Low Body Mass Index as a Risk Factor for the Onset of Porosity of the Mandibular Bone in the Elderly

Objective: To investigate whether a low body mass index (BMI) has a significant relationship with mandibular bone porosity progression by conducting a mandibular inferior cortex (MIC) classification in elderly Japanese people. Material and Methods: A total of 266 study subjects, aged 70 at baseline, were recruited for this study, conducted from 1998 to 2007. The subjects were divided into two groups according to changes in the MIC on serial panoramic radiographs during this nine-year study period: a no change group (MIC-NC) and a change group (MIC-C). All subjects in the MIC-C showed changes trending toward greater fragility. We evaluated the BMI at baseline. Logistic regression analysis was performed to assess the relationship between the MIC condition during the nine-year period (0: MIC-NC, 1: MIC-C) and BMI (kg/m2) adjusted for gender, current health status (CHS), and smoking habit (SH) at baseline. Results: The mean and standard deviations of the BMI at baseline in the MIC-NC and MIC-C were 22.8 ± 2.1 and 21.8 ± 2.5 kg/m2 for males and 23.1 ± 2.9 and 21.9 ± 2.4 kg/m2 for females. There was a significant relationship between the MIC condition and the BMI in both males (p=0.04) and females (p=0.01). The logistic regression analysis revealed a significant association between the MIC condition over the nine-year period and the BMI (OR=0.84, p=0.003), which was adjusted depending on the gender (OR=5.18, p=0.000), CHS (OR=0.53, p=0.015), and SH (OR=4.15, p=0.002) at baseline. Conclusion: A low BMI carries a risk of developing mandibular bone porosity by measuring the MIC condition in panoramic radiographs

Novel c.2216T > C (p.I739T) Mutation in Exon 13 and c.1481T > A (p.L494X) Mutation in Exon 8 of MUT Gene in a Female with Methylmalonic Acidemia

We report herein a 1.5-year-old girl with methylmalonic acidemia (MMA) in whom two missense mutations were found: a novel I739T mutation located in exon 13 and the L494X mutation in exon 8. The results of organic acid test showed a pronounced increase in methylmalonate excretion with increased methylcitrate and 3-OH-propionate excretion, leading to a diagnosis of MMA, and Vitamin B12 administration was started. Analysis of the mut gene confirmed a T-to-A substitution at nucleotide position 1481 in exon 8 and a T-to-C substitution at nucleotide position 2216 in exon 13, leading to the amino acid isoleucine at position 739 being changed to threonine, resulting in c.2216T > C (p.I739T). The patient has now been on high-dose oral administration of Vitamin B12 and carnitine therapy (900 mg of levocarnitine chloride) for 5 years without experiencing further attacks, and her cognitive and motor development is normal. Further tests on residual enzyme activity, as well as experience with more cases, may shed light on the relationship between gene mutations and phenotypes in MMA

Oral health status: relationship to nutrient and food intake among 80‐year‐old Japanese adults

Objectives The aim of this cross‐sectional study was to investigate the relationship of oral health status defined on the basis of presence of posterior occluding pairs ( POP s) and adequacy of removable denture fit as determined by self‐report to nutrient and food intake among older Japanese. Methods The subjects were 353 Japanese aged 80 years in 2008 and were classified into four groups according to the number of POP s, defined as pairs of occluding natural, restored, or fixed prosthetic postcanine teeth (range: 0–8) and removable denture status. The groups were: (i) good dentition ( n  =   56; 8 POP s and no removable prosthesis), (ii) well‐fitting dentures ( n  =   158; <8 POP s with self‐reported good‐fitting dentures), (iii) ill‐fitting dentures ( n  =   70; <8 POP s with self‐reported ill‐fitting dentures), and (iv) compromised dentition ( n  =   69; <8 POP s and no removable prosthesis). Multivariable analysis of the differences in nutrient and food intake outcome variables which were collected via validated food frequency questionnaire among the four oral health status groups was conducted using general linear models. Results Intake of multiple nutrients was significantly ( P  <   0.05) lower in the group with ill‐fitting dentures or compromised dentition than in the good dentition group. Vegetable, fish, and shellfish consumption was significantly lower in the ill‐fitting dentures or compromised dentition groups. No significant differences were seen in dietary intake between the well‐fitting dentures and good dentition groups. Conclusions Dietary intake was poorer in those with self‐perceived ill‐fitting dentures or fewer POP s than among those having all POP s. Regular dental care to maintain intact dentition, as well as dental treatment to replace missing teeth and ensure adequate denture fit and function, may be important to the diet intake and subsequent nutritional status of older Japanese.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/108691/1/cdoe12100.pd

Effect of lifestyle on 6‐year periodontitis incidence or progression and tooth loss in older adults

AimTo evaluate the longitudinal association of combined healthy lifestyle factors with incidence or progression of periodontitis and tooth loss in older adults.Materials and methodsThis 6‐year study included 374 Japanese 70‐year olds with 7,157 teeth, from a source eligible baseline population of 554 individuals. Four lifestyle factors—cigarette smoking, physical activity, relative weight, and dietary quality—were scored as healthy (1 point) or unhealthy (0 point). Adding the individual scores generated the “healthy lifestyle score” (0–4 points). Multilevel mixed‐effects logistic regression models were applied to evaluate tooth‐specific associations between the baseline healthy lifestyle score and the incidence or progression of periodontitis (increase in clinical attachment loss ≥3 mm) and tooth loss.ResultsAfter 6 years, 19.0% of the teeth exhibited periodontitis incidence or progression and 8.2% were lost. Compared with a healthy lifestyle score of 0–1 (least healthy), the highest score (4 points) was associated with a significantly lower tooth‐specific risk of periodontitis (adjusted odds ratio = 0.32; 95% confidence interval: 0.16–0.62) and tooth loss (adjusted odds ratio = 0.42; 95% confidence interval: 0.23–0.77).ConclusionsSimultaneous adherence to multiple healthy lifestyle factors significantly lowers the risk of incidence or progression of periodontitis and tooth loss in older adults.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/145573/1/jcpe12920_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/145573/2/jcpe12920.pd

経動脈的化学塞栓術における予防的抗菌薬と肝膿瘍発症の関連 : 後方視的コホート研究

Objectives: Clinical evidence on prophylactic antibiotics for transarterial chemoembolization (TACE) to prevent liver abscess is limited because liver abscess is a rare event. This study aimed to analyse the association between prophylactic antibiotic use for TACE and the occurrence of liver abscess after TACE. Methods: Using the nationwide Diagnosis Procedure Combination database in Japan, we retrospectively identified patients who underwent TACE for hepatic cancer between July 2010 and March 2017. The primary outcome was liver abscess requiring procedural intervention within 30 days of TACE. Secondary outcomes included 30-day in-hospital mortality and length of stay. Propensity score matching was performed to adjust for potential confounding factors and compare outcomes between patients with and without prophylactic antibiotics. Results: Among 167 544 eligible patients, 134 712 received antibiotics and 32 832 did not. In the matched cohort of 29 211 pairs, the proportion of patients with liver abscess requiring procedural intervention was significantly lower in the antibiotics group than in the no-antibiotics group (0.08% vs. 0.22%, p 0.001; relative risk (95% confidence interval), 0.35 (0.22-0.57); absolute risk reduction, 0.0014 (0.0008-0.0021); and number needed to treat, 696 (476-1223)). There was no significant difference in 30-day in-hospital mortality between the groups. The length of stay was longer in the antibiotics group than in the no-antibiotics group (median, 10 vs. 9 days, p < 0.001). Conclusions: Prophylactic antibiotic use in patients undergoing TACE was associated with a reduced occurrence of liver abscess requiring procedural intervention.博士（医学）・甲第794号・令和3年6月25日Copyright © 2021 The Author(s). Published by Elsevier Ltd.. All rights reserved

心室中隔欠損症に対する小児心臓カテーテル検査における麻酔方法と重症合併症の関連

Pediatric cardiac catheterization requires unconsciousness and immobilization through general anesthesia or sedation. This study aimed to compare the occurrence of severe complications in pediatric diagnostic cardiac catheterization for ventricular septal defect between general anesthesia and sedation performed under similar institutional environments. Using the Japanese Diagnosis Procedure Combination database, we retrospectively identified pediatric patients (aged <2 years) who underwent diagnostic cardiac catheterization for ventricular septal defect between July 2010 and March 2019. The composite outcome was the occurrence of severe complications, including catecholamine use and intensive care unit admission, within seven days after catheterization. Overlap weighting based on propensity scores was used to adjust for patient- and hospital-level confounding factors. We identified 3159 patients from 87 hospitals, including 930 under general anesthesia and 2229 under sedation. The patient- and hospital-level baseline characteristics differed between the groups. After adjustment, the proportion of patients with severe complications was significantly higher in the general anesthesia group than in the sedation group (2.4% vs. 0.6%; risk difference, 1.8% [95% confidence interval, 0.93–2.6%]). Severe complications occurred more frequently in the general anesthesia group than in the sedation group. Further research on anesthetic methods is necessary to assess the safety and accuracy of pediatric diagnostic cardiac catheterization.博士（医学）・甲第867号・令和5年3月15

Visible light induced electron transfer behavior of a CeO2-loaded HfO2/carbon cluster nanocomposite material

The microwave-irradiated calcination of HfOCl2/starch complex I under an air atmosphere produced the HfO2/carbon cluster composite material which is denoted as Ic. The obtained composite material could decompose methylene blue under the irradiation of light (λ > 460 nm). The surface of Ic was loaded with CeO2 particles to obtain CeO2-loaded composite material, which can decompose the aqueous silver nitrate solution and produce O2 and Ag in the ratio of 1:4.2. Water photo-decomposition experiment was also carried out using Pt-modified composite materials