Transoral removal of a hilo-parenchymal submandibular sialolith.

In sialolithiasis, the lithiasis is often large and located at the junction of the middle and posterior third of the duct, in the hilum region. In such cases, transoral approach for submandibular lithiases (TASL) is a useful treatment of choice in patients with large submandibular stones that can be palpated bimanually.

Effects of xylitol-containing chewing gum on the oral microbiota.

In this interventional study, a randomized controlled trial was used to evaluate the short-term effects of xylitol-containing chewing gum on the salivary microbiota. In total, 70 healthy adult men recruited from the Japan Ground Self Defense Force participated in the study during a 2-day training at Yamaguchi camp, Yamaguchi Prefecture, Japan. The men were randomly divided into two groups: one group chewed two pieces of xylitol-containing chewing gum 7 times/day for 2 days (n = 34) and the other did not (n = 36). Baseline and follow-up stimulated saliva samples were collected and the salivary microbial composition was assessed using the 16S rRNA gene next-generation sequencing analysis. The total salivary bacterial count was quantified using a quantitative real-time PCR system. No statistically significant difference was found between the two groups regarding any parameter analyzed in the baseline samples; however, the follow-up samples of the test group showed significantly lower total salivary bacterial count than those of the control group. Conversely, no significant difference was observed in the overall composition of the salivary microbiota between the baseline and follow-up samples of the two groups. These results indicate that xylitol-containing chewing gum inhibits the increase in total salivary bacteria over a short time during which the salivary microbial composition is not affected.

Chewing xylitol gum improves self-rated and objective indicators of oral health status under conditions interrupting regular oral hygiene.

Chewing xylitol gum provides oral health benefits including inhibiting Streptococcus mutans plaque. It is thought to be especially effective in conditions where it is difficult to perform daily oral cleaning. Our study aim was to determine the effects of chewing xylitol gum on self-rated and objective oral health status under a condition interfering with oral hygiene maintenance. A randomized controlled intervention trial was conducted on 55 healthy ≥ 20-year-old men recruited from the Japan Ground Self Defense Force who were undergoing field training. Participants were randomly assigned to a test group (chewing gum; n = 27) or a control group (no gum; n = 28) and the researchers were blinded to the group assignments. The Visual Analog Scale (VAS) scores of oral conditions subjectively evaluated oral health, and the stimulated salivary bacteria quantity objectively evaluated oral health 1 day before field training (baseline) and 4 days after the beginning of field training (follow-up). VAS scores of all three oral conditions significantly increased in the control group (malodor: p < 0.001; discomfort: p < 0.001; dryness: p < 0.001), but only two VAS scores increased in the test group (malodor: p = 0.021; discomfort: p = 0.002). The number of salivary total bacteria significantly increased in the control group (p < 0.01), while no significant change was observed in the test group (p = 0.668). Chewing xylitol gum positively affects self-rated and objective oral health status by controlling oral hygiene under conditions that interfere with oral hygiene maintenance.

[Comparison of naftopidil and silodosin in the treatment of male lower urinary tract symptoms associated with benign prostatic hyperplasia: a randomized, crossover study].

We compared the efficacy, safety, and patient preferences for two α1-adrenoceptor (AR) antagonists with different affinity for AR subtypes, naftopidil (Naf) and silodosin (Silo), for the treatment of male lower urinary tract symptoms associated with benign prostatic hyperplasia (male LUTS/BPH). New patients diagnosed with male LUTS/BPH were randomly divided into either the Naf-Silo group or the Silo-Naf group (Naf : 50-75 mg once daily for 2 weeks followed by 75 mg once daily for 4 weeks ; Silo : 2-4 mg twice daily for 2 weeks followed by 4 mg twice daily for 4 weeks). A survey was conducted to evaluate patient drug preferences after completion of the study and the reasons for the preferences. Naf and Silo improved the total International Prostate Symptom Score (IPSS) compared with baseline. There was no significant difference between Naf and Silo in improvement in the IPSS total score. Adverse effects were more frequent with Silo than with Naf (P=0. 002). No significant difference in patient preference for the drugs was observed. These findings indicate that Naf and Silo provide similar clinical efficacy, with no difference in patient preference for the drugs, although adverse effects were significantly more frequent with Silo than with Naf.

Biphasic and monophasic sarcomatoid carcinoma of the urinary bladder.

We report a rare case of sarcomatoid carcinoma of the urinary bladder which showed both of biphasic and monophasic phenotypes through its clinical course. A 64 year-old man presented with gross hematuria and interrupted voiding. Radiological examination demonstrated a pedunculated tumor in the bladder with no distant metastases. Pathological diagnosis of transurethral resection revealed biphasic sarcomatoid carcinoma, pT1, composed of squamous cell carcinoma component and spindle cell component. The disease repeated local recurrences and partial and total cystectomies were performed, respectively. The recurrent tumors were monophasic sarcomatoid carcinoma purely composed of spindle cell component. The patient died of local and metastatic disease 13 months after the diagnosis. We consider that sarcomatoid carcinoma should be resected radically at the initial surgical treatment because of aggressive potential of spindle cell component. To our knowledge, this is the first case in which biphasic sarcomatoid carcinoma of the bladder recurred as monophasic tumor. The pathological study and management of this neoplasm are discussed, and the literature is reviewed.

Transcriptional repression by the basic helix-loop-helix protein Dec2: multiple mechanisms through E-box elements.

Dec2, a member of the basic helix-loop-helix (bHLH) superfamily, has been shown to function as a transcriptional repressor and is implicated in cell proliferation and differentiation. In addition, Dec2 transcripts exhibit a striking circadian oscillation in the suprachiasmatic nucleus. To identify the molecular mechanisms by which Dec2 regulates gene expression, we carried out structure-function analyses. Gel retardation and luciferase assays showed that Dec2, as well as its related protein Dec1, preferentially binds to class B E-box elements (CACGTG) as a homodimer and represses the transcription of target genes in a histone deacetylase (HDAC)-dependent manner. Functional studies with the GAL4-DNA binding domain fusion proteins identified the domain responsible for the repression activity of Dec2 in its C-terminal region, which is also necessary to recruit HDAC1. In addition, the basic and HLH domains of Dec2 were required for DNA binding and homodimerization, respectively. In contrast, Dec proteins repressed a MyoD-activated promoter activity of muscle creatine kinase gene through class A E-box in an HDAC1-independent manner. Dec2 formed a heterodimer with MyoD through the basic and HLH domains. Consistent with this, both the basic and HLH domains were required for the ability of Dec2 to inhibit the transcriptional activity of MyoD. These findings indicate that Dec2 employs multiple mechanisms, including DNA-binding and protein-protein interactions, to achieve E-box-dependent transcriptional repressions.