Aim: The aim of this study was to establish the reliability and validity of the Japanese version of the short version of the Dental Anxiety Inventory (S-DAI). 　Methods: The Japanese translated versions of the S-DAI and Dental Fear Survey (DFS) were administered to patients and attendants who were visiting a general dental office. 　Results: One hundred and sixty-seven participants (response rate = 90.3%) filled out two questionnaires assessing dental anxiety (The Japanese S-DAI and DFS). Cronbach’s α for the reliability of the Japanese S-DAI in the present sample was 0.908. In the Japanese S-DAI, factor analysis revealed one factor with an eigenvalue >1. The Japanese S-DAI correlated with the DFS (r=0.812, p < 0.001). 　Conclusions: The Japanese version of the S-DAI appears reliable and demonstrates cross-cultural validity. It may be a valuable tool for quantifying dental fear in Japanese populations.

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Background: Photodynamic therapy (PDT) is an effective laser treatment for locally advanced carcinoma and is promising as neoadjuvant chemotherapy before surgery. The aim of this study was to clarify the adverse effects of PDT using a photosensitizer, talaporfin sodium (Laserphyrin^®), for wound healing. 　Methodology: For PDT, a laser light with a wavelength of 660 nm and a frequency of 10 Hz with a total energy fluency of 60 J/cm² was used. Macroscopic and histological findings of wound healing after PDT were examined in vivo (4-week-old male BALB/c mice). 　Results: In Model 1, in which skin was cut at 0, 3, 7 days after PDT (n=3, each), wounds were similarly healed 7 days after cutting in all groups, and regenerating epithelium and the number of fibroblasts on histological findings were not different. In Model 2, in which skin defects were created before or after PDT, the size of the defects was larger at day 7 in the groups with skin defects before or after PDT in comparison with groups with no PDT. 　However, macroscopic wound healing at day 14 was complete in all groups and there were no significant differences among the groups by this point. Histological findings of skin defects at day 14 showed no significant difference in terms of regenerating epithelium and number of fibroblasts in each group with or without PDT. 　Conclusions: PDT did not influence wound healing and can be safely applied before surgical therapy.

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　Treatments for hyperphosphatemia in dialysis patients include dietary therapy and oral administration of phosphate binders; however, it has recently been suggested that oral administration of sevelamer hydrochloride, a phosphate binder, may cause metabolic acidosis. Owing to the decreased supply of sevelamer hydrochloride after the Eastern Japan Great Earthquake Disaster on March 11, 2011, hyperphosphatemia patients switched to another phosphate binder, lanthanum carbonate. Here, we retrospectively evaluated the effect of this medication substitution on metabolic acidosis in patients on maintenance hemodialysis. 32 patients, who underwent maintenance hemodialysis at Nagasaki Kidney Center in Japan, were enrolled in our study and followed to evaluate the effect of switching medication on metabolic acidosis at 3 months after switching from sevelamer hydrochloride to lanthanum carbonate. The mean dose of sevelamer hydrochloride prior to the earthquake disaster was 3 g/day, and the mean dose of lanthanum carbonate thereafter was 0.9 g/day. Three months after the medication was changed, the concentration of bicarbonate ion did not increase significantly (p = 0.186), whereas pH and base excess increased significantly (p = 0.007 and p = 0.036, respectively). In this study, although the HCO₃ - level was not significantly changed, the pH and base excess were significantly increased. Our findings indicate that lanthanum carbonate ameliorates metabolic acidosis.

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　Body mass index (BMI) is well known as an independent risk factor for insulin resistance. In addition, lower BMI and lower insulin levels are recognized as specific characteristics of Asian diabetes patients. Since the triglyceride-to-HDL-cholesterol ratio (TG-HDL) is positively associated with insulin level, but inversely associated with insulin sensitivity, we supposed that diabetes combined with high but not with low TG-HDL might be positively associated with BMI. We therefore conducted a cross-sectional study of 2,431 Japanese subjects (905 men and 1,526 women) aged 30-79 years, who underwent a general health check, to investigate associations between BMI, diabetes and its subtypes that we defined on the basis of TG-HDL levels, which in turn were categorized according to sex-specific tertiles. Among the 172 diabetic patients identified in the study group, 45 showed low TG-HDL and 82 high TG-HDL. We found a significant inverse association between low-TG-HDL diabetes and BMI, and a significant positive association between high-TG-HDL diabetes and BMI. The multivariable-adjusted odds ratio and 95%CI for a 1SD increment in BMI (3.03 kg/m² for men and 3.44 kg/m² for women) for low-TG-HDL diabetes was 0.53 (95%CI: 0.36-0.77) and 1.57 (95%CI: 1.24-2.01) for high-TG-HDL diabetes. These findings demonstrated that for Japanese subjects associations between diabetes and BMI are strongly influenced by the TG-HDL status. Since a previous study of ours found that diabetes combined with high TG-HDL ratios constitutes a risk for atherosclerosis, these findings may serve as an effective tool for estimating risk of atherosclerosis for diabetes patients.

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Open infrarenal aortic clamping has been performed for traumatic pelvic hemorrhage or aortic rupture, and there are few reports of its use in the field of obstetrics and gynecology¹⁾. We report a patient with placenta previa accreta who was successfully treated by open infrarenal aortic clamping.

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　A 45-year-old woman experiencing back pain showed signs of metabolic acidosis and electrolyte imbalances. The results of blood and urine tests indicated Fanconi syndrome and renal tubular acidosis. An x-ray showed vertebral fractures, which were thought to responsible for the back pain. In addition, the patient had proteinuria and renal dysfunction; therefore, renal biopsy was performed, and tubulointerstitial nephritis (TIN) was diagnosed. While investigating TIN, primary biliary cirrhosis and Sjögren’s syndrome were also detected. She had been previously diagnosed with chronic thyroiditis. We report a rare case of TIN and 3 autoimmune disorders with review of literature.

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