Cross-sectional study of the factors associated with the number of teeth in middle-aged and older persons with intellectual disabilities

BACKGROUND

We investigated the number of teeth in middle-aged and older individuals with intellectual disability and evaluated the related factors.

METHODS

A questionnaire survey on oral health was administered to 604 persons over 40 years old with intellectual disabilities in Aichi Prefecture, Japan. The questionnaire designed for this study included items on diagnosis of disability, severity of intellectual disability and type of residence. As oral-health-related factors, the proxy-reported number of teeth, family dentist, regular dental check-ups, problems during dental treatment and tooth-brushing frequency were evaluated. A multinomial logistic regression analysis was performed using the proxy-reported number of teeth (≥20, 10-19 or 0-9) as the dependent variable, and the odds ratios (ORs) and 95% confidence intervals (CIs) of independent variables were calculated. In addition, linear regression analysis was performed using the proxy-reported number of teeth as the dependent variable.

RESULTS

In the multivariate multinomial logistic regression analysis, age, diagnosis of disability and type of residence were significantly associated with having 10-19 versus ≥20 teeth. Participants with autism spectrum disorder had a significantly lower OR for 10-19 teeth compared with those with intellectual disability [OR (95% CI): 0.49 (0.22-1.08)]. Age, diagnosis of disability, regular dental check-ups and tooth-brushing frequency were significantly associated with having 0-9 versus ≥20teeth. Participants with Down syndrome had a significantly higher OR for 0-9 teeth compared with those with intellectual disability [OR (95% CI): 3.17 (1.09-9.23)]. The ORs for 0-9 teeth of participants who did not attend regular dental check-ups and who brushed their teeth 1 time/day compared with ≥3 times/day were significantly high, and the OR (95% CI) was 2.37 (1.06-5.30) and 4.76 (1.09-20.77), respectively. [Corrections made on 22 August 2022, after first online publication: in the previous sentence, "who attend" has been changed to "who did not attend".] In the multivariate linear regression analysis, age, diagnosis of disability and regular dental check-ups were significantly associated with the proxy-reported number of teeth. The proxy-reported number of teeth was -0.42 less with each 1-year increase in age. With autism spectrum disorder, the proxy-reported number of teeth was 0.74 more compared with intellectual disability. In Down syndrome, the proxy-reported number of teeth was -0.93 less compared with intellectual disability. The proxy-reported number of teeth was -2.12 less for those who did not have regular dental check-ups.

CONCLUSIONS

The number of teeth in middle-aged and older individuals with intellectual disability was related to age and the type of disability. Regular dental visits may be effective at preventing tooth loss in middle-aged and older persons with intellectual disability.

Utility of the Berlin Initiative Study-1 equation for the prediction of serum vancomycin concentration in elderly patients aged 75 years and older

Accurate assessment of renal function is essential for determining serum vancomycin (VCM) concentration. Creatinine clearance (Ccr)-calculated using the Cockcroft and Gault (CG) equation-can be used to evaluate renal function for determining VCM dosage. However, Ccr-based evaluation may not be an accurate representation of the renal function in the elderly. Herein, we examine the effectiveness of estimated glomerular filtration rate (eGFR) calculated using the Berlin Initiative Study-1 (BIS1) equation, for predicting the serum VCM concentration. Herein, we retrospectively analyzed patients (aged ≥ 75 years) who had received VCM. Serum VCM concentration was predicted based on Ccr and eGFR. eGFR was calculated using the Japanese equation for eGFR (eGFR_JAP), Modification of Diet in Renal Disease (MDRD) equation (eGFR_MDRD), chronic kidney disease epidemiology collaboration (CKD-EPI) equation (eGFR_CKD-EPI), and BIS1 equation (eGFR_BIS1). The predicted serum VCM concentration was compared with the measured values. Prediction bias, accuracy, and precision were evaluated by calculating the mean prediction error (ME), mean absolute prediction error (MAE), and root mean squared prediction error (RMSE). Our results showed that the ME between the measured and the predicted values calculated using Ccr and each eGFR was the largest and smallest when calculated based on Ccr and eGFR_MDRD, respectively. MAE and RMSE were the largest and smallest when calculated based on Ccr and eGFR_BIS1, respectively. A significant difference was observed in the MAE associated with eGFR_JAP, eGFR_MDRD, and eGFR_CKD-EPI compared to that associated with eGFR_BIS1. In conclusion, our results suggest that the BIS1 equation might be useful for determining the VCM dosage in the elderly.

Diet-Induced Mouse Model of Atopic Dermatitis

Atopic dermatitis (AD) is a common skin disease characterized by chronic inflammation and itchiness. Although skin barrier dysfunction and immune abnormalities are thought to contribute to the development of AD, the precise pathogenic mechanism remains to be elucidated. We have developed a unique, diet-induced AD mouse model based on the findings that deficiencies of certain polyunsaturated fatty acids and starches cause AD-like symptoms in hairless mice. Here, we present a protocol and tips for establishing an AD mouse model using a custom diet modified from a widely used standard diet (AIN-76A Rodent Diet). We also describe methods for evaluating skin barrier dysfunction and analyzing itch-related scratching behavior. This model can be used not only to investigate the complex pathogenic mechanism of human AD but also to study the puzzling relationship between nutrition and AD development.

Interaction-Induced Shubnikov-de Haas Oscillations in Optical Conductivity of Monolayer MoSe_{2}

We report polarization-resolved resonant reflection spectroscopy of a charge-tunable atomically thin valley semiconductor hosting tightly bound excitons coupled to a dilute system of fully spin- and valley-polarized holes in the presence of a strong magnetic field. We find that exciton-hole interactions manifest themselves in hole-density dependent, Shubnikov-de Haas-like oscillations in the energy and line broadening of the excitonic resonances. These oscillations are evidenced to be precisely correlated with the occupation of Landau levels, thus demonstrating that strong interactions between the excitons and Landau-quantized itinerant carriers enable optical investigation of quantum-Hall physics in transition metal dichalcogenides.

Periodontitis Is Associated with Chronic Obstructive Pulmonary Disease

Although they are known to share pathophysiological processes, the relationship between periodontitis and chronic obstructive pulmonary disease (COPD) is not fully understood. The aim of the present study was to test the hypothesis that periodontitis is associated with a greater risk of development of COPD, when smoking is taken into account. The analysis in a 5-y follow-up population-based cohort study was based on 900 community-dwelling Japanese adults (age: 68.8 ± 6.3 [mean ± SD], 46.0% male) without COPD aged 60 or older with at least 1 tooth. Participants were classified into 3 categories according to baseline periodontitis severity (no/mild, moderate, and severe). COPD was spirometrically determined by a fixed ratio of <0.7 for forced expiratory volume in 1 s (FEV1)/forced vital capacity (FVC) and by FEV1/FVC below the lower limit of normal. Poisson regression was used to calculate the relative risk (RR) of developing COPD according to the severity of periodontitis. The population attributable fraction (PAF) was also calculated. During follow-up, 22 (2.4%) subjects developed COPD. Compared with no/mild periodontitis subjects, a significantly increased risk of COPD occurred among severe periodontitis subjects (RR = 3.55; 95% confidence interval [CI], 1.18 to 10.67), but no significant differences were observed between the no/mild and moderate categories (RR = 1.48; 95% CI, 0.56 to 3.90). After adjustment for potential confounders, including smoking intensity, the relationship between severe periodontitis and risk of COPD remained significant (RR = 3.51; 95% CI, 1.15 to 10.74). Likewise, there was a positive association of periodontitis severity with risk of COPD ( P for trend = 0.043). The PAF for COPD due to periodontitis was 22.6%. These data highlight the potential importance of periodontitis as a risk factor for COPD.

Relationship of Metabolic Syndrome to Periodontal Disease in Japanese Women: The Hisayama Study

Recent studies have suggested that several systemic conditions—such as obesity, hypertension, hyperlipidemia, and diabetes—are related to periodontitis. The objective of this study was to examine the relationship between periodontitis and 5 components of metabolic syndrome—abdominal obesity, triglyceride level, high-density lipoprotein cholesterol level, blood pressure, and fasting blood sugar level—in 584 Japanese women. In multivariate analyses, persons exhibiting more components of metabolic syndrome had significantly higher odds ratios for a greater pocket depth and clinical attachment loss than did those with no components; the odds ratios for a greater pocket depth and clinical attachment loss of the persons exhibiting 4 or 5 components were 6.6 (95% confidence interval = 2.6–16.4) and 4.2 (95% confidence interval = 1.2–14.8), respectively. These results indicate that metabolic syndrome increases risk of periodontitis, and suggest that people exhibiting several components of metabolic syndrome should be encouraged to undergo a periodontal examination.

The Severity of Periodontal Disease is Associated with the Development of Glucose Intolerance in Non-diabetics: The Hisayama Study

Inflammation is hypothesized to play a significant role in the development of type 2 diabetes; however, reports on clinical inflammatory conditions are limited. Studies have suggested that periodontitis affects glucose control in diabetics. This community-based study examined the relationship between periodontitis and glucose tolerance status, including changes in status. The relationship between periodontal condition and the results of a 75-g oral glucose tolerance test was examined in 961 adults in 1998. Deep pockets (mean pocket depth > 2.0 mm) were significantly associated with impaired glucose tolerance and with diabetes as compared with shallow pockets (< 1.3 mm). In the subgroup with normal glucose tolerance 10 years previously, subjects who subsequently developed impaired glucose tolerance were significantly more likely to have deep pockets. Deep pockets were closely related to current glucose tolerance status and the development of glucose intolerance.

Dietary deficiencies of unsaturated fatty acids and starch cause atopic dermatitis-like pruritus in hairless mice

Hairless mice fed with a special diet (named HR-AD) show atopic dermatitis (AD)-like pruritic skin inflammation that is almost completely resolved with the supplementation of an unsaturated fatty acid (UFA), the linoleic acid (LA). This suggests that the dietary deficiency of LA is the key cause of this dermatitis. However, because there is no appropriate control diet for HR-AD, the involvement of other dietary ingredients cannot be ruled out. Furthermore, it has not yet been tested whether only UFA deficiency can cause such AD-like pruritus. In this study, using semi-purified custom diets, we attempted to reproduce this syndrome. Four-week-old hairless mice were maintained on a widely used standard diet American Institute of Nutrition-76A (AIN-76A), its modifications, or HR-AD. Several modifications of fat and carbohydrate components revealed that dietary deficiency of both UFAs and cornstarch was required to induce severe skin barrier dysfunction as typically occurred in HR-AD-fed mice. An UFA- and cornstarch-deficient diet caused severe AD-like pruritus comparable to HR-AD, despite weak Th2 immune responses and absence of immunoglobulin E production. On the other hand, a diet lacking UFAs but containing cornstarch significantly alleviated the development of pruritic dermatitis. Furthermore, the supplementation of wheat starch similarly improved skin barrier function. In conclusion, this study showed that a lack of certain starches might also be the cause of diet-induced AD. Our findings could help to reproduce the diet-induced AD itch model and also provide evidence that certain starches can have protective and ameliorative effects on AD-like pruritus.

[How to protect the surgeons' faces against spurting blood from the ascending aorta]

The blood spurting from the ascending aorta is uncomfortable for cardiac surgeons. To protect the surgeons' faces from this spurting blood, we use a longitudinal half of a plastic bottle, which is semi see-through. While the assistant is holding this device above the ascending aorta, the surgeons can proceed the operation with good surgical view.

[One stage repair for extensive aortic aneurysm using the pull-through technique]

We describe 2 cases of extensive aortic aneurysm. One was an 88-year-old female with a diagnosis of a rupture of the distal descending aortic aneurysm and the distal arch aneurysm. The 2nd case was a 68-year-old female who had undergone graft replacement of the ascending aorta for acute type A dissection 5 years before. She was diagnosed with an enlarging aneurysm of the false lumen from the transverse arch to the distal descending aorta. We performed 1 stage replacement of the aortic arch and the descending thoracic aorta by using the pull-through technique with a long elephant trunk (LET) through a median sternotomy under selective cerebral perfusion. Distal anastomosis of LET was done by posterior mediastinal approach. Postoperative courses were uneventful without neurological deterioration or respiratory distress.

Serum levels of resistin and adiponectin in women with periodontitis: the Hisayama study

Resistin and adiponectin, recently discovered adipokines, are secreted from adipose tissue, with postulated opposing functions in insulin resistance and inflammation. More recently, an abundance of resistin was detected in macrophages, which suggests its important role in inflammation. The aim of this study was to clarify circulating serum adipokine levels in women with periodontitis. Thirty-four women with moderate to severe periodontitis and 42 control individuals with healthy gingiva (50- to 59-year-old women) were selected. The serum level of adipokines was analyzed between groups, along with the obesity index, smoking status, and age. Having periodontitis was significantly associated with an increased level of resistin, both in bivariate (OR, 3.0; 95% CI, 1.2-7.6) and multivariate (adjusted OR, 3.1; 95% CI, 1.1-8.6) analyses. The association of periodontitis with a decreased level of adiponectin did not reach statistical significance. It was concluded that an increased serum resistin level in middle-aged Japanese women with periodontitis may affect systemic health.

The Extent of Alveolar Bone Loss Is Associated With Impaired Glucose Tolerance in Japanese Men

BACKGROUND

The treatment of periodontal disease in diabetic patients is reported to have a beneficial effect on their glucose control. A recent study indicated that having deep pockets is significantly associated with past development of glucose intolerance in non-diabetic individuals using an oral glucose tolerance test (OGTT). These findings suggest that periodontal disease is a risk factor for diabetes, although more evidence is needed.

METHODS

A total of 193 Japanese men aged 50 to 54 years with at least 10 teeth were examined as part of a comprehensive health examination before retirement from the Japan Self-Defense Force. Alveolar bone loss of the posterior teeth was measured on a panoramic x-ray film. An OGTT was administered and impaired glucose tolerance (IGT) and diabetes were defined. The relationships between the mean ratio of alveolar bone loss to root length and OGTT results were analyzed after adjusting for known risk factors for diabetes.

RESULTS

The proportion of subjects with IGT increased significantly in the subjects with higher tertiles of alveolar bone loss (P<0.05). In the multivariate logistic regression analysis excluding diabetic subjects, the adjusted OR for IGT to normal glucose tolerance (NGT) increased in subjects with higher tertiles of alveolar bone loss (P for trend=0.03). In the subjects with the highest tertile of alveolar bone loss, the adjusted OR for IGT to NGT was 4.27 (95% confidence interval [CI]: 1.41 to 12.9; P=0.01).

CONCLUSION

The degree of alveolar bone loss is significantly associated with IGT, suggesting that periodontitis with alveolar bone loss is associated with impaired glucose tolerance.

Relationship between obesity, glucose tolerance, and periodontal disease in Japanese women: the Hisayama study

BACKGROUND

Recent studies have reported a relationship between obesity and periodontal disease. Obesity is the strongest risk factor for type 2 diabetes, which is, in turn, a risk factor for periodontal disease. An oral glucose tolerance test is necessary to diagnose diabetes; however, no study has examined the relationship between obesity and periodontal disease by taking oral glucose tolerance test results into consideration.

METHODS

In all, 584 Japanese women aged between 40 and 79 years old, with at least 10 teeth, underwent health examinations. Body mass index, waist-hip ratio, body fat, and oral glucose tolerance test results were used as independent variables with known risk factors for periodontal disease. Mean probing pocket depth and mean attachment loss were used as the dependent variables.

RESULTS

In all of the analyses, body mass index, body fat, and waist--hip ratio were significantly associated with the highest quintile of mean probing pocket depth, even when adjusted for oral glucose tolerance test results. In the multivariate analysis, the subjects with the highest quartile of body mass index had a significantly higher odds ratio (OR) for the highest quintile of mean probing pocket depth [OR, 4.3; 95% confidence interval (CI), 2.1--8.9; p<0.001], whereas neither impaired glucose tolerance nor diabetes were significantly associated with deep pockets. The relationships between the obesity indexes and mean attachment loss did not reach statistical significance.

CONCLUSION

Obesity was associated with deep pockets in Japanese women, even after adjusting for oral glucose tolerance test.

Relationship between dental care and oral health in institutionalized elderly people in Japan

This study examined the relationship between dental care and dental health status in institutionalized elderly people in Japan through a 6-year prospective cohort study. All the 719 subjects received both baseline and follow-up surveys. The uptake of dental care was examined at the follow-up survey. We examined the relationship between baseline variables and the provision of dental care, and the relationship between dental care and change of oral health status. About 47% of the subjects and about 60% of the baseline dentate subjects received some dental treatment during the 6-year follow-up period. The subjects who were in better systemic and dental health at baseline used dental services frequently. The number of teeth needing extraction decreased in the subjects who received dental treatment, and increased in the untreated subjects. Denture status was better in the treated subjects than in the untreated subjects. Dental care appears to be an important factor in maintaining a healthy oral status for the institutionalized elderly.

[Successful total arch replacement for a 92-year-old woman with acute Stanford A aortic dissection: report of a case]

We reported a successful case of emergent total arch replacement for a nonagenarian with acute Stanford A aortic dissection. A 92-year-old woman complained of general fatigue, with hypotension. Echocardiography showed moderate pericardial effusion and aortic regurgitation. Computed tomography (CT) scan showed widely extended aortic dissection from the ascending aorta to descending thoracic aorta, and cardiac tamponade. An emergent total arch replacement was performed under hypothermic selective cerebral perfusion with bladder temperature of 22.5 degrees C. Although she suffered from pneumothorax, renal insufficiency and gastrointestinal (GI) bleeding postoperatively, she tolerated the operation and complications, well. She is now leading a good life with the same level of activities of daily living (ADL) as preoperative one.

Immune response to Japanese rabies vaccine in domestic dogs

To evaluate the immune response induced by Japanese rabies vaccine for veterinary use as international units (IU), we measured levels of rabies antibody in serum samples from dogs by the rapid fluorescent focus inhibition test (RFFIT). In dogs immunized with a reference vaccine (potency level of 3.1 IU/ml), prepared by the same method as that used to produce commercial vaccine, and its dilutions (1 : 2 or 1 : 4), neutralizing-antibody levels increased to 1.0-2.0 IU/ml over a period of 1 month and then decreased to 0.2-1.5 IU/ml over a period of 1 year after the first vaccination and showed a remarkable increase to 12-47 IU/ml after the second vaccination. Sixty-five (74.7%) of the 87 serum samples from domestic dogs that were tested were seropositive (> or =0.1 IU/ml). However, the seropositive rate in dogs less than 1-year old at the time of vaccination was low (57.1%), and the antibody levels in these dogs were not sufficiently high for the rabies antibody titre in serum to be maintained for 1-year. Levels of rabies antibody in all serum samples were also measured by the virus neutralizing test (VNT), and a strong correlation (r > 0.95) was found between the results of the RFFIT and those of the VNT.

[Removal of methicillin-resistant staphylococcus aureus infected pacemaker leads under cardiopulmonary bypass: report of a case]

A 71-year-old man, who underwent an intravenous pacemaker implantation previously, suffered from fever and local infection of the generator pocket. A blood culture showed positive for methicillin-resistant staphylococcus aureus (MRSA). He underwent removal of total pacemaker system under cardiopulmonary bypass support successfully. Two leads were tightly adhered to the right atrial free wall, tricuspid valve and right ventricular trabeculation. Postoperative course was uneventful with administration of antibiotics for 5 weeks. Removal under cardiopulmonary bypass is considered to be an effective procedure for treatment of patients with infected pacemaker lead.

Morphogenetic activity of extracellular matrices on cultured podocytes. Laminin accelerates podocyte process formation in vitro

Morphogenetic effects of various extracellular matrix proteins on the renal podocyte were investigated using the conditionally immortalized podocyte cell line. Podocytes were plated on glass coverslips and coated with the following matrix proteins: laminin-10/11, laminin-1, fibronectin, collagen type IV, collagen type I. Three hours after plating, podocytes on laminins developed prominent processes, while those on other matrix proteins started to elongate processes after two days. Vinculin-immunolabeling showed that podocytes plated on laminins possessed thin rod-shaped focal contacts, whereas those on fibronectin showed large dot-shaped focal contacts. Inhibition of serine/threonine protein kinases induced podocyte process formation in an extracellular matrix-independent manner. The present study reveals the significance of laminin on podocyte morphogenesis in vitro, and shows that different extracellular matrix proteins trigger different intracellular signals governing podocyte morphogenesis. Taken together with our previous studies, podocyte process formation is thought to be regulated by protein Ser/Thr phosphorylation.

[Mid-term outcome of aortic arch operation for true aneurysms; using an axillary artery perfusion]

To prevent cerebral infarction during perioperative period, we have used an axillary artery for systemic perfusion and selective cerebral perfusion for aortic arch operation. Since 1996, 34 aortic arch operations were performed in our institution. Simultaneous 5 CABGs, 4 AVRs, 2 aortic root replacements and 1 MVR were performed. There were 2 hospital deaths (5.9%, sepsis and acute heart failure) and only 1 (2.9%) cerebral infarction. There were no deaths in patients over 75 years of age and in patients with extensive aneurysm which were replaced by 2-staged operation. Overall 3 years survival was 94.1% with no further death. We conclude that aortic arch operation through an axillary artery perfusion and with hypothermic selective cerebral perfusion can be performed with very low mortality and morbidity.

Nitric oxide-dependent and -independent inhibition by lipopolysaccharide of phosphoinositide hydrolysis in vascular smooth muscle

The present study was designed in order to clarify the mechanisms of diminished phosphoinositide (PI) hydrolysis by lipopolysaccharide (LPS) in blood vessels. In vitro pretreatment of rat aortic strips with LPS (1 microg/ml) for 10 or 24 hrs inhibited 5-hydroxytryptamine (5-HT, 100 microM)-induced inositol monophosphate accumulation in a time-dependent manner. Coincubation of the aortas with N(G)-monomethyl-L-arginine (LNMMA, 1 mM) completely prevented the early diminution of 5-HT-stimulated PI hydrolysis after 10-hr exposure to LPS but did not affect the delayed diminution after 24-hr exposure. Coincubation with cycloheximide (1 microM) did not prevent the delayed LPS-induced diminution of phosphoinositide hydrolysis. Tetraethylammonium (10 mM) did not restore the diminished phosphoinositide hydrolysis after 24-hr exposure to LPS, suggesting that the diminution is not due to K+ channel activation. Sodium fluoride (10 mM)-induced inositol monophosphate accumulation was also decreased in the aortic strips after LPS incubation for 24 hrs, and this decrease was not prevented by coincubation with LNMMA. LPS incubation time-dependently increased nitric oxide (NO) production in the aortas, which was completely inhibited by LNMMA or cycloheximide. These results suggest that NO is mainly involved in the inhibitory action of LPS on stimulated-PI hydrolysis in the early stage, while in the later stage, a factor(s) besides NO causes attenuation of the stimulated-PI hydrolysis.

Passive immunization with milk produced from an immunized cow prevents oral recolonization by Streptococcus mutans

Cell surface protein antigen (PAc) and water-insoluble glucan-synthesizing enzyme (GTF-I) produced by cariogenic Streptococcus mutans are two major factors implicated in the colonization of the human oral cavity by this bacterium. We examined the effect of bovine milk, produced after immunization with a fusion protein of functional domains of these proteins, on the recolonization of S. mutans. To prepare immune milk, a pregnant Holstein cow was immunized with the fusion protein PAcA-GB, a fusion of the saliva-binding alanine-rich region (PAcA) of PAc and the glucan-binding (GB) domain of GTF-I. After eight adult subjects received cetylpyridinium chloride (CPC) treatment, one subgroup (n = 4) rinsed their mouths with immune milk and a control group (n = 4) rinsed with nonimmune milk. S. mutans levels in saliva and dental plaque decreased after CPC treatment in both groups. Mouth rinsing with immune milk significantly inhibited recolonization of S. mutans in saliva and plaque. On the other hand, the numbers of S. mutans cells in saliva and plaque in the control group increased immediately after the CPC treatment and surpassed the baseline level 42 and 28 days, respectively, after the CPC treatment. The ratios of S. mutans to total streptococci in saliva and plaque in the group that received immune milk were lower than those in the control group. These results suggest that milk produced from immunized cow may be useful for controlling S. mutans in the human oral cavity.

Molecular cloning of Bombyx cerebral opsin (Boceropsin) and cellular localization of its expression in the silkworm brain

We have cloned a cDNA for a novel opsin from the larval brain of the silkworm Bombyx mori in which the photoperiodic photoreceptor had been supposed to reside in the cephalic central nervous system (CNS). Its deduced amino acid sequence was composed of 381 amino acids and included amino acid residues highly conserved in insect visual pigments. This opsin belonged to the long wavelength photoreceptor group of insect opsins and showed the greatest degree of homology (84%) with the green visual photoreceptor in the sphingid moth. We have designated this Bombyx cerebral opsin as Boceropsin. Southern blotting experiments indicated that the Boceropsin gene is present in a single copy, and RT-PCR analysis revealed that Boceropsin mRNA is expressed in the larval brain but not in the subesophageal ganglion (Sg) or thoracic ganglion (Tg). Immunohistochemical analyses demonstrated that Boceropsin protein is present bilaterally in some defined cells localized in the brain of Bombyx larvae. This is the first report of expression of an opsin-based protein in CNS of an insect. The possibility that the Boceropsin functions as the photoperiodic receptive pigment in the silkworm is also discussed.

Decrease in Ca(2+)-sensitizing effect of UD-CG 212 Cl, a metabolite of pimobendan, under acidotic condition in canine ventricular myocardium

We studied the influence of acidosis on the positive inotropic effect of UD-CG 212 Cl (4,5-dihydro-6-[2-(4-hydroxyphenyl)-1H-benzimidazole-5-yl]-5-methyl-3(2H)-pyridazinone), an active metabolite of pimobendan, in canine ventricular trabeculae loaded with aequorin. The positive inotropic effect of UD-CG 212 Cl was markedly suppressed under acidotic conditions. The maximal contractile response to UD-CG 212 Cl was attained at 10(-5) M in the control condition at pH 7.4, but was not achieved even at 10(-4) M during acidosis. The maximal inotropic effect of UD-CG 212 Cl was 18% of the maximal response to isoproterenol (ISO(max)) in association with an increase in Ca(2+) transients of 7% of ISO(max) in the control, while they are 8 and 6% of ISO(max) under acidosis, respectively. Acidosis abolished the increase in myofilament Ca(2+) sensitivity induced by UD-CG 212 Cl, whereas the increase in Ca(2+) transients induced by the compound was not affected by acidosis. In conclusion, UD-CG 212 Cl elicited a positive inotropic effect even under acidosis, however, UD-CG 212 Cl was much less effective as a cardiotonic agent under acidosis mainly due to a decrease in the Ca(2+)-sensitizing effect under acidotic condition.

Synthesis, characterization, and stereochemistry of oxorhenium(V) complexes with 2-aminoethanethiolate

A series of oxorhenium(V) complexes with 2-aminoethanethiolate (aet), [ReO(aet-N,S)(D-pen-N,O,S)] (2), [[ReO(aet-N,S)(2)](2)O] (3), [ReO(Cl)(aet-N,S)(2)] (4), and [ReO(aet-N,S)(Haet-S)(2)]Cl(2) ([5]Cl(2)) was newly prepared starting from ReO(4)(-). The reaction of NH(4)ReO(4) with a 1:1 mixture of Haet.HCl and D-H(2)pen (D-penicillamine) in the presence of SnCl(2).2H(2)O in water gave 2, 3, and the known complex [ReO(D-Hpen-N,S)(D-pen-N,O,S)] (1). These complexes were fractionally precipitated by controlling the pH of the reaction solution. The complex 2 was also prepared in a higher yield by a similar reaction using methanol as a solvent. The crystal structure of 2 was determined by X-ray crystallography; 2 crystallizes in the tetragonal space group P4(3) with a = 9.621(1), c = 12.911(1) A, V = 1195.0(3) A(3), and Z = 4. The oxorhenium(V) core in 2 is coordinated by a bidentate-N,S aet ligand and a tridentate-N,O,S D-pen ligand, having a distorted octahedral geometry with a cis-N cis-S configuration in the equatorial plane perpendicular to the O-Re-O axis. The 1:2 reaction of NH(4)ReO(4) with Haet.HCl in the presence of SnCl(2).2H(2)O in methanol produced 4, which is interconvertible with 3, while the corresponding 1:3 reaction resulted in the isolation of [5]Cl(2). The complexes 4 and 5 were also structurally characterized; 4 crystallizes in the monoclinic space group P2(1)/c with a = 6.839(1), b = 10.0704(6), c = 14.1075(8) A, beta = 91.729(8) degrees, V = 971.2(2) A(3), and Z = 4, while [5]Cl(2) crystallizes in the triclinic space group P1 with a = 11.938(3), b = 12.366(3), c = 5.819(1) A, alpha = 102.71(2), beta = 101.28(2), gamma = 75.41(2) degrees, V = 802.0(3) A(3), and Z = 2. In 4, the oxorhenium(V) core is octahedrally coordinated by two bidentate-N,S aet ligands, which form a cis-N cis-S configurational equatorial plane with a Cl(-) ion trans to the oxo ligand. On the other hand, the oxorhenium(V) core in [5](2+) is coordinated by one bidenate-N,S aet and two monodentate-S Haet ligands, having a distorted trigonal-bipyramidal geometry with S and N donors at the apical positions.

Relationship between upper body obesity and periodontitis

Upper body obesity, related to visceral fat accumulation, is known to increase the risk of various adult diseases, especially type 2 diabetes and cardiovascular disease. This study was conducted to clarify the relationship between upper body obesity and periodontitis. We studied 643 apparently healthy, dentulous Japanese adults who attended programs at Fukuoka Health Promotion Center. Waist-hip ratio, body-mass index (BMI), and body fat were significant risk indicators for periodontitis after adjustment for known risk factors (p < 0.002). Subjects were divided into four BMI (or body fat) categories. In only the subjects with high waist-hip ratio, higher categories of BMI (or body fat) significantly increased the adjusted risk of periodontitis, compared with subjects with low waist-hip ratios and the lowest category of BMI (or body fat). The reported relationship between cardiovascular disease and periodontitis should be reconsidered, since abdominal adiposity or visceral fat can be related to both diseases.

Concomitant aortic arch and root replacement using a stentless xenograft for acute type A dissection

A 78-year-old woman with an aortic root aneurysm and aortic regurgitation developing acute type A dissection successfully underwent aortic root replacement using a stentless xenograft during core cooling, followed by total aortic arch replacement under selective cerebral perfusion with deep hypothermia. This bioprosthesis can be used in the same way as a free-hand homograft and potentially provides an aggressive, safe option for acute aortic dissection requiring aortic root reconstruction in elderly patients.

Isolation of the third component of complement and its derivative with anaphylatoxin-like activity from the plasma of the newt Cynops pyrrhogaster

The third component of complement (C3) of a newt, Cynops pyrrhogaster, was purified using a fast protein liquid chromatography technique. The purified newt C3 consists of two polypeptide chains (the molecular masses of the alpha and beta-chains of C3 were 120,000 and 70,000, respectively) linked by disulfide bonds. The alpha-chain retained an internal thiolester bond that was cleaved with methylamine, and the N-terminal amino acid sequence of the alpha-chain was XVQLIDAKAGKAAKF. Digestion of newt C3 with trypsin yielded fragments that induced significant histamine release from newt peritoneal cells. These results indicate that newt C3 retains structural and functional properties shared with mammalian C3.

Inhibitory effect of bovine milk lactoferrin on the interaction between a streptococcal surface protein antigen and human salivary agglutinin

Human whole saliva induces aggregation of Streptococcus mutans cells via an interaction between a surface protein antigen (PAc) of the organism and salivary agglutinin. Bovine milk inhibits the saliva-induced aggregation of S. mutans. In this study, the milk component that possesses inhibitory activity against this aggregation was isolated and found to be lactoferrin. Surface plasmon resonance analysis indicated that bovine lactoferrin binds more strongly to salivary agglutinin, especially to high molecular mass glycoprotein, which is a component of the agglutinin, than to recombinant PAc. The binding of bovine lactoferrin to salivary agglutinin was thermostable, and the optimal pH for binding was 4.0. To identify the saliva-binding region of bovine lactoferrin, 11 truncated bovine lactoferrin fragments were constructed. A fragment corresponding to the C-terminal half of the lactoferrin molecule had a strong inhibitory effect on the saliva-induced aggregation of S. mutans, whereas a fragment corresponding to the N-terminal half had a weak inhibitory effect. Seven shorter fragments corresponding to lactoferrin residues 473-538 also showed a high ability to inhibit the aggregation of S. mutans. These results suggest that residues 473-538 of bovine lactoferrin are important in the inhibition of saliva-induced aggregation of S. mutans.

Characteristics of patients complaining of halitosis and the usefulness of gas chromatography for diagnosing halitosis

OBJECTIVE

The purpose of this study was to examine the characteristics of patients complaining of halitosis and to evaluate the diagnostic accuracy of 3 methods of measuring halitosis.

STUDY DESIGN

The actual degree of halitosis was determined through use of an organoleptic test in 155 patients aged 46 +/- 17 years (mean +/- SD). The volatile sulfur compounds (VSCs) were determined with gas chromatography and with sulfide monitoring.

RESULTS

The organoleptic test revealed that 55% of the subjects had either no mouth odor or slight mouth odor. There was a significant correlation between the organoleptic score and the total VSC level as determined through use of other methods. The critical discrimination value of the total VSC level was calculated to be 0.057 ppm for gas chromatography and 0.117 ppm for sulfide monitoring; high sensitivity and specificity were obtained when the gas chromatography value was used. The amount of tongue coating was significantly greater in the halitosis-positive group than in the halitosis-negative group, whereas there was no difference in salivary flow rate between the 2 groups.

CONCLUSION

These results indicate that determining VSCs with gas chromatography is a useful means of diagnosing halitosis.

Role of CD4+ T cells in the rat to mouse cardiac xenotransplantation

T cell subsets involved in rejection of xenografts were analyzed using a rat to mouse cardiac xenotransplant model. Proliferating response and interleulin-2 (IL-2) production in recipients' spleen cells were almost completely abrogated by elimination of L3T4+ T cells, but not by elimination of Lyt2.1+ T cells. Cytotoxic T lymphocyte (CTL) activities were mediated by both L3T4+ and Lyt2.1+ T cells with the help of IL-2-producing L3T4+ T cells. Administration of anti-L3T4 monoclonal antibody (mAb) into recipient mice resulted in a significant prolongation of graft survival (mean graft survival was 29.2 days). Moreover, anti-L3T4 mAb treatment plus thymectomy led to indefinite graft survival. Anti-rat endothelial cell (EC) antibody production in the grafted mice was remarkably suppressed by anti-L3T4 mAb treatment. In contrast, Lyt2.1 mAb treatment did not prolong the graft survival and did not suppress anti-EC antibody production. These results indicated the absolute requirement of L3T4+ T cells in the rejection of rat to mouse cardiac xenografts.

Psychological condition of patients complaining of halitosis

OBJECTIVES

The purpose of this study was to examine the relationship between the actual degree of malodor and the psychological condition of patients complaining of halitosis.

METHODS

The subjects consisted of 155 patients aged 46+/-17 years (mean+/-SD) who visited the Halitosis Clinic at Kyushu University Dental Hospital, Fukuoka, Japan. The Cornell Medical Index (CMI) Health Questionnaire was used to evaluate the psychological condition of patients. The degree of halitosis was estimated by the organoleptic test.

RESULTS

Fifty-five percent of the patients had no or slight odor. Patients with a lower degree of halitosis showed a stronger psychopathological profile. There was a significant correlation between the degree of halitosis and the tendency toward neurosis (Spearman's rank correlation coefficient r=-0.37, P<0.001).

CONCLUSIONS

The results suggest that psychological condition is closely associated with symptoms of patients complaining of halitosis. The CMI Health Questionnaire may be a helpful tool for the diagnosis of patients who complain of halitosis.

Influence of dentition status on physical disability, mental impairment, and mortality in institutionalized elderly people

The loss of teeth is known to influence the mastication of foods and nutritional status. Therefore, we hypothesize that poor dentition status can impair the systemic health of the aged. To clarify the influence of dentition status on deterioration in physical ability, mental impairment, and mortality, we conducted a six-year prospective cohort study of the institutionalized elderly living in 29 of the 30 institutions for the elderly in Kitakyushu, Japan. Bivariate analysis revealed that worse dentition status at baseline led to significantly worse physical and mental impairment, and higher mortality. In a multiple logistic regression analysis, the physical ability of edentulous subjects without dentures significantly deteriorated compared with that of dentate subjects with 20 or more teeth. The six-year mortality rate of the edentulous subjects without dentures was significantly higher than that of the subjects with 20 or more teeth. Poorer dentition status, especially edentulousness without dentures, may therefore be related to deterioration in the systemic health of the aged.

Two distinct mechanisms underlie the stimulation of neurotransmitter release by phorbol esters in clonal rat pheochromocytoma PC12 cells

Phorbol ester treatment induces the phosphorylation of SNAP-25 at Ser(187) and the potentiation of Ca(2+)-induced dopamine (DA) and acetylcholine (Ach) release from PC12 cells. In order to evaluate the functional consequences of phosphorylation, quantitative analysis was carried out using an anti-phosphopeptide antibody that specifically recognizes SNAP-25 phosphorylated at Ser(187). DA and ACh release, assayed in low-K(+) as well as high-K(+) solution, increased by treating the cells with phorbol-12-myristate-13-acetate (PMA); however, the stimulation of high-K(+)-dependent release occurred at lower concentrations and with shorter exposures to PMA than that of the basal release in low-K(+)-solution. The PMA-induced phosphorylation of SNAP-25 did not correlate with the potentiation of high-K(+)-dependent neurotransmitter release. The potentiation of high-K(+)-dependent DA release by phorbol 12,13-diacetate (PDA), a water soluble phorbol ester, almost completely disappeared within 1 min after washing PDA in the presence of okadaic acid, conditions under which the phosphorylation of SNAP-25 persisted for at least 15 min. PMA-induced phosphorylation of SNAP-25 was inhibited by staurosporine, however, the potentiation of high-K(+)-dependent DA release was suppressed only partially. These results indicate that protein kinase activation does not account for a large fraction of the phorbol ester-induced potentiation of depolarization-dependent neurotransmitter release from PC12 cells.

Simple and rapid detection of Streptococcus mutans and Streptococcus sobrinus in human saliva by polymerase chain reaction

Streptococcus mutans and Streptococcus sobrinus are major pathogens causing dental caries in humans. A simple and rapid method to detect these species in human saliva simultaneously was developed using the polymerase chain reaction (PCR). Chromosomal DNA was extracted by boiling bacterial cells in lysis solution containing 1% Triton X-100. Oligonucleotide primers specific for portions of the glucosyltransferase genes (gtfB of S. mutans and gtfI of S. sobrinus) were designed. After PCR using two sets of these primers, S. mutans and S. sobrinus were specifically identified. The method was capable of amplifying DNA fragments specific for these species from chromosomal DNA extracted from 1 x 10(3) cells, or from 10 microliters of clinical saliva samples containing 1 x 10(3) colony-forming units of either streptococcal species. A second PCR, using the first PCR product as a template with newly designed internal primers, made it possible to detect 1 x 10(2) colony-forming units of either streptococcal species in 10 microliters of saliva samples. These results indicate that the PCR method developed in this study is useful for detecting S. mutans and S. sobrinus in saliva and that it can be used in epidemiological studies to evaluate the prevalence level of these organisms.

Comparative study of the N-glycans of human monoclonal immunoglobulins M produced by hybridoma and parental cells

Cell-cell hybridization is one method of establishing cell lines capable of producing an abundance of antibodies. In order to clearly characterize antibodies produced by hybridomas, the influence of cell-cell hybridization on the glycosylation of produced antibodies should be studied. In this report, we describe structural changes of the N-glycans in immunoglobulin M (IgM) produced by a hybridoma cell line termed 3-4, which was established through hybridization of an IgM-producing Epstein-Barr virus transformed human B-cell line termed No. 12, and a human myeloma cell line termed P109. We analyzed the structures of sugar chains on the constant region of the mu-chain of IgMs produced by parental No. 12 cells and hybridoma 3-4 cells. In both parental cells and hybridoma cells, the predominant structures at Asn171, Asn332, and N395 were fully galactosylated biantennary complex types, with or without core fucose and/or bisecting GlcNAc. However, the amount of bisecting GlcNAc was markedly decreased in the hybridoma cells. Therefore, the activity of UDP-N-acetylglucosamine:beta-D-mannoside beta-1,4-N-acetylglucosaminyltransferase (GnT-III) responsible for the formation of bisecting GlcNAc was measured in parental cells and hybridoma cells. No. 12 cells showed some GnT-III activity, whereas P109 cells showed no such activity. The corresponding level of activity observed in hybridoma 3-4 cells was much lower than that in No. 12 cells. The above results demonstrated a reduction in the intracellular activity of GnT-III in the hybridoma cells, which was largely due to the influence of P109 cells. Moreover, the sugar chain structures of IgMs produced by the cells reflected the level of GnT-III activity.

Synthesis and structure-activity relationships of a new class of selective EP3 receptor agonist, 13,14-didehydro-16-phenoxy analogues of prostaglandin E1

A series of 13,14-didehydro-16-phenoxy analogues of prostaglandin E1 was synthesized and their agonistic activity on EP receptor subtypes was evaluated. 13,14-Didehydro-16-phenoxy-1-decarboxy analogues, 7e and 7f, display highly selective activity on the EP3 receptor subtype, thus, their utility as a selective anti-ulcer agent can be expected.

Exogenous 20K growth hormone (GH) suppresses endogenous 22K GH secretion in normal men

The physiological and pharmacological functions of the 20-kDa human GH (20K-hGH) isoform are unknown. We conducted a pharmacokinetic study of recombinant 20K-hGH in human subjects (Phase I clinical trial). Placebo or 20K-hGH was administered sc to normal men (20-31 yr of age, n = 6-8 per group) at 2100 h. Serum 20K- and 22K-hGH levels were monitored every 30 min for 24 h by specific enzyme-linked immunosorbent assays. Serum free fatty acid, insulin-like growth factor I, insulin, and glucose levels were measured for 24 h. In the placebo group, the secretion profiles of endogenous 20K- and 22K-hGH were pulsatile and similar to each other. The proportion of 20K- to 22K-hGH was fairly constant. In the 20K-hGH-treated groups, serum 20K-hGH levels increased in a dose-dependent manner over the dose range of 0.01-0.1 mg/kg. Maximum serum 20K-hGH levels were reached at 3-4 h and decreased with half-lives of 2-3 h. Marked suppression of endogenous 22K-hGH secretion was observed in a time-dependent manner. Serum free fatty acid and insulin-like growth factor I levels were significantly elevated (P < 0.01) at 4, 8, and 12 h and at 8, 12, and 24 h after 20K-hGH administration, respectively. Serum insulin and glucose levels did not change significantly within 24 h. These results suggested that: 1) regulation of 20K-hGH secretion is physiologically the same as that of 22K-hGH; 2) the pharmacokinetics after sc injection of 20K-hGH are comparable with those of 22K-hGH; 3) 20K-hGH regulates hGH secretion through "GH-induced negative feedback mechanisms"; and 4) administration of 20K-hGH is expected to exert GH actions (growth-promoting activity and lipolytic activity). Monitoring of serum 20K- and 22K-hGH levels may be useful in evaluating the effects of administered GH isoforms on their own release from the pituitary.

An ileostomy at the aganglionic ileum for total colon aganglionosis

For the initial management of total colon aganglionosis (TCA), an ileostomy is usually created at the distal end of the ganglionic bowel, which is associated with profuse diarrhea resulting in a water and electrolyte imbalance as well as malnutrition during the ileostomy period. An ileostomy at the aganglionic ileum several centimeters toward the anal side of the transition for TCA is thus expected to cause bowel retention without any bowel obstruction and to facilitate water reabsorption in the small bowel. We performed this procedure in 2 babies with TCA. The length of the aganglionic ileum was 50 cm and 10 cm, respectively. The ileostomies were made 5 cm distal to the transition at 1 month and 1 day after birth, respectively. Oral feedings were well tolerated, resulting in adequate weight gain and the stools were semisolid during the ileostomy periods. Definitive operations using the Duhamel procedure with a right colon patch graft without the creation of a new ileostomy were successfully performed at 7 and 3 months of age, respectively. The postoperative courses were satisfactory. An ileostomy at the aganglionic ileum appears to be the method of choice as initial management for patients with TCA.

Detection of exogenous growth hormone (GH) administration by monitoring ratio of 20kDa- and 22kDa-GH in serum and urine

We previously demonstrated that individual subjects have fairly constant ratios of serum concentrations of 20 kDa- (20K) and 22 kDa-GH (22K). The aim of this study is to demonstrate the possibility of utilizing the changes in the ratio of 20K/22K for detecting the exogenous administration of 22K. A male patient with idiopathic dilated cardiomyopathy (age 51) received 22K (4U, s.c.) every other day. The concentrations of 20K and 22K in serum and urine were measured using enzyme-linked immunosorbent assays before and after administration. The administration of 22K increased total GH concentration, and markedly decreased the ratio of 20K/22K in serum, especially 2-10 h after the administration. From calculations, it became clear that the concentration of exogenous 22K reached a peak between 2-4 h after the administration and decreased to a negligible level after 24 h. The ratio of 20K/22K in the 0-24 h urine was 5 times lower than that in the 24-48 h urine. These data suggest that, by monitoring the ratio of 20K/22K in serum or urine, it is possible to determine whether or not GH has been externally administered and to calculate the serum GH that has been administered.

A case of biliary atresia with cystic dilatation of the extrahepatic bile duct and polysplenia syndrome

A 79-day-old girl presented with jaundice and acholia. Laboratory findings disclosed elevated levels of bilirubin, transaminases, and gamma-glutamyl transferase. A chest X-ray film showed dextrocardia. A computed tomographic scan revealed a cystic mass at the porta hepatis, multiple spleens in the right side of the abdomen, and absence of the inferior vena cava. Under the diagnosis of biliary atresia (BA) (I-cyst) associated with polysplenia syndrome, a hepatic portojejunostomy was performed at 80 days of age. The postoperative course was uneventful, and the jaundice cleared. Although the occurrence of associated anomalies in BA is rare, polysplenia is most commonly seen, and its incidence is reported to be 2% to 10%. Patients with BA and polysplenia usually have a poor prognosis, however, this patient may have a good prognosis due to uneventful recovery from the jaundice.