Touch-Cure Polymerization at the Composite Cement-Dentin Interface

Ceramic restorations are often adhesively luted onto the tooth prep. The so-called touch-cure concept was developed to yield optimum polymerization of composite cement at the restoration-cement-tooth interface for immediate bond stabilization. Although this touch cure is theorized to initiate polymerization at the interface when the accelerator in the primer makes contact with the cement, this process has not yet been proven. This study aimed to elucidate the mechanism of touch cure by measuring the degree of conversion (DC) of composite cement applied with or without an accelerator-containing tooth primer (TP) versus an accelerator-free primer using real-time Fourier-transform infrared spectroscopy (RT-FTIR) and attenuated total reflection (ATR)-FTIR. Interfacial bond strength was measured in shear mode, the accelerator composition confirmed by X-ray fluorescence analysis (XRF), and the interfacial interaction of TP and composite cement with dentin investigated by X-ray diffraction (XRD), focused-ion-beam scanning electron microscopy (FIB-SEM) with 3-dimensional interface reconstruction, and transmission electron microscopy (TEM). RT/ATR-FTIR revealed the significantly highest DC when the composite cement was applied with the accelerator-containing primer. XRF disclosed a vanadium compound as a novel chemical accelerator within TP, instead of a classic chemical curing initiator system, to set off touch cure as soon the cement contacts the previously applied primer. Although the TP contains the acidic functional monomer 10-MDP for adhesion to tooth tissue, touch cure using the accelerator-containing TP combined the fastest/highest DC with the highest bond strength. FIB-SEM and TEM confirmed the tight interfacial interaction at dentin with submicron hybridization along with stable 10-MDP also Ca-salt nanolayering.

Molecular and clinical characterization of glucokinase maturity-onset diabetes of the young (GCK-MODY) in Japanese patients

AIMS

To investigate the molecular and clinical characteristics of the largest series of Japanese patients with glucokinase maturity-onset diabetes of the young (GCK-MODY), and to find any features specific to Asian people.

METHODS

We enrolled 78 Japanese patients with GCK-MODY from 41 families (55 probands diagnosed at the age of 0-14 years and their 23 adult family members). Mutations were identified by direct sequencing or multiplex ligation-dependent probe amplification of all exons of the GCK gene. Detailed clinical and laboratory data were collected on the probands using questionnaires, which were sent to the treating physicians.　Data on current clinical status and HbA1c levels were also collected from adult patients.

RESULTS

A total of 35 different mutations were identified, of which seven were novel. Fasting blood glucose and HbA1c levels of the probands were ≤9.3 mmol/l and ≤56 mmol/mol (7.3%), respectively, and there was considerable variation in their BMI percentiles (0.4-96.2). In total, 25% of the probands had elevated homeostatic assessment of insulin resistance values, and 58.3% of these had evidence of concomitant Type 2 diabetes in their family. The HbA1c levels for adults were slightly higher, up to 61 mmol/mol (7.8%). The incidence of microvascular complications was low. Out of these 78 people with GCK-MODY and 40 additional family members with hyperglycaemia whose genetic status was unknown, only one had diabetic nephropathy.

CONCLUSIONS

The molecular and clinical features of GCK-MODY in Japanese people are similar to those of other ethnic populations; however, making a diagnosis of GCK-MODY was more challenging in patients with signs of insulin resistance.

Influence of vitamin A on the quality of beef from the Tajima strain of Japanese Black cattle

Influence of vitamin A on the beef quality of the Tajima strain of Japanese Black cattle was studied. Marbling scores were correlated with serum vitamin A concentrations just before slaughter (r = -0.38). The mean marbling score of the low vitamin A group that were not supplemented with vitamin A after 15 months of age was significantly higher than that of the group supplemented with high vitamin A. However, there was no significant difference in the marbling scores between the group that were not given vitamin A after 23 months of age and the high vitamin A supplemented group. These results suggest that vitamin A supplementation affects carcass marbling only if given before 23 months of age, in these cattle.

Mitochondrial inclusion bodies (intracytoplasmic acidophilic droplets) in neurons of chicken spinal cords increase with age

We studied the pathologic features of neurons that contain intracytoplasmic acidophilic droplets (IADs) in chicken spinal cords. The IADs were lustrous spheroid bodies scattered in the cytoplasm of neurons, variable in size, and protein-rich bodies stained eosinophilic with hematoxylin-eosin, acidophilic with Azan, blue indigo with phosphotungstic acid hematoxylin, and yellow-green with Elastica van Gieson stain histopathologically. Ultrastructurally, almost all IADs were observed as homogeneous highly electron-dense spheroid bodies enclosed by double-limited membranes. Small IADs were observed in mitochondria. Anatomically, IAD-CNs were observed only in the ventral horn of the spinal cord between the fourth sacral and third lumbal vertebrae, and they were particularly frequent in the third sacral vertebrae. Their appearance and accumulative amount were likely to increase with age, while the clinical and pathologic significances of IAD-CNs remain unclear.

Class I Gap-formation in Highly-viscous Glass-ionomer Restorations: Delayed vs Immediate Polishing

Delaying polishing for one day resulted in improved gap-formation for Class I restoration of highly-viscous conventional and conventional glass-ionomer cements

Enhanced vertical alveolar bone augmentation by recombinant human bone morphogenetic protein-2 with a carrier in rats

This study aimed to evaluate the effect of recombinant human bone morphogenetic protein-2 (rhBMP-2) on vertical bone regeneration of edentulous ridge. Bilateral upper first and second molars of 8-week-old Wistar rats were extracted and the ridges were allowed to heal for 3 weeks. Compressed poly(lactic-co-glycolic acid) copolymer/gelatin sponge (PGS) was used as a carrier of rhBMP-2. PGS alone (control group) or PGS with 5 mug rhBMP-2 (test group) was implanted at the top part of alveolar ridge. The sham group received no implantation. The rats were killed at 1, 2, 4, 8 and 12 weeks after implantation and examined histologically and histomorphometrically. In the test group, significant bone augmentation was evident on the alveolar ridge throughout the experimental period. Histomorphometric analysis revealed greater tissue volume and height of alveolar bone in the test group compared with the control and sham groups (P < 0.05) from 4 weeks onward and the augmented tissues (5 mm3 in tissue volume and 1.5 mm in bone height) were maintained until 12 weeks. Osteoblast surface increased at 2 and 4 weeks and osteoid thickness reached a peak (25 microm) at 2 weeks. Dynamic variables, which represented calcification, were higher in the test group than the control and sham groups at 4 and 8 weeks (P < 0.05). These results suggest that use of rhBMP-2/PGS may achieve vertical bone augmentation, and stabilizes denture prosthesis or makes up for inadequate bone mass for implant prosthesis.

Certified reference material for radionuclides in fish flesh sample IAEA-414 (mixed fish from the Irish Sea and North Sea)

A certified reference material (CRM) for radionuclides in fish sample IAEA-414 (mixed fish from the Irish Sea and North Seas) is described and the results of the certification process are presented. Nine radionuclides (40K, 137Cs, 232Th, 234U, 235U, 238U, 238Pu, 239+240Pu and 241Am) were certified for this material. Information on massic activities with 95% confidence intervals is given for six other radionuclides (90Sr, 210Pb(210Po), 226Ra, 239Pu, 240Pu 241Pu). Less frequently reported radionuclides (99Tc, 129I, 228Th, 230Th and 237Np) and information on some activity and mass ratios are also included. The CRM can be used for quality assurance/quality control of the analysis of radionuclides in fish sample, for the development and validation of analytical methods and for training purposes. The material is available from IAEA, Vienna, in 100 g units.

Co-occurrence of three different mutations in the bilirubin UDP-glucuronosyltransferase gene in a Chinese family with Crigler-Najjar syndrome type I and Gilbert's syndrome

Crigler-Najjar syndrome type I is a severe form of hereditary unconjugated hyperbilirubinemia and is caused by homozygous or compound heterozygous mutations of the bilirubin UDP-glucuronosyltransferase gene (UGT1A1). We analyzed the bilirubin UDP-glucuronosyltransferase gene in a female Chinese patient with Crigler-Najjar syndrome type I. Relatives of the patient were also analyzed. The patient was homozygous for a nonsense mutation of R341X. The patient's father, sister and brother, all diagnosed with Gilbert's syndrome, were compound heterozygotes of R341X, P229Q, and an insertion mutation of the TATA box [A(TA)7TAA]. Heterozygotes of nonsense mutations (Q331X and C280X) in our previous study had either Crigler-Najjar syndrome type II or Gilbert's syndrome, but heterozygotes of R341X (mother and grandmothers) were normal. An in vitro expression study of homozygous and heterozygous models of R341X showed 0 and 58%, respectively, of normal enzyme activity. Therefore, the present results indicate that carriers of the nonsense mutation could be normal for plasma bilirubin concentration, Gilbert's syndrome and Crigler-Najjar syndrome type II. The results also suggest the importance of the accumulation of prevalent or polymorphic mutation in the etiology of Gilbert's syndrome and Crigler-Najjar syndrome type II.

Plasma treatment increased shear bond strength between heat cured acrylic resin and self-curing acrylic resin

Self-curing acrylic resin is generally used for the repair of a fractured denture base. However, re-fracture of the repaired denture base resin often occurs because of poor bonding strength between the base resin and self-curing repair resin. The effect of plasma treatment on the shear bond strength between heat cured acrylic resin and the self-cured acrylic was examined. It was revealed that plasma irradiation is effective in increasing the shear bond strength. Plasma irradiation does not cause environmental pollution, as it does not require chemicals. It is a useful method to increase adhesive strength between heat cured acrylic resin and self-curing acrylic resin.

Finite element analysis of the effect of the bucco-lingual position of artificial posterior teeth under occlusal force on the denture supporting bone of the edentulous patient

To improve the quality of the complete denture prosthesis, the bucco-lingual position of the artificial posterior teeth must be determined with consideration of the shape of the maxillary and mandibular residual ridge and the relationship between them. The arrangement of posterior artificial teeth should be considered not only for the denture stability but also for the avoidance of high pressure on the supporting structures. A two-dimensional finite element method program to investigate the statics for the contour of the complete denture and the residual ridge was developed. With this program, the effect of the bucco-lingual position of the artificial posterior teeth under occlusal force on the denture supporting bone could be investigated.

Visual observation of the dynamic flow of elastomer rubber impression material between the impression tray and oral mucosa while seating the impression tray

The purpose of this study was to inspect visually, the dynamics of the impression flow at seating of the impression tray. The effects of the relief and the escape hole of the impression tray on the impression flow were also examined. Three types of the transparent impression tray (flat tray, relief tray and escape hole tray) were prepared. Transparent silicone polymer was put on the impression tray surface. Four drops of the dark blue silicone impression material was injected into the transparent silicone polymer on the impression tray. The impression tray was seated on the model of the denture-supporting mucosa. The movement of the four drops caused by the impression flow was visually recorded with the video camera and examined. The result for the flat tray showed that the impression material moved from inside to the outside. It was also shown that the speed of the moved impression material increased as the seating of the impression tray advanced. The results for the relief tray and the escape hole tray showed the effect of the relief and the escape hole prepared to the impression tray on the speed and the direction of the flow of the impression material.

Galvanic skin response of oral cancer patients during speech

Severe speech difficulty is often caused after surgery of an oral cancer. Prosthetic treatment with a removable obturator prosthesis is generally provided for such patients. Although some speech ability is recovered with prosthetic treatment, patients sometimes complain of continued dissatisfaction with their speech. However, it is difficult to evaluate the dissatisfaction. Therefore, a new method for evaluation is desirable. In this study, such a new method using the galvanic skin response as the index for the dissatisfaction of the patient was developed, and its objectivity was investigated. Eleven patients with maxillary bone defects were selected. Prior to the evaluation, improvement of speech with the removable prosthesis was confirmed using the speech intelligibility test and the visual analogue scale. The electrical resistant value at pronunciation was measured with the measuring system composed with the apparatus (galvanic skin response (GSR) measuring apparatus), the personal computer program. The changes for the electrical resistant value after pronunciation were evaluated by calculating the decrease ratio at pronunciation [(the mean electrical resistance before pronunciation - the mean electrical resistance after pronunciation)/the mean electrical resistance before pronunciation]. This decrease ratio at pronunciation was defined as the index of the speech dissatisfaction of the subject. The mean values for the decrease ratio with prosthesis were significantly smaller than the values without prosthesis (P < 0.05). From the results of this study, it is suggested that the measurement of the electrical resistance change of the skin during speech could be a new method for evaluating the speech dissatisfaction of the post-oral-cancer patient.

Huge cystic lymphangioma of the pancreas: report of a case

We report herein the case of a 33-year-old woman who presented with palpable abdominal swelling found to be caused by a huge lymphangioma of the pancreas. An abdominal computed tomographic (CT) scan showed a large multilocular cystic mass with water-dense contents, which was derived from the pancreatic head. A pancreaticoduodenectomy (PD) was performed because the tumor had invaded the duodenum. The resected tumor, which was 23 x 12 x 23 cm in size with 21 of serous fluid, was pathologically diagnosed as a cystic lymphangioma. The endothelial cells lining the internal surface of the cystic spaces were immunohistochemically positive for factor VIII-R antigen and CD31. Our review of the literature revealed 45 reports of lymphangioma of the pancreas, including this one, but to the best of our knowledge this is only the fifth case that required a PD. Nevertheless, we recommend that a complete resection be performed to reduce the risk of recurrence.

[A case of granulomatous angiitis of the central nervous system presented with subacute mental deterioration resembling diffuse white matter disease]

We reported a 60-year-old man with granulomatous angiitis of the central nervous system (GACNS) manifesting as subacute mental deterioration. His first symptoms were nausea and vomiting which brought him to a hospital, where no abnormality was found except for gastritis. One month later, he began to feel dizziness and brain tumor was suspected by a neurosurgeon with the MRI findings such as abnormal T2 signal and swelling in his brainstem. While he was followed up, he gradually presented mental change, disorientation and dysmnesia with the abnormal T2 signal spreading over the cerebral white matter bilaterally. Corticosteroid therapy was started based on the suspicion of a lymphoproliferative disease, and his symptoms and the abnormal MRI findings improved. Then he was referred to our department for further evaluation. Because we could not find any evidence of systemic diseases and he had been almost fully recovered, we discontinued the therapy. Soon after that, his mental deterioration as well as the abnormal T2 signal lesions on MRI relapsed. By open brain biopsy, the diagnosis of GACNS was established, and steroid pulse therapy was started. His symptoms and the abnormal T2 signal lesions improved gradually and the steroid was tapered to the maintenance dose without remission. Since the laboratory and imaging findings are not specific for the diagnosis of the angiitis confined to the central nervous system, brain biopsy is recommended for these disorders.

Accelerated DNA fragmentation of the denture-bearing mucosal epithelium in an animal model of diabetes

This study examined the effect of masticatory pressure transmitted directly to the hard palate mucosa on the final stage of terminal differentiation of keratinizing system of rats with and without streptozotocin-induced diabetes mellitus. In the nondiabetic rats with masticatory pressure, the number of terminal-deoxynucleotidyl-transferase-mediated deoxyuridine-triphospate-biotin nick end labelling (TUNEL) positive cells tended to increase about twice as much as in the nondiabetic rats without pressure with and without denture. A similar tendency of increase was observed in the diabetic rats without pressure. The synergy of the mechanical pressure and diabetic condition for 2 weeks greatly accelerated the DNA fragmentation, showing 8-fold increase in TUNEL positive cells over the normal control, and caused exfoliation of the stratum corneum. A 4-week exposure of diabetics to the masticatory pressure induced laminar splitting in the midst of the spinosum. Some cells in the stratum granulosum exhibited a sign of DNA fragmentation when laminar splitting took place in the vital cell layer. Premature DNA fragmentation may disturb the adhesion between spinosum cells and prevent the maturation of stratum corneum. Increase in Bax protein-like immunoreactivity in these epithelial cells as revealed by immunocytochemistry may underlie the premature DNA fragmentation in the oral masticatory epithelium under pressure in diabetic patients.

Chemotherapy-induced unconjugated hyperbilirubinemia caused by a mutation of the bilirubin uridine-5'-diphosphate-glucuronosyltransferase gene

Chemotherapy for malignant neoplasms sometimes causes unconjugated hyperbilirubinemia in the absence of liver dysfunction. We analyzed the association of chemotherapy-induced hyperbilirubinemia with mutations of the bilirubin uridine-5'-diphosphate (UDP)-glucuronosyltransferase gene (UGT1A1) from two leukemic patients in whom chemotherapy resulted in a hyperbilirubinemic response. We isolated genomic DNA from peripheral blood samples and amplified UGT1A1 by polymerase chain reaction. The amplified DNA fragments were analyzed by direct sequencing. The genes of the two patients revealed an identical heterozygous missense mutation in exon 1 (211G-->A: G71R). This UGT1A1 mutation may be the basis of chemotherapy-induced unconjugated hyperbilirubinemia.

Prolonged unconjugated hyperbilirubinemia associated with breast milk and mutations of the bilirubin uridine diphosphate- glucuronosyltransferase gene

OBJECTIVE

Breast milk jaundice is a common problem in nursing infants. It has been ascribed to various breast milk substances, but the component or combination of components that is responsible remains unknown. During our study of defects of the bilirubin uridine diphosphate-glucuronosyltransferase gene (UGT1A1) in patients with hereditary unconjugated hyperbilirubinemia (Crigler-Najjar syndrome and Gilbert's syndrome) and neonatal hyperbilirubinemia, we encountered a prolonged case associated with breastfeeding; after cessation of breastfeeding, the infant's bilirubin level became normal. Genetic analysis revealed a missense mutation identical to that found in patients with Gilbert's syndrome, which usually causes jaundice after puberty. We analyzed the bilirubin UGT1A1 of infants with prolonged unconjugated hyperbilirubinemia associated with breast milk to ascertain whether genetic factors are involved.

PATIENTS AND METHODS

We analyzed 17 breastfed Japanese infants with apparent prolonged jaundice (total serum bilirubin concentrations above 171 micromol/L [10 mg/dL]) 3 weeks to 1 month after their birth. Except for jaundice, the infants were healthy and did not show evidence of hemolytic anemia, liver dysfunction, or hypothyroidism. After cessation of breastfeeding, the serum bilirubin concentration began to decrease in all cases. When breastfeeding was resumed, serum bilirubin concentration again became elevated in some infants, but the concentration fell to within normal by 4 months of age. We analyzed the polymerase chain reaction-amplified exon, promoter, and enhancer regions of UGT1A1 by direct sequencing.

RESULTS

Sixteen infants had at least one mutation of the UGT1A1. Seven were homozygous for 211G-->A (G71R), which is the most common mutation detected in the East Asian population, and the mutant enzyme had one third of the normal activity. G71R is the most common missense mutation we found in our analyses in Japanese patients with Gilbert's syndrome, and it corresponds to a UGT1A1 polymorphism in the Japanese population (the allele frequency is.16). One was heterozygous for 1456T-->G (Y486D) and homozygous for 211G-->A. Six were heterozygous for 211G-->A. One was heterozygous for both 211G-->A and a TATA box mutation (A(TA)7TAA). One had a heterozygous mutation in an enhancer region (C-->A at -1353). We did not detect a homozygous A(TA)7TAA mutation, which was the most common cause of Gilbert's syndrome in European population, in this study of Japanese infants with prolonged hyperbilirubinemia triggered by breast milk.

CONCLUSIONS

The results indicate that defects of UGT1A1 are an underlying cause of the prolonged unconjugated hyperbilirubinemia associated with breast milk. One or more components in the milk may trigger the jaundice in infants who have such mutations. The mutations we found were identical to those detected in patients with Gilbert's syndrome, a risk factor of neonatal nonphysiologic hyperbilirubinemia and a genetic factor in fasting hyperbilirubinemia.

Relationship of p53 and vascular endothelial growth factor expression of clinicopathological factors in human scirrhous gastric cancer

Although scrirrhous cancer has the highest malignant potential among various types of gastric cancer, its pathogenesis is still unclear. The relationship between expression of p53 or vascular endothelial growth factor (VEGF) and clinicopathological variables was investigated by immunohistochemical analysis of archival specimens from 40 patients with scirrhous gastric cancer. Staining for p53 and VEGF was observed in the nuclei and cytoplasm of the tumor cells, respectively. There was no significant association between expression of p53 or VEGF and sex, age, depth of invasion, lymph node metastasis or histological stage. Peritoneal dissemination was the most frequent mode of recurrence, and the depth of tumor invasion was a crucial factor. The recurrence rate was 83.9% (2/9) in patients without serosal invasion. Only 7 out of 40 patients (17.5%) survived without recurrence. Among them, the VEGF-positive rate was 14.3% (1/7), whereas it was 52.6% (10/19) in the patients with recurrence. There was no correlation between p53 and VEGF staining. These findings suggest that the progression of scirrhous gastric cancer may be promoted by VEGF overexpression, which is not upregulated by p53 mutation.

Argyrophilic nucleolar organizer regions (AgNORs) in mucosal epithelium under experimental denture bases in rats

The purpose of this study was to evaluate changes in the argyrophilic nucleolar organizer region (AgNOR) counts in mucosal epithelium induced by continuous or intermittent compressive pressure exerted through experimental denture bases and to examine the relationships between the AgNOR count, histopathological changes and the intensity of the pressure under denture bases. Continuous or intermittent compressive pressure exerted through the denture bases was applied to the hard palate of the molar region in rats. A morphometric analysis of AgNORs was performed in denture-supporting tissue 3 days and 1, 2, 4, 8, 12 and 20 weeks after the denture insertion. From the results of this study, it was found that non-pressure contact of the denture bases with palatal tissues did not change the AgNOR count. The AgNOR count was decreased by continuous or intermittent compressive pressure, and then recovered to almost the same level as with the non-pressure contact at 20 weeks following a decrease of the pressure. The AgNOR counts in the epithelium under the denture bases were revealed to be related to the histopathological changes in the denture-supporting tissues and the intensity of the pressure under the denture bases.

A case of anorexia nervosa with hyperbilirubinaemia in a patient homozygous for a mutation in the bilirubin UDP-glucuronosyltransferase gene

Gilbert syndrome was diagnosed in a girl with anorexia nervosa and unconjugated hyperbilirubinaemia. Since the patient was starved and hyperbilirubinaemic, the loading test was not used for the diagnosis but analysis of the bilirubin UDP-glucuronosyltransferase gene (UGT1A1) instead. The patient was homozygous for a missense mutation that replaced guanine with adenine at nucleotide number 211 (211G-->A: G71R). The unconjugated hyperbilirubinaemia was apparently induced by the fasting state. Homozygous missense mutations of the gene have been generally recognized as responsible for Crigler-Najjar syndrome type II; the results obtained here, however, confirm that Gilbert syndrome may also be caused by a homozygous missense mutation of UGT1A1.

CONCLUSION

Since anorexia nervosa patients are in a fasting state, they may show moderate unconjugated hyperbilirubinaemia if they have Gilbert syndrome. Gene analysis of such cases will rule out hepatic damage. Homozygous missense mutations of the bilirubin-UDP-glucuronosyltransferase gene cause not only Crigler-Najjar syndrome type II but also Gilbert syndrome.

Association of neonatal hyperbilirubinemia with bilirubin UDP-glucuronosyltransferase polymorphism

OBJECTIVE

The incidence of nonphysiologic neonatal hyperbilirubinemia is twice as high in East Asians as in whites. We studied whether the condition was associated with mutations in the gene for bilirubin uridine 5'-diphosphate-glucuronosyltransferase (UGT1A1), a key enzyme of bilirubin catabolism.

DESIGN

We analyzed the UGT1A1 gene in 25 Japanese neonates who had nonphysiologic hyperbilirubinemia (serum bilirubin >257 micromol/L) with no obvious cause. They had all received phototherapy. The background control population consisted of 50 Japanese neonates whose transcutaneous jaundice index was monitored during the first week of life. We detected mutations by direct sequencing of polymerase chain reaction-amplified fragments of the gene.

RESULTS

We found a polymorphism for UGT1A1 in exon 1; a G-->A transition at nucleotide 211 caused arginine to replace glycine at position 71 of corresponding protein product (G71R). The frequency of the mutated allele in the hyperbilirubinemic group (0.34) was significantly higher (chi2 = 5.56) than in the control group (0.16). In the control group the peak transcutaneous jaundice index of the carriers of G71R was significantly higher than it was in the normal infants.

CONCLUSIONS

The missense mutation causing G71R is the first reported polymorphism for UGT1A1, and the mutation is a risk factor for nonphysiologic neonatal hyperbilirubinemia. The high incidence of hyperbilirubinemia in the Japanese may be attributable to the high frequency of this missense mutation.

The effect of diabetes mellitus on histopathological changes in the tissues under denture base bearing masticatory pressure

The effect of streptozotocin-induced diabetes mellitus on histopathological changes in tissues bearing masticatory pressure exerted through an experimental denture base has been studied in animal specimens. Experimental dentures, which prescribed the masticatory pressure by the amount of subsidence of the denture base (100, 50 or 13 microm), were constructed for the hard palate of the molar regions of rats. It was revealed that streptozotocin-induced diabetes mellitus (1) weakened the intercellular junctions in the epithelium and gradually enhanced this state with time, (2) lessened the atrophic and proliferative reactions in the epithelial ridge and prolonged their appearance period, (3) enhanced the compression of lamina propria mucosae and prolonged the appearance period of this reaction, (4) enhanced the inflammatory change and extended its appearance period, (5) lowered the threshold for the inflammatory reaction induced by the masticatory pressure, (6) increased the number of osteoclasts and prolonged the period of their presence, (7) lowered the threshold for osteoclastic bone resorption induced by the masticatory pressure, (8) inhibited the appearance of osteoblasts following the disappearance of osteoclasts and (9) accelerated the decline rate of masticatory pressure exerted to the denture supporting tissues. Therefore, it can be concluded that the streptozotocin-induced diabetes mellitus in the animals tested deteriorated the tolerance of the denture supporting tissues to masticatory pressure.

The effect of diabetes mellitus on histopathological changes in the denture-supporting tissues under continuous mechanical pressure in rat

The histopathological changes in denture-supporting tissues of streptozotocin-induced diabetes mellitus rat were studied in relation to continuous mechanical pressure exerted through an experimental denture base. The experimental dentures were designed to load continuous mechanical pressures (3.4, 1.5 or 0.5 kPa) to the hard palate of the molar region of a rat. From the results of this study, the following conclusions were drawn: the streptozotocin-induced diabetic condition (1) tended to prolong the appearance period of a shortened epithelial ridge, and weakened the phenomenon, (2) reduced the appearance period and severity of the compression of epithelium, (3) delayed the time of manifestation of the proliferative change in the recovery process of the shortened epithelial ridge, and weakened the phenomenon, (4) prolonged the appearance period of the compressed lamina propria mucosae, and enhanced the phenomenon, (5) reduced the number of osteoclasts, (6) lowered the threshold for induction of the osteoclastic bone resorption to between 1.5 and 0.5 kPa, (7) inhibited the appearance of osteoblast which follows the disappearance of osteoclasts, (8) did not induce any inflammatory change, and (9) tended to enhance the longitudinal change of the continuous mechanical pressure. The histopathological changes in the denture-supporting tissues of the streptozotocin-induced diabetes mellitus rat related highly to the longitudinal change of the continuous mechanical pressure exerted through the denture base. From the results of this study, it was suggested that the streptozotocin-induced diabetic condition lowers the tolerance of the denture-supporting tissues to continuous mechanical pressure.

Surgical management for a malignancy of the digestive organs accompanied with an abdominal aortic aneurysm

Surgical management of patients with simultaneous coexisting malignancy of the digestive organs and an abdominal aortic aneurysm (AAA) remains controversial. In the five patients who underwent the aneurysmectomy first, no complications developed after an aneurysmectomy and a resection of malignancy could be performed within 4 weeks, whereas postoperative complications after the resection of malignancy developed in two of them. Two patients underwent a one-stage operation, in which one was unable to tolerate the two procedures, and no postoperative complications were seen; however, one patient with cardiac dysfunction who first underwent an aneurysmectomy died 3 months after operation due to cardiac and renal failure. These results indicate that the aneurysmectomy first is preferred, when such patients do not have absolute indications of malignancy or AAA; however, a one-stage operation should be chosen when the patients show a disturbance of key organs.

Gilbert syndrome caused by a homozygous missense mutation (Tyr486Asp) of bilirubin UDP-glucuronosyltransferase gene

We report a case of Gilbert syndrome caused by a homozygous missense mutation (Tyr486Asp) of the bilirubin UDP-glucuronosyltransferase gene. Homozygous missense mutations of the gene have previously been recognized as responsible for Crigler-Najjar syndrome type II. We conclude that Gilbert syndrome in some patients results from homozygous missense mutations of the UDP-glucuronosyltransferase gene.

[A case of refractory pulmonary fistula, managed with bronchoscopic therapy using occluding spiral embolus]

We report a successful case of bronchoscopic therapy using occluding spiral embolus and fibrin glue for refractory pulmonary fistula. A 22-year-old female underwent left lower lobectomy for giant bulla of the lung. Air leakage began 6 days after lobectomy. Closing alveolar fistula was performed 12 days after first operation. Relapsing air leakage began 4 days after second operation. Bronchography revealed a fistula from left B1+2c. The insertion of embolus through bronchofiberscope, following administration of fibrin glue, was performed to close the fistula. This method is effective for refractory pulmonary fistula.

p53 overexpression and proliferative activity do not correlate with lymph node metastasis in early gastric cancer

We investigated p53 overexpression and the proliferative activity of the primary lesion as well as the clinicopathological features of 75 patients with gastric cancer invading the submucosa (sm cancer), of whom 14 (18.7%) had lymph node metastasis. Among the clinicopathologic features studied, only lymphatic invasion by the primary tumor was related to lymph node metastasis. There was no relationship between immunohistochemical staining for p53 protein or Ki-67 and lymph node metastasis. The p53-positive rate was 35.7 and 57.1% in patients with and without metastasis, respectively, while the mean Ki-67 labeling index was 38.9 and 38.1%, respectively. Our results suggest that p53 mutation or the proliferative activity of sm cancer do not influence lymph node metastasis, even though p53 mutation may enhance the proliferative activity and metastatic potential of advanced gastric cancer.

Measurement of pancreatic blood flow to prevent pancreatic juice leakage after pancreas-preserving total gastrectomy for gastric cancer

In patients with gastric cancer, distal pancreatectomy was frequently performed for complete removal of the lymph nodes along the splenic artery, but this procedure sometimes induced pancreatic juice leakage, subphrenic abscess, and postoperative diabetes. To avoid these complications, pancreas-preserving total gastrectomy (PP) was developed by Maruyama et al. [World J Surg 1995; 19:552-536], with which the spleen, splenic artery, and fatty connective tissue including lymph nodes could be removed completely without distal pancreatectomy. From 1988 to 1995, 36 patients underwent PP in our department. Although there were no operative deaths and no patient developed postoperative diabetes, pancreatic juice leakage was observed in 4 patients (11.1%). We assumed that ischemia of the distal pancreas may have caused this pancreatic juice leakage and investigated the relationship between pancreatic blood flow (PBF) and this complication in 12 recent patients. A significant negative correlation between PBF in the pancreatic tail and the peak amylase level (PAL) in the drain fluid was demonstrated. Two patients with PBF values of 4.5 and 5.2 ml/min/100 g tissue, respectively, and a PAL of more than 2 x 10(5) U/l developed pancreatic juice leakage, whereas the 10 patients without this complication had PBF values above 6 ml/min/100 g tissue and a PAL of less than 2 x 10(4) U/l. These results suggest that measurement of PBF may be useful to predict the leakage of pancreatic juice after PP and that distal pancreatectomy may be preferable when PBF is extremely low.

Ferrocene-oligonucleotide conjugates for electrochemical probing of DNA

Toward the development of a universal, sensitive and convenient method of DNA (or RNA) detection, electrochemically active oligonucleotides were prepared by covalent linkage of a ferrocenyl group to the 5'-aminohexyl-terminated synthetic oligonucleotides. Using these electrochemically active probes, we have been able to demonstrate the detection of DNA and RNA at femtomole levels by HPLC equipped with an ordinary electrochemical detector (ECD) [Takenaka,S., Uto,Y., Kondo,H., Ihara,T. and Takagi,M. (1994) Anal. Biochem., 218, 436-443]. Thermodynamic and electrochemical studies of the interaction between the probes and the targets are presented here. The thermodynamics obtained revealed that the conjugation stabilizes the triple-helix complexes by 2-3 kcal mol-1 (1-2 orders increment in binding constant) at 298 K, which corresponds to the effect of elongation of additional several base triplets. The main cause of this thermodynamic stabilization by the conjugation is likely to be the overall conformational change of whole structure of the conjugate rather than the additional local interaction. The redox potential of the probe was independent of the target structure, which is either single- or double stranded. However, the potential is slightly dependent (with a 10-30 mV negative shift on complexation) on the extra sequence in the target, probably because the individual sequence is capable of contacting or interacting with the ferrocenyl group in a slightly different way from each other. This small potential shift itself, however, does not cause any inconvenience on practical applications in detecting the probes by using ECD. These results lead to the conclusion that the redox-active probes are very useful for the microanalysis of nucleic acids due to the stability of the complexes, high detection sensitivity and wide applicability to the target structures (DNA and RNA; single- and double strands) and the sequences.

Serum levels of circulating intercellular adhesion molecule 1 in hepatocellular carcinoma

BACKGROUND/AIMS

This is a comparative study of the relationship between.

MATERIAL AND METHODS

Serum levels of circulating intercellular adhesion molecule-1 (cICAM-1) were measured by ELISA assay in four patients with chronic hepatitis (CH), 16 with liver cirrhosis (LC), 38 with hepatocellular carcinoma (HCC), and in nine healthy controls.

RESULTS

No significant difference in cICAM-1 levels was observed between LC and HCC. The cICAM-1 level in HCC did not correlate with tumor markers but correlated well with tumor size. cICAM-1 level in HCC Stage III + IV was significantly higher than that of Stage I, and was higher in HCC with liver metastasis as opposed to HCC without metastasis. Furthermore, the cICAM-1 level of HCC decreased significantly after hepatectomy.

CONCLUSION

These findings showed a close relationship between cICAM-1 and the progress of intrahepatic metastasis of HCC, indicating a possibility for using cICAM-1 as a prognostic marker.

Liposomal ATP protects the liver from injury during shock

Liposomes are useful drug carriers. In this study, adenosine triphosphate (ATP) was entrapped in liposomes (Lip-ATP). Anesthetized rats were given Lip-ATP (5 mg/kg as ATP), free ATP (5 mg/kg) or saline (control group) during stabilization. Then, the rats were exposed to 30 min of hypovolemic shock and 30 min of reperfusion. Administration of Lip-ATP significantly improved hepatic blood flow during shock (13.2 +/- 1.7 ml/min/100 g tissue in the Lip-ATP group vs. 9.4 +/- 2.2, in the control group, and 8.9 +/- 2.9 in the free ATP group) and during reperfusion (20.9 +/- 2.3, 16.3 +/- 2.2, and 16.2 +/- 1.8 ml/min/100 g tissue, respectively). The serum levels of hepatic enzymes (ALT, AST and LDH) were significantly lower in the Lip-ATP group after reperfusion when compared with the control and free ATP groups. Administration of Lip-ATP also produced the best recovery of hepatic ATP level. These findings indicate that Lip-ATP increased hepatic blood flow during shock and reperfusion, presumably by improving the energy charge and metabolism of the hepatocytes. Thus, Lip-ATP appears to be a useful agent for liver injury induced by hypovolemic shock.

[Postoperative abdominal lymph node recurrence of intrathoracic esophageal cancer with a long-term complete response to radiation and split CF therapy (CDDP and 5-FU)--a case report]

We experienced complete remission in a patient with postoperative abdominal lymph node recurrence of intrathoracic esophageal cancer after treatment with radiation (60Co: 30 Gy) and split CF therapy (CDDP: 20 mg/day + 5-FU: 1 g/day for 5 days). Since then, this patient has remained in complete remission for 43 months with intermittent split CF therapy one or two times a year.

A case of triple early gastric cancer in the remnant stomach

A 63-yr-old man, who had undergone distal gastrectomy and gastrojejunostomy (Billroth II method) 32 yr previously for duodenal ulcer, was admitted with suspected gastric remnant cancer. An upper gastrointestinal series and endoscopy revealed a protruding lesion at the stoma of the remnant stomach. Total gastrectomy with resection of the adjacent jejunum was performed. Histological examination demonstrated two well-differentiated adenocarcinomas (a mixed type I and IIc lesion with submucosal invasion and a type IIa lesion with intramucosal invasion) and a type IIc mucocellular carcinoma located in the mucosa. Gastritis cystica polyposa also was observed in the remnant stomach. The combination of three early gastric cancers and gastritis cystica polyposa suggests that the mucosa of the remnant stomach had a high malignant potential. The patient has survived without recurrence for 5 yr since the operation.

Comparison of the inhibitory effect of the angiogenesis inhibitor, TNP-470, and mitomycin C on the growth and liver metastasis of human colon cancer

Angiogenesis inhibitors have attracted considerable interest. The anti-tumor and anti-metastatic effects of TNP-470, an angiogenesis inhibitor, and mitomycin C (MMC), a representative anti-neoplastic agent, were investigated using a xenotransplanted human colon cancer, TK-4. Suturing of small pieces of TK-4 tumors to the cecal wall in nude mice (orthotopic transplantation) induced liver metastasis. Mice were randomly divided into 3 groups; a control group given saline solution, a group receiving TNP-470 and a group receiving MMC. TNP-470 was given s.c. on alternate days for 5 weeks from day 10 after cecal transplantation and MMC was administered intraperitoneally (i.p.) once a week from day 10 after cecal transplantation. MMC significantly inhibited cecal tumor growth. In the control group, liver metastases developed in 9 out of 10 mice, including 3 with more than 20 metastatic foci. Liver metastasis also developed in 8 out of 10 mice receiving MMC, 2 of which had many metastases. In contrast, liver metastasis developed in only 2 out of 8 mice in the TNP-470 group and neither of these animals had numerous metastases.

Intra-arterial liposomal adriamycin for metastatic adenocarcinoma of the liver

A liposome-entrapped liposome form of Adriamycin (Lip-ADM) has been demonstrated to cause less myocardial and gastrointestinal toxicity than free ADM. In the present study, Lip-ADM prepared by the remote loading method was administered to 3 patients with metastatic adenocarcinoma of the liver via a reservoir with the catheter located in the proper hepatic artery. The primary tumor was gastric cancer in 2 patients and sigmoid colon cancer in 1. Lip-ADM was administered at doses of 10, 20 or 50 mg per time. The total ADM dose was 170, 490, and 760 mg, respectively. No severe adverse effects, such as nausea, vomiting, stomatitis, alopecia or cardiotoxicity, were observed in any of the patients. Although mild leukocytopenia (2,800/microliters) was observed in 1 patient, anemia or thrombocytopenia did not occur. The survival time was respectively 6, 15, and 17 months from the start of Lip-ADM administration. A partial response was obtained in 1 patient and stable disease in 1 patient. Administration of Lip-ADM via a reservoir appears to be a useful treatment for patients with metastatic adenocarcinoma of the liver, since the low toxicity of this preparation allows an increase of the total dose of ADM.

Prevention of gastric ulcer or acute gastric mucosal lesions accompanying bleeding after abdominal aortic aneurysm surgery

We have previously reported that the decrease in gastric mucosal blood flow (GMBF) and consumption coagulopathy (CC) mainly contribute to the development of postoperative bleeding in the upper gastrointestinal (GI) tract in patients with abdominal aortic aneurysm (AAA). In the present study, we investigated whether our treatment for patients with low GMBF or CC effectively prevented postoperative gastric bleeding induced by gastric ulcer or acute gastric mucosal lesion. Preoperative endoscopic examinations in 66 patients with AAA and 60 patients with arteriosclerosis obliterance (ASO) revealed that 50.0% of AAA and 16.6% of ASO patients had accompanying gastric ulcer or multiple erosions. In 38 AAA and 36 ASO patients, GMBF was measured using a laser Doppler flowmeter through an endoscope. The GMBF was severely impaired in AAA patients and moderately impaired in ASO patients. The platelet counts and fibrinogen levels were significantly decreased in these 38 AAA patients compared with controls. Furthermore, fibrinogen degeneration product (FDP) levels in 36.8% of AAA patients were more than 20 micrograms/dl. Based on these findings, patients with low GMBF were treated postoperatively with H2-blocker, and patients with CC were treated preoperatively with heparin. After these treatments, only 1 of 38 AAA patients developed postoperative upper GI tract bleeding and could be treated conservatively after 1988, whereas in prior years postoperative upper GI tract bleeding developed in 7 of 112 patients, three of whom required emergency surgery.

Clinico-radiological findings of neuro-Behçet's syndrome

We examined 21 cases of Neuro-Behçet's syndrome in detail, and present here their clinicoradiological characteristics. Clinically, signs of pyramidal tract and meningeal irritation were frequently observed. In contrast to previous reports, our study demonstrated a near equal frequency in the occurrence of focal cerebral lesions and that of focal brain stem lesions. Notably, our results showed that the atrophy of both the cerebrum and the brain stem was often observed, indicating the presence of continuous disease activity in the central nervous system (CNS). In accordance with the high frequency of meningeal irritation signs, all of our cases exhibited pleocytosis in the cerebrospinal fluid (CSF). These results indicated the possibility that chemical mediators secreted from infiltrating cells in the CSF may somehow inflict damage to the CNS in Neuro-Behçet's syndrome.

[The expression of neural cell adhesion molecule (NCAM), neural invasion and recurrence patterns in rectal cancer--a study using anti-NACM (neural cell adhesion molecule) antibody]

Neural invasion may be one of the main causes of local recurrence, but its mechanism has not been sufficiently clarified. We previously reported that the expression of NCAM on cancer cells was correlated with neural invasion in pancreatic cancer. In this study, we examined the neural affinity of rectal cancer cells and the relationship between neural invasion and recurrence patterns of rectal cancers. A total of 64 rectal adenocarcinoma were examined. Specimens from 17 patients (27%) revealed perineural invasion. The incidence of neural invasion increased with the frequency of venous invasion and the degree of lymph node metastasis, but not significantly. The incidence of the expression of NCAM in rectal cancer cell was 45.3 percent. Neural invasion of rectal carcinoma was significantly related to the expression of NCAM (p < 0.05). NCAM immunocytolocalization was classified into the focal type, and the diffuse type. Concerning the recurrence type, 8 of 9 cases that developed local recurrence showed either presence of neural invasion or expression of NCAM. Liver metastasis was associated with absence of neural invasion or NCAM expression. The expression of NCAM may contribute to local recurrence, whereas the absence of NCAM may predict liver metastasis.

[A family of paramyotonia congenita]

We reported a family with paramyotonia congenita which affected six members through three generations. The homogenous clinical features presenting paramyotonia followed by flaccid tetraparesis were found in all patients. In gene analysis using patient's blood, previously identified sodium channel gene point mutations were not present, suggesting the possibility of another sodium channel gene mutation in this family.

Correlation between tumor proliferation and tumor tissue level of urokinase-type plasminogen activator

We established a xenotransplanted human colon cancer strain, TK-3, which produces urokinase-type plasminogen activator (U-PA) and carcinoembryonic antigen (CEA) simultaneously. Immunohistochemical staining of U-PA revealed that U-PA was located in the cytoplasm of cancer cells. Using TK-3, we investigated whether the tissue level of U-PA changed when the tumor proliferated locally. The mice were divided into three groups: mice of group A, B and C were sacrificed at 4, 5 and 6 weeks after tumor inoculation, respectively. The tissue level of U-PA was 0.78 +/- 0.183 ng/mg protein in group A, 0.95 +/- 0.189 in group B and 1.13 +/- 0.311 in group C. The values of groups B and C increased significantly compared with those of group A, and the tumor weight in each group showed a similar increase. The level of plasminogen activator inhibitor type 2 also increased (0.14 +/- 0.078 ng/mg protein in group A, 0.17 +/- 0.096 in group B, 0.24 +/- 0.172 in group C). On the other hand, the tissue level of CEA did not change significantly (78 micrograms/g tissue in group A, 88 in group B, 76 tissue in group C), and no correlation was observed between the tissue levels of U-PA and CEA. These results suggest that U-PA plays an important role not only in metastasis, but also in local tumor proliferation, and that its biological action in the autocrine system is independent of CEA.

Cervical cord birth injury and subsequent development of syringomyelia: a case report

A 2830 g full-term baby, born by breech delivery, exhibited weak crying and sucking and severe hypotonia of the extremities after birth. Magnetic resonance imaging (MRI) showed marked thinning of the cervical cord at the level of C4 and C5. This lesion evolved into focal syringomyelia by the fourth month after birth. In this patient, MRI was useful in detecting the initial spinal cord injury, which appeared as marked thinning, and the subsequent syringomyelia as well. The role of birth trauma in cervical spinal cord injuries is discussed.

Effect of liposomal interleukin-2 on ascites-forming rat hepatoma

Interleukin-2 was entrapped in liposomes (Lip-IL-2) and injected into rats. The intraperitoneal injection of Lip-IL-2 into rats bearing an ascites-forming rat hepatoma (AH-66) significantly increased the survival time when compared with rats administered free IL-2 or saline-containing liposomes. The number of peritoneal exudate cells (PEC) increased markedly after intraperitoneal injection of Lip-IL-2 and consisted mainly of macrophages. The level of tumor necrosis factor alpha (TNF-alpha) and the intensity of free radicals increased in the ascites at 48 hrs after Lip-IL-2 administration, whereas TNF-alpha was not detected and the intensity of free radicals did not increase after free IL-2 administration. Our findings suggested that entrapment of IL-2 into liposomes enhanced its potential for cancer therapy, presumably by activating macrophages to produce TNF-alpha and free radicals.

Possible role of plasminogen activator inhibitor 2 in the prevention of the metastasis of gastric cancer tissues

The concentrations of urinary type plasminogen activator (u-PA), plasminogen activator inhibitor 1 (PAI-1), and PAI-2 were measured in gastric cancer tissues and adjacent healthy mucosal tissues. Levels of u-PA, PAI-1 and PAI-2 were higher in cancer than in control tissues. PAI-1 levels were higher together with the progression of cancer however there were no differences in u-PA or PAI-2 levels. Tumors with higher PAI-1 and lower PAI-2 levels tend to metastasize to remote lymph nodes. When the numbers of involved lymph nodes were analyzed, tumors with the large number of metastatic lymph nodes showed higher PAI-1 and lower PAI-2 level. No difference was shown in u-PA levels among these groups. These tendencies were more significant in patients with progressed gastric cancer. These results suggest that tumor with higher PAI-2 levels tend to localize or have less tendency to metastasize to lymph nodes. On the other hand PAI-1 was generally higher in tumor with invasion into nearby tissue or with nodal metastasis.

Multiple sclerosis in Hokkaido, the northernmost island of Japan: prospective analyses of clinical features

We analyzed the clinical features of multiple sclerosis (MS) prospectively seen between July 1986 and October 1989 on Hokkaido island, the northernmost part of Japan. Clinical features were generally considered to be intermediate between the previous Japanese reports and those of Western countries. Devic's disease was rare and simultaneous bilateral visual loss at on set was not too common this series, differing from that previously reported of Japanese MS. The high incidence of acute transverse myelopathy and lesser involvement of the cerebellum, however, support the previous view. Further clinical and epidemiological studies will be necessary on this island.

Therapeutic effects of liposomal adriamycin in combination with tumor necrosis factor-alpha

Liposomes as drug carriers in cancer chemotherapy have attracted considerable interest. To enhance the therapeutic effect of Adriamycin entrapped in liposomes (Lip-ADM) on human solid tumors, we investigated the therapeutic effects of Lip-ADM in combination with recombinant human tumor necrosis factor-alpha (rTNF-alpha), which is known to have specific effects on tumor vasculature. rTNF-alpha or saline solution was injected intravenously into nude mice bearing a human colon cancer strain, HC-1, at 1 hour before intravenous administration of Lip-ADM. The significant therapeutic effect of Lip-ADM in combination with rTNF-alpha was demonstrated by the evaluation with tumor growth curve and the actual tumor weights, in comparison with groups of mice treated with saline solution, rTNF-alpha alone, or with a Lip-ADM after saline. Levels of Adriamycin in tumor tissue in the Lip-ADM in combination with rTNF-alpha-treated group were higher than those in Lip-ADM with saline solution-treated group.