歯科インプラント周囲の骨吸収に関する臨床疫学研究

Background: During functional loading, the design of the dental implant may have an effect on the response of marginal bone. Objectives: The purpose of this study was to report the prevalence of peri-implantitis, and to compare radiographic parameters around Brånemark and Replace Select dental implants and evaluate whether disparities in the morphologic features of these two indistinct implant systems, particularly their abutment-implant attachment, had an influence on the health of surrounding tissues and marginal bone loss (MBL). Materials and Methods: Collection of data was done at the Department of Fixed Prosthodontics, the Department of Maxillo-Facial Prosthodontics, and Oral Implant Center of Tokushima University Hospital, in Tokushima, Japan; between March 2003 and followed until January 2017. Patients who have been treated with the Replace Select internal type implant and the Brånemark variety were selected as cohort. Marginal bone level measurements were evaluated via periapical and panoramic radiographs taken at regular follow-up visit. These dimensions were calculated, starting from the orientation mark at the implant abutment interface to the bottommost perceived contact area of marginal bone with the aforementioned implant system. The change in the level of bone was estimated by calculating the variation involving an initial reference value and the follow-up values. Results: An average loss of bone at 0.65 ± 1.51 mm (range 0.36 to 7.89 mm) in the Replace Select group was observed, while in the Brånemark group 0.7 ± 1.32 mm (range 0.62 to 8.64 mm) was observed. Spearman rank correlation exhibited a statistically significant positive correlation between progress of bone loss around implant body and interval from implantation in the Brånemark group, whereas in the Replace Select group it was not significant. The Brånemark group exhibited significant (P = 0.0269) negative correlation of MBL and its diameters, whereas the Replace Select group did not exhibit such correlation. Conclusion: Within the limits of this study, it can be concluded that deviations in the morphologic attributes of these two diverse implant systems had an influence on the health of surrounding tissues and MBL. The Brånemark implants showed a significant increase in MBL (> 1.8mm) as the time of placement elapses. This marked MBL was greater in females than males, in posterior than in anterior, and in the narrow platform implants than the regular platform implants or the wide platform implants. On the other hand, results suggested that this bone loss was greater in the mandible than the maxilla, in single-unit implant crowns than multiple implant restorations in the Replace Select group

INCS suppresses H1R gene expression

The purpose of this study is to examine the effect of intranasal corticosteroid (INCS) administration on histamine H1 receptor (H1R) gene expression in the nasal mucosa of healthy participants and the effects of dexamethasone on basal and histamine-induced H1R mRNA expression, and histamine-induced phosphorylation of extracellular signal-regulated kinase (ERK) in HeLa cells. Sixteen healthy participants were given INCS once daily for a week. After pretreatment of dexamethasone, HeLa cells were treated with histamine. Levels of H1R mRNA and phosphorylation of ERK were measured using real time PCR and immunoblot analysis, respectively. Levels of H1R mRNA in the nasal mucosa of healthy participants receiving INCS was significantly decreased. Dexamethasone suppressed basal levels of H1R mRNA, and histamine-induced up-regulation of H1R mRNA and ERK phosphorylation in HeLa cells. These data suggested that corticosteroid inhibited both basal transcription and histamine-induced transcriptional activation of H1R through its suppression of ERK phosphorylation in the signaling pathway involved in H1R gene transcription. It is further suggested that pre-seasonal prophylactic administration of INCS suppresses both basal and pollen-induced upregulation of H1R gene expression in the nasal mucosa of patients with pollinosis, leading to prevention of the exacerbation of nasal symptoms during peak pollen season

Identification of prophylactic drugs for oxaliplatin-induced peripheral neuropathy using big data

Background: Drug repositioning is a cost-effective method to identify novel disease indications for approved drugs; it requires a shorter developmental period than conventional drug discovery methods. We aimed to identify prophylactic drugs for oxaliplatin-induced peripheral neuropathy by drug repositioning using data from large-scale medical information and life science information databases. Methods: Herein, we analyzed the reported data between 2007 and 2017 retrieved from the FDA’s database of spontaneous adverse event reports (FAERS) and the LINCS database provided by the National Institute of Health. The efficacy of the drug candidates for oxaliplatin-induced peripheral neuropathy obtained from the database analysis was examined using a rat model of peripheral neuropathy. Additionally, we compared the incidence of peripheral neuropathy in patients who received oxaliplatin at the Tokushima University Hospital, Japan. The effects of statins on the animal model were examined in six-week-old male Sprague–Dawley rats and seven or eight-week-old male BALB/C mice. Retrospective medical chart review included clinical data from Tokushima University Hospital from April 2009 to March 2018. Results: Simvastatin, indicated for dyslipidemia, significantly reduced the severity of peripheral neuropathy and oxaliplatin-induced hyperalgesia. In the nerve tissue of model rats, the mRNA expression of Gstm1 increased with statin administration. A retrospective medical chart review using clinical data revealed that the incidence of peripheral neuropathy decreased with statin use. Conclusion and relevance: Thus, drug repositioning using data from large-scale basic and clinical databases enables the discovery of new indications for approved drugs with a high probability of success

Myocardial Impairment Detected by Late Gadolinium Enhancement in Hypertrophic Cardiomyopathy: Comparison with 99mTc-MIBI/Tetrofosmin and 123I-BMIPP SPECT

Purpose: Myocardial fibrosis is considered to be an important factor in myocardial dysfunction and sudden cardiac death in hypertrophic cardiomyopathy (HCM). The purpose of this study was to compare myocardial fibrosis detected by late gadolinium enhancement (LGE) on cardiac MRI with myocardial perfusion and fatty acid metabolism assessed by single photon emission computed tomography in HCM.Materials and Methods: We retrospectively evaluated 20 consecutive HCM patients (female, 7; mean age, 53.4 years) who underwent LGE, technetium-99m methoxyisobutylisonitrile/tetrofosmin (99mTc-MIBI/tetrofosmin), and iodine-123 beta-methyl-iodophenylpentadecanoic acid (123I-BMIPP) imaging. We calculated the myocardium-to-lumen signal ratio (M/L) for LGE in 17 segments based on the American Heart Association statement. Scoring of 99mTc-MIBI/tetrofosmin (PI) and 123I-BMIPP (BM) was performed for each segment using a 5-point scale (0, normal; 4, highly decreased).Results: Nineteen of 20 patients (95%) and 153 of 340 segments (45%) showed LGE. M/Ls were 0.42ｱ・.16, 0.55ｱ・.17, and 0.65ｱ・.24 in PI0/BM0, PI0/BM1-4 and PI1-4/BM1-4, respectively. All M/Ls were significantly higher than that of a normal control (0.34ｱ・.14) (p<0.001).Conclusions: Myocardial fibrosis in HCM can occur despite normal perfusion and fatty acid metabolism, and is more strongly associated with disorders of fatty acid metabolism than with perfusion abnormalities. M/L may be a useful indicator of disease severity

Impact of frailty on long-term mortality in older patients receiving intensive care via the emergency department

The aim of this study was to evaluate whether frailty was associated with 6-month mortality in older adults who were admitted to the intensive care unit (ICU) with an illness requiring emergency care. The investigation was a prospective, multi-center, observational study conducted among the ICUs of 17 participating hospitals. Patients >= 65 years of age who were admitted to the ICU directly from an emergency department visit were assessed to determine their baseline Clinical Frailty Scale (CFS) scores before the illness and were surveyed 6 months after admission. Among 650 patients included in the study, the median age was 79 years old, and overall mortality at 6 months was as low as 21%, ranging from 6.2% in patients with CFS 1 to 42.9% in patients with CFS >= 7. When adjusted for potential confounders, CFS score was an independent prognostic factor for mortality (one-point increase in CFS, adjusted risk ratio with 95% confidence interval 1.19 [1.09-1.30]). Quality of life 6 months after admission worsened as baseline CFS score increased. However, there was no association between total hospitalization cost and baseline CFS. CFS is an important predictor of long-term outcomes among critically ill older patients requiring emergent admission