MITSUYOSHI YOSHIDA

ABSTRACT Objective We aimed to examine the effects of oral care in patients with terminal cancer approaching death. Background Patients with terminal‐stage cancer often experience symptoms like oral dryness and candidiasis. Previous studies showed that without professional dental care, oral hygiene significantly worsens within 3 weeks before death. Therefore, oral management is essential for patients with terminal cancer. However, the specific effects of oral hygiene in these patients remain unclear. Material and Methods Twenty patients were admitted to two palliative care units at our institution between June 2022 and May 2023 and received oral care multiple times before death. Oral hygiene was assessed using the Oral Health Assessment Tool (OHAT), and oral dryness was evaluated with an oral moisture checker. The Face Rating Scale (FRS) was assessed before and after professional oral care. Results During the week of death, the number of people who were able to speak and follow instructions decreased, while the number who used sedatives and oxygen increased. There was no significant difference in the degree of oral dryness before oral care between the time of hospitalisation and the week of death. However, oral dryness improved significantly after oral care at admission (before: 21.0 ± 8.3, after: 26.7 ± 3.2) and the week of death (before: 16.8 ± 8.4, after: 25.8 ± 3.7). There was no difference in the time taken for oral care or FRS scores at admission and the week of death. Conclusion Continuous oral care in patients with terminal cancer can prevent worsening oral hygiene and maintain moisture.

This study investigated the swallowing dynamics of jelly, thickened liquid, and thin liquid in selected stroke patients who exhibited near-normal swallowing function with screening tests. Videofluoroscopic examination compared the pharyngeal transit time (PTT), pharyngeal delay time (PDT), and laryngeal elevation delay time (LEDT). Of 175 patients (104 men, 71 women; mean age: 68.6 ± 12.0 years) evaluated, 24 (13.7%) experienced aspiration, significantly prolonging LEDT in swallowing thin liquid. PTT did not differ in swallowing jelly, thickened liquid, or thin liquid among the patients who did not aspirate. However, in two-phase analysis of PTT, performed before and after the jelly passed the epiglottis, the former was significantly prolonged, whereas the latter was significantly shortened. PDT was significantly longer with jelly than with thickened and thin liquids. LEDT was significantly longer in swallowing thin liquids. Apparently, the thin liquid reached the pyriform sinus before maximum laryngeal elevation, posing a risk of laryngeal penetration and aspiration during swallowing. A thicker liquid prolonged the time taken to reach the pyriform sinus, reducing aspiration risk. Moreover, oropharyngeal passage of jelly took longer, triggering the swallowing reflex around the vallecula and allowing the jelly to pass through the hypopharynx after laryngeal closure.

ABSTRACT Background There is growing interest in the relationship between oral function and lifestyle‐related diseases. Objectives This study aimed to investigate the associations between the results of oral function tests and those of blood tests for lipid abnormalities, glucose metabolism and kidney function. Methods A total of 118 individuals aged ≥ 50 years (80 men and 38 women) who had undergone health check‐ups at our hospital in 2021 and 2023 were examined. Based on the fasting blood glucose (GLU), HbA1c, high‐density lipoproteins (HDL), low‐density lipoproteins (LDL), urea nitrogen (BUN) and estimated glomerular filtration rate (eGFR) values obtained from the health check‐up results; the subjects were divided into two groups: those with test values outside the reference range in 2021 and/or 2023 and those with test values within the reference range. The results of seven oral function tests were compared between the groups using the Mann–Whitney U test. p < 0.05 was considered significant. Results The group with GLU and HbA1c values outside the reference ranges had significantly lower numbers of remaining teeth (RTN) and oral diadochokinesis (OD) values compared to the group within the reference range. The groups with HDL and LDL values outside the standard ranges had a significantly higher tongue coat index (TCI) and significantly lower OD. Significant differences in TCI and OD/ta/ /ka/ were observed between BUN groups within and outside the reference range. Likewise, significant differences in TCI, RTN and OD/ta/ /ka/ were observed between eGFR groups within and outside the reference range. Conclusions Subjects with blood test values outside the reference range exhibited a decline in oral function, indicating that a decline in oral function might increase the risk of lifestyle‐related diseases and facilitate the progression of frailty.

Abstract Introduction Velopharyngeal insufficiency (VPI) in cleft palate patients often requires surgical intervention. This study evaluates the effectiveness of four‐dimensional computed tomography (4D‐CT) in assessing velopharyngeal function (VPF) pre‐ and postoperatively. Case presentation Four pediatric patients with cleft palate underwent 4D‐CT imaging before and after surgery. Velar length, thickness, elevation angle, and minimum cross‐sectional area were measured during sustained phonation. Conclusion 4D‐CT provided detailed imaging without patient discomfort, allowing both qualitative and quantitative analysis. While surgery improved velopharyngeal motion in most cases, further research is needed to understand the relationship between structural changes and hypernasality outcomes.