With the aid of a “Talk Eye” device, we investigated the eye movements of dental students in the clinic, The participants in this study were a total of 30 undergraduates who had never visited our clinic previously. The measurement of their eye movements was started when the subjects came within a distance of 1 m from the reception desk, and continued until they walked a distance of about 9 m along the central aisle to reach a dental chair (goal) on the right at the end of the passage. The measurements taken during their walk from 0m to 7m points were analyzed. The results were as follows:
1) The initial points of fixation were found in the upper left direction among the largest group (40.0%) of the subjects, followed by the lower left in 30.0%, the upper right with 26.7% and the lower right with 3.3%.
2) Before the eyes rested on the intial point of fixation, 36.7% of the subjects shifted their eyes from the lower left to point O, and 26.6%, from the upper left to point O. Though there were no ocular movements from the upper right or lower right to point O movements toward the Z axis were observed in 36.7% of the examinees.
3) The resting time on a fixation point was 44.5 ms on the average. At the 1 m point, the students' eyes rested on a point in the lower right part of the dental chair for the longest, 77.0 ms. The next longest resting time was on the left side of the goal, 73.1 ms at the 6 m point, followed by 63.5 ms at the 1 m point and 62.4 ms at the starting point. This was probably because the subjects' attention was drawn to what they thought stood in their way.
4) A check of the distribution of all the points of fixation showed that 25.1% were in the upper right; 10.8%, the lower right; 35.3%, the upper left; and 28.8%, the lower left.
5) The saccadic movements of eyes simultaneously in changing the point of fixation within the angle of visual field were smallest at the 0 m point in the lower right, but became larger as they got closer to the goal.
6) In subjects who walked quickly, the points of fixation were concentrated in the area around point O.
7) No significant difference was observed in the distribution of fixation points between the subjects who wore glasses and those who did not.
From the above, we concluded that the students have a tendency to look to the goal and the direction in which they walk while giving heed to things along the way.

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To investigate how a child patient in an inverted dorsal position looks at the face of his dentist in a sitting position in the treatment room, the child's eye movements were determined, using a photograph of the dentist's face as a test image. The based an results of eye movements were analyzed based on gazing time, gazing frequency, time up to primary seeing, glance-scanned scope, angle of saccadic eye movements, contour line-passed frequency, glance directivity, primary gazing site and figure-background relationships. Then, the subjects were divided into a group of 74 children aged below 6 years and a group of 100 children aged above 6 years and a comparative examination of the results of eye movements between both groups led to the following conclusions:
1. Age differences in eye movements were noted in glance-scanned scope, angle of saccadic eye movements and contour line-passed frequency.
2. The children aged below and above 6 years proved to have glance scanning confined to narrow and broad scopes, respectively.
3. The children aged below and above 6 years proved to show small and large angles of saccadic eye movements respectively.
4. The children aged below and above 6 years had concentrated their vision inside the dentist's face and shifted between the face and the background beyond the contour, respectively.
5. Compared with the children aged above 6 years, the children aged below 6 years tended to recognize the entire characteristics of dentist's face.

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The problems of 3 oral cancer patients who committed suicide were investigated from a medicosocial standpoints.
The first patient was a 58-year old male with cancer of the tongue (T3NOMO). The tumor responded well to induction chemoradiotherapy and conservative surgery with selective neck dissection was performed. After that, the patient had been free from the tumor, living together with his wife, son and daughter without worrying about financial matters. However, he complained of a severe pain in his neck and shoulder, and he killed himself by hanging in his house 2 years and 9 months after the operation.
The second patient was a 68-year old female with malignant lymphoma (B cell type) in the submandibular node. She received CHOP therapy. Originally, her mental condition was normal, but depressive tendencies became noticeable at the end of the second course and her depression progressed along with negative effects such as oral mucositis and pneumonia. Four months after the initiation of chemotherapy, the patient's mental dystress appeared to improve in parallel with improvement in her physical condition. She wished for a short stay in her home, and we agreed to her request as a trial for permanent discharge. That night, she committed suicide by hanging herself in her home.
The third patient was a 71-year-old female with oral squamous carcinoma which transformed from oral floride papillomatosis, which had been treated with large doses of external irradiation. Due to the irradiation, severe fibrous degeneration of the oral mucosa and submucosal tissues was induced and severe jaw trismus was resulted. Considering the initial therapy, chemotherapy with peplomycin and 5-Fu was performed. Fortunately, the tumor responded well and only limited excision of the remaining tumor was performed. After remission, she was living by herself in a lonely village, relying on national social security. Although she was free of tumor, shd had been suffering dysphagia, and she killed herself by jumping into the Inland Sea 4 years after remission. These cases suggest that the mental condition of cancer patients should be cared for by establishing close human relationships between each patient and the medical staff and by considering the social enviroment of the patient.

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Dying with dignity means as follows; terminally ill patients should be cared not to live along more, but to be cared to become comfortable, that is to say, not to suffer from pain or agony, to continue to have consciousness to his/her death, and to continue to live with the dignity as a human being to the end, which is in other word natural death. This is far from euthanasia. Euthanasia is to make die a patient, because his/her pain or agony is intractable. In the background of the appearance of dying with dignity, there has been development of bioethics and citizens' need for quality of life. So, in order to accomplish dying with dignity, any citizen live everyday with dignity, and care-giver should brush up the philosophy in medicine and perform comprehensive medicine.

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Euthanasia is to make a patient die intentionally in order to set him/her free from agony or pain according to his/her own will. In other word, it shows a citizen's desire on death and dying without any pain or agony. This problem has developed with the development of bioethics. In Japan, some miserable cases were judged properly. Especially the 6 'points on euthanasia which Nagoya high court showed were marked internationally and gave much influence to many cases on euthanasia in many countries. The case on euthanasia of Tokai university were found guilty, but was in more consideration of the doctor's circumstances. In Holland, the euthanasia has been admitted by the law, but the conditions are severe and the circumstances are not easy. It is still now under trials and errors internationally. But, now the time has come for every citizen to consider about his/her own death and dying by him/herself.

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This study was designed to evaluate whether mental stress was decreased by chewing Gummi candies and chewing gum.
The subjects consisted of 10 male students without malocclusion at Tsurumi University School of Dental Medicine. The test materials were a candy called Gummi (Meiji Seika Kaisha, Ltd., Gummi Grape 100 (^®)) and chewing gum produced for this study. Stress was imposed by the addition test method. The subjects rested for 20 min after starting the experiment. Then, the subjects performed a 1-minute addition test (addition test group). After resting for 20 min, the subjects chewed Gummi for 5 min and performed a 1-minute addition test during Gummi chewing (Gummi group). Furthermore, after resting for 20 min, the subjects chewed chewing gum for 5 min and perfomed a 1-minute addition test during gum chewing (chewing gum group). The changes in plasma ACTH, serum cortisol, plasma adrenaline, plasma noradrenaline, facial skin temperature by thermography, blood pressure, pulse rate, SpO₂ and ECG were observed at rest and during addition tests while the subjects chewed nothing, Gummi, or chewing gum.
The plasma ACTH concentrations were 12.7±8.7 pg/ml (mean±SD) at rest, 11.6 ±9.3 pg/ml after the addition test without gum chewing, 8.2±3.9 pg/ml after Gummi chewing, and 8.4±5.3 pg/ml after gum chewing. The serum cortisol concentrations were 8.6±4.0 jig/dl at rest, 8.9±4.0 μg/dl after the addition test without gum chewing, 8.1±3.4 μg/dl after Gummi chewing, and 6.3±2.0 μg/dl after gum chewing. The plasma adrenaline concentrations were 110.8±48.3 pg/ml at rest, 119.0±59.0 pg/ml after the addition test without gum chewing, 106.3±38.4 pg/ml after Gummi chewing, and 89.7±29.9 pg/ml after gum chewing. The plasma noradrenaline concentrations were 556.8±307.3 pg/ml at rest, 593.8±319.3 pg/ml after the addition test without gum chewing, 530.9±223.5 pg/ml after Gummi chewing, and 492.0±169.6 pg/ml after gum chewing. The frequencies of EDA were 25.0±6.0 during the addition test without gum chewing, 21.1±6.6 during the addition test with Gummi chewing, and 22.3±4.8 during the addition test with gum chewing. The facial skin temperatures were 34.28±0.26°C at rest, 34.41±0.24°C after the addition test without gum chewing, 34.13 ± 0.22t before the addition test during Gummi chewing, 34.21±0.20° after Gummi chewing, 34.14±0.42°C before the addition test during chewing gum chewing, and 34.26±0.42t after gum chewing. The systolic pressures were 116.7±8.8mmHg at rest, 118.3±7.9 mmHg after the addition test without chewing, 121.3±10.7 mmHg after Gummi chewing, and 118.2±9.6 mmHg after gum chewing. The diastolic pressures were 70.2±7.0 mmHg at rest, 71.4±7.5 mmHg after the addition test without chewing, 73.2±6.6 mmHg after Gummi chewing, and 72.3±7.5 mmHg after gum chewing. The pulse rates were 74.3±10.4/min at rest, 74.4 ± 10.4/min after the addition test without chewing, 74.3±10.6/min after Gummi chewing, and 76.2±12.4/min after gum chewing. The Sp0₂ was 96.0±1.1% at rest, 96.3±0.8% after the addition test without chewing, 96.1±0.6% after Gummi chewing, and 96.5±0.7% after gum chewing. There were no significant differences in the ECG, before and after gum chewing.
These results indicate that mental stress during light activities is decreased by chewing Gummi and chewing gum.

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A review has been made of the immunological system, especially the relationship between T-cells and the results of mental tests.
The results are as follows:
The subjects were 42 patients with complaints regarded as psychogenic, namely, 24 cases of tongue pain, 5 cases of psychogenic temporomandibular joints syndrome, 4 cases of psychogenic dry mouth, 3 cases each of tooth and gum pain, and 3 cases of relapsed aphthous stomatitis. Their ages varied from 16 to 76 with an average of 52.3.
Method: The patients were classified into those with a of helper-T cell/suppressor-T cell ratio (hereinafter called CD 4/8 ratio) of over 2.0 (hereinafter called the high CD 4/8 ratio group) and those with a ratio of less than 2.0 (hereinafter called the low CD 4/8 ratio group). The review was made of the relationship to the results of mental tests.
Results: 89.4% of patients in the low CD 4/8 ratio group were in the III, IV area of CMI, compared with 56.5% in the high CD 4/8 ratio group.
The low CD 4/8 ratio group showed a depressive tendency with a slight SDS of Zung and on the Masked Depressionsurvey table of Inoue.
Regarding item of B of Kyusyuu Medical Index, the low CD 4/8 ratio group recorded high value of 24.0, and the high CD 4/8 ratio group 16.7.

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A review has been made of the immunological system, especially on the relationship among T-cells, catecholamine (hereinafter called CA) and the duration of psycho-social stress.
The subjects were 42 patients with complaints regarded as psychologenic, namery, 24 cases of tongue pain, 5 cases psychogenic temporomandibular joints syndrome, 4 cases of psychogenic dry mouth, 3 cases each of tooth and gum pain, 3 cases of relapsed aphthous stomatitis. Their age ranged from 16 to 76 with and average 52.3.
CA was measured for the mean and tasts for immunity functions were made on T-cells, B-cells, helper-T cells, and suppressor-T cells.
Test were entrusted to SRL Inc.
The patients were classified into those with a CD 4/8 ratio of less than 2.0 (hereinafter called the low CD 4/8 ratio group) and those with a CD 4/8 ratio over 2.0 (hereinafter called the high CD 4/8 ratio group) A decrease of CD4 was observed in the low CD 4/8 ratio group, and a decrease of CD8 in high CD 4/8 ratio group. The period during which outpatients exprienced stress was judged to be 18.8 months for the low CD 4/8 ratio group, compared with only 12.3 months for the high CD 4/8 ratio group.
A higher value of noradrenaline as CA was observed in the low CD 4/8 raito group.

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Pain experienced by patients suffering from pain-producing diseases encountered in an oral surgery practice may be either organic or non-organic in nature. It is clinically important to now the differences of these types of pain. The nature of pain from pericoronitis of the third molars was studied in 140 males and 228 females. The control group consisted of 1, 775 males and 2, 433 females patients suffering from other pain-producing diseases. A questionnaire about their pain was used and items characteristic of pain from third molar pericoronitis were statistically extracted. The properties of pain, such as the specific areas of the organic nature, reserved judgment and non-organic nature, were examined using classification charts of organic and inorganic pains constructed from a pain questionnaire. When the characteristic items of the whole third molar pericoronitis group were examined for specific areas, the pain experienced by the group as a whole was classified as organic pain. In the future, the nature of pain in individual cases of third molar pericoronitis will be analyzed. Research has been planned to examine the actual state of pain and the reasons why pain in third molar pericoronitis, which is of an organic nature, may express non-organic features.

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[in Japanese]

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