Effects of periodontal treatment on carotid intima-media thickness in patients with lifestyle-related diseases: Japanese prospective multicentre observational study

Atherosclerosis, a chronic inflammatory disease in arterial blood vessels, is one of the major causes of death in worldwide. Meanwhile, periodontal disease is a chronic inflammatory disease caused by infection with periodontal pathogens such as P. gingivalis (Porphyromonas gingivalis). Several studies have reported association between periodontal infection and atherosclerosis, but direct investigation about the effects of periodontal treatment on atherosclerosis has not been reported. We have planned Japanese local clinics to determine the relationship between periodontal disease and atherosclerosis under collaborative with medical and dental care. A prospective, multicentre, observational study was conducted including 38 medical patients with lifestyle-related diseases in the stable period under consultation at participating medical clinics and 92 periodontal patients not undergoing medical treatment but who were consulting at participating dental clinics. Systemic and periodontal examinations were performed before and after periodontal treatment. At baseline, LDL-C (low-density lipoprotein cholesterol) levels and percentage (%) of mobile teeth were positively related to plasma IgG (immunoglobulin) antibody titer against P. gingivalis with multivariate analysis. Corresponding to improvements in periodontal clinical parameters after treatment, right and left max IMT (maximum intima-media thickness) levels were decreased significantly after treatment (SPT-S: start of supportive periodontal therapy, SPT-1y: at 1 year under SPT, and SPT-3y: at 3 years under SPT). The present study has clarified our previous univariate analysis results, wherein P. gingivalis infection was positively associated with progression of atherosclerosis. Thus, routine screening using plasma IgG antibody titer against P. gingivalis and periodontal treatment under collaborative with medical and dental care may prevent cardiovascular accidents caused by atherosclerosis.     

Self-reported rate of eating is significantly associated with body mass index in Japanese patients with type 2 diabetes. Japan Diabetes Clinical Data Management Study Group (JDDM26)

We examined whether the rate of eating was associated with the body mass index and glycemic control status in Japanese patients with type 2 diabetes (50% women, mean±SD age 59.4±7.5years). Rapid eating was significantly associated with body mass index (p=0.047). The body mass index of those who reported eating quickly was 0.8kg/m(2) higher than in individuals who reported eating at medium speed even after adjustment for known confounders. No significant association was observed between the rate of eating and HbA(1c). Our findings suggest an association between self-reported rapid eating and an elevated body mass index in patients with type 2 diabetes.     

Regulation of osteoclast apoptosis and motility by small GTPase binding protein Rac1.

The role of Rac1 in osteoclast survival and bone-resorbing activity was examined using adenovirus vector expression systems. Rac1 is critically involved in M-CSF receptor signaling and mediates survival signaling primarily through PI3K/Akt pathways. Rac1 also plays a significant role in bone resorptive activity, probably by regulating the motility of osteoclasts. INTRODUCTION: Rac1 is a member of Rho family small G-proteins, and recent studies have revealed that it mediates anti-apoptotic signals in some types of cells. Rac1 is reported to be required for the cytoskeletal organization and bone-resorbing activity of osteoclasts, but their roles in osteoclast survival and function are not fully elucidated. MATERIALS AND METHODS: We constructed the adenovirus vector carrying cDNA of either the dominant negative Rac1 (Rac1(DN)) or constitutively active Rac1 (Rac1(CA)) gene, and osteoclast-like cells (OCLs) generated in mouse co-culture system were infected with these viruses. To examine the role of Rac1 in osteoclast survival and function, we performed pit formation assays, survival assays, and Western blotting, including an activated-Rac1 pull-down assay using adenovirus-infected OCLs. To further clarify the mechanism of Rac1 regulation in osteoclast survival, some specific inhibitors and adenovirus vectors of signal transduction molecules were used. To quantify membrane movement before and after macrophage colony-stimulating factor (M-CSF) treatment, OCLs expressing either enhanced green fluorescent protein (EGFP) or Rac1(DN) were recorded with a time-lapse video microscope. RESULTS: Adenovirus vector-mediated dominant negative Rac1 (Rac1(DN)) expression significantly reduced pit formation, and promoted their apoptosis. M-CSF rapidly activated Rac1, and the prosurvival effect of M-CSF for OCLs was abrogated by Rac1(DN) overexpression. Constitutively active Rac1 enhanced OCL survival, which was completely suppressed by phosphatidylinositol 3'-kinase (PI3K) inhibitors, whereas a Mek inhibitor had only partial effect. Rac1(DN) also partially blocked the activation of Akt induced by the overexpressing catalytic subunit of PI3K. Using time-lapse video microscopy, we found that Rac1(DN) expression reduced membrane ruffling and the spreading of OCLs in response to M-CSF. CONCLUSIONS: Small guanosine triphosphatase (GTPase) Rac1 is critically involved in M-CSF receptor signaling and mediates survival signaling of osteoclasts primarily by modulating PI3K/Akt pathways. Rac1 also plays a significant role in the bone resorptive activity of cells, probably by regulating the motility of osteoclasts.     

Quantification of area and percentage of infarcted myocardium by single photon emission computed tomography with thallium-201 : A comparison with serial serum CK-MB measurements

In order to quantify the size of the infarcted myocardium, two kinds of data processing techniques were applied to single photon emission computed tomography (SPECT) with thallium-201 and its clinical reliability was evaluated by comparing it with the infarct sizing procedure with the serial serum creatine kinase-MB measurements in 14 patients with acute myocardial infarction. After maximum-count circumferential profile analysis, short axis images were reformatted into an unfolded surface map and a bull's eye view map. The SPECT-determined infarct size was defined as the area or the percentage of hypoperfused myocardium of which the profile count was less than the mean minus 2SD derived from 8 normal subjects. The infarct area was calculated from the number of pixels with an abnormal count and expressed in an unfolded surface map. The percentage was calculated from the number of abnormal profile points and displayed in a bull's eye view map. A high linear correlation was observed between the enzymatically determined infarct size and the infarct area or the percentage (r = .947, r = .872, respectively), despite underestimations in 2 patients with accompanying right ventricular infarction and overestimations in 2 patients with prior anterior infarction. Moreover, a close negative correlation was found between the left ventricular ejection fraction and the infarct area or the percentage (r = .836, r = .821, respectively). Thus, the semiautomatic techniques for processing thallium-201 SPECT images might contribute to the quantitative estimation and display of infarcted myocardium and have high clinical reliability.     

A case of lymphangiomas arising contiguously from the rib and thoracic spine

Reported is a rare case of lymphangiomas arising contiguously from the left 6 th rib and thoracic spine of a 33-year-old female. The localization of the osteolytic lesions that had been observed by chest X-rays were more precisely detected by subsequent computed tomography. Histologically, dilated vessels lined with endothelial cells were observed in the bone marrow. Immunostaining uncovered factor VIII-related antigens in the endothelial of the small vessels, but not in those of the larger vessels. In order to differentiate lymphangiomas from hemangiomas of the bone, not only should the histological features of the lymph vessels be observed at time of operation also the ability these vessels to retain lymph is important. Primary lymphangioma of the bone should be differentiated from lymphangiomatosis and massive osteolysis, which show a poor prognosis.