Metalloproteinase Inhibition Protects against Reductions in Circulating Adrenomedullin during Lead‐induced Acute Hypertension

Intoxication with lead (Pb) results in increased blood pressure by mechanisms involving matrix metalloproteinases (MMPs). Recent findings have revealed that MMP type two (MMP‐2) seems to cleave vasoactive peptides. This study examined whether MMP‐2 and MMP‐9 levels/activities increase after acute intoxication with low lead concentrations and whether these changes were associated with increases in blood pressure and circulating endothelin‐1 or with reductions in circulating adrenomedullin and calcitonin gene‐related peptide (CGRP). Here, we expand previous findings and examine whether doxycycline (a MMPs inhibitor) affects these alterations. Wistar rats received intraperitoneally (i.p.) 1st dose 8 μg/100 g of lead (or sodium) acetate, a subsequent dose of 0.1 μg/100 g to cover daily loss and treatment with doxycycline (30 mg/kg/day) or water by gavage for 7 days. Similar whole‐blood lead levels (9 μg/dL) were found in lead‐exposed rats treated with either doxycycline or water. Lead‐induced increases in systolic blood pressure (from 143 ± 2 to 167 ± 3 mmHg) and gelatin zymography of plasma samples showed that lead increased MMP‐9 (but not MMP‐2) levels. Both lead‐induced increased MMP‐9 activity and hypertension were blunted by doxycycline. Doxycycline also prevented lead‐induced reductions in circulating adrenomedullin. No significant changes in plasma levels of endothelin‐1 or CGRP were found. Lead‐induced decreases in nitric oxide markers and antioxidant status were not prevented by doxycycline. In conclusion, acute lead exposure increases blood pressure and MMP‐9 activity, which were blunted by doxycycline. These findings suggest that MMP‐9 may contribute with lead‐induced hypertension by cleaving the vasodilatory peptide adrenomedullin, thereby inhibiting adrenomedullin‐dependent lowering of blood pressure.     

Lower‐lobe predominant pleuroparenchymal fibroelastosis

Upper‐lobe predominance of elastofibrosis is agreed upon for the diagnosis of clinical pleuroparenchymal fibroelastosis (PPFE). We herein describe a patient with dermatomyositis‐related interstitial pneumonia with a histology of lower‐lobe predominant PPFE. A 71‐year‐old woman who had been diagnosed with dermatomyositis‐related interstitial pneumonia died of respiratory failure. The computed tomography patterns of the lower lobes showed reticular and ground‐glass opacities with traction bronchiectasis. An autopsy revealed that the bilateral lower lobes were sclerotic with decreased air volume. A microscopic examination of the lower lobes showed pleural fibrosis and subpleural elastofibrosis without the structural destruction, indicative of histological PPFE. PPFE histology was also evident in the upper lobes but relatively modest compared to that of the lower lobes. In addition, because the computed tomography images of the patient were suggestive of non‐PPFE‐type fibrosis, lower‐lobe dominant PPFE might be overlooked in daily practice.     

Clinical Implications of t(11;14) in Patients with Multiple Myeloma Undergoing Autologous Stem Cell Transplantation

Conventional cytogenetic analyses and fluorescent in situ hybridization (FISH) are helpful for stratifying patients with multiple myeloma (MM) into high-risk [t(4;14), t(14;16), and/or del 17p] and standard-risk [t(11;14)] categories. However, the prognosis of patients with MM treated with autologous stem cell transplantation (ASCT) stratified according to these categories remains unclear. This retrospective observational study analyzed 97 patients with MM who received a single, planned ASCT after treatment with 200 mg/m² melphalan between 2001 and 2011. The patients were grouped according to chromosomal abnormality, including t(11;14) (n?=?45), t(4;14) (n?=?31), del 17p (n?=?10), t(11;14) with del 17p (n?=?7), and t(4;14) with del 17p (n?=?4). Median overall survival (OS) of the t(11;14) group (64.1 months) was not significantly different from that of the t(4;14) group (not reached), but it was significantly longer than that of the del 17p group (23.0 months; P?=?.002). G-banding revealed that the median OS of the t(11;14) group with additional chromosomal abnormalities (ACAs) (46.2 months) was significantly shorter than that of the t(11;14) group without ACAs (not reached; P?=?.005) and the t(4;14) group (not reached; P?=?.010). These findings highlight the importance of G-banding in patients with t(11;14) MM.     

Effect of rinsing alginate impressions using acidic electrolyzed water on dimensional change and deformation of stone models

This study investigated the effect of rinsing alginate impressions using acidic electrolyzed water on the dimensional change and deformation of stone models. Two brands of alginate impression materials were used. The impressions were rinsed using tap water or acidic electrolyzed water with a pH of 2.3, an oxidation-reduction potential of 1,230 mV, and a residual chlorine concentration of 45.0 ppm for 30 sec or 3 min. The sectional profiles of the stone models obtained from them were measured using a three-dimensional coordinate measuring system. For the same rinsing time, there was no significant difference in dimensional change between the two types of rinsing water. The change in shape from the master die was approximately the same for the stone models obtained from rinsed impressions using either water. The results suggest that the use of acidic electrolyzed water rather than tap water for rinsing is an acceptable treatment for alginate impressions.     

Clinical evaluation of a low-friction attachment device during canine retraction

OBJECTIVE: The present study used a split-mouth design to compare the amount of canine movement and the retraction time between brackets with Clear Snap and brackets with stainless steel ligature wires for three different levels of retraction force. MATERIALS AND METHODS: A sample of 30 patients was used. After initial leveling, the canine was retracted using a 50-g (n = 10), 100-g (n = 10), or 150-g (n = 10) closed-coil spring. The canine on one side was chosen at random, and Clear Snap was attached to the bracket during the retraction period. The other side was used as a control. The amount of canine retraction was measured with a digital vernier caliper. Statistical analysis was performed by analysis of variance. RESULTS: The average canine retraction time was approximately 2 to 3 months less in all experimental groups (50, 100, and 150 g) compared to the control group. In the control group, 150 g resulted in a shorter duration of canine retraction compared to 50 g. There was no significant difference in the duration of canine retraction among the experimental groups. A greater amount of mean total canine movement was observed in all experimental groups compared to the control groups. CONCLUSION: A shorter duration of canine retraction time was observed with Clear Snap attached when compared with the control. The authors suggest that with the use of Clear Snap, less than 50 g of force may effectively retract a canine.