Eicosapolyenoic acids of serum lipids of Japanese islanders with low incidence of cardiovascular diseases

Japanese are unique among the peoples of developed countries in having a high intake of eicosapentaenoic acid (C 20:5) from fresh fish and this may in part contribute to their low incidence of cardiovascular diseases. Mass spectroscopic analyses of eicosapolyenoic acids (C20:3, C20:4 and C20:5) were carried out on the serum of aged persons living on Kohama island in Okinawa and known to have the lowest incidence of cardiovascular diseases in Japan. All but 4 of the 77 persons examined (73.94 +/- 7.81 years old) led active fishing-farming lives. The total amount of eicosapolyenoic acids in the serum of persons on Kohama island (46.77 +/- 7.46 mg/100 ml) was higher (p less than 0.001) than that in people on mainland Japan, owing to the higher intake of fresh fish (147.7 g/day). A positive correlation (p less than 0.01) was found between serum C 20:5 concentration (6.82 +/- 2.54 mg/100 ml) and high density lipoprotein concentration (55.38 +/- 13.83 mg/100 ml). In addition, there were positive correlations (p less than 0.01) between serum C 20:3 concentration (6.58 +/- 1.61 mg/100 ml) and total cholesterol (188.60 +/- 32.30 mg/100 ml), and triglyceride and skinfold thickness. The blood pressure level (p less than 0.01), incidence of abnormal ECG (p less than 0.05), and salt intake (6.2-8.3 g/day) estimated from urinalysis, were all lower than the average figures for Japanese of similar ages. No persons examined showed Q-wave on ECG. The percentage of smokers and drinkers were similar for Kohama island and mainland Japan.

Vascular abnormalities and elevated blood pressure in mice lacking adrenomedullin gene

BACKGROUND

Adrenomedullin (AM) is a vasodilating peptide involved in the regulation of circulatory homeostasis and in the pathophysiology of certain cardiovascular diseases. Levels of AM are markedly increased in the fetoplacental circulation during pregnancy, although its function there remains unknown. To clarify the physiological functions of AM, we chose a gene-targeting strategy in mice.

METHODS AND RESULTS

Targeted null mutation of the AM gene is lethal in utero: the mortality rate among AM(-/-) embryos was >80% at E13.5. The most apparent abnormality in surviving AM(-/-) embryos at E13.5 to E14.0 was severe hemorrhage, readily observable under the skin and in visceral organs. Hemorrhage was not detectable at E12.5 to E13.0, although the yolk sac lacked well-developed vessels. Electron microscopic examination showed endothelial cells to be partially detached from the basement structure at E12.5 in vitelline vessels and hepatic capillaries, which allowed efflux of protoerythrocytes through the disrupted barrier. The basement membrane was not clearly recognizable in the aorta and cervical artery, and the endothelial cells stood out from the wall of the lumen, only partially adhering to the basement structure. AM(+/-) mice survived to adulthood but exhibited elevated blood pressures with diminished nitric oxide production.

CONCLUSIONS

AM is indispensable for the vascular morphogenesis during embryonic development and for postnatal regulation of blood pressure by stimulating nitric oxide production.

Evidence for association between paraoxonase gene polymorphisms and atherosclerotic diseases

Paraoxonase 1 (PON1) is proposed to have an anti-atherogenic action. Two polymorphisms at the PON1 (M/L55 and Q/R192) have been shown to be associated with coronary artery disease (CAD). This conclusion is not drawn universally, however, and specific ethnic characteristics may be important determinants in this association. Recently two homologues of PON1 - PON2 and PON3 - were identified and Sanghera et al. demonstrated C/S311 polymorphism at PON2 was associated with the risk of CAD. Within that context, we investigated the association between the aforementioned three polymorphisms and CAD and ischemic stroke in a Japanese population. The study population included 431 control subjects, 210 CAD patients, and 235 ischemic stroke patients. Genotype distributions and allele frequencies of M/L55 and C/S311 were similar among the control and patient groups, whereas the R192 allele frequency was significantly higher (P<0.001) in CAD (75%) and ischemic stroke (76%) patients than in control subjects (65%). When confounding influences of other risk factors were controlled for by multivariate analysis, R192 remained an independent risk determinant (additive model: OR (95% CI), P value CAD: 2.01 (1.45-2.79), 0.0001; ischemic stroke: 1.84 (1.34-2.52), 0.0002 (three genotypes into calculation)). Taken together, our data indicate that the Q/R192 is principally associated with both CAD and ischemic stroke in Japanese.

Influence of phase transformation on the torsional and bending properties of nickel-titanium rotary endodontic instruments

AIM

To investigate the relationship between the functional properties and the phase transformation of nickel-titanium endodontic instruments.

METHODOLOGY

Five types of rotary nickel-titanium endodontic instruments with a 0.30 mm diameter tip (EndoWave, HERO 642, K3, ProFile.06, and ProTaper) were selected to investigate torsional and bending properties, and phase transformation behaviour. A torsional test was performed according to ISO publication 3630-1, and maximum torque and angular deflection at fracture were measured. Bending load of the instruments was measured in a cantilever-bending test at 37 degrees C with the maximum deflection of 4.0 mm. A stainless steel K-file was used for reference. Phase transformation behaviour was measured by differential scanning calorimetry (DSC). From the DSC curve, transformation temperatures were calculated. Data were analysed by anova and the Tukey-Kramer's test.

RESULTS

The maximum torsional torque values of HERO, K3 and ProTaper were significantly higher (P < 0.05) than those of EndoWave, ProFile and K-file. The K-files had the lowest torque value. Angular deflection at fracture was significantly higher (P < 0.05) for K-files than that for any nickel-titanium instrument. The bending load values of HERO and K3 were significantly higher (P < 0.05) than those of EndoWave, ProFile, ProTaper and K-file. The K-files had the lowest load value, although residual deflection remained. The transformation temperatures of HERO and K3 were significantly lower (P < 0.05) than those of EndoWave, ProFile and ProTaper.

CONCLUSIONS

The functional properties of nickel-titanium endodontic instruments, especially their flexible bending load level, were closely related to the transformation behaviour of the alloys.

Renal damage and salt-dependent hypertension in aged transgenic mice overexpressing endothelin-1

The recent development of endothelin-1 (ET-1) antagonists and their potential use in the treatment of human disease raises questions as to the role of ET-1 in the pathophysiology of such cardiovascular ailments as hypertension, heart failure, renal failure and atherosclerosis. It is still unclear, for example, whether activation of an endogenous ET-1 system is itself the primary cause of any of these ailments. In that context, the phenotypic manifestations of chronic ET-1 overproduction may provide clues about the tissues and systems affected by ET-1. We therefore established two lines of transgenic mice overexpressing the ET-1 gene under the direction of its own promoter. These mice exhibited low body weight, diminished fur density and two- to fourfold increases in the ET-1 levels measured in plasma, heart, kidney and aorta. There were no apparent histological abnormalities in the visceral organs of young (8 weeks old) transgenic mice, nor was their blood pressure elevated. In aged (12 months old) transgenic mice, however, renal manifestations, including prominent interstitial fibrosis, renal cysts, glomerulosclerosis and narrowing of arterioles, were detected. These pathological changes were accompanied by decreased creatinine clearance, elevated urinary protein excretion and salt-dependent hypertension. It thus appears that mild, chronic overproduction of ET-1 does not primarily cause hypertension but triggers damaging changes in the kidney which lead to the susceptibility to salt-induced hypertension.

Phase transformation behaviour and bending properties of hybrid nickel?titanium rotary endodontic instruments

AIM

To investigate the bending properties of hybrid rotary nickel-titanium endodontic instruments in relation to their transformation behaviour.

METHODOLOGY

Four types of nickel-titanium rotary endodontic instruments with different cross-sectional shapes (triangular-based and rectangular-based) and different heat treatment conditions (super-elastic type and hybrid type with shape memory effect) were selected to investigate bending properties and phase transformation behaviour. Bending load of the instruments was measured in a cantilever-bending test at 37 degrees C with the maximum deflection of 3.0 mm. A commercial rotary instrument, ProFile (PF; Dentsply Maillefer, Ballaigues, Switzerland) was used as a reference for the bending test. Phase transformation temperatures were calculated from the diagrams obtained from differential scanning calorimetry. Data were analysed by anova and Scheffe's test.

RESULTS

The bending load values of the hybrid type that had undergone additional heat treatment at the tip were significantly lower (P < 0.05) than those of the super-elastic type with no additional heat treatment. The bending load values of rectangular-based cross-sectional shaped instruments were significantly lower (P < 0.05) than those of triangular-based cross-sectional shaped instruments. Phase transformation temperatures (M(s) and A(f) points) of the hybrid type were significantly higher (P < 0.05) than the super-elastic type. The M(f) and A(s) points of the tip part were significantly higher (P < 0.05) than those of the whole part of the hybrid instrument.

CONCLUSIONS

Additional heat treatment of hybrid nickel-titanium instruments may be effective in increasing the flexibility of nickel-titanium rotary instruments.

Relationship between home blood pressure measurement and medication compliance and name recognition of antihypertensive drugs

This study examined the relationship of home blood pressure measurement to medication compliance and name recognition of antihypertensive drugs in outpatients with hypertension. A total of 1,452 consecutive outpatients (842 males, 610 females; mean age 65+/-11 yr) seeking care at our institute answered questions at our cardiovascular outpatient clinic such as whether they had a sphygmomanometer at home, how often they measured their blood pressure at home, and how often they missed taking their medication. Among a total of 777 patients on antihypertensive drugs who had a sphygmomanometer at home, 16 of the 242 patients (6.5%) who measured their home blood pressure every day occasionally missed taking their medication, whereas this number was 22 for the 216 patients (10.1%) who measured their home blood pressure several times a week, 16 for the 146 patients (11.0%) who measured their home blood pressure several times a month, and 25 for the 173 patients (14.5%) who never measured their home blood pressure (p< 0.01 between patients who measured their home blood pressure every day and those who did not measure their home blood pressure). Among a total of 271 patients taking one or two antihypertensive drugs, the number of patients who could name their antihypertensive drugs was 47 of the 86 patients (55%) who measured their home blood pressure every day, 43 of the 78 patients (55%) who measured their home blood pressure several times a week, 24 of the 41 patients (58%) who measured their home blood pressure several times a month, and 22 of the 66 patients (33%) who never measured their home blood pressure (p< 0.02). In conclusion, medication compliance and antihypertensive drug name recognition were better in patients who measured their home blood pressure than in patients who did not measure their home blood pressure. From these results, we conclude that physicians should recommend home blood pressure measurement to patients being treated with antihypertensive drugs, because there is a possibility that home blood pressure measurement might improve medication compliance.

Pulpal blood flow assessed by laser Doppler flowmetry in a tooth with a horizontal root fracture

Horizontal root fractures of both maxillary central incisors were diagnosed radiographically; neither responded to electric pulp testing nor to cold testing. The pulp of the right incisor was necrotic, whereas the pulpal status of the left incisor was uncertain. Pulpal blood flow of the teeth was measured with laser Doppler flowmetry. The blood flow of the left central incisor was 4.0. Eight months after the injury, a local anesthetic with a vasoconstrictor was administered to confirm pulp vitality. The blood flow of the tooth was decreased to 51% of the preanesthesia value after the local anesthesia. At 19 months after the injury, it responded to both the electric pulp test and cold test. Laser Doppler flowmetry is a noninvasive method of evaluating the blood flow status in human teeth, and it may provide a clinically reliable method of assessing pulpal vitality.

Effect of diltiazem on the pharmacokinetics of propranolol, metoprolol and atenolol

The pharmacokinetic interaction between diltiazem and three beta-adrenoceptor blockers propranolol, metoprolol and atenolol was investigated in healthy volunteers given diltiazem 30 mg or placebo t.d.s. for 3 days, followed by a single dose of propranolol 20 mg, metoprolol 40 mg or atenolol 50 mg. The AUCs of propranolol and metoprolol were significantly increased after diltiazem and it significantly prolonged the elimination half-life of metoprolol. In contrast, it did not significantly affect the pharmacokinetics of atenolol. Propranolol significantly decreased the resting pulse rate after diltiazem pretreatment as compared to placebo. The results indicate that diltiazem impaired the clearance of propranolol and metoprolol, which are principally metabolized by an oxidative pathway, and that the kinetic interaction between diltiazem and propranolol may partly be related to the significant reduction in the pulse rate produced by the latter.

The effects of age and gender on the stereoselective pharmacokinetics of verapamil

The effects of age and gender on the pharmacokinetics of verapamil stereoisomers were examined. Eighty milligrams of racemic verapamil was given orally to 12 young and 12 elderly healthy subjects, half of whom were women. The area under the plasma concentration-time curves (AUC) of (S)- and (R)-verapamil were greater in the elderly group than in the young group [(S)-/(R)-verapamil (mean +/- SD), 214.4 +/- 123.0/1582.2 +/- 763.0 and 50.4 +/- 36.5/584.9 +/- 252.4 ng.hr/ml for the elderly and young groups, respectively (p < 0.001/p < 0.001)]. Conversely, the apparent oral clearance values of (S)- and (R)-verapamil were significantly smaller in the elderly group than in the young group [(S)-/(R)-verapamil (mean +/- SD), 4.8 +/- 3.0/0.53 +/- 0.21 and 22.5 +/- 21.3/1.30 +/- 0.67 L/hr/kg for the elderly and young groups, respectively (p < 0.01/p < 0.001)]. The ratio of apparent oral clearance of (S)- to (R)-verapamil was significantly smaller in the elderly group than in the young group. As a consequence, the negative chronotropic and dromotropic effect of verapamil was observed in the elderly group. This study suggests that the effect of age on metabolism was greater for (S)-verapamil than for (R)-verapamil.

Comparison of the pharmacokinetics, pharmacodynamics, and safety of oral (Catapres) and transdermal (M-5041T) clonidine in healthy subjects

The pharmacokinetic as well as pharmacodynamic properties of a transdermal clonidine, M-5041T (M) and its safety were compared with those of oral clonidine, Catapres (Nippon Boehringer Ingelheim, Hyogo, Japan). One patch of M containing 6 mg of clonidine was applied on the right chest for 3 days or one tablet of Catapres (.075 mg) was given orally every 12 hours for 3 days in eight healthy subjects. The study was conducted by a crossover design with 14 to 16 days' interval between the cross-over. Blood and urine samples for clonidine concentration were obtained, and blood pressure (BP) was measured for a 168-hour period after application of M and for a 96-hour period after initiation of Catapres therapy. Plasma concentration of clonidine increased gradually after application of M and decreased gradually after removal, whereas this parameter increased rapidly during the absorption phase and decreased rapidly in the elimination phase after each dosage of Catapres. Elimination half-life of clonidine after removal of M was significantly greater than that after the final dosage of Catapres. No significant difference was observed in maximum plasma concentration or area under the plasma concentration-time curve between the two trials. The BP lowering effects of M and Catapres did not differ significantly. Adverse symptoms occurred more frequently during Catapres therapy than during treatment with M. Most of these symptoms were observed when plasma clonidine concentration was relatively higher in each trial. These results suggest that M is effective for the treatment of hypertension with a lower incidence of adverse symptoms.(ABSTRACT TRUNCATED AT 250 WORDS)

Chronopharmacological study of furosemide in rats

The present experiment was undertaken to determine whether or not the effects of furosemide depend upon the administration time and, if so, to study the mechanism(s) for these variations. After administration of furosemide (5 mg/kg) in Wistar rats at 10:00 or at 22:00, urine volume and urinary excretion of sodium, furosemide, and prostaglandin E2 (PGE2) were measured. Urine volume and urinary excretion of sodium and furosemide, but not PGE2, were significantly greater when furosemide was administered at 10:00 than when it was administered at 22:00. There was a good correlation between the urinary output of furosemide and the urine volume, or the urinary sodium. It is concluded that the effects of furosemide vary with the administration time and these variations depend upon the amount of furosemide secreted in urine.

Daily variations in platelet aggregation and adhesion in healthy subjects

Platelet aggregation is known to show a morning rise. The present study was undertaken to examine whether platelet aggregation and adhesion show a peak in the afternoon. Platelet aggregation stimulated by 4 microM of adenosine diphosphate, 1 micrograms/ml of collagen, 4 microM of epinephrine and 0.5 mM of arachidonic acid, and platelet adhesion determined by platelet retention on a glass bead column were measured for a period of 28-hour with an interval of 4 hours in 6 healthy subjects. Platelet aggregation in response to 4 different aggregating agents showed a bimodal daily variation with peaks in the morning and in the afternoon. However platelet adhesion only showed a peak in the morning. Previous studies have demonstrated the increases in the onset of acute myocardial infarction (MI) in the morning and afternoon periods. As enhanced platelet aggregation is involved in the development of acute MI, the present study suggests that the rise in platelet aggregation contributes to the increase in acute MI in the morning and in the afternoon. The present study suggests that the enhancement of platelet adhesion, which might be involved in thromboembolic events, may be another triggering factor for the onset of acute MI.

Chronopharmacological study of furosemide in rats: (II). Influence of beta-adrenoceptor blockade

We have previously demonstrated a time-dependent variability in the diuretic effect of furosemide in rats. The present study was undertaken to evaluate the influence of beta-adrenoceptor blockade on these time-dependent variations. Furosemide (5 mg/kg) was administered intra-arterially in Wistar rats at 1000 hrs (03HALO) or at 2200 hrs (15HALO) with pretreatment with either propranolol (10 mg/kg) or atenolol (10 mg/kg). Urine was collected for 60 min after furosemide administration and urinary excretion of sodium and furosemide were determined respectively. Propranolol pretreatment abolished the temporal variations observed in urine volume, urinary sodium and furosemide levels during the observation periods. With atenolol pretreatment, however, all these variables were significantly greater at 1000 hrs (03HALO) than at 2200 hrs (15HALO) as observed in the previous study. These results suggest that the beta-adrenoceptor-mediated stimuli, which is blocked by propranolol but not by atenolol, is responsible for the time-dependent changes in the diuretic effect of furosemide.

Chronopharmacological study of nitrendipine in healthy subjects

Nitrendipine 20 mg or placebo was given orally to eight healthy subjects in a cross-over design separated by 1 or 2 weeks. Drug was given at 9:00 AM (morning dosage) or at 9:00 PM (evening dosage). Systolic and diastolic blood pressure (SBP, DBP) were measured just before and 1, 2, 3, 4, 5, 7, 9, 12 and 24 hrs after treatment. Plasma nitrendipine concentrations were determined at 0.5, 1, 2, 3, 4, 5, 7, 9, 12 and 24 hrs and plasma catecholamines were measured at 2 and 5 hrs following drug administration. SBP did not decrease significantly after nitrendipine compared to after placebo at 9:00 AM or at 9:00 PM. DBP decreased significantly at 2, 3, 4 and 5 hrs after nitrendipine at 9:00 AM, but only at 4 hours after the 9:00 PM dose. Mean plasma nitrendipine concentrations during the absorption phase were lower after the evening dosage compared to the morning interval. Maximum plasma concentration (Cmax) was significantly lower and time to maximum concentration (tmax) tended to be longer after the evening dosage. Area under the plasma concentration-time curve from 0 to 24 hours (AUC0-24) and half-life of the terminal elimination phase (t1/2 beta) of the morning and evening dosages did not differ. A significant correlation was observed between plasma nitrendipine concentrations and changes in DBP during the drug treatment. Plasma noradrenaline concentrations were significantly higher 5 hours after nitrendipine compared to after placebo at 9:00 AM, but not at 9:00 PM.(ABSTRACT TRUNCATED AT 250 WORDS)

Er:YAG laser modification of root canal dentine: influence of pulse duration, repetitive irradiation and water spray

The aim of this study was to determine the effects of varying parameters of Er:YAG laser irradiation with and without water spray cooling on root canal dentine in vitro. After horizontally removing tooth crowns from extracted human teeth, roots were axially sectioned into thin slices, exposing the root canal surface. An Er:YAG laser delivered 10-30 J/cm(2) into a 0.4-mm diameter laser spot on the root canal surface. Single pulses of different lengths (80-280 micro s) were applied with and without water spray cooling/irrigation, and sequences of three pulses at a repetition rate of 30 Hz were applied at selected pulse parameters. The irradiated samples were investigated using both confocal laser scanning microscopy (CLSM) and scanning electron microscopy (SEM). At most irradiation conditions, the root canal dentine surface was ablated. Three-dimensional images from CLSM revealed that the cavity walls were not smooth. Depths of the cavities revealed significant differences between the cavities. No debris was observed at the surface of cavities at any irradiation condition. Strong melting and recrystallisation, or unusually flat surfaces with open dentinal tubules were obtained with sequences of three pulses without water cooling. CLSM is an effective tool for investigation of laser effects on root canal dentine. By varying the irradiation conditions, the Er:YAG laser can induce different modifications of root canal surface, which may be very interesting for root canal preparation.

Chronopharmacology of enalapril in hypertensive patients

The pharmacokinetics and pharmacodynamics of enalapril, an angiotensin converting enzyme inhibitor, are reported to vary with the time of administration. The present study was undertaken to examine whether the effect of enalapril on plasma bradykinin (BK), substance P and prostaglandin E2 (PGE2), which are likely to be involved in the mechanism of enalapril-induced cough, might also be affected by its time of administration. Enalapril 5 mg or placebo was given orally at 10:00 h (day trial) or 22:00 h (night trial) to 12 patients with essential hypertension. Serum concentrations of total drug (enalapril + enalaprilat, its active metabolite) during the day and night trials did not differ significantly at any time. However, serum enalaprilat tended to be higher and its maximum concentration greater in the day trial than in the night trial. Blood pressure 24 h after administration of enalapril was reduced at 22:00 h, but not at 10:00 h. Plasma BK tended to increase following enalapril administration at 10:00 h, but not at 22:00 h. Remarkable increases in plasma BK were observed in two patients in the day trial and one of them also complained of cough. However, no such increase in plasma BK or subsequent adverse effect were recorded in the night trial. Plasma substance P and PGE2 did not change significantly following enalapril administration either in the day or night trial. The results suggest that the response of BK to enalapril is affected by the time of administration. In patients who complain of cough during treatment with enalapril during the daytime, this adverse effect might be diminished or eliminated by a switch to night-time administration.

Role of dopamine in the regulation of blood pressure and the renin--angiotensin--aldosterone system in conscious rats

1. In conscious rats, intracerebroventricular injection of dopamine resulted in a decrease in blood pressure, whereas injection of metoclopramide, the dopamine antagonist, produced an increase in blood pressure. The central depressor effect of dopamine was attenuated by a subpressor pretreatment with intraventricular metoclopramide, but not by phentolamine. 2. Intravenous administration of dopamine increase blood pressure. This increase in blood pressure was almost completely abolished by intravenous phentolamine. Metoclopramide, when injected intravenously, did not reduce any change in blood pressure. 3. Plasma renin activity and plasma aldosterone concentration were decreased by intraventricular injection of dopamine, and increased by that of metoclopramide. In contrast, intravenous administration of metoclopramide increased plasma aldosterone concentration without changing plasma renin activity. Plasma concentrations of potassium, sodium and corticosterone were not affected by these treatments. 4. These results suggest that the dopaminergic system in the brain, but not in the systemic circulation, is involved in the regulation of blood pressure. It is also suggested that the central dopaminergic system participates in the regulation of aldosterone secretion by changes in the renin--angiotensin axis, whereas the peripheral dopaminergic modulation of aldosterone secretion appears to occur independently of the renin--angiotensin system.

Differences of chronopharmacokinetic profiles between propranolol and atenolol in hypertensive subjects

Previous studies have shown that the absorption rate of a lipophilic, but not hydrophilic, agent is faster after the night dosage than after the morning dosage in nocturnal rodents. The present study examines whether such a difference in chronopharmacokinetic profiles between lipophilic and hydrophilic agents also exists in humans. Propranolol (20 mg), a lipophilic beta-blocker, or atenolol (50 mg), a hydrophilic beta-blocker, was given orally to 13 hypertensive patients at 9:00 AM (day trial) or 9:00 PM (night trial) by a crossover design. Plasma concentrations of propranolol and its metabolites, 4-hydroxypropranolol and naphthoxylactic acid, and atenolol were determined just before and at 0.5, 1, 1.5, 2, 3, 4, 6, 12, and 24 hours after treatment. Maximum plasma concentration (Cmax) and area under the plasma concentration-time curve (AUC) of propranolol in the day trial were significantly greater than those in the night trial. Time to maximum plasma concentration (tmax) was significantly shorter in the day trial. No significant difference was observed in the elimination half-life between the two trials. There were similar administration time-dependent changes in the Cmax for 4-hydroxypropranolol and naphthoxylactic acid. On the other hand, although the Cmax of atenolol was greater and its tmax was shorter in the day trial, the differences did not reach significance. These results suggest that propranolol, but not atenolol is absorbed more rapidly after the morning dosage than after the night dosage. Based on these findings, the authors speculate that the absorption rate of a lipophilic, but not hydrophilic, agent is faster after the morning dosage than after the night dosage in humans.

Progression of osteoporosis in cancellous bone depending on trabecular structure

Progression of osteoporosis is caused by a decline in bone formation activity relative to the resorption activity. In this paper, the authors carried out a theoretical analysis of the progression of osteoporosis to estimate the osteoporotic change in the upper end of the femur. According to this analysis, the progression rate of osteoporosis in cancellous bone depends on the product of remodeling activity, Ract, and the trabecular structure parameter, Ktr. To confirm that the theoretical results were reasonably comparable to actual osteoporotic change, these two factors were measured in rabbits. From the results, it was concluded that the highest progression rate was shown in bar/bar-like trabecular structure (type 3); the next highest rate, was shown in plate/bar-like structure (type 2); and the plate/plate-like structure (type 1) was the most insensible. Furthermore, the bone volume fractions of cancellous bone were measured at the upper end of human femurs with and without osteoporosis. Then the measured value was compared with the theoretical value for each type of trabecular structure. Results showed that the decrease in bone volume fraction predicted by Eq. 7 was well in accord with the actual decrease.

Influence of rotational speed on torque/force generation and shaping ability during root canal instrumentation of extracted teeth with continuous rotation and optimum torque reverse motion

AIM

To evaluate how different rotational speeds affect the torque/force generation and shaping ability of rotary root canal instrumentation using JIZAI (MANI, Utsunomiya, Japan) nickel-titanium instruments in continuous rotation and optimum torque reverse (OTR) motion.

METHODOLOGY

Mesial root canals of extracted mandibular molars were instrumented up to size 25, 0.04 taper using JIZAI instruments, and anatomically matched canals were selected based on geometric features of the canal [canal volume (mm³ ), surface area (mm² ), length, 15°-20° curvature and radius of curvature (4-8 mm)] after micro-computed tomographic scanning. An automated root canal instrumentation and torque/force analysing device was programmed to permit a simulated pecking motion (2 s downward and 1 s upward at 50 mm min^-1 ). The selected canals were prepared with size 25, 0.06 taper JIZAI instruments using continuous rotation or OTR motion and further subdivided according to the rotational speed (300 or 500 rpm, n = 10 each). Real-time clockwise/counterclockwise torque and downward/upward force were recorded using a custom-made torque/force analysing device. Then, the registered pre- and post-operative micro-computed tomographic datasets were examined to evaluate the canal volume changes and centring ratios at 1, 3, 5 and 7 mm from the apical foramen. Data were analysed using two-way analysis of variance or the Kruskal-Wallis test and Mann-Whitney U test with Bonferroni correction (α = 5%).

RESULTS

Maximum upward force and clockwise torque were significantly smaller in 500 rpm groups than in 300 rpm groups (P < .05); however, no significant difference was found between continuous rotation and OTR motion (P > .05). OTR motion developed higher maximum counterclockwise torque than continuous rotation (P < .05). Maximum downward force, canal volume changes and centring ratios were not significantly different among all groups (P > .05). There was no file fracture in any of the groups.

CONCLUSIONS

Under laboratory conditions using JIZAI instruments, a rotational speed of 500 rpm generated significantly lower maximum screw-in forces and torque values than rotational speed of 300 rpm. Continuous rotation and OTR motion performed similarly in shaping the canals.