We used gaze­point analysis to clarify the degree of gazing at the mouth region in closed ­lip and smiling facial photographs. Eye­tracking for 20 subjects was performed while they looked at facial images. Measurement sites were set at the eyes, nose and mouth of the images. We investigated heat maps of the total gaze point retention time, the percent­ age of subjects with initial gaze points at each measurement site, and gaze point reten­ tion times at each site. For all investigated items, the subjects gazed at the mouth in smiling faces more than in closed­mouth faces. The gaze point retention time for the eyes in the smiling faces was significantly shorter than that in the closed­mouth faces,and the gaze point retention time for the mouth in the smiling faces was significantly longer. We found that the subjects gazed at the mouth of the smiling faces for a longer time than at the closed­mouth faces. (J Osaka Dent Univ 2017;51:73­-79)

Application of aroma inhalation is likely to enhance antimicrobial action. We studied the influence of sympathetic nerve stimulation and aroma inhalation on both SIgA and lac­ toferrin secretion in the rat submandibular gland. We found no spontaneous secretion from the submandibular gland in the control rats. Although the flow of the saliva evoked by black pepper and cardamom was very small in volume, a marked saliva secretion was found evoked when isoprenaline stimulation was combined with black pepper or carda­ mom inhalation. Significant secretion of SIgA and lactoferrin was not obtained with black pepper or cardamon inhalation alone. However, there was considerable secretion of SIgA and lactoferrin induced when isoprenaline stimulation was combined with black pepper inhalation. The salivary amylase activity induced by aroma inhalation was approximately 10% that of isoprenaline stimulation alone. Combined use of the two enhanced salivary amylase activity compared with stimulation by isoprenaline alone. Their combined use had a syn­ ergistic effect. These results suggest that the use of aroma inhalation enhances salivary antibacterial activity, and that this activity may be induced by the sympathetic nervous system. In ad­ dition, aroma inhalation imparts a greater effect on SIgA and lactoferrin secretion than does solitary sympathetic stimulation alone. We hypothesized that aroma inhalation might positively influence the intraoral environment. (J Osaka Dent Univ 2017;51:81-88)

We did a retrospective study of the initial medical interview and blood screening exami­ nation of patients with dry mouth syndrome. We selected 330 patients (51 males and 279 females) between 27 and 102 years of age with an average age of 67 years. In addition,we determined if there were any previous and/or present systemic diseases, and if the patients regularly took medicine. The largest number of subjects were in the 71 to 80 years age bracket 37.0% (122/330), and the male/female ratio was 51:279 (15.5% : 84.5%). The higher outrange ratio of mean corpuscular volume (MCV) was 36.7% (121/330) and the lower was 12.4% (41/330). The higher outrange ratio of mean corpuscular hemoglobin (MCH) was 36.7% (121/330), and the lower was 8.2% (27/330). The ratio of abnormal meas­ urements of RF was 10.3% (34/330), while the ratio of abnormal measurements of iron was 37.9% (125/330). Abnormal measurements for zinc were 13.9% (46/330), 37.6% (124/330) for hypertension, and 12.4% (41/330) for gastroesophageal reflux disease. Hyperlipi­ daemia was 11.8% (39/330) and diabetes mellitus was 7.0% (23/330). The percentage of patients taking minor tanquilizers was 16.4% (54/330), while 7.9% (26/330) were taking H2 blockers. It appears that anemia might be an important initial screening factor for dry mouth syndrome. (J Osaka Dent Univ 2017; 51: 89­-93)

In order to measure the exposure of medical care workers to sevoflurane, we established a method to determine its level in the air of operating rooms, which may be polluted with anesthetic gas. The level was measured using a gas chromatograph with an electron cap­ ture detector (ECD). Vacuum sampling bottles were filled with air, and sevoflurane was vaporized in the bottles. In Experiment 1, we measured the sevoflurane concentration. The peak area was calculated using data analysis software. Statistical analysis was per­ formed and a favorable correlation was observed. In Experiment 2, we investigated the optimum measurement condition of sevoflurane. Changes in the peak area with changes in the sample inlet temperature were investigated. Statistical analysis showed that the peak area at 200°C was significantly larger than those at other temperatures. (J Osaka Dent Univ 2017; 51: 95­-98)

Japan has become a super­aged society at a precipitous rate in recent years, and there is a need for comprehensive care targeting the ever­increasing number of elderly and others requiring care. There is also a growing awareness in medical settings that mainte­ nance of satisfactory intraoral conditions and function is linked to whole body health. Consequently, there is a need for implementation of oral care that will allow the elderly and persons requiring care to enjoy their meals. In addition, a system is needed that en­ compasses both the fields of medicine and dentistry for treatment of perioperative and terminal stage patients. In both situations, the dental hygienist plays a central role. This study used the results of national statistical surveys carried out by the Japanese Ministry of Health, Labour and Welfare to clarify the employment status of dental hygien­ ists. We also evaluated the status of treatment and guidance performed by dental hygien­ ists in medical settings and investigated the future supply and demand for dental hygien­ ists. The results showed that almost half the individuals who pass the national examination to qualify as dental hygienists do not find employment in this field. In subgroup analysis stratified by age, the number of new graduates who leave their job in dental hygiene within three to four years of starting, or who do not start work, is increasing. The rea­ sons for this low employment rate must be determined. At the same time, the number of dental hygienists over 30 years of age who are employed is increasing, and this is par­ ticularly true for those over 50 years of age. The supply and demand for dental hygien­ ists should be studied. An understanding of the reemployment of qualified dental hygien­ ists should include how improvements in their work­life balance might allow them to make use of their qualifications throughout their working lives. Approximately 90% of dental hygienists currently work at dental clinics ;however,growth in the number of these clinics has recently shown signs of slowing. In addition,the number of dental hygienists per clinic is increasing very slowly. Nonetheless, the de­ mand for dental hygienists at the frontline of medicine and medical care is increasing due to the growing recognition of the need for specialized intraoral management during the perioperative period in hospitals and other health care settings. The demand for den­ tal hygienists will probably continue to increase in the future. (J Osaka Dent Univ 2017; 51: 99­-104)

Invasion of lymphocytes and other immunocompetent cells have been confirmed in in­ flamed periodontal tissue such as occurs with chronic periodontitis. Local immune re­ sponses by NK cells and other immunocompetent cells are considered a factor in the progression of periodontal disease. Although IL-17 participates in various cells and is in­ volved in various inflammatory pathologies, the effect of IL-17 on NK cells is not clearly understood. In a previous study, we reported that IL-17 stimulation (50, 100, 200 ng/mL) suppresses the cytotoxicity of NK92 cells. In this study, we investigated mechanisms of intracellular signal transduction pathways that suppress the cytotoxicity of IL-17 stimu­ lated NK92 cells. We confirmed that NK92 cells expressed sufficient IL-17RA to induce in­ tracellular signaling transduction and cell function by FACS analysis. We confirmed that an even lower concentration of IL-17 (10, 20 ng/mL) suppresses the cytotoxicity on NK92 cells in our model. In this study, we examined the phosphorylation of MAPKs (ERK, JNK and p38) and GSK3­-βin NK92 cells stimulated with IL-17 (10, 20 ng/mL) for 5 min. The phosphorylation of ERK and JNK were not altered in the absence or presence of IL-17 stimulation. Phosphorylation of p38 was observed even in the absence of IL-17. However,phosphorylation of p38 in the absence of IL-17 was suppressed by IL-17 stimulation. GSK3­-βwas slightly phosphorylated in the absence of IL-17, while this phosphorylation was increased in the presence of IL-17. These results suggest that suppressing phosphoryla­ tion of p38 and increaseing phosphorylation of GSK3­βmay affect the intracellular sig­ naling mechanism that suppresses the cytotoxicity of IL-17 stimulated NK92 cells. (J Osaka Dent Univ 2017; 51: 105­-113)

The local immune response by NK cells is an important factor in the progression of peri­ odontal disease. Human NK cells are a homogeneous population that can be divided into five subpopulations based on the surface markers CD16 and CD56. We have confirmed that although NK92 cells do not express CD16, CD56 is highly expressed by FACS analy­ sis. This indicates that NK92 cells are classified as subpopulations of CD56^bright CD16^-.We performed FACS analysis after intracellular staining of intracellular granules and cytoki­ nes. We could not observe any effect of IL-12 family cytokines (IL­-23, IL­-27 and IL­-35),other than IL­-12 in perforin 1 and IFN­-γ production. These results suggest that IL­-23, IL­-27 and IL­-35 may not exert the same effect as IL-12 when stimulated alone in perforin 1 and IFN­-γ production, respectively. A small amount of granzyme B production was de­ tected by stimulation of IL-12, IL­-27 or IL­-35. However, granzyme B production by IL­-27 or IL­-35 stimulation was smaller than granzyme B production by IL-12 stimulation. These re­ sults suggested the possibility that IL­-27 or IL­-35 has an effect on granzyme B produc­ tion of NK92 cells. (J Osaka Dent Univ 2017; 51: 115-­123)

Bisphenol A (BPA) is a well-­known environmental endocrine disrupter. Previously, we re­ ported that perinatal low­-dose BPA impaired gender differences in the open­-field test and enhanced emotional responses in mature rat offspring. However, the influence of BPA on immature offspring remains unclear. In recent years, there has been an increased focus on childhood health risks, and BPA is no exception. In this study, we evaluated behav­ ioral and hormonal changes in pre­-weaning offspring. BPA was administered to pregnant rats from gestational day 14 to birth (15 μg/kg/day). The behavioral test utilized a novel apparatus consisting of a straight alley-­type field (6cm x 44cm x 15cm), and spontane­ ous behaviors (rearing, ambulation, grooming and immobility) were examined at 20 days of age. BPA exposure increased the frequency of rearing and decreased the duration of immobility compared to vehicle exposure. Additionally, BPA exposure increased ambula­ tion in male rats. Finally, basal levels of serum corticosterone were lower in BPA­ exposed rats than in vehicle­exposed rats, when measured at 24 days of age. We found that prenatal BPA exposure produced a trend of hyperactivity potentially related to a mild state of stress suppression in immature rats. (J Osaka Dent Univ 2017; 51: 125-­129)

Aging simulation­-based training provides an opportunity for the trainee to experience physical changes in the elderly. It has been shown to promote psychological empathy and enhance understanding of others. An aging simulation­-based training program was launched in the Department of Geriatric Dentistry at Osaka Dental University in fiscal year 2001 as a part of preclinical practice prior to clinical training in hospitals for stu­ dents who have completed their basic dental education. The data obtained was examined through quantitative text analysis using a combined approach and the open source text mining software KH Coder 2.00 e. Tabulations based on the coding rules ‹understanding of physical/psychological aspects›, ‹empathic understanding›, and ‹changes in self­ consciousness› accounted for 71.2%, 44.7%, and 34.8% of the responses, respectively. We objectively confirmed that the aging simulation­-based training program for dental stu­ dents enhancd their understanding of the elderly. In addition, it highlighted the impor­ tance of appropriate simulation procedures and the importance of the content of the training. (J Osaka Dent Univ 2017; 51: 131-­135)

We studied the prevalence of human papillomavirus (HPV) infections in patients with epi­ thelial dysplasia and squamous cell carcinoma of the oral mucosa, as well as the expres­ sion of p53, p53 (mutant type), Rb, p16, p21 and cyclin D1. The subjects were patients with irritation fibroma (IF), mild dysplasia (MiD), moderate dysplasia (MoD), severe dys­ plasia (SD), carcinoma in situ (CIS), well differentiated squamous cell carcinoma (WSCC) and poorly differentiated squamous cell carcinoma (PSCC) diagnosed at Osaka Dental University Hospital. Six patients, each with one of these conditions were examined. HPV was detected by in situ hybridization (ISH). Expression of p53, p53 (mutant type), Rb,p16, p21 and cyclin D1 was assessed by immunohistochemical staining (IHC). All cases were negative for HPV by ISH. For IHC, marked expression of p53 and mutant type p53 was seen in WSCC and PSCC. We could not detect expression of p21 in CIS,WSCC or PSCC. Marked expression of Rb and cyclin D1 was seen in CIS, WSCC and PSCC. We could not detect expression of p16 in WSCC or PSCC. The results suggested that HPV infections have low correlation with oral cancer. We found that p16 is a useful indicator of HPV infection. (J Osaka Dent Univ 2017; 51: 137-­144)

On completion of the English curriculum of Osaka Dental University School of Dental Hy­ giene, the students participated in a questionnaire. Results revealed that the second and third year students have very little confidence in conducting basic hygienist procedures in English with foreign patients. Based on the results and feedback from the question­ naire, the authors revised the English curriculum to feature chair­side role playing and video recording as opposed to conventional classroom instruction by listening and speaking. After the first year students completed this new curriculum, questionnaire re­ sults revealed a marked improvement in their confidence with English communication skills. (J Osaka Dent Univ 2017; 51: 145­-150)

The seating location in the classroom is thought to have a close relationship to the aca­ demic performance of each student. However, as teachers taking part in higher educa­ tion, we know that "common sense" must give way to many exceptional cases. To verify the truth of this widely held belief, we recorded the students' seating locations at a den­ tal hygiene college for many years, and correlated this information with their academic performance. As the rooms in which they were taught were identical, and the seating ar­ rangements were consistent throughout the years, it allowed us to analyze the data in a single environment. Many studies have reported that although students with poor grades sit in "low interaction" seats, students with good grades do not select "high interaction"seats, but rather prefer to occupy "moderate interaction" seats. Average or middle stu­ dents tended to have no favored location. We were not able to correlate each student's academic performance with her preferred seating location, especially in the case of high performing students. However, the pre­ ferred seating location for students with poor grades tended to follow commonly ac­ cepted norms which have been described in many reports. Our findings suggest that stu­ dents who are at risk of failing could be determined by where they sit in the classroom. This helps to identify the potentially unsuccessful candidates, and permits remedial ac­ tion at an early stage. (J Osaka Dent Univ 2017; 51: 151­-156)