BackgroundAssociations between temporomandibular disorder (TMD) and psychological variables, pain conditions, and daily activities have been reported more commonly in middle-aged individuals than in children. However, to determine factor-specific preventive programs for TMD, it is important to evaluate the associations between multiple factors and TMD symptoms during childhood. The aim of this study was to assess the relationship between TMD symptoms and other orofacial pain conditions, daily activities, and trait anxiety in a population-based cross-sectional survey of Japanese children and adolescents.MethodsA total of 1,415 subjects (11–15 years old) self-reported their TMD symptoms, headache, neck pain, and toothache, and completed questionnaire scales that assessed 15 daily activities. Trait anxiety was assessed using the State Trait Anxiety Inventory for Children-Trait (STAIC-T) scale. Subjects were dichotomized into a TMD group or control group, based on whether they reported at least 1 TMD symptom: the TMD group (≥1 TMD symptom, n = 182) and the control group (no TMD symptoms, n = 1,233). Data were analyzed using the chi-square test and multivariate logistic regression analysis.ResultsThe prevalence rates for headache and neck pain were significantly higher in the TMD group than in the control group (44.0% vs. 24.7% and 54.4% vs. 30.0%, respectively; both P < 0.001). The odds ratios for TMD symptoms in subjects with neck pain and frequent diurnal clenching were 2.08 (P < 0.001) and 3.69 (P = 0.011), respectively. Moreover, high STAIC-T scores were weakly associated with TMD symptoms.ConclusionsIn this young Japanese population, TMD symptoms were associated with other orofacial pain conditions, particularly neck pain, although they were only weakly associated with trait anxiety. Diurnal clenching was strongly associated with TMD symptoms. Health professionals should carefully consider these factors when developing appropriate management strategies for TMD in children and adolescents.

Traumatic acute subdural hematoma (ASDH) is a major clinical entity in traumatic brain injury (TBI). It acts as a space occupying lesion to increase intracranial pressure, and is often complicated by co-existing lesions, and is modified by cerebral blood flow (CBF) changes, coagulopathy, and delayed hematomas. Because of its complicated pathophysiology, the mortality of ASDH is still remaining high. In this review article, its epidemiology, pathophyiology, surgical treatment, and salvage ability are described. With regard to epidemiology, as the population ages, growing number of elderly patients with ASDH, especially patients with prehospital anticoagulant and antiplatelets, increase. Concerning pathophysiology, in addition to well-known initial intracranial hypertension and subsequent ischemia, delayed hyperemia/hyperperfusion, or delayed hematoma is being recognized frequently in recent years. However, optimal treatments for these delayed phenomenons have not been established yet. With regard to surgical procedures, all of craniotomy, decompressive craniectomy, and initial trephination strategies seem to be effective, but superiority of each procedure have not been established yet. Since Glasgow Coma Scale (GCS) scores, age, papillary reaction, and computed tomographic findings are strongly correlated to outcome, each factor has been investigated as an indicator of salvage ability. None of them, however, has been defined as such one. In future studies, epidemiological changes as population ages, management of delayed pathophysiology, superiority of each surgical procedures, and salvage ability should be addressed.

Summary: Mild to moderate hypothermia (30-33°C) re duces brain injury after brief «2-h) periods of focal isch emia, but its effectiveness in prolonged temporary isch emia is not fully understood. Thirty-two Sprague-Dawley rats anesthetized with 1. 5% isoflurane underwent 3 h of middle cerebral artery occlusion under hypothermic (33°C) or normothermic (37°C) conditions followed by 3 or 21 h of reperfusion under normothermic conditions (n = 8/group). Laser-Doppler estimates of cortical blood flow showed that intraischemic hypothermia reduced both postischemic hyperperfusion (p .;; 0.01) and post ischemic delayed hypoperfusion (p .;; 0.01). Hypothermia reduced the extent of blood-brain barrier (BBB) disrupWhen blood flow is restored after brief periods of focal ischemia, infarct size is smaller than after per manent occlusion (Jones et aI., 1981;Marcoux et al., 1982; DeGirolami et aI., 1984; Kaplan et aI., 1991; Memezawa et aI., 1992). Restoration of blood flow after prolonged ischemia, however, may ini tially result in hyperperfusion followed by sustained and progressive hypoperfusion, the extent of which depends on the severity and duration of the isch- 620tion as estimated from the extravasation of Evans blue dye at 6 h after the onset of ischemia (p .;; 0.01). Hypo thermia also r,educed the volume of both brain edema (p .;; 0.01) and neuronal damage (p .;; 0.01) as estimated from Nissl-stained slides at both 6 and 24 h after the onset of ischemia. These results demonstrate that mild intrais chemic hypothermia reduces tissue injury after prolonged temporary ischemia, possibly by attenuating postisch emic blood flow disturbances and. by reducing vasogenic edema resulting from BBB disruption. Key Words: Blood-brain barrier-Brain edema-Delayed postisch emic hypoperfusion-Focal cerebral ischemia-Hypo thermia-Postischemic hyperperfusion.

The purpose of this study was to identify and compare the perspectives of dental students towards their career choice and dental education in Japan and Sweden. One hundred and fourteen dental students from the Nippon Dental University, Japan and 43 dental students from the Karolinska Institutet, Sweden participated in this study. Information was derived from a self-answered questionnaire consisting of five items for career choice and six items for dental education. Chi-square test and Wilcoxon signed-rank test were used for comparison. Significant differences were detected for 10 questionnaire items between the two countries. Regarding motivation towards the career choice, 44% of Swedish students indicated interpersonal motives related to helping other people, whereas 32% of Japanese students indicated expectations of their family in the dental profession. As future career options, 64% of Japanese and 47% of Swedish students planned to work as general dentists. More Swedish students (37%) preferred specialisation than Japanese students (17%). Nearly three-quarters of the Swedish students were satisfied with the teaching faculty of their school, whilst only 32% of the Japanese students indicated content. The perspectives of dental students were different in Japan and Sweden. This study provides a description of the perspectives of Japanese and Swedish dental students and enables better understanding of career decision and dental curriculum issues.

The aim of this study was to identify and compare the attitudes of dental students toward their career choice and dental education in three different countries. Three hundred thirty-six dental students from the , participated in this study. Information was derived from a questionnaire consisting of career choice items and dental education items. Significant differences in the responses of the participants from each of the three countries were detected for each of the questionnaire items (P<0.001).Regarding factors that may have served as motivations for career choice, the majority of dental students from each country indicated positive reasons such as interpersonal motives, caring for other people, and academic interest. For future career options, the majority of Japanese and Canadian students planned to work as general dentists. Thai students were more likely than Japanese or Canadian to prefer specialization than practicing general dentistry. Nearly three-quarters of the Canadian and Thai students were satisfied with the teaching faculty of their schools, while only a quarter of the Japanese students indicated satisfaction. The findings from this study enhance our understanding of differences and/or similarities among dental students in three nations; this information may help to define strategies to improve the quality of international student exchange programs.