Treatment of infected root canals with 4-META/MMA-TBB resin

This review paper describes the various applications of 4-methacryloxyethyl trimellitate anhydride/methyl methacrylate-tri-n-butyl borane (4-META/MMA-TBB) and reviews research studies on the treatment of infected root canals using 4-META/MMA-TBB resin. 4-META/MMA-TBB resin exhibits good biocompatibility, polymerisation, and adhesiveness to dentine. As a result, it has improved the previously low success rates of root-end sealing, root canal filling, and perforation sealing in difficult cases. Root-end sealing of resected surfaces using 4-META/MMA-TBB during apicoectomy and intentional replantation prevents leakage from root canal and root resorption. 4-META/MMA-TBB can offer sealing for root canals with opened root apex in which pressure could not be applied during root canal filling. In this paper we will discuss clinical cases related to the application of this resin and the benefits of 4-META/MMA-TBB resin

Antibacterial and cytotoxic effects of photoexcited Au clusters via blue high-power or white low-power light emitting diode irradiation

The development of photosensitizers and light sources has enabled the use of antimicrobial photodynamic therapy (aPDT) in various dental therapies. In the present study, we compared the antibacterial and cytotoxic effects of Au clusters photoexcited by blue and white LED irradiation. We fabricated novel photosensitizers, captopril-protected gold (Capt-Au) clusters and lysozyme-stabilized gold (Lyz-Au) clusters, for aPDT. Au clusters were then photoexcited by two kinds of light sources, blue high-power and white low-power light-emitting diodes (LEDs). Since white LED contains a wide spectrum of light (400–750 nm), white LED would be relevant for aPDT even if using a low-power source. The turbidity and viability of Streptococcus mutans were assessed following application of Capt-Au clusters (500 μg/mL) or Lyz-Au clusters (1,000 μg/mL) photoexcited by a blue high-power LED (1,000 mW/cm2) or white low-power LED (80 mW/cm2). In addition, the cytotoxicity of Au clusters and LED irradiation was evaluated in NIH3T3 and MC3T3-E1 cells. Au clusters photoexcited by the white low-power LED equally decreased the turbidity and viability of S. mutans compared with blue high-power LED. However, Au clusters photoexcited by white LED irradiation caused decreased cytotoxicity in mammalian cells compared with those photoexcited by blue LED irradiation. In conclusion, white LEDs possess biosafe properties for aPDT using Au clusters

Annual Parallax Distance to the K-type star system IRAS 22480+6002 measured with VERA

We present the astrometric VLBI observations of water masers associated with IRAS 22480+6002 (IRC+60370, hereafter I22480) with the VLBI Exploration of Radio Astrometry (VERA). The stellar type of I22480 looks unusual as a stellar maser source and has been debated since the 1970s. We successfully determined the annual parallax of a group of the water maser spots, pi=0.400+/-0.025 mas, corresponding to a distance to I22480 of D=2.50 /+0.17/-0.15 kpc. This suggests that the estimated bolometric luminosity of I22480 should be revised to 35 000 L_sun, favoring a K-type supergiant rather than an RV Tau-type variable star previously suggested. Although the spectral type is unusual as a stellar maser source, the internal motions of the water maser features suggest that the water masers are associated with the circumstellar envelope of this star. Taking into account a possible stellar motion with respect to the maser feature motions, we derived a secular proper motion of I22480, (mu_alpha, mu_delta)=(-2.58+/-0.33, -1.91+/-0.17) [mas yr^-1]. The derived motion of I22480 in the Milky Way has a deviation by ~ -30 km/s in the galactic azimuthal direction from a circular motion estimated from the galactocentric distance to I22480 and assumption of a flat Galactic rotation curve. This peculiar motion is still comparable to those typically seen in the water maser sources located in the Perseus spiral arm. Taking into account the peculiar motion and the proximity to the Galactic midplane (z ~60 pc), I22480 may be a member of the Galactic thin disk.Comment: 11 pages, 7 figures, accepted by PASJ (issue on vol. 65, No.1). Figure formats were correcte

Graphene oxide scaffold accelerates cellular proliferative response and alveolar bone healing of tooth extraction socket

Graphene oxide (GO) consisting of a carbon monolayer has been widely investigated for tissue engineering platforms because of its unique properties. For this study, we fabricated a GO-applied scaffold and assessed the cellular and tissue behaviors in the scaffold. A preclinical test was conducted to ascertain whether the GO scaffold promoted bone induction in dog tooth extraction sockets. For this study, GO scaffolds were prepared by coating the surface of a collagen sponge scaffold with 0.1 and 1 μg/mL GO dispersion. Scaffolds were characterized using scanning electron microscopy (SEM), physical testing, cell seeding, and rat subcutaneous implant testing. Then a GO scaffold was implanted into a dog tooth extraction socket. Histological observations were made at 2 weeks postsurgery. SEM observations show that GO attached to the surface of collagen scaffold struts. The GO scaffold exhibited an interconnected structure resembling that of control subjects. GO application improved the physical strength, enzyme resistance, and adsorption of calcium and proteins. Cytocompatibility tests showed that GO application significantly increased osteoblastic MC3T3-E1 cell proliferation. In addition, an assessment of rat subcutaneous tissue response revealed that implantation of 1 μg/mL GO scaffold stimulated cellular ingrowth behavior, suggesting that the GO scaffold exhibited good biocompatibility. The tissue ingrowth area and DNA contents of 1 μg/mL GO scaffold were, respectively, approximately 2.5-fold and 1.4-fold greater than those of the control. Particularly, the infiltration of ED2-positive (M2) macrophages and blood vessels were prominent in the GO scaffold. Dog bone-formation tests showed that 1 μg/mL GO scaffold implantation enhanced bone formation. New bone formation following GO scaffold implantation was enhanced fivefold compared to that in control subjects. These results suggest that GO was biocompatible and had high bone-formation capability for the scaffold. The GO scaffold is expected to be beneficial for bone tissue engineering therapy

Treatment outcomes of laparoscopic radical prostatectomy at Kawasaki Medical School Hospital

　Laparoscopic radical prostatectomy (LRP) was carried out in 196 patients with prostate cancer between December 2009 and November 2017 at Kawasaki Medical School Hospital, and the therapeutic outcomes were assessed. An extraperitoneal approach was used in all cases except 1 and the median follow-up period was 55 months (range, 10-117 months). The median patient age was 69 years (range, 56-79 years), median body mass index was 23.3 kg/m2 (range, 15.2-33.2 kg/m2 ), and median prostate-specific antigen (PSA) level at diagnosis was 7.4 ng/mL (range, 2.2-42.0 ng/mL). Clinical stages of T1c, T2a, T2b, T2c, T3a, and T3b accounted for 63, 43, 31, 57, 1, and 1 case, respectively, while Gleason scores at biopsy of ≥ 6, 7, and ≥ 8 accounted for 26, 138, and 32 cases, respectively. The median prostate volume was 22.0 mL (range, 7.3-65.6 mL), median operating time was 266 minutes (range, 142-540 minutes), and median blood loss (including in urine) was 650 mL (range, 10-5,800 mL). During the initial induction period, 94 patients received autologous blood transfusion and 7 received allogeneic blood transfusion. Nerve-sparing prostatectomy was performed in 17 cases (bilateral in 3, unilateral in 14). Capsular invasion was observed in 57 cases (29.1%) and positive resection margins were observed in 51 cases (26.4%). The median indwelling catheter duration was 6 days (range, 4-26 days) and the median hospital stay after surgery was 11 days (range, 8-34 days). The main complications were intraoperative rectal injury in 7 cases (3.6%), postoperative inguinal hernia in 28 (14.3%), and urethral stenosis in 8 (4.1%). The rate of urinary incontinence at ≥ 1 year after surgery was 32.7% and the rate of PSA recurrence was 15.8%. The overall survival rate was 95.6% at 5 years and 94.7% at 10 years. In conclusion, the oncological outcomes were similar to that reported by previous reports, but postoperative stress urinary incontinence and complications were slightly worse. In the future, further improvement of the surgical technique was desired

Outcomes of robot-assisted partial nephrectomy in the treatment of renal cell carcinoma at Kawasaki Medical School Hospital

　Robot-assisted partial nephrectomy (RAPN) was introduced in our hospital for treating small renal cell carcinoma in May 2018; we examined treatment outcomes in 24 patients (25 kidneys) who had undergone this procedure till 2019. The median observation period was 11 months (range, 1-17 months). The patients’ age range was 43-77 years (median, 68 years). Fourteen men and 10 women underwent the procedure. Their BMI was 17.9-39.7 (median, 24.1) kg/m2 . In one patient, RAPN was performed twice at different times for treating bilateral renal cancer. The right kidney was affected in 12 cases and the left kidney in 13 cases. The clinical cancer stage was T1a in 20 cases and T1b in 5 cases. Tumor sizes were 0.9-6.2 cm (median, 2.5 cm), and RENAL nephrometry scores were 4-10 (median, 7). The transperitoneal approach was used in 22 cases, and the retroperitoneal approach in 3. The operating durations were 147-358 min (median, 225 min), console durations were 59-394 min (median, 152 min), and renal ischemia durations were 8-54 min (median, 21 min). Blood loss was 10-700 ml (median 10 ml), and none of the patients underwent blood transfusion. The histopathological analysis of the resected tumors revealed clear cell renal cell carcinoma in 20 cases, chromophobe renal cell carcinoma in 2 cases, and papillary renal cell carcinoma, angiomyolipoma, and leiomyoma in 1 case each. All margins were negative. The postoperative hospital stay lengths were 5-14 days (median, 9 days). The postoperative deterioration in renal function was mild, and there were no severe complications. In the early stages after its introduction, RAPN was safely performed and allowed for the preservation of renal function. We plan to continue studying more cases going forward

当院の女性過活動膀胱患者における抗コリン薬とβ3アドレナリン受容体作動薬の内服継続率に関する検討

　過活動膀胱（overactive bladder：以下OAB）は，尿意切迫感や頻尿などの下部尿路症状を有し，加齢とともに増加する傾向がある．OAB 患者の治療薬として，本邦では抗コリン薬とβ3アドレナリン受容体作動薬が推奨，使用されている．今回，女性OAB 患者に対する，抗コリン薬とβ3アドレナリン受容体作動薬の内服継続率，副作用，内服中止理由に関してretrospective に検討した．対象は，2013年１月から12月の１年間に当院泌尿器科を受診した初診の女性OAB 患者，87名とした．β3アドレナリン受容体作動薬投与群と抗コリン薬投与群の内服継続率は，β3アドレナリン受容体作動薬投与群は，12か月で38.8％，60か月で18.1％，抗コリン薬投与群は，12か月18.4%，60か月で7.9％であり，β3アドレナリン受容体作動薬投与群の方が若干継続率は良いものの，両群間に差は認めなかった．副作用に関しては，抗コリン薬投与群の方が多く，口喝が17例（44.7%），便秘が15例（39.5%）であった．薬剤中止の理由は両群とも自然寛解によるものが多かった．　Overactive bladder (OAB) involves lower urinary tract symptoms such as urinary urgency and polyuria, and tends to increase with age. In Japan, the drugs recommended and used for treatment of OAB patients are anticholinergic agents and β3 adrenalin receptor agonists. The present study was a retrospective investigation of the rates of long-term administration of anticholinergic agents and β3 adrenalin receptor agonists, adverse effects with these drugs, and reasons for discontinuation of administration, with female OAB patients. The subjects were 87 female patients who were examined at this hospital\u27s Urology Dept. over 1 year between January and December 2013, and diagnosed as having OAB for the first time. With respect to the rates of long-term administration, in the β3 adrenalin receptor agonist group the rates of administration for 12 and 60 months, respectively, were 38.8% and 18.1%, and these rates in the anticholinergic agent group were 18.4% and 7.9%, so the long-term administration rates were somewhat higher in the β3 adrenalin receptor agonist group, but no difference between the groups was found. Adverse effects were more frequent in the anticholinergic agent group, with 17 subjects in that group (44.7%) developing buccal dryness, and 15 (39.5%) developing constipation. In both groups, the most frequent reason for discontinuation of administration was spontaneous remission

Use of the index of pulmonary vascular disease for predicting long-term outcome of pulmonary arterial hypertension associated with congenital heart disease

AimsLimited data exist on risk factors for the long-term outcome of pulmonary arterial hypertension (PAH) associated with congenital heart disease (CHD-PAH). We focused on the index of pulmonary vascular disease (IPVD), an assessment system for pulmonary artery pathology specimens. The IPVD classifies pulmonary vascular lesions into four categories based on severity: (1) no intimal thickening, (2) cellular thickening of the intima, (3) fibrous thickening of the intima, and (4) destruction of the tunica media, with the overall grade expressed as an additive mean of these scores. This study aimed to investigate the relationship between IPVD and the long-term outcome of CHD-PAH.MethodsThis retrospective study examined lung pathology images of 764 patients with CHD-PAH aged <20 years whose lung specimens were submitted to the Japanese Research Institute of Pulmonary Vasculature for pulmonary pathological review between 2001 and 2020. Clinical information was collected retrospectively by each attending physician. The primary endpoint was cardiovascular death.ResultsThe 5-year, 10-year, 15-year, and 20-year cardiovascular death-free survival rates for all patients were 92.0%, 90.4%, 87.3%, and 86.1%, respectively. The group with an IPVD of ≥2.0 had significantly poorer survival than the group with an IPVD <2.0 (P = .037). The Cox proportional hazards model adjusted for the presence of congenital anomaly syndromes associated with pulmonary hypertension, and age at lung biopsy showed similar results (hazard ratio 4.46; 95% confidence interval: 1.45–13.73; P = .009).ConclusionsThe IPVD scoring system is useful for predicting the long-term outcome of CHD-PAH. For patients with an IPVD of ≥2.0, treatment strategies, including choosing palliative procedures such as pulmonary artery banding to restrict pulmonary blood flow and postponement of intracardiac repair, should be more carefully considered