Color stability of bleached tooth enamel brushed with different stain-removing toothpastes.

OBJECTIVE: The effects of four toothpastes on the color stability of in-office bleached tooth specimens were determined. MATERIALS AND METHODS: We evaluated an experimental toothpaste (EXP) and three commercially available toothpastes: Colgate Optic White (OPW), Aquafresh White & Protect (AWP), and Crest 3D White (CDW). OPW, AWP, and CDW contained inorganic abrasives, whereas EXP and AWP contained sodium polyphosphate. Forty-eight randomly selected human-extracted maxillary central incisors were bleached and brushed twice daily over 30 days. We analyzed the final color difference (ΔE*ab, ΔE00 , ΔWID ), arithmetic average surface roughness (Ra) of the enamel measured on days 0 and 30, and scanning electron microscopy images of enamel surfaces and toothpastes. ΔE*ab, ΔE00 , ΔWID , and Ra were analyzed using one-way analysis of variance and Tukey's test (α = 0.05). RESULTS: ΔE*ab and ΔE00 values were significantly lower after toothbrushing with EXP, OPW, and CDW than with AWP. OPW induced the greatest positive ΔWID . Ra was significantly increased by OPW and CDW, but slightly increased by AWP, with cube-like particles, and EXP, with no particle-like structures. CONCLUSIONS: Only EXP stabilized the color of bleached teeth without increasing the enamel surface roughness. Sodium polyphosphate with approximately 10 phosphate groups was effective at removing stains. CLINICAL SIGNIFICANCE: The effect of toothpaste on the color stability of bleached teeth depends on the constituting abrasives and chemical components. Polyphosphoric acid has different stain-removal effects depending on its degree of polymerization. Additionally, although certain types of abrasives may be effective for color stability, they also increase the surface roughness of the enamel.

N2O emission factors for organic amendments in Japan from measurement campaign and systematic review.

Organic amendments are important sources of nitrous oxide (N2O) emissions from agricultural soils. In 2020, the total amount of N in organic amendments applied to Japanese agricultural soils (440 ktN) was larger than that of synthetic fertilizer (374 ktN). However, N2O emissions from organic amendments were estimated by using the country-specific N2O emission factor (EF) for synthetic fertilizer (0.31 % for rice paddy, 2.9 % for tea, and 0.62 % for other crops) in the National Greenhouse Gas Inventory Report of Japan. Thus, we conducted a N2O flux measurement campaign at 12 different experimental sites across Japan to estimate fertilizer-induced N2O EFs for major organic amendments in Japan, that is, poultry manure compost, swine manure compost, cattle manure compost, and organic fertilizer pellets. In addition, we conducted systematic review of N2O emissions and EFs for organic amendments, including data from our measurement campaign and published data from peer-reviewed papers in Japan. The final dataset, including the field measurement campaign and published data, resulted in 404 observations (including synthetic fertilizer and zero-N control) in 29 sites. Results showed that soil type affected EFs, that is, the mean EF of Andosols was lower than that of non-Andosols, which is similar to the case of EFs for synthetic fertilizer. Mean EFs for poultry manure compost, swine manure compost, cattle manure (compost and slurry), and non-animal manure organic fertilizers were 0.83 % (uncertainty range of 2.5th and 97.5th percentile: 0.09 % to 3.46 %), 0.70 % (0.02 % to 2.45 %), 0.39 % (0.00 % to 1.62 %), and 1.16 % (0.41 % to 3.03 %), respectively, when weighted by area of soil types. The mean EF of all organic amendments was 0.84 % (0.00 % to 2.91 %), when the area of soil type and amount of organic amendment used in Japan were considered. Our study provides country-specific EFs to estimate N2O emission from organic amendments in Japan.

Effect of chemical surface treatment of contaminated CAD-CAM resin composite blocks on surface free energy and bond strength.

PURPOSE: To evaluate the effects of four chemical treatment methods on the contaminated surfaces of VITA ENAMIC (EN) and CERASMART (CS) resin composite computer-aided design-computer-aided manufacturing blocks (RCBs). METHODS: Each RCB was contaminated with a handpiece oil for 1 minute. These contaminated surfaces were then chemically treated by Gel Etchant (PA), Ivoclean (IC), Monobond Etch & Prime (MB), or Ceramics Etch (HF) reagents (n= 12), after which their shear bond strengths, morphologies, failure modes, and surface free energies were examined. RESULTS: The shear bond strengths of the HF-treated surfaces significantly exceeded those of the specimens treated with the other reagents. Adhesive fractures were observed for both the EN and CS blocks after 24 hours of treatment with lubricating oil, PA, and IC. The largest numbers of mixed and cohesive fractures were detected for the MB- and HA-treated specimens. The HF-treated EN and CS blocks possessed the highest surface free energies. The bonding strengths of the resin composites decreased after the contamination of their surfaces; however, the adhesion properties of both blocks were considerably improved by chemical treatment. CLINICAL SIGNIFICANCE: The lubricating oil contamination of dental handpieces significantly reduces the adhesion between the CAD-CAM resin composite block and the resin composite. Therefore, it is necessary to remove contamination and improve the adhesiveness using an optimal chemical surface treatment.

Intravascular ultrasound predictors of acute side branch occlusion in coronary artery bifurcation lesions just after single stent crossover.

OBJECTIVES: We aimed to assess the intravascular ultrasound (IVUS) predictors of acute side branch (SB) occlusions just after single stent crossover in percutaneous coronary intervention (PCI) for coronary bifurcation lesions. BACKGROUND: PCI for bifurcation lesions remains technically challenging and has more clinical complications such as SB occlusion than non-bifurcation lesions. Although single stent crossover is the most common approach in treating bifurcation lesions, the predictors of acute SB occlusion are unclear. METHODS: Single stent crossover was performed on 174 patients with a total of 272 bifurcation lesions who were enrolled in this study. Each patient also underwent pre-PCI IVUS in a major vessel (MV). SB was defined as ostium diameter of ≥1.5 mm measured by IVUS, and occluded SB was defined as a thrombolysis in myocardial infarction flow grade of ≤2 just after stent implantation. We defined the SB diameter ratio as ostial SB total diameter (media-to-media) divided by ostial SB luminal diameter (intima-to-intima). RESULTS: There were 52 SBs in the occluded group (19.1%). There were no significant differences in baseline characteristics between the SB occluded and non-SB occluded groups. Logistic-regression analysis revealed that the thickness of MV plaque on the bilateral sides of SB at the junction site and the SB diameter ratio were independent predictors of SB occlusion just after stent implantation. CONCLUSIONS: In the IVUS observation, the MV plaque thickness at the junction site and the SB diameter ratio are predictors of acute SB occlusion just after single stent crossover.

ENDOGENOUS CARBON MONOXIDE CONCENTRATION IN BLOOD ELEVATES IN ACUTE CORONARY SYNDROME OF NONSMOKER POPULATION.

BACKGROUND: Carbon monoxide (CO) was previously only considered as a highly toxic pollutant since it binds to hemoglobin with high affinity. Recently, however, it has been recognized as a signaling molecule with regulatory roles in many physiological and pathophysiological processes within the cardiovascular system. The aim of this study was to clarify the behavior of CO in patients with acute coronary syndrome (ACS). METHODS: We assessed 235 patients with suspected ACS, 98 smokers (88 male, 62 ± 14 years) and 137 nonsmokers (77 male, 72 ± 13 years), who had undergone emergent cardiac catheterization and blood sampling for calculation of carboxyhemoglobin (COHb). Patients were categorized into 4 groups: smoking patients with ACS (n=77), smoking patients without ACS (n=21), non-smoking patients with ACS (n=97), and non-smoker patients without ACS (n=40). We investigated whether biomarkers were related to COHb levels. RESULTS: LogCOHb was significantly higher in the smoking patients compared to non-smoking patients (0.30 ± 0.12 vs. 0.45 ± 0.18, P < 0.01). Interestingly, among the non-smoking patients, COHb was increased in the ACS patients compared to the non ACS patients (0.31 ± 0.12 vs. 0.25 ± 0.12 P < 0.01). In contrast, among the smoking patients, there was no difference in COHb between the ACS and non-ACS patients (0.45 ± 0.18 vs. 0.44 ± 0.18, n.s.). There were no correlations between COHb and any of the biomarkers. CONCLUSIONS: These results suggest that endogenous CO may be useful to assess the risk of cardiovascular stress.

STENTING STRATEGY AND FOLLOW-UP RESULTS OF MULTI-CENTER REGISTRY IN FUKUSHIMA CITY FOR LEFT MAIN CORONARY ARTERY DISEASE: BARE METAL STENT VERSUS DRUG-ELUTING STENT.

An appropriate treatment strategy for left main trunk (LMT) lesions is still controversial in the drug-eluting stent (DES) era. Consecutive LMT stenting cases (n = 155) between January 2008 and January 2013 in 4 hospitals in Fukushima city were retrospectively analyzed. We excluded the patients suffering from cardiogenic shock before the stenting procedure. Among those cases, 60 patients had acute coronary syndrome, and remaining 95 had stable angina pectoris. Out of 155 cases, 45 patients were treated with bare metal stents (BMSs) and 110 patients were treated with DESs. All cases were succeeded in the initial procedure. Mean stent size of BMS was 3.85 ± 0.34 mm while that of DES was 3.46 ± 0.17 mm (P<0.001). At the follow up coronary angiography (255-day on average), % stenosis of BMS group was 26.6 ± 15.0% and that of DES group was 20.4 ± 12.6% (P = 0.006). The mean observation period for clinical events was 738.8 ± 480.3 days. Major adverse cardiac events-free rates for each group were compared and no significant differences were evident between the 2 groups (11.1% vs. 19.1%, ns). The present study demonstrated that use of BMSs would be a viable option in the treatment of LMT lesions when it is possible to use a large-sized stent (>3.5 mm).

Serum tenascin-C level is associated with coronary plaque rupture in patients with acute coronary syndrome.

Tenascin-C, a large oligometric glycoprotein of the extracellular matrix, increases the expression of matrix metalloproteinases that lead to plaque instability and rupture, resulting in acute coronary syndrome (ACS). We hypothesized that a high serum tenascin-C level is associated with plaque rupture in patients with ACS. Fifty-two consecutive ACS patients who underwent emergency percutaneous coronary intervention (PCI) and, as a control, 66 consecutive patients with stable angina pectoris (SAP) were enrolled in this study. Blood samples were obtained from the ascending aorta just prior to the PCI procedures. After coronary guide-wire crossing, intravascular ultrasonography (IVUS) was performed for assessment of plaque characterization. Based on the IVUS findings, ACS patients were assigned to two groups according to whether there was ruptured plaque (ruptured ACS group) or not (nonruptured ACS group). There were 23 patients in the ruptured group and 29 patients in the nonruptured group. Clinical characteristics and IVUS measurements did not differ between the two groups. Tenascin-C levels were significantly higher in the ruptured ACS group than in the SAP group, whereas there was no significant difference between the nonruptured ACS and SAP groups. Importantly, in the ruptured ACS group, tenascin-C levels were significantly higher than in the nonruptured ACS group (71.9 ± 34.9 vs 50.5 ± 20.5 ng/ml, P < 0.005). Our data demonstrate that tenascin-C level is associated with pathologic conditions in ACS, especially the presence of ruptured plaque.

Senescence marker protein-30 (SMP30) deficiency impairs myocardium-induced dilation of coronary arterioles associated with reactive oxygen species.

Senescence marker protein-30 (SMP30) decreases with aging. Mice with SMP30 deficiency, a model of aging, have a short lifespan with increased oxidant stress. To elucidate SMP30's effect on coronary circulation derived from myocytes, we measured the changes in the diameter of isolated coronary arterioles in wild-type (WT) mice exposed to supernatant collected from isolated paced cardiac myocytes from SMP30 KO or WT mice. Pacing increased hydrogen peroxide in myocytes, and hydrogen peroxide was greater in SMP30 KO myocytes compared to WT myocytes. Antimycin enhanced and FCCP (oxidative phosphorylation uncoupler in mitochondria) decreased superoxide production in both groups. Addition of supernatant from stimulated myocytes, either SMP30 KO or WT, caused vasodilation. The degree of the vasodilation response to supernatant was smaller in SMP30 KO mice compared to WT mice. Administration of catalase to arterioles eliminated vasodilation in myocyte supernatant of WT mice and converted vasodilation to vasoconstriction in myocyte supernatant of SMP30 KO mice. This vasoconstriction was eliminated by olmesartan, an angiotensin II receptor antagonist. Thus, SMP30 deficiency combined with oxidant stress increases angiotensin and hydrogen peroxide release from cardiac myocytes. SMP30 plays an important role in the regulation of coronary vascular tone by myocardium.

Pulmonary hypertension and refractory heart failure in a patient with Crow-Fukase (POEMS) syndrome.

We experienced the case of a 67-year-old man with refractory heart failure. He presented with dyspnea and progressive pitting edema of the lower limbs. Diuretics were insufficient to improve his symptoms. Cardiac catheterization demonstrated pulmonary hypertension. Additional examinations confirmed polyneuropathy, organomegaly, endocrinopathy and monoclonal gammopathy. The plasma vascular endothelial growth factor (VEGF) level was 1,340 pg/mL. The patient was diagnosed with Crow-Fukase (POEMS) syndrome. Echocardiography detected left ventricular hypertrophy and diastolic dysfunction. Polysomnography demonstrated severe sleep-disordered breathing. We herein describe a case of pulmonary hypertension with Crow-Fukase syndrome accompanied by left ventricular diastolic dysfunction and sleep-disordered breathing.

Age-related oxidant stress with senescence marker protein-30 deficiency plays a pivotal role in coronary artery spasm.

OBJECTIVES: We examined the mechanism of coronary artery spasm related to oxidant stress with aging in senescence marker protein-30 (SMP30)-deficient mice because SMP30 decreases with aging and SMP30 knockout (KO) mice show a short life with increased oxidant stress. METHODS: To examine the effect of SMP30 on coronary artery vasomotor tone, we measured the endothelium-dependent [5-hydroxytryptamine (5-HT)] response of isolated, pressurized coronary arteries from SMP30 KO and wild-type (WT) mice (n=10 each). RESULTS: In SMP30 KO mice, 5-HT-induced vasoconstriction occurred, which altered vasodilation with dithiothreitol, a thiol-reducing agent. In WT mice, 5-HT-induced vasodilation occurred. Administration of 5-HT from the aortic sinus induced a coronary artery spasm in SMP30 KO mice, which was prevented by the intravenous administration of Y-27632, rho-kinase inhibitor. The fluorescence level of monochlorobimane in coronary arteries, which covalently labels the reduced total thiols, decreased in SMP30 KO mice, but reverted to a level comparable with that of WT mice on treatment with Y-27632. From these results, SMP30 provides protection against coronary artery spasm. CONCLUSION: Chronic oxidant stress associated with aging plays an important role in coronary artery spasm related to thiol oxidation and rho-kinase signaling.

Coronary artery spasm related to thiol oxidation and senescence marker protein-30 in aging.

BACKGROUND: Senescence marker protein-30 (SMP30) decreases with aging, and SMP30 knockout (KO) mice show a short life with increased oxidant stress. AIMS: We assessed the effect of oxidant stress with SMP30 deficiency in coronary artery spasm and clarify its underlying mechanisms. RESULTS: We measured vascular responses to acetylcholine (ACh) and sodium nitroprusside (SNP) of isolated coronary arteries from SMP30 KO and wild-type (WT) mice. In SMP30 KO mice, ACh-induced vasoconstriction occurred, which was changed to vasodilation by dithiothreitol (DTT), a thiol-reducing agent. However, Nω-nitro-L-arginine-methyl ester, nitric oxide (NO) synthase inhibitor, or tetrahydrobiopterin did not change the ACh response. In isolated coronary arteries of WT mice, ACh-induced vasodilation occurred. Inhibition of glutathione reductase by 1, 3-bis(2-chloroethyl)-1-nitrosourea decreased ACh-induced vasodilation (n=10, p<0.01), which was restored by DTT. To evaluate the thiol oxidation, we measured the fluorescence of monochlorobimane (MCB) in coronary arteries, which covalently labels the total. The fluorescence level to MCB decreased in SMP30 KO mice, but with DTT treatment restored to a level comparable to that of WT mice. The reduced glutathione and total thiol levels were also low in the aorta of SMP30 KO mice compared with those of WT mice. Administration of ACh into the aortic sinus in vivo of SMP30 KO mice induced coronary artery spasm. INNOVATION: The thiol redox state is a key regulator of endothelial NO synthase activity, and thiol oxidation was associated with endothelial dysfunction in the SMP30 deficiency model. CONCLUSION: These results suggest that chronic thiol oxidation by oxidant stress is a trigger of coronary artery spasm, resulting in impaired endothelium-dependent vasodilation.

Deep seating of 5 Fr. guiding catheter across the stenosis with 5 in 7 method was effective for severely calcified lesion.

A 57-year-old male with end stage renal disease underwent coronary angiography (CAG). The CAG revealed two vessel disease with severe calcification. A week after the percutaneous coronary intervention (PCI) to the left anterior descending coronary artery (LAD), we performed PCI to the right coronary artery (RCA). Because of the calcification, no devices could be crossed. We then performed 5 in 7 method using Heartrail ST01, and inserted it across the stenosis, with dilatation balloon at the distal RCA as anchoring. Finally we managed to implant two stents. We report that 5 in 7 method and deep seating of 5 Fr. guiding catheter were effective for the severely calcified lesion.

A reduction of coronary flow reserve is associated with chronic kidney disease and long-term cardio-cerebrovascular events in patients with non-obstructive coronary artery disease and vasospasm.

BACKGROUND: Coronary flow reserve (CFR) provides essential information about the coronary microvasculature. Chronic kidney disease (CKD) is a risk factor for cardio-cerebrovascular diseases. We hypothesized that low CFR is associated with CKD and long-term cardio-cerebrovascular events in the patients without obstructive coronary artery diseases and vasospasm. METHOD AND RESULTS: In this study, 73 patients suspected with coronary artery disease but had no epicardial coronary stenosis and vasospasm were enrolled. There were 13 CKD patients and CFR was measured using the Doppler flow wire methods in the left anterior descending artery. CFR was significantly lower in CKD group than non-CKD group (3.13 ± 0.6 vs. 4.00 ± 1.1, P = 0.007). From multivariate logistic regression analysis, the independent factor associated with the presence of CKD was only CFR (odds ratio 3.85, 95% confidence interval 1.27-11.70, P = 0.017). In the patients with low CFR (≤ 2.8), cardio-cerebrovascular events were more common than those with normal CFR (CFR > 2.8). Besides, in the patients who had both low CFR and CKD, long-term cardio-cerebrovascular events were more likely to occur than those with normal CFR or non-CKD. CONCLUSIONS: Our data suggest that low CFR is associated with CKD and cardio-cerebrovascular events in the patients without coronary stenosis and vasospasm.

Long-term clinical outcomes after deferral of percutaneous coronary intervention of intermediate coronary stenoses based on coronary pressure-derived fractional flow reserve.

Coronary pressure-derived fractional flow reserve (FFR) has been used to evaluate functional severity of coronary artery stenoses. The cut-off point of 0.75 was considered to be the indication for percutaneous coronary intervention (PCI). In this study, we examined the prognosis of patients in whom PCI was deferred because the lesion was not significant by FFR (≥0.75). We measured FFR of 44 patients (50 lesions with angiographically intermediate stenoses by pressure wire between 2002 and 2009. Out of 44 patients (50 lesions), functionally non-significant stenoses with FFR≥0.75 were 29 patients (33 lesions) and PCI was deferred. In the remaining 15 patients (17 lesions), FFR was <0.75 and PCI was performed. Patients were followed up for an average period of 53 months with endpoints of major adverse cardiac events (MACE; cardiac death, acute coronary syndrome, PCI, and coronary artery bypass grafting). The rate of MACE was 2/29 (6.9%) in patients with FFR≥0.75 and 2/15 (13.3%) in those with FFR<0.75, and it was not statistically different between the two groups. Since long-term clinical outcomes after deferral of PCI of intermediate coronary stenoses based on FFR were excellent (annual event rate 1.6%/year), FFR is a useful index to judge the indication of PCI and risk-stratify patients for MACE.

Very late stent thrombosis and neointimal plaque rupture after implantation of sirolimus-eluting stents: observations with angiography, IVUS and OCT.

Drug-eluting stent (DES) dramatically reduces the incidence of restenosis and rates of target lesion revascularization. Although several reports suggest that very late stent thrombosis could occur in patients after DES implantation, neointimal plaque rupture may be uncommon in the patients treated with DES compared with bare-metal stent. It is unclear that the reason why the patient in acute coronary syndrome (ACS) treated with DES has a high frequency of very late stent thrombosis and pathophysiological mechanisms of neointimal plaque rupture after DES implantation. We report a case of very late stent thrombosis with the findings of neontimal plaque rupture as well as incomplete stent apposition 4 years after sirolimus-eluting stent implantation in ACS.

Cetuximab inhibits growth, peritoneal dissemination, and lymph node and lung metastasis of endometrial cancer, and prolongs host survival.

The purpose of this study was to explore the possibility of molecular-targeted therapy with anti-epidermal growth factor receptor (EGFR) antibody (cetuximab) for endometrial cancer to develop a new treatment for advanced endometrial cancer. We analyzed EGFR protein expression and gene mutations in the human endometrial cancer cell line HEC1A, and evaluated the in vitro and in vivo effects of cetuximab on HEC1A. EGFR expression was observed in HEC1A cells, but no mutations in the EGFR gene were detected. Cetuximab inhibited HEC1A cell growth and invasion and VEGF-A production in vitro, and HECIA cell tumor growth, its peritoneal dissemination with ascites, and lymph node and lung metastasis in vivo. In addition, the antibody prolonged the survival of a mouse model of systemic metastasis. These results suggest the possibility of molecular-targeted therapy using cetuximab for endometrial cancer.