring the effects of synchronous pharyngeal electrical stimulation with swallowing carbonated water on cortical excitability in the human pharyngeal motor system. Reviewed

    Magara J, Michou E, Raginis-Zborowska A, Inoue M, Hamdy S

    Neurogastroenterology and motility : the official journal of the European Gastrointestinal Motility Society   28 ( 9 )   1391 - 1400   2016.9

  • 口腔顔面領域の感覚 運動機能の統合 嚥下機能の理解から治療戦略へ

    井上 誠, 辻村 恭憲, 真柄 仁, 辻 光順

    Journal of Oral Biosciences Supplement   2016   158 - 158   2016.9

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  • 孤束核グルタミン酸受容体は嚥下誘発に関与する

    辻村 恭憲, 辻 光順, 酒井 翔悟, 鈴木 拓, 真柄 仁, 井上 誠

    嚥下医学   5 ( 2 )   290 - 290   2016.9

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  • 疾患別にみた舌圧発現の特徴

    真柄 仁, 辻 光順, 林 宏和, 辻村 恭憲, 堀 一浩, 井上 誠

    嚥下医学   5 ( 2 )   292 - 293   2016.9

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  • 口腔ケア介入患者の肺炎発症に関係する因子

    堀川 奈穂美, 堀 一浩, 伊藤 加代子, 辻村 恭憲, 真柄 仁, 船山 さおり, 酒井 翔悟, 小野 高裕, 井上 誠

    老年歯科医学   31 ( 2 )   190 - 191   2016.9

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  • 口腔ケア介入患者の肺炎発症に関係する因子

    堀川 奈穂美, 堀 一浩, 加藤 加代子, 辻村 恭憲, 真柄 仁, 船山 さおり, 酒井 翔悟, 小野 高裕, 井上 誠

    日本老年歯科医学会総会・学術大会プログラム・抄録集   27回   154 - 154   2016.6

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  • くちのかわき外来受診者における治療および転帰に関する検討

    伊藤 加代子, 船山 さおり, 金子 昇, 濃野 要, 池 真樹子, 高野 綾子, 井上 誠

    日本老年歯科医学会総会・学術大会プログラム・抄録集   27回   216 - 216   2016.6

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  • Esophageal Involvement in Multiple System Atrophy Reviewed

    Takayoshi Shimohata, Hiroshige Taniguchi, Hideaki Nakayama, Kazuhiro Hori, Makoto Inoue, Masatoyo Nishizawa

    NEUROLOGY   86   2016.4

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  • Differential response properties of peripherally and cortically evoked swallows by electrical stimulation in anesthetized rats Reviewed

    Takanori Tsujimura, Kojun Tsuji, Jin Magara, Shogo Sakai, Taku Suzuki, Yuki Nakamura, Kayoko Nozawa-Inoue, Makoto Inoue

    BRAIN RESEARCH BULLETIN   122   12 - 18   2016.4

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    We compared onset latency, motor-response patterns, and the effect of electrical stimulation of the cortical masticatory area between peripherally and cortically evoked swallows by electrical stimulation in anesthetized rats. The number of swallows and the motor patterns were determined using electromyographic recordings from the thyrohyoid, digastric, and masseter muscles. The onset latency of the first swallow evoked by electrical stimulation of the cortical swallowing area (Cx) was significantly longer than that evoked by stimulation of the superior laryngeal nerve (SLN). The duration of thyrohyoid burst activity associated with SLN-evoked swallows was significantly longer than that associated with either Cx-evoked or spontaneous swallows. Combining Cx with SLN stimulation increased the number of swallows at low levels of SLN stimulation. Finally, A-area (the orofacial motor cortex) stimulation inhibited Cx-evoked swallows significantly more than it inhibited SLN-evoked swallows. These findings suggest that peripherally and cortically evoked swallows have different response properties and are affected differently by the mastication network. (C) 2016 Elsevier Inc. All rights reserved.

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  • Changes in the oral moisture and the amount of microorganisms in saliva and tongue coating after oral ingestion resumption: A pilot study Reviewed

    Natsuki Kishimoto, Roxana Stegaroiu, Satoko Shibata, Kayoko Ito, Makoto Inoue, Akitsugu Ohuchi

    Open Dentistry Journal   10   79 - 88   2016.3

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    Background and Objective: Tube feeding has been significantly associated with a higher rate of aspiration pneumonia that is mainly related to oral microorganisms and a reduced salivary flow. Thus, the difference in the mode of nutritional intake is expected to affect the oral environment, but this has not yet been fully clarified. The purpose of this study was to investigate, in tube-fed patients, changes in the oral moisture and the counts of microorganisms in saliva and tongue coating, which occur after oral ingestion resumption. Methods: Study participants were 7 tube-fed inpatients of the Niigata University Medical and Dental Hospital (72.7±8.5 years old) who received dysphagia rehabilitation at the Unit of Dysphagia Rehabilitation until oral ingestion resumption. Their oral health, swallowing, and nutrition status, oral mucosal moisture, amount of unstimulated saliva and the counts of microorganisms (total microorganisms, streptococci, Candida) in saliva and tongue coating were investigated and compared before and after the recommencement of oral intake. Results: Tongue coating, choking, oral mucosal moisture and amount of unstimulated saliva were improved significantly after resumption of oral ingestion. The other investigated parameters did not significantly change, except for the streptococci in tongue coating, which significantly increased 1 week after oral ingestion recommencement, but decreased thereafter. Conclusion: After oral intake resumption, oral mucosal moisture and amount of unstimulated saliva were improved. However, because of a transitory increase in the counts of streptococci with oral ingestion recommencement, it is important to appropriately manage oral hygiene in these patients, according to the changes in their intraoral microbiota.

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  • Importance of professional oral hygiene in preventing medication-related osteonecrosis of the jaw Reviewed

    Ohnishi Y, Ito K, Kitamura R, Funayama S, Hori K, Inoue M

    IJOMS   15   85 - 92   2016.3

  • Effect of body posture on involuntary swallow in healthy volunteers Reviewed

    Yoshitaka Shiino, Shogo Sakai, Ryosuke Takeishi, Hirokazu Hayashi, Masahiro Watanabe, Takanori Tsujimura, Jin Magara, Kayoko Ito, Tetsu Tsukada, Makoto Inoue

    PHYSIOLOGY & BEHAVIOR   155   250 - 259   2016.3

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    Clinically, reclining posture has been reported to reduce risk of aspiration. However, during involuntary swallow in reclining posture, changes in orofacial and pharyngeal movement before and during pharyngeal swallow should be considered. Further, the mechanisms underlying the effect of body posture on involuntary swallow remain unclear. The aim of the present study was to determine the effect of body posture on activity patterns of the suprahyoid muscles and on patterns of bolus transport during a natural involuntary swallow. Thirteen healthy male adults participated in a water infusion test and a chewing test. In the water infusion test, thickened water was delivered into the pharynx at a very slow rate until the first involuntary swallow was evoked. In the chewing test, subjects were asked to eat 10 g of gruel rice. In both tests, the recording was performed at four body postures between upright and supine positions. Results showed that reclining changed the location of the bolus head at the start of swallow and prolonged onset latency of the swallowing initiation. Muscle burst duration and white-out time measured by videoendoscopy significantly increased with body reclining and prolongation of the falling time. In the chewing test, reclining changed the location of the bolus head at the start of swallow, and the frequency of bolus residue after the first swallow increased. Duration and area of EMG burst and whiteout time significantly increased with body reclining. These data suggest that body reclining may result in prolongation of pharyngeal swallow during involuntary swallow. (C) 2015 Elsevier Inc All rights reserved.

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  • 口腔への温度刺激がもたらす嚥下機能への影響

    神田 知佳, 竹石 龍右, 真柄 仁, 辻村 恭憲, 井上 誠

    日本顎口腔機能学会雑誌   22 ( 2 )   146 - 147   2016.3

  • Esophageal Involvement in Multiple System Atrophy Reviewed

    Hiroshige Taniguchi, Hideaki Nakayama, Kazuhiro Hori, Masatoyo Nishizawa, Makoto Inoue, Takayoshi Shimohata

    DYSPHAGIA   30 ( 6 )   669 - 673   2015.12

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    The prevalence of esophageal involvement and its impact on clinical manifestations in patients with multiple system atrophy (MSA) remains unknown. We recruited 16 consecutive patients with dysphagia associated with MSA (MSA group) and 16 consecutive patients with dysphagia associated with amyotrophic lateral sclerosis (ALS group). We assessed the presence or absence of food stagnation within the esophagus using videofluorography. Food stagnation within the esophagus was observed in 16 patients (100 %; 7 severe, 9 mild) in the MSA group and in 4 patients (25 %; 4 mild) in the ALS group (P &lt; 0.001). Follow-up videofluorography revealed that food stagnation in patients with MSA could exacerbate during the disease course. Patients with MSA and severe food stagnation showed a wide range of intraesophageal stasis by videofluorography. Among the 16 patients in the MSA group, 4 developed aspiration pneumonia and 1 died of suffocation associated with food regurgitation during continuous positive airway pressure therapy. In conclusion, food stagnation within the esophagus occurs more frequently in MSA patients with dysphagia than in ALS patients with dysphagia. Because food stagnation can cause serious complications such as aspiration pneumonia and suffocation, patients with MSA should be evaluated by videofluorography, especially those with stagnation in the esophageal phase.

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  • New Swallowing Evaluation Using Piezoelectricity in Normal Individuals Reviewed

    Yuichiro Sogawa, Shinji Kimura, Toru Harigai, Naoki Sakurai, Akira Toyosato, Taro Nishikawa, Makoto Inoue, Akira Murasawa, Naoto Endo

    DYSPHAGIA   30 ( 6 )   759 - 767   2015.12

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    This study aimed to elucidate the relationship between the piezoelectric waveform latency, hyoid bone movement, surface electromyogram (sEMG), and the pharyngeal transit time (PTT) during swallowing. Forty-one healthy subjects were divided into three age groups: younger (20-39 years, n = 8), middle-aged (40-59 years, n = 9), and older (60-79 years, n = 24). Motion analysis of the hyoid bone using videofluorography (VF), waveform analysis of the front neck using piezoelectric films, and sEMG of the suprahyoid muscle group were performed simultaneously. Latencies of the three movement phases were defined as upward (VFS1), forward (VFS2), and returning to starting position (VFS3). The three phases of the piezoelectric waveform-from wave initiation of the negative wave to the start of the second deep negative wave; from the start of the second deep negative wave to the start of the last positive wave (SLPW); and from the SLPW to the end of the last positive wave-were defined as PS1, PS2, and PS3, respectively. VFS1-3 and PS1-3 were significantly correlated. VFS1 and PS1 latencies were significantly longer with thick liquid than with thin liquid. VFS2, PS1, and PS2 latencies were longer in the older group than in the other two groups. The start of PS1 was nearly equal to those of sEMG and VFS1. Bolus arrival time in the valleculae was statistically equal to the end of the PS1 with both thin and thick liquids. To establish the swallowing screening using Piezoelectric film, further investigation is necessary in the dysphagia patients.

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  • Changes in jaw muscle activity and the physical properties of foods with different textures during chewing behaviors Reviewed

    Hiroko Iguchi, Jin Magara, Yuki Nakamura, Takanori Tsujimura, Kayoko Ito, Makoto Inoue

    PHYSIOLOGY & BEHAVIOR   152 ( Pt A )   217 - 224   2015.12

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    This study aimed to investigate how the activity of the masseter (Mas) and suprahyoid (Hyoid) muscles is influenced by the physical properties of food, how changes in the rheological properties of food differ between different foods during the process of food reduction, and how different salivary flow rates affect bolus-making capability during masticatory behavior in healthy humans. Ten healthy adults participated in this study. Electro-myographic (EMG) recordings were obtained from the Mas and Hyoid muscles, and 15 g of steamed rice and rice cake was prepared as test foods. In the ingestion test, the subjects were asked to eat each food in their usual manner. The chewing duration, number of chewing cycles before the first swallow, Mas and Hyoid EMG activity, and chewing cycle time were compared between the foods. Total chewing duration was divided into three substages: early, middle, and late; chewing cycle time and EMG activity per chewing cycle of each substage were compared between the foods and among the substages. In the spitting test, the rheological properties of the bolus at the end of each substage were compared between the foods and among the substages. Finally, stimulated salivary flow rates were measured and the relationships between salivary flow rate and chewing duration, EMG activity, and changes in physical food characteristics were investigated. There were significant differences in total chewing duration and the number of chewing cycles, but not in chewing cycle time, between the foods, which had similar hardness values. The EMG activity levels of the Mas and Hyoid per chewing cycle for the rice cake were significantly greater than for the steamed rice throughout the recording periods. While Mas activity did not change among the substages during chewing, Hyoid EMG activity decreased as chewing progressed. Chewing cycle time also gradually decreased as chewing progressed. The hardness of both foods initially increased, then gradually decreased back to baseline. The adhesiveness of the rice cake initially increased, and did not fall throughout the recording period; the adhesiveness of the steamed rice did not significantly change. Cohesiveness barely changed in either of the two foods during chewing, but was significantly greater for the rice cake than for the steamed rice. Finally, a correlation between the stimulated salivary flow rate and chewing performance was evident only in a change in Mas EMG activity. The current results demonstrate that the activities of the Mas and Hyoid muscles changed as chewing progressed, and were affected by hardness, adhesiveness, and cohesiveness. Salivary flow rate may affect the changes in Mas activity during the process of bolus formation. (C) 2015 Elsevier Inc. All rights reserved.

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  • 更年期女性の口腔乾燥感と更年期症状との関連に関する検討

    篠原 千鶴子, 伊藤 加代子, 船山 さおり, 井上 誠

    新潟歯学会雑誌   45 ( 2 )   111 - 112   2015.12

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  • Peripheral and central control of swallowing initiation in healthy humans Reviewed

    Seiya Aida, Ryosuke Takeishi, Jin Magara, Masahiro Watanabe, Kayoko Ito, Yuki Nakamura, Takanori Tsujimura, Hirokazu Hayashi, Makoto Inoue

    PHYSIOLOGY & BEHAVIOR   151   404 - 411   2015.11

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    We investigated (1) how peripheral inputs might assist central inputs in the control of voluntary evoked swallowing, (2) inter-individual variation in involuntary and voluntary swallowing initiation, and (3) whether natural chewing behavior affects the initiation of involuntary swallowing in healthy humans. Eleven participants completed a repetitive saliva swallowing test (RSST), chewing test (CHEW), and rest period,(REST). In RSST, participants repetitively swallowed as quickly as possible. In CHEW, subjects chewed gum freely. We delivered pharyngeal electrical stimulation (PEStim) to the laryngopharynx and compared the number of swallows that occurred with and without PEStim. PEStim significantly increased the number of voluntary evoked swallows in RSST, as well as the number of swallows in CHEW and REST trials, although this facilitatory effect was larger in REST trials. We found a positive correlation between the number of swallows at RSST without PEStim and that at REST with PEStim within individuals. Additionally, we found a significant positive correlation between the number of swallows at RSST with PEStim and the sum of that at RSST without PEStim and at REST with PES. Based on the current results, we suggest that (1) peripheral inputs within a certain range appear to facilitate the central inputs that control voluntary swallowing, (2) inter-individual variations in swallowing initiation may arise from differences in the excitability of the common neural network in the lower brainstem, and (3) during chewing, food reduction in the oral cavity is prioritized, such that the neural network associated with chewing may regulate swallowing initiation. (C) 2015 Elsevier Inc. All rights reserved.

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  • 口腔生理学分野の研究最前線Frontier in the field of Oral Physiology 嚥下時における口腔感覚の変調

    酒井 翔悟, 辻 光順, 真柄 仁, 辻村 恭憲, 井上 誠

    Journal of Oral Biosciences Supplement   2015   116 - 116   2015.9

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  • 上喉頭神経刺激による口腔感覚の変調

    酒井 翔悟, 辻 光順, 真柄 仁, 辻村 恭憲, 井上 誠

    日本顎口腔機能学会雑誌   22 ( 1 )   40 - 41   2015.9

  • 咽頭粘膜への電気刺激がもたらす嚥下機能への即時および長期効果

    井上 誠, 竹石 龍右, 渡邉 賢礼, 真柄 仁, 林 宏和, 辻村 恭憲, 堀 一浩

    嚥下医学   4 ( 2 )   283 - 283   2015.9

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  • Coordination in oro-pharyngeal biomechanics during human swallowing Reviewed

    Qiang Li, Yoshitomo Minagi, Kazuhiro Hori, Jugo Kondoh, Shigehiro Fujiwara, Kenichi Tamine, Makoto Inoue, Yoshinobu Maeda, Yongjin Chen, Takahiro Ono

    PHYSIOLOGY & BEHAVIOR   147   300 - 305   2015.8

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    In swallowing, the tongue contacts against the hard palate to generate pressure for propelling a bolus from the oral cavity into the pharynx. Meanwhile, the hyoid and larynx move upward and forward to facilitate the bolus from the pharynx into the esophagus. It has been well known that sequential coordination between those actions is critical for safety accomplishment of swallowing. However, the absence of noninvasive assessment for it limits the detection to the physiological symptom of dysphagia. We applied a sensor sheet on the hard palate to measure tongue contact pressure and a bend sensor on the frontal neck to monitor the laryngeal movement, which was synchronized with hyoid motion for assessing the coordination between both actions in 14 healthy male subjects when swallowing 5 ml of water. The sequential order of tongue pressure and hyoid movement was successfully displayed. Tongue pressure was produced after slight movement of the hyoid and closely to the hyoid elevation, then reached a maximum when the hyoid stabilized in the most anterior superior position, and ceased concurrently with the onset of hyoid descent. Additionally, the synchronized data from both sensors showed positive correlations between identified time points on the laryngeal signal waveform and onset, peak and offset of tongue pressure. Our sensing system successfully showed the coordination between tongue pressure production and hyoid motion, and could be a simple and noninvasive method for clinicians to evaluate the oral and pharyngeal stages of swallowing. (C) 2015 Elsevier Inc. All rights reserved.

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  • Suppression of the swallowing reflex by stimulation of the red nucleus Reviewed

    Yoshihide Satoh, Kojun Tsuji, Takanori Tsujimura, Ken'Ichi Ishizuka, Makoto Inoue

    BRAIN RESEARCH BULLETIN   116   25 - 33   2015.7

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    We study whether the red nucleus is involved in control of swallowing. The swallowing reflex was induced in anesthetized rats by repetitive electrical stimulation of the superior laryngeal nerve. The electromyographic activities of the mylohyoid and thyrohyoid muscles were recorded in order to identify the swallowing reflex. Repetitive electrical stimulation applied to the red nucleus reduced the number of swallows. The onset latency of the first swallow was increased during repetitive electrical stimulation applied to the magnocellular part of the red nucleus. Microinjection of monosodium glutamate into the red nucleus also reduced the number of swallows. The onset latency of the first swallow was increased after microinjection of monosodium glutamate into the magnocellular part of the red nucleus. These results imply that the red nucleus is involved in the control of swallowing. (C) 2015 Elsevier Inc. All rights reserved.

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  • Dysphagia Rehabilitation in Japan

    Makoto Inoue

    JOURNAL OF NUTRITIONAL SCIENCE AND VITAMINOLOGY   61   S72 - S73   2015.5

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    In Japan, one of the most common causes of death in elderly people is aspiration pneumonia. Maintenance of oral hygiene and feeding functions are important elements, especially in patients with dysphagia caused by stroke, neurological diseases, and after operations on the head and neck cancer, as well as in the elderly to prevent aspiration pneumonia. It should also be noted that not only oral health care and physical therapy related to feeding functions but also dental treatment is included in the clinical management during interventions whenever needed. On the other hand, for the patients and/or elderly in need of assistance in maintaining a safe diet, it is recommended that a specialized team comprising physicians, dentists, and speech therapists in functional rehabilitation observes meal conditions of the subjects and evaluates such factors as meal contents, posture during meals, usage of dishes and cutlery, meal times, status of consciousness, perception, and motivation. First, I will present the clinical interventions to those patients, which include oral health care, dental treatment, physical therapy and meal assistance, as well as team approaches in those circumstances. In addition, clinical and basic research results will be introduced, which are expected to foster the understanding of physiology in chewing and swallowing. These results are also expected to develop the clinical technology to maintain or recover the feeding functions.

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  • 咽頭電気刺激による嚥下機能への驚くべき効果

    林 宏和, 竹石 龍右, 真柄 仁, 谷口 裕重, 辻村 恭憲, 堀 一浩, 井上 誠

    日本顎口腔機能学会雑誌   21 ( 2 )   142 - 143   2015.3

  • The neural mechanisms underlying swallowing

    Makoto Inoue

    Brain and Nerve   67 ( 2 )   157 - 168   2015.2

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    Swallowing is regarded as the first step in nutrition
    it transports food boluses and liquid from the mouth to the stomach and is a defensive response to prevent aspiration. Swallowing movements are produced by a central pattern generator (CPG) located in the lower brainstem. The swallowing CPG includes two main groups of neurons: one is located within the nucleus tractus solitarii and contains the generator neurons involved in triggering, shaping, and timing the sequential or rhythmic swallowing pattern and the other is located in the ventrolateral medulla and contains switching neurons that distribute the swallowing drive to various pools of related motoneurons. Swallowing movements can be triggered by either central inputs or peripheral inputs from pharyngeal and laryngeal regions, but the precise neural mechanisms of the swallowing CPG remain to be fully elucidated. This review discusses the fundamental knowledge of ingestion behaviors, with a focus on swallowing.

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  • Comparison of mechanical analysis and tongue pressure analyses during squeezing and swallowing of gel agents Reviewed

    Hori K, Hayashi H, Yokoyama S, Ono T, Ishihara S, Magara J, Taniguchi H, Funami T, Maeda Y, Inoue M

    Food Hydrocolloids   44   145 - 155   2015.2

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  • Changes in the frequency of swallowing during electrical stimulation of superior laryngeal nerve in rats Reviewed

    Kojun Tsuji, Takanori Tsujimura, Jin Magara, Shogo Sakai, Yuki Nakamura, Makoto Inoue

    BRAIN RESEARCH BULLETIN   111   53 - 61   2015.2

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    The aim of the present study was to investigate the adaptation of the swallowing reflex in terms of reduced swallowing reflex initiation following continuous superior laryngeal nerve stimulation. Forty-four male Sprague Dawley rats were anesthetized with urethane. To identify swallowing, electromyographic activity of the left mylohyoid and thyrohyoid muscles was recorded. To evoke the swallowing response, the superior laryngeal nerve (SLN), recurrent laryngeal nerve, or cortical swallowing area was electrically stimulated. Repetitive swallowing evoked by continuous SLN stimulation was gradually reduced, and this reduction was dependent on the resting time duration between stimulations. Prior SLN stimulation also suppressed subsequent swallowing initiation. The reduction in evoked swallows induced by recurrent laryngeal nerve or cortical swallowing area stimulation was less than that following superior laryngeal nerve stimulation. Decerebration had no effect on the reduction in evoked swallows. Prior subthreshold stimulation reduced subsequent initiation of swallowing, suggesting that there was no relationship between swallowing movement evoked by prior stimulation and the subsequent reduction in swallowing initiation. Overall, these data suggest that reduced sensory afferent nerve firing and/or trans-synaptic responses, as well as part of the brainstem central pattern generator, are involved in adaptation of the swallowing reflex following continuous stimulation of swallow-inducing peripheral nerves and cortical areas. (C) 2014 Elsevier Inc. All rights reserved.

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  • Ultra-wide-field retinal images in an eye with a small-aperture corneal inlay. Reviewed International journal

    Yokota R, Koto T, Inoue M, Hirakata A

    Journal of cataract and refractive surgery   41 ( 1 )   234 - 236   2015.1

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    UNLABELLED: We evaluated the ultra-wide-field retinal images for a 53-year-old man who developed peripheral retinal tears in an eye implanted with a Kamra corneal inlay after laser in situ keratomileusis. The peripheral fundus was photographed using the ultra-wide-field Optos imaging system. The images had a dark ring in the center of the retinal images that moved with eye movement. Photographs of the peripheral retinal tears were taken by directing the eye laterally to move the dark ring away from the retinal tears. The retinal tears were photocoagulated while viewing the retina through a wide-angle contact lens and with the eye directed laterally. We recommend using a wide-angle viewing lens to examine and treat an eye implanted with a corneal inlay. FINANCIAL DISCLOSURE: No author has a financial or proprietary interest in any material or method mentioned.

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  • 上喉頭神経刺激時の開口反射の変調とそのメカニズムの解明

    酒井 翔悟, 辻 光順, 真柄 仁, 辻村 恭憲, 井上 誠

    新潟歯学会雑誌   44 ( 2 )   120 - 120   2014.12

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  • ヒト咽頭粘膜への電気刺激がもたらす嚥下機能の可塑性変化

    竹石 龍右, 真柄 仁, 谷口 裕重, 林 宏和, 辻村 恭憲, 堀 一浩, 井上 誠

    新潟歯学会雑誌   44 ( 2 )   131 - 131   2014.12

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  • 米飯ならびに餅食品摂取の生理学的評価

    井口 寛子, 林 宏和, 真柄 仁, 堀 一浩, 谷口 裕重, 伊藤 加代子, 井上 誠

    新潟歯学会雑誌   44 ( 2 )   120 - 120   2014.12

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  • 口腔機能の改善が嚥下機能回復に寄与した一例

    設樂 仁子, 手嶋 謡子, 真柄 仁, 谷口 裕重, 井上 誠

    新潟歯学会雑誌   44 ( 2 )   93 - 98   2014.12

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    症例は79歳男性、当院呼吸器内科に左小細胞肺癌/右非小細胞肺癌切除術後で通院中であったが、2014年3月19日から発熱を伴う全身状態悪化により3月22日に当院呼吸器内科に緊急入院となった。右下葉の斑状影を伴う肺炎、肝嚢胞の腫大と内部出血を認め、さらに脳梗塞を併発した。抗生剤、解熱剤投与にて徐々に全身状態改善みられ、内服を試みたところ、むせが頻回に認められたため、4月1日に摂食嚥下機能回復部に紹介された。初診時、全身状態として低栄養、炎症傾向が継続しており、摂食機能評価では、口腔衛生状態は不良、改定水飲みテスト3b点であった。介入3日目の嚥下内視鏡検査実施では、咽頭残留はあるもの摂取方法や食形態の制限を行うことで誤嚥・喉頭侵入なく食事摂取可能と判断し、4日目よりペースト食にて食事を開始した。口腔機能の改善、食形態の改善を図るため、15日目に義歯の製作を開始、17日目には嚥下造影検査を施行し、液体のとろみ付け継続の必要性を確認した。28日目には上下全部床義歯を装着、数回の調整を行い、32日目に行った摂食機能評価では口腔衛生状態、口腔内乾燥は顕著な改善を認め、改定水飲みテスト5点に改善、食形態の食上げは可能と判断し、粥食を米飯に食上げした。42日目に実施した嚥下造影検査では、前回と比べ喉頭侵入量の改善は認めたものの、液体の多量摂取時には不顕性誤嚥を認めたため、液体に1%程度のゆるめのとろみを付けることを継続とした。当科介入中に、口腔機能の改善に伴い摂食嚥下機能が回復し、43日目に経過良好にて転院となった。(著者抄録)

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  • 上喉頭神経刺激時における開口反射と三叉神経核領域での神経伝達の変調への影響

    酒井 翔悟, 辻 光順, 真柄 仁, 辻村 恭憲, 井上 誠

    Journal of Oral Biosciences Supplement   2014   148 - 148   2014.9

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  • 嚥下時における顎反射の変調とそのメカニズム

    酒井 翔悟, 辻 光順, 真柄 仁, 辻村 恭憲, 井上 誠

    日本顎口腔機能学会雑誌   21 ( 1 )   48 - 49   2014.9

  • 咽頭電気刺激がもたらす嚥下関連機能の神経可塑性変化

    真柄 仁, 谷口 裕重, 林 宏和, 竹石 龍右, 辻村 恭憲, 堀 一浩, 井上 誠

    日本顎口腔機能学会雑誌   21 ( 1 )   52 - 53   2014.9

  • 咀嚼運動が嚥下反射に与える影響

    谷口 裕重, 堀 一浩, 林 宏和, 辻村 恭憲, 真柄 仁, 井上 誠

    老年歯科医学   29 ( 2 )   104 - 105   2014.9

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  • 嚥下誘発における孤束核グルタミン酸受容体の役割(The role of glutamate receptors in the nucleus of the solitary tract of the intitation of swallows)

    辻村 恭憲, 辻 光順, 酒井 翔悟, 真柄 仁, 井上 誠

    Journal of Oral Biosciences Supplement   2014   149 - 149   2014.9

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  • 咀嚼運動が嚥下反射に与える影響

    谷口 裕重, 堀 一浩, 林 宏和, 辻村 恭憲, 真柄 仁, 井上 誠

    日本老年歯科医学会総会・学術大会プログラム・抄録集   25回   110 - 110   2014.6

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  • Tongue Pressure Modulation for Initial Gel Consistency in a Different Oral Strategy Reviewed

    Sumiko Yokoyama, Kazuhiro Hori, Ken-ichi Tamine, Shigehiro Fujiwara, Makoto Inoue, Yoshinobu Maeda, Takahiro Funami, Sayaka Ishihara, Takahiro Ono

    PLOS ONE   9 ( 3 )   e91920   2014.3

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    Background: In the recent hyper-aged societies of developed countries, the market for soft diets for patients with dysphagia has been growing and numerous jelly-type foods have become available. However, interrelationships between the biomechanics of oral strategies and jelly texture remain unclear. The present study investigated the influence of the initial consistency of jelly on tongue motor kinetics in different oral strategies by measuring tongue pressure against the hard palate.
    Methods: Jellies created as a mixture of deacylated gellan gum and psyllium seed gum with different initial consistencies (hard, medium or soft) were prepared as test foods. Tongue pressure production while ingesting 5 ml of jelly using different oral strategies (Squeezing or Mastication) was recorded in eight healthy volunteers using an ultra-thin sensor sheet system. Maximal magnitude, duration and total integrated values (tongue work) of tongue pressure for size reduction and swallowing in each strategy were compared among initial consistencies of jelly, and between Squeezing and Mastication.
    Results: In Squeezing, the tongue performed more work for size reduction with increasing initial consistency of jelly by modulating both the magnitude and duration of tongue pressure over a wide area of hard palate, but tongue work for swallowing increased at the posterior-median and circumferential parts by modulating only the magnitude of tongue pressure. Conversely, in Mastication, the tongue performed more work for size reduction with increasing initial consistency of jelly by modulating both magnitude and duration of tongue pressure mainly at the posterior part of the hard palate, but tongue work as well as other tongue pressure parameters for swallowing showed no differences by type of jelly.
    Conclusions: These results reveal fine modulations in tongue-palate contact according to the initial consistency of jelly and oral strategies.

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  • 摂食に関連した咽頭と食道機能の加齢変化とその関係

    谷口 裕重, 真柄 仁, 林 宏和, 辻 光順, 酒井 翔梧, 堀 一浩, 井上 誠

    日本顎口腔機能学会雑誌   20 ( 2 )   132 - 133   2014.3

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    摂食に関連した咽頭と食道機能の加齢変化とその関係について検討した。健常若年男性10例、健常高齢男性12例を対象とした。全ての被験食で若年者と比較して高齢者で食道内残留スコアが高値を示した。とろみ液体、粥で若年者と比較して高齢者で咽頭内残留スコアが高値を示した。嚥下反射惹起ポイントは全ての被験食で若年者と比較して高齢者で高値を示した。若年者群では食道、咽頭、口腔の各パラメータ間で有意な相関を認めなかったが、高齢者群では食道内残留と咽頭、口腔のいくつのパラメータ間で相関を認めた。とろみ液体と粥では咽頭内残留スコアが高い被験者は食道内残留スコアも有意に高値を示した。とろみ液体と粥では、嚥下反射惹起ポイントが高い被験者は食道内残留スコアが有意に高値を示した。とろみ液体と粥では、Eichner's分類B群およびC群がA群と比較して食道内残留スコアが有意に高かった。

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    Other Link: https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2014&ichushi_jid=J02994&link_issn=&doc_id=20140630270004&doc_link_id=%2Fex2gakuk%2F2014%2F002002%2F004%2F0132-0133%26dl%3D0&url=http%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fex2gakuk%2F2014%2F002002%2F004%2F0132-0133%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

  • 舌接触補助床の装着が嚥下機能に及ぼす影響

    真柄 仁, 林 宏和, 神田 知佳, 堀 一浩, 井上 誠

    嚥下医学   3 ( 1 )   157 - 157   2014.2

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  • How do tablet properties influence swallowing behaviours? Reviewed

    Shinya Yamamoto, Hiroshige Taniguchi, Hirokazu Hayashi, Kazuhiro Hori, Takanori Tsujimura, Yuki Nakamura, Hideaki Sato, Makoto Inoue

    JOURNAL OF PHARMACY AND PHARMACOLOGY   66 ( 1 )   32 - 39   2014.1

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    ObjectivesBehavioural performance of tablet swallowing was evaluated with different tablet conditions in terms of size, number and surface coating.
    MethodsFour different types of tablets were prepared: small or large, and with or without a surface coating. Fourteen normal male adults were instructed to swallow the prepared tablets with 15ml of water. The number of tablets in one trial was changed from one to three. To evaluate swallowing and tablet transport, electromyographic activity was recorded in the left suprahyoid muscles, and videofluorographic images were examined.
    Key findingsAll tablet conditions (size, number and surface coating) affected the swallowing performance in terms of total number of swallows, electromyographic burst patterns and location of remaining tablets. Increases in the size and number of tablets increased the number of swallows and electromyographic burst area and duration. In addition, all of these parameters increased while swallowing tablets without a coating compared with tablets with a coating. Location of the remaining tablets was mainly within the mouth.
    ConclusionsThis study only clarified the normal pattern of tablet swallowing under several conditions in healthy subjects, but the results may facilitate comprehensive evaluation and treatment planning in terms of administering medication to dysphagic patients.

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  • How do tablet properties influence swallowing behaviours? Reviewed

    Yamamoto Shinya, Taniguchi Hiroshige, Hayashi Hirokazu, Hori Kazuhiro, Tsujimura Takanori, Nakamura Yuki, Sato Hideaki, Inoue Makoto

    J Pharm Pharmacol   66 ( 1 )   32 - 39   2014.1

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    OBJECTIVES: Behavioural performance of tablet swallowing was evaluated with different tablet conditions in terms of size, number and surface coating. METHODS: Four different types of tablets were prepared: small or large, and with or without a surface coating. Fourteen normal male adults were instructed to swallow the prepared tablets with 15 ml of water. The number of tablets in one trial was changed from one to three. To evaluate swallowing and tablet transport, electromyographic activity was recorded in the left suprahyoid muscles, and videofluorographic images were examined. KEY FINDINGS: All tablet conditions (size, number and surface coating) affected the swallowing performance in terms of total number of swallows, electromyographic burst patterns and location of remaining tablets. Increases in the size and number of tablets increased the number of swallows and electromyographic burst area and duration. In addition, all of these parameters increased while swallowing tablets without a coating compared with tablets with a coating. Location of the remaining tablets was mainly within the mouth. CONCLUSIONS: This study only clarified the normal pattern of tablet swallowing under

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  • 当院NSTが介入した摂食・嚥下障害患者の動向

    谷口 裕重, 堀 一浩, 真柄 仁, 村山 稔子, 小師 優子, 小山 諭, 井上 誠

    静脈経腸栄養   29 ( 1 )   384 - 384   2014.1

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  • Introduction of performance assessment into the "Study Skills" course and its practical problems

    Ono Kazuhiro, Nishiyama Hideyoshi, Yagi Minoru, Stegaroiu Roxana, Shigetani Yoshimi, Yamamura Kensuke, Inoue Makoto, Maeda Takeyasu

    新潟大学高等教育研究   1 ( 2 )   5 - 8   2014

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    新潟大学歯学部では,初年次教育として大学学習法を実施している.この授業は講義・演習での知識や技能をもとに,レポート作成とプレゼンテーションを行うもので,その学習活動を通して,間題解決能力,論理的思考力,表現力の開発をねらいとしている.今回,学習成果の直接評価に向けて,パフォーマンス評価を導入すべく,レポートからこれら能力を読み解くルーブリックづくりに取り組んだ.また,この経験からみえてきたパフォーマンス評価の難点とその対処について検討した.その結果,パフォーマンス評価により能力を把握できる可能性が示されたが,導入には教員の理解と協力,能力と関連した適切な評価観点の設定,評価の信頼性を高める工夫,評価と指導の一体化を考慮した授業デザインなど,いくつかの課題があることも明らかになった.The curriculum of Niigata University Faculty of Dentistry provides the &quot;Study Skills&quot; course as first year education. The ultimate goal of this course is to develop student abilities of problem solving, logical thinking and expression. For that purpose, each student is guided through the process of writing a report and presenting its content. To access the degree to which these abilities were achieved, we created a rubric and used it to evaluate the student reports. Based on the experience of this trial, we discussed problems for the introduction of performance assessment into the course. Although performance assessment has a high potential to grasp these abilities, there are some practical problems that may interfere with its introduction, such as &quot;how to involve the faculty in assessment&quot;, &quot;how to establish dimensions of the rubric that appropriately relate with the student abilities&quot;, &quot;how to increase the reliability of assessment&quot;, &quot;how to design the course to allow for a connection between assessment and instruction&quot;.

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  • 舌接触補助床の装着による嚥下機能改善効果の検討

    真柄 仁, 堀 一浩, 林 宏和, 井上 誠

    顎顔面補綴   36 ( 2 )   114 - 114   2013.12

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  • 麻酔下ラットにおける上喉頭神経連続電気刺激時の嚥下反射誘発の減衰

    辻 光順, 辻村 恭憲, 酒井 翔悟, 真柄 仁, 井上 誠

    新潟歯学会雑誌   43 ( 2 )   160 - 160   2013.12

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  • 当院NSTにおける摂食・嚥下障害患者の動向について

    谷口 裕重, 堀 一浩, 真柄 仁, 村山 稔子, 小師 優子, 小山 諭, 井上 誠

    日本摂食・嚥下リハビリテーション学会雑誌   17 ( 3 )   S222 - S223   2013.12

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  • Role of tongue pressure production in oropharyngeal swallow biomechanics. Reviewed International journal

    Kazuhiro Hori, Hiroshige Taniguchi, Hirokazu Hayashi, Jin Magara, Yoshitomo Minagi, Qiang Li, Takahiro Ono, Makoto Inoue

    Physiological reports   1 ( 6 )   e00167   2013.11

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    The tongue is important for orofacial movements, including swallowing. Although numerous studies have focused on tongue pressure against the palate, its physiological role has not been fully evaluated. The tongue pressure generation may have the temporal coordination with the swallowing relational organs. The aim of this study was to clarify the physiological mechanisms of tongue pressure and to investigate the temporal relationship among tongue pressure, supra-hyoid muscle activity, and videofluorographic (VF) images during swallowing. Fifteen healthy young subjects participated. Tongue pressure measured using a sensor sheet with five channels, electromyographic EMG, and VF was recorded synchronously during 4-ml barium swallowing. Swallowing behavior in VF images with and without the sensor sheet was compared. Furthermore, the temporal relationship between events measured from tongue pressure, EMG, and VF was evaluated. Swallowing behavior on VF images was not affected by placement of the sensor sheet. Tongue pressure at the posterio-lateral point of the hard palate tended to have biphasic peaks. Tongue pressure production with a monophasic pattern appeared during the same period as the second peak in the biphasic pattern. The onset of tongue pressure was later than the start of hyoid movement and onset of EMG, and offset was observed between the hyoid at the up-forward position and reposition. Onset of tongue pressure at the anterior area was correlated with the start of slight hyoid elevation. Offset of tongue pressure at the posterio-lateral points was strongly time locked with the hyoid at the up-forward position. The present results suggested the temporal coordination of tongue pressure generation with the swallowing-related organs. That is, the tongue pressure was produced for bolus propulsion, and was closely related to hyoid movement temporally during swallowing. These results may contribute to clarify the clinical state with the disorder of tongue kinetics.

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  • Effects of pharyngeal water stimulation on swallowing behaviors in healthy humans Reviewed

    Yuki Nakamura, Aya Hatakeyama, Yasuyuki Kitada, Takanori Tsujimura, Hiroshige Taniguchi, Makoto Inoue

    EXPERIMENTAL BRAIN RESEARCH   230 ( 2 )   197 - 205   2013.10

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    The aims of the present study were to determine whether the interval between swallows and the electromyographic (EMG) burst patterns of the suprahyoid muscles is affected by peripheral inputs during swallowing. Eighteen normal adults were asked to perform repetitive voluntary swallowing as quickly as possible, and three variables of swallowing were measured and evaluated, i.e., the swallowing intervals and the time interval between the onset and peak (rising time) and between the peak and offset (falling time) of the suprahyoid EMG burst. During recording, pharyngeal fluid infusion was applied with distilled water or 0.3 M NaCl solution at a very slow infusion rate (0.2 mL/min). The former and latter were used to activate and inhibit the excitation of water-sensitive receptors in the pharynx, respectively. The swallowing interval was significantly shorter during infusion of water than during infusion of NaCl solution. The rising time was also significantly shorter during infusion of water than during infusion of NaCl solution. There was a linear positive correlation between these values and facilitatory effects: the longer either the swallowing interval or rising time with infusion of 0.3 M NaCl solution, the stronger the facilitation of swallowing by the activation of water receptors. Facilitatory effects on the swallowing interval and rising time showed a linear correlation. It is suggested that weak liquid stimulation changed sensory inputs into the swallowing center and synchronously modulated the swallowing interval and time interval between the onset and peak of the EMG burst.

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  • One step polymerizing technique for fabricating a hollow obturator Reviewed

    Kazuhiro Hori, Tetsuo Miyamoto, Takahiro Ono, Masaaki Yamamoto, Naoko Shiroshita, Yoshinobu Maeda, Makoto Inoue

    JOURNAL OF PROSTHODONTIC RESEARCH   57 ( 4 )   294 - 297   2013.10

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    Purpose: Although a closed hollow obturator is often applied to post maxillectomy patients, it has a few problems such as complexity of fabrication and water leakage to inside. A one step curing technique to fabricate a closed hollow obturator by constructing a small hollow bulb made by two thermoplastic resin sheets is described in the present report.
    Methods: In the one step curing technique, after dewaxing the wax denture fabricated conventionally, one size smaller hollow body was fabricated with two thermoplastic resin sheets and set into the investment mold as a core. Then the circumferential part of obturator was cured by the pour type resin.
    This technique was used to fabricate an obturator prosthesis in a 60-year-old post-maxillectomy patient. The weight of this obturator was well controlled and the definitive prosthesis weighed 22 g. At a one year follow-up, the obturator fared well without any water leakage or breakage.
    Conclusions: This technique allows the fabricator to control the thickness and weight of the obturator by the amount of relief provided by the hollow bulb. It also rectifies the disadvantages of the closed hollow obturator such as water leakage and complexity of fabrication. Crown Copyright (C) 2013 Published by Elsevier Ireland on behalf of Japan Prosthodontic Society. All rights reserved.

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  • Biomechanics of human tongue movement during bolus compression and swallowing. Reviewed

    Hayashi H, Hori K, Taniguchi H, Nakamura Y, Tsujimura T, Ono T, Inoue M

    Journal of oral science   55 ( 3 )   191 - 198   2013.9

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    We evaluated the effects of gel consistency and bolus volume on ingestion in humans. Eight healthy men were asked to ingest liquids, and sample foods of different gel consistencies and volumes, as usual. Tongue pressure against the hard palate was recorded at five points, and bolus flow was recorded using videoendoscopic images. The number of squeezes increased as gel consistency and volume increased. The integrated magnitude of tongue pressure during squeezing increased with increasing gel consistency. Bolus propulsion into the pharynx was affected by bolus characteristics, and location of the bolus head at the onset of pharyngeal swallowing was not related to squeezing behavior. The trigger point at which pharyngeal swallowing began was subject-dependent. During swallowing, the magnitude of tongue pressure moderately increased with increasing gel consistency, as compared with squeezing. Tongue pressure was not related to bolus volume. The current results suggest that patterns of tongue pressure during squeezing and swallowing are differentially affected by bolus conditions. However, healthy subjects differed in the techniques used for squeezing and swallowing. (J Oral Sci 55, 191-198, 2013)

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  • Fluoroscopic Evaluation of Tongue and Jaw Movements During Mastication in Healthy Humans Reviewed

    Hiroshige Taniguchi, Koichiro Matsuo, Hideto Okazaki, Mitsumasa Yoda, Haruhi Inokuchi, Marlis Gonzalez-Fernandez, Makoto Inoue, Jeffrey B. Palmer

    DYSPHAGIA   28 ( 3 )   419 - 427   2013.9

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    When chewing solid food, part of the bolus is propelled into the oropharynx before swallowing; this is named stage II transport (St2Tr). However, the tongue movement patterns that comprise St2Tr remain unclear. We investigated coronal jaw and tongue movements using videofluorography. Fourteen healthy young adults ate 6 g each of banana, cookie, and meat (four trials per foodstuff). Small lead markers were glued to the teeth and tongue surface to track movements by videofluorography in the anteroposterior projection. Recordings were divided into jaw motion cycles of four types: stage I transport (St1Tr), chewing, St2Tr, and swallowing. The range of horizontal tongue motion was significantly larger during St1Tr and chewing than during St2Tr and swallowing, whereas vertical tongue movements were significantly larger during chewing and St2Tr than during swallowing. Tongue movements varied significantly with food consistency. We conclude that the small horizontal tongue marker movements during St2Tr and swallowing were consistent with a "squeeze-back" mechanism of bolus propulsion. The vertical dimension was large in chewing and St2Tr, perhaps because of food particle reduction and transport in chewing and St2Tr.

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  • Laryngeal and tracheal afferent nerve stimulation evokes swallowing in anaesthetized guinea pigs Reviewed

    Takanori Tsujimura, Chioma Udemgba, Makoto Inoue, Brendan J. Canning

    JOURNAL OF PHYSIOLOGY-LONDON   591 ( 18 )   4667 - 4679   2013.9

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    center dot Activation of vagal afferent nerves innervating the tracheal and laryngeal mucosa evokes swallowing in anaesthetized guinea pigs.
    center dot The swallowing evoked by airway stimulation was probably initiated by the activation of the same afferent nerves that regulate coughing but occurred at lower stimulus intensities and was less susceptible to desensitization than the cough reflex.
    center dot We speculate that the swallowing associated with airway sensory nerve activation is a key component of airways protection from aspiration.
    Abstract We describe swallowing reflexes evoked by laryngeal and tracheal vagal afferent nerve stimulation in anaesthetized guinea pigs. The swallowing reflexes evoked by laryngeal citric acid challenges were abolished by recurrent laryngeal nerve (RLN) transection and mimicked by electrical stimulation of the central cut ends of an RLN. By contrast, the number of swallows evoked by upper airway/pharyngeal distensions was not significantly reduced by RLN transection but they were virtually abolished by superior laryngeal nerve transection. Laryngeal citric acid-evoked swallowing was mimicked by laryngeal capsaicin challenges, implicating transient receptor potential vanilloid 1 (TRPV1)-expressing laryngeal afferent nerves arising from the jugular ganglia. The swallowing evoked by citric acid and capsaicin and evoked by electrical stimulation of either the tracheal or the laryngeal mucosa occurred at stimulation intensities that were typically subthreshold for evoking cough in these animals. Swallowing evoked by airway afferent nerve stimulation also desensitized at a much slower rate than cough. We speculate that swallowing is an essential component of airway protection from aspiration associated with laryngeal and tracheal afferent nerve activation.

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  • Biomechanics of human tongue movement during bolus compression and swallowing. Reviewed

    Hayashi Hirokazu, Hori Kazuhiro, Taniguchi Hiroshige, Nakamura Yuki, Tsujimura Takanori, Ono Takahiro, Inoue Makoto

    J Oral Sci   55 ( 3 )   191 - 198   2013.9

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    We evaluated the effects of gel consistency and bolus volume on ingestion in humans. Eight healthy men were asked to ingest liquids, and sample foods of different gel consistencies and volumes, as usual. Tongue pressure against the hard palate was recorded at five points, and bolus flow was recorded using videoendoscopic images. The number of squeezes increased as gel consistency and volume increased. The integrated magnitude of tongue pressure during squeezing increased with increasing gel consistency. Bolus propulsion into the pharynx was affected by bolus characteristics, and location of the bolus head at the onset of pharyngeal swallowing was not related to squeezing behavior. The trigger point at which pharyngeal swallowing began was subject-dependent. During swallowing, the magnitude of tongue pressure moderately increased with increasing gel consistency, as compared with squeezing. Tongue pressure was not related to bolus volume. The current results suggest that patterns of tongue pressure during squeezing and swallowing are differentially affected by bolus conditions. However, healthy subjects differed in the techniques used for squeezing and swallowing.

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    Other Link: http://search.jamas.or.jp/link/ui/2015016896

  • 男性におけるドライシンドローム有訴率に関する検討

    伊藤 加代子, 濃野 要, 船山 さおり, 金子 昇, 山田 亜紀, 畠山 文, 佐々木 綾子, 井上 誠

    老年歯科医学   28 ( 2 )   225 - 225   2013.9

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  • 麻酔下ウサギにおける自律神経活動変化が及ぼす開口反射への影響

    酒井 翔悟, 辻 光順, 真柄 仁, 辻村 恭憲, 井上 誠

    Journal of Oral Biosciences Supplement   2013   150 - 150   2013.9

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  • 摂食・嚥下機能スクリーニング検査時の評価 嚥下内視鏡検査(VE)結果との比較

    神田 知佳, 林 宏和, 真柄 仁, 堀 一浩, 井上 誠

    言語聴覚研究   10 ( 3 )   215 - 215   2013.9

  • Development of a System to Monitor Laryngeal Movement during Swallowing Using a Bend Sensor Reviewed

    Qiang Li, Kazuhiro Hori, Yoshitomo Minagi, Takahiro Ono, Yong-jin Chen, Jyugo Kondo, Shigehiro Fujiwara, Kenichi Tamine, Hirokazu Hayashi, Makoto Inoue, Yoshinobu Maeda

    PLOS ONE   8 ( 8 )   e70850   2013.8

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    Background: Swallowing dysfunction (also known as dysphagia), which results in a deterioration of nutritional intake, slows rehabilitation and causes aspiration pneumonia, is very common following neurological impairments. Although videofluorographic (VF) examination is widely used for detecting aspiration, an objective and non-invasive method for assessing swallowing function has yet to be established because of a lack of adequate devices and protocols. In this paper, a bend sensor whose resistance is altered by bending was introduced to monitor swallowing-related laryngeal movement.
    Methods: Six healthy male volunteers were recruited in the present study. Specific time points on the signal waveform produced by the bend sensor were defined to describe laryngeal movement by differential analysis. Additionally, the physiological significance of the obtained waveform was confirmed by analyzing the sequential correlations between the signal waveform from the bend sensor and hyoid bone kinetics simultaneously recorded by VF.
    Results: Seven time points were successfully defined on the signal waveform to reference laryngeal movement. Each time point was well correlated with certain VF events, with evidence of no significant time lags, and there were positive correlations between waveform time points and matched VF events. Furthermore, obvious similarities were noticed between the duration of each phase on the signal waveform and the duration of the matched hyoid bone activity.
    Conclusions: The present monitoring system using a bend sensor might be useful for observing the temporal aspects of laryngeal movement during swallowing, and it was well coordinated with hyoid bone movement.

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  • The Inf1uence of Subjective Oral Dryness and Salivary Volume on Polydipsia in Patients with Schizophrenia Reviewed

    Naito M, Ito K, Funayama S, Inoue M

    International Journal of Oral-Medical Sciences   12 ( 1 )   29 - 34   2013.6

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    Aim: For the treatment of polydipsia, medication and occupational therapy are implemented. Since polysipsia canʼt be completely intercepted, patients are isolated or restrained in severe case. Determining the predictive factors of polysipsia may lead to decreasing abnormal water consumption. This study aimed to reveal the influence of subjective oral dryness, salivary volume and other factors including medication on polydipsia in patients with schizophrenia. Methods: Fifty-two patients were divided into two groups: a polydipsia patient (PD) group and a non-polydipsia patient (NPD) group. Their age, medical history, age of onset of schizophrenia, duration of suffering, tobacco, frequency of mouth opening, subjective oral dryness, number of medications, number of xerogenic medications, chlorpromazine (CPZ) equivalent dose, salivary volume and salivary spinability were investigated. Results: The number of total medications was significantly higher than that of the NPD group. Subjective oral dryness of the PD group was rated as ʻsevereʼ compared with the NPD group, and the frequency of mouth opening in the PD group was higher than the NPD group, though there were no significant differences. There was no significant difference in salivary volume and spinability between the two groups. Logisticregression analysis that demonstrated the predictors of polydipsia were tobacco and number of medications. Conclusion: It was shown that the predictors of polydipsia were tobacco and number of medications. The polydipsia may reduce by decreasing medications and quitting tobacco.

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  • 男性におけるドライシンドローム有訴率に関する検討

    伊藤 加代子, 濃野 要, 船山 さおり, 金子 昇, 山田 亜紀, 畠山 文, 佐々木 綾子, 井上 誠

    日本老年歯科医学会総会・学術大会プログラム・抄録集   24回   191 - 191   2013.6

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  • Effects of chewing and swallowing behavior on jaw opening reflex responses in freely feeding rabbits Reviewed

    Aki Yamada, Yuka Kajii, Shogo Sakai, Takanori Tsujimura, Yuki Nakamura, Sajjiv Ariyasinghe, Jin Magara, Makoto Inoue

    NEUROSCIENCE LETTERS   535   73 - 77   2013.2

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    It has been reported that the jaw opening reflex (JOR) evoked by intra-oral innocuous stimulation was suppressed during a reflex swallow in anesthetized animals only. However, the mechanism of JOR inhibition during swallowing has not yet been elucidated. The aim of the present study was to investigate the effects of peripheral nerve stimulation on masticatory behaviors, as well as the modulation of low threshold afferent evoked JOR responses during chewing and swallowing in freely feeding animals. The JOR in the digastric muscle was evoked by low threshold electrical stimulation of the inferior alveolar nerve (IAN). Changes in the peak-to-peak amplitude of digastric electromyographic responses were compared among the phases of chewing and swallowing. IAN stimulation did not produce any differences in cycle duration, gape of the jaw in one cycle, or swallowing interval, suggesting a minimal effect on feeding behaviors. The JOR amplitude during the fast-closing, slow-closing, and slow-opening phases of chewing was significantly smaller than that of the control (recorded when the animal was at rest) and fast-opening phase. During swallowing, the JOR amplitude was significantly less than the control. Inhibition of the JOR during swallowing is assumed to prevent unnecessary opposing jaw opening motion. (C) 2013 Elsevier Ireland Ltd. All rights reserved.

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  • Differences in Chewing Behavior during Mastication of Foods with Different Textures Reviewed

    Shiozawa M, Taniguchi H, Hayashi H, Hori K, Tsujimura T, Nakamura Y, Ito K, Inoue M

    Journal of Texture Studies   44 ( 1 )   45 - 55   2013.2

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  • 顎関節症患者における唾液分泌量とストレスの関連

    山田 亜紀, 伊藤 加代子, 荒井 良明, 奥村 暢旦, 高嶋 真樹子, 船山 さおり, 井上 誠

    日本口腔診断学会雑誌   26 ( 1 )   119 - 119   2013.2

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  • 新しい紙パック容器の使い勝手を検証する

    椎野 良隆, 真柄 仁, 大井 孝, 酒井 翔梧, 辻 光順, 林 宏和, 堀 一浩, 鈴木 絵里, 井上 誠

    日本顎口腔機能学会雑誌   19 ( 2 )   174 - 175   2013.2

  • 舌骨位は嚥下機能に影響を与えるか

    真柄 仁, 林 宏和, 神田 知佳, 住谷 美幸, 塚野 英樹, 堀 一浩, 谷口 裕重, 井上 誠

    日本顎口腔機能学会雑誌   19 ( 2 )   160 - 161   2013.2

  • 口腔乾燥症の認知度に関するweb調査

    伊藤 加代子, 船山 さおり, 山田 亜紀, 井上 誠

    日本口腔診断学会雑誌   26 ( 1 )   133 - 133   2013.2

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  • 歯科衛生士教育課程における口腔乾燥症の講義および実習に関するアンケート調査 Reviewed

    伊藤 加代子, 隅田 好美, 井上 誠

    日本歯科医学教育学会雑誌   28 ( 3 )   148 - 154   2012.12

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    唾液分泌量が減少すると、口腔粘膜が乾燥する。そのため、歯科治療時にデンタルミラー、ロールワッテなどが粘膜に張り付き、疼痛や不快感を起こすことがある。したがって、唾液分泌量が減少している患者の歯科診療にあたっては、苦痛を軽減する配慮が必要である。しかし、歯科衛生士教育課程に口腔乾燥症に関する実習を導入した報告はない。新潟大学歯学部口腔生命福祉学科では、歯科衛生士教育課程において、口腔乾燥症に関する講義・実習を行っている。本稿の目的は、口腔乾燥症に関する講義および実習の紹介と、アンケート調査の結果を検討することである。2009年から3年間、本学歯学部口腔生命福祉学科3年次学生に口腔乾燥症に対する講義および実習を行った。講義および実習後に、理解度、必要性に関するアンケートを行った。その結果、受講した全員が講義および実習を理解できたと答えていた。また、実習の必要性については、全員が必要であると答えていた。実習が「将来役に立つと思う」と回答したのは、98.5%であった。唾液分泌量と理解度および必要性、有用性の間には、関連性は認められなかった。本アンケート調査は、実習直後に行ったため、理解度も必要性も高いという回答が多かったと思われる。今後、講義や実習に対する関心度の調査、卒後の再調査による評価を加えることによって、口腔乾燥症に関する学習効果の向上を図る必要がある。(著者抄録)

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  • 顎関節症患者における唾液分泌量とストレスの関連

    山田 亜紀, 伊藤 加代子, 荒井 良明, 奥村 暢旦, 高嶋 真樹子, 船山 さおり, 井上 誠

    日本口腔内科学会雑誌   18 ( 2 )   102 - 102   2012.12

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  • 口腔乾燥症の認知度に関するweb調査

    伊藤 加代子, 船山 さおり, 山田 亜紀, 井上 誠

    日本口腔内科学会雑誌   18 ( 2 )   116 - 116   2012.12

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  • Differential involvement of two cortical masticatory areas in modulation of the swallowing reflex in rats Reviewed

    Takanori Tsujimura, Kojun Tsuji, Sajjiv Ariyasinghe, Takako Fukuhara, Aki Yamada, Hirokazu Hayashi, Yuki Nakamura, Koichi Iwata, Makoto Inoue

    NEUROSCIENCE LETTERS   528 ( 2 )   159 - 164   2012.10

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    To clarify the functional role of cortical descending inputs involved in the swallowing reflex, the effect of electrical stimulation of two cortical masticatory areas (CMAs: A- and P-area) on rhythmic jaw movements (RJMs) and superior laryngeal nerve (SLN)-evoked swallows were studied. RJMs and swallowing reflex were elicited by repetitive electrical stimulation of CMAs and the SLN, respectively. The electromyographic activities of jaw-closer (masseter), jaw-opener (digastric), and laryngeal-elevator (thyrohyoid) muscles were recorded to identify the RJMs and swallowing reflex. The number of evoked swallows was significantly lower, and swallowing interval was significantly longer during A-area stimulation compared with those without stimulation. Conversely, these parameters were not significantly altered during P-area stimulation. The inhibition of swallows by A-area stimulation was not affected by an increase in sensory input by wooden stick application between upper and lower teeth, or A-area stimulation preceding SLN stimulation. The present findings suggest that the swallowing reflex is inhibited by activation of the A-area, but not the P-area. Since no changes in swallows were seen after the increase in intraoral sensory input and prior activation of masticatory central pattern generator (CPG), swallowing inhibition may be mediated by direct inputs from the A-area or inputs via the masticatory CPG into the swallowing CPG. (c) 2012 Elsevier Ireland Ltd. All rights reserved.

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  • Moistened techniques considered for patients’comfort and operators’ease in dental treatment Reviewed

    Ito K, Funayama S, Katsura K, Saito M, Kaneko N, Nohno N, Yamada A, Sumida Y, Inoue M

    International Journal of Oral-Medical Sciences   11 ( 2 )   85 - 89   2012.9

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    <b>Aim</b>: In dental treatment, to remove an instrument, such as dental mirror or to remove a dental cotton roll inserted in the gingivobuccal fold, often brings the patient discomfort or pain. To prevent these uncomfortable conditions, dental instruments or dental cotton rolls are moistened based on an empirical basis. However, there has been no research done evaluating whether discomfort is reduced by these techniques. The purpose of this study was to evaluate the effects of moistened techniques on the patientsʼ discomfort and the operatorsʼ ease. <b>Materials and Methods</b>: Thirty eight subjects without hyposalivation were studied. Two procedures were implemented. One was that a dry or moistened dental mirror was removed after exclusion of the buccal mucosa. The other was removal of a dental cotton roll from the gingivobuccal fold after either moistening it or leaving it dry. The subjectsʼcomfort and the operatorsʼ treatment ease were evaluated on five point scales. <b>Results</b>: During these procedures, the subjectsʼ comfort was significantly increased by moistening of both the dental mirror and the cotton roll. The ease of performing both procedures was also significantly increased for operators in the moistened condition. In addition, there was a significant positive correlation between the subjectsʼ comfort and the operatorsʼ ease. <b>Conclusion</b>: When using dental instruments and removing cotton rolls, moistening increases both the subjectsʼ comfort and operatorsʼ treatment ease.

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  • The Digastric Muscle is Less Involved in Pharyngeal Swallowing in Rabbits Reviewed

    Takanori Tsujimura, Aki Yamada, Yuki Nakamura, Takako Fukuhara, Kensuke Yamamura, Makoto Inoue

    DYSPHAGIA   27 ( 2 )   271 - 276   2012.6

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    The swallowing reflex is centrally programmed by the lower brain stem, the so-called swallowing central pattern generator (CPG), and once the reflex is initiated, many muscles in the oral, pharyngeal, laryngeal, and esophageal regions are systematically activated. The mylohyoid (MH) muscle has been considered to be a "leading muscle" according to previous studies, but the functional role of the digastric (DIG) muscle in the swallowing reflex remains unclear. In the present study, therefore, the activities of single units of MH and DIG neurons were recorded extracellularly, and the functional involvement of these neurons in the swallowing reflex was investigated. The experiments were carried out on eight adult male Japanese white rabbits anesthetized with urethane. To identify DIG and MH neurons, the peripheral nerve (either DIG or MH) was stimulated to evoke action potentials of single motoneurons. Motoneurons were identified as such if they either (1) responded to antidromic nerve stimulation of DIG or MH in an all-or-none manner at threshold intensities and (2) followed stimulation frequencies of up to 0.5 kHz. As a result, all 11 MH neurons recorded were synchronously activated during the swallowing reflex, while there was no activity in any of the 7 DIG neurons recorded during the swallowing reflex. All neurons were anatomically localized ventromedially at the level of the caudal portion of the trigeminal motor nucleus, and there were no differences between the MH and DIG neuron sites. The present results strongly suggest that at least in the rabbit, DIG motoneurons are not tightly controlled by the swallowing CPG and, hence, the DIG muscle is less involved in the swallowing reflex.

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  • 自由行動下ウサギにおける開口反射の変調

    山田 亜紀, 辻村 恭憲, 梶井 友佳, 福原 孝子, 井上 誠

    新潟歯学会雑誌   42 ( 1 )   60 - 60   2012.6

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  • 口腔乾燥症診断シートを用いた口腔乾燥症の診断

    伊藤 加代子, 濃野 要, 船山 さおり, 山田 亜紀, 井上 誠

    日本老年歯科医学会総会・学術大会プログラム・抄録集   23回   138 - 138   2012.6

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  • Individual-dependent effects of pharyngeal electrical stimulation on swallowing in healthy humans Reviewed

    Hideki Tsukano, Hiroshige Taniguchi, Kazuhiro Hori, Takanori Tsujimura, Yuki Nakamura, Makoto Inoue

    Physiology and Behavior   106 ( 2 )   218 - 223   2012.5

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    The present study tested whether electrical stimulation increases the number of voluntary repetitive swallows in humans. In addition, the potential of initiating both voluntary and involuntary swallows was compared using electrical stimulation. Fourteen normal male adults were instructed to perform repetitive voluntary swallowing as quickly as possible over 30. s, and the number of swallows was counted with and without repetitive electrical stimulation (80% of maximal tolerated intensity
    0.1. ms in pulse duration
    30. Hz) of the nasal cavity, nasopharynx, oropharynx, or laryngopharynx. Although the number of swallows was significantly increased during electrical stimulation of the laryngopharynx, oropharynx, and nasopharynx, there was a wide variation in the number among subjects. The number of reflexively evoked swallows (i.e., involuntary swallows) by pharyngeal stimulation also varied greatly, and there was a significant linear correlation in the number of swallows between voluntary and involuntary swallows. The present study demonstrated the facilitatory effects of pharyngeal electrical stimulation on voluntary swallowing in humans. Furthermore, the potentials of initiation of voluntary swallows are identical to those of involuntary swallows, which suggests that the swallowing central pattern generator is a common component of both neuronal networks and therefore is responsible for inter-individual variations. © 2012 Elsevier Inc.

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  • Individual-dependent effects of pharyngeal electrical stimulation on swallowing in healthy humans. Reviewed

    Tsukano Hideki, Taniguchi Hiroshige, Hori Kazuhiro, Tsujimura Takanori, Nakamura Yuki, Inoue Makoto

    Physiol Behav   106 ( 2 )   218 - 223   2012.5

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    The present study tested whether electrical stimulation increases the number of voluntary repetitive swallows in humans. In addition, the potential of initiating both voluntary and involuntary swallows was compared using electrical stimulation. Fourteen normal male adults were instructed to perform repetitive voluntary swallowing as quickly as possible over 30 s, and the number of swallows was counted with and without repetitive electrical stimulation (80% of maximal tolerated intensity; 0.1 ms in pulse duration; 30 Hz) of the nasal cavity, nasopharynx, oropharynx, or laryngopharynx. Although the number of swallows was significantly increased during electrical stimulation of the laryngopharynx, oropharynx, and nasopharynx, there was a wide variation in the number among subjects. The number of reflexively evoked swallows (i.e., involuntary swallows) by pharyngeal stimulation also varied greatly, and there was a significant linear correlation in the number of swallows between voluntary and involuntary swallows. The present study demonstrated the facilitatory effects of pharyngeal electrical stimulation on voluntary swallowing in humans. Furthermore, the potentials of initiation of

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  • ホルモン補充療法の口腔領域における効果に関する文献レビュー

    伊藤 加代子, 松木 貴彦, 井上 誠

    日本女性医学学会雑誌   20 ( 1 )   35 - 48   2012.4

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    口腔疾患に対するホルモン補充療法(HRT)の効果を明らかにするため、文献検索を行った。PubMedから391件、医学中央雑誌から142件の該当文献が得られ、そのうち57件について検討した。ヒトを対象とした文献は41件で、多くがアメリカ、フィンランドの文献であった。筆頭著者の73.2%は歯科所属であった。57件の文献をアウトカムによって、口腔乾燥感および唾液、口腔の不快感、残存歯数、歯周疾患、顎骨骨密度、インプラント、顎関節症の七つに分けて検討した。HRTは口腔の不快感と顎骨骨密度に対しては効果があるといえる可能性が高い。一方、その他のアウトカムについてはコンセンサスが得られていないことが分かった。

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  • Effects of pharyngeal electrical stimulation on the swallowing reflex and its possible clinical application

    Makoto Inoue

    Clinical Neurology   52 ( 11 )   1192 - 1194   2012

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    The present study tested whether electrical stimulation increases the number of voluntary repetitive swallows in humans and if summation of peripheral inputs increases the number of swallows. In addition, the potential of initiating both voluntary and involuntary swallowing was compared and the effect of chewing behaviors on the initiation of swallowing evoked by the electrical stimulation was evaluated. Facilitatory effect of both the mid- and hypo-pharyngeal stimulation was much larger than that of mid-pharyngeal stimulation. The longer the pulse duration was, the larger the number of swallows was, suggesting temporal and spatial summation of peripheral inputs into the swallowing center. There was a wide variation in the number of swallows among subjects. The number of reflexively evoked swallowing (i.e., involuntary swallow) by pharyngeal stimulation also varied greatly, and there was a significant linear correlation in the number of swallows between voluntary and involuntary swallowing, which suggests that the swallowing central pattern generator is a common component of both neuronal networks and therefore is responsible for inter-individual variations. The chewing strongly inhibited the initiation of swallows. Although it should be clarified how the chewing behaviors modulate swallowing function, these data suggest the functional interaction between chewing and swallowing centers.

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  • ヒト反射性嚥下を誘発する末梢の化学刺激とその中枢機構

    川本 健介, 井上 拓哉, 成松 花弥, 中村 由紀, 井上 誠, 矢作 理花, 北田 泰之

    日本味と匂学会誌   18 ( 3 )   335 - 338   2011.12

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  • Organization of pERK-immunoreactive cells in trigeminal spinal nucleus caudalis, upper cervical cord, NTS and Pa5 following capsaicin injection into masticatory and swallowing-related muscles in rats Reviewed

    Takanori Tsujimura, Masamichi Shinoda, Kuniya Honda, Suzuro Hitomi, Masaaki Kiyomoto, Shingo Matsuura, Ayano Katagiri, Kojun Tsuji, Makoto Inoue, Yoshi Shiga, Koichi Ituata

    BRAIN RESEARCH   1417   45 - 54   2011.10

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    Many phosphorylated extracellular signal-regulated kinase (pERK)-immunoreactive (IR) cells are expressed in the trigeminal spinal subnucleus caudalis (Vc), upper cervical spinal cord (C1-C2), nucleus tractus solitarii (NTS) and paratrigeminal nucleus (Pa5) after capsaicin injection into the whisker pad (WP), masseter muscle (MM), digastric muscle (DM) or stemohyoideus muscle (SM). The pERK-IR cells also showed NeuN immunoreactivity, indicating that ERK phosphorylation occurs in neurons. The pERK-IR cells were significantly reduced after intrathecal injection of MEK 1/2 inhibitor PD98059. The pERK-IR cells expressed bilaterally in the Vc and C1-C2 after capsaicin injection into the unilateral DM or SM, whereas unilaterally in the Vc and C1-C2 after unilateral WP or MM injection. After capsaicin injection into the WP or MM, the pERK-IR cell expression in the Vc was restricted rostrocaudally within a narrow area. However, the distribution of pERK-IR cells was more wide spread without a clear peak in the Vc and C1-C2 after capsaicin injection into the DM or SM. In the NTS, the unimodal pERK-IR cell expression peaked at 0-720 mu m rostral from the obex following capsaicin injection into WP, MM, DM or SM. In the ipsilateral Pa5, many pERK-IR cells were observed following capsaicin injection into the SM. The number of swallows elicited by distilled water administration was significantly smaller after capsaicin injection into the we, MM or DM but not SM compared to that of vehicle-injected rats. Various noxious inputs due to the masticatory or swallowing-related muscle inflammation may be differentially involved in muscle pain and swallowing reflex activity. (C) 2011 Elsevier B.V. All rights reserved.

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  • 上喉頭神経への電気刺激時にみられる開口反射の変調と自律神経活動との関係

    福原 孝子, 梶井 友佳, 辻村 恭憲, 山田 亜紀, 井上 誠

    Journal of Oral Biosciences   53 ( Suppl. )   147 - 147   2011.9

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  • 過活動膀胱患者において副作用の少ないイミダフェナシンはソリフェナシンと同等の有効性を示す GAP(Global Assessment Study of Anti-cholinergics on Efficacy and Tolerability for Patients with OAB)Study

    西井 久枝, 井上 誠, 伊藤 加代子, 深井 喜代子, 酒本 貞昭, 伊東 健治, 松下 全巳, 芳賀 一徳, 松本 哲朗

    泌尿器外科   24 ( 9 )   1489 - 1500   2011.9

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    過活動膀胱に対するイミダフェナシンおよびソリフェナシンの有効性を比較した。さらに、口腔乾燥および便秘の発現について評価した。蓄尿症状の評価は過活動膀胱症状質問票を用いた。口腔乾燥については口腔乾燥質問票を用い、便秘については便秘評価尺度により評価した。過活動膀胱症状スコアの変化量において両群間に差は認められなかった。その結果、イミダフェナシンとソリフェナシンは同等の有効性を有することが示された。(著者抄録)

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  • 過活動膀胱を中心とした高齢者における健康調査

    伊藤 加代子, 井上 誠, 深井 喜代子, 西井 久枝, 松本 哲朗

    Progress in Medicine   31 ( 6 )   1609 - 1618   2011.6

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    インターネットによる質問調査で、40歳以上の男性100名、女性199名の合計299名(平均年齢66.9歳)を対象とした過活動膀胱(overactive bladder:OAB)を中心とする健康調査を実施した。過活動膀胱症状質問票(overactive bladder symptom score:OABSS)を用いて調査した結果、OABと判定された患者は全体の約16.7%であった。しかしながら、OABと判定された患者の中で下部尿路機能障害の治療を受けている患者はわずかに14.0%であった。口腔乾燥質問票(dry mouth score:DMS)および便秘評価尺度(constipation assessment scale:CAS)を用いて口腔乾燥および便秘症状を評価した結果、OABと判定された回答者ではそれらのスコアが有意に高かった。以上の結果、高齢者におけるOAB治療は不十分であり、また治療薬である抗コリン薬を処方する場合は、その副作用(口腔乾燥、便秘)に注意が必要と考えられた。(著者抄録)

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  • Effects of electrical stimulation of the superior laryngeal nerve on the jaw-opening reflex Reviewed

    Takako Fukuhara, Takanori Tsujimura, Yuka Kajii, Kensuke Yamamura, Makoto Inoue

    BRAIN RESEARCH   1391   44 - 53   2011.5

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    The present study aimed to examine whether the jaw-opening reflex (JOR) is modulated during swallowing, and if so, to compare the modulation between the low- and high-threshold afferent-evoked reflex responses. Experiments were carried out on 11 anesthetized rabbits. The inferior alveolar nerve was stimulated to evoke the JOR in the digastric muscle. The stimulus intensity was either 1.5 (low threshold) or 4.0 (high threshold) times the threshold for eliciting the JOR. As a conditioning stimulation, the superior laryngeal nerve (SLN) was repetitively stimulated to evoke the swallowing reflex. The stimulus intensity ranged from 0.6 to 8.0 times the threshold to evoke the swallowing reflex during SLN stimulation over 20 s. Electromyographic (EMG) activities of the digastric and mylohyoid muscles were recorded, and the peak-to-peak EMG amplitude of the digastric muscle was measured and compared with and without SLN stimulation, as well as with and without swallowing. Comparisons were also made between low- and high-threshold afferent-evoked JORs. The JOR was strongly suppressed during SLN stimulation. The degree of suppression increased and the latency for the JOR was delayed when the stimulus current applied to the SLN was increased. Such modulation was apparent when the low-threshold afferent-evoked JOR was recorded. Effects of motor outputs of swallowing events and those of single-pulse stimulation of SLN on the inhibition of the JOR were not noted. These results suggest that the JOR evoked by both the low- and high-threshold afferents was inhibited during laryngeal sensory input and following swallowing, probably to prevent opposing jaw movements evoked by oral sensory input during swallowing. (C) 2011 Elsevier B.V. All rights reserved.

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  • 口腔乾燥症患者への診療時配慮事項に関する衛生士養成課程実習導入の試み

    伊藤 加代子, 船山 さおり, 隅田 好美, 井上 誠

    老年歯科医学   25 ( 2 )   253 - 254   2010.9

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  • 新潟大学医歯学総合病院加齢歯科診療室「くちのかわき外来」の受診患者に関する検討

    船山 さおり, 伊藤 加代子, 安達 大雅, 梶井 友佳, 勝良 剛詞, 斉藤 美紀子, 濃野 要, 金子 昇, 五十嵐 敦子, 井上 誠

    新潟歯学会雑誌   39 ( 2 )   203 - 204   2009.12

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  • オーラルディアドコキネシスの測定法に関する検討 Reviewed

    伊藤 加代子, 葭原 明弘, 高野 尚子, 石上 和男, 清田 義和, 井上 誠, 北原 稔, 宮崎 秀夫

    老年歯科医学   24 ( 1 )   48 - 54   2009.6

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    2006年から介護予防事業の一つとして口腔機能の向上が取り入れられた。その評価項目の1つであるオーラルディアドコキネシスの測定法には、ICレコーダーで録音し回数をカウントする方法(IC法)、電卓のメモリー機能を用いる方法(電卓法)、ペンで点を打つ方法(ペン打ち法)などがある。今回われわれは、オーラルディアドコキネシス回数を自動的に測定することができる新しい口腔機能測定器「健口くん」を開発した。本研究の目的は、従来のIC法、電卓法および「健口くん」を用いる方法でオーラルディアドコキネシス回数を測定し、その結果を比較検討することである。79歳の高齢者49名(男性26名、女性23名)、および80歳の高齢者355名(男性175名、女性180名)を対象とした。対象者に、/pa//ta//ka/の順番でそれぞれ5秒間できるだけ早く繰り返し発音するように指示し、IC法、電卓法、健口くん法で測定した。健口くん法による平均値は/pa/で6.0±0.9回/秒、/ta/で6.0±0.9回/秒、/ka/で5.7±0.8回/秒であった。健口くん法とIC法には有意な高い相関が認められた。電卓法では相関が低く、1秒間に7.0回を過ぎると電卓でのミスカウント数が大きくなっていた。電卓のキーを叩くタッピング運動の速度には限界があるため、正確に測定できない可能性があると思われた。したがって、新しい口腔機能測定器を用いる健口くん法は、オーラルディアドコキネシス回数の測定に有用であることが示唆された。(著者抄録)

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  • Effects of food texture and head posture on oropharyngeal swallowing Reviewed

    Tetsu Tsukada, Hiroshige Taniguchi, Sachiko Ootaki, Yoshiaki Yamada, Makoto Inoue

    JOURNAL OF APPLIED PHYSIOLOGY   106 ( 6 )   1848 - 1857   2009.6

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    Tsukada T, Taniguchi H, Ootaki S, Yamada Y, Inoue M. Effects of food texture and head posture on oropharyngeal swallowing. J Appl Physiol 106: 1848-1857, 2009. First published March 26, 2009; doi:10.1152/japplphysiol.91295.2008.-This study aimed to describe the electromyographic (EMG) activity patterns of the genioglossus (GG) and suprahyoid (SHy) muscles during swallowing. The effects of changes in food texture/consistency and head posture on transport of the swallowed bolus were also investigated. Participants were 10 normal adults. Test foods consisted of a liquid, a syrup, or 4 ml of paste made from 0.5% or 1.0% agar. Each food was swallowed with the head in one of three positions, and EMGs and videofluorographic (VF) images were recorded. Mean values of onset, peak, and offset times, peak amplitude, area, and duration of the EMG burst were measured. The total swallowing time, oral ejection time, pharyngeal transit time, clearance time, fauces transit time, and upper esophageal sphincter (UES) transit time were measured. The GG muscle burst patterns showed two peaks (GG1 and GG2) during each swallowing. The offset time and duration of the GG1 burst and the onset, peak, and offset times and duration of both the GG2 and SHy bursts were significantly affected by food texture. There were no significant differences in bolus transit time among the different experimental conditions. Regression analyses demonstrated significant linear relationships between the tongue tip touching the palate and the peak of the GG1 burst, between passage of the bolus tail at the fauces and offset of the GG1 burst, between passage of the bolus tail at the UES and peak of the GG2 burst, and between passage of the bolus tail at the UES and offset of the SHy burst. These results demonstrate that the duration, but not the amplitude, of tongue and suprahyoid muscle activity were increased with increasing hardness of food during swallowing and that the bolus transit time can be fixed within a certain range of physical food properties.

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  • Immunohistochemical detection of ENaCβ in the terminal Schwann cells associated with the periodontal Ruffini endings of the rat incisor Reviewed

    Yasumasa Hitomi, Akiko Suzuki, Yoshiro Kawano, Kayoko Nozawa-Inoue, Makoto Inoue, Takeyasu Maeda

    Biomedical Research   30 ( 2 )   113 - 119   2009

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    Epithelial sodium channels (ENaCs) are a subfamily of ion channels within the degenerin/ENaC (DEG/ENaC) superfamily. Previous studies have shown the immunolocalization of ENaC in the neural elements of the cutaneous mechanoreceptors as well as dorsal root and trigeminal ganglion neurons, indicating the involvement of this molecule in mechanotransduction. The present study examined the expression of ENaCβ, a major component of ENaC protein, in the mechanoreceptive Ruffini endings in the periodontal ligament of the rat incisors by immunohistochemistry. The expression of ENaCβ in the trigeminal ganglion - which innervates the periodontal Ruffini endings - was also investigated at the mRNA and protein levels. Furthermore, double staining and a nerve injury experiment were applied to clarify its detailed localization in the periodontal Ruffini endings. ENaCβ immunoreaction in the trigeminal ganglion was recognizable in the comparatively large neurons which have been considered to mediate mechanotransduction. Immunohistochemistry for ENaCβ demonstrated dendritic ramifications of the Ruffini endings as well as the rounded cells in the periodontal ligament. Double staining with ENaCβ and either PGP9.5 or S-100 protein showed immunoreaction for ENaCβ in both the axonal and glial elements in the periodontal ligament. Some ENaCβ positive cells with rounded profiles were reactive to non-specific cholinesterase activity. Furthermore, a transection of the inferior alveolar nerve failed to eliminate the rounded cells with ENaCβ reaction, indicating that they were the terminal Schwann cells associated with the periodontal Ruffini endings. These findings suggest that ENaCβ is a key mechanotransducing channel in the periodontal Ruffini endings. Probably, the terminal Schwann cells together with the axon terminals regulate mechanotransduction in the periodontal endings.

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  • ワッテ法と吐唾法による唾液分泌量の比較 Reviewed

    船山 さおり, 伊藤 加代子, 濃野 要, 人見 康正, 宮崎 秀夫, 井上 誠, 五十嵐 敦子

    新潟歯学会雑誌   38 ( 2 )   95 - 101   2008.12

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    口腔乾燥症の診断には、安静時唾液分泌量の測定が重要である。一般的に吐唾法が用いられているが、唾液を吐出する能力を必要とするため唾液の吐出が難しい患者への応用は困難である。ワッテ法は、術者がロールワッテを舌下部へ挿入し、唾液を吸収させる方法であるため吐出が不要である。また、測定時間はわずか30秒間もしくは60秒間と比較的短く簡便である。しかし、その有用性およびカットオフ値に関する検討はまだなされていないのが現状である。そこで、ワッテ法のドライマウスの臨床における有用性を検討する目的で、ワッテ法と吐唾法との比較検討を行った。被験者は、口腔乾燥を自覚していない健常者26名と新潟大学医歯学総合病院くちのかわき外来受診者10名の計36名とした。吐唾法による15分間の安静時唾液、30秒間および60秒間のワッテ法による唾液分泌量を測定し分析した。その結果、吐唾法による安静時唾液分泌量とワッテ法30秒値、60秒値との間にいずれも有意な正の相関が認められた。従って、ワッテ法は唾液分泌測定法のひとつとして利用できることが示唆された。さらに、ワッテ法における唾液分泌機能低下の目安としてカットオフ値を算出した結果、30秒値は0.14g、60秒値は0.25gとなった。本研究の被験者のうち、唾液分泌が実際に減少しているものは9名のみであった。今後、被験者を増やし、ワッテ法におけるカットオフ値を明確にする必要があると考えている。(著者抄録)

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  • Correspondence between food consistency and suprahyoid muscle activity, tongue pressure, and bolus transit times during the oropharyngeal phase of swallowing Reviewed

    Hiroshige Taniguchi, Tetsu Tsukada, Sachiko Ootaki, Yoshiaki Yamada, Makoto Inoue

    JOURNAL OF APPLIED PHYSIOLOGY   105 ( 3 )   791 - 799   2008.9

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    This study aimed to evaluate the effects of food texture and viscosity on the swallowing function by measuring tongue pressure and performing a videofluorographic (VF) examination. Eleven normal adults were recruited for this study. Test foods with different consistencies and liquid contents, i.e., a half-solid nutrient made of 0.8 and 1.5% agar powder, syrup, and a liquid containing 40 wt/vol% barium sulfate, were swallowed, and the anterior (AT) and posterior tongue pressures (PT) and electromyographic (EMG) activity of the suprahyoid muscles were recorded, together with VF images. The timing of each event obtained from EMG, tongue pressure, and VF recordings was measured and then compared. We found that the AT and PT activity patterns were similar and showed a single peak. The peak, area, and time duration of all of the variables for AT and PT and EMG burst increased with increasing hardness of the bolus. The onset of the EMG burst always preceded those of the AT and PT activities, while there were no significant differences in peak and offset times among EMG burst, AT, and PT. Total swallowing time and oral ejection time were significantly longer during the swallowing of 1.5% agar than any other boluses, while pharyngeal transit time and clearance time were significantly longer during the swallowing of syrup, which was as hard as the liquid, but showed a higher viscosity than the liquid. The results suggested that the major effects of food hardness were to delay oral ejection time, which strongly delays total swallowing time. In addition, pharyngeal bolus transit is not dependent on the hardness of food but on its viscosity.

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  • Relation between Bolus Size and Hyoid Movement during Normal Ingestion in Humans Reviewed

    Miwako Honma, Atsushi Okada, Shuichi Nomura, Makoto Inoue, Yoshiaki Yamada

    Journal of Oral Biosciences   49 ( 3 )   180 - 189   2007

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    Hyoid action was studied regarding bolus movement during normal ingestion in five subjects using videofluorography in the sagittal plane. The subjects were asked to take one mouthful of steamed rice and chew it normally until the mouth was empty. Food intake, transport to the postcanines, chewing, and swallowing were identified using frame-by-frame analysis of the images. Two types of swallowing were identified during the sequence: interposed and terminal swallowing. The former was observed during chewing, while the latter was observed at the end of the sequence. Differences were observed in the size of the food bolus passing through the pharyngo-esophageal junction: a larger volume was observed for the interposed swallow, which was reflected in the dilation of the junction and a longer time taken for the passage of food. There was no difference in hyoid movement between the two swallows, either in the vertical or horizontal direction, i.e., the hyoid moved maximally during its function in swallowing, regardless of the bolus size passing through the pharyngo-esophageal junction. This suggests that the swallowing-related motor action involved in hyoid movement is unaffected by sensory input. © 2007, Japanese Association for Oral Biology. All rights reserved.

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  • Effects of Food Consistency on Tongue Pressure during Swallowing Reviewed

    Kaori Sugita, Makoto Inoue, Hiroshige Taniguchi, Sachiko Ootaki, Atsuko Igarashi, Yoshiaki Yamada

    Journal of Oral Biosciences   48 ( 4 )   278 - 285   2006

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    Tongue pressure against the anterior and posterior portions of the hard palate as well as the electromyographic activity of suprahyoid muscle during swallowing test foods with three different consistencies (thinned, medium, and thickened paste) and liquid were recorded. Significant differences and wide variations were noted in the peak amplitude and area of posterior tongue pressure, which was larger for thickened paste compared to liquid, thinned, and medium pastes. Regarding the anterior tongue pressure, the duration was significantly longer during swallowing thickened paste compared to liquid and thinned paste, while there were no differences in the peak amplitude and area. The results suggest that a basic pattern of tongue pressure is maintained during swallowing but is modulated by sensory feedback in a different manner between the anterior and posterior portions of the tongue to complete propulsion of the bolus in the oral cavity. © 2006, Japanese Association for Oral Biology. All rights reserved.

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  • Changes in reflex responses of the genioglossus muscle during sleep in rabbits Reviewed

    Y Harasawa, M Inoue, S Ariyasinghe, K Yamamura, Y Yamada

    BRAIN RESEARCH   1065 ( 1-2 )   79 - 85   2005.12

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    Changes in reflex responses in the genioglossus (GG) muscle evoked by electrical stimulation of the inferior alveolar nerve and GG muscle tone (background activity, BGA) were investigated during sleep-wakefulness stages in rabbits. The GG muscle showed two types of electromyographic activity patterns: a respiration-related phasic activity and non-respiration-related activity. GG reflex responses and BGA exhibited a stage-dependent decrease as they were constantly suppressed from quiet wakefulness to non-rapid eye movement sleep (NREMS) to rapid eye movement sleep (REMS). Degree of suppression of reflexes was much larger than that of BGA regardless of GG activity patterns. When amplitude of reflex responses was compared between with and without rapid eye movements during REMS, no difference between the conditions was noted. These results suggest that excitability of the GG muscle is affected by sleep stages by not only a modulation of excitability in motoneurons but also in interneurons involved in the reflex arc. (C) 2005 Elsevier B.V. All rights reserved.

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  • Unilateral application of an inflammatory irritant to the rat temporomandibular joint region produces bilateral modulation of the jaw-opening reflex Reviewed

    M Noguchi, M Kurose, K Yamamura, M Inoue, Y Taguchi, BJ Sessle, Y Yamada

    BRAIN RESEARCH BULLETIN   67 ( 3 )   182 - 188   2005.10

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    The aim of this study was to determine the effect of unilateral acute inflammation of cramofacial deep tissues on the ipsilateral and contralateral jaw-opening reflex (JOR). The effects of mustard oil (MO), injected into the temporomandibular joint region, were tested on the JOR recorded in the digastric muscle and evoked by low-intensity electrical stimulation of the ipsilateral and contralateral inferior alveolar nerve in anesthetized rats. The MO injection induced a long-lasting suppression of the amplitude of both ipsilaterally and contralaterally evoked JOR, although the latency and duration of the JOR were unaffected. The suppressive effect was more prominent for the contralaterally evoked JOR, and observed even when background activity in the digastric muscle was increased by the MO injection. The results indicate that changes in the, JOR amplitude following MO injection do not simply reflect alterations in motoneuronal excitability, and suggest that inflammation of deep craniofacial tissues modulates low-threshold sensory transmission to the motoneurons. (c) 2005 Elsevier Inc. All rights reserved.

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  • Coordination of cranial motoneurons during mastication Reviewed

    Y Yamada, K Yamamura, M Inoue

    RESPIRATORY PHYSIOLOGY & NEUROBIOLOGY   147 ( 2-3 )   177 - 189   2005.7

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    Mastication is the first stage of digestion and involves several motor processes such as food intake, intra-oral food transport, bolus formation and chewing in its broad sense. These complicated motor functions can be accomplished by the well-coordinated activities in various cranial motoneurons innervating the jaw, hyoid, tongue and facial muscles. The brainstem masticatory central pattern generator (CPG) plays a crucial role in generating basic activity patterns of these cranial motoneuron groups. However, descending inputs from higher brain (e.g., cerebral cortex) and mastication-generated peripheral sensory inputs also play important roles in modulating the activity pattern of each motoneuron so that the final motor outputs fit the environmental demand. In this review, we focus on the coordination of the trigeminal, facial and hypoglossal motoneurons during mastication. We first summarize findings showing the activity patterns of muscles innervated by these motoneurons during natural mastication, and then discuss the possible neural mechanisms underlying their coordinated activities during mastication. (C) 2005 Elsevier B.V. All rights reserved.

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  • Modulation of jaw reflexes induced by noxious stimulation to the muscle in anesthetized rats Reviewed

    M Kurose, K Yamamura, M Noguchi, M Inoue, S Ootaki, Y Yamada

    BRAIN RESEARCH   1041 ( 1 )   72 - 86   2005.4

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    Previous studies have shown that jaw reflexes and activity patterns of the jaw muscles were modulated in the presence of jaw muscle pain. However, there is no study comparing the modulatory effects on the jaw reflexes induced by noxious stimulation to the jaw muscle. To clarify this, effects of the application of mustard oil (MO), an inflammatory irritant, into the temporalis (jaw-closing) muscle on (1) jaw-opening reflex evoked by tooth pulp stimulation (TP-evoked JOR) as a nociceptive reflex, (2) jaw-opening reflex evoked by interior alveolar nerve stimulation as a non-nociceptive reflex and (3) jaw-closing reflex evoked by trigeminal mesencephalic nucleus stimulation as a proprioceptive reflex were investigated in anesthetized rats. The MO application induced suppression of all reflexes. and the effect on the TP-evoked JOR was more prominent than on the other reflexes. To elucidate the involvement of endogenous opioid system for the suppressive effect, a systemic administration of naloxone following the MO application was conducted. The MO-induced suppressive effect on the TP-evoked JOR was reversed by the naloxone administration. The results suggest that noxious stimulation to the jaw muscle modulate jaw reflexes particularly for the nociceptive jaw-opening reflex, and the modulatory effect includes both facilitatory and inhibitory aspects. The results also suggest that pain modulatory systems such as the endogenous opioid system play a crucial role in the suppression of the nociceptive transmissions related to nociceptive reflexes, and in some pathological states, defense reflexes may not be evoked properly. (c) 2005 Elsevier B.V. All rights reserved.

    DOI: 10.1016/j.brainres.2005.02.003

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  • Effects of food consistency on the pattern of extrinsic tongue muscle activities during mastication in freely moving rabbits Reviewed

    M Inoue, Y Harasawa, K Yamamura, S Ariyasinghe, Y Yamada

    NEUROSCIENCE LETTERS   368 ( 2 )   192 - 196   2004.9

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    The effects of physical characteristics of foods on the coordination of extrinsic tongue muscle activities during natural mastication were evaluated. Electromyograms of tongue-retractor (styloglossus, SG) and tongue-protractor (genioglossus, GG) muscles as well as the jaw-movement trajectories were recorded during raw rice and chow pellet chewing in the freely moving rabbit. Each masticatory cycle included a jaw closing (Cl) phase consisting of a fast-closing (FC) and a slow-closing (SC) phase, and a jaw opening (Op) phase. The duration of the Cl and SC phases was found to be much larger while the duration of the FC phase was much smaller during rice chewing than pellet chewing. The jaw movements during rice chewing had smaller amplitudes of the gape and lateral excursion of the jaw as compared with those during pellet chewing. The SG muscle had a double-peaked burst activity in each masticatory cycle with one peak during the Op phase (the SG1 burst) and the other during the Cl phase (the SG2 burst). They were significantly larger during pellet chewing as compared with rice chewing, but the duration of the SG2 burst was significantly longer during rice chewing than pellet chewing. The offset of the SG2 burst was delayed during rice chewing as compared with that during pellet chewing. There was little difference in the activity pattern of the GG burst between the foods. Our present results suggest that the SG muscle activity could be modified by the sensory feedback possibly to adapt to environmental demands during chewing. (C) 2004 Elsevier Ireland Ltd. All rights reserved.

    DOI: 10.1016/j.neulet.2004.07.043

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  • Extrinsic tongue and suprahyoid muscle activities during mastication in freely feeding rabbits Reviewed

    M Inoue, S Ariyasinghe, K Yamamura, Y Harasawa, Y Yamada

    BRAIN RESEARCH   1021 ( 2 )   173 - 182   2004.9

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    To evaluate the coordination of tongue and suprahyoid muscle activities during natural mastication, electromyogratus (EMGs) of jaw-closer, jaw-opener, suprahyoid (mylohyoid, MH), tongue-retractor (styloglossus, SG) and tongue-protractor (genioglossus, GG) muscles were recorded as well as the jaw-movement trajectories in vertical and horizontal axes in awake rabbits. Each masticatory cycle had three components including the fast-closing (FC), slow-closing (SC) and opening (Op) phases. The duration of the SC phase was much longer during pellet chewing while the durations of the FC and Op phases were much shorter during pellet chewing than bread or banana chewing. The jaw movements during banana chewing had a small amplitude of lateral excursion and a large amplitude of gape as compared with those during pellet and bread chewing. The MH muscle exhibited double-peaked EMG bursts during the Op phase. The MH bursts in the late part of the Op phase were dominant on the non-chewing side during pellet and bread chewing. The SG muscle also exhibited double-peaked EMG bursts. During pellet and bread chewing, the SG bursts during the SC phase were significantly larger on the chewing side than the non-chewing side. These bursts were also dominant during pellet chewing as compared with banana chewing. There was little difference in the GG bursts between the chewing and non-chewing sides or among the foods. Our results suggest that patterns of the MH and SG muscle activity are affected by the peripheral inputs and/or chewing patterns while those of the GG muscle activity was less modulated regardless of the consistency of foods. (C) 2004 Elsevier B.V. All rights reserved.

    DOI: 10.1016/j.brainres.2004.06.047

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  • Coordination of jaw and extrinsic tongue muscle activity during rhythmic jaw movements in anesthetized rabbits Reviewed

    S Ariyashinghe, M Inoue, K Yamamura, Y Harasawa, M Kurose, K Yamada

    BRAIN RESEARCH   1016 ( 2 )   201 - 216   2004.8

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    To clarify the jaw-closer and tongue-retractor muscle activity patterns during mastication, electromyographic activity of the styloglossus (SG) as a tongue-retractor and masseter (Mass) as a jaw-closer muscles as well as jaw-movement trajectories were recorded during cortically evoked rhythmic jaw movements (CRJMs) in anesthetized rabbits. The SG and Mass muscles were mainly active during the jaw-closing (C1) phase. The SG activity was composed of two bursts in one masticatory cycle; one had its peak during the jaw-opening (Op) phase (SG1 burst) and the other during the C1 phase (SG2 burst). The Mass activity during the C1 phase was dominant on the working side (opposite to the stimulating side) while the SG1 and SG2 bursts were not different between the sides. When the wooden stick was inserted between the molar teeth on the working side during CRJMs, the facilitatory effects on the SG1 and SG2 bursts on both sides were noted as well as those on the Mass bursts, but the effects on the SG1 burst seemed to be weak as compared with those on the Mass and SG2 bursts. The difference in the burst timing between the sides was noted only in the SG1 burst. When the trigeminal nerves were blocked, the peak and area of the SG and Mass burst decreased during CRJMs, and the facilitatory effects of the wooden stick application on the muscles were not noted. The results suggest that the jaw and tongue muscle activities may be adjusted to chew the food and make the food bolus. (C) 2004 Elsevier B.V. All rights, reserved.

    DOI: 10.1016/j.brainres.2004.05.005

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  • Activity of peri-oral facial muscles and its coordination with jaw muscles during ingestive behavior in awake rabbits Reviewed

    S Ootaki, K Yamamura, M Inoue, JKC Amarasena, M Kurose, Y Yamada

    BRAIN RESEARCH   1001 ( 1-2 )   22 - 36   2004.3

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    To study peri-oral facial muscle activity patterns and coordination with jaw muscles during ingestive behavior, electromyographic (EMG) activities in the peri-oral facial (buccinator: BUC, orbicularis oris: ORB) and jaw (masseter, digastric) muscles along with jaw movement trajectories were recorded in awake rabbits. A standardized amount of apple in a cylindrical shape was used as the test food. The period from food intake to just before swallowing (the masticatory sequence) was divided into three masticatory periods (preparatory period, rhythmic chewing period and preswallow period) based on the activity pattern of jaw muscles and jaw movement trajectories, and jaw movements and EMG activities in both the jaw and facial muscles during each masticatory period were assessed. Both the jaw and facial muscles were active throughout the masticatory sequence, and the activity patterns of facial muscles and the pattern of coordination between the facial and jaw muscles varied for each masticatory period. No consistent pattern was noted for the BUC activity during the preparatory period, whereas the OR-B showed tonic activity throughout this period. During the rhythmic chewing and preswallow periods, both the ORB and BUC showed jaw-movement-related rhythmic bursts. However, significant differences were noted in the burst properties in both facial muscles and their temporal correlations with the jaw muscle activities between these two periods. Results Suggest that the neural mechanisms regulating facial muscle activities may differ between the masticatory periods, and such mechanisms may contribute to the well-coordinated orofacial movements required for smooth masticatory sequence. (C) 2003 Elsevier B.V. All rights reserved.

    DOI: 10.1016/j.brainres.2003.11.037

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  • Convergence of selected inputs premotor neurons with possible from sensory afferents to trigeminal projections to masseter motoneurons in the rabbit Reviewed

    M Inoue, K Nozawa-Inoue, R Donga, Y Yamada

    BRAIN RESEARCH   957 ( 1 )   183 - 191   2002.12

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    Peripheral input convergence on trigeminal premotor neurons in the vicinity of trigeminal motor nucleus has been investigated. Thirty neurons were identified by their antidromic responses to microstimulation of the masseteric subnucleus of trigeminal motor nucleus (NVmot-mass). Peripheral receptive fields were found in the buccal mucosae, periodontal ligaments, palate, tongue and vibrissae for 16 neurons located in the intertrigeminal area (NVint), supratrigeminal area (NVs), main sensory trigeminal nucleus (NVsnpr) and subnucleus gamma of the oral nucleus of the spinal trigeminal tract (NVspo-gamma). Eleven neurons in the NVint, NVs and NVspo-gamma responded to passive jaw opening: nine neurons were activated and two were inhibited. None of the neurons responded to both the orofacial mechanical stimulation and passive jaw opening. Forty-six percent of neurons (13 out of 28 tested) received inputs from the inferior alveolar nerve (IAN) and 53% of neurons (8 out of 15 tested) received inputs from the infraorbital nerve (ION). Out of 15 neurons tested for inputs from the IAN and ION, 7 neurons in the NVsnpr and NVspo-gamma received input from both. Sixteen percent of neurons (4 out of 25) received inputs from the masseteric nerve (MassN). None of the neurons with inputs from IAN and/or ION also received inputs from the MassN. We suggest that trigeminal premotor interneurons with projections to the NVmot-mass fall into two broad categories, those with inputs from the IAN and/or ION and those with inputs from the MassN, possibly muscle spindle afferents, and no neuron receiving inputs from both. (C) 2002 Elsevier Science B.V. All rights reserved.

    DOI: 10.1016/S0006-8993(02)03662-4

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  • Effects of the inferior alveolar nerve stimulation on tongue muscle activity during mastication in freely behaving rabbits Reviewed

    H Aeba, K Yamamura, M Inoue, K Hanada, S Ariyasinghe, Y Yamada

    BRAIN RESEARCH   956 ( 1 )   149 - 155   2002.11

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    Genioglossus (Gg) reflexes elicited by electrical stimulation of the inferior alveolar nerve were examined in naturally chewing rabbits. To eliminate possible contaminations of the digastric (Dig) activity in the Gg responses, the Dig nerve was denervated bilaterally. Masticatory and tongue muscles were well coordinated during chewing after the denervation; i.e., there were no significant differences in the phase durations between before and after denervation. The Gg reflex measured was divided into three categories depending on the chewing phase (i.e., jaw-opening, OP; fast-closing, FC; and slow-closing, SC) in which the stimulus was delivered. The reflex amplitude was phasically modulated for the phases, in that the amplitude in the OP phase was larger than that in any other phase (P&lt;0.05). On the other hand, the amplitude in the FC and SC phases was not significantly different to each other and from the control value obtained when the animal was awake and resting. The pattern of the modulation in the reflex amplitude was different from the previous report as to the Dig reflex in that OP&lt;FCsimilar toSC&lt;control was obtained. The results suggest that the modulatory mode in the Gg and Dig reflexes may be different in the pattern of the modulation under the natural chewing behavior and the Gg reflex is independent of the masticatory muscles in the nature. The reflex could be more sensitive to control the tongue movements collecting food bolus in the OP phase during chewing than in the jaw-closing phase. (C) 2002 Elsevier Science B.V. All rights reserved.

    DOI: 10.1016/S0006-8993(02)03512-6

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  • Tongue and jaw muscle activities during chewing and swallowing in freely behaving rabbits Reviewed

    K Naganuma, M Inoue, K Yamamura, K Hanada, Y Yamada

    BRAIN RESEARCH   915 ( 2 )   185 - 194   2001.10

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    To study the function of the tongue and the coordination among jaw, tongue, and hyoid muscles during chewing and swallowing, we recorded the electromyographic activities from the masseter (Mas), digastric (Dig), mylohyoid (Myl), thyrohyoid (Thy), genioglossus (Gg) and styloglossus (Sg) muscles as well as jaw movement trajectories in the freely behaving rabbit. Three phases were identified in the chewing cycle (fast- and slow-closing and opening phases). The Gg (main tongue protruder) was active synchronously with the Dig during opening. The Sg (tongue retractor) showed two peaks in each cycle, one in the opening phase and the other in the closing phase. The latter may have a role in retracting the tongue during jaw closing. The co-contraction of the antagonists (i.e. Gg and S-) during opening may contribute to shape the tongue to be appropriate to gather the foodstuff. In the swallowing cycle, five phases were identified, two in the closing phase and three in the opening phase. Regression analysis revealed that swallowing cycles had a longer cycle duration than that of the chewing cycles due to an extra phase (a pause) inserted in the opening phase, where there was a small co-activation in the jaw opening and closing muscles. The findings suggest that the swallowing center affects masticatory center in the central nervous system, and may also support the view that the masticatory burst timing begins with the Dig activities in the middle of the opening phase. (C) 2001 Elsevier Science BY All rights reserved.

    DOI: 10.1016/S0006-8993(01)02848-7

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  • Changes in jaw reflexes by stimulation of the hypothalamus in anesthetized rabbits Reviewed

    M Inoue, K Nozawa-Inoue, Y Miyaoka, Y Yamada

    NEUROSCIENCE RESEARCH   41 ( 1 )   61 - 65   2001.9

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    Changes in the masseteric monosynaptic reflex (MMR) and jaw-opening reflex (JOR) responses resulting from conditioning stimulation in the hypothalamus were studied in anesthetized rabbits. Stimulation of the lateral hypothalamus evoked a facilitation of the MMR and an inhibitory or facilitatory effect on the JOR. The facilitatory effect on JOR was stronger than that on the MMR. The facilitatory effective site for the JOR was in the dorsal and lateral directions as compared to the inhibitory field. The results suggest two functionally distinct regions in the lateral hypothalamus that separately project to the jaw-opening muscles. (C) 2001 Elsevier Science Ireland Ltd and the Japan Neuroscience Society. All rights reserved.

    DOI: 10.1016/S0168-0102(01)00260-7

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  • Changes in reflex responses of the masseter and digastric muscles during sleep in freely behaving rabbits Reviewed

    M Inoue, K Yamamura, T Nakajima, Y Yamada

    NEUROSCIENCE RESEARCH   34 ( 1 )   37 - 44   1999.5

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    The aim of this study was to clarify the modulation of motoneuron excitability in masticatory muscles during sleep. For this purpose, changes in the reflex responses of the masseter and digastric muscles between sleep and wakefulness were studied in freely behaving rabbits. Stimulation of the jaw closing muscle spindle afferents induced the masseteric monosynaptic reflex (MMR). During quiet sleep (QS), which gradually replaced quiet wakefulness, the mean MMR amplitude showed no change. During active sleep (AS), MMR amplitudes were markedly reduced, but they were confounded by the occasional occurrence of facilitation in the amplitude. The facilitatory reflexes were often related to rapid eye movements (REMs). However, the excitatory input probably did not originate from the same region as the REM generator, since the REM and the large MMR did not always occur simultaneously. On the other hand, jaw opening reflexes remained inhibited. The results indicated that there is mainly a difference in the excitability between the two groups of motoneurons during AS; masseter motoneuron activity was inhibited but occasionally facilitated by excitatory inputs occurring in association with REMs, however, the digastric motoneuron activity was remained inhibited. The excitatory inputs may induce dysfunctional muscle contraction of the jaw closing muscles as seen in bruxism. (C) 1999 Elsevier Science Ireland Ltd. All rights reserved.

    DOI: 10.1016/S0168-0102(99)00031-0

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  • Effects of stimulation in the hypothalamus on jaw reflexes Reviewed

    M Inoue, Y Yamada

    NEUROBIOLOGY OF MASTICATION - FROM MOLECULAR TO SYSTEMS APPROACH   1186   383 - 386   1999

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    We studied effects of electrical stimulation in the hypothalamus on the masseteric monosynaptic reflex (MMR) and the jaw-opening reflex (JOR) in rabbits. MMRs were obtained in the masseter EMG (electromyogram) after the electrical stimulation of the trigeminal mesencephalic nucleus. JORs were obtained in the digastric EMG after electrical stimulation of the inferior alveolar nerve. As for conditioning stimulus, the electrode was located in the hypothalamus. Short and small facilitation (260%) was obtained in the MMR when the conditioning was delivered in the lateral hypothalamic area. The C-T interval of this facilitation was less than 10 ms. On the other hand, the typical effect on JOR was a large facilitation (900%) followed by a late inhibition (30%). The C-T interval of the facilitation was less than 10 ms and approximately 40 ms for the inhibition. The area in the hypothalamus where the stimuli were effective, was larger for JOR than MMR. We concluded that the lateral hypothalamic area acted differently on the masseter and digastric motoneurons. We discussed the relationship between the craniomandibular disorders such as bruxism and the limbic system.

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  • Effects of food consistency on the modulatory mode of the digastric reflex during chewing in freely behaving rabbits Reviewed

    K Yamamura, M Inoue, N Igarashi, Y Takahashi, Y Yamada

    BRAIN RESEARCH   796 ( 1-2 )   257 - 264   1998.6

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    Effects of food consistency on the mode of the phase-linked modulation in the digastric reflex amplitude were examined in naturally chewing rabbits. Two test foods with different textures (bread as a soft food, pellet as a hard food) were used. The digastric reflex was elicited by electrical stimulation (10 train pulses at 2 kHz) of the inferior alveolar nerve. The amplitude of the digastric reflex measured was divided into three categories depending on the chewing phases in which the stimulus was delivered and each value was compared with the control response obtained when the animal was resting. The reflex was strongly inhibited in the jaw-opening phase and no difference was observed in the inhibitory effect between the foods. In the jaw-closing phase, larger digastric reflexes than those in the opening phase were elicited with both foods. This was the case in both the fast-closing and slow-closing phases. Reflex amplitude was significantly larger during chewing of the hard food than the soft food and, thereafter, inhibition of the reflex was observed only during chewing of the soft food in the closing phase. The results suggest the following: (1) food consistency may affect the central mechanism which regulates the digastric reflex and (2) the reflex may contribute to the regulation of masticatory force during chewing particularly hard food. (C) 1998 Elsevier Science B.V. All rights reserved.

    DOI: 10.1016/S0006-8993(97)01470-4

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  • Reflexogenic areas for velopharyngeal closure in rabbits. (共著) Reviewed

    Dysphagia   Summer;13(3):156-9.   156 - 159   1998

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    DOI: 10.1007/PL00009566

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Books

  • よくわかる地域包括ケア

    Makoto Inoue( Role: Joint author ,  摂食嚥下の機能が低下した人へのケア)

    ミネルヴァ書房  2018 

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    Responsible for pages:144-147   Language:Japanese Book type:Textbook, survey, introduction

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  • Monthly Book Medical Rehabilitation

    Makoto Inoue( Role: Joint author ,  咀嚼の生理学)

    全日本病院出版会  2017 

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    Responsible for pages:1月8日   Language:Japanese Book type:Scholarly book

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  • 新よくわかる顎口腔機能

    Makoto Inoue( Role: Joint author ,  嚥下運動)

    医歯薬出版株式会社  2017 

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    Responsible for pages:171-173   Language:Japanese Book type:Scholarly book

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  • チームで診る高齢者脆弱性骨折手術と周術期管理

    Makoto Inoue( Role: Joint author ,  摂食嚥下障害とリハビリテーション)

    株式会社医薬ジャーナル社  2017 

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    Responsible for pages:152-166   Language:Japanese Book type:Scholarly book

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  • 高齢者歯科学習ノート

    Makoto Inoue( Role: Joint author ,  摂食嚥下に関連する解剖・生理)

    株式会社永末書店  2017 

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    Responsible for pages:183-187   Language:Japanese Book type:Textbook, survey, introduction

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  • コメディカル専門基礎科目シリーズ「リハビリテーション概論・リハビリテーション医学」

    Makoto Inoue( Role: Joint author ,  摂食嚥下のリハビリテーション)

    理工図書株式会社  2017 

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    Responsible for pages:15-36   Language:Japanese Book type:Textbook, survey, introduction

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  • 質疑応答No.4823

    Makoto Inoue( Role: Joint author ,  食事箋作成で嚥下障害の検査方法)

    日本医事新報社  2016 

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    Responsible for pages:66   Language:Japanese Book type:Dictionary, encyclopedia

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  • 摂食嚥下リハビリテーション

    Makoto Inoue( Role: Joint author ,  摂食嚥下と呼吸)

    医歯薬出版株式会社  2016 

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    Responsible for pages:92-93   Language:Japanese Book type:Textbook, survey, introduction

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  • 新潟大学歯学部創立50周年記念誌「食べる」文化をみつめて

    Makoto Inoue( Role: Joint author ,  「100歳」までおいしく食べたい)

    医歯薬出版株式会社  2016 

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    Responsible for pages:124-129   Language:Japanese Book type:General book, introductory book for general audience

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  • 脳と神経

    Makoto Inoue( Role: Joint author ,  【「食べる」を考える】 嚥下の神経機構)

    医学書院  2015 

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    Responsible for pages:157-168   Language:Japanese Book type:Scholarly book

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  • 基礎歯科生理学第6版

    Makoto Inoue( Role: Joint author ,  吸啜)

    医歯薬出版株式会社  2014 

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    Responsible for pages:350-354   Language:Japanese Book type:Dictionary, encyclopedia

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  • 今日の治療指針

    Makoto Inoue( Role: Joint author ,  口腔環境と摂食・嚥下障害)

    医学書院  2012 

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    Responsible for pages:1297-1298   Language:Japanese

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  • 新口腔の生理から?をとく

    Makoto Inoue( Role: Joint author ,  どうして「おえっ」となりやすい人でも食物は飲み込めるのだろう?)

    デンタルダイヤモンド社  2012 

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    Responsible for pages:76-80   Language:Japanese Book type:Scholarly book

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  • 黒岩恭子の口腔ケア&口腔リハビリはなぜ食べられる口になるのか

    Makoto Inoue( Role: Joint author)

    デンタルダイヤモンド社  2012 

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    Language:Japanese Book type:Scholarly book

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  • 口腔ケアガイド

    Makoto Inoue( Role: Joint author ,  摂食・嚥下機能障害を伴う疾患の口腔ケア)

    文光堂  2011 

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  • 歯科衛生士のための摂食・嚥下リハビリテーション学

    Makoto Inoue( Role: Joint author ,  摂食・嚥下に関わる機能)

    医歯薬出版株式会社  2011 

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    Responsible for pages:36-47   Language:Japanese Book type:Textbook, survey, introduction

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  • これからの非常食・災害食に求められるもの3

    Makoto Inoue( Role: Joint author ,  災害時における食と福祉)

    株式会社光琳  2011 

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    Responsible for pages:218-225   Language:Japanese Book type:Scholarly book

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  • 口腔からみた全身との関わり

    Makoto Inoue( Role: Joint author ,  においの感覚総論:口腔からみた全身との関わり)

    医歯薬出版株式会社  2009 

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    Responsible for pages:86-88   Language:Japanese Book type:Scholarly book

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  • 歯学生のための摂食・嚥下リハビリテーション学

    Makoto Inoue( Role: Joint author ,  摂食嚥下のメカニズム?)

    医歯薬出版株式会社  2008 

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    Responsible for pages:21-28   Language:Japanese Book type:Textbook, survey, introduction

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  • 顎運動および筋電図検査法

    Makoto Inoue( Role: Joint author ,  筋電図や嚥下造影検査を用いた嚥下運動の記録法)

    有限会社八木出版  2008 

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    Responsible for pages:80-87   Language:Japanese Book type:Scholarly book

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  • 咀嚼・嚥下機能の検査法

    Makoto Inoue( Role: Joint author ,  嚥下の基礎的知識―嚥下の神経機構―)

    有限会社 八木出版  2007.3 

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    Responsible for pages:13-22   Language:Japanese Book type:Scholarly book

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  • 新潟大学大学院医歯学総合研究科ブックレット新潟大学編集委員会編.ブックレット新潟大学「食べる」介護編(共著)

    Makoto Inoue( Role: Joint author ,  摂食・嚥下機能とその障害)

    新潟日報事業社  2006.9 

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    Responsible for pages:32-37   Language:Japanese Book type:Scholarly book

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  • 口腔の生理から?を解く

    Makoto Inoue( Role: Joint author ,  どうして食べ物を細かく粉砕して磨りつぶして飲み込めるのだろうか?)

    デンタルダイヤモンド社  2006.6 

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    Responsible for pages:48-51   Language:Japanese Book type:Dictionary, encyclopedia

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  • これからの非常食・災害食に求められるもの

    Makoto Inoue( Role: Joint author ,  震災への取り組み―新潟大学歯学部より―)

    株式会社 光琳  2006.6 

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    Responsible for pages:132-140   Language:Japanese Book type:Scholarly book

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  • よくわかる顎口腔機能

    Makoto Inoue( Role: Joint author ,  嚥下と嚥下障害)

    医歯薬出版株式会社  2005.7 

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    Responsible for pages:148-172   Language:Japanese Book type:Scholarly book

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  • 新潟大学大学院医歯学総合研究科ブックレット新潟大学編集委員会編,ブックレット新潟大学 続「食べる」―食べるの科学―

    Makoto Inoue( Role: Joint author ,  味わうことの最終段階―飲み込むことの大切さ―)

    新潟日報事業社  2003.10 

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    Responsible for pages:24-31   Language:Japanese Book type:Scholarly book

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  • Neurobiology of mastication from molecular to systems

    Makoto Inoue( Role: Joint author ,  Effects of stimulation in the hypothalamus on the jaw reflexes)

    Elsevier (Amsterdam)  1999.9 

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    Responsible for pages:383-386   Language:English Book type:Scholarly book

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MISC

  • Consideration of the assessment methods and cutoff values to diagnose the oral hypofunction.

    小貫和佳奈, 小貫和佳奈, 板離子, 真柄仁, 辻村恭憲, 伊藤加代子, 那小屋公太, 羽尾直仁, 坂井遥, 中嶋優太, 井上誠, 井上誠, 井上誠

    日本口腔リハビリテーション学会学術大会プログラム・抄録集   35th (CD-ROM)   2021

  • Survey of the assessment and management for the patients with oral hypofunction

    板離子, 小貫和佳奈, 小貫和佳奈, 真柄仁, 辻村恭憲, 伊藤加代子, 那小屋公太, 羽尾直仁, 坂井遥, 中嶋優太, 井上誠, 井上誠, 井上誠

    日本口腔リハビリテーション学会学術大会プログラム・抄録集   35th (CD-ROM)   2021

  • 皮膚筋炎ならびにその合併症により対応に苦慮した嚥下障害の一例

    落合勇人, 渡邊賢礼, 那小屋公太, 山田真子, 辻村恭憲, 井上誠, 井上誠

    日本言語聴覚学会(Web)   22nd   2021

  • 健常者における呼吸と嚥下の協調

    羽尾直仁, 笹杏奈, 辻村恭憲, 那小屋公太, 中嶋優太, 真柄仁, 井上誠

    日本口腔リハビリテーション学会雑誌   33 ( 1 )   2020

  • 急性期摂食嚥下障害患者の経口摂取と口腔機能との関係

    坂井遥, 笹杏奈, 伊藤加代子, 井上誠

    日本口腔リハビリテーション学会雑誌   33 ( 1 )   2020

  • 健常若年者における呼吸と嚥下の協調

    羽尾直仁, 羽尾直仁, 笹杏奈, 辻村恭憲, 那小屋公太, 中嶋優太, 坂暢晃, 後藤理恵, 真柄仁, 井上誠, 井上誠, 井上誠

    新潟歯学会雑誌   50 ( 2 )   2020

  • Coordination between respiration and chewing/swallowing in healthy humans

    羽尾直仁, 笹杏奈, 辻村恭憲, 那小屋公太, 真柄仁, 井上誠

    日本顎口腔機能学会学術大会プログラム・事前抄録集   64th (Web)   2020

  • 【これでナットク!摂食嚥下機能評価のコツ】機器を用いた評価 筋電図検査

    井上 誠

    MEDICAL REHABILITATION   ( 240 )   105 - 112   2019.9

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    Language:Japanese   Publisher:(株)全日本病院出版会  

    筋電図検査とは、表面電極や針電極を用いて対象とする筋の活動電位(筋電位)を記録することで、筋収縮の定量的評価を行うものである。表面筋電図では電極を皮膚や粘膜上に貼付するため、ターゲットとする筋活動を非侵襲的に広く記録することができる反面、筋を限定して記録するのが難しいという欠点をもつ。針電極では、限定した部位の単一運動単位を記録でき、波形解析や伝導速度の計測により、脳神経内科疾患などの診断に用いることができるが、電極刺入時に痛みを伴うことや、筋の限局部位のみの評価であることから深部の筋活動の記録以外には適さず、摂食嚥下運動という統合機能の評価には向かない。目的に応じて嚥下内視鏡検査や嚥下造影検査などを併用し、多面的なアプローチを行うことによって機能評価が可能となる。(著者抄録)

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  • 摂食嚥下リハビリテーションを実施したクロウ・深瀬(POEMS)症候群の1例

    羽尾 直仁, 辻村 恭憲, 白石 成, 井上 誠

    新潟歯学会雑誌   49 ( 1 )   19 - 24   2019.6

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    クロウ・深瀬(POEMS)症候群の治療中に誤嚥性肺炎を発症し、摂食嚥下リハビリテーションを行った一例を報告する。症例は83歳男性。2012年にPOEMS症候群と診断され、サリドマイド治験に参加し、加療されていた。2017年11月に誤嚥性肺炎の診断で入院となり、摂食嚥下機能評価目的に当科初診となった。初診時、随意咳嗽力が低下し、粗そう性および湿性嗄声を認め、最長発声持続時間は9.9秒であった。反復唾液嚥下テスト3回、とろみ付き液体1ml摂取では3%以上のSpO2低下と頸部聴診にて湿性音を認めた。嚥下内視鏡検査では、喉頭浮腫および唾液誤嚥を認め、少量の食物摂取も困難であった。重度咽頭期障害の診断にて、口腔ケアおよび間接訓練にて介入を開始した。介入23日目に嚥下造影検査を経て、直接訓練を開始したものの、介入44日目に熱発とCRPの上昇があり、痰喀出も困難な状況のため直接訓練は中止となった。介入63日目に摂食嚥下リハビリテーション目的で地域医療支援病院に転院となり、2ヵ月間のリハビリテーションを実施したものの嚥下機能に明らかな改善はみられなく、胃瘻造設のため当院へ再入院となった。唾液誤嚥レベルの重度咽頭期障害は変わらなかったものの、転院前は困難であった痰喀出は可能であった。その後も直接訓練と間接訓練を継続し、最終的に少量のゼリー摂取が可能となり、リハビリテーション病院への転院を迎えた。(著者抄録)

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  • 【これでわかる、対応できる 口腔乾燥症の診査と治療】【これでわかる、対応できる 口腔乾燥症の診査と治療】

    伊藤 加代子, 船山 さおり, 井上 誠

    The Quintessence   38 ( 6 )   54 - 67   2019.6

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  • 頚静脈孔神経鞘腫術後に嚥下障害を認めてバルーン訓練が奏功した一例

    日野遥香, 那小屋公太, 白石成, 鈴見梨紗, 上村由紀子, 高波里帆, KULVANICH Sirima, 井上誠

    日本摂食嚥下リハビリテーション学会学術大会抄録集(Web)   25th   2019

  • Effect of long-lasting laryngeal TRPV1 activation on initiation of swallowing in anesthetized rats

    吉原翠, 那小屋公太, 真柄仁, 辻村恭憲, 井上誠

    日本顎口腔機能学会雑誌   26 ( 1 )   2019

  • 「食の支援ステーション」来訪者の症状別ニーズに関する調査

    笹杏奈, 伊藤加代子, 吉原翠, 竹井絵理, 坂井遥, 上村由紀子, 秋元幸平, 井上誠, 井上誠, 井上誠

    日本摂食嚥下リハビリテーション学会学術大会抄録集(Web)   25th   2019

  • 皮膚筋炎に起因した嚥下障害に対し摂食嚥下リハビリテーションを行った2症例

    石澤尚子, 石澤尚子, 真柄仁, 渡邊賢礼, 笹杏奈, 井上誠, 井上誠

    日本口腔リハビリテーション学会学術大会プログラム・抄録集   33rd   2019

  • 介護保険施設利用者における口腔機能向上および栄養改善プログラムに関する質的研究

    伊藤 加代子, 枝広 あや子, 渡部 芳彦, 小原 由紀, 本橋 佳子, 森下 志穂, 本川 佳子, 井上 誠, 渡邊 裕, 平野 浩彦

    老年歯科医学   33 ( 2 )   142 - 142   2018.9

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  • 【高齢者の口腔機能-オーラルフレイル-】口腔乾燥症・味覚障害への対応

    伊藤 加代子, 船山 さおり, 井上 誠

    Geriatric Medicine   56 ( 8 )   755 - 758   2018.8

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    口腔乾燥症や味覚障害は、「乾いた食べ物を食べづらい」、「飲み込みづらい」、「何を食べてもおいしくない」、「常に嫌な味がする」などの症状を呈し、食思不振から低栄養を招くこともある。しかし高齢者の中には、口腔乾燥症や味覚障害であることに気づかず、水を飲むことで対処していたり、知らない間に塩分過剰摂取になっていることもある。医療従事者や周囲の者がこれらの症状に気づき、医療機関受診を勧奨し、適切な治療を行うことで、QOLの向上を図ることが可能である。(著者抄録)

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  • 【高齢者の口腔機能-オーラルフレイル-】 口腔乾燥症・味覚障害への対応

    伊藤 加代子, 船山 さおり, 井上 誠

    Geriatric Medicine   56 ( 8 )   755 - 758   2018.8

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    口腔乾燥症や味覚障害は、「乾いた食べ物を食べづらい」、「飲み込みづらい」、「何を食べてもおいしくない」、「常に嫌な味がする」などの症状を呈し、食思不振から低栄養を招くこともある。しかし高齢者の中には、口腔乾燥症や味覚障害であることに気づかず、水を飲むことで対処していたり、知らない間に塩分過剰摂取になっていることもある。医療従事者や周囲の者がこれらの症状に気づき、医療機関受診を勧奨し、適切な治療を行うことで、QOLの向上を図ることが可能である。(著者抄録)

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  • 聴神経腫瘍術後に脳幹・小脳出血を合併し摂食嚥下障害を認めた1症例 Reviewed

    笹 杏奈, 辻 光順, 渡邊 賢礼, 那小屋 公太, 伊藤 加代子, 真柄 仁, 辻村 恭憲, 井上 誠

    新潟歯学会雑誌   48 ( 1 )   37 - 41   2018.6

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    聴神経腫瘍術後に嚥下障害を認めた一例を報告する。症例は56歳女性。2017年2月に小脳・脳幹を圧迫する聴神経鞘腫に対する摘出術施行、術後左小脳出血及び延髄から橋にかけて低吸収域を認めたため、脳内血腫除去および減圧開頭術が施行された。術後11日目に嚥下機能評価目的に当科初診となった。小脳前庭症状としての姿勢保持困難と失調性構音障害、球麻痺症状としての顔面神経麻痺、舌運動減弱、開鼻声を伴う右カーテン徴候を認めた。反復唾液嚥下テストは2回、改訂水飲みテストおよびとろみ付液体3ccでのテストでは3a点(嚥下後湿性音あり)であった。嚥下内視鏡検査時、安静時より咽頭内分泌物貯留、左側披裂・声帯は傍正中位固定で声門閉鎖不良、ホワイトアウトは減弱しており、とろみ付液体摂取時の食道流入不良、鼻咽腔逆流を認めた。さらに、残留物は不顕性誤嚥をしていた。重度摂食嚥下障害の診断にて、口腔ケア・間接訓練から介入を開始した。耐久性が改善した術後19日目以降は間接訓練の負荷を増やし、少量のとろみ付液体を用いた直接訓練も開始した。術後35日目に実施した嚥下造影検査では、依然として嚥下後の咽頭残留量が多く食事開始にはいたらなかった。転院を前に術後55日目に実施した最終評価では、幻暈などの前庭症状は改善していたものの球麻痺症状に大きな変化は認められなかった。最終的に食事開始までは至らなかったものの、訓練の効果による咽頭残留の軽減と姿勢調整を行うことで安全な経口摂取方法の提案ができた。(著者抄録)

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  • 舌癌術後の摂食嚥下障害に対し間接訓練ならびに直接訓練を実施した1症例 Reviewed

    小貫 和佳奈, 笹 杏奈, 辻 光順, 渡邊 賢礼, 白石 成, 伊藤 加代子, 真柄 仁, 辻村 恭憲, 井上 誠

    新潟歯学会雑誌   48 ( 1 )   43 - 48   2018.6

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    頭頸部癌術後は、高頻度に摂食嚥下障害を生じる。今回、舌癌術後に摂食嚥下障害を生じ、リハビリテーションによる食形態や姿勢の調整によって経口摂取が可能となった症例を経験したので報告する。症例は68歳の男性。舌亜全摘術、両側頸部郭清術、腹直筋皮弁再建術、気管切開術、胃瘻造設術後、放射線治療開始と同時にN大学医歯学総合病院摂食嚥下機能回復部に紹介受診となった。初診時、頸部拘縮、舌切除による創部瘢痕化を伴う口腔移送不良・鼻咽腔閉鎖不全・咽頭収縮不全を認めた。嚥下内視鏡検査と嚥下造影検査により、リクライニング60度、左側臥位・右側頸部回旋位にてとろみ付液体2ccの食道流入が可能なことを確認して、毎日の間接訓練および代償法を用いた直接訓練を開始した。術後放射線治療の影響による口腔粘膜炎は自制内であり、訓練手技を獲得して耐久性が向上した介入29日目より食事開始、介入35日目には口腔移送改善を目的として舌接触補助床を用いた訓練を開始したものの、違和感や嘔気が強く常時使用にはいたらなかった。今後は、経口摂取のみでの栄養確保、歯科補綴学的アプローチによる口腔準備期の改善も可能であると考えている。(著者抄録)

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  • 介護保険施設利用者における口腔機能向上および栄養改善プログラムに関する質的研究

    伊藤 加代子, 枝広 あや子, 渡部 芳彦, 小原 由紀, 本橋 佳子, 森下 志穂, 本川 佳子, 井上 誠, 渡邊 裕, 平野 浩彦

    日本老年歯科医学会総会・学術大会プログラム・抄録集   29回   [P一般 - 001]   2018.6

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  • 介護保険施設利用者における口腔機能向上および栄養改善プログラムに関する質的研究

    伊藤 加代子, 枝広 あや子, 渡部 芳彦, 小原 由紀, 本橋 佳子, 森下 志穂, 本川 佳子, 井上 誠, 渡邊 裕, 平野 浩彦

    日本老年歯科医学会総会・学術大会プログラム・抄録集   29回   [P一般 - 001]   2018.6

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  • 新潟県内の病院における摂食嚥下障害の評価およびリハビリテーション診療体制調査 Reviewed

    張替 徹, 木村 慎二, 眞田 菜緒, 遠藤 直人, 伊藤 加代子, 井上 誠

    日本摂食・嚥下リハビリテーション学会雑誌   22 ( 1 )   3 - 11   2018.4

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    【目的】新潟県内の病院における摂食嚥下障害の評価とリハビリテーション(以下、リハ)の実施状況、診療受け入れが可能な病院の分布を把握し、地域の摂食嚥下障害診療システムを構築するうえでの課題について検討する。【方法】調査期間は2014年7月1日から8月30日。新潟県内の全病院に調査用紙を郵送した。内容は、摂食嚥下障害の評価とリハ実施の有無、関わる職種、検査内容、摂食嚥下障害のための特別食の有無・種類、摂食嚥下障害の評価・リハ(評価かリハの一方あるいは両方)の他医療機関からの受け入れ、受け入れ不可能な理由などである。調査結果から、摂食嚥下障害患者の受け入れが可能な病院の分布図を作成した。【結果】130病院中120病院(92.3%)から回答を得た。評価は93病院(回答した120病院の77.5%)、リハは83病院(69.2%)で実施されていた。評価・リハに関わる職種は、言語聴覚士が71病院(評価・リハが実施されていた94病院の75.5%)、医師70病院(74.5%)、看護師65病院(69.1%)などであった。嚥下造影検査は41病院(評価が実施されていた93病院の44.1%)、嚥下内視鏡検査は29病院(31.2%)で実施されていた。特別食は120病院中94病院(78.3%)で提供されていた。評価・リハの外来での受け入れ意向があったのは120病院中47病院(39.2%)、入院での受け入れ意向があったのは60病院(50.0%)であった。受け入れ不可能な理由は、人員の不足、経験・知識の不足、機器の準備がない、などであった。精査(嚥下造影検査か嚥下内視鏡検査の一方あるいは両方)を実施、かつ外来受け入れ意向があったのは120病院中33病院(27.5%)、入院受け入れ意向があったのは37病院(30.8%)で、成人の受け入れ可能な病院はすべての二次医療圏に存在したが、2つの二次医療圏で小児の受け入れ可能な病院がなかった。【結論】新潟県では約70%の病院で摂食嚥下障害の評価・リハが実施されていたが、他医療機関からの受け入れ可能な病院は3割程度であった。小児の受け入れ可能な病院がない2つの二次医療圏の解消が課題である。(著者抄録)

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  • 身体的フレイル患者における歩行機能と口腔機能との関連

    井上 誠, 保田 麻里, 真柄 仁

    8020: はち・まる・にい・まる   ( 17 )   136 - 137   2018.2

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  • 嚥下反射の誘発に関わる末梢の受容機構

    吉原翠, 鈴木拓, 那小屋公太, 辻村恭憲, 井上誠

    Journal of Oral Biosciences Supplement (Web)   2018   2018

  • 摂食嚥下障害の臨床普及に向けて 第3報 摂食嚥下治療登録医養成事業の展開

    真柄仁, 真柄仁, 笹杏奈, 辻村恭憲, 竹石龍右, 井上誠, 井上誠

    日本摂食嚥下リハビリテーション学会学術大会抄録集(Web)   24th   2018

  • 口腔乾燥症の基本的な診査・診断と治療 Reviewed

    伊藤 加代子, 井上 誠

    老年歯科医学   32 ( 3 )   305 - 310   2017.12

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    超高齢社会およびストレス社会到来に伴い、今後、口腔乾燥症患者は増加する可能性がある。口腔乾燥症の診療にあたっては、1)傾聴・受容・共感の姿勢を大切にすること、2)口腔乾燥症の原因は複数あることが多いため見落とさないように留意すること、3)情報収集に努め、治療の選択肢を増やすこと、4)一般市民に向け、広く情報発信に努めること、が重要である。口腔乾燥症の診査、診断、治療について概説した。

    DOI: 10.11259/jsg.32.305

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  • 【HRTガイドライン2017年度版 改訂の要点と最近の話題】 [CQ編] 舌痛症とHRT

    伊藤 加代子, 松木 貴彦, 井上 誠

    産科と婦人科   84 ( 12 )   1489 - 1493   2017.12

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    更年期世代の女性には、のぼせ、ほてりなどのいわゆる更年期症状のほか、口腔乾燥感、味覚異常、顎関節痛、舌痛などの口腔に関する疾患が多く認められる。このうち、舌痛症は口腔灼熱感(BMS)の一症状としてとらえられている。BMSの治療法には、薬物療法や原因除去療法があげられる。薬物療法のうちホルモン補充療法(HRT)については、BMSが改善したという報告や症状の改善が認められないという報告があり、見解の一致をみていないのが現状である。(著者抄録)

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  • 【歯科との連携をどうする-高齢者の生活を支えるために-】 口腔乾燥症への対応

    伊藤 加代子, 井上 誠

    Progress in Medicine   37 ( 10 )   1175 - 1178   2017.10

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  • 若手の口腔生理学研究最前線 ラット三叉神経運動核の背側網様体に存在するPhox2b陽性ニューロンの電気生理学的および形態学的特性はPhox2b陰性ニューロンと異なる

    那小屋 公太, 中村 史朗, 中山 希世美, 望月 文子, 佐藤 文彦, 吉田 篤, 井上 誠, 井上 富雄

    Journal of Oral Biosciences Supplement   2017   169 - 169   2017.9

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  • ラット三叉神経運動核背側網様体に存在するPhox2b陽性ニューロンの生理学的・形態学的性質

    那小屋 公太, 中村 史朗, 中山 希世美, 望月 文子, 佐藤 文彦, 吉田 篤, 井上 誠, 井上 富雄

    Journal of Oral Biosciences Supplement   2017   300 - 300   2017.9

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  • 【嚥下障害に対する新たなアプローチ】 摂食嚥下障害に対する電気刺激療法

    井上 誠

    The Japanese Journal of Rehabilitation Medicine   54 ( 9 )   672 - 675   2017.9

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    リハビリテーションの分野において、電気刺激療法は鎮痛や筋力強化などの目的で古くから使用されてきた。筋力強化をめざした電気刺激療法は、脳血管疾患患者の摂食嚥下障害に対する理学療法として浸透してきたが、その効果に関するエビデンスはいまだ十分に得られていない。一方、筋力強化とは別に、感覚神経への刺激を通して、中枢神経系に働きかけることによって嚥下運動にかかわる中枢神経系の改善をめざした治療法もある。本稿では、電気刺激療法の種類や原理を紹介したうえで、中枢強化を目的とする電気刺激療法にも触れ、摂食嚥下障害への応用について、今後の展望と課題を解説する。(著者抄録)

    DOI: 10.2490/jjrmc.54.672

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  • 転写因子Phox2bを発現する三叉神経運動核背側網様体ニューロンの生理学的および形態学的解析

    那小屋 公太, 中村 史朗, 中山 希世美, 望月 文子, 吉田 篤, 井上 誠, 井上 富雄

    日本顎口腔機能学会雑誌   24 ( 1 )   50 - 51   2017.9

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  • 【摂食嚥下障害リハビリテーションABC】 総論 構造と機能 咀嚼の生理学

    井上 誠

    MEDICAL REHABILITATION   ( 212 )   1 - 8   2017.7

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    咀嚼は、摂食運動の初期に食塊形成を行う過程であり、咀嚼を開始・維持するとともに運動パターンを決定する大脳皮質、パターン形成の場である延髄のパターン発生器と呼ばれる神経細胞集団、食物粉砕と食塊形成に直接かかわる顎、舌、顔面の筋などがかかわる。加えて、口腔内で食塊の情報をとらえてこれを脳に伝えることは円滑な咀嚼運動遂行にとって必須である。そのための受容器として、歯に加えられた触圧覚や位置感覚を伝える歯根膜機械受容器と閉口筋の筋紡錘がある。これらの刺激は、安静時には開口反射や閉口反射を引き起こすが、咀嚼中には抑制を受けることで、不必要な反射が咀嚼を障害しないための制御機構が働く。咀嚼によって分泌される唾液や味覚は、食べることを楽しむためのアイテムである。食物の粉砕をゴールとするのではなく、食べるための咀嚼を考えるうえで、咀嚼と嚥下の機能連関を考えることが重要である。(著者抄録)

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  • 低酸素脳症発症後に嚥下障害を認めた一例 Reviewed

    吉原 翠, 上村 由紀子, 大口 繭美, 砂田 悠香子, 竹内 千華子, 白石 成, 辻村 恭憲, 井上 誠

    新潟歯学会雑誌   47 ( 1 )   33 - 37   2017.6

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    低酸素脳症発症後に嚥下障害を認めた一例を報告する。症例は69歳女性。2015年11月より右気胸にて当院呼吸器感染症内科に入院した。入院6日目に院内で緊張性気胸を再発し、心肺停止に伴う低酸素脳症を発症した。発症58日目に意識レベルの改善を認め、嚥下機能評価のため当科初診となった。指示理解不良で意識レベルはJCS I-3であり、口腔衛生状態は不良で、残存歯は少ないが義歯使用により咬合支持が得られる状態であった。発声・腹式呼吸は不可だった。顎舌顔面の感覚あるものの、舌運動は不良で、呼吸状態不良につき頬ふくらまし・吸引は不可だった。頸部運動は不良で、反復唾液嚥下テストは0回だった。介入3日目(発症60日目)、嚥下内視鏡検査を実施した。安静時より咽頭に分泌物の貯留あり。とろみ摂取時には、喉頭侵入および咽頭残留があったものの誤嚥は認められなかった。先行期から嚥下咽頭期にわたる機能的嚥下障害と診断し、口腔ケア・間接訓練から介入を開始した。呼吸状態安定時のみ少量の直接訓練を実施した。介入57日目(発症114日目)には、義歯調整を行った後に、嚥下造影検査を実施した。液体・ゆるめのとろみにて声門上まで喉頭侵入し、固形物は喉頭蓋谷及び舌背に残留を認めた。ティースプーン一杯量を摂取した際に、患者は咽頭残留を自覚できた。食事による訓練が可能と判断し、全粥・半固形食とろみ付きの食事を開始した。並行して舌運動訓練を実施し、最終的に全粥・半固形食を3食摂取可能となった。(著者抄録)

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  • REVERSAL OF A VIRTUAL LESION IN HEALTHY HUMAN PHARYNGEAL MOTOR CORTEX BY HIGH-FREQUENCY RTMS OVER THE CEREBELLUM

    Masahiro Watanabe, Emilia Michou, Alicja Raginis-Zborowska, Jin Magara, Makoto Inoue, Shaheen Hamdy

    GASTROENTEROLOGY   152 ( 5 )   S144 - S144   2017.4

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  • ゼリーの舌押し潰し嚥下時における舌圧発現と舌骨移動

    村上 和裕, 堀 一浩, 皆木 祥伴, 藤原 茂弘, 徳田 佳嗣, Salazar Simonne E, 上原 文子, 井上 誠, 小野 高裕, 前田 芳信

    日本顎口腔機能学会雑誌   23 ( 2 )   138 - 139   2017.3

  • 有床義歯装着者の機能評価のガイドライン(2016改訂版)

    皆木 省吾, 山崎 要一, 矢谷 博文, 志賀 博, 山口 泰彦, 服部 佳功, 吉田 教明, 石垣 尚一, 加藤 均, 三浦 宏之, 荒川 一郎, 岡本 和彦, 小野 高裕, 横山 正起, 岡田 和樹, 小川 徹, 菅沼 岳史, 藤澤 政紀, 沖 和広, 坂口 究, 重本 修伺, 瑞森 崇弘, 小見山 道, 田中 恭恵, 堀 一浩, 渡邉 明, 宮脇 正一, 山田 一尋, 斉藤 一誠, 長谷川 信乃, 早崎 治明, 井上 富雄, 井上 誠, 大川 周治, 川良 美佐雄, 祇園白 信仁, 小林 博, 古谷野 潔, 佐々木 啓一, 田中 昌博, 田村 康夫, 野村 修一, 藤村 哲也, 増田 裕次, 鱒見 進一, 倉持 淳子, 昆 はるか, 櫻井 直樹, 山本 早織, 日本顎口腔機能学会, 日本顎口腔機能学会ガイドライン統括委員会

    日本顎口腔機能学会雑誌   23 ( 2 )   E3 - E35   2017.3

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  • 顎関節症患者の機能評価のガイドライン(2016改訂版)

    皆木 省吾, 山崎 要一, 矢谷 博文, 志賀 博, 山口 泰彦, 服部 佳功, 吉田 教明, 石垣 尚一, 加藤 均, 三浦 宏之, 荒川 一郎, 岡本 和彦, 小野 高裕, 横山 正起, 岡田 和樹, 小川 徹, 菅沼 岳史, 藤澤 政紀, 沖 和広, 坂口 究, 重本 修伺, 瑞森 崇弘, 小見山 道, 田中 恭恵, 堀 一浩, 渡邉 明, 宮脇 正一, 山田 一尋, 斉藤 一誠, 長谷川 信乃, 早崎 治明, 井上 富雄, 井上 誠, 大川 周治, 川良 美佐雄, 祇園白 信仁, 小林 博, 古谷野 潔, 佐々木 啓一, 田中 昌博, 田村 康夫, 野村 修一, 藤村 哲也, 増田 裕次, 鱒見 進一, 倉持 淳子, 昆 はるか, 櫻井 直樹, 山本 早織, 日本顎口腔機能学会, 日本顎口腔機能学会ガイドライン統括委員会

    日本顎口腔機能学会雑誌   23 ( 2 )   E37 - E109   2017.3

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  • ラット三叉神経運動核の背側網様体に存在するPhox2b陽性ニューロンの電気生理学的および形態学的特性はPhox2b陰性ニューロンと異なる

    那小屋公太, 那小屋公太, 中村史朗, 中山希世美, 望月文子, 佐藤文彦, 吉田篤, 井上誠, 井上富雄

    Journal of Oral Biosciences Supplement (Web)   2017   ROMBUNNO.US15‐4 (WEB ONLY)   2017

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    J-GLOBAL

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  • ラット三叉神経運動核背側網様体に存在するPhox2b陽性ニューロンの生理学的・形態学的性質

    那小屋公太, 那小屋公太, 中村史朗, 中山希世美, 望月文子, 佐藤文彦, 吉田篤, 井上誠, 井上富雄

    Journal of Oral Biosciences Supplement (Web)   2017   ROMBUNNO.P1‐34 (WEB ONLY)   2017

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  • 摂食嚥下障害の臨床普及に向けて 第2報 嚥下内視鏡セミナー

    古志奈緒美, 真柄仁, 辻村恭憲, 笹杏奈, 竹石龍右, 井上誠

    日本摂食嚥下リハビリテーション学会学術大会抄録集(Web)   23rd   2017

  • 摂食嚥下障害の臨床普及に向けて 第1報 摂食嚥下治療登録医養成研修

    真柄仁, 真柄仁, 古志奈緒美, 笹杏奈, 竹石龍右, 辻村恭憲, 井上誠

    日本摂食嚥下リハビリテーション学会学術大会抄録集(Web)   23rd   2017

  • 歩行機能と摂食機能の比較 身体的フレイル患者における検討

    保田 麻里, 真柄 仁, 井上 誠

    日本口腔リハビリテーション学会雑誌   29 ( 1 )   60 - 61   2016.12

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  • フレイルリスク患者における歩行機能と口腔・嚥下機能との関連

    保田 麻里, 真柄 仁, 小幡 裕明, 上原 彰史, 和泉 徹, 井上 誠

    新潟歯学会雑誌   46 ( 2 )   113 - 114   2016.12

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  • 最近のトピックス 地域一般住民を対象とした摂食嚥下セミナーの紹介

    伊藤 加代子, 船山 さおり, 辻村 恭憲, 真柄 仁, 辻 光順, 酒井 翔悟, 鈴木 拓, 井上 誠

    新潟歯学会雑誌   46 ( 2 )   95 - 96   2016.12

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  • 神経難病患者の最大舌圧と嚥下機能との関連

    安保 俊秀, 塚田 徹, 井上 誠

    竹田綜合病院医学雑誌   42   9 - 15   2016.12

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    神経難病では、疾患の進行とともに嚥下機能も低下していく。しかし、これらの疾患の嚥下機能を経時的に評価した報告は少なく、さらに嚥下機能を簡易的、客観的に評価する検査がほとんどないのが現状である。今回の研究では、嚥下口腔期の評価として重要とされる舌筋力を測定し数値化できる舌圧に着目し、当院入院中の神経難病患者の舌圧と口腔期嚥下機能との関連を調べた。最大舌圧と嚥下造影検査(Videofluoroscopic examination:VF)を利用し、疾患別、経口摂取可否、食形態別で比較した。現在までに、全ての比較において有意な差は認められていないが、症例数を増やし調査を進めていくことで、神経難病における最大舌圧と口腔期嚥下機能への影響を明らかにできるものと期待している。(著者抄録)

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  • Blockade of swallow initiation evoked by capsaicin following co-application of QX-314 and capsaicin in anesthetized rats

    Kojun Tsuji, Takanori Tsujimura, Shogo Sakai, Taku Suzuki, Jin Magara, Makoto Inoue

    CHEMICAL SENSES   41 ( 9 )   E266 - E267   2016.11

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  • What causes bitter taste phantoms?

    Saori Funayama, Kayoko Ito, Makoto Inoue

    CHEMICAL SENSES   41 ( 9 )   E235 - E235   2016.11

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  • Role of ENaC in initiation of swallows in anesthetized rats

    Takanori Tsujimura, Kojun Tsuji, Shogo Sakai, Taku Suzuki, Jin Magara, Makoto Inoue

    CHEMICAL SENSES   41 ( 9 )   E219 - E219   2016.11

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  • 摂食嚥下障害のリハビリテーションの臨床と技術への期待

    井上 誠

    バイオメカニズム学会誌   40 ( 4 )   229 - 234   2016.11

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    人口の高齢化や疾患の多様化が進んだことにより、「食べる・飲む」ことの機能障害である摂食嚥下障害に注目が集まっている。これまでの医療は、摂食嚥下機能障害に対して、主として経管栄養などの代替栄養を用いることを選択してきた。近年、高齢者の増加に伴い、人間らしく生きることを追求すれば食物の経口摂取は当然の権利であると見直されてきたこと、また国民医療費の負担増などの社会的問題の顕在化、などをきっかけとして摂食嚥下リハビリテーションが広まりつつあるが、摂食嚥下機能の評価、エビデンスを伴う治療的アプローチに関しては、未だ多くの課題が残されている。本稿では、摂食嚥下障害の背景にある日本の超高齢社会の実態を踏まえて、今後の医療発展のためにどのような臨床技術・研究が望まれているかについて解説する。(著者抄録)

    DOI: 10.3951/sobim.40.4_229

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  • 食事箋作成に必要な検査は?

    井上 誠

    日本医事新報   ( 4823 )   66 - 67   2016.10

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  • 嚥下研究Basics 末梢刺激がもたらす嚥下機能への影響

    井上 誠

    嚥下医学   5 ( 2 )   245 - 245   2016.9

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  • 咀嚼の重要性を再考する

    井上 誠

    歯界展望   128 ( 3 )   435 - 449   2016.9

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  • 研修歯科医に対する介護保険施設での口腔ケアおよび摂食指導研修 Reviewed

    船山 さおり, 伊藤 加代子, 堀 一浩, 谷口 裕重, 辻村 恭憲, 中村 由紀, 真柄 仁, 渡邊 賢礼, 林 宏和, 辻 光順, 酒井 翔悟, 井上 誠

    日本摂食・嚥下リハビリテーション学会雑誌   20 ( 2 )   80 - 85   2016.8

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    介護保険施設において、口腔ケアおよび摂食指導を必要としている要介護高齢者は少なくない。今後、研修歯科医が食事の場面に立ち会い、摂食指導をすることが重要であるが、その機会はまだ少ないと考えられる。新潟大学では、特別養護老人ホームを週に1回訪問し、口腔ケアや摂食指導を行っているが、その際に研修歯科医が2〜3名ずつ同行して、実際の口腔ケアや摂食指導を研修している。今後、よりよい研修プログラムを提供するため、研修歯科医の介護保険施設における口腔ケアおよび摂食指導の経験の有無や、本プログラムを研修した感想等に関するアンケート調査を実施した。対象は、2009〜2013年度に、口腔ケアおよび摂食指導の研修を行った本学研修歯科医144名とし、口腔ケアおよび摂食指導に対する知識・経験の有無について調査した。その結果、80.4%が口腔ケアの知識があると回答していたが、実際に口腔ケアあるいは摂食指導を経験したことがある者は少なかった(口腔ケア56.6%、摂食指導18.2%)。また、大半が、口腔ケアおよび摂食指導が勉強になったと回答していた。口腔ケアあるいは摂食指導に対する歯科専門スタッフの介入価値があると思うと回答した者は、口腔ケアでは82.5%、摂食指導では78.3%と高い割合を示した。要介護高齢者の数は増加の一途をたどっており、今後、口腔ケアおよび摂食指導において歯科医師が果たす役割は、ますます大きくなっていくと思われる。患者家族やコメディカルに摂食指導をする立場にある歯科医師の臨床研修に、介護保険施設等における口腔ケアおよび摂食指導を導入することは重要であるといえる。(著者抄録)

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  • 【高齢者の嚥下障害の評価とリハビリテーション】 高齢者の嚥下障害の実態

    井上 誠

    Journal of Clinical Rehabilitation   25 ( 8 )   742 - 752   2016.8

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  • EXCITING THE HUMAN SWALLOWING MOTOR SYSTEM BY COMBINATION STIMULI: EFFECTS OF PHARYNGEAL STIMULATION AND CARBONATED LIQUIDS

    J. Magara, E. Michou, M. Inoue, S. Hamdy

    GUT   65   A126 - A127   2016.6

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    DOI: 10.1136/gutjnl-2016-312388.226

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  • Esophageal Involvement in Multiple System Atrophy

    Takayoshi Shimohata, Hiroshige Taniguchi, Hideaki Nakayama, Kazuhiro Hori, Makoto Inoue, Masatoyo Nishizawa

    NEUROLOGY   86   2016.4

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  • Does Combining Pharyngeal Electrical Stimulation With Simultaneous Swallowing of Carbonated Liquids Enhance the Cortical Swallowing Motor System?

    Jin Magara, Emilia Michou, Makoto Inoue, Shaheen Hamdy

    GASTROENTEROLOGY   150 ( 4 )   S858 - S859   2016.4

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  • ゼリー嚥下時の舌圧発現様相と舌骨移動との関係

    村上 和裕, 小野 高裕, 皆木 祥伴, 藤原 茂弘, 徳田 佳嗣, 堀 一浩, 井上 誠, 磯野 舞, 石原 清香, 池上 聡, 中馬 誠, 船見 孝博, 前田 芳信

    日本顎口腔機能学会雑誌   22 ( 2 )   148 - 149   2016.3

  • 【高齢社会と口腔の健康】 避けて通れない摂食嚥下障害への取り組み

    井上 誠

    保団連   ( 1200 )   8 - 17   2015.12

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  • 小脳橋角部髄膜腫摘出術後に嚥下障害を認めた一例 Reviewed

    鈴木 拓, 神田 知佳, 辻村 恭憲, 堀 一浩, 井上 誠

    新潟歯学会雑誌   45 ( 2 )   81 - 85   2015.12

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    小脳橋角部髄膜腫摘出術後に嚥下障害を認めた一例を報告する。症例は57歳女性。2015年1月9日、疼痛の制御困難につき、当院脳神経外科入院下にて摘出術施行された。同月13日(術後4日目)、嚥下機能評価目的に当科初診。口腔衛生状態は不良で、残根歯多数認め、臼歯部の咬合支持はほぼ無い状態。安静時より湿性嗄声を認め、自己喀痰は困難。左側三叉・顔面・舌咽・迷走・舌下神経領域の運動・感覚不全麻痺あり。反復唾液嚥下テストは0回、唾液誤嚥の疑いを認めたために0.5mlの水飲みテストを行ったところむせを認めた。以上より、準備期から嚥下咽頭期にわたる機能的嚥下障害と診断して、まずは口腔ケア、間接訓練より介入開始。術後18日目、嚥下内視鏡検査を実施。検査食の咽頭部残留を認めるも明らかな誤嚥を認めなかったことから、翌日より直接訓練を開始。術後27日目、嚥下造影検査実施。右側臥位・左側頸部回旋位では、中間位に比して嚥下後の咽頭部残留が減少したことから、姿勢調整により経口摂取可能と判断して同日より食事開始。経過に応じ食上げを行い、並行して新義歯作製および咀嚼訓練実施。最終的に中間位にて米飯・軟々菜食まで摂取可能となり、術後86日目に自宅退院に至った。(著者抄録)

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  • 【簡単にも詳しくも!お口の乾燥が気になる患者さんに説明しよう!唾液が減るとなぜ悪い?】

    伊藤 加代子, 井上 誠

    歯科衛生士   39 ( 10 )   17 - 25   2015.10

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  • 地域在住自立高齢者における口腔機能と身体バランス能力の関係

    泉野 裕美, 堀 一浩, 澤田 美佐緒, 福田 昌代, 畑山 千賀子, 野村 慶雄, 重信 直人, 小野 高裕, 井上 誠

    老年歯科医学   30 ( 2 )   163 - 164   2015.9

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  • ゼリー押し潰し摂取におけるStage II transportと舌圧発現様相の関係

    村上 和裕, 小野 高裕, 藤原 茂弘, 皆木 祥伴, 徳田 佳嗣, 堀 一浩, 井上 誠, 礒野 舞, 中尾 理美, 中馬 誠, 船見 孝博, 前田 芳信

    日本顎口腔機能学会雑誌   22 ( 1 )   38 - 39   2015.9

  • 咽頭への溶液刺激が嚥下時喉頭運動と舌骨上筋群筋活動に与える影響 Reviewed

    本間 正寿, 林 豊彦, 井上 誠, 道見 登

    日本顎口腔機能学会雑誌   22 ( 1 )   6 - 13   2015.9

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    これまで嚥下誘発のメカニズムや嚥下運動関連筋活動のパターンを解明するために、さまざまな生理学的研究が行われてきた。そこでは、舌骨上筋・下筋群などの嚥下関連筋の筋電図、喉頭や舌などの運動などが評価対象となっているが、これらを同時に記録した例は少なく、さらに嚥下誘発条件の違いがもたらす効果についてはいまだに明らかにされていない。そこで本研究では、喉頭運動と舌骨上筋群筋電図の同時測定により、咽頭への溶液刺激が嚥下動態に与える影響について解析することを目的とした。健常成人10名を対象に、蒸留水もしくは0.3 M NaCl溶液による咽頭刺激時の随意性嚥下運動および反射性嚥下運動を記録し、各溶液間における随意性嚥下の比較および随意性嚥下と反射性嚥下の比較を行った。随意性嚥下時の溶液間の比較では、喉頭運動の挙上第1相のみに有意な変化がみられた。一方、随意性嚥下と反射性嚥下の比較では、反射性嚥下に比べて随意性嚥下で挙上第1相が延長し、第2相が短縮していた。第1相の延長は、嚥下反射の準備として舌骨を引き上げることを示し、第2相の短縮は、その準備により随意性運動から反射性運動への移行が円滑になっていること示すと考えられる。(著者抄録)

    DOI: 10.7144/sgf.22.6

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  • 嚥下医学ベーシックサイエンス 咀嚼と嚥下反射に関する最近の知見

    井上 誠

    嚥下医学   4 ( 2 )   182 - 188   2015.9

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  • 口腔の生理から考える臨床像 嚥下からみた咀嚼

    井上 誠

    日本歯科評論   75 ( 7 )   129 - 134   2015.7

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  • 地域在住自立高齢者における口腔機能と身体バランス能力との関係

    泉野 裕美, 堀 一浩, 澤田 美佐緒, 福田 昌代, 畑山 千賀子, 野村 慶雄, 重信 直人, 小野 高裕, 井上 誠

    日本老年歯科医学会総会・学術大会プログラム・抄録集   26回   163 - 163   2015.5

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  • 地域在住自立高齢者における口腔機能と体力との関連

    泉野 裕美, 堀 一浩, 澤田 美佐緒, 福田 昌代, 畑山 千賀子, 野村 慶雄, 重信 直人, 伊藤 加代子, 井上 誠

    神戸常盤大学紀要   ( 8 )   114 - 114   2015.3

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  • 地域在住自立高齢者における口腔機能と体力との関連

    泉野 裕美, 堀 一浩, 澤田 美佐緒, 福田 昌代, 畑山 千賀子, 野村 慶雄, 重信 直人, 伊藤 加代子, 井上 誠

    神戸常盤大学紀要   ( 8 )   114 - 114   2015.3

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  • 炭酸水がもたらす嚥下の変調

    神田 知佳, 中村 由紀, 林 宏和, 竹石 龍右, 篠田 有希, 亀谷 典弘, 岡本 武久, 井上 誠

    日本顎口腔機能学会雑誌   21 ( 2 )   144 - 145   2015.3

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    DOI: 10.7144/sgf.21.144

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    Other Link: http://search.jamas.or.jp/link/ui/2015356211

  • 口腔環境の評価に基づく摂食・咀嚼・嚥下訓練方法に関するプロジェクト研究 摂食嚥下障害患者における経口摂取と口腔内環境の関係

    井上 誠

    日本歯科医学会誌   34   99 - 103   2015.3

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    口腔ケアは嚥下障害を有する患者において、誤嚥性肺炎予防のために重要とされている。本研究では、嚥下障害患者の経口摂取開始や食事形態のアップが、口腔環境の改善にどのような効果をもたらすかについて調べた。対象は、経管栄養中の入院患者のうち、口腔ケアを必要とする17名とした。初診後に通常の摂食嚥下リハビリテーションに加えて、以下の項目について毎週計測もしくは記録した;経口摂取状況、食事形態、摂食機能、口腔衛生状態、舌苔付着、舌背と頬粘膜の水分量、唾液分泌量、口腔内の細菌数である。その結果、口腔環境、ことに口腔衛生状態、舌苔付着、舌背水分量は経口摂取や食事形態のアップに従って改善していった。また、これらの項目の値は互いに高い相関を示した。唾液分泌量、口腔内の細菌数は食事摂取や食事形態によって影響を受けなかった。摂食機能のうち、顎口腔顔面舌運動、構音、最大発声時間などが、口腔環境との間に高い相関を示した。本研究の結果、口腔衛生状態を口腔ケアによって改善するだけでなく、日々の経口摂取そのものが口腔環境の改善に大きく影響することが示唆された。(著者抄録)

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  • 【「食べる」を考える】 嚥下の神経機構

    井上 誠

    BRAIN and NERVE: 神経研究の進歩   67 ( 2 )   157 - 168   2015.2

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    嚥下は,反射性にも随意性にも誘発可能な運動である。また,嚥下は必要な栄養や水分を口腔から咽頭,食道を経て胃へと送り込む消化管活動であるだけでなく,誤嚥や窒息を防ぐための防御反応でもある。嚥下運動の誘発とパターン形成に関わるのは延髄のパターン発生器と呼ばれる細胞集団であり,咽喉頭からの入力や大脳皮質などからの入力が閾値を超えることにより,一連の活動が引き起こされる。(著者抄録)

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  • Analysis of effects of pharyngeal water stimulation on swallowing behaviors using swallowing function evaluation system SFN/3A

    HOMMA Masatoshi, HAYASHI Toyohiko, MICHIMI Noboru, TANIGUCHI Hiroshige, INOUE Makoto

    IEICE technical report. ME and bio cybernetics   114 ( 361 )   77 - 82   2014.12

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    The initiation of swallowing reflex are known to have two different types such as voluntary swallowing and reflex swallowing. To clarify such initiation mechanism, many studies have been done to analyze swallowing behaviors under the condition of pharyngeal water stimulation. However, most studies evaluated merely electromyography of related muscles, but have yet to directory evaluate the movement of swallowing organs such as the larynx. Then we applied swallowing function evaluation system SFN/3A that we have developed into this analysis. Experiments using 5 healthy volunteers revealed that 0.3M NaCl solution extended the first phase of the laryngeal elevation in voluntary swallowing by its inhibitory effect, while distiller water shortened the first phase of the elevation by its promoting effect. In addition, reflex swallowing was verified to shorten the first phase of the elevation as well as to extend the second phase, suggesting that reflex motion components of the elevation is accelerated in reflex swallowing.

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    Other Link: http://search.jamas.or.jp/link/ui/2015325644

  • 炭酸水刺激による嚥下変調効果について

    神田 知佳, 中村 由紀, 林 宏和, 竹石 龍右, 井上 誠

    新潟歯学会雑誌   44 ( 2 )   131 - 132   2014.12

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  • 地域在住自立高齢者における口腔機能と体力との関連

    泉野 裕美, 堀 一浩, 澤田 美佐緒, 福田 昌代, 畑山 千賀子, 野村 慶雄, 重信 直人, 伊藤 加代子, 井上 誠

    老年歯科医学   29 ( 2 )   136 - 137   2014.9

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  • 【実践例に学ぶ 地域での摂食嚥下障害への取り組み】 地域における摂食嚥下障害への取り組み

    井上 誠

    Journal of Clinical Rehabilitation   23 ( 9 )   844 - 851   2014.9

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  • 地域在住自立高齢者における口腔機能と体力との関連

    泉野 裕美, 堀 一浩, 澤田 美佐緒, 福田 昌代, 畑山 千賀子, 野村 慶雄, 重信 直人, 伊藤 加代子, 井上 誠

    日本老年歯科医学会総会・学術大会プログラム・抄録集   25回   142 - 142   2014.6

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  • 食道癌術後に両側反回神経麻痺を認めた一例 Reviewed

    小山 吉人, 真柄 仁, 谷口 裕重, 栗田 浩, 井上 誠

    新潟歯学会雑誌   44 ( 1 )   33 - 36   2014.6

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    症例は56歳男性で2012年12月頃に嚥下時のつかえ感を自覚、新潟大学医歯学総合病院消化器外科を受診し、進行性食道癌(T3N0M0 Stage III)の診断にて、2013年4月に右食道切除・3領域郭清術施行した。術後両側反回神経麻痺を生じ気管切開術施行、術後14日目に経口摂取再開目的に摂食嚥下回復部を受診した。初診時機能評価では、嗄声を認め、発声持続時間6秒、改定水飲みテストは3a点であった。嚥下内視鏡検査では、両側声門の正中固定、両側喉頭披裂の不全麻痺および嚥下時のホワイトアウト不良を認めたため、両側反回神経麻痺・咽頭圧形成不全を伴う嚥下咽頭期障害と診断した。間接訓練として、息こらえ訓練、プッシング訓練、直接訓練として、1%とろみ水を用いた訓練を開始した。訓練開始後7日目、嚥下造影検査施行し、液体での喉頭侵入、全粥・混合食にて咽頭残留が認められたが、複数回嚥下で誤嚥像なくクリアランスを保てた。以上の結果から、液体とろみ付け、全粥・半固形食(ペースト食)にて食事を開始した。その後嚥下間接訓練の継続、及び段階的な食上げを実施し、訓練開始後25日で経過良好につき自宅退院・外来通院となった。訓練開始後49日目の嚥下造影検査では、食道入口部直下の狭窄、食塊停滞を認め、消化器外科にて食道拡張術を施行、再評価し通過障害は改善した。吻合部位の食道停滞の再発が認められてはいるものの、現在も当科外来通院を1ヵ月単位で継続し、咽頭期の嚥下機能に関しては経過良好である。(著者抄録)

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  • プロジェクト・バイオ 摂食・嚥下障害のサポート 食の支援ステーションの紹介

    井上 誠

    生物工学会誌   92 ( 5 )   242 - 243   2014.5

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  • 訪問歯科診療および訪問歯科診療見学実習に対する学生の意識調査

    伊藤 加代子, 堀 一浩, 谷口 裕重, 辻村 恭憲, 真柄 仁, 井上 誠

    日本歯科医学教育学会雑誌   30 ( 1 )   20 - 26   2014.4

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    超高齢社会の到来に伴い、訪問歯科診療の需要も増加しているが、供給は十分になされていないのが現状である。その理由として、在宅の訪問歯科診療実施が不安だという報告もある。今後、増加する訪問歯科診療の需要に応えるには、歯学部学生に対して、訪問歯科診療見学実習を実施し、実習後に評価を行って実習内容の改善に努めることが必要であると考える。新潟大学歯学部歯学科では、1998年から6年次生に対して訪問歯科診療見学実習を行っている。今回、訪問歯科診療に対する意識および現在行われている訪問歯科診療見学実習の評価に関する情報収集を目的として、質問紙法による調査を実施した。2013年に、6年次生を対象とした訪問歯科診療見学実習前後に無記名の質問紙調査を行い、比較検討した。解析対象となった33名全員が、実習を有意義であると回答していた。有意差は認められなかったものの、訪問歯科診療を「大変」と思う者および訪問歯科診療に対する不安は実習後に減少しており、訪問歯科診療を実際に見学することによって訪問歯科診療の実状を知ることができたためだと考えられる。その一方、見学後の総括で、訪問歯科診療で行うことが可能な診療や診療姿勢についての指導が必要であることも明らかになった。今後、見学内容をさらに改善し、継続していきたいと考えている。(著者抄録)

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  • 高齢者における喉頭運動の視覚フィードバックを用いた喉頭挙上訓練の効果

    覚嶋 慶子, 林 豊彦, 道見 登, 谷口 裕重, 井上 誠

    日本摂食・嚥下リハビリテーション学会雑誌   18 ( 1 )   22 - 29   2014.4

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    【目的】摂食・嚥下リハビリテーションのひとつにメンデルソン手技がある。この手技には、患者への教示や動作習得が困難などの臨床的な問題がある。そこでわれわれは、喉頭運動を直接視覚にフィードバックしながら喉頭挙上訓練を行えるシステムを開発してきた。これまで、短期間の訓練効果は、健常者および高齢者を用いて実験的に検証した。次の段階として、今回は、高齢者において連続した5日間にわたる喉頭挙上訓練の効果を検証した。【方法】被験者は、男性健常高齢者10名(平均70.3±4.6歳)とした。1回の喉頭挙上動作は、5秒間喉頭をできるだけ高い位置に保つとした。次の3ステップで、喉頭挙上訓練を5日間継続して行った:1)画面を見ない、2)画面を見る、3)画面を見ない。分析パラメータは、1)喉頭挙上量[mm]、2)喉頭挙上時間[s]、3)5mm喉頭挙上時間[s]、4)10mm喉頭挙上時間[s]の4つとした。【結果】喉頭挙上量は、5日目のステップ1/2間で有意な増加が確認できた。挙上時間は、3パラメータすべてで1日目のステップ1/2間に、5mm喉頭挙上時間および10mm喉頭挙上時間で5日目のステップ1/2間に有意な増加が確認できた。1日目/5日目間の比較では、喉頭挙上量と5mm喉頭挙上時間において、ステップ2で有意な増加が確認できた。【考察】喉頭挙上量では、5日間の継続訓練により、喉頭挙上法が習得できたと考えられる。安静位以上の喉頭挙上および安静位から5mm以上の喉頭挙上は、ともに5日間で習得可能であった。視覚バイオフィードバックは、5mm以上の挙上に効果的であった。一方、安静位から10mm以上の喉頭挙上は、視覚バイオフィードバックを用いれば長く挙上できたが、5日間では必ずしも習得できなかった。以上から、視覚バイオフィードバックを用いた継続訓練は、「喉頭挙上量の増加」、「喉頭の高い位置での維持」に有効であると考えられる。(著者抄録)

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  • 舌圧・喉頭運動計測システムによるパーキンソン病患者の嚥下動態評価

    皆木 祥伴, 小野 高裕, 李 強, 藤原 茂弘, 堀 一浩, 井上 誠, 前田 芳信, 横江 勝, 望月 秀樹

    日本顎口腔機能学会雑誌   20 ( 2 )   134 - 135   2014.3

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    舌圧・喉頭運動計測システムによるパーキンソン病(PD)患者の嚥下動態について検討した。治癒中のPD患者10例を対象とした。健常成人男性と比較してPD患者群の方が低い舌圧最大値を示した。嚥下時に舌圧発現を認めないChがみられた。さらに、通常は前方よりCh1-3の順に知多圧舌圧発現が見られる口蓋正中部において、発現順序の乱れがみられた。経口摂取している比較的軽度のPD患者においても、嚥下時舌運動の円滑な遂行が障害されていることが示唆された。PD患者においても喉頭運動波形は明瞭に記録され、解析点の抽出が可能であった。また、嚥下における喉頭運動の主たる部分T2(舌骨の急速挙上開始)-T6(舌骨の下降終了)は健常者に比べて延長する傾向にあり、しばしば再嚥下がみられた。PD患者の嚥下障害を非侵襲的に評価できる可能性が示唆された。

    DOI: 10.7144/sgf.20.134

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    Other Link: https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2014&ichushi_jid=J02994&link_issn=&doc_id=20140630270005&doc_link_id=%2Fex2gakuk%2F2014%2F002002%2F005%2F0134-0135%26dl%3D0&url=http%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fex2gakuk%2F2014%2F002002%2F005%2F0134-0135%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

  • 口腔への味溶液刺激がもたらす随意性嚥下への効果 Reviewed

    畠山 文, 中村 由紀, 真柄 仁, 辻村 恭憲, 谷口 裕重, 堀 一浩, 井上 誠

    日本顎口腔機能学会雑誌   20 ( 2 )   106 - 114   2014.3

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    味覚刺激が嚥下運動にどのような変化を与えるかについて調べることを目的として、異なる濃度の塩味またはうま味溶液を口腔内に微量注入した時の随意性嚥下運動を記録した。健常成人29名を対象として、出来るだけ早く繰り返し嚥下するよう指示し、その際に咽頭または口腔への溶液刺激(0.2mL/min)を与えた。咽頭への溶液刺激は蒸留水または0.3 M NaCl溶液とし、口腔への溶液刺激は蒸留水または3種類のNaイオン濃度(6mM、40mM、240mM)のうま味溶液(モル濃度比2対1のグルタミン酸ナトリウムとイノシン酸ナトリウム混合溶液)、うま味溶液と同濃度のNaイオンを含むNaCl溶液とした。測定開始後4から9回目までの各嚥下間の平均時間を嚥下間隔時間として各条件間で比較した。NaCl溶液、蒸留水いずれの咽頭刺激においても嚥下間隔時間の顕著な個人差が認められた。NaCl溶液刺激時の嚥下間隔時間は蒸留水よりも有意に長く、咽頭の水受容器による嚥下反射誘発促進効果、NaCl溶液による水受容器応答の抑制が確認された。さらにNaCl溶液刺激時の嚥下間隔時間が長い被験者ほど蒸留水刺激による随意性嚥下の促進効果が高かった。一方、口腔への溶液刺激では、うま味溶液刺激時のみ蒸留水に対して有意な短縮を認めた。随意性嚥下能力の高い順から上位群、中位群、下位群ごとに嚥下間隔時間の変化を調べたところ、上位群、下位群では各溶液の濃度の違いによる有意な差は認められなかったのに対して、中位群のみ溶液濃度が高くなるに従って嚥下間隔時間の短縮を認めた。以上の結果は、中位群におけるうま味成分がもつ随意性嚥下への促進効果を示唆するものである。随意性嚥下誘発能力の個人差をもとに、末梢入力に対する嚥下運動誘発の時間間隔を比較したところ、咽頭刺激時とは異なっていたことから、口腔への味覚刺激がもつ嚥下中枢への効果は単なる加重効果として捉えられず、その効果の作用機序の理解に向けてはさらなる議論が必要である。(著者抄録)

    DOI: 10.7144/sgf.20.106

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  • 帰ってきた!Dr.イノウエの咀嚼を科学する!(Chewing 3)(最終回) 超高齢社会のなかで考える咀嚼の重要性

    井上 誠

    デンタルハイジーン   34 ( 3 )   290 - 295   2014.3

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  • 帰ってきた! Dr.イノウエの咀嚼を科学する!(Chewing 2) 咀嚼と嚥下 切っても切れないその関係性

    井上 誠

    デンタルハイジーン   34 ( 2 )   184 - 189   2014.2

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  • 帰ってきた!Dr.イノウエの咀嚼を科学する!(Chewing1) 食べる機能からみた咀嚼の重要性

    井上 誠

    デンタルハイジーン   34 ( 1 )   74 - 79   2014.1

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  • 地域在住自立高齢者における口腔機能と体力との関連性

    泉野 裕美, 澤田 美佐緒, 福田 昌代, 畑山 千賀子, 野村 慶雄, 重信 直人, 堀 一浩, 伊藤 加代子, 井上 誠

    新潟歯学会雑誌   43 ( 2 )   147 - 147   2013.12

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  • 【高齢者社会にむけた医療のパラダイムチェンジ】 高齢者の咀嚼機能 高齢者と加齢の問題整理

    井上 誠

    医と食   5 ( 6 )   290 - 292   2013.12

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  • 介護老人施設に入所している高齢者の摂食・嚥下機能にかかわる状況と施設の対応 Reviewed

    中山 富子, 伊藤 加代子, 井上 誠

    新潟歯学会雑誌   43 ( 2 )   119 - 127   2013.12

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    介護老人施設入所者の摂食・嚥下機能にかかわる状況と施設の対応を明らかにする目的で、東京都内にある特別養護老人ホーム3施設、老人保健施設2施設を対象とし、独自に作成したアンケート用紙を事前に郵送後、訪問した。アンケートの回答を確認しながら、インタビューにより内容の補足や追加を行った。平均年齢や平均介護度が高い施設に摂食・嚥下障害がある入所者が多い傾向であった。これらの施設は非経口摂取者も多かった。経口摂取者では、常食を食べている人の割合が少なく、食事摂取量も少ない傾向であり、食事介助を必要とする人数が多かった。入所者の食事摂取への対応で、食事介助や食事時間、食事場所については、看護・介護する職員の高齢者の食に対する思いや考えが反映されている結果であった。摂食・嚥下障害がある入所者に実施しているケアで、「摂食・嚥下訓練」は2施設で実施していたが、いずれも胃瘻入所者への楽しみのための経口摂取であり、摂食・嚥下機能向上のための積極的な訓練は行われていなかった。摂食・嚥下機能の評価は2施設が訪問歯科医師による嚥下内視鏡検査を実施していた。要介護高齢者を多数抱える介護老人施設でさえも、摂食・嚥下障害に対する十分な対策が統一して取られていない現状が捉えられた。(著者抄録)

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  • 嚥下時における舌骨の運動様相と食塊移送の検討 Reviewed

    真柄 仁, 林 宏和, 神田 知佳, 堀 一浩, 谷口 裕重, 小野 和宏, 井上 誠

    日本顎口腔機能学会雑誌   20 ( 1 )   22 - 32   2013.9

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    本研究は、嚥下障害のある患者と健常者の舌骨運動時間と距離、舌骨位、および食塊移送のタイミングを比較することにより、嚥下障害における病態の一つと考えられる舌骨位の下垂が嚥下機能にどのように影響しているかを検証することを目的とした。対象は、嚥下障害を主訴として来院され嚥下造影検査を行った65名の患者(以下患者群)、対照として健常被験者10名(以下健常群)とした。得られたデータから、舌尖の運動開始を基準に舌骨運動・食塊移送の時間経過を計測し、また、第四頸椎前下縁を基準として舌骨位を計測し、患者群と健常群で比較を行った。患者群では食塊移送時間が口腔、咽頭ともに延長しており、更に食塊の咽頭流入は嚥下反射惹起を示す急速な舌骨挙上と比べ有意に先行していた。第四頸椎を基準とした場合、患者群と健常群に明らかな舌骨位の違いは認めなかった。疾患別の検索を行うと、嚥下反射以降は各疾患とも類似した舌骨の動きが認められたが、嚥下反射前は複雑な軌跡を示した。いくつかの疾患では、嚥下反射惹起前の舌骨の移動距離と移動時間に正の相関関係が認められたため、舌骨位が嚥下反射惹起遅延に影響を与えている可能性が考えられた。(著者抄録)

    DOI: 10.7144/sgf.20.22

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  • 口腔への化学刺激は嚥下運動に変化をもたらすか?

    畠山 文, 中村 由紀, 矢作 理花, 北田 泰之, 井上 誠

    日本顎口腔機能学会雑誌   20 ( 1 )   46 - 47   2013.9

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    DOI: 10.7144/sgf.20.46

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  • 【高齢者の栄養について考える】 高齢者の嚥下障害

    谷口 裕重, 真柄 仁, 井上 誠

    静脈経腸栄養   28 ( 5 )   1069 - 1074   2013.9

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    高齢者の摂食・嚥下障害の問題は、複数の疾患がもたらす病態の複雑化、多剤服用がもたらす副作用、生理的加齢変化や認知機能の低下といった本人の問題のみならず、キーパーソンをはじめとする周囲の環境によって予後が左右される可能性も高いことなどを十分に考慮する必要がある。臨床現場では、嚥下機能にとって重要な役割をもつ舌と舌骨筋の機能変化に注意を払うことが大切である。全身と舌の加齢に伴う機能低下を比較すると、舌筋の筋萎縮の速度が全身の筋に比べて遅いことは、加齢に伴う全身の運動機能低下に対して舌運動機能の衰退が比較的検出されにくいことと関連していると考えられる。これに対して、喉頭を上から吊ってこれを引き上げるために重要な働きを示す舌骨上筋は加齢による影響を受けやすく、喉頭下垂や咽頭収縮と喉頭閉鎖との時間的協調を崩すこととなり、結果的に誤嚥のリスクを増加させるのかも知れない。(著者抄録)

    DOI: 10.11244/jjspen.28.1069

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  • 【在宅静脈経腸栄養 今日の進歩】 (Part-3)誤嚥性肺炎の予防対策 神経難病患者における嚥下時食塊動態の特徴

    谷口 裕重, 堀 一浩, 辻村 恭憲, 下畑 享良, 小山 諭, 井上 誠

    臨床栄養   別冊 ( JCNセレクト8 在宅静脈経腸栄養 今日の進歩 )   70 - 75   2013.8

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    2006〜2010年に当院を摂食・嚥下評価目的で受診した神経難病患者のうち、嚥下造影検査時に液体3mlの誤嚥を認めなかった筋萎縮性側索硬化症(ALS)患者35例と多系統萎縮症(MSA)患者43例および進行性核上性麻痺(PSP)患者5例の3疾患群と、健常者11例を加えた4群間で嚥下時の食塊移送状態を比較し、各疾患の特徴について検討した。結果、ALS患者の特徴として、嚥下反射惹起前に食塊が中咽頭から下咽頭にかけて流入し、嚥下後の咽頭内食塊残留が顕著であった。MSA患者では咽頭内食塊残留が他疾患に比べて少なかったものの、食塊の咽頭内早期流入が顕著であった。PSP患者は3疾患うち最も重度な嚥下機能障害を示した。すなわち、食塊が早期に下咽頭まで流入し、また咽頭内残留率が高かった。

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  • 経管栄養離脱による口腔内の水分量および微生物量の変化

    岸本 奈月, ステガロユ・ロクサーナ, 柴田 佐都子, 上松 弘幸, 伊藤 加代子, 塚野 英樹, 林 宏和, 住谷 美幸, 真柄 仁, 辻村 恭憲, 中村 由紀, 谷口 裕重, 堀 一浩, 井上 誠, 大内 章嗣

    日本歯科衛生学会雑誌   8 ( 1 )   114 - 114   2013.8

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  • 食の支援ステーションにおける実態調査 Reviewed

    梶井 友佳, 別府 茂, 秋元 幸平, 山野井 澄江, 井口 寛子, 井上 誠, 山田 好秋

    日本摂食・嚥下リハビリテーション学会雑誌   17 ( 2 )   153 - 163   2013.8

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    要介護度にかかわらず、食べることは高齢者の楽しみのひとつにあげられるが、摂食・嚥下機能障害(以下摂食・嚥下障害)を有する在宅高齢者も多い。病院や高齢者介護施設では、専門職による摂食機能評価や検査をもとに嚥下障害の程度を判断し、口から食べる工夫を積み重ねてきた。しかし、在宅で介護を受ける摂食・嚥下障害者にとっては、介護保険による生活支援は行われているものの、その障害についての知識も乏しく、また専門職の介在も少ないため、情報発信の場を検討する必要がある。このため、在宅で生活する摂食・嚥下障害を有する高齢者の現状とニーズを調査する目的から、新潟大学医歯学総合病院に介護食品や介護食器具およびその資料を展示する「食の支援ステーション」を設置し、専門職員を配置して来訪者の相談に対応するとともに、「食の支援ステーション」の来訪者にアンケート調査を実施し、今後の課題を検討した。平成21年10月から3年間で来訪した2,433名のうち、アンケートに答えた相談者は370名であった。相談者の年齢は50〜70歳代が68.4%を占め、調査時点で食事の問題を抱えている人は87.3%と非常に多かった。また、相談の対象は本人が34.2%であるのに対し、家族が59.0%と、介護者による相談が多かった。支援を必要とする内容は、咀嚼・嚥下に関する問題が多く、希望する情報も介護食に関するものが多かった。「食の支援ステーション」に対する要望としては、専門職による製品の解説が最も多く、次いで展示商品の購入の要望が多かった。以上より、在宅摂食・嚥下障害者に対する専門的な介入は重要であることが示された。自立した食事や介護者の負担軽減のために、食の支援ステーション活動としては、障害の程度に対応した介護食や介護食器具の選択ができるよう、助言や製品の説明などが重要であることが示唆された。(著者抄録)

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  • 「ドライマウス手帳」の作成とその改善点に関する調査 Reviewed

    伊藤 加代子, 船山 さおり, 濃野 要, 山田 亜紀, 金子 昇, 勝良 剛詞, 佐々木 綾子, 井上 誠

    口腔衛生学会雑誌   63 ( 4 )   337 - 343   2013.7

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    口腔乾燥症の診療では唾液分泌量を測定するが、その結果を記録するツールはほとんど見当たらない。また、他疾患の治療のための薬剤追加やストレスの原因となるイベント事象などは、唾液分泌量や乾燥感に大きな影響を与えるが、それらを記録するツールもない。したがって、症状の記録、患者-医療従事者間の情報共有、診療科間の情報共有、患者への情報提供、の4つを目的とした「ドライマウス手帳」を作成し、2012年4月に発行した。その後、医療従事者に対して、手帳のデザインや内容に関する無記名の質問紙調査を行った。質問紙調査の結果、手帳の大きさ、厚さ、文字の大きさ、唾液分泌量や症状の記入欄の大きさ、豆知識の情報量について「ちょうどよい」と回答した者はいずれも過半数を占めていた。改善点として挙げられたのは、常用薬剤の記入欄、症状のある部分を記入できる口腔内の図の掲載や、舌痛症や灼熱感などに関する情報提供などであったため、今後、手帳を改訂する際に検討したい。将来的には、口腔乾燥症と診断された患者すべてにドライマウス手帳を配布することで、患者-医療従事者間、医療従事者-医療従事者間の情報共有、患者自身の症状把握が進み、口腔乾燥症の診療の一助となればと考えている。(著者抄録)

    DOI: 10.5834/jdh.63.4_337

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  • 【摂食・嚥下障害患者への対応】 摂食・嚥下障害患者への対応を考える前に必要な知識の整理 摂食嚥下の生理学を中心に

    井上 誠

    日本補綴歯科学会誌   5 ( 3 )   254 - 264   2013.7

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    摂食・嚥下障害に対する臨床を行う上で、歯科や口腔機能のもつ可能性を考慮することは非常に重要である。本稿では、周知の摂食・嚥下リハビリテーションにおける機能評価や訓練内容についてではなく、食べることを全身機能と考えること、歯科独自の視点の必要性を理解するための基礎的知識について解説する。また、これまでのほとんどの機能研究が咀嚼または嚥下のみに特化していたが、口腔機能・咀嚼機能と嚥下機能の機能連関に注目することの面白さを考え、臨床への足掛かりとするためのヒントにする。最後に、口腔ケアをどのように考えるかについての更なる知識の整理をしたい。(著者抄録)

    DOI: 10.2186/ajps.5.254

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    Other Link: http://search.jamas.or.jp/link/ui/2014188968

  • 世界的な超高齢社会へ向けての歯科医療の在り方 新潟大学歯学部の取り組み

    井上 誠

    日本歯科医師会雑誌   66 ( 4 )   362 - 363   2013.7

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  • 補綴装置を用いた摂食・嚥下リハビリテーションが奏功した重症筋無力症症例 Reviewed

    堀 一浩, 真柄 仁, 谷口 裕重, 井上 誠

    顎顔面補綴   36 ( 1 )   54 - 60   2013.6

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    症例は43歳女性で、12年前に重症筋無力症と診断され、神経内科での治療と軟口蓋挙上型鼻咽喉補綴装置(PLP)を使用した摂食・嚥下リハビリテーションを行い、経過観察となっていた。再診時にPLP装着時に食事できないとの訴えがあり、診察所見および各種試験の結果、軟口蓋挙上不良による鼻咽腔閉鎖不全および舌萎縮と可動性低下が問題と考え、舌接触補助機能を付与したPLPの製作を行うこととした。維持力は4ヶ所のワイヤークラスプに求め、軟口蓋全体で支持を得る設計とした。製作したPLPと旧PLPを比較したところ、軟口蓋の挙上量はほぼ同じであったが、口蓋部分のボリュームが異なっており、舌との接触がしやすい形態で、反復唾液嚥下テストなどの機能評価により装着時の改善を確認した。装着後は唾液の嚥下がしやすくなり、構音機能の改善、努力性発声が少なくなって装着時間が延長した。装着後2年11ヵ月で良好に経過している。

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  • 嚥下機能評価システムSFN/3Aにおける喉頭位置トラッキング法の改良 Reviewed

    本間 正寿, 林 豊彦, 道見 登, 谷口 裕重, 井上 誠

    電子情報通信学会技術研究報告(MEとバイオサイバネティックス)   113 ( 103 )   33 - 38   2013.6

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    典型的な嚥下リハビリテーション法のひとつにメンデルソン手技がある。しかし、この手技は、習得が難しいため、十分な訓練効果が得られにくいという基本的な問題がある。そこで我々は、この訓練を支援するために、嚥下機能評価システムSFN/3Aを開発してきた。本システムは、前頸部正中矢状面内の皮膚面形状を測定し、その形状をリアルタイム表示できる。さらに、喉頭位置をトラッキングすることにより、被験者に喉頭運動を視覚フィードバックできる。しかし、喉頭の突出が少ない人ではトラッキングが困難になることがあった。そこで、本研究では、トラッキング確度を向上するために、従来のトラッキングソフトウェアを改良し、その改善効果を少量の水の嚥下を用いた実験で評価した。その結果、喉頭挙上量、喉頭挙上速度の計測値に影響することなく、トラッキング確度を2倍まで改善することができた。(著者抄録)

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  • 女性におけるドライシンドロームの有訴率に関するWeb調査 Reviewed

    伊藤 加代子, 高松 潔, 濃野 要, 山田 亜紀, 船山 さおり, 小川 真里子, 井上 誠

    日本女性医学学会雑誌   20 ( 3 )   399 - 405   2013.4

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    【目的】近年、ドライシンドロームという概念が注目されている。これは、眼、鼻腔、口腔、腟、皮膚などにおける乾燥症状を一つの乾燥症候群として捉えようとする概念である。特定部位における乾燥感の有訴率の調査は数多くなされているが、乾燥感の関連性について同一被験者で調査した報告はない。そこで、眼、鼻腔、口腔、腟、皮膚における乾燥感の有訴率およびその関連性について検討することを目的としてWeb調査を行った。【方法】2012年5月に、インターネット・リサーチシステムを用いて、「お体の症状に関するアンケート調査」を行った。対象者は30、40、50、60、70代の女性、各62名の合計310名とした。年齢・既往歴・服用薬剤名および眼・鼻腔・口腔・腟・皮膚の乾燥感に関する質問を設定し、記述統計を行った。【結果】眼・鼻腔・口腔・腟・皮膚の乾燥感は、それぞれ169名(54.5%)、96名(31.0%)、128名(41.3%)、42名(13.6%)、153名(49.4%)が有していた。乾燥感の部位が1ヶ所の者は68名(21.9%)、2ヶ所以上は168名(54.2%)であった。また、眼の乾燥感を有する169名のうち142名(84.0%)が、鼻腔については96名全員が、口腔については112名(87.5%)、腟では40名(95.2%)、皮膚では130名(85.0%)が他の部位の乾燥感も有していた。特に腟の乾燥感を有する者の61.9%が、5ヶ所すべてに乾燥があると回答していた。【考察】乾燥感がある部位が2ヶ所以上であるものが半数以上であったことから、今後、乾燥感を訴える患者に対しては、他の部位の乾燥感の聞きとりおよび適切な診療科への紹介が必要であると考えられる。特に腟については、腟乾燥を有する者の60%以上が5ヶ所全ての乾燥感を持っていたため、留意して診療する必要があるといえる。(著者抄録)

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  • 地域在住高齢者における口腔機能向上プログラム効果と舌筋力および体力との関連性

    泉野 裕美, 澤田 美佐緒, 福田 昌代, 畑山 千賀子, 野村 慶雄, 重信 直人, 堀 一浩, 井上 誠

    神戸常盤大学紀要   ( 6 )   70 - 70   2013.3

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  • 地域在住高齢者における口腔機能向上プログラム効果と舌筋力および体力との関連性

    泉野 裕美, 澤田 美佐緒, 福田 昌代, 畑山 千賀子, 野村 慶雄, 重信 直人, 堀 一浩, 井上 誠

    神戸常盤大学紀要   ( 6 )   70 - 70   2013.3

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  • 嚥下時舌圧発現と喉頭運動の協調性

    皆木 祥伴, 李 強, 小野 高裕, 堀 一浩, 近藤 重悟, 藤原 茂弘, 田峰 謙一, 林 宏和, 井上 誠, 前田 芳信

    日本顎口腔機能学会雑誌   19 ( 2 )   162 - 163   2013.2

  • ヒト咽頭部への化学刺激による随意性・反射性嚥下への効果

    中村 由紀, 畠山 文, 矢作 理花, 北田 泰之, 井上 誠

    日本顎口腔機能学会雑誌   19 ( 2 )   158 - 159   2013.2

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    DOI: 10.7144/sgf.19.158

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  • 要介護高齢者における療養管理指導に関する検討 Reviewed

    近藤 匡晴, 伊藤 加代子, 辻村 恭憲, 堀 一浩, 井上 誠

    新潟歯学会雑誌   42 ( 2 )   89 - 96   2012.12

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    【目的】居宅療養管理指導では、口腔内の衛生管理と口腔機能の評価が義務付けられている。今回、居宅療養管理指導の実施が対象者にもたらした効果について検討した。【対象と方法】S市在住で訪問診療の希望があった20名(82.2±8.0歳)を対象とした。訪問歯科診療および居宅療養管理指導を継続し、初診時と3ヵ月後の要介護度、摂食機能評価(栄養摂取状況、経口摂取状態、洗口能力、舌運動、頬運動、口輪筋運動、咀嚼運動、嚥下運動、義歯使用状況)、口腔清掃状況の各項目を比較し、それぞれ4段階で評価した。また、改善度について3段階で評価した。【結果】往診依頼内容は歯科治療8例、義歯治療7例、口腔ケア・摂食機能療法5例で、義歯治療依頼における要介護度が有意に低かった。摂食機能に関わる各項目を介入前後で比較したところ、いずれの項目についても統計学的に有意な変化は認められなかった。一方、改善度に関する解析では、いずれの項目も「変化なし」が有意に多かった。【考察】居宅療養管理指導を行うことで口腔衛生面、摂食に関わる機能の維持は可能だった。しかし、食事形態や経口摂取状況が低下したケースが認められたのは、予防的措置あるいは摂食機能以外の要因によると考えられる。本研究の結果、要介護高齢者であっても適切な歯科治療および療養管理指導を行うことで、要介護度の悪化防止と摂食機能の維持が可能なことが示唆された。(著者抄録)

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  • 嚥下機能にまつわる昨今の生理学的知見

    井上 誠

    新潟歯学会雑誌   42 ( 2 )   77 - 88   2012.12

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    新潟大学医歯学総合病院摂食・嚥下機能回復部では、摂食・嚥下機能障害(嚥下障害)患者に対して、専門的検査、診断ならびに摂食機能の回復訓練を中心としたリハビリテーションを行っている。その中で、嚥下障害の病態を正しく把握し、それぞれの症例に応じた臨床的アプローチを確立するために、正常な嚥下動態を数値化することを目標として、嚥下関連筋活動・嚥下圧、更にレントゲンビデオや内視鏡による食物動態の同時記録を行うことで食品の物性と嚥下関連の筋活動の大きさや持続時間、また各筋活動のタイミングや食物動態との関係を調べてきた。その結果を踏まえ、嚥下中枢、嚥下反射と咽頭刺激、咀嚼中の嚥下反射惹起の抑制、嚥下反射誘発に関わる咽頭への化学刺激について述べた。

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  • 喉頭運動の視覚フィードバックを用いた喉頭挙上訓練 Reviewed

    佐藤 将大, 覚嶋 慶子, 林 豊彦, 前田 義信, 渡辺 哲也, 道見 登, 谷口 裕重, 井上 誠

    日本摂食・嚥下リハビリテーション学会雑誌   16 ( 3 )   235 - 242   2012.12

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    【目的】摂食・嚥下機能が衰えた高齢者や障害者に行うリハビリテーションでの間接訓練に、メンデルゾーン手技がある。この手技は舌骨喉頭挙上の改善を目的としているが、患者への教示が難しく、動作習得に時間がかかるという欠点がある。そこで著者らは、バイオフィードバック手法を用いて効率的に喉頭挙上を目指す訓練法を考案した。本研究の目的は、喉頭運動測定器SFN/3Aの開発、および本装置を用いた喉頭挙上訓練効果の検証である。【方法】被験者は、健常成人男性10名および老人保健施に入所する高齢男性4名とした。健常者は、バイオフィードバックを用いる群と、用いない群とに分けた。健常者(BFあり群)と高齢者群では、次の3ステップで喉頭挙上実験を行った:1)画面を見ない、2)画面を見る、3)画面を見ない。健常者(BFなし群)は、3ステップすべてを通して、画面を見ずに喉頭挙上した。1回当たりの喉頭挙上時間は5秒とした。分析から、1)喉頭挙上量[mm]、2)喉頭挙上時間[s]、3)挙上維持時間[s]のパラメータを算出した。【結果】喉頭挙上量は、健常者(BFあり群)ではステップ1〜3を通して増加傾向が確認されたが、健常者(BFなし群)では変化がなかった。喉頭挙上時間は、両群とも変化がみられなかった。挙上維持時間では、両群ともに増加傾向がみられた。高齢者では、全パラメータにおいて、ステップ1/2間で有意な増加や増加傾向がみられた。ステップ2/3間では、挙上維持時間のみで有意な減少が確認された。【考察】健常者は、一度バイオフィードバック訓練を行うと、その後バイオフィードバックを与えなくとも、喉頭挙上ができたと考えられる。一方、高齢者は、5分程度のバイオフィードバック訓練を行うだけでは、喉頭挙上法を完全には体得できないと考えられる。以上まとめれば、健常者と高齢者では、両者ともにバイオフィードバック効果は認められたが、高齢者では、動作習得のために繰り返しの訓練が必要になると考えられる。(著者抄録)

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  • 嚥下障害の神経メカニズムと新たな治療戦略 咽頭電気刺激がもたらすヒト嚥下誘発促進効果の臨床応用への期待

    井上 誠

    臨床神経学   52 ( 11 )   1192 - 1194   2012.11

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    DOI: 10.5692/clinicalneurol.52.1192

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  • 屈曲センサを用いた喉頭運動記録法の開発

    李 強, 皆木 祥伴, 堀 一浩, 小野 高裕, 近藤 重悟, 藤原 茂弘, 田峰 謙一, 林 宏和, 井上 誠, 前田 芳信

    日本顎口腔機能学会雑誌   19 ( 1 )   56 - 57   2012.10

  • 口腔乾燥症診断シートを用いた口腔乾燥症の診断

    伊藤 加代子, 濃野 要, 船山 さおり, 山田 亜紀, 井上 誠

    老年歯科医学   27 ( 2 )   206 - 207   2012.9

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  • ヒト随意性嚥下における旨味刺激の効果

    畠山 文, 中村 由紀, 北田 康之, 矢作 理花, 井上 誠

    Journal of Oral Biosciences Supplement   2012   130 - 130   2012.9

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  • 経口摂取が口腔内水分量と唾液中および舌苔の細菌量・細菌叢に与える影響 嚥下障害を併発するSS患者に嚥下直接訓練を実施した1症例

    岸本 奈月, Roxana Stegaroiu, 上松 弘幸, 柴田 佐都子, 塚野 英樹, 中村 由紀, 伊藤 加代子, 井上 誠, 大内 章嗣

    日本歯科衛生学会雑誌   7 ( 1 )   206 - 206   2012.8

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  • 大学学習法へのパフォーマンス評価の導入

    小野 和宏, 井上 誠, 山村 健介, 西山 秀昌, 八木 稔, ステガロユ・ロクサーナ, 重谷 佳見, 前田 健康, 高橋 雄介, 松下 佳代

    日本歯科医学教育学会総会・学術大会プログラム・抄録集   31回   141 - 141   2012.7

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  • 舌清掃が塩味閾値に与える影響 Reviewed

    伊藤 加代子, 船山 さおり, 山田 亜紀, 井上 誠

    新潟歯学会雑誌   42 ( 1 )   37 - 40   2012.6

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    目的:高血圧患者の塩味閾値は健常者よりも有意に高いことが報告されており、味覚閾値を改善すると塩分の過剰摂取を防止できる可能性がある。しかし、舌清掃による舌苔除去が味覚に与える影響について検討した報告はない。本研究の目的は、舌清掃によって塩味閾値が低下するかどうか検討することである。方法:N市在住の健常女性9名を対象として、舌清掃介入による前後比較を行った。評価項目は、舌苔付着範囲(4段階)、舌苔厚さ(3段階)、塩味認知閾値(全口腔法13段階)とした。また、開始前、6日後、12日後に、味の感じやすさ(5段階)、料理の際の味付けの変化の有無、舌ブラシ使用後の痛みの有無についてアンケートを行った。上記評価項目について味覚正常群(全口腔法10以下)と、味覚鋭敏群(11以上)の2群にわけて解析した。結果および考察:舌苔付着範囲、舌苔厚さ、塩味認知閾値のいずれも有意な変化は認められなかった。次に、味覚正常群と、味覚鋭敏群の2群にわけて認知閾値の変化量について解析したところ、味覚正常群の方が有意に低下していた。味覚鋭敏群では、もともと閾値が低いため、舌清掃をしても、それ以上の低下が認められなかったと考えられる。味覚正常群では、舌清掃によって塩味認知閾値が有意に低下していることから、塩味認知閾値が10以下の場合、舌ブラシを用いた舌清掃が有効であることが示唆された。(著者抄録)

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    Other Link: https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2012&ichushi_jid=J00999&link_issn=&doc_id=20120725420005&doc_link_id=%2Fdj2ngtdt%2F2012%2F004201%2F005%2F0037-0040%26dl%3D0&url=http%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fdj2ngtdt%2F2012%2F004201%2F005%2F0037-0040%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

  • Analysis of ingestive motor function during tablet swallowing using swallowing function evaluation system SFN/3A

    KAKUSHIMA Keiko, HAYASHI Toyohiko, MAEDA Yoshinobu, WATANABE Tetsuya, MICHIMI Noboru, TANIGUCHI Hiroshige, INOUE Makoto

    18 ( 2 )   200 - 201   2012.2

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  • Ingestion of the Gel Agent with Tongue Squeezing

    HAYASHI Hirokazu, HORI Kazuhiro, YOKOYAMA Sumiko, YAHAGI Rika, TANIGUCHI Hiroshige, TAMINE Kenichi, ONO Takahiro, INOUE Makoto

    18 ( 2 )   198 - 200   2012.2

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  • 摂食・嚥下リハビリテーションにおける筋電図評価

    谷口 裕重, 堀 一浩, 中村 由紀, 井上 誠

    日本顎口腔機能学会雑誌   18 ( 2 )   184 - 185   2012.2

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    DOI: 10.7144/sgf.18.184

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  • 今、臨床の現場で求められることは? 摂食・嚥下リハビリテーションの最前線 差し迫った"地域におけるアプローチ"を考える

    辻村 恭憲, 井上 誠

    The Quintessence   31 ( 1 )   103 - 114   2012.1

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  • 地域在住高齢者における口腔機能向上プログラム効果と口腔機能および体力との関連性

    泉野裕美, 澤田美佐緒, 福田昌代, 畑山千賀子, 野村慶雄, 重信直人, 堀一浩, 井上誠

    日本歯科衛生学会雑誌   Vol.7 ( No.1 )   P200   2012

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  • 前下小脳動脈動脈瘤術後に嚥下障害を併発した若年者に対しリハビリテーションを行った1例

    のき田 健史, 中村 由紀, 井上 誠

    新潟歯学会雑誌   41 ( 2 )   107 - 110   2011.12

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  • Effects of electrical pharyngeal stimulation on the modulation of swallowing reflex

    INOUE Takuya, NARIMATSU Kaya, HAYASHI Hirokazu, TANIGUCHI Hiroshige, HORI Kazuhiro, INOUE Makoto

    18 ( 1 )   68 - 69   2011.10

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  • 歯科衛生士の臨床でおさえておきたい解剖・生理 Dr.イノウエの丸わかり!「食べる」のメカニズム(No.12)[最終回] みんなで取り組む摂食・嚥下障害への対応

    井上 誠

    デンタルハイジーン   31 ( 10 )   1060 - 1064   2011.10

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  • ヒト咽頭部への感覚刺激がもたらす反射性嚥下とその個人差

    成松 花弥, 井上 拓哉, 川本 健介, 中村 由紀, 井上 誠, 矢作 理花, 北田 泰之

    Journal of Oral Biosciences   53 ( Suppl. )   168 - 168   2011.9

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  • 上喉頭神経電気刺激により誘発される嚥下反射の発育変化

    梶井 友佳, 福原 孝子, 中村 由紀, 辻村 恭憲, 井上 誠

    Journal of Oral Biosciences   53 ( Suppl. )   178 - 178   2011.9

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  • 歯科衛生士の臨床でおさえておきたい解剖・生理 Dr.イノウエの丸わかり!「食べる」のメカニズム(No.11) 食べること・飲み込むことに障害をもつ人への支援 口腔ケアと"療法士"としての役割について考える

    井上 誠

    デンタルハイジーン   31 ( 9 )   946 - 949   2011.9

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  • 上喉頭神経誘発嚥下に対する2つの皮質咀嚼野刺激の異なる変調効果

    辻村 恭憲, 福原 孝子, 山田 亜紀, 中村 由紀, 岩田 幸一, 井上 誠

    Journal of Oral Biosciences   53 ( Suppl. )   144 - 144   2011.9

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  • 入院患者の歯科的介入の必要性を判断するためのスクリーニング用紙の開発

    塚田 しげみ, 柴田 佐都子, 梶井 友佳, 中村 由紀, 辻村 恭憲, 谷口 裕重, 堀 一浩, Stegaroiu Roxana, 井上 誠, 大内 章嗣

    日本歯科衛生学会雑誌   6 ( 1 )   135 - 135   2011.8

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  • 歯科衛生士の臨床でおさえておきたい解剖・生理 Dr.イノウエの丸わかり!「食べる」のメカニズム(No.10) 食べること・飲み込むことに障害をもつ人への支援 私たち歯科医療職ができること

    井上 誠

    デンタルハイジーン   31 ( 8 )   888 - 891   2011.8

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  • 歯科衛生士の臨床でおさえておきたい解剖・生理 Dr.イノウエの丸わかり!「食べる」のメカニズム(No.9) 高齢者が抱える問題(咬むことは長生きの秘訣?)

    井上 誠

    デンタルハイジーン   31 ( 7 )   776 - 779   2011.7

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  • 歯科衛生士の臨床でおさえておきたい解剖・生理 Dr.イノウエの丸わかり!「食べる」のメカニズム(No.8) 高齢者が抱える問題(「食べる」機能の問題)

    井上 誠

    デンタルハイジーン   31 ( 6 )   663 - 667   2011.6

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  • 歯科衛生士の臨床でおさえておきたい解剖・生理 Dr.イノウエの丸わかり!「食べる」のメカニズム(No.7) 高齢者が抱える問題(障害を考える)

    井上 誠

    デンタルハイジーン   31 ( 5 )   548 - 552   2011.5

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  • 歯科衛生士の臨床でおさえておきたい解剖・生理 Dr.イノウエの丸わかり!「食べる」のメカニズム(No.6) 構音機能を考える

    井上 誠

    デンタルハイジーン   31 ( 4 )   386 - 390   2011.4

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  • 歯科衛生士の臨床でおさえておきたい解剖・生理 Dr.イノウエの丸わかり!「食べる」のメカニズム(No.5) 巧みな技 咀嚼から嚥下へ

    井上 誠

    デンタルハイジーン   31 ( 3 )   262 - 265   2011.3

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  • Multilateral evaluation of swallowing bolus with different consistency

    TANIGUCHI Hiroshige, HORI Kazuhiro, YAHAGI Rika, HAYASHI Hirokazu, INOUE Makoto

    17 ( 2 )   152 - 153   2011.2

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  • Training of laryngeal elevation for elderly people using a visual biofeedback of larynx movement

    SATO Masahiro, KAKUSHIMA Keiko, HAYASHI Toyohiko, WATANABE Tetsuya, MAEDA Yoshinobu, MICHIMI Noboru, TANIGUCHI Hiroshige, INOUE Makoto

    17 ( 2 )   150 - 151   2011.2

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  • 歯科衛生士の臨床でおさえておきたい解剖・生理 Dr.イノウエの丸わかり!「食べる」のメカニズム(No.4) 巧みな技 嚥下

    井上 誠

    デンタルハイジーン   31 ( 2 )   144 - 147   2011.2

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  • 歯科衛生士の臨床でおさえておきたい解剖・生理 Dr.イノウエの丸わかり!「食べる」のメカニズム(No.3) 咀嚼の重要性 「口」と「喉」と「鼻」からみる

    井上 誠

    デンタルハイジーン   31 ( 1 )   25 - 28   2011.1

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  • Neural mechanisms of swallowing inhibition following noxious orofacial stimulation

    Takanori Tsujimura, Makoto Inoue, Koichi Iwata

    Journal of Oral Biosciences   53 ( 2 )   137 - 142   2011

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    The number of water-induced swallows was decreased following capsaicin injection into the facial (whisker pad) skin, masseter or lingual muscle. The capsaicin-induced inhibitory effect on the swallowing reflex was depressed after intrathecal administration of mitogen-activated protein kinase (MAPK) kinase (MEK) inhibitor. The inhibitory effect on swallowing following capsaicin injection into the lingual muscle was diminished by paratrigeminal nucleus (Pa5) lesioning. Many phosphorylated extracellular signal-regulated kinase-like immunoreactive neurons in the nucleus tractus solitarii (NTS) showed gamma-aminobutyric acid (GABA) immunoreactivity and capsaicin-induced inhibition of the swallowing reflex was diminished by local microinjection of the GABAA receptor antagonist into the NTS. The present findings suggest that facial skin-NTS, masseter muscle-NTS, lingual muscle-NTS and lingual muscle-Pa5-NTS pathways are involved in the swallowing inhibition by facial, masseter and lingual pain, and that the activation of GABAergic NTS neurons may be involved in inhibition of the swallowing reflex.

    DOI: 10.2330/joralbiosci.53.137

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  • 新潟大学歯学部における教員研修(FD)の概要と今後の方向性 Reviewed

    安島 久雄, 魚島 勝美, 小野 和宏, 藤井 規孝, 井上 誠, 山村 健介, 齋藤 功, 興地 隆史, 高木 律男, 前田 健康, 新潟大学歯学部, 委員会

    日本歯科医学教育学会雑誌   26 ( 3 )   349 - 353   2010.12

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    新潟大学歯学部では、教員の資質向上を目的として、平成14年にFD委員会を発足させた。今回、これまで行ってきたFaculty development(FD)活動の概要を報告するとともに、歯学部FDと大学院FDとの連携やスムースな移行を検討するための体系化マップを作成し、FDのあり方や方向性について検討した。これまでに行われてきたFD活動を列挙して体系化マップを作成し、これまでの問題点や改善点を検証して今後に必要なプログラムの立案を行った。委員会発足当初は、全教員を対象として学生教育に必須と考えられる基本的な知識・技能・態度の習得に力点をおいたFD活動が行われていた。しかし近年では、新任者から段階的に研修活動ができるようにFDプログラムの整備がなされ、計画的にFDを開催するとともに、個別対応型FDや参加・体験型FDへとその活動の中心が推移している。これまでの本委員会の活動を体系化マップとしてまとめることにより、平成19年度からは、その役割が、大学院教育の実質化促進へと展開しつつあることが明確になり、今後は歯学部FDで積み重ねた経験を基に、高いレベルの大学院FDに移行させるためのプログラム立案が可能と考えられた。今後は単なるイベント型FDのみならず、各教員の日常的な研修環境の整備やニーズに即したプログラムの企画を通して、教員の研究指導力の開発を目標とすることが重要であると思われた。(著者抄録)

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  • 歯科衛生士の臨床でおさえておきたい解剖・生理 Dr.イノウエの丸わかり!「食べる」のメカニズム(No.2) 脳の機能からみた咀嚼の重要性(1)

    井上 誠

    デンタルハイジーン   30 ( 12 )   1192 - 1195   2010.12

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  • ヒト随意性嚥下に対する味覚刺激の効果 Reviewed

    矢作 理花, 北田 泰之, 井上 誠

    日本味と匂学会誌   17 ( 3 )   247 - 250   2010.12

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    咽頭喉頭部(LP)に水を注入し、水受容器を興奮させると、嚥下がしやすくなり、嚥下間隔時間が短くなる。そこで、健常成人7名(男性4名、女性3名、平均年齢25.1±1.7歳)を被験者にLPに0.3M NaCl液を注入、次に舌前方部に5基本味の味覚刺激水溶液を注入し、味覚刺激の嚥下効果について検討した。その結果、1)舌の前方部の味覚刺激は随意性嚥下に対し促進効果があることが見い出され、舌の前方部への味覚刺激液の注入は低速度の注入で嚥下を繰り返することで舌縁部、更に舌縁後方葉状乳頭領域と有郭乳頭領域にも刺激液が広がりをみせ、これらの領域の味覚受容器を刺激したものと考えられた。2)LPの局所麻酔後にも麻酔前と同様な味覚刺激の嚥下促進効果が観察され、味覚刺激の効果はLPの感覚受容器の刺激とは関係せず、舌の味覚受容器の興奮に起因すると考えられた。この結果は嗜好に関係なく、どの味刺激でもほぼ同じように嚥下を促進することを示しており、味覚刺激時にはそれぞれの味質の味覚情報が上位中枢に伝えられる一方で、随意性嚥下では上位中枢からの嚥下中枢のパターン発生器(CPG)へ向う下行性の入力が途中のどこかの部位において、味質に関係なく味覚受容器からの興奮をCPGに切り替える機構が存在すると考えられた。

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  • 歯科衛生士の臨床でおさえておきたい解剖・生理 Dr.イノウエの丸わかり!「食べる」のメカニズム(No.1) 「食べること」の大切さ・意味

    井上 誠

    デンタルハイジーン   30 ( 11 )   1088 - 1091   2010.11

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  • 高齢者の口腔乾燥感と神経症症状および服薬との関連 Reviewed

    船山 さおり, 伊藤 加代子, 濃野 要, 五十嵐 敦子, 井上 誠, 葭原 明弘, 宮崎 秀夫

    口腔衛生学会雑誌   60 ( 5 )   575 - 583   2010.10

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    高齢者の口腔乾燥感は主に薬剤の副作用によって生じると言われている。高齢者はストレスへの耐性が低いが、神経症症状と口腔乾燥感との関連を検討した報告は少ない。また、服薬および神経症症状と口腔乾燥感に関して、同じ対象者において同時に検討した報告も少ない。よって本研究では、高齢者における口腔乾燥感の自覚頻度を明らかにするとともに、服薬および神経症症状と口腔乾燥感の関連について検討することを目的とした。高齢者398名を対象として、質問紙や面接聞き取り等により口腔乾燥感、服薬状況および神経症症状を調査した。神経症症状の評価には、日本版GHQ30を用いた。口腔乾燥感を有する者は60.4%、神経症症状を有する者は27.6%であった。服薬中の者は72.3%、服薬数の最頻値は2剤であった。口渇高頻度薬剤の服用者は18.7%、服薬数の最頻値は1剤であった。口腔乾燥感を従属変数、性、神経症症状および口渇高頻度薬剤の服用を説明変数としたロジスティック回帰分析を行った結果、神経症症状のある者(オッズ比:2.059、p&lt;0.05)および口渇高頻度薬剤の服用者(オッズ比:2.552、p&lt;0.05)は、そうでない者と比べ統計学的に有意に口腔乾燥感のある者の割合が高かった。以上により、高齢者において神経症症状が、服薬と同様に口腔乾燥感に関連していることが示唆された。(著者抄録)

    DOI: 10.5834/jdh.60.5_575

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  • 随意嚥下閾値に関わる食塊の物性 Reviewed

    島田 久寛, 谷口 裕重, 井上 誠

    日本摂食・嚥下リハビリテーション学会雑誌   14 ( 2 )   106 - 115   2010.8

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    【目的】食品は口腔内に取り込まれると、歯・舌・頬粘膜・口蓋などにより粉砕されるとともに、唾液と混合されて食塊が形成される。本研究は、食品粉砕による食塊の粒度の違いや唾液との混合による水分値の違いが食塊物性にどのような影響を与えるのか、さらに咀嚼を経ない随意嚥下時に口腔内に存在する食塊物性の特徴を明らかにすることを目的とした。【方法】試料として粒度の異なる微粒子状の試料4種(アーモンド粉砕品:大・中・小、さらしあん)を用いた。模擬唾液3種(蒸留水・キサンタンガム0.05%水溶液・キサンタンガム0.2%水溶液)の添加量を変化させて各試料と混合したものを疑似食塊として、それぞれの組み合わせによって作製した疑似食塊のテクスチャー特性値(硬さ、凝集性、付着性)、さらにガラス板上での広がり面積により流動性の値を得た。さらに、健常者を用いてこれらの試料を口腔内に含んだ後に嚥下直前に吐き出してもらい、それらの水分値を測定した。【結果】各試料とも、模擬唾液の添加量を変化させることで、疑似食塊の物性が大きく変化した。水分値の違いによる物性変化の過程は、食品の粒度により異なっていたものの、嚥下直前食塊の水分値における疑似食塊の物性をみると限られた帯域に分布しており、硬さは9400から11900N/m2、凝集性は0.48から0.66、付着性は1000から3300J/m3、流動性は20から70cm2の間に収束していた。また、アーモンド粉砕品(大)を食塊として使用した際には、多くの被験者が嚥下にいたらず、さらにこの試料を用いた疑似食塊を用いた場合、上記の帯域にあてはめることができなかった。【結論】食品の粒度や含有水分量の増減により、食塊物性は変化した。また、食塊の硬さ、凝集性、付着性、および流動性には、随意嚥下可能と判断するための適した範囲があると考えられる。(著者抄録)

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  • 嚥下障害のメカニズムと対策 歯科の立場から

    井上 誠

    新潟医学会雑誌   124 ( 8 )   430 - 432   2010.8

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  • 多系統萎縮症(MSA)における口腔衛生状態の悪化とその関連因子 Reviewed

    柴田 佐都子, 大瀧 祥子, 井上 誠

    障害者歯科   31 ( 2 )   184 - 192   2010.6

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    多系統萎縮症(MSA)では、呼吸器障害や呼吸器感染の発症頻度が高く、これらはしばしば生死にかかわる問題となる。MSAに伴い発症する呼吸器感染症の原因には口腔機能障害や口腔衛生との関与が予測されることから、MSA患者の口腔衛生状態とこれに関係すると思われる口腔機能の実態を明らかにすることを目的として、本研究を立案した。対象としてMSA患者19名、健常者20名を選択した。口腔衛生状態の評価として歯面ごとのプラーク付着の記録(PCR)とう蝕活動性試験、身体能力として機能的自立度評価法(FIM)中の運動項目と握力、口腔機能の評価として安静時と刺激時の唾液分泌量、/ta/および/ka/音の音節反復速度、舌左右反復速度、舌最大突出力を測定して両群間で比較した。MSA群では、PCRとう蝕活動性が有意に高く、口腔機能や身体機能では全評価項目において有意に低下していた。また、MSA群ではPCRと、/ta/音、/ka/音の音節反復速度、FIMとの間に負の相関、罹病期間との間に正の相関を認めた。MSA群の口腔衛生状態を悪化させる要因としては、舌の運動能力の低下、日常生活動作(ADL)の低下、唾液分泌量の低下、罹病期間の延長が複合して関与しているものと思われた。以上よりMSA患者の病態やADLを考慮し、多職種連携のもとに継続的な口腔ケアを行う必要性が示唆された。(著者抄録)

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  • 当科における摂食・嚥下障害小児患者の実態調査

    梶井 友佳, 大瀧 祥子, 井上 誠

    小児歯科学雑誌   48 ( 2 )   362 - 362   2010.4

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  • Changes in the jaw opening reflex responses during feeding

    YAMAMOTO Shinya, FUKUHARA Takako, KAJII Yuka, TSUJIMURA Takanori, INOUE Makoto

    16 ( 2 )   140 - 141   2010.2

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  • Initiation of swallowing and its modulation evoked by the pharyngeal stimulation

    INOUE Makoto, TSUKANO Hideki, ADACHI Taiga, YAHAGI Rika, HORI Kazuhiro

    16 ( 2 )   142 - 143   2010.2

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  • 下顎運動時頭頸部協調の筋電図学的評価

    敦井 智賀子, 荒井 良明, 谷口 裕重, 矢作 理花, 堀 一浩, 井上 誠

    日本顎口腔機能学会雑誌   16 ( 2 )   112 - 123   2010.2

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    下顎タッピング運動や咀嚼時の頭部と下顎の協調運動は中枢性に制御されているという報告があるが、これらの運動に後頸筋群がどのように関与しているかについては明らかにされていない。本研究では、頸筋が顎機能にいかに関わるかを検索することを目的とし、下顎運動と顎筋および頭頸部筋の筋電図の同時記録を行った。被験者は全身と顎口腔系に臨床的な異常を認めない健常成人11人(男性、平均年齢29.3歳)とした。記録内容は右側咬筋及び舌骨上筋群、両側胸鎖乳突筋及び後頸筋群の表面筋電図、ならびに頭部及び下顎運動の3次元運動とした。被験者には、頭部無拘束下、90度座位にて椅子に定位させた後、1)咬頭嵌合位ならびに後方歯牙接触位時の記録、2)75/60Hzの速度での下顎タッピング運動を12秒間、十分に軟化したガム(8.7g)の右咀嚼を12秒間行った際の記録を行った。結果として、1)下顎を咬頭嵌合位から後方歯牙接触位に後退させることにより舌骨上筋群の活動とともに胸鎖乳突筋および後頸筋群の筋活動が増加した。2)下顎タッピング時の顎開口量と頭部前後屈量は、いずも咀嚼時のものに比べて有意に大きかった。個体内での運動の安定性を調べた変動係数は、規定された運動であるタッピング時のほうがいずれの値においても小さい傾向があった。3)胸鎖乳突筋および後頸筋群はいずれのリズム下顎運動時にも開口相に明らかな活動を認めた。4)胸鎖乳突筋には、閉口相にもピークが観察された。ことに咀嚼側の活動は、タッピング時と咀嚼時で有意差が認められた。結論:胸鎖乳突筋、後頸筋群はともに顎位の決定や頭頸部協調活動に深く関与するが、その協調様式は互いに異なる可能性をもつ。また、咀嚼時の閉口時における胸鎖乳突筋活動は食物粉砕に関わる咬筋活動の上昇に伴い発現するものであると示唆された。(著者抄録)

    DOI: 10.7144/sgf.16.112

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  • Brainstem neurons receiving inputs from the superior laryngeal nerve and their involvements in the swallowing

    Makoto Inoue, Takanori Tsujimura, Takako Fukuhara, Yuka Kajii

    JOURNAL OF PHYSIOLOGICAL SCIENCES   60   S150 - S150   2010

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  • 骨格性下顎前突症患者の嚥下時筋活動は手術前後で変化する

    篠倉千恵, 福井忠雄, 井上誠, 齋藤功

    日本矯正歯科学会大会プログラム・抄録集   69th   166   2010

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  • Effects of afferent inputs from superior laryngeal nerve on the jaw opening reflex responses

    Takako Fukuhara, Takanori Tsujimura, Yuka Kajii, Hirokazu Hayashi, Makoto Inoue

    JOURNAL OF PHYSIOLOGICAL SCIENCES   60   S150 - S150   2010

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  • Involvement of NTS nociceptive neurons in an inhibition of swallows following orofacial noxious stimulation

    Takanori Tsujimura, Takako Fukuhara, Yuka Kajii, Koichi Iwata, Makoto Inoue

    JOURNAL OF PHYSIOLOGICAL SCIENCES   60   S151 - S151   2010

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  • 骨格性下顎前突症患者の嚥下時筋活動と手術前後での変貌

    篠倉千恵, 福井忠雄, 齋藤功, 井上誠

    日本摂食嚥下リハビリテーション学会雑誌   13 ( 3 )   407   2009.12

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  • 骨格性下顎前突症患者の嚥下時筋活動パターンについて

    篠倉千恵, 井上誠, 福井忠雄, 齋藤功

    新潟歯学会雑誌   39 ( 2 )   205 - 206   2009.12

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  • 骨格性下顎前突症患者における嚥下時筋活動パターンの定量的評価

    篠倉千恵, 福井忠雄, 齋藤功, 井上誠

    日本顎口腔機能学会雑誌   16 ( 1 )   48 - 49   2009.10

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    DOI: 10.7144/sgf.16.48

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  • ブラシの形態による舌清掃効果の違いについて Reviewed

    伊藤 加代子, 福原 孝子, 高地 いづみ, 井上 誠

    日本摂食・嚥下リハビリテーション学会雑誌   13 ( 2 )   77 - 87   2009.8

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    【目的】誤嚥性肺炎予防という観点からも、口臭予防という観点からも舌清掃は重要である。近年、形態が異なる舌ブラシが多種開発されているが、使用効果に関する客観的データは少なく、歯科医療従事者以外の介護スタッフが適切な舌ブラシを選択するのは困難である。よって、舌ブラシ選択の指標を作成することを目的として、舌ブラシの形態による清掃効果を検討した。【対象と方法】老人福祉施設に入所している39名を対象とし、A群(両面の細かいナイロンブラシタイプの舌ブラシ)、B群(アーチワイヤー状のねじりブラシタイプの舌ブラシ)、C群(スポンジブラシ)の3群に分けた。各ブラシを用いて、介護者による清掃を14日間実施し、舌苔の評価と口腔衛生状態に関するアンケートによる評価を行った。【結果および考察】どの群においても経時的に舌苔の厚みが有意(p&lt;0.05)に改善していたが、ブラシによる違いは認められなかった。舌苔の厚みによって分析したところ、舌苔が厚い群ではA群が有意(p&lt;0.05)に改善していた。また、有意差は認められなかったものの、ケア時の痛みはA群、C群で少なく、べたつきはB群およびC群で改善する傾向が認められた。アンケートの自由筆記欄には、B群では痛みがあったため十分な清掃ができないまま中断してしまったという記載があった。A群のほうがB群より与える痛みが少なかったので、舌苔の除去効果が大きかった可能性が考えられる。【結論】どのブラシでも継続して使用することによって、舌苔の厚みが改善することが明らかになった。また、舌苔が厚い場合は両面の細かいナイロンブラシタイプの舌ブラシが、べたつき感改善にはアーチワイヤー状のねじりブラシタイプの舌ブラシが有効であり、ケア時の痛みやブラシへの抵抗が少ないのは、両面の細かいナイロンブラシタイプの舌ブラシおよびスポンジブラシであることが示唆された。(著者抄録)

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  • 歯科口腔生理と病態生理 摂食・嚥下機能の画像ならびに筋電図学的評価

    井上 誠

    日本病態生理学会雑誌   18 ( 1 )   65 - 67   2009.5

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  • 骨格性下顎前突症患者における嚥下時筋活動パターンの定量的評価

    篠倉千恵, 井上誠, 丹原惇, 福井忠雄, 齋藤功

    日本顎変形症学会雑誌   19 ( 2 )   100   2009.5

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  • CHANGES IN AMPLITUDES OF JAW OPENING REFLEX DURING NATURAL FEEDING IN THE RABBIT

    Shinya Yamamoto, Takako Fukuhara, Kensuke Yamamura, Hirokazu Hayashi, Makoto Inoue

    JOURNAL OF PHYSIOLOGICAL SCIENCES   59   480 - 480   2009

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  • EFFECTS OF SWALLOWING ON THE JAW OPENING REFLEX

    Takako Fukuhara, Yuka Kajii, Shinya Yamamoto, Kensuke Yamamura, Makoto Inoue

    JOURNAL OF PHYSIOLOGICAL SCIENCES   59   291 - 291   2009

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  • EFFECTS OF ELECTRICAL STIMULATION IN THE PHARYNGEAL REGION ON THE REFLEX SWALLOWING

    Taiga Adachi, Hiroshige Taniguchi, Sachiko Ootaki, Yoshiaki Yamada, Makoto Inoue

    JOURNAL OF PHYSIOLOGICAL SCIENCES   59   480 - 480   2009

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  • 13.Effects of pharyngeal and laryngeal stimulation on the swallowing function

    ADACHI Taiga, TSUKANO Hideki, TANIGUCHI Hiroshige, HAYASHI Hirokazu, INOUE Makoto

    ( 42 )   33 - 34   2009

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  • 11.The quantitative evaluation of the muscle activity patterns during swallowing in patients with mandibular prognathism

    SASAKURA Chie, FUKUI Tadao, SAITO Isao, INOUE Makoto

    ( 42 )   29 - 30   2009

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  • 筋萎縮性側索硬化症例における舌萎縮と嚥下時の食塊移送との関係 Reviewed

    谷口 裕重, 大瀧 祥子, 梶井 友佳, 山田 好秋, 井上 誠

    日本顎口腔機能学会雑誌   15 ( 1 )   30 - 37   2008.10

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    本研究は筋萎縮性側索硬化症(Amyotrophic Lateral Sclerosis,ALS)患者の主症状のひとつである舌萎縮に注目し、嚥下造影検査(Videofluorography,VF)を用いて嚥下時の食塊動態を調べることにより、舌萎縮の進行が嚥下機能に及ぼす影響を検討した。被験者としてALS患者19名、対照として健常高齢成人11名に対してVFを行った。検査時の被験試料として40wt/vol%硫酸バリウム溶液3mlを用いた。得られたデータより誤嚥の有無、誤嚥・喉頭侵入のタイプ、嚥下後の咽頭内食塊残留量、舌骨挙上を嚥下開始の指標とした食塊移送時刻、食塊通過時間を計測した。VF画像より誤嚥の有無を評価した結果、ALS患者の中で誤嚥がみられたすべての症例において舌萎縮像が観察された。さらにALS患者の舌萎縮無群に対して、舌萎縮有群では嚥下後の咽頭内残留量が多かった。誤嚥が認められなかったALS患者の舌萎縮有群と舌萎縮無群、さらに対照群を合わせた3群間で食塊動態を比較したところ、舌萎縮有群ではクリアランスタイム、食道入口部通過時間が有意に延長し、また嚥下反射開始前に食塊先端が咽頭最下端部に到達していた。舌の形態異常および運動不良などにより口腔内保持が困難および嚥下惹起遅延となった結果、嚥下前に食塊が下咽頭まで流入していたことが原因と考えられた。以上より、ALS患者において舌萎縮がみられた場合、嚥下関連運動機能の低下とともに咽頭内残留量が増加しさらに液体の咽頭内停滞時間が延長するために食塊の誤嚥もしくは喉頭侵入を起こす可能性が高いことが示された。(著者抄録)

    DOI: 10.7144/sgf.15.30

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  • 食道入口部開大不全に対して手術とリハビリテーションを行い経口摂取に至った一例 Reviewed

    安達 大雅, 大瀧 祥子, 井上 誠, 山田 好秋

    新潟歯学会雑誌   37 ( 2 )   201 - 204   2007.12

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    今回、我々は脳幹梗塞後遺症により食道入口部開大不全を伴う嚥下障害を生じ、2年余りの完全経腸栄養の時期を経て、耳鼻科での外科手術の後に当科にてリハビリテーションを行い、経口摂取が可能となった症例を経験したので、その概要について報告する。患者は56歳男性で椎骨動脈乖離性動脈瘤破裂によりくも膜下出血を来たし、その後右延髄梗塞を合併して球麻痺、重度左麻痺が残存した。当初より嚥下造影検査時には食道入口部開大不全が明らかであり、経口摂取は困難と判断されて発症4ヵ月後に胃瘻造設された。経口摂取やリハビリテーションを希望して発症から1年後に当科を初診された時点でも症状の改善はみられず、リハビリテーションの適応ではないと判断した。外科的対応を主眼において当院耳鼻科を紹介し、同科にて発症後約2年後に輪状咽頭筋切断術と喉頭挙上術を行った。術後8日目より当科にてリハビリテーションを再開した。その後の嚥下造影検査結果では下顎を上前方に突き出して食道入口部を開く代償法が有効であった。この代償法の獲得訓練を行い、全粥半固形食を摂るまでに回復した。完全経腸栄養の状態から家庭で食事ができるまでに至った意義は非常に大きいと考える。本症例は耳鼻科による外科手術とその後の当科におけるリハビリテーションによる新たな摂食方法の獲得のどちらが欠けてもこのような改善が期待できなかったケースとして、多職種連携の重要性を実証したものといえる。(著者抄録)

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  • 姿勢や食塊の性状の違いがヒトのオトガイ舌筋の筋電図活動に与える影響 Reviewed

    杉野 伸一郎, 谷口 裕重, 塚田 徹, 大瀧 祥子, 梶井 友佳, 山田 好秋, 井上 誠

    日本顎口腔機能学会雑誌   14 ( 1 )   13 - 23   2007.10

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    咀嚼、嚥下、吸啜、呼吸、発話など顎口腔顔面領域のさまざまな機能に対して重要な役割をもつ舌の客観的評価を行なうことを目的として、外舌筋のひとつであるオトガイ舌筋筋電図を記録し嚥下運動を含めた種々の随意運動時の活動様式を定量的に評価した。健常成人10名を対象として、左側舌骨上筋群、左側オトガイ舌筋筋電図記録を行った。実験1では、安静位、最大開口位、最大舌突出位、最大舌突出より舌のみ引っ込めという状態を各々約5秒間とらせ、安定した2秒間の平均筋活動量を測定した。実験2では、被験食品として選択した液体、シロップ、硬さの異なる2つの寒天ゼリー各4mlを指示嚥下にて摂取した際の各筋活動を記録した。さらに各被験食品摂取時に、頸部中間位、前屈位、回旋位のいずれかをとらせた。オトガイ舌筋は2峰性の活動を示したことから、それぞれの活動を舌筋1バースト、舌筋2バーストとして各被験食品、姿勢ごとの各筋活動の持続時間、ピーク値、そして全体の活動状態を表す平方二乗根(筋活動量)を求めて比較した。最大舌突出時にはオトガイ舌筋の筋電図活動が大きく増加したのに対して、最大舌突出から顎位を変化させずに舌のみを引っ込めた時にはオトガイ舌筋筋電図活動はほぼ消失し、さらに舌骨上筋群筋電図活動にも減少がみられたことから舌突出に関わる舌骨上筋群の活動が示唆された。嚥下時の記録では、すべての値は食塊が硬くなるに従い大きくなる傾向がみられたものの、有意差が得られたのは舌筋1の持続時間のみであった。姿勢の変化による筋電図活動の違いはみられなかった。以上の結果から、今回我々が開発したオトガイ舌筋の筋電図記録ユニットの有用性が確かめられ、さらに物性の異なる食塊嚥下時のオトガイ舌筋の変調パターンについては、硬い食塊に対する前半の活動持続時間のみが延長することによって食品の物性変化に適応することが明らかとなった。(著者抄録)

    DOI: 10.7144/sgf.14.13

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  • 自由運動下のマウスを用いた咀嚼運動パターンの解析

    黒瀬雅之, 山村健介, HOSSAIN Zakir, RAHMAN Mostafeezur, 井上誠, 吉田教明, 前田健康, 山田好秋

    J Oral Biosci   49 ( Supplement )   117   2007.8

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  • 食事療法 ALSにおける摂食・嚥下障害の評価および対応法

    谷口 裕重, 井上 誠

    難病と在宅ケア   13 ( 4 )   51 - 54   2007.7

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  • 自律顎運動シミュレータJSN/3Aにおける歯根膜咬筋反射機能の再現 Reviewed

    山岸 直也, 小島 正樹, 林 豊彦, 中村 康雄, 中嶋 新一, 井上 誠

    電子情報通信学会技術研究報告(MEとバイオサイバネティックス)   107 ( 72 )   25 - 28   2007.5

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    我々は、顎運動メカニズム解明のために、ヒトに近い構造および制御法をもつ自律顎運動シミュレータJSN/3Aを開発してきた。ヒトの咀嚼動作では、噛みしめ時に歯根膜受容器を利用した反射が働いていることが知られている。その中でも、歯の接触直後に起きる歯根膜咬筋反射は、咀嚼機能において特に重要である。この反射は、抑制区間と促進区間の2相をもつことが知られている。しかし、咀嚼時におけるこれらの詳しい役割はまだ明らかにされていない。その解明のために我々は、第一大臼歯に装着した咬合力センサのデータを利用して、歯根膜咬筋反射をJSN/3Aにおいて再現した。実験の結果から、抑制区間は歯の接触直後において咬合力の急激な増加を抑制する傾向があり、促進区間は抑制区間後に咬合力を増加する傾向があることが示唆された。(著者抄録)

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  • 自由行動下マウスを用いた咀嚼運動の解析

    黒瀬 直子, 黒瀬 雅之, 山村 健介, 平野 秀利, 井上 誠, 山田 好秋

    新潟歯学会雑誌   36 ( 2 )   311 - 312   2006.12

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  • Daily Work at the Dysphagia Rehabilitation Clinic

    Inoue Makoto

    Niigata dental journal   36 ( 2 )   39 - 40   2006.12

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    Other Link: http://hdl.handle.net/10191/1339

  • 高齢者向け米菓の研究 Reviewed

    高橋 肇, 伊藤 彰, 江川 広子, 渡辺 紀之, 井上 誠, 新井 映子, 山田 好秋

    日本咀嚼学会雑誌   16 ( 2 )   70 - 82   2006.11

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    高齢者が摂食しやすい米菓の物性と嗜好性を明らかにし、新たに開発した米菓(以後開発型)がこれらの特性を満たす米菓かどうかを明らかにする目的で、米菓の物性測定、咀嚼筋の筋電図測定および官能評価を行った。対照試料として硬い順に草加型、おかき型、新潟型、ベビー型の市販品を用いた。得られた結果は以下の通りである。1.高齢被験者にとって、米菓の摂食可否を決める主な要因は「硬さ」であった。2.米菓の硬さ(見かけのヤング率)は、草加型&gt;おかき型&gt;新潟型&gt;開発型=ベビー型の順であり、若年被験者(N=66)の「咀嚼時の硬さ」における官能評価結果と一致していた。3.開発型とベビー型は見かけのヤング率8.56×10^6N/m以下であり、高齢被験者でも摂食可能であった。4.見かけのヤング率平均値(x)と咬筋総活動量平均値(y)にはy=0.15x+1.52(R2=0.83)の関係がみられ、硬い米菓ほど咬筋活動量が増加していた。5.硬い米菓ほど咀嚼回数が増加し、その結果、咀嚼時間と咬筋総活動量が増加していた。6.高齢被験者にとって、米菓の硬さは主に捕食時に問題となり、硬いものほど咬筋の活動時間を延長させ、咬筋初回活動量を大きくする傾向があった。7.「食感」が、米菓の嗜好性で最も重要な項目であった。8.嗜好性を評価した全項目で、若年被験者、高齢被験者ともに開発型をベビー型より高く評価した。以上の結果から、開発型は高齢者の嗜好性を満たし、かつ食べやすい物性の米菓であることが明らかとなった。(著者抄録)

    DOI: 10.14858/soshaku1991.16.70

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  • Electromyographic study on the coordination of head and neck movements during jaw movements

    Tsurui Chikako, Arai Yoshiaki, Inoue Makoto, Taniguchi Hiroshige, Yamada Yoshiaki

    The Journal of Japanese Society of Stomatognathic Function   13 ( 1 )   40 - 41   2006.10

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    Other Link: http://search.jamas.or.jp/link/ui/2007112132

  • 自由行動下マウスを用いた咀嚼運動の解析

    黒瀬雅之, 山村健介, MOSTAFEEZUR Rahman, 井上誠, 吉田教明, 前田健康, 山田好秋

    J Oral Biosci   48 ( Supplement )   135   2006.9

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  • Effects of food consistency and posture on swallowing function in man

    Taniguchi Hiroshige, Inoue Makoto, Yamada Yoshiaki

    The Journal of Japanese Society of Stomatognathic Function   12 ( 2 )   132 - 133   2006.2

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    Other Link: http://search.jamas.or.jp/link/ui/2007120713

  • 嚥下反射誘発時の関連筋活動の協調と変調

    吉津 和憲, 井上 誠, 杉野 伸一郎, 豊里 晃, 山村 健介, 山田 好秋

    新潟歯学会雑誌   35 ( 2 )   259 - 260   2006.1

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  • Pattern of modulation of the jaw-opening reflex during mastication

    Mostafeezur Rahman, Yamamura Kensuke, Inoue Makoto, Kurose Masayuki, Yamada Yoshiaki

    Proceedings of Annual Meeting of the Physiological Society of Japan   2006 ( 0 )   189 - 189   2006

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    Effects of mastication on the jaw-opening reflex (JOR) were studied in awake rabbits. The JOR was evoked by unilateral low-intensity electrical stimulation of the inferior alveolar nerve either chewing or non-chewing side before (control) and during mastication. The entire masticatory sequence (from food intake to just before swallow) was divided into three functionally different masticatory periods (preparatory, rhythmic-chewing and preswallow periods) based on the jaw movements and the related activity pattern of the jaw muscles, and each chewing cycle in each period was further divided into jaw-closing and jaw-opening phases. Then amplitude of the JOR was compared 1) among the masticatory periods and 2) between the stimulation sides (i.e. chewing or non-chewing sides). Overall, the JOR was suppressed during mastication. Although the suppressive effect on the JOR did not differ between the stimulation sides, considerable differences were noted in the suppressive effect among the masticatory periods. During rhythmic-chewing and preswallow periods, the JOR was strongly suppressed in the jaw-closing phase (8 to 20% of the control), but the suppressive effect was phasically weakened (30 to 61% of the control) in the late part of the jaw-opening phase. On the other hand, such phase-dependent fluctuation in the suppressive effect was not observed during the preparatory period. The findings suggest that neural mechanisms modulating the JOR during the preparatory period may be different from other masticatory periods. &lt;b&gt;[J Physiol Sci. 2006;56 Suppl:S189]&lt;/b&gt;

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  • 自由行動下のウサギにおける睡眠時オトガイ舌筋反射活動の変調

    原澤 陽二, 井上 誠, 山村 健介, 山田 好秋

    新潟歯学会雑誌   34 ( 2 )   278 - 278   2005.1

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  • Modulatory pattern of the jaw-opening reflex during mastication in awake rabbits

    Rahman Mostafeezur, Yamamura Kensuke, Inoue Makoto, Kurose Masayuki, Yamada Yoshiaki

    Proceedings of Annual Meeting of the Physiological Society of Japan   2005 ( 0 )   S172 - S172   2005

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    Previous studies have shown that the jaw-opening reflex (JOR) is modulated during mastication. However in these studies, analyses have been carried out for limited period within the masticatory sequence (i.e. from food intake to just before swallow). Our aim is to study if the modulatory pattern of the JOR is consistent throughout the masticatory sequence in awake rabbits. The masticatory sequence was divided into three masticatory periods (preparatory, rhythmic-chewing and preswallow periods) based on the jaw movement patterns and the activity pattern of the jaw muscles. Electromyographic activity of the jaw-opening muscle (Digastric) and the jaw movement trajectories were recorded. Repetitive electrical stimulation (single pulse, 0.2 ms duration at a rate of 1 Hz, 1.2 times the threshold) of the inferior alveolar nerve was conducted before (for control response) and during mastication to evoke the JOR. The amplitude of the JOR was normalized to the control response and the modulatory pattern of the JOR was compared among the masticatory periods. The JOR was generally suppressed during the rhythmic-chewing and the preswallow periods; the suppressive effect was phasically weakened in the middle part of the jaw opening during the rhythmic-chewing period. On the other hand, the reflex was not only suppressed but also facilitated during the preparatory period. The results suggest that the modulatory pattern of the jaw-opening reflex is different among the masticatory periods. &lt;b&gt;[Jpn J Physiol 55 Suppl:S172 (2005)]&lt;/b&gt;

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  • 2.Effects of food consistency and posture on swallowing function in man

    Taniguchi Hiroshige, Inoue Makoto, Yamada Yoshiaki

    ( 35 )   12 - 13   2005

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  • Electromyographic Activity of Genioglossus Muscle during Orofacial Movements in Humans

    Yamamoto K, Harasawa Y, Hasegawa M, Nakao A, Inoue M, Yamada Y

    The Journal of Japanese Society of Stomatognathic Function   11 ( 1 )   51 - 53   2004.11

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  • 自由行動下のウサギにおける舌筋反射活動の睡眠相依存性の変調

    原澤 陽二, 井上 誠, 山村 健介, Mostafeezur Rahman, 山田 好秋

    Journal of Oral Biosciences   46 ( 5 )   409 - 409   2004.9

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  • 実験的筋への痛み刺激が顎反射に及ぼす影響

    黒瀬 雅之, 山村 健介, 井上 誠, 野口 真紀子, Ariyasinghe Sajjiv, 山田 好秋

    新潟歯学会雑誌   33 ( 2 )   285 - 286   2004.1

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  • Changes in the reflex responses of genioglossus muscle in the freely moving rabbit

    Harasawa Yohji, Inoue Makoto, Ariyasinghe Sajjiv, Yamamura Kensuke, Yamada Yoshiaki

    Proceedings of Annual Meeting of the Physiological Society of Japan   2004 ( 0 )   S178 - S178   2004

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    The aim of the present study was (1) to investigate how the tongue reflex is modulated during wakefulness and sleep and (2) to examine if modulation of the tongue reflex activities during active sleep is related with respiratory phases or rapid eye movements in the freely moving rabbit. Electromyographic (EMG) activity of tongue muscle was recorded in the genioglossus (tongue-protruder, GG) muscle, and the GG reflex was evoked by electrical stimulation of the inferior alveolar nerve. The current intensity of stimulus was set at 1.5 times threshold to evoke the reflex to evaluate the modulatory mode of GG reflex. Peak to peak amplitude of EMGs in the reflex was compared among wakefulness and sleep stages.GG activity showed a wide variation, some had respiratory-related activity and others did not. However, in all animals, the reflex was suppressed during sleep, and the inhibition was significantly stronger during active sleep than that during quiet sleep. In some cases, the reflex was completely suppressed during active sleep. Furthermore, during this sleep stage, the reflex amplitude during inspiratory phase was larger than that during expiratory phase. On the other hand, the rapid eye movements during active sleep were not related to the changes in the reflex activity during active sleep. Not only basic but also clinical studies have paid attention to loss of tone in upper airway muscles including tongue muscles during sleep. The neuronal mechanisms controlling tongue muscle activity in sleep were discussed. &lt;b&gt;[Jpn J Physiol 54 Suppl:S178 (2004)]&lt;/b&gt;

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  • Tongue muscle activity during chewing and swallowing in man

    Inoue Makoto, Harasawa Yohji, Yamamoto Keiji, Yamamura Kensuke, Yamada Yoshiaki

    Proceedings of Annual Meeting of the Physiological Society of Japan   2004 ( 0 )   S179 - S179   2004

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    Tongue movements participate in oro-facial motor functions including chewing, sucking, swallowing, speech, respiration and so on. Although previous studies reported the coordination of jaw and tongue movements to clarify the patterns of tongue muscle activity, our knowledge as to the functional role of tongue muscles during chewing and swallowing in humans is still limited due to the technical difficulty to record the dynamic activity of tongue muscles. In this study, we recorded the EMG activity of left tongue protruder (genioglossus, GG), jaw-closer and supra- and infra-hyoid muscles during command swallow and natural mastication of test foods as well as rhythmic experimental open-close jaw movements in healthy subjects. For GG recording, the electrode assembly was fabricated on a dental acrylic resin. During command swallow, the subject was required to swallow test foods in different postures which were upright and head inclined w/ and w/o body reclinced to test the effects of head and body postures on the tongue activity. The activity pattern of GG muscle was different among the postures. During experimental rhythmic open-close jaw movements, all the muscles recorded were well-coordinated while the coordination was not observed in the case of natural mastication. Particularly, the GG activity did not always show the rhythmicity. The results suggest the variability of human tongue activity during mastication and swallowing. &lt;b&gt;[Jpn J Physiol 54 Suppl:S179 (2004)]&lt;/b&gt;

    DOI: 10.14849/psjproc.2004.0.S179.1

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  • 実験的筋への痛み刺激が異なる感覚により誘発される顎反射に及ぼす影響

    黒瀬 雅之, 山村 健介, 井上 誠, 野口 真紀子, Sajjiv Ariyasinghe, 山田 好秋

    歯科基礎医学会雑誌   45 ( 5 )   352 - 352   2003.9

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  • 自由行動下のウサギにおける睡眠時舌筋反射活動の変調

    原澤 陽二, 井上 誠, Sajjiv Ariyasinghe, 山村 健介, 平野 秀利, 山田 好秋

    歯科基礎医学会雑誌   45 ( 5 )   355 - 355   2003.9

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  • 口腔からの感覚情報伝達機構の咀嚼時変調様式 大脳皮質感覚野誘発応答と反射の比較

    山村 健介, 黒瀬 雅之, 井上 誠, 平野 秀利, 山田 好秋

    歯科基礎医学会雑誌   45 ( 5 )   347 - 347   2003.9

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  • 顎口腔顔面運動に関わる運動ニューロンのプレモーターニューロンの局在

    井上 誠, Sajjiv Ariyasinghe, 原澤 陽二, 山村 健介, 山田 好秋

    歯科基礎医学会雑誌   45 ( 5 )   353 - 353   2003.9

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  • 家兎咀嚼筋活動と顎運動との関係

    中村 優也, 高品 朋江, 井上 誠, 山田 好秋, 杉村 忠敬

    歯科基礎医学会雑誌   45 ( 5 )   352 - 352   2003.9

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  • Changes in tongue reflex responses during sleep

    Inoue Makoto

    Niigata dental journal   33 ( 1 )   57 - 58   2003.7

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  • Effects of food texture on extrinsic tongue muscle activity during mastication in the rabbit.

    M. Inoue, Y. Harasawa, S. Ariyasinghe, K. Yamamura, Y. Yamada

    JOURNAL OF DENTAL RESEARCH   82   B296 - B296   2003.6

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  • 9. Effects of Experimental Pain of Jaw-Closing Muscle on Jaw Reflexes

    Kurose Masayuki, Yamamura Kensuke, Inoue Makoto, Noguchi Makiko, Ariyasinghe Sajjiv, Yamada Yoshiaki

    The Journal of Japanese Society of Stomatognathic Function   9 ( 2 )   218 - 219   2003.4

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    DOI: 10.7144/sgf.9.218

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  • 閉口筋に与えた痛み刺激が開口反射及び閉口反射に及ぼす影響

    黒瀬 雅之, 山村 健介, 野口 真紀子, 井上 誠, 山田 好秋

    歯科基礎医学会雑誌   44 ( 5 )   454 - 454   2002.9

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  • 自由行動下のウサギにおける睡眠時咀嚼筋反射活動の変調

    井上 誠

    歯科基礎医学会雑誌   43, pp. 353-359 ( 4 )   353 - 359   2001.8

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    DOI: 10.2330/joralbiosci1965.43.353

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  • Sensory afferent and descending input convergences on trigeminal premotor interneurones and their projections in the rabbit

    M Inoue, K Nozawa-Inoue, R Donga

    JOURNAL OF PHYSIOLOGY-LONDON   533   70P - 70P   2001.5

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  • 食品の物性の違いが顎舌協調運動に与える影響 Reviewed

    顎機能誌   7, pp. 37-45   2001

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  • The tongue muscle activities during swallowing in freely behavingrabbits

    Kazuo Naganuma, Yoshiaki Yamada, Makoto Inoue

    Niigata dental journal   30 ( 2 )   73 - 74   2000.12

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  • 下歯槽神経への電気刺激により誘発される外舌筋反射性活動の咀嚼時変調について

    饗場 広和, 井上 誠, 花田 晃治, 山田 好秋

    歯科基礎医学会雑誌   41 ( 5 )   497 - 497   1999.8

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  • 睡眠時における咬筋神経の興奮性の変調

    井上 誠, 山村 健介, 中島 民雄, 山田 好秋

    新潟歯学会雑誌   28 ( 1 )   100 - 100   1998.7

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  • Changes in the jaw reflex amplitude during sleep and wakefulness.

    M Inoue, K Yamamura, T Nakajima, Y Yamada

    JOURNAL OF DENTAL RESEARCH   77   1006 - 1006   1998

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  • Effects of food consistency on the modulatory mode of the digastric reflex during chewing in freely behaving rabbits(共著)

    Brain Research   802   289 - 293   1998

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Awards

  • 日本顎口腔機能学会第59回学術大会優秀賞

    2017.11   日本顎口腔機能学会  

    阿志賀大和ら

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  • 日本顎口腔機能学会第57回学術大会優秀賞

    2017.10   日本顎口腔機能学会  

    渡邊賢礼ら

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  • 第59回歯科基礎医学会学術大会優秀ポスター発表賞生理学部門

    2017.9   歯科基礎医学会  

    那小屋公太ら

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    Award type:Award from Japanese society, conference, symposium, etc.  Country:Japan

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  • 第18回日本咳嗽研究会優秀演題賞

    2016.10   日本咳嗽研究会  

    辻村恭憲ら

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  • 日本顎口腔機能学会第55回学術大会優秀賞

    2015.11   日本顎口腔機能学会  

    神田知佳ら

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  • 日本顎口腔機能学会第54回学術大会優秀賞

    2015.4   日本顎口腔機能学会  

    酒井翔悟ら

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  • 第25回日本咀嚼学会学術大会優秀口演賞

    2014.9   日本咀嚼学会  

    井上 誠ら

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  • 日本歯科衛生学会学術発表奨励賞・公益財団法人ライオン歯科衛生研究所賞

    2014.9   日本歯科衛生学会  

    岸本奈月ら

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  • 日本摂食嚥下リハビリテーション学会奨励賞

    2014.9   日本摂食嚥下リハビリテーション学会  

    高橋圭三ら

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  • 日本食品工業展アカデミックプラザ賞

    2014.6   日本食品工業展  

    新潟大学大学院医歯学総合研究科摂食嚥下リハビリテーション学分野

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    Award type:International academic award (Japan or overseas)  Country:Japan

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  • 日本顎口腔機能学会第52回学術大会優秀賞

    2014.4   日本顎口腔機能学会  

    真柄 仁ら

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  • 第32回日本生体医工学会甲信越支部大会優秀賞

    2012.9   日本生体医工学会  

    覚嶋慶子ら

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  • 第23回日本老年歯科医学会学術大会

    2012.6   日本老年歯科医学会  

    林 宏和ら

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  • 平成23年度日本味と匂学会論文賞

    2011.10   日本味と匂学会  

    矢作理花ら

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  • 第29回日本口腔腫瘍学会総会学術大会優秀ポスター賞

    2011.1   日本口腔腫瘍学会  

    児玉泰光ら

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  • 歯科基礎医学会賞

    2010.9   歯科基礎医学会  

    辻村恭憲

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  • Neuroscience Wiley-Blackwell Publishing Young Investigator Research Award, IADR

    2010.7   IADR  

    Takanori Tsujimura

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  • 日本食品工業展アカデミックプラザ賞

    2008.5   日本食品工業展  

    新潟大学大学院医歯学総合研究科摂食嚥下リハビリテーション学分野

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  • 第3回日本顎口腔機能学会奨励賞

    2002.7   日本顎口腔機能学会  

    Makoto Inoue

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  • 第13回歯科基礎医学会賞

    2000.9   歯科基礎医学会  

    Makoto Inoue

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Research Projects

  • Trigeminal Interneurer Activity in Mastication and Swallowing

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  • Clinical Approach to Dysphagia

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  • Changes in the Excitability of Masticatory and tougue Motoneurons during Sleep

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  • Cordination of Jaw and Tongue Morements during Mastication

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Teaching Experience

  • 摂食リハ関係コースワークIIB

    2022
    Institution name:新潟大学

  • 摂食リハ関係コースワークIB

    2022
    Institution name:新潟大学

  • 嚥下障害学IA

    2021
    Institution name:新潟大学

  • 摂食嚥下機能評価支援学特論

    2021
    Institution name:新潟大学

  • 臨床歯学コースワーク(摂食リハ関係コースワークII)

    2021
    Institution name:新潟大学

  • 嚥下障害学IIB

    2021
    Institution name:新潟大学

  • 摂食嚥下機能評価支援学

    2021
    Institution name:新潟大学

  • 臨床歯学コースワーク(摂食リハ関係コースワークI)

    2021
    Institution name:新潟大学

  • 嚥下障害学IIA

    2021
    Institution name:新潟大学

  • 基礎・臨床連続講義II(摂食・嚥下機能評価学)

    2021
    Institution name:新潟大学

  • 嚥下障害学IB

    2021
    Institution name:新潟大学

  • 「食べる」

    2021
    Institution name:新潟大学

  • ネットワーク型先端歯学研究

    2021
    Institution name:新潟大学

  • 摂食嚥下障害学

    2020
    Institution name:新潟大学

  • 食と健康の科学

    2020
    Institution name:新潟大学

  • 加齢歯科学

    2020
    Institution name:新潟大学

  • 歯学研究演習

    2020
    Institution name:新潟大学

  • 口腔生理学

    2018
    Institution name:新潟大学

  • 臨床歯学コースワーク(摂食リハ関係コースワークⅠ)

    2017
    -
    2020
    Institution name:新潟大学

  • 嚥下障害学ⅡA

    2017
    -
    2018
    Institution name:新潟大学

  • 臨床歯学コースワーク(摂食リハ関係コースワークⅡ)

    2017
    -
    2018
    Institution name:新潟大学

  • 嚥下障害学ⅠB

    2017
    Institution name:新潟大学

  • 生理学Ⅱ

    2017
    Institution name:新潟大学

  • 嚥下障害学ⅠA

    2017
    Institution name:新潟大学

  • 嚥下障害学ⅡB

    2017
    Institution name:新潟大学

  • 基礎・臨床連続講義Ⅱ(摂食・嚥下機能評価学)

    2017
    Institution name:新潟大学

  • 口腔機能管理学

    2016
    -
    2018
    Institution name:新潟大学

  • 統合科目Ⅰ

    2015
    -
    2019
    Institution name:新潟大学

  • 加齢歯科学Ⅰ

    2014
    -
    2018
    Institution name:新潟大学

  • 「食べる」

    2013
    -
    2020
    Institution name:新潟大学

  • 食=「人」に「良」

    2011
    Institution name:新潟大学

  • 顎顔面診断・治療学

    2010
    -
    2019
    Institution name:新潟大学

  • 歯学研究入門

    2010
    -
    2017
    Institution name:新潟大学

  • 摂食・嚥下障害治療学

    2009
    Institution name:新潟大学

  • 口腔機能管理支援学総論

    2009
    Institution name:新潟大学

  • 摂食嚥下機能評価支援学B

    2009
    Institution name:新潟大学

  • 摂食・嚥下障害治療学演習

    2009
    Institution name:新潟大学

  • 臨床歯学コースワーク(顎口腔機能評価コース)

    2009
    Institution name:新潟大学

  • 統合科目Ⅱ

    2008
    -
    2019
    Institution name:新潟大学

  • 加齢歯科学Ⅱ

    2008
    -
    2018
    Institution name:新潟大学

  • 臨床予備実習

    2008
    -
    2009
    Institution name:新潟大学

  • 早期臨床実習ⅠB

    2008
    -
    2009
    Institution name:新潟大学

  • 歯科臨床概論

    2007
    Institution name:新潟大学

  • 高齢者・障害者歯科学

    2007
    Institution name:新潟大学

  • 生体機能学

    2007
    -
    2017
    Institution name:新潟大学

  • 統合科目II

    2007
    Institution name:新潟大学

  • 加齢歯科学II

    2007
    Institution name:新潟大学

  • 早期臨床実習IB

    2007
    Institution name:新潟大学

▶ display all