Desquamative Gingivitis

Desquamative gingivitis (DG) is characterized by erythematous, epithelial desquamation, erosion of the gingival epithelium, and blister formation on the gingiva. DG is a clinical feature of a variety of diseases or disorders. Most cases of DG are associated with mucocutaneous diseases, the most common ones being lichen planus, mucous membrane pemphigoid, and pemphigus vulgaris. Proper diagnosis of the underlying cause is important because the prognosis varies, depending on the disease. This chapter presents the underlying etiology that is most commonly associated with DG. The current literature on the diagnostic and management modalities of patients with DG is reviewed

Gingival Nikolsky’s Sign: A Valuable Tool in Identifying Oral Manifestations of Mucous Membrane Pemphigoid and Pemphigus Vulgaris

Autoimmune bullous diseases are a group of rare, chronic blistering diseases that affects the skin and mucous membranes. Mucous membrane pemphigoid (MMP) is the most frequently occurring autoimmune bullous disease in the oral cavity, followed by pemphigus vulgaris (PV). Early diagnosis of MMP or PV is critical for proper management and prevention of potential serious complications. This study was based on a retrospective review of 39 cases that were classified as MMP (25 patients) or PV (14 patients). Nikolsky’s sign characterized by epithelial detachment as a result of slight pressure or rubbing the oral mucosa is a simple test that can confirm the existence of gingival desquamation. A positive reaction was confirmed in 38 patients (97.4%) at their first visit. This result indicates that patients showing positive Nikolsky’s sign should include MMP or PV in the differential diagnosis and, in that case, histopathological examination and direct immunofluorescence testing are critical to establish the final diagnosis. For the early diagnosis of autoimmune bullous disorders, oral healthcare providers should consider the use of the test for Nikolsky’s sign that may ultimately lead to the early diagnosis of MMP and PV or other diseases or disorders

Desquamative Gingivitis: Early Sign of Mucous Membrane Pemphigoid and Pemphigus Vulgaris

Early signs and symptoms of autoimmune bullous diseases such as mucous membrane pemphigoid (MMP) or pemphigus vulgaris (PV) develop in the oral cavity in almost all cases. Desquamative gingivitis (DG) is a clinical manifestation common to several diseases or disorders and is frequently associated with autoimmune bullous diseases. This is a retrospective study of 37 patients with MMP (24 cases) or PV (13 cases) including 10 males and 27 females with a mean age of 58.4 years. The study indicates that DG is an early sign of autoimmune bullous diseases such as MMP or PV. About 70.3% of the oral lesions were confined only to the gingiva, and DG was the only manifestation of the diseases. Since some lesions remain limited to the oral cavity for a long period of time, patients diagnosed with MMP or PV should be closely followed because they must be immediately referred to other experts when they develop lesions on parts of their body other than the oral cavity. The oral healthcare provider should collaborate with other healthcare experts including dermatologists, ophthalmologists, and otolaryngologists to evaluate and manage patients with autoimmune bullous diseases in the oral cavity

Noninvasive assessment of the cardiac baroreflex Response to downward tilting and comparison with the phenylephrine method

AbstractOBJECTIVESWe studied the relation between changes in systolic blood pressure and RR interval during downward tilting in comparison with assessment of baroreflex sensitivity (BRS) measured by the phenylephrine method (Phe-BRS) and with measures of heart rate variability (HRV).BACKGROUNDThe method most extensively used for assessing BRS involves bolus injections of phenylephrine. Several noninvasive methods proposed to assess BRS have not been widely applied in the clinical setting.METHODSSixteen healthy male volunteers were studied (mean age ± SD 27.5 ± 4.6 years). Arterial blood pressure using tonometry and electrocardiogram was simultaneously recorded. After 20 min of 70° upright tilting, the table was returned to supine position at a speed of 3.2°/s. Subsequently, BRS was assessed using an intravenous bolus injection of phenylephrine (2 to 3 μg/kg). Heart rate variability under resting conditions also was analyzed.RESULTSIn all subjects, a beat to beat systolic blood pressure increase associated with corresponding RR interval lengthening was observed during downward tilting as well as during phenylephrine administration. During both testing procedures, these two variables showed linear correlation, and the slope of regression line during downward tilting (DT-BRS) correlated significantly with Phe-BRS (r = 0.79, p = 0.0003). The DT- and Phe-BRS also correlated significantly with the high frequency component of resting HRV (r = 0.70, p = 0.0023 for DT-BRS; r = 0.58, p = 0.0185 for Phe-BRS).CONCLUSIONSWe conclude that in a small homogeneous group DT-BRS provided an assessment of reflex cardiac vagal function comparable to that obtained by the phenylephrine method

Free-space optical channel estimation for physical layer security

We present experimental data on message transmission in a free-space optical (FSO) link at an eye-safe wavelength, using a testbed consisting of one sender and two receiver terminals, where the latter two are a legitimate receiver and an eavesdropper. The testbed allows us to emulate a typical scenario of physical-layer (PHY) security such as satellite-to-ground laser communications. We estimate information-theoretic metrics including secrecy rate, secrecy outage probability, and expected code lengths for given secrecy criteria based on observed channel statistics. We then discuss operation principles of secure message transmission under realistic fading conditions, and provide a guideline on a multi-layer security architecture by combining PHY security and upper-layer (algorithmic) security

High-dose Dexamethasone Therapy as the Initial Treatment for Idiopathic Thrombocytopenic Purpura: Protocol for a Multicenter, Open-label, Single Arm Trial

Standard therapy for idiopathic thrombocytopenic purpura (ITP) has not been established. We are conducting a multicenter, prospective trial to determine the efficacy and safety of short-term, high-dose dexamethasone therapy in ITP patients aged 18-80 years with platelet counts of <20, 000 /μL, or with <50, 000/ μL and bleeding symptoms. The primary endpoints of this trial are the proportion of responses (complete plus partial response) on day 180 (day 46+180) after the completion of the 46-day high-dose dexamethasone therapy. The results of this investigation of the effectiveness and safety of this regimen will be essential for the establishment of standard therapy for ITP

Innovative design of bone quality-targeted intervertebral spacer: accelerated functional fusion guiding oriented collagen and apatite microstructure without autologous bone graft

BACKGROUND CONTEXT: Although autologous bone grafting is widely considered as an ideal source for interbody fusion, it still carries a risk of nonunion. The influence of the intervertebral device should not be overlooked. Requirements for artificial spinal devices are to join the vertebrae together and recover the original function of the spine rapidly. Ordered mineralization of apatite crystals on collagen accelerates bone functionalization during the healing process. Particularly, the stable spinal function requires the ingrowth of an ordered collagen and apatite matrix which mimics the intact intervertebral microstructure. This collagen and apatite ordering is imperative for functional bone regeneration, which has not been achieved using classical autologous grafting. PURPOSE: We developed an intervertebral body device to achieve high stability between the host bone and synthesized bone by controlling the ordered collagen and apatite microstructure. STUDY DESIGN: This was an in vivo animal study. METHODS: Intervertebral spacers with a through-pore grooved surface structure, referred to as a honeycomb tree structure, were produced using metal 3D printing. These spacers were implanted into normal sheep at the L2–L3 or L4–L5 disc levels. As a control group, grafting autologous bone was embedded. The mechanical integrity of the spacer/bone interface was evaluated through push-out tests. RESULTS: The spacer with honeycomb tree structure induced anisotropic trabecular bone growth with textured collagen and apatite orientation in the through-pore and groove directions. The push-out load of the spacer was significantly higher than that of the conventional autologous graft spacer. Moreover, the load was significantly correlated with the anisotropic texture of the newly formed bone matrix. CONCLUSIONS: The developed intervertebral spacer guided the regenerated bone matrix orientation of collagen and apatite, resulting in greater strength at the spacer/host bone interface than that obtained using a conventional gold-standard autologous bone graft. CLINICAL SIGNIFICANCE: Our results provide a foundation for designing future spacers for interbody fusion in human.Matsugaki A., Ito M., Kobayashi Y., et al. Innovative design of bone quality-targeted intervertebral spacer: accelerated functional fusion guiding oriented collagen and apatite microstructure without autologous bone graft. Spine Journal 23, 609 (2023); https://doi.org/10.1016/j.spinee.2022.12.011

エタノール資化性酵母の検索とその培養条件(エタノール資化性酵母に関する研究(第1報),自然科学編)

同定株112株,未同定分離株105株合計217株の酵母を供試菌とし,エタノールを炭素源とする合成培地を用いてエタノール資化性酵母の検索を行なった。エタノール資化性の高い菌株として,Pichia membranaefaciens No.304, Pichia sake form. αNo.101, Pocjoa farinosa No.115, Pichia farinosa No.121, Candida rugosa LKB6111, Yeast No.62-72の6菌株を選択した。これら6菌株の酵母増殖におよぼす窒素源,天然栄養源などの影響を検討した。天然栄養源としては、一般にCorn steep liquorがよく,Candida rugosa, Yeast No.62-72では肉エキスの添加効果もすぐれていた。Corn steep liquorの添加適量は菌株によって異なり0.1%～0.2%であった。エタノール濃度は2～6%でよく増殖したが,8%では生育が阻害され,10%ではほとんど生育は認められなかった。尿素・硫酸アンモニウム混合窒素源を用いてエタノール培地で培養を行なった結果,P. sake form.αは硫酸アンモニウム5%混用で,また,P.membranaefaciens, Candida rugosaおよびYeast No.62-72は硫酸アンモニウム10%混用でpHの上昇が抑制され,雑菌の汚染防止に役立つと考えられた。しかし,Yeast No.67-72以外の酵母菌株では硫酸アンモニウムの混用により,酵母の増殖を低下させる傾向があった。エタノールに対する酵母菌体収率は,エタノール1%培地ではPichia membrancefaciensが73.8%で最も高く,エタノール2%および4%培地ではYeast No.62-72がそれぞれ69.5%, 63.3%,またエタノール6%培地ではPichia farinosa No.115が56.4%で,いずれも良好な結果をえた。Six yeast strains, Pichia membranaefaciens No.304, Pichia sake form. α No.101, Pichia farinosa No.115, Pichia farinosa No.121, Candida rugosa LKB 6111 and yeast No.62-72, utilizing ethanol as a carbon source were selected from 217 strains of yeast (identified 112 strains, unidentified 105 strains). These selected strains showed a good growth on the medium containing 2～6 per cent ethanol, 0.1～0.2 per cent urea and 0.1 per cent corn steep liquor. The growth, however, decreased at a concentration of 8 per cent, and was inhibited at a concentration of 10 per cent of added ethanol. The growth characteristics of the selected six ethanol-assimilating yeast strains were investigated in shaking culture on the ethanol medium containing urea and ammonium sulphate at various proportions. By the addition of 5～20 per cent ammonium sulphate to urea as nitrogen, the growth of these yeasts, except yeast No.62-72 strain, decreased with the increase of ammonium sulphate concentration. However, the rise of pH was decreased during cultivation and it is shown that the depression of pH protects the culture from bacterial contamination. Optimal concentration of corn steep liquor as a natural nutrient for yeast growth was between 0.1～0.2 per cent, differing among the strain. Cell yield from ethanol supplied to the medium reached 73.8 per cent on 1 per cent ethanol medium for Pichia membranaefaciens No.304

A Functional SNP in BNC2 Is Associated with Adolescent Idiopathic Scoliosis

Adolescent idiopathic scoliosis (AIS) is the most common spinal deformity. We previously conducted a genome-wide association study (GWAS) and detected two loci associated with AIS. To identify additional loci, we extended our GWAS by increasing the number of cohorts (2,109 affected subjects and 11,140 control subjects in total) and conducting a whole-genome imputation. Through the extended GWAS and replication studies using independent Japanese and Chinese populations, we identified a susceptibility locus on chromosome 9p22.2 (p = 2.46 × 10−13; odds ratio = 1.21). The most significantly associated SNPs were in intron 3 of BNC2, which encodes a zinc finger transcription factor, basonuclin-2. Expression quantitative trait loci data suggested that the associated SNPs have the potential to regulate the BNC2 transcriptional activity and that the susceptibility alleles increase BNC2 expression. We identified a functional SNP, rs10738445 in BNC2, whose susceptibility allele showed both higher binding to a transcription factor, YY1 (yin and yang 1), and higher BNC2 enhancer activity than the non-susceptibility allele. BNC2 overexpression produced body curvature in developing zebrafish in a gene-dosage-dependent manner. Our results suggest that increased BNC2 expression is implicated in the etiology of AIS