Oral function declines in older individuals due to disease and age-related changes, making them vulnerable to oral and physical frailty. Therefore, it is important to manage the decline in oral function in older outpatients. Oral hypofunction is diagnosed by seven tests related to oral function, oral hygiene, oral moisture, occlusal force, oral diadochokinesis, tongue pressure, masticatory function, and swallowing function. However, sex or age were not factored into the current reference values of these tests. We included subjects attending the dental hospital clinic for maintenance, and recorded and analyzed oral hypofunction and the factors associated with its diagnosis. Of the 134 outpatients (53 males and 81 females, mean age 75.2 ± 11.2 years), 63% were diagnosed with oral hypofunction. Oral hypofunction prevalence increased significantly with age, and significant variations were observed in all tests. Furthermore, oral hygiene and swallowing function were not associated with oral hypofunction diagnosis. All examined factors decreased with increasing age, even after adjusting sex, except for oral hygiene and moisture. Occlusal force and masticatory function were higher in men after adjusting age. This study suggested that older outpatients were likely to be diagnosed with oral hypofunction, and that the test reference value and their selection for oral hypofunction should be reconsidered.

Weherein report a case of aceruloplasminemia in a 27-year-old man who had a 10-year history of diabetes mellitus. The patient developed a convulsion, most likely as a result of hypoglycemia. Unexpectedly, this episode left him in a prolonged state of unconsciousness, which necessitated neurological testing and imaging. Brain MRI showed bilateral hypo-intensities in the basal ganglia and thalamus. Molecular analysis revealed a novel splicing mutation in the ceruloplasmin (CP) gene that would result in the skipping of exon 3 during transcription. This case suggests that diabetes associated with aceruloplasminemia can becomemanifest in the teens. (Internal Medicine 42: 599-604, 2003)

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Objective To clarify the effect of oral health guidance on tongue‐lip motor function in the outpatients visiting the Showa University Dental Hospital (Tokyo, Japan). Background The management of the oral function of older people visiting a dental hospital is important. Previous studies have revealed that tongue‐lip motor function is easy to improve. However, the impact of oral health guidance on tongue‐lip motor function in the outpatients of dental hospital requires further elucidation. Materials and Methods The participants (n = 35) included patients who were diagnosed with low tongue‐lip motor function on evaluation by oral diadochokinesis (ODK) at the outpatient clinic. They underwent a second examination approximately 6‐12 months later. Their demographic characteristics were recorded. Oral health guidance was provided through an educational leaflet on oral hypofunction when the participants visited the clinic. It included content on tongue twisters, voice training and a range of movement and muscle training of the tongue and lip. Results Following oral health guidance on tongue‐lip motor function, the ODK values changed from 5.6 at the first examination to 6.0 at the second for /pa/, from 5.6 to 5.8 for /ta/ and from 5.2 to 5.4 for /ka/. This improvement was not significantly associated with age, sex, measurement period or number of visits. Conclusion The findings of this longitudinal study suggested that oral health guidance using an oral hypofunction educational leaflet may be effective in improving the tongue‐lip motor function of outpatients who had low tongue‐lip motor function, regardless of the measurement period or the number of visits to the dental hospital.

The expression of nitric oxide synthase (NOS) in human gynecological cancers, including ovarian cancers, uterocervical cancers, and endometrial cancers for example, was examined by the reverse transcriptase/polymerase chain reaction, coupled with Southern hybridization and by immunohistochemistry. Nitric oxide synthase II (NOS II), an inducible form, was expressed in more than 90% of the cancers. Nitric oxide synthase I (NOS I), a neuronal form, was expressed in 58% of all the ovarian cancers, in which the serous type is found more frequently (5 out of 7) than the mucinous type (2 out of 6), and in all clear-cell cancers. The frequency of NOS I expression in uterocervical cancers and endometrial cancers was relatively low. Nitric oxide synthase III (NOS III), an endothelial form, was detected in 25% of ovarian and 33% of endometrial cancers, while no expression was detected in uterocervical cancers. In terms of cancer types, all clear-cell adenocarcinomas and most of the serous-type adenocarcinomas expressed both NOS I and NOS II, while most uterine squamous carcinomas and endometrial adenocarcinomas expressed only NOS II. However, there was no correlation between the frequency of NOS expression and patients' age or the clinical stage of the disease. Since NO increases vascular permeability and blood flow, the high frequency of NOS expression in gynecological cancers may serve to stimulate and promote tumor growth.