Risk factors for postoperative complications following oral surgery

AbstractObjective The objective of this study was to clarify significant risk factors for postoperative complications in the oral cavity in patients who underwent oral surgery, excluding those with oral cancer.Material and Methods This study reviewed the records of 324 patients who underwent mildly to moderately invasive oral surgery (e.g., impacted tooth extraction, cyst excision, fixation of mandibular and maxillary fractures, osteotomy, resection of a benign tumor, sinus lifting, bone grafting, removal of a sialolith, among others) under general anesthesia or intravenous sedation from 2012 to 2014 at the Department of Oral and Maxillofacial Reconstructive Surgery, Hiroshima University Hospital.Results Univariate analysis showed a statistical relationship between postoperative complications (i.e., surgical site infection, anastomotic leak) and diabetes (p=0.033), preoperative serum albumin level (p=0.009), and operation duration (p=0.0093). Furthermore, preoperative serum albumin level

Circulatory changes in rheumatoid fingers as estimated by thermography and photoelectric plethysmography

In an attempt to evaluate circulatory changes in patients with rheumatoid arthritis (RA), 20 patients with classical or definite RA as determined by ARA criteria and twenty healthy volunteers serving as control were randomly selected. None of the patients showed the clinical signs suggesting Raynaud's phenomenon. Thermograms as well as photoelectric plethysmograms were obtained solely from the right middle finger tip of each examinee. The whole hand was then immersed in the cold (10℃) water and kept there for one minute. After wiping away the wet hand with a dry towel very gently, we followed the sequential changes of the tempe· rature of the third finger tip and the period of time necessary for the tip to return to the original temperature prior to the cold water immersion was measured and expressed as 'return time' in minute. Before exposure to the cold, the mean values of temperature of the finger tips between the two groups were not significantly different. As opposed to the normal pattern in which one can find the warmest point at the finger tip and which was more frequently found in the control group of the current study, a type in which the distal part of the finger was much cooler than the proximal area (so-called 'distal cold type') was observed in 8 RA patients, whereas only four demonstrated this pattern in the control group. After brief exposure to the cold, eight out of 20 rheumatoid patients showed much prolonged return time (longer than 20 minutes), while only three of 20 controls remained with prolonged cool periphery, The difference between the two, however, was not statistically significant. Studies of the digital plethysmograph revealed that 70% of all the rheumatoids showed abnormal patterns: sclerotic and monophasic waves were discovered in 55% of the patients. In contrast, seventy percent of the normal control demonstra· ted normal wave pattern. Although the significant difference was not noted, the mean height of the systolic peak of the plethysmograph derived from the rheumatoid group tended to be much reduced, suggesting the reduced blood volume at the finger tips. Six RA patients and 13 normals who showed normal plethysmographic pattern before immersion in the cold water, demonstrated rapid return to the original temperature. Only in one normal control with a normal wave pattern, prolonged return time was observed, although the height of the systolic peak of the plethysmogram in this particular case was well within normal limit. Digital circulatory disturbance, however, was strongly suspected in eight RA patients with severely prolonged return time, They all showed abnormal wave patterns of the plethysmogram, including 2 cases with peripheral plateau wave, Markedly reduced heights of the systolic peaks were also demonstrated in all. Further elaborate studies including digital arteriography were indicated to implicate any organic change in the digital vessels, such as digital arteritis in RA first reported by Bywaters in 1957

Long-term results of the open stent-grafting technique for extended aortic arch disease

ObjectiveThis report elucidates the long-term safety and effectiveness of extended aortic arch replacement with an open stent-grafting technique from our 12 years of experience.MethodsFrom 1994 to 2004, 126 patients (mean age 67.8 years) with different pathologic conditions of the aortic arch with extension to the descending aorta (57 dissections [acute/chronic = 31/26] and 69 aneurysms) were operated on with an open stent-grafting technique. During deep hypothermic circulatory arrest with selective cerebral perfusion, the stent graft was delivered through the transected proximal aortic arch, and arch replacement with a 4-branched prosthesis was performed.ResultsOperative mortality within 30 days was 3.2%. Perioperative morbidity included 7 (5.6%) strokes and 8 (6.3%) spinal injuries (paraplegia in 3, transient paraparesis in 5). Sixty-three percent of the patients were extubated within 24 hours. In long-term follow-up (mean 60.4 ± 36.5 months, maximum 153 months), survival was 81.1%, 63.3%, and 53.7% at 1, 5, and 8 years. Five (3.9%) late endoleaks were observed but treated with successful additional endovascular repair. Freedom from endoleaks was 98.0%, 91.1%, and 91.1% for 1, 5, and 8 years, respectively.ConclusionLong-term observation showed safety and good durability of the open stent-grafting technique for aortic arch disease. This technique could be an attractive treatment option for aortic arch aneurysm with distal extension and aortic dissection requiring aortic arch replacement

Expression of anti-fungal peptide, β-defensin 118 in oral fibroblasts induced by C. albicans β-glucan-containing particles

Objective: Although oral fibroblasts are thought to have the potential to enhance host defenses against Candida albicans , it is unknown whether they are able to recognize Candida cell components to increase the expression of antifungal peptides, such as defensin factors, against Candida infection. Methodology: We performed expression profiles of defensin genes induced by heat-killed C. albicans in oral immortalized fibroblasts (GT1) using cDNA microarray analysis. From those results, quantitative RT-PCR was used to examine the effects of Candida β-glucan-containing particles (β-GPs) on β-Defensin 118 (DEFB 118) expression in oral mucosal cells. Furthermore, the antifungal activities of recombinant DEFB 118 against C. albicans and C. glabrata were investigated using fungicidal assays. Results: Microarray analysis showed that DEFB118, β-Defensin 129 (DEFB129), and α-Defensin 1 (DEFA1) genes were induced by heat-killed C. albicans and that their mRNA expressions were also significantly increased by live as well as heat-killed C. albicans . Next, we focused on DEFB118, and found that GT1, primary fibroblasts, and RT7 (oral immortalized keratinocytes) constitutively expressed DEFB118 mRNA expression in RT-PCR. Furthermore, C. albicans β-GPs significantly increased the expression of DEFB118 mRNA in GT1 and primary fibroblasts. Although DEFB118 mRNA expression in RT7 was significantly induced by both live and heat-killed C. albicans, C. albicans β-GPs failed to have an effect on that expression. Finally, recombinant DEFB118 significantly decreased the survival of both strains of C. albicans in a dose-dependent manner, whereas no effects were seen for both C. glabrata strains. Conclusion: DEFB118, induced by C. albicans β-GPs from oral fibroblasts, may play an important role in oral immune responses against C. albicans infection

Naïve rat umbilical cord matrix stem cells significantly attenuate mammary tumor growth through modulation of endogenous immune responses

Background: Un-engineered human and rat umbilical cord matrix stem cells (rUCMSC) attenuate growth of several types of tumors in mice and rats. However, the mechanism by which UCMSC attenuate tumor growth has not been studied rigorously. Methods- The possible mechanisms of tumor growth attenuation by rUCMSC were studied using orthotopic Mat B III rat mammary tumor grafts in female F344 rats. Tumor-infiltrating leukocytes were identified and quantified by immunohistochemical image analysis. Potential cytokines involved in lymphocyte infiltration in the tumors were determined by microarray and Western blot analysis. The Boyden chamber migration assay was performed for the functional analysis of identified cytokines. Results: rUCMSC markedly attenuated the tumor growth; this attenuation was accompanied by considerable lymphocyte infiltration. Immunohistochemical analysis revealed that the majority of infiltrating lymphocytes in the rUCMSC-treated tumors were CD3+ T cells. In addition, treatment with rUCMSC significantly increased infiltration of CD 8+ and CD4+ T cells and NK cells throughout tumor tissue. CD68+ monocytes/macrophages and FoxP3+ regulatory T cells were scarcely observed, only in the tumors of the PBS control group. Microarray analysis of rUCMSC identified that monocyte chemotactic protein (MCP)-1 is involved in rUCMSCinduced lymphocyte infiltration in the tumor tissues. Discussion: These results suggest that naïve rUCMSC attenuated mammary tumor growth at least in part by enhancing host anti-tumor immune responses. Thus, naïve UCMSC can be used as powerful therapeutic cells for breast cancer treatment, and MCP-1 may be a key molecule to enhance the effect of UCMSC at the tumor site

DNA Methylation Is Dispensable for the Growth and Survival of the Extraembryonic Lineages

SummaryDNA methylation regulates development and many epigenetic processes in mammals [1], and it is required for somatic cell growth and survival [2, 3]. In contrast, embryonic stem (ES) cells can self-renew without DNA methylation [4–6]. It remains unclear whether any lineage-committed cells can survive without DNA-methylation machineries. Unlike in somatic cells, DNA methylation is dispensable for imprinting and X-inactivation in the extraembryonic lineages [7–12]. In ES cells, DNA methylation prevents differentiation into the trophectodermal fate [13]. Here, we created triple-knockout (TKO) mouse embryos deficient for the active DNA methyltransferases Dnmt1, Dnmt3a, and Dnmt3b (TKO) by nuclear transfer (NT), and we examined their development. In chimeric TKO-NT and WT embryos, few TKO cells were found in the embryo proper, but they contributed to extraembryonic tissues. TKO ES cells showed increasing cell death during their differentiation into epiblast lineages, but not during differentiation into extraembryonic lineages. Furthermore, we successfully established trophoblastic stem cells (ntTS cells) from TKO-NT blastocysts. These TKO ntTS cells could self-renew, and they retained the fundamental gene expression patterns of stem cells. Our findings indicated that extraembryonic-lineage cells can survive and proliferate in the absence of DNA methyltransferases and that a cell's response to the stress of epigenomic damage is cell type dependent

ICG fluorescence catheter system in TaTME

Background. Sometimes intraoperative urethral injury occurs in Transanal total mesorectal excision (TaTME). The aim of this study is to investigate the usefulness of indocyanine green (ICG) fluorescent catheter system for avoiding intraoperative urethral injury in TaTME in experimental model. Methods. A urethral catheter was filled with the mixture of albumin and ICG and raw hams were applied in layers as the surrogate model of rectourethral muscle. The detectability of ICG fluorescence in this catheter was investigated by using laparoscope-type fluorescence camera system. Results. Fluorescence was detected when ICG was mixed with albumin or peripheral blood. ICG fluorescence could be detected within 4 mm depth of layered raw hams as the surrogate model. Quantitative analysis of the picture detected that ICG fluorescence plateaued in lower concentration than that of serum. Conclusion. ICG fluorescent catheter system may be useful for avoiding intraoperative urethral injury in TaTME

Effects of CEACAM1 in oral keratinocytes on HO-1 expression induced by Candida β-glucan particles

Objective: Carcinoembryonic antigen-related cell adhesion molecule 1 (CEACAM1) is a member of the carcinoembryonic antigen family. Although its expression has been found in chronic oral inflammatory epithelium, this study aimed to know whether CEACAM1 in oral keratinocytes participates in host immune response against Candida albicans . Methodology: We investigated CEACAM1 expression in oral keratinocytes induced by C. albicans as well as by Candida cell wall component β-glucan particles (β-GPs). Furthermore, the effects of CEACAM1 on β-GPs-induced heme oxygenase-1 (HO-1) expression and its related signals were examined. Results: Fluorescence staining showed CEACAM1 expression in oral keratinocytes (RT7) cells, whereas quantitative reverse transcription (RT)-PCR indicated that both live and heat-killed C. albicans increased CEACAM1 mRNA expression in RT7 cells. Examinations using quantitative RT-PCR and western blotting indicated that CEACAM1 expression was also increased by β-GPs derived from C. albicans . Specific siRNA for CEACAM1 decreased HO-1 expression induced by β-GPs from C. albicans as well as the budding yeast microorganism Saccharomyces cerevisiae . Moreover, knockdown of CEACAM1 decreased β-GPs-induced ROS activity in the early phase and translocation of Nrf2 into the nucleus. Conclusion: CEACAM1 in oral keratinocytes may have a critical role in regulation of HO-1 for host immune defense during Candida infection

Human Umbilical Cord Matrix Mesenchymal Stem Cells Suppress the Growth of Breast Cancer by Expression of Tumor Suppressor Genes

Citation: Ohta, N., Ishiguro, S., Kawabata, A., Uppalapati, D., Pyle, M., Troyer, D., . . . Tamura, M. (2015). Human Umbilical Cord Matrix Mesenchymal Stem Cells Suppress the Growth of Breast Cancer by Expression of Tumor Suppressor Genes. Plos One, 10(5), 17. doi:10.1371/journal.pone.0123756Human and rat umbilical cord matrix mesenchymal stem cells (UCMSC) possess the ability to control the growth of breast carcinoma cells. Comparative analyses of two types of UCMSC suggest that rat UCMSC-dependent growth regulation is significantly stronger than that of human UCMSC. Their different tumoricidal abilities were clarified by analyzing gene expression profiles in the two types of UCMSC. Microarray analysis revealed differential gene expression between untreated naive UCMSC and those co-cultured with species-matched breast carcinoma cells. The analyses screened 17 differentially expressed genes that are commonly detected in both human and rat UCMSC. The comparison between the two sets of gene expression profiles identified two tumor suppressor genes, adipose-differentiation related protein (ADRP) and follistatin (FST), that were specifically up-regulated in rat UCMSC, but down-regulated in human UCMSC when they were co-cultured with the corresponding species' breast carcinoma cells. Over-expression of FST, but not ADRP, in human UCMSC enhanced their ability to suppress the growth of MDA-231 cells. The growth of MDA-231 cells was also significantly lower when they were cultured in medium conditioned with FST, but not ADRP over-expressing human UCMSC. In the breast carcinoma lung metastasis model generated with MDA-231 cells, systemic treatment with FST-over-expressing human UCMSC significantly attenuated the tumor burden. These results suggest that FST may play an important role in exhibiting stronger tumoricidal ability in rat UCMSC than human UCMSC and also implies that human UCMSC can be transformed into stronger tumoricidal cells by enhancing tumor suppressor gene expression