上顎骨の顎矯正手術後の移動のうち，最も術後安定性を得にくいのは下方移動である。今回重度の反対咬合を有する上顎骨劣成長の片側性唇顎口蓋裂症例に対し，Le Fort Ⅰ型骨切り術による下方移動後にメッシュプレートにより骨片固定を行い良好な治療結果が得られたので報告する。
患者は初診時年齢21歳4ヶ月の左側唇顎口蓋裂の女性。前歯の反対咬合と鼻部の変形を主訴として明海大学病院に来院した。顔貌はconcave profileを呈し，中顔面の陥凹と顔面高の短小を認めた。骨格系は，上顎骨劣成長（SNA：66.5°）による骨格性下顎前突（ANB：－10.5°）を呈していた。左側に未閉鎖の顎裂を認めた。
22歳4ヶ月時に顎裂部骨移植を施行した。術前矯正治療後の24歳2ヶ月時に，Le Fort Ⅰ型骨切り術を施行した。上顎左側と右側で各々5.0mmと2.0mmの前方移動と，両側5.0mmの下方移動を行った。骨片間に空隙が生じたため，強固なチタン製メッシュプレートとスクリューによる固定を行った。術後1年9ヶ月経過後の評価では，上顎骨の前下方移動は良好に維持されていた。25歳9ヶ月時に耳介軟骨移植術および鼻唇溝皮弁による外鼻再建術を施行し，鼻尖は前方へ移動し扁平な鼻形態も改善した。

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2011年3月11日に発生した東日本大震災により、日本は東北地方太平洋沿岸部を中心として、物的にも人的にも甚大な被害を被った。この状況の下、多くの政治家や有識者からはこの被害からの復旧を足掛かりとして、日本全体の復興へとつなげるべきとの意見が出され、政府もその方針を踏襲しようとしている。しかしながら、現在の日本の政情は継続的な改革がままならないほどの脆弱性を有しており、日本全体の復興に向けた力強い構想や戦略を打ち出すことができるのか、甚だ疑問の残るところでもある。そこで本稿では、政治的な脆弱性に打ち勝つことのできる構想や戦略を導くためのフレームワークを提言し、継続的な復興を成し遂げることのできる政策の立案に寄与したい。

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上下顎骨の著しい不調和を生じる骨格性不正咬合に対し，顎矯正手術を伴う外科的矯正治療が適応となる．この顎矯正手術では咬合の機能的改善のみならず，顔貌の形態不調和の改善も重要である．本研究では，非被曝かつ短時間で三次元撮影が可能であるハンディタイプ3Dカメラを用いて上下顎移動術前後の鼻口唇形態の変化について検討することを目的とした．対象は骨格性下顎前突の診断のもと顎矯正手術を行った女性患者10名とし，3Dカメラを用いて手術前後の顔面軟組織形態を測定し，その変化について統計的な処理を行った．その結果，鼻翼幅の増加，鼻孔の長径の減少およびNasolabial angleの増加などを有意に認め，顎骨の移動に伴い外鼻形態の変化が生じることが明らかとなった．今後，コーンビームCT（以下，CBCT）を用いた術前のシミュレーションと合わせて3Dカメラによる軟組織の分析評価を併用することで，患者の主訴の改善および，より精度の高い外科的矯正治療が可能となることが期待される．

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To reduce degree of freedom of Strawberry-Harvesting Robot for Elevated Cultivation, this study is an investigatation to limit direction of harvest approach to inside of planter. To show validity of this proposition, we investigated approachable angle for 55 of ripe strawberries. The result of this investigation shows Inside-Harvesting-Approach is enough to practice use. In addition, about 90 % strawberries are approachable even if we limit direction of harvest approach to back of the strawberry.

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Lemierre’s syndrome is a rare serious systemic infection that is accompanied by thrombophlebitis of the internal jugular vein and septic embolism triggered by an infection of the head and neck. We report a case of Lemierre’s syndrome which developed after infected root canal treatment. The patient was a 53-year-old man who had worsening swelling of the left cheek since infected root canal treatment performed 4 days earlier. The patient was urgently admitted to the otorhinolaryngology department of our hospital because of suspected cellulitis in the left cheek. Our department was consulted to identify the source of the infection. He had swelling and redness from the left cheek to the periorbital area. Intraoral findings showed that the left mandibular first molar was undergoing root canal treatment, but no inflammation was found in the surrounding gingiva. Blood tests revealed a high inflammatory response with WBC 13,600/μl and CRP 25.98mg/dl. A panoramic radiograph showed an apical lesion on the left mandibular first molar. Contrast-enhanced CT showed thrombotic embolism in the left internal jugular vein and external jugular vein. Based on the above, antibacterial therapy was started with the diagnosis of Lemierre’s syndrome due to dental infection, and the left mandibular first molar, which was the causative tooth, was extracted under local anesthesia. When anticoagulant therapy was started at the same time, the condition improved over time.

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北海道石狩地方で野生化したアライグマ(Procyon lotor)260個体のうち13個体からオーシストが検出され,少なくとも,Eimeria procyonisに近似の種(E. cf. procyonis)とIsospora ohioensisが同定された。日本で野生化したアライグマにおけるEimeria属オーシストの確認はこれが初めてである。また,I. ohioensisのオーシストのアライグマから確認は初報告と考えられる。ラテックス凝集反応によるトキソプラズマToxoplasma gondiiの血清抗体検査により,陽性率13.5%から15.0%を得たが,アライグマの原産地である北米に比べ低めであった。

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Objective: Two-jaw surgery is often performed in patients with facial asymmetry to improve malocclusion and facial esthetics. However, undesired changes of the nasal morphology may collaterally occur due to repositioning of the maxillary bone. The purpose of this study was to investigate the influence of two-jaw surgery on nasal morphology in orthognathic patients with facial asymmetry using 3-dimensional computed tomography (3D-CT) image analysis.
Materials and Methods: Twelve patients (7 females and 5 males, mean age at the time of surgery: 24.3±5.9 years) with facial asymmetry who had undergone two-jaw surgery were enrolled. Pre-surgical facial 3D-CT images (T₁) were superimposed on images obtained 4 months post-surgery (T₂) using 3D imaging software. The 3D coordinate system constructed by Frankfurt horizontal (FH) plane was used for the analysis, including the frontal plane, incorporating orbits on both sides, and the sagittal plane, intersecting at the midpoint between the orbits. After superimposing the T₁ and T₂ images, soft-tissue 3D-CT images were reconstructed, and changes in external nasal morphology were analyzed. Furthermore, linear and angular measurements of hard and soft tissues, as well as measurements of the external nasal aperture area were obtained and compared between T₁ and T₂.
Results: T₂ images showed anterior placement of nasal area soft tissues resulting in widening of the nasal wing, and a significant reduction in canting of the alar base and the lip. The external nasal aperture area was similar between the shifted and non-shifted sides at T₁. At T₂, the nasal aperture was significantly increased in both the shifted and non-shifted sides, but the aspect of change was the same. Positive correlations were seen between the horizontal/vertical movement of ANS and nasal soft tissues, and between the cant of the occlusal plane and the alar base.
Conclusion: The study showed that two-jaw surgery is an effective treatment modality for patients with facial asymmetry. However, since nasal area soft tissues were correlated with movement of ANS, the effect of maxillary movement on nasal soft tissues must be considered when making the treatment plan.

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In mandibular protrusion cases who undergo short lingual osteotomy（SL）, interference between the distal mandibular segment and medial pterygoid muscle（MPM）is occasionally seen at setback operation. The interference causes posterior deviation of the mesial mandibular segment and affects the postoperative stability. Thus, the relationship between the MPM and the mesial segment was examined three-dimensionally using preoperative CT images.
In this study, 18 cases of mandibular protrusion（7 males and 11 females, average age at first visit: 22.4 years old）who visited Meikai University Hospital were examined. All cases were not affected by any congenital anomalies, and the lateral deviation of Me was within 3mm. Lateral cephalograms were taken immediately before surgery（T1）, less than 5 weeks after surgery （T2）, and more than 1 year after surgery（T3）. CTs were taken at T1. Seven of the 18 cases showed postoperative anterior relapse of more than 2.0mm at Me from T2 to T3（group U）. The relapse of the other 11 cases（group S）was 2.0mm or less. Using DICOM data of CT, MTM was reconstructed three-dimensionally, and the relationship with the mesial mandibular segment was analyzed.
There was no significant difference in the amount of mandibular setback and decrease in SNB angle between group S and group U from T1 to T2. Group U, but not group S, showed posterior deviation of the mesial mandibular segment from T1 to T2. MPM was significantly inclined less laterally in group U than group S at T1, indicating that cases in group U exhibited closer proximity of MPM to the mandibular ramus.
These findings suggest that the proximity of MPM to the mandibular ramus at T1 is one of the risk factors causing interference, and affects the postoperative stability when performing SL. Simulation of MTM, together with the mandible, is informative in predicting postoperative stability at SSRO.

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Facial morphology improvements are obtained following two-jaw surgery in mandibular protrusion patients. Changing external nasal morphology does not always lead to good results in all patients. In this study, using 3-dimentional computed tomography (3D-CT), we examined the changes of external nasal morphology of patients who had undergone two-jaw surgery to correct mandibular protrusion. Seven adult patients (5 male; 2 female) who had been treated by two-jaw surgery associated with upward transposition of the posterior maxilla were enrolled in this study. 3D analysis software superimposed 3D-CTs of the pre-operative and post-operative stages (at least 6 months after surgery) on the hard tissue surfaces. We employed the 3D coordinate system constructed by Frankfort horizontal (FH) plane, the frontal plane incorporating the orbitals on both sides and the sagittal plane intersecting at the midpoint between the orbitals. After superimposition, soft tissue images of 3D-CT were reconstructed and changes in external nasal morphology were three-dimensionally analyzed. 3D geographical analysis, linear and angular measurements were performed for the most inferior points on the nasal alar (LBi, RBi) on bilateral sides, the most anterior point on the nose (Prn), the most anterior point on the columella of the nose (Cm), the most posterior superior point on the nasolabial curvature (Sn) and the most anterior point on the convexity of the upper lip (Vu). Correlation of hard tissue and soft tissue changes were statistically analyzed by Spearman's rank correlation analysis.
LBi and RBi moved anterior according to the anterior movement of point A. Increase in distance of both LBi and RBi and angle of LBi-Prn-RBi were observed. We found significant increase in the area of external nasal aperture. Positive correlation was seen between the anterior movement of point A and the distance of LBi and RBi.
These results imply that our superimposition of CT images using the 3D coordinate system are useful to compare soft tissue changes before and after surgery. Further investigation for more information about the factors that influence facial morphology changes is necessary since the changes may not be uniform due to the individual variety of soft tissue characterization, and the direction and amount of maxillary movement by Le Fort I osteotomy.

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