Association between periodontitis and systemic bone mineral density in Japanese community-dwelling postmenopausal women

Objective

The purpose of this cross-sectional study was to evaluate the association between loss of attachment (LA) which is clinical index of periodontitis and bone mineral density (BMD) of the lumbar vertebrae and femur measured with dual energy X-ray absorptiometry (DXA) in Japanese community-dwelling postmenopausal women.

Subjects and methods

Subjects were 347 women aged 55–74. The oral cavity was divided into 6 areas according to the WHO's method for the determination of the clinical attachment level score (CALscore); the LA was measured at 6 sites using a WHO probe in 17, 16, 11, 26, 27, 37, 36, 31, 46, and 47, and the values were recorded in mm. Then, we assessed BMD of the lumbar vertebrae (L2–L4) and femur (femoral neck, proximal part) by DXA. Based on these data, analysis of covariance was used to estimate relation between periodontitis and systemic BMD status excluding effect of age. Multiple linear regression analysis was used to estimate relation between periodontitis and BMD adjusted for 17 variables.

Results

Significant differences were observed in the mean value between the mean CALscore = 0 and CALscore ≥ 1 groups in the Z value in lumbar vertebrate (106.9 ± 18.7 vs. 102.3 ± 1.0, p < 0.05, t-test). Multiple regression analysis was conducted using the mean LA as dependent variable. Lumbar vertebral BMD (regression coefficient: B = −1.039 ± 0.379, p = 0.007), femoral neck BMD (B = −1.332 ± 0.627, p = 0.034), and proximal femoral BMD (B = −1.329 ± 0.536, p = 0.014) all exhibited a significant negative correlation with the mean LA.

Conclusion

A significant negative correlation was observed between periodontal disease and truncal bone BMD in this study.     

Long-term outcomes after surgical and endovascular treatment of spinal dural arteriovenous fistulae

Purpose

To examine the validity of our treatment strategy for spinal dural arteriovenous fistulae (SDAVF), based on the treatment results and the long-term outcome.

Methods

This study included 50 SDAVF patients (38 men, 12 women, mean age 63.2 years) with progressive myelopathy. The treatment strategy involved embolization as the initial management tool and surgery if embolization was considered unsuitable. Their medical records were evaluated to identify the treatment results and functional outcomes. The mean follow-up period was 81.2 months (range 27–184 months).

Results

Complete obliteration was achieved in 22 (71.0 %) of 31 embolized patients and in 18 of 19 (94.7 %) operated patients. The initial success rate was significantly lower in embolized than operated patients. At the last follow-up, 33 of the 50 patients (66 %) manifested improved gait and 16 (32 %) improved micturition. The activity of daily living (ADL) was improved in 33 (66 %). When we compared the rates of functional improvement at the last follow-up, there was no significant difference between patients treated initially by embolization or surgery.

Conclusions

The long-term outcomes in SDAVF patients treated by multidisciplinary management with first-line embolization were comparable to those in earlier surgical series. However, our results were unable to demonstrate the superiority of endovascular embolization to surgical treatment for SDAVF. For the purpose of justifying endovascular embolization as a first-line treatment for SDAVF, it will be necessary to show further improvement in both the initial treatment success and the complication rates.

     

Control of 3D limb dynamics in unconstrained overarm throws of different speeds performed by skilled baseball players

This study investigated how the human CNS organizes complex three-dimensional (3D) ball-throwing movements that require both speed and accuracy. Skilled baseball players threw a baseball to a target at three different speeds. Kinematic analysis revealed that the fingertip speed at ball release was mainly produced by trunk leftward rotation, shoulder internal rotation, elbow extension, and wrist flexion in all speed conditions. The study participants adjusted the angular velocities of these four motions to throw the balls at three different speeds. We also analyzed the dynamics of the 3D multijoint movements using a recently developed method called "nonorthogonal torque decomposition" that can clarify how angular acceleration about a joint coordinate axis (e.g., shoulder internal rotation) is generated by the muscle, gravity, and interaction torques. We found that the study participants utilized the interaction torque to generate larger angular velocities of the shoulder internal rotation, elbow extension, and wrist flexion. To increase the interaction torque acting at these joints, the ball throwers increased muscle torque at the shoulder and trunk but not at the elbow and wrist. These results indicates that skilled ball throwers adopted a hierarchical control in which the proximal muscle torques created a dynamic foundation for the entire limb motion and beneficial interaction torques for distal joint rotations.     

The usefulness of day-service in maintaining general nutritional status in elderly Japanese: a longitudinal study

Day-service, commuting service for elderly people requiring care at home, is one healthcare option in Japan. To date, however, there exist no studies that have examined the effects of day-service use on health outcomes in Japan. The objective of the present longitudinal study was to determine whether there is an association between day-service use and various physical and mental health outcomes in elderly people requiring care. The subjects were 61 elderly persons who required between 25 and 49 min of assistance per day and used long-term care insurance. Measurements included demographic characteristics, activities of daily living, frequency of day-service use, body weight, height, grip strength, thigh muscle volume, degree of depression (Geriatric Depression Scale), the mini-mental state examination, and serum albumin and blood hemoglobin levels in the baseline and follow-up surveys two years later. In the day-service user group, the mean changes in serum albumin concentrations using day-service once, twice and three < or = times/week were -0.2, -0.3, and 0 g/dl, respectively, and the mean changes in blood hemoglobin were -0.7, -0.5, and 0.2 g/dl, respectively. The two-year change in serum albumin concentrations was less (p = 0.024) in subjects using day-service "three < or = times" (0 g/dl) than "twice" (-0.3 g/dl). The two-year change in blood hemoglobin was also less (p = 0.043) in subjects using day-service "three < or = times" (0.2 g/dl) than "twice" (-0.5 g/dl). The present study has shown that frequent use of day-service is useful in maintaining general nutritional status in elderly people.     

Spatial and topologic distribution of verapamil-sensitive atrial tachycardia originating from the vicinity of the atrioventricular node

BACKGROUND: Little information exists regarding the precise distribution of verapamil-sensitive atrial tachycardia originating from the vicinity of the atrioventricular node (V-AT). METHODS: In 12 patients with V-AT, we examined the spatial and topologic distribution of tachycardia origin relative to the His bundle (HB) site. The V-AT origin was divided into six areas: anterior (A-HB), posterior (P-HB), superior (S-HB), inferior (I-HB), lateral (L-HB), and septal (SP-HB) portion of HB catheter. Three dimensional distance between the distal pair of the electrodes of HB catheter and that of V-AT origin (DIS) was obtained by calculating the distances on the right and left anterior fluoroscopic images. Topologic distribution was expressed as the interval between the onset of the atrial electrogram of V-AT origin and that of HB catheter (INT). RESULTS: The tachycardia origin was observed at the P-HB in four, S-HB in two, I-HB in two, SP-HB in three, and L-HB in one patient. The tachycardia cycle length, DIS, and INT were 369 +/- 67 ms, 12 +/- 3 mm, and -12 +/- 8 ms, respectively. After successful ablation of initial V-AT (1st V-AT), V-AT with a different origin (2nd V-AT) was induced in five patients. The tachycardia origin, tachycardia cycle length, DIS, and INT of the 2nd V-AT (P-HB in three, S-HB in one, and SP-HB in one patient; 333 +/- 66 ms, 8 +/- 3 mm, and -11 +/- 4 ms, respectively) were not different from those of 1st V-AT. CONCLUSIONS: V-AT often shows a shift in tachycardia origin to another site where the spatial and topologic distributions are similar to those of 1st V-AT.     

Kampo Medicines for Mite Antigen-Induced Allergic Dermatitis in NC/Nga Mice

We have established an allergic dermatitis model in NC/Nga miceby repeated local exposure of mite antigen for analyzing atopicdermatitis. We examined how four Kampo medicines, Juzen-taiho-to,Hochu-ekki-to, Shofu-san and Oren-gedoku-to, on the dermatitismodel to obtain basic information on their usefulness for treatingatopic dermatitis. Mite antigen (Dermatophagoides farinae crudeextract) solution at a concentration of 10 mg/ml was paintedon the ear of NC/Nga mice after tape stripping. The procedurewas repeated five times, at 7 day intervals. An apparent biphasicear swelling was caused after the fourth and fifth antigen exposureswith elevated serum IgE levels and accumulation of inflammatorycells. In the cervical lymph nodes and ear lobes, the five proceduresof antigen exposure induced interleukin-4 mRNA expression butreduced interferon- mRNA expression. Oral administration ofall four Kampo medicines inhibited the formation of ear swellingand inflammatory cell accumulation. Juzen-taiho-to and Hochu-ekki-toapparently prevented the elevation of serum IgE level. Furthermore,the four Kampo medicines showed a tendency to prevent not onlythe increase in interleukin-4 mRNA expression but also the decreasein interferon- mRNA expression. The present results indicatethat Juzen-taiho-to, Hochu-ekki-to, Shofu-san and Oren-gedoku-tomay correct the Th1/Th2 balance skewed to Th2, and this activityhelps inhibit dermatitis in NC/Nga mice. The ability of theKampo medicines to correct the Th1/Th2 balance seems to underlietheir effectiveness in treating of atopic dermatitis.     

Synergistic effects of chlorpromazine and perphenazine on several chemotherapeutic agents. I. General profile of the effects measured by the filter paper strip-agar diffusion method with Escherichia coli and Pseudomonas aeruginosa.

The combination effects of chlorpromazine (CPZ) and periphenazine (PPZ) with beta-lactam antibiotics (ampicillin, carbenicillin, cefazolin) and nalidixic acid group compounds (nalidixic acid, piromidic acid and pipemidic acid) have been estimated to be synergistic by the filter paper strip-agar diffusion method (Dye's method) with Escherichia coli and Pseudomonas aeruginosa as test organisms. The observed synergism might be associated with their inhibition of various enzymes including ATPase and DNAase as well as with their specific binding to DNA. Similar synergistic effects of CPZ and PPZ have been shown by the broth dilution method. Based on these findings, it seems to be a fascinating project to devise a new phenothiazine drug without influence in mental disease that will have a greater measure of synergistic effect when combined with the above-studied antibacterial agents.