PURPOSE: To investigate the biomechanical effect of marginal bone resorption (MBR) on the mandibular mini implant (MI)-retained overdenture (MI-OD) on the edentulous model. MATERIALS AND METHODS: The experimental mandibular edentulous model was modified from a commercial model with 2 mm thick artificial soft tissue under denture base. Two MIs (Φ2.6 mm x 10 mm) were bilaterally placed between the lateral incisor and the canine area and attached with magnetic attachments. Three groups were set up as follows: 1) alveolar bone around the MI without MBR (normal group), 2) with MBR to 1/2 the length of the implant (resorption group), and 3) complete denture (CD) without MI (CD group). Strain around the MI, pressure near the first molar area, and displacement of denture were simultaneously measured, loading up to 50 N under bilateral/ unilateral loading. Statistical analysis was performed using independent-samples t test and one-way ANOVA (α=.05). RESULTS: The strain around the MI with MBR was approximately 1.5 times higher than that without MBR. The pressure in CD was higher than in MI-ODs (P <.05), while there was no statistical difference between the normal and resorption group (P >.05). Similarly, the CD demonstrated a greater displacement of the denture base than did the MI-ODs during bilateral and unilateral loadings (P <.05). CONCLUSION The strain around the MI with MBR was approximately 1.5 times higher than that without MBR. The pressure on posterior alveolar ridge and denture displacement of MI-ODs significantly decreased compared to CDs, even when MBR occurs. Bilateral balanced occlusion was recommended for MI-ODs, especially when MBR occurred.

Objective: To introduce a successful experience of tapering high-dose opioids using spinal analgesia. Case: A 53-year-old man suffering from buttock-pain due to sacral metastasis of rectal cancer, was referred to our hospital for specialized cancer pain treatment and opioid reduction. At the time of admission, he was taking 5040 mg/day of oral morphine equivalent dose of opioids and NRS was still 10/10. Although the dosage was too high, an illicit transactions, diversion or psychological dependence were ruled out. Exacerbation of pain and tolerance formation due to the rapid increase of opioid dose seemed to be a vital factor. After admission, the high-dose opioid was gradually reduced while epidural and intrathecal analgesia were introduced. After 30 days of adjustment, the dose of systemic opioid was finally reduced to 120 mg/day (oral morphine equivalent) with 24 mg/day of intrathecal morphine at the time of transfer to his primary hospital. Conclusion: Cancer pain can result in high-dose opioids administration. Specialized pain treatment may be useful in weaning patients from high-dose opioids, but early concomitant use is recommended to avoid becoming high-dose opioid.

BACKGROUND/AIMS: Few studies are available that have investigated the risk factors for overlapping irritable bowel syndrome (IBS)-like symptoms in patients with inactive inflammatory bowel disease (IBD). The present study has 3 objectives: (1) to assess the prevalence of IBS-like symptoms in Japanese patients with inactive IBD using Rome III criteria, (2) to examine the relationship of IBS-like symptoms to health related quality of life (HR-QOL), and (3) to investigate associations for developing IBS-like symptoms in patients with inactive IBD. METHODS: IBS-like symptoms were evaluated using the Rome III questionnaire for functional gastrointestinal disorders. HR-QOL and hospital anxiety and depression scale were evaluated. RESULTS: IBS-like symptoms were found in 17.5% (7/40) of patients with inactive ulcerative colitis, 27.1% (29/107) of patients with inactive Crohn’s disease (CD), and 5.3% (23/438) of healthy control subjects. The QOL level was significantly lower and anxiety score was significantly higher in inactive CD patients with IBS-like symptoms than in those without such symptoms (P = 0.003, P = 0.009). Use of anti-anxiety drugs was associated with the presence of IBS symptoms (P = 0.045). HR-QOL score was lower and anxiety score was higher in patients with inactive ulcerative colitis, but the difference was not statistically significant. CONCLUSIONS: The prevalence of IBS-like symptoms in inactive IBD patients was significantly higher than in healthy controls. Inactive CD patients with IBS-like symptoms has low QOL and anxiety; suggesting that anxiety may be associated with symptom development in such patients.
Anti-Anxiety Agents ; Anxiety ; Asian Continental Ancestry Group* ; Colitis, Ulcerative ; Depression ; Gastrointestinal Diseases ; Humans ; Inflammatory Bowel Diseases* ; Irritable Bowel Syndrome ; Prevalence* ; Quality of Life ; Risk Factors