Jun-nosuke Narikawa

Usefulness of a commercial enzyme-linked immunosorbent assay kit for Candida mannan antigen for detecting Candida in oral rinse solutions.

OBJECTIVE The aim was to test the performance of a commercial enzyme-linked immunosorbent assay (ELISA) kit for Candida mannan antigen for detecting Candida in oral rinse solutions. STUDY DESIGN Forty-eight oral rinse solutions (38 from patients and 10 from healthy volunteers) were available. Mannan antigen was measured using a commercial sandwich ELISA kit, Unimedi Candida. The result of the mannan assay was compared with the result of conventional detection and identification by culture. RESULTS The result of the mannan assay revealed that 31 of 38 clinical and 3 of 10 healthy volunteer samples were positive for Candida. Using the culture as a gold standard, the overall sensitivity and specificity of the mannan antigen detection were 90.9% and 46.2%, respectively. CONCLUSIONS The results of this study suggested that mannan antigen detection might be a possible and sensitive technique for the detection of oral Candida. The conditions of the ELISA-based assay should be optimized for oral rinse solutions.

Three Cases of Oral Cancer in a Patient with Dementia-The Problems in Patient Management During Hospitalization-

高齢化社会を迎え, 痴呆症を有し口腔癌を発症する高齢者も増加してきている。この様な患者の治療は大変困難である。最近われわれは, 痴呆を有する高齢者の口腔癌患者を3症例経験し, 様々な治療上の問題点が明らかとなった。痴呆症を有する患者との意思の疎通は困難であり, 疾患・診療に対する理解が得られないため, 入院管理が非常に困難である。合併症や痴呆に起因する様々な要因により, 治療法の選択に制約がある。またさらに家族の治療への積極的な協力が得にくく, 治療はより難しくなる。痴呆を有する患者の治療方針を決定する際には, 腫瘍の進展度全身状態, 合併症だけでなく, 年齢, 痴呆の重症度患者のQOL, 家族の意向等を考慮することが重要であると考えられた。