Cross-Sectional Inverse Association of Regular Soy Intake with Insulin Resistance in Japanese Elderly

Levels of isoflavones, biomarkers of soy intake, in 24-hour urine (24U) were inversely related to coronary heart disease (CHD) mortality in the World Health Organization's Cardiovascular Disease and Alimentary Comparison Study. Considering 24 U isoflavone levels were highest and CHD mortality was lowest in the Japanese, who maintained the world's longest life expectancy, the association of regular soy intake with cardiometabolic risk was investigated in Japanese adults (20-49 years old) and elderly (50-79 years old). In multivariate analysis adjusted for age, sex, and drug treatments, mean 24 U isoflavone excretion was significantly inversely associated with insulin resistance in the elderly and significantly associated with blood folate and potassium in the elderly, but also positively associated with 24 U salt in the elderly. These findings indicate that low-salt soy should be recommended to improve glucose metabolism in elderly Japanese.

Vertical symphyseal osteotomy

For the treatment of mild crossbite with increased bigonial distance, the authors performed a vertical symphyseal osteotomy on six patients in the last 3 years. Three of these patients had cleft lip deformities and the others had operations for orthodontic or aesthetic reasons. After exposing the mandible through the buccal mucosal incision, both premolars were extracted with or without conventional segmental osteotomy. The two vertical symphyseal osteotomies were performed with approximately 1 cm between them, and the central part of the mandibular bone was discarded. The bilateral segments of the mandibular body were fixed in the midline using titanium miniplates. Satisfactory results were obtained with a reduction in the size of the mandibular arch, which produced better three-dimensional proportions in the bimaxillary area. No patients had temporomandibular joint problems, however postoperative orthodontics were essential for this type of operation.

Three-dimensional analysis of craniofacial bones using three-dimensional computer tomography

We studied the three-dimensional (3D) deformities in patients with congenital facial anomalies, such as cleft lip and palate or hemifacial microsomia using three-dimensional CT (3DCT) images. At the same time, the data from the 3DCT was processed and analyzed using a 3DCT measurement system which we have recently developed. The coordinates of the 67 test points on the craniofacial bones were determined on a 3D image prepared by the 3DCT measurement system. Using this system, we prepared the 'skeletograms', which present deformities of craniofacial bones in detail as a 3D wire frame model, for detailed analysis of the craniofacial bones' deformities.

[Three-dimensional morphological analysis for craniofacial deformity]

Morphological analysis of the craniofacial deformity has been performed by cephalometric radiography, but even with this method, it is difficult to analyze the cases with complicated deformity. The purpose of the present study is to develop the new 3-D CT morphological analyzing system in order to investigate complicated craniofacial deformity. Using the 67 landmarks, we established the 3 D line drawing method. Then the reproducibility of the landmarks were examined and the clinical cases were investigated. The measurement of landmarks were carried out 10 times by the same operator, and standard deviation of 67 landmarks were calculated. Some landmarks which were difficult to identify showed high value of standard deviation. However, it was almost same value between standard deviation of most of the landmarks and the CT system error. Therefore, location of landmarks in the system were found to be reproducible. This new analyzing system was performed in clinical cases with craniofacial deformity. In such cases, cranium deformity and complicated deformity such as twist-form arrangement of cranium, maxilla and mandible were detected. The 3-D CT morphological analysis is effective for analyzing severe craniofacial deformity which was impossible to recognize with conventional cephalometric analysis.

[The clinical study on occurrence of TMJ dysfunction in orthodontic patients]

Occlusal disharmony is considered to be the most significant factor of temporomandibular joint (TMJ) dysfunction, but the relationship between malocclusion and TMJ dysfunction has been unknown yet. The purpose of present study was to investigate the relationship between TMJ dysfunction and occlusal disharmony (eccentric occlusal contacts and functional shift of the mandible) in orthodontic patients. The subjects were 533 orthodontic patients, 209 males and 324 females, who were received at the Department of Orthodontics, School of Dentistry, Hokkaido University from April 1985 to March 1988. Their ages ranged from 8 to 38 years old. All were prior to orthodontic treatment. The results were as follows 1. The prevalence of TMJ dysfunction was 27.6%, 24.9% in males and 29.3% in females. The difference was insignificant between males and females. 2. The patients with TMJ dysfunction increased after 13-15 years old, corresponding to dental age IV A (Hellman's classification). 3. In patients with TMJ dysfunction, the highest frequency of symptom of TMJ dysfunction was joint sounds (77.6%), the second was pain (22.4%), the third was disturbance of mandibular movement (4.8%). The complication of those symptoms were compounded in 26.3% of the total patients. 4. The prevalence of TMJ dysfunction had no relation to specific malocclusion and maxillofacial morphologic characteristic. 5. Most patients with TMJ dysfunction had occlusal disharmony (95.9%). 6. Eccentric occlusal contacts were found most frequently in patients with open bite and functional shift of the mandible was found most frequently in patients with deep bite. From these findings, the prevalence of TMJ dysfunction was frequent in orthodontic patients, however the symptoms were objective and the patients were not aware of TMJ dysfunction. TMJ dysfunction had no relation to specific malocclusion but some kinds of occlusal disharmony were easy to occur in specific malocclusion and TMJ dysfunction was induced by those etiological factors.

[Hyoid bone position and airway accompanied with influence of head posture]

The position of hyoid bone has been analyzed using roentgenogram. But, due to the great variability with the change of head posture, the position could not be determined correctly. In the present study, we investigated the influence of head posture to the position of hyoid bone. Subjects consisted of 32 Japanese males, those mean age was 25.8 years. Lateral cephalograms had been taken for each subjects at 5 different head posture. The findings were as follows. 1. Superimposed on SN plane, hyoid bone moved along the line of menton to 4th cervical vertebrae (C4) with the change of head posture. The hyoid bone moved in parallel with the line of 3rd cervical vertebrae (C3) to C4 (cervical plane). In spite of these movements, RH kept an uniform ratio. 2. The distances between sella turcica and hyoid bone and between C3 and hyoid bone, and the angle between menton, porion and hyoid bone, were at constant value. 3. Some measurements included the distance between hyoid bone and menton and the angle between nasion, sella turcica, hyoid bone showed very high correlation with the change of head posture. 4. EpPW1 (the width of airway) and the distance from C4 to hyoid bone showed almost the same change. It means the position of hyoid bone has a great influence on airway.