In Situ Transmission Electron Microscopy Study of Bubble Behavior Near the Surface of Ice Crystals by Using a Liquid Cell With a Peltier Cooling Holder

Liquid cell transmission electron microscopy (LC-TEM) is a unique technique that permits in situ observations of various phenomena in liquids with high spatial and temporal resolutions. One difficulty with this technique is the control of the environmental conditions in the observation area. Control of the temperature ranging from room temperature to minus several tens of degrees Celsius, is desirable for controlling the supersaturation in various materials and for observing crystallization more easily. We have developed a cooling transmission electron microscopy specimen holder that uses Peltier devices, and we have combined it with a liquid cell to realize accurate temperature control in LC-TEM. We evaluated this system by using water as a specimen. Motionless bubbles, shown to be voids containing pressurized gas, formed in the specimen sometime after the temperature had reached -12°C. An electron diffraction pattern showed that the specimen turned into ice Ih after the formation of these bubbles, confirming that our system works properly and can induce crystallization. In addition, we analyzed the behavior of bubbles formed in the ice Ih, and we discussed the formation of these bubbles and their internal pressure.

In situ electron tomography for the thermally activated solid reaction of anaerobic nanoparticles

The nanoscale characterization of thermally activated solid reactions plays a pivotal role in products manufactured by nanotechnology. Recently, in situ observation in transmission electron microscopy combined with electron tomography, namely four-dimensional observation for heat treatment of nanomaterials, has attracted great interest. However, because most nanomaterials are highly reactive, i.e., oxidation during transfer and electron beam irradiation would likely cause fatal artefacts; it is challenging to perform the artifact-free four-dimensional observation. Herein, we demonstrate our development of a novel in situ three-dimensional electron microscopy technique for thermally activated solid-state reaction processes in nanoparticles (NPs). The sintering behaviour of Cu NPs was successfully visualized and analyzed in four-dimensional space-time. An advanced image processing protocol and a newly designed state-of-the-art MEMS-based heating holder enable the implementation of considerably low electron dose imaging and prevent air exposure, which is of central importance in this type of observation. The total amount of electron dose for a single set of tilt-series images was reduced to 250 e^- nm^-2, which is the lowest level for inorganic materials electron tomography experiments. This study evaluated the sintering behaviour of Cu NPs in terms of variations in neck growth and particle distance. A negative correlation between the two parameters is shown, except for the particle pair bound by neighbouring NPs. The nanoscale characteristic sintering behavior of neck growth was also captured in this study.

Prognostic value of machine learning for acute heart failure

Funding Acknowledgements

Type of funding sources: None.

Background

At onset of acute heart failure (AHF), various clinical fundamental parameters including vital sign, laboratory data, or initial treatment were investigated, and we can roughly estimate the prognosis. However, machine learning method for prediction of the prognosis was not studied.

Purpose

To elucidate prognostic value of machine learning for AHF comparing conventional statistical model.

Methods

We enrolled consecutive 300 patients with AHF (79.5 ± 12.1 years, 158 Males). Patients with acute coronary syndrome, mechanical circulatory support cases, and cardio-pulmonary arrest cases were excluded. The patients were randomly divided into 80% (240 cases) and 20% (60 cases), and the former was used as train data, and the latter as validation data. Objective variable was set as cardiac death in one year. First, logistic regression analysis with Akaike’s information criterion (AIC) was performed, and extracted predictive parameters. The predictive model for the cardiac prognosis was constructed by cut-off value of ROC curve analysis of propensity score was calculated. Next, machine learning (random forest method and deep learning) to build predictive model was performed with the predictors. Finally, accuracy of each predictive model was compared.

Results

Thirty cases showed cardiac death in one year. Logistic regression with AIC extracted 8  predictors, and the cut off-value of propensity score with the 6 parameters was 0.110. The accuracy was 0.714 and area under ROC (AUROC) was 0.836. Conversely, random forest method demonstrated the accuracy as 0.927, AUROC 0.860. On deep learning, the accuracy was 0.937 and AUROC 0.901. 

The top 4 high feature importance of random forest were Cl/red blood cell count/pH/Anion Gap. However, accuracy of those predictors was lower than that of machine learning.

Conclusion

Machine learning was a powerful tool to predict cardiac prognosis of AHF, comparing with conventional statistical model. Abstract Figure. Statistical model

Diagnostic performance of deep learning on 12-leads electrocardiography for recurrence after pulmonary vein isolation in patients with persistent atrial fibrillation

Background

Several patients with persistent atrial fibrillation (per-AF) suffer from recurrence after pulmonary vein isolation (PVI). Various methods to predict the recurrence were tried, but deep learning on 12-leads electrocardiography (ECG) after PVI was not studied.

Purpose

To elucidate diagnostic performance of deep learning on 12-leads ECG after PVI in patients with per-AF

Methods

We enrolled consecutive 109 patients with per-AF who underwent PVI (68.8±10.0 years, 83 males) excluding failure cases. We defined recurrence in 3–12 months after PVI. From the ECG just after PVI, five beats of each lead were sampled separately. Deep learning (convolutional neural network on bitmap ECG image) was performed by transfer learning of Inception-Resnet-V2 model. Gradient weighted class activation color mapping (GradCam) was performed to detect convolutional importance in the lead.

Results

Thirty-six patients showed recurrence in the period. Lead II (accuracy 0.701), aVR (0.690) were the top 2 leads of prediction, which showed larger accuracy than statistical accuracies of Non PV foci = SVC (accuracy = 0.541) and left atrial diameter >50mm (0.596). In lead II, GradCam spotlighted strong convolution of latter half of P wave in recurrent case, and former half of P wave and T wave in no-recurrent case.

Conclusions

Deep learning on ECG was a powerful tool to predict recurrence of per-AF after PVI.

Funding Acknowledgement

Type of funding sources: None. Results of deep learningResults of GradCam

Sphenoparietal sinus and superficial middle cerebral vein thrombosis: A case report and review of literature

BACKGROUND

Cerebral venous sinus thrombosis is rare and might be overlooked by healthcare providers. It often occurs in the transverse sinuses, superior sagittal sinus, and the vein of Trolard. Sphenoparietal sinus (SPS) and/or superficial middle cerebral vein (SMCV) thrombosis is rare and only 12 cases reported in the literature.

CASE DESCRIPTION

We report a 47-year-old woman with iron deficiency anemia associated with myoma uteri who developed left SPS and SMCV thrombosis. She presented with sudden unconsciousness, right hemiplegia, and aphasia. Brain computed tomography showed subcortical hemorrhages in the left frontal and temporal lobes. Magnetic resonance imaging did not reveal the cause of the bleeding. Although antihypertensive treatment with nicardipine was initiated, she deteriorated into coma the next day and underwent emergency decompressive craniectomy. Thrombosis of the SMCV was identified during surgery. Re-examination of preoperative T2 star-weighted imaging revealed thrombosis of the SPS and SMCV.

CONCLUSION

All but one of the reviewed cases had the thrombosis develop on the left side, which may be attributed to anatomical and brain functional laterality. When an edematous change or cortical hemorrhage of unknown cause is encountered within the perisylvian region, especially on the left side, the possibility of SPS and SMCV thrombosis should be considered.

Novel -75°C SEM cooling stage: application for martensitic transformation in steel

Microstructural changes during the martensitic transformation from face-centred cubic (FCC) to body-centred cubic (BCC) in an Fe-31Ni alloy were observed by scanning electron microscopy (SEM) with a newly developed Peltier stage available at temperatures to  −75°C. Electron channelling contrast imaging (ECCI) was utilized for the in situ observation during cooling. Electron backscatter diffraction analysis at ambient temperature (20°C) after the transformation was performed for the crystallographic characterization. A uniform dislocation slip in the FCC matrix associated with the transformation was detected at −57°C. Gradual growth of a BCC martensite was recognized upon cooling from −57°C to −63°C.

Electron tomography imaging methods with diffraction contrast for materials research

Transmission electron microscopy (TEM) and scanning transmission electron microscopy (STEM) enable the visualization of three-dimensional (3D) microstructures ranging from atomic to micrometer scales using 3D reconstruction techniques based on computed tomography algorithms. This 3D microscopy method is called electron tomography (ET) and has been utilized in the fields of materials science and engineering for more than two decades. Although atomic resolution is one of the current topics in ET research, the development and deployment of intermediate-resolution (non-atomic-resolution) ET imaging methods have garnered considerable attention from researchers. This research trend is probably not irrelevant due to the fact that the spatial resolution and functionality of 3D imaging methods of scanning electron microscopy (SEM) and X-ray microscopy have come to overlap with those of ET. In other words, there may be multiple ways to carry out 3D visualization using different microscopy methods for nanometer-scale objects in materials. From the above standpoint, this review paper aims to (i) describe the current status and issues of intermediate-resolution ET with regard to enhancing the effectiveness of TEM/STEM imaging and (ii) discuss promising applications of state-of-the-art intermediate-resolution ET for materials research with a particular focus on diffraction contrast ET for crystalline microstructures (superlattice domains and dislocations) including a demonstration of in situ dislocation tomography.

Development of a three-dimensional tomography holder for in situ tensile deformation for soft materials

An in situ straining holder capable of tensile deformation and high-angle tilt for electron tomography was developed for polymeric materials. The holder has a dedicated sample cartridge, on which a variety of polymeric materials, such as microtomed thin sections of bulk specimens and solvent-cast thin films, can be mounted. Fine, stable control of the deformation process with nanoscale magnification was achieved. The holder allows large tensile deformation (≃800 μm) with a large field of view (800 × 200 μm before the deformation), and a high tilt angle (±75°) during in situ observations. With the large tensile deformation, the strain on the specimen can be as large as 26, at least one order of magnitude larger than the holder's predecessor. We expect that meso- and microscopic insights into the dynamic mechanical deformation and fracture processes of polymeric materials can be obtained by combining the holder with a transmission electron microscope equipped with an energy filter. The filter allows zero-loss imaging to improve the resolution and image contrast for thick specimens. We used this technique to study the deformation process in a silica nanoparticle-filled isoprene rubber.

Chronic Intra Oral Pain and Depressive Symptoms in Japanese Community-Dwelling Elderly: A Longitudinal Study

OBJECTIVE

The incidence of major depressive disorder in the elderly ranges from 0.2 to 14.1/100 person-years, and the incidence of clinically relevant depressive symptoms is 6.8/100 person-years. This study aimed to assess the longitudinal relationship between chronic intra oral pain and depressive symptom in Japanese elderly.

BASIC RESEARCH DESIGN

3-year cohort study.

PARTICIPANTS

212 community-dwelling seniors (129 men, 83 women) aged 77 years residing in the city of Niigata, Japan in 2005.

INTERVENTIONS

At baseline, subjects were asked about chronic intra oral pain (tooth, gingival or denture pain), with response choices of "yes" or "no". Any type of pain, was counted as chronic intra oral pain.

MAIN OUTCOME MEASURES

The General Health Questionnaire 30 (GHQ-30) was used to assess depression at follow up. The Tokyo Metropolitan Institute of Gerontology (TMIG) Index of Competence was used to assess activities of daily living.

RESULTS

In multivariate logistic regression, baseline intra oral pain predicted depressive symptoms at follow up (Odds Ratio = 3.2, 95% CI = 1.32-7.81) after adjusting for serum HbA1c, creatinine and working life.

CONCLUSIONS

Chronic intra oral pain increased the risk for the development of depressive symptoms in the elderly.

Abstract P5-03-05: Sphingosine-1-phosphate produced by sphingosine kinase 1 and exported via ABCC1 shortens survival of mice and humans with breast cancer

Background: Sphingosine-1-phosphate (S1P), a bioactive sphingolipid mediator that is generated by sphingosine kinase 1 (SphK1) when it is phosphorylated (pSphK1) inside cells, has been implicated in regulation of many process important for breast cancer progression. Previously we have shown that S1P is exported out of human breast cancer cells by ATP-binding cassette (ABC) transporter ABCC1, but not by ABCB1, both known multidrug resistance proteins that efflux chemotherapeutic agents. However, the pathological consequences of these events to breast cancer progression and metastasis have not been elucidated. Here, we report that high expression of ABCC1, but not ABCB1, is associated with poor prognosis in breast cancer patients via exporting S1P.

Materials and methods: Microarray based gene expression data of 2509 patients associated with their survival were obtained from METABRIC database. Single gene survival analysis based on expressin of SphK1, and dual ABCC1 or ABCB1 and SphK1 survival analyses were perfomerd. For protein analyses, tissues were obrained from 275 patients with stage 1-3 breast cancers treated in Yokohama City University Medical Center in Japan between 2006 and 2008. The expression of pSphK1 was analyzed by immunohistochemistry and investigate the relationship with clinicopathological findings. For in vitro and in vivo experiments, breast cancer cell lines were transfected by ABCB1, ABCC1 or vector transiently or stably. BALB/c nu/nu mice and BALB/c mice were used for in vivo experiments. S1P was measured by LC-ESI-MS/MS.

Results: SphK1 expression significantly associate with worse overall survival (median survival of 124 months with high SphK1 expression compared to 163 months for patients with low SphK1 expression, p=0.0014). Although patients with high ABCC1 expression had only a slightly worse overall survival of 150 months, those with high levels of both SphK1 and ABCC1 had much worse prognosis with median overall survival of 114 months (p < 0.0068). Such association was not observed with ABCB1 expression. The frequency of strong pSphK1 protein expression was higher in HER2 enrhiched or TNBC than in Luminal. pSphK1 was more prevalent and increased in a larger tumors and in tumors from patients with lymph node metastases. Patients with breast cancers that express both pSphK1 and ABCC1 proteins have significantly shorter disease free survival. Overexpression of ABCC1, but not ABCB1, in human MCF7 and murine 4T1 cells enhanced S1P secretion, proliferation and migration of breast cancer cells. Implantation of breast cancer cells overexpressing ABCC1, but not ABCB1, into the mammary pad markedly enhanced tumor growth, angiogenesis and lymphangiogenesis with concomitant increases in lymph node and lung metastases as well as shorter survival of mice. Interestingly, S1P exported via ABCC1 from breast cancer cells upregulated transcription of SphK1 and its own formation.

Conclusions: Our findings suggest that production and export of S1P via ABCC1, but not ABCB1, is associated with worse overall and disease free survival of breast cancer patients and that S1P axis play a role in aggressive biology of breast cancer progression and metastasis.

Citation Format: Yamada A, Nagahashi M, Aoyagi T, Huang W-C, Lima S, Miyazaki H, Narui K, Ishikawa T, Endo I, Waters MR, Milstien S, Spiegel S, Takabe K. Sphingosine-1-phosphate produced by sphingosine kinase 1 and exported via ABCC1 shortens survival of mice and humans with breast cancer [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P5-03-05.

A 5-year longitudinal study of association of maximum bite force with development of frailty in community-dwelling older adults

To determine whether maximum bite force (MBF), an objective measure of oral function, is associated with development of frailty in community-dwelling older adults. This prospective cohort study included community-dwelling Japanese adults aged 75 years at baseline (n = 322). Baseline MBF was measured using an electronic recording device (Occlusal Force-Meter GM10). Follow-up examinations, including physical fitness and anthropometric evaluation and structured questionnaires, were administered annually over a 5-year period to determine the incidence of frailty, which was defined by the presence of 3 or more of the following 5 components derived from the Cardiovascular Health Study: low level of mobility, low physical activity level, weakness, shrinking and poor endurance and energy. Adjusted hazard ratios (HRs) of incidence of frailty according to sex-stratified tertiles of baseline MBF were calculated using Cox proportional hazards regression models. During the follow-up, 49 participants (15.2%) developed frailty. Participants in the lower tertile of MBF exhibited a significantly greater risk of frailty than those in the upper tertile. After adjustment for sex, depression, diabetes and Eichner index, the adjusted HRs for frailty in the upper through lower tertiles of MBF were 1.00 (reference), 1.27 (95% confidence interval [CI]: 0.50-3.20) and 2.78 (95% CI: 1.15-6.72), respectively (P for trend = .01). Poor oral function, as indicated by low MBF, increases the risk of development of frailty among elderly men and women.

Three-dimensional visualization of dislocations in a ferromagnetic material by magnetic-field-free electron tomography

In conventional transmission electron microscopy, specimens to be observed are placed in between the objective lens pole piece and therefore exposed to a strong magnetic field about 2 T. For a ferromagnetic specimen, magnetization of the specimen causes isotropic and anisotropic defocusing, deflection of the electron beam as well as deformation of the specimen, which all become more severe when the specimen tilted. Therefore electron tomography on a ferromagnetic crystalline specimen is highly challenging because tilt-series data sets must be acquired without changing the excitation condition of a specific diffraction spot. In this study, a scanning transmission electron microscopy (STEM) tomography method without magnetizing a ferromagnetic specimen has been developed for three-dimensional (3D) visualization of dislocations in α-Fe, which is a typical ferromagnetic material. Magnetic-field-free environment down to 0.38 ± 0.07 mT at the specimen position is realized by demagnetizing the objective lens pole piece of a commercial STEM instrument. By using a spherical aberration corrector with the magnetic-field-free environment, an "aberration corrected Low-Mag STEM mode" with no objective lens field reaches a convergence semi angle ∼1 mrad and a spatial resolution ∼5 nm, and shows an adequate performance of imaging dislocations under a two-beam excitation condition for a low-index diffracted beam. The illumination condition for the aberration corrected Low-Mag STEM mode gives no overlap between the direct beam disk (spot) and neighboring diffraction disks. An electron channeling contrast imaging technique, in which an annular detector was located at a doughnut area between the direct beam and the neighboring diffracted beams, was effectively employed with the aberration corrected Low-Mag STEM mode to keep image intensity high enough even at large specimen-tilt angles. The resultant tomographic observation visualized 3D dislocation arrangements and active slip planes in a deformed α-Fe specimen.

In-situ straining and time-resolved electron tomography data acquisition in a transmission electron microscope

This paper reports the preliminary results of a new in-situ three-dimensional (3D) imaging system for observing plastic deformation behavior in a transmission electron microscope (TEM) as a directly relevant development of the recently reported straining-and-tomography holder [Sato K et al. (2015) Development of a novel straining holder for transmission electron microscopy compatible with single tilt-axis electron tomography. Microsc. 64: 369-375]. We designed an integrated system using the holder and newly developed straining and image-acquisition software and then developed an experimental procedure for in-situ straining and time-resolved electron tomography (ET) data acquisition. The software for image acquisition and 3D visualization was developed based on the commercially available ET software TEMographyTM. We achieved time-resolved 3D visualization of nanometer-scale plastic deformation behavior in a Pb-Sn alloy sample, thus demonstrating the capability of this system for potential applications in materials science.

Tuning of the interval in a nanohole array of anodic porous alumina through deformation of polymer templates

A new type of process for the fabrication of ideally ordered anodic porous alumina with the desired hole interval is demonstrated.

Socio-Demographic Risk Indicators for Tooth Mortality in Rural Sri Lankans

To explore the socio-demographic factors associated with tooth loss in rural inhabitants of Sri Lanka, a random sample of 2178 males aged 20-60 years was selected using multistage cluster sampling procedure. The number of missing and present teeth was recorded excluding third molars and the subjects were interviewed to elicit socio-demographic information as well as oral hygiene and tobacco consumption habits. The mean number of teeth lost in the sample was 5.17±5.43. Tooth loss increased significantly with age. Sinhalese had significantly fewer lost teeth (5.05±5.38) compared to Tamils (6.54±6.18) and Muslims (6.02±5.21) whereas education, income, oral hygiene practices and tobacco use were significantly associated with tooth loss in the bivariate analysis. A forward stepwise multiple regression analysis revealed that age, Muslim ethnicity and quantified tobacco use were positively associated with tooth loss while better socio-economic conditions and good oral hygiene habits were negatively linked with tooth mortality independent of other factors. Age, Muslim ethnicity, quantified tobacco use, income, education, brushing frequency and substance used for cleaning had significantly affected tooth loss. Quantified tobacco use and oral hygiene may be regarded as modifiable socio-demographic risk indicators associated with tooth mortality in Sri Lankans. Asia Pac J Public Health 2003; 15(2): 105-110.

Factors Associated with Severe Periodontitis in Rural Cambodia

An analytical cross-sectional study was conducted with 812 subjects aged 35-74 years in Prek Russey commune, Cambodia to detect some factors associated with severe periodontitis. Four calibrated examiners employed Community Periodontal Index (CPI) to ascertain periodontal pocket depth (PD) and loss of epithelial attachment (LA). A questionnaire was used to obtain tobacco and alcohol consumption habits. One hundred (12.3%) subjects had one or more sextants with ≥ 4mm PD and ≥ 6mm LA (severe periodontitis). Smoking, tobacco chewing and age were significantly associated with severe periodontitis in bivariate analysis while only age and quantified smoking remained significant in a logistic regression analysis. The impact of quantified smoking on severe periodontitis was almost negligible [OR: 1.0006 (95% CI: 1.0001, 1.001)] compared to that of age [OR ranged from 8.3 at 45-54 years to 22 at 65-74 years (95% CI: 3.1, 62.3)]. Nevertheless, both age and quantified smoking can be considered as factors associated with severe periodontitis in rural Cambodians. Asia Pac J Public Health 2004; 16(1): 50-53.

Maximum bite force at age 70 years predicts all-cause mortality during the following 13 years in Japanese men

There is limited information on the impact of oral function on mortality among older adults. The aim of this prospective cohort study was to examine whether an objective measure of oral function, maximum bite force (MBF), is associated with mortality in older adults during a 13-year follow-up period. Five hundred and fifty-nine community-dwelling Japanese (282 men and 277 women) aged 70 years at baseline were included in the study. Medical and dental examinations and a questionnaire survey were conducted at baseline. Maximum bite force was measured using an electronic recording device (Occlusal Force-Meter GM10). Follow-up investigation to ascertain vital status was conducted 13 years after baseline examinations. Survival rates among MBF tertiles were compared using Cox proportional hazards regression models stratified by sex. There were a total of 111 deaths (82 events for men and 29 for women). Univariable analysis revealed that male participants in the lower MBF tertile had increased risk of all-cause mortality [hazard ratio (HR) = 1·94, 95% confidence interval (CI) = 1·13-3·34] compared with those in the upper MBF tertile. This association remained significant after adjustment for confounders (adjusted HR = 1·84, 95% CI = 1·07-3·19). Conversely, no association between MBF and all-cause mortality was observed in female participants. Maximum bite force was independently associated with all-cause mortality in older Japanese male adults. These data provide additional evidence for the association between oral function and geriatric health.

Association between dental status and food diversity among older Japanese

OBJECTIVE

To investigate the relationship of dental status to food diversity among older Japanese.

DESIGN AND SETTING

A community-based cross-sectional study conducted in the town of Tosa, Kochi Prefecture, Japan.

METHODS

The study participants were 252 Japanese (84 men and 168 women, average age 81.2 years) and dentate participants were classified into three groups: 1-9 teeth, 10-19 teeth and 20 or more teeth. Food diversity was assessed as a validated measure of dietary quality using the 11-item Food Diversity Score Kyoto (FDSK-11), which evaluates frequency of consumption of 11 main food groups. Multivariable analysis of the differences in FDSK-11 score ranging from 0 to 11, with a higher score indicating greater food diversity, among the three dental status groups was conducted using general linear models. All the performed analyses were stratified by gender.

RESULTS

There was no association between dental status and food diversity score in models for men. In contrast, women with ≤ 9 teeth and with 10-19 teeth had significantly lower FDSK-11 scores than women with ≥ 20 teeth after adjusting for confounders (p < 0.001 and p = 0.009, respectively). Additionally, there was a trend toward lower scores for FDSK-11 with fewer teeth (p = 0.001).

CONCLUSION

A less varied diet, as indicated by low FDSK-11 score, was observed in female participants with fewer teeth. Tooth loss was associated with poor diet quality among older Japanese women.

Development of a novel straining holder for transmission electron microscopy compatible with single tilt-axis electron tomography

We have developed a newly designed straining specimen holder for in situ transmission electron microscopy (TEM) compatible with high-angle single tilt-axis electron tomography. The holder can deform a TEM specimen under tensile stress with the strain rate between 1.5 × 10(-6) and 5.2 × 10(-3) s(-1). We have also confirmed that the maximum tilt angle of the specimen holder reaches ±60° with a rectangular shape aluminum specimen. The new specimen holder, termed as 'straining and tomography holder', will have wide range potential applications in materials science.

Lower lip repair using double opposing rectangular rotation flaps with reconstruction of the mentolabial groove and mental protuberance

The use of a rectangular flap is a well known technique for upper lip repair in cleft lip, but is less common for lower lip repair after tumour resection. We have found this type of flap to be favourable for lower lip reconstruction, especially for the lip to mental region. We describe herein an improvement to the technique in which two opposing rectangular flaps, with the length of one side equal to the vertical distance from the mentolabial groove to the vermilion border, were raised on the lateral sides of a U-shaped defect. Reconstruction was performed by interdigitation of the two flaps and a bilateral vermilion advancement flap. This new approach allows a distinct mentolabial groove and mental protuberance to be created by utilizing two opposing rectangular flaps and redundant tissue, without sacrificing sensation and muscle function. Our results suggest that the technique provides excellent functional and cosmetic outcomes in restoration of the lower lip in properly selected patients.

Mandibular inferior cortex erosion as a sign of elevated total serum calcium in elderly people: a 9-year follow-up study

OBJECTIVES

The mandibular inferior cortex (MIC) classification that was determined by observing the mandible distally from the mental foramen in panoramic radiography can be considered to reflect bone loss in the jaws. The purpose of this 9-year study was to investigate whether there is a relationship between MIC condition and total serum calcium (TSC) in elderly Japanese people.

METHODS

A total of 280 subjects aged 70 years at baseline (137 males and 143 females) took part in this longitudinal study design. TSC and dental panoramic radiographs were carried out at the baseline in 1998 and the final year in 2007.

RESULTS

The results of the MIC measurement were divided into two groups according to changes in MIC after the 9-year study period, namely no change group and change group. A significant relationship was found in females but not in males between the MIC condition and the TSC. The regression showed that female subjects are 3.26 times more likely to have increased erosion of the inferior border of the mandible than male subjects after the 9-year study period.

CONCLUSIONS

These results suggest that an increase in erosion of the inferior border of the mandible was significantly associated with an elevated TSC after 9 years and only in females.

Discontinuation of leisure time impact-loading exercise is related to reduction of a calcaneus quantitative ultrasound parameter in young adult Japanese females: a 3-year follow-up study

A 3-year follow-up study on 334 young Japanese females enrolled in a university at the age of 18 years revealed that discontinuation of leisure time impact-loading exercises performed in junior high and/or high school was associated with increased risk of reduction in calcaneus osteo-sono assessment index (OSI).

INTRODUCTION

Bone strength rapidly increases during puberty and reaches its peak by the end of adolescence. The aim of this study was to determine the lifestyle factors that influence the maintenance of calcaneus OSI in young adult females around the time when peak bone mass is attained.

METHODS

Annual health checkups including OSI measurements, anthropometrics, lifestyle analysis, and blood examination were performed 4 times on 334 Japanese females enrolled in a university at the age of 18 years. According to the slope of OSI change during the 3-year follow-up, the subjects were grouped into two categories: OSI loss (the lowest tertile) and OSI gain/stable (the second and third tertiles).

RESULTS

At the baseline assessment, the OSI loss group had higher OSI and height and an earlier menarche age than the OSI gain/stable group. Performing leisure time impact-loading exercise in junior high and/or high school but discontinuing it at university was associated with increased risk of OSI loss, independent of OSI, height and weight at the age of 18 years, weight change during follow-up, age of menarche, energy-adjusted nutrient intake, and alcohol drinking; the odds ratios were 4.1-4.9 compared with those performing impact-loading exercise at university. In particular, duration, frequency, and subjective intensity of impact-loading exercise during high school were positively associated with OSI loss.

CONCLUSION

Discontinuation of leisure time impact-loading exercises performed during late adolescence is associated with an increased risk of OSI loss in young adult females during the 3-year follow-up period.

Serum albumin levels and 10-year tooth loss in a 70-year-old population

Serum albumin levels are a practical marker of general health status in the elderly and have been used to determine the severity of underlying diseases and the risk for death. This longitudinal study evaluated the relationship between serum albumin concentrations and tooth loss over 10 years in elderly subjects, after controlling for confounding factors. A sample of 554 dentate subjects among enrolled subjects (n = 600) was involved in this planned longitudinal study with follow-up examinations after 5 and 10 years. At the 5-year follow-up, 373 (67·3%), subjects were available for re-examination. In addition, 331 (59·7%) were available at the 10-year follow-up. Multiple Poisson regression analysis was conducted to evaluate the relationship between the number of missing teeth over 5 or 10 years and serum albumin levels at baseline after adjusting for 10 variables: gender, serum markers levels at baseline, dental status, smoking habits and educational years and oral health behaviour. The number of missing teeth over 5 or 10 years was significantly negatively associated with serum albumin levels at baseline [incidence rate ratios (IRR) = 0·373, P < 0·0001 for 5 years; IRR = 0·570, P < 0·0001 for 10 years]. We conclude that elderly subjects with hypoalbuminemia are at high risk for 5- and 10-year tooth loss.

Atomic and electronic structure of ultrathin Bi(111) films grown on Bi2Te3(111) substrates: evidence for a strain-induced topological phase transition

We studied the atomic and electronic structures of ultrathin Bi(111) films grown on Bi(2)Te(3) by means of angle-resolved photoemission, first-principles calculations, and low-energy electron diffraction. These Bi films were found to be strained due to the influence of the substrate. Accordingly, the band structure is affected and Bi undergoes a topological phase transition; it is shown that the Z(2) topological invariant in three dimensions switches from +1 (trivial) to -1 (nontrivial or topological). This was clearly confirmed from the change in the surface-state dispersion near the Fermi level. Our discovery offers a method to produce novel topological systems from simple materials.

Peroxisome proliferator-activated receptor (PPAR) γ polymorphism, vitamin D, bone mineral density and periodontitis in postmenopausal women

OBJECTIVES

PPARg regulates bone metabolism and inflammation. Our previous study suggested PPARg Pro12Ala polymorphism to represent a susceptibility factor for periodontitis in pregnant Japanese women. Several recent papers have drawn attention to a possible link between low bone mineral density (BMD) and periodontitis in postmenopausal women. Since the pathogenesis for both involve bone remodeling, they might share common risk factors such as gene polymorphisms and vitamin D level. The present study investigated possible associations between the PPARgPro12Ala polymorphism, periodontitis, BMD and serum 25(OH)D in postmenopausal Japanese women.

MATERIALS AND METHODS

PPARgPro12Ala genotypes of 359 women were determined by PCR-RFLP. BMD and periodontal parameters of each woman were measured. Serum 25(OH)D levels were determined by radioimmunoassay.

RESULTS

PPARgPro12Ala polymorphism was not associated with periodontitis or BMD as an independent factor. Serum 25(OH)D was significantly higher in Ala allele carriers compared to non-carriers. Only in the Ala allele carriers, positive correlations were found between mean clinical attachment level and BMD, between BMD and 25(OH)D, and between percentage of sites with probing depth ≥ 4 mm and 25(OH)D.

CONCLUSIONS

PPARgPro12Ala polymorphism was not independently associated with periodontitis or BMD. However, the polymorphism might be a modulator of the relationship between the two conditions in postmenopausal Japanese women.

Differential effects of a murine monoclonal antibody reactive with the disialylgalactosyl residue on the growth of melanoma cells and T cell activation

A murine monoclonal antibody, S2-566, was generated by immunization with a melanoma line, SK-MEL-28. Although AbS2-566 showed a similar reaction pattern with that of anti-GD3 mAbR24 in cell surface serology, it recognized a disialyl galactosyl structure not only in GD3 but in GT1a and GQ1b. The suppression of the growth of cultured melanoma cells by AbS2-566 was not obvious, in contrast with AbR24. However, the mitogenic effects of AbS2-566 on peripheral lymphocytes were observed showing similar kinetics to those of mAbR24, suggesting different signaling effects based on the different epitope structures.