[Pulmonary Adenocarcinoma in Situ with Positive Findings in Pleural Lavage Cytology].

We report a rare case of positive findings in pleural lavage cytology(PLC) in the patient with pulmonary adenocarcinoma in situ (AIS). A 78-year-old woman was presented with a 30 mm pure groundglass nodule (GGN) in the left upper lobe on chest computed tomography (CT). After 2 years follow- up, thoracoscopic surgery was performed to resect the nodule. PLC was performed before pulmonary resection. Histopathological diagnosis was 25 mm AIS. However, PLC showed positive findings of malignant cells. CT examination at 1 year and 6 months postoperatively showed pleural dissemination findings and the patient died of lung cancer at 3 years and 2 months postoperatively. PLC's contribution to TNM staging has not yet been clarified. The positive findings in PLC and large size of pure GGN were considered likely to be poor prognostic indicators.

[Acute Coronary Syndrome in a Patient with Giant Coronary Artery Aneurysm:Report of a Case].

Coronary artery aneurysm is a rare entity defined as expansion more than 1.5 times of normal coronary artery in diameter. A 77-year-old male was admitted to our hospital with a diagnosis of acute coronary syndrome and a giant right coronary artery aneurysm. Coronary angiography showed occlusion of the right coronary artery and significant stenosis of left anterior descending artery and left circumflex artery. Enhanced computed tomography( CT) showed a right coronary artery aneurysm with a diameter of 38 mm. Urgent coronary artery bypass grafting and coronary artery ligation proximal and distal to the aneurysm were performed. His postoperative course was uneventful.

Effect of impression holding time and tray removal speed on the dimensional accuracy of impressions for artificial abutment tooth inclined.

Oral scanners allow dental impressions to be taken in a short time without the use of an impression material. However, it has been noted that high impression accuracy cannot be obtained in cases where the abutment is inclined or in cases where the span is long. Consequently, in daily clinical practice, impressions are often created using silicone impression material. When taking an impression using silicone impression material, the curing time or the removal time of the impression material are often based on the intuition of the dental staff. This study investigated the effects of impression holding time and impression tray removal speed on the dimensional accuracy of impressions. A specimen with an abutment inclined 30° to the removal direction of an impression was prepared. Four types of silicone rubber impression materials were used. Impressions were taken with two levels of holding time and two levels of removal speed using an autograph. The diameter of stone models was measured at 3, 6, and 9 mm from the baseline of each. The height of the inclined and opposite sides was also measured. Two-way analysis of variance was used to analyze data regarding the assessment of the effects of holding time and tray removal speed. The reproducibility of the impressions was affected by the volume of undercut caused by the inclined abutment. For a large undercut, longer holding times and faster tray removal speeds are recommended to reduce the deformation of silicone rubber impressions.

Association between serum IgG antibody titers against Porphyromonas gingivalis and liver enzyme levels: A cross-sectional study in Sado Island.

BACKGROUND: Previous studies have reported associations between nonalcoholic fatty liver disease, periodontitis, and obesity. Serum immunoglobulin G (IgG) antibody titer against Porphyromonas gingivalis, a major pathogen of periodontitis, is an established indicator of periodontal infection. However, the relationship between the antibody titer and liver enzyme levels has not been clarified yet. A study in the elderly was needed to evaluate the effect of long-term persistent bacterial infection on liver function. The objective of this study was to investigate the association between liver function and infection by P. gingivalis, and the effect of obesity on the association. METHODS: A cross-sectional study was conducted in adult outpatients visiting Sado General Hospital, in Niigata Prefecture, Japan, from 2008 to 2010. The final participants included 192 men and 196 women (mean age 68.1 years). Multivariable logistic regression analyses were performed to assess the association between the serum IgG antibody titer and the levels of aspartate aminotransferase (AST), alanine aminotransferase (ALT), and γ-glutamine transferase (GGT) levels. RESULTS: In women, serum IgG antibody titers against P. gingivalis was associated with elevated ALT, but not with AST or GGT, independent of covariates (p = 0.015). No significant association was found between the antibody titer and the elevated liver enzymes in men. The effect of obesity on the relationship between antibody titer and liver enzyme levels was not statistically significant. CONCLUSIONS: A cross-sectional analysis of adult outpatients suggested an association between P. gingivalis infection and ALT levels in women. The effect of obesity on this association was not statistically significant.

Association of liver enzyme levels and alveolar bone loss: A cross-sectional clinical study in Sado Island.

BACKGROUND: The interaction of periodontopathic bacteria with host immune system induces the production of inflammatory mediators which leads to alveolar bone loss (ABL), the essential feature of periodontitis. Concurrently, periodontal diseases cause the elevation of blood cytokine levels, the alteration of gut microbiota and the dissemination of enterobacteria to the liver. Owing to these mechanisms, periodontal disease might be a risk for liver dysfunction. Several epidemiological studies have reported associations between periodontal diseases and liver dysfunction, although the association between ABL and liver dysfunction has not been investigated. This cross-sectional study determined if elevated serum liver enzyme levels were associated with ABL in Japanese adults. MATERIAL AND METHODS: Japanese adults living on Sado Island who visited Sado General Hospital were invited to participate in the study. Participants over 40 years of age who underwent dental panoramic radiography and blood tests were included. Drinking and smoking habits were self-administered. After excluding patients with edentulous jaw, diagnosed liver diseases, and those on dialysis, data from 44 men and 66 women with a mean age of 73 years were analyzed. The average percentage of ABL for each participant was calculated for mesial and distal sites of all remaining teeth. The levels of serum aspartate aminotransferase (AST), alanine aminotransferase (ALT) and gamma-glutamyltransferase (GGT) were determined. Univariate analyses were performed to select covariates to be put in multivariate analyses. The association between elevated serum liver enzyme levels and the highest quartile of ABL were assessed by multiple logistic regression analysis. RESULTS: After adjusting for covariates, no significant association was found between elevated serum AST, ALT, or GGT levels as dependent variables and the highest quartile of ABL as an explanatory variable. CONCLUSIONS: There was no significant association between the elevation of serum liver enzyme levels and ABL in Japanese adults. Key words:Liver enzymes, dental panoramic radiography, alveolar bone loss, Japanese adults.

The number of remaining teeth as a risk indicator of cognitive impairment: A cross-sectional clinical study in Sado Island.

Most studies that have demonstrated an association between number of remaining teeth and cognitive impairment have treated teeth as a continuous variable, although the relationship is nonlinear. The aim of this cross-sectional study was to determine the critical number of remaining teeth in hospital outpatients at which the association with cognitive impairment becomes apparent. Japanese adults living on Sado Island who visited Sado General Hospital were invited to participate in Project in Sado for Total Health. In total, 2,530 adults were interviewed and had their teeth counted; 1,476 of these individuals also completed the Mini-Mental State Examination (MMSE) and underwent measurement of their serum high-sensitivity C-reactive protein (hsCRP) levels. Patients on dialysis and those with hsCRP ≥ 10 mg/L were excluded. The final study group consisted of 565 adults (290 men and 275 women) of mean age 69.8 (range 29-91) years. An MMSE score < 24 was considered to indicate cognitive impairment. The subjects were categorized according to whether they had an edentulous jaw or one to 10, 11-20, 21-27, or ≥28 remaining teeth. One hundred twenty-eight of the 565 study participants were diagnosed to have cognitive impairment. Multiple logistic regression analysis revealed associations of cognitive impairment with older age, ischemic heart disease, smoking, and alcohol consumption. After adjustment for covariates, having one to 10 remaining teeth was significantly associated with cognitive impairment. There is a significant association between having only one to 10 remaining teeth and cognitive impairment in hospital outpatients.

The T allele at the g.1471620G>T in the EDG1 gene associated with high marbling in Japanese Black cattle is at a low frequency in breeds not selected for marbling.

Our previous study detected a single nucleotide polymorphism (SNP), g.1471620G>T, in the 5' flanking region of the endothelial differentiation sphingolipid G-protein-coupled receptor 1 (EDG1) gene, which has been considered as a positional functional candidate for the gene responsible for marbling, and showed association of the g.1471620G>T SNP with marbling in Japanese Black beef cattle. In the present study, we investigated the allele frequency distribution of the g.1471620G>T SNP among the 5 cattle breeds, Japanese Black, Japanese Brown, Japanese Short Horn, Holstein, and Brown Swiss breeds. The T allele at the g.1471620G>T SNP associated with high marbling was found at high frequency in Japanese Black breed that has been subjected to a strong selection for high marbling, while the allele was absent or at very low frequencies in the other breeds that have not been strongly selected for high marbling. Based on this finding, we hypothesized that the pressure of the strong selection for high marbling in Japanese Black breed has increased the frequency of the T allele at the g.1471620G>T SNP in the EDG1.

[Comparison of three testing methods of fracture toughness using indirect composite].

PURPOSE: The aim of this study was to determine the adaptability of fracture toughness evaluation and the relationship between three testing methods: single-edge notched beam fracture toughness test (SENB), indentation fracture toughness test (IF), and notchless triangular prism fracture toughness test (NTP). METHODS: Two types of indirect composite, Ceramage and Estenia C&B, were used. Four types of experimental specimens were prepared under two curing conditions for each composite resin. One curing condition was only light curing and the other was heat curing after light curing. The fracture toughness value (K(Ic)) of the experimental specimens was measured by each of the three fracture toughness tests. K(Ic) of each test was compared by ANOVA and Tukey's multiple comparison test for the adaptability of fracture toughness evaluation. Then the correlation of two tests was evaluated by a simple linear regression analysis. RESULTS: Evaluation of the load-strain curve (or load-deflection curve) and fracture surface observation of SEM suggested the plane strain fracture phenomenon. K(Ic) values obtained by the three testing methods were significantly different (p<0.01). SENB could separate significantly these experimental specimens into four groups. IF could separate them into two groups. NTP could separate them into three groups. The fracture toughness evaluation of NTP was almost the same as that of SENB. The relationship between SENB and NTP showed a significant correlation (R(2)=99.7%) and its equation was NTP (K(Ic))=0.82 SENB(K(Ic))+1.05. IF did not show a significant correlation. CONCLUSION: These indirect composites tested exhibited different fracture toughnesses. This difference occurred due to the contents and curing conditions. The adaptability of fracture toughness evaluation showed different values depending on the testing method. The relationship of SENB and NTP showed a significant correlation.

[Effect of prism length on the notchless triangular prism fracture toughness test].

PURPOSE: The purpose of this study was to clarify the effect of holding condition with different prism length on the Notchless Triangular Prism (NTP) fracture toughness test and to define the prism length as a measuring condition. METHODS: Two kinds of NTP prism (ceramic and composite resin) were fabricated by CAD/CAM and each prism was adjusted to one of three lengths (8.0 mm, 12.0 mm, 16.0 mm). NTP was conducted for prism specimens made under six different conditions. The displacement of prism specimen holder gap (Delta d) and maximum fracture load (Pmax) were recorded and then a fractogram of each prism was inspected by SEM. RESULTS: Inclined stable fracture propagation was observed on the fractogram of the 8.0-mm prism. Both Delta d and Pmax of the 8.0-mm prism were significantly higher than those of the other lengths. CONCLUSIONS: A prism length of at least 12.0 mm is needed for the NTP because the 8.0-mm prism did not have a sufficient holding condition. The fracture toughness of the ceramic (3.68+/-0.09 MPa.m(1/2)) was significantly higher than that of the composite resin (2.38+/-0.20 MPa.m(1/2)).

Finite element analysis of the influence of implant inclination, loading position, and load direction on stress distribution.

The selection of the appropriate alignment of an implant and the position of implantation are vital for its longterm success. Excessive load is generated around inclined implants, causing microcracks in the bone, which result in implant loosening and eventual failure. This study was designed to analyze the stress distribution caused by varying the degree of inclination of an implant body and varying the loading position and direction, using the finite-element method of stress analysis. Buccal and lingual two-dimensional simulation models of a cylinder implant, embedded in the first molar edentulous cross-section of the mandible, were prepared, and the stress distribution and maximum principal stresses were recorded. Regardless of the point and direction of loading, compressive stresses were relatively greater when the implant was inclined. This tendency became more pronounced when a 45 degrees loading direction and eccentric loading were tested. For the inclined model, with a 45 degrees loading direction, the compressive stress was observed on the cortical bone adjacent to the direction of inclination, while tensile stress was observed on the opposite side.

Buccal and coronal bone augmentation using forced eruption and buccal root torque: a case report.

The following case report describes the buccal and coronal bone augmentation around an irretrievable tooth using forced eruption and buccal root torque for immediate nonsubmerged implant placement. A mandibular left second premolar with degree 2 mobility, severe buccal bone resorption, and interproximal angular bony defects was subjected to forced eruption and buccal root torque. Five months after this process, the tooth was displaced 15 mm coronally and the root apex faced buccally. Buccal and coronal bone augmentation and soft tissue enlargement were evident at reentry surgery. This technique enabled proper implant placement in a situation where the bone was compromised.