Application of a Chairside Anaerobic Culture Test for Endodontic Treatment

Periapical lesions are caused by bacterial infections. The fundamental objective of endodontic treatment is to eliminate bacteria present in the root canal system because they play an important role in the development and maintenance of periapical lesions. Therefore, confirming the absence of bacteria before filling root canals is important. Anaerobic culture tests have been used in many endodontic cases, and they have brought about good treatment outcomes. These tests, however, require specific apparatuses and bacteriological techniques. Here, we report a chairside anaerobic culture test that does not require any specialized apparatuses or techniques. We also report two endodontic cases in which this simple test was used. Both patients were diagnosed with chronic purulent periapical lesions. After confirming the absence of bacteria in the root canals, they were filled with gutta-percha points. At followup, the radiolucencies showed recovery, although longterm observation is under way. From these results, the authors conclude that this simple chairside anaerobic culture test is effective for evaluating periapical lesion treatment procedures

Identifcation of P2Y receptors involved in oleamide-suppressing infammatory responses in murine microglia and human dendritic cells

Abstract Microglia, a type of immune cell in the central nervous system, are involved in inflammation leading to neurodegenerative diseases. We previously identified oleamide from fermented dairy products as a neuroprotective compound suppressing microglial inflammation. Oleamide is an endocannabinoid and displays anti-inflammatory activity via the cannabinoid-2 (CB2) receptor; however, the mechanism underlying this anti-inflammatory activity has not been fully elucidated. Here, we found that the suppressive effect of oleamide on microglial tumor necrosis factor-α (TNF-α) production was canceled by inhibitors of G-protein-coupled receptor (GPCR) downstream signaling but not by a CB2 antagonist, suggesting that GPCRs other than CB2 are involved in the anti-inflammatory effects of oleamide. An extensive screen for GPCRs using a transforming growth factor-α shedding assay system identified P2Y1, P2Y4, P2Y6, P2Y10, and P2Y11 as candidates for the oleamide target. P2Y1 and P2Y10 agonists suppressed microglial TNF-α production, while a pan P2 receptor antagonist canceled the suppressive effect. Furthermore, we observed a relationship between the P2Y1 agonistic activities and the suppressive activities of oleamide and its analogs. Taken together, our results suggest that, in addition to CB2, P2Y type receptors are the potential targets of oleamide, and P2Y1 plays a role in the suppression of microglial inflammatory responses by oleamide. (200/200 words

Endoscopic removal of subgaleal hematoma in a 7-year-old patient treated with anticoagulant and antiplatelet agents

Background: Subgaleal hematomas frequently occur in children after head trauma and extend over the cranial sutures. Although conservative treatment suffices in most cases, surgical removal of a subgaleal hematoma is indicated when the patient presents with anemia and headache associated with its progressive enlargement. Copyright:Case Description: We present the case of a 7-year-old boy who was medicated with warfarin and aspirin due to a hypoplastic left ventricle and fell from a rock wherein he hit his head in the frontal region. Although a computed tomography scan of the head revealed no intracranial lesion, an extracranial hematoma was found to extend over the cranial sutures, leading to the diagnosis of subgaleal hematoma. The hematoma continued to grow gradually despite the cessation of warfarin and aspirin therapy immediately after the head trauma. Since the patient\u27s headache and anemia were progressing as the hematoma enlarged, removal of the hematoma was performed 3 days after admission. Endoscopic hematoma removal was planned to enable accurate coagulation of the sites of bleeding and removal of the maximal amount of hematoma through minimal incision. The hematoma was completely removed, and the patient\u27s postoperative course was excellent with alleviation of both the anemia and the headache. No sign of hematoma recurrence could be detected during 2 years follow-up.Conclusion: An angled endoscope can allow visualization of the deep subgaleal space, and this technique enabled direct visualization of the bleeding sites and accurate coagulation to prevent recurrence of hematoma. Endoscopic techniques, such as minimally invasive techniques, can allow sufficient removal of subgaleal hematoma with minimal morbidity, especially in patients such as ours

ヨシダ ニクシュ イショク ラット ノ ケッショウ オヨビ ソシキ ノ アミノグラム ノ ケントウ : シュヨウ リュウシュツ ジョウミャク ケッショウ アミノグラム

悪性腫瘍に対するアミノ酸インバランス療法の臨床応用を目的として、インバランスと するアミノ般を決定するために実験を行なった。 環境によく馴化した、生後約5週、体重150g前後の雄性ドンリュウラットを2群に 分け、4時間の絶食の後、エーテル麻酔下に以下の操作を行った。 コントロール群(以下C群)右腎部皮下に生食水O.1mlを注入した。15例。 腫瘍移植群(以下T群)右腎部皮下に1×17 7個の吉田肉腫を生食水にてO.1mｌと したものを移植した。18例。 以上の操作以後は経口自由摂取とし、操作後7日目にエーテル麻酔下に開腹し、腹部大 動脈・左総腸骨静脈(以後、健側静脈)およびT群からはさらに腫瘍からの流出静脈(流 出静脈は右総腸骨静脈に流入する)より採血した後、腫瘍を摘出した。大動脈血の一部は 血液生化学的検査に供し、残りの大動脈血と静脈血の血漿を除タンパク後、血漿遊離アミ ノ酸を分析した。腫瘍は摘出後重量を測定し、直ちに-2O℃以下にて凍結保存した。凍 結保存された腫瘍を、1g計測し、トリクロロ酢酸法に準じて処理して得られた5mlの上 清の一部にて腫瘍の組織遊離アミノ酸を、また、この際の沈殿物を6規定の塩酸で105℃ 、24時間の加水分解を行ない、腫瘍の組織蛋白構成アミノ酸を分析した。 開始時体重および屠殺時体重とも両群間に有意差を認めなかった。肝重量も両群間に有 意差を認めなかった。腫瘍重量は8.0±0.7gであった。血液生化学的検査では、T群の TP・Albが有意に低値をとり、CRE・Kも有意に低値をとり、肉腫による末期状態 と考えられた。血漿中の総アミノ酸濃度ではT群腫瘍側静脈はT群動脈・T群健側静脈と 比べ、有意に高値を示した。C群とT群で比較すると、必須アミノ酸でT群腫瘍側静脈の みがC群静脈より有意に高値をとった。個々のアミノ酸でみると必須アミノ酸では、ほと んどのアミノ酸が腫瘍側静脈・健側静脈・動脈の順に測定値が高かったが、Val・Il eu・Leuは動脈・腫瘍側静脈・健側静脈の順、Pheは腫瘍側静脈・動脈・健側静脈 の順に測定値が高かった。非必須アミノ酸でもほとんどのアミノ酸が腫瘍側静脈・健側静脈 動脈の順に測定値が高かったが、Asn・Glu・Ornは腫瘍側静脈・動脈・健側静脈 静脈の順、CySは動脈・健側静脈・腫瘍側静脈の順に測定値が高かった。個々のアミノ 酸の流れ(動脈→組織→静脈)をモル比で比較してみると必須アミノ酸では組織遊離アミ ノ酸・組織蛋白構成アミノ酸ともに動静脈血より高値をとるアミノ酸は認めなかった。非 必須アミノ酸ではAsp・Glu・Gly・Proの4種のアミノ酸は組織遊離アミノ酸 ・組織蛋白構成アミノ酸ともに動静脈血より高値をとった。個々のアミノ酸をそれぞれ、 動脈・組織遊離アミノ酸・組織歪白構成アミノ酸・健側静脈血中での測定値の高い順に並 べてみると、Glu・Aspの2つのアミノ酸が血中で低く、組織中で非常に高い順位に なる。以上の結果より、吉田肉腫に対してはGluとAspの2つのアミノ酸がインバラ ンス療法のターゲットになりうることが示唆された。An experiment was conducted to find amino acids which can be utilized as targets in amino acid imbalanced treatment for cancer. 1. A 150g male Donryu rat received a subcutaneous Yoshida sarcoma implantation. Then， amino acids contained in the inflowing artery，outflowing vein，contralateral vein，and tumor tissue were analyzed. 2. Plasma and tissue were measured for glutamic acid (Glu) and aspartic acid (Asp) concentrations，which were kept in low concentrations in plasma and high concentrations in tissue. 3. Glu and Asp were suggested as targets for imbalanced amino acid treatment for use in Yoshida sarcoma treatment

Supplementation With Whey Peptide Rich in β-Lactolin Improves Cognitive Performance in Healthy Older Adults: A Randomized, Double-Blind, Placebo-Controlled Study

Epidemiological reports showed that consumptions of fermented dairy products are beneficial for cognitive decline in elderly. Our previous preclinical studies have demonstrated that intakes of whey peptide rich in the β-lactolin [β-lactopeptide of glycine-thereonine-tryptophan-tyrosine (GTWY)] improve memory and attention by regulating monoamine system, and clinical study using neuropsychological test suggested that consumptions with GTWY-rich whey peptide enhance cognitive performance associated with the frontal cortex activity. However, corresponding interventional studies in humans are limited. Objectives: to evaluate the effects of the whey peptide on cognitive functions in healthy older adults using a randomized, double-blinded, placebo-controlled trial design. 114 healthy subjects aged 50–75 were supplemented with the whey peptide or placebo for 12 weeks, and changes in cognitive function were assessed using neuropsychological tests at weeks 0, 6, and 12 of the intervention. Neuropsychological tests included assessments for memory functions (subtests from Wechsler memory scale-revised, standard verbal paired-associate learning test, and recognition memory test for faces), assessments for attention (cancelation and detection tests), and assessments for general cognitive functions (repeatable battery for assessments of neuropsychological status). Cerebral blood flow was also assessed using near-infrared spectroscopy (NIRS) after 6 weeks of intervention. This study was registered on the 19 November, 2017 in the database of the University Hospital Medical Information Network (UMIN) prior to enrollment of subjects (Registration No. UMIN000030461: https://www.umin.ac.jp/ctr/index-j.htm). In the whey peptide group, visual paired-associates I and visual cancelation tests were significantly improved compared with those in the placebo group at weeks 6 and 12 of the intervention, respectively. Visuospatial and constructional scores of the repeatable battery for assessments of neuropsychological status and standard verbal paired-associate learning tests (S-PA) also tended to be improved by the intervention at week 12. Daily intakes of GTWY-rich whey peptide show beneficial effects on cognitive performance, especially associative learning memory and control of attention, in healthy older adults and might prevent age-related cognitive declines

センコウセイ フクマクエン デ ハッショウ シタ ショウチョウ gastrointestinal stromal tumor ノ 1レイ

We report a case of gastrointestinal stromal tumor (GIST) with perforation in the jejunum and peritoneal dissemination. A 64 year-old man admitted our hospital with severe abdominal pain. He had findings of panperitonitis and the abdominal CT examination revealed free air and an intraabdominal abscess. We suspected perforation of the small intestine and operated. There were two adjacent tumors (6cm in diameter each) of the jejunum and peritoneal dissemination, and one of them was perforated. We performed a jejunojejunostomy and resected as all disseminated tumors as possible. Histopathological findings showed that the tumors were composed of spindle cell proliferation with three or four mitoses per high-power fields (HPF). Because tumor cell were positive for c-kit and CD34, and negative for alpha-smooth muscle actin and S-100 immunohistochemically, we diagnosed these tumors as “maligmant GIST of small intestine, uncommitted type”. Perforation of GIST is rare. Only 20 cases of GIST with peritonitis due to perforation have been reported in Japan, including the present case. Of 20 cases, 14 were small intestinal GIST. Small intestinal GIST should be recognized as a high-risk group of malignancy and perforation

Significant Improvement in Chronic Persistent Headaches Caused by Small Rathke Cleft Cysts After Transsphenoidal Surgery

Purpose Rathke cleft cysts (RCC) usually are asymptomatic and can be observed via the use of conservative methods. Some patients with RCCs, however, have severe headaches even if they are small enough to be confined to the sella, and these small RCCs seldom have been discussed. This study presents an investigation into clinical characteristics of small RCCs associated with severe headaches, demonstrating efficacy and safety of endoscopic transsphenoidal surgery (ETSS) to relieve headaches. Methods In this study, 13 patients with small RCCs (maximum diameter <10 mm) who presented with headaches and were treated by ETSS at our institute from 2009 to 2014 were recruited. These RCCs were treated Headache Impact Test-6 (HIT-6) score was calculated both pre- and postoperatively to evaluate headache severity. Results All patients complained of severe headaches, which disturbed their daily life. Most headaches were nonpulsating and localized in the frontal area. Characteristically, 6 patients (46%) experienced severe headaches with sudden onset that continued chronically. HIT-6 score was 64 on average, meaning headaches affected daily life severely. After surgical decompression of the cyst, headache in all of the patients improved dramatically and HIT-6 score decreased significantly to 37, suggesting that headaches were diminished. No newly developed deficiencies of the anterior pituitary lobe function were detected. Postoperative occurrence of diabetes insipidus was found in 2 patients, both of which were transient. No recurring cysts were found. Conclusions Severe headaches can develop from small RCCs. In the present study, ETSS was performed on such patients effectively and safely to relieve their headaches. © 2017 Elsevier Inc.Embargo Period 12 month

Anxiolytic Effect of Aromatherapy Massage in Patients with Breast Cancer

We examined how aromatherapy massage influenced psychologic and immunologic parameters in 12 breast cancer patients in an open semi-comparative trial. We compared the results 1 month before aromatherapy massage as a waiting control period with those during aromatherapy massage treatment and 1 month after the completion of aromatherapy sessions. The patients received a 30 min aromatherapy massage twice a week for 4 weeks (eight times in total). The results showed that anxiety was reduced in one 30 min aromatherapy massage in State-Trait Anxiety Inventory (STAI) test and also reduced in eight sequential aromatherapy massage sessions in the Hospital Anxiety and Depression Scale (HADS) test. Our results further suggested that aromatherapy massage ameliorated the immunologic state. Further investigations are required to confirm the anxiolytic effect of aromatherapy in breast cancer patients

Contribution of sellar dura integrity to symptom manifestation in pituitary adenomas with intratumoral hemorrhage

Purpose: Although hemorrhage within pituitary adenomas frequently exacerbates the symptoms, there are many grades of severity. Moreover, the contributing factors for symptom severity are still controversial. Methods: This retrospective study included 82 patients who underwent transsphenoidal surgery for pituitary adenomas with intratumoral hemorrhage. The grades of preoperative symptoms were classified into group A, asymptomatic or minor symptoms; group B, moderate symptoms sufficient for complain; and group C, severe symptoms disturbing daily life. Results: The hemorrhage volume within an adenoma was significantly higher in group C (92.6%) than in groups A (48.6%) and B (58.7%). Both headache and diplopia were dominant in group C, occurring in 72.2% and 27.8% of the patients, respectively. In group C, there was no significant difference in frequency between adenoma extensions into the sphenoid sinus (0%) and involvement of the cavernous sinus of Knosp grade 4 (0%), and extensions into the suprasellar region were not common (38.9%). The most distinctive feature was that “no extrasellar extension” was found only in group C (41.2%), and “multidirectional extension” was not detected in this group (0%). Multiple regression analysis revealed that the most powerful determining factors were the high frequencies of intratumoral hemorrhage and lack of extrasellar and multidirectional extensions. Conclusion: Rapid volume expansion of a hematoma and lack of extension or unidirectional extension might lead to significant compression of the sellar and surrounding structures. Of note, the integrity of the sellar dura might contribute to the acute onset of symptom manifestations caused by hemorrhage in pituitary adenomas. © 2017 Springer Science+Business Media, LLCEmbargo Period 12 month