Multidirectional lip-closing force in adult females after short-term lip training.

The purpose of this study was to investigate the multidirectional lip-closing force in adult females before and after short-term lip training. Sixty-six Japanese females participated in this study. The subjects performed lip training that involved maintaining 200 or 400 g of bottled water in the oral vestibule. The signals of directional lip-closing force were investigated in eight directions before training and 5 and 7 days after the lip training. The differences in the closing force between pre- and post-training were then analysed statistically. The lip-closing force increased in the following order: pre-training, 5 days post-training and 7 days post-training in every direction (P < 0·05). The patterns of the increase in the lip-closing force in the upper, lower, right and left directions as a result of the repetitions were similar. No significant differences were noted between the training effects with loads of 200 and 400 g. Our findings demonstrated that the lip-closing force was influenced by the short-term lip training.

Localization and function of the accessory protein Mfa3 in Porphyromonas gingivalis Mfa1 fimbriae.

The fimbriae of Porphyromonas gingivalis, the causative agent of periodontitis, have been implicated in various aspects of pathogenicity, such as colonization, adhesion and aggregation. Porphyromonas gingivalis ATCC 33277 has two adhesins comprised of the FimA and Mfa1 fimbriae. We characterized the PGN0289 (Mfa3) protein, which is one of the three accessory proteins of Mfa1 fimbriae in P. gingivalis. The Mfa3 protein was present in two different sizes, 40 and 43 kDa, in the cell. The 43-kDa and 40-kDa Mfa3 were detected largely in the inner membrane and the outer membrane, respectively. Purified Mfa1 fimbriae contained the 40-kDa Mfa3 alone. Furthermore, the 40-kDa Mfa3 started with the Ala(44) residue of the deduced amino acid sequence, indicating that the N-terminal region of the nascent protein expressed from the mfa3 gene is processed in the transport step from the inner membrane into fimbriae. Immuno-electron microscopy revealed that Mfa3 localized at the tip of the fimbrial shaft. Interestingly, deletion of the mfa3 gene resulted in the absence of other accessory proteins, PGN0290 and PGN0291, in the purified Mfa1 fimbriae, suggesting that Mfa3 is required for integration of PGN0290 and PGN0291 into fimbriae. A double mutant of mfa3 and fimA genes (phenotype Mfa1 plus, FimA minus) showed increased auto-aggregation and biofilm formation similar to a double mutant of mfa1 and fimA genes (phenotype Mfa1(-) , FimA(-) ). These findings suggest that the tip protein Mfa3 of the Mfa1 fimbriae may function in the integration of accessory proteins and in the colonization of P. gingivalis.

Multidirectional lip-closing force in adults with mandibular deviation.

The purpose of this study was to investigate the relationship between multidi-rectional lip-closing force and facial soft tissue morphology in adults with mandibular deviation. Fifteen Japanese adults with mandibular deviation participated in this study. The deviation value was defined as the horizontal distance between soft tissue menton and the facial midline. The side of the soft tissue menton relative to the facial midline was defined as the deviated side and the opposite side as the non-deviated side. The signals of directional lip-closing force (DLCF) were investigated in 8 directions. Total lip-closing force (TLCF) was calculated by adding DLCFs in 8 directions. Correlations and differences between the variables were analysed statistically. Significant positive correlations between TLCF and DLCFs were determined in six directions with the exception of the horizontal direction. Significant positive correlations for seven pairs of opposing DLCFs were found. The lower non-deviated DLCF was smaller than the three pairs of opposing lip-closing forces. Negative significant correlation was found between the deviation value and the upper deviated DLCF (P < 0·05). In individuals with mandibular deviation, lip-closing force in the lower non-deviated direction was found to be smaller than the opposing lip-closing forces. When mandibular deviation was greater, the upper deviated lip-closing force was smaller.

Successful treatment of refractory T-cell acute lymphoblastic leukemia by unmanipulated stem cell transplantation from an HLA 3-loci mismatched (haploidentical) sibling.

We describe a patient with refractory T-cell acute lymphoblastic leukemia who successfully underwent unmanipulated stem cell transplantation from an HLA 3-loci mismatched (haploidentical) sibling. In order to avoid severe graft-versus-host disease (GVHD), we used intensified GVHD prophylaxis consisting of tacrolimus, a short course of methotrexate, methylprednisolone, and mycophenolate mofetil. Hematopoietic reconstitution was rapid, with neutrophil count >5 x 10(8)/l on day +16, and platelet count >2 x 10(10)/l on day +25. There was no evidence of clinical acute GVHD. Bacterial, fungal, and viral infections were well controlled with antibiotics. The patient is still in complete remission past day +400. We suggest that unmanipulated HLA-mismatched transplantation with intensified GVHD prophylaxis is an alternative option for patients who do not have an HLA-identical donor.

Human masticatory muscle volume and zygomatico-mandibular form in adults with mandibular prognathism.

Although several investigators have reported associations between masticatory muscles and skeletal craniofacial form, there is no agreement on the association. We tested the hypothesis that masticatory muscle volume correlates with the size and form of the adjacent local skeletal sites. For this purpose, we investigated the morphological association of the cross-sectional area and volume of temporal and masseter muscles with zygomatico-mandibular skeletal structures using computerized tomography (CT) in 25 male adults with mandibular prognathism. Muscle variables significantly correlated with widths of the bizygomatic arch and temporal fossa but not with the cranium width. Masseter volume significantly correlated with cross-sectional areas of the zygomatic arch and mandibular ramus. Masseter orientation was almost perpendicular to the zygomatic arch and mandibular antegonial region. The zygomatic arch angle significantly correlated with the antegonial angle. The results of the study suggest that the masticatory muscles exert influence on the adjacent local skeletal sites.

A three-dimensional method of visualizing the temporomandibular joint based on magnetic resonance imaging in a case of juvenile chronic arthritis.

AIM: The purpose of this study was to present a new visualizing method for temporomandibular joint (TMJ) pathology in 3D at several condylar positions and to apply the method to a case of juvenile chronic arthritis (JCA) with previously diagnosed bilateral TMJ disorder and to a subject without signs and symptoms from the TMJ. SUBJECT: The 20-year-old female patient had suffered from polyarticular JCA from the age of 6 years 8 months. The present study is based on a follow-up examination after the completion of orthodontic treatment with the Herbst appliance. Both TMJs were examined using magnetic resonance imaging (MRI) at closed and open mouth positions. The mandibular condyle, the glenoid fossa and the articular disc were segmented and 3D reconstruction of these structures was carried out. RESULTS: The condyle was characterized by an increased sagittal diameter with osteophyte-like formation at the anterior aspect of the condylar head and flattening of the superior surface. The depth of the glenoid fossa was reduced and the articular eminence was remarkably flat. The articular disc was markedly diminished and posteriorly placed on the condylar head. The distance of the condylar path during mouth opening was reduced and the curvature of the condylar path was quite flat. The disc moved slightly posteriorly on the condylar head and remained in the glenoid fossa during mouth opening. CONCLUSION: The imaging modality described improves visualization of TMJ morphology and gains insight into the TMJ pathology of the JCA patient, adding to understanding of the clinical problems.

Pain and other cardinal TMJ dysfunction symptoms: a longitudinal survey of Japanese female adolescents.

Longitudinal data were obtained for 4 years from 361 Japanese high school girls between the ages of 12 and 16. The data were analysed for the occurrence of pain and its associations with the occurrence of other cardinal TMJ dysfunction symptoms and occlusal states. It was determined that even if pain or noise or jaw-deviation symptoms appeared, those symptoms did not necessarily last thereafter. The symptoms were not persistent but rather appeared and disappeared repetitively. Those who exhibited noise during at least one of the surveys of the 4-year survey period showed a significantly higher prevalence of pain than those who did not exhibit noise at all (P < 0.05). Those who exhibited noise by the age of 13 showed a significantly higher prevalence of pain than those who exhibited noise after age 14 (P < 0.1). The temporal occurrence of pain depended upon the appearance of noise and the age at which noise first appeared. On the other hand, the occurrence of pain symptoms was not necessarily related to specific types of malocclusions, which suggests the significance of multifactorial contributions in understanding the aetiology of pain rather than the occlusal factor.

[In-111-labeled leukocyte brain SPECT imaging in acute ischemic stroke in man].

This study was performed to investigate the role of leukocyte accumulation in human cerebral infarction and its association with neurological functional outcome. A total of 42 patients diagnosed as acute ischemic stroke (22 embolism, 17 thrombosis, 3 TIA) were examined. Leukocyte accumulation was studied using indium-111-labeled leukocyte brain single-photon emission computed tomography (SPECT). Volume of brain infarction was evaluated by CT and/or MRI. The data were compared with the cerebral blood flow (CBF) imaging. Immediately after CBF study by SPECT using either technetium-99m hexamethylpropyleneamine oxine (Tc-99m-HMPAO) or technetium-99m ethyl-cysteinate dimer (ECD), In-111-labeled autologous leukocytes were injected intravenously. Brain scan for leukocytes was performed after 48 hours. The European Stroke Scale was used for neurological assessment. Thirteen patients with cerebral embolism and three patients with cerebral thrombosis showed intensive accumulation of leukocytes in the region of low flow. Leukocyte's accumulation was not seen in patients with TIA. The accumulation of leukocytes was more noticeable in the central zone of the ischemia. Patients who showed negative leukocyte accumulation revealed clinically mild functional outcome and the size of infarction on CT and/or MRI was small. The regional accumulation of leukocytes was seen in all the patients with hemorrhagic infarction, but the degree of hemorrhage on CT did not have significant influence on the amount of leukocyte accumulation. Abnormal accumulation of leukocytes was associated with reduced CBF during the acute embolic stroke. The present clinical study revealed that leukocyte accumulation correlated with the poor neurological functional outcome in patients with acute embolic stroke. The present study confirms that leukocytes contribute to the ischemic tissue damage of the brain and demonstrates a clinical evidence that the regional accumulation of leukocytes has a deleterious effect on the brain following ischemia.

The prevalence of cardinal TMJ dysfunction symptoms and its relationship to occlusal factors in Japanese female adolescents.

Cross-sectional data were obtained from 1182 Japanese high school girls of 12 and 15 years old. The data were analysed for the prevalence of specific occlusal features and the prevalence of cardinal Temporomandibular Joint Dysfunction (TMJD) symptoms in different occlusion groups. The associations between occlusal features and TMJD symptoms were analysed by the Z-analysis. The results were as follows: the prevalence of TMJD symptoms (total) was about 23% in both age groups examined. Noise had the highest prevalence of the specific TMJD symptoms in both age groups (16% and 11%). With age and for different occlusion groups, there was a significant increase in deviation on opening (P < 0.001) and a decrease in pain and noise (P < 0.05). No significant associations were found between the occurrence of TMJD symptoms (total) and occlusal features in all the examined occlusion groups. With respect to specific TMJD symptoms, however, the investigation of the different groups revealed a significant association (P < 0.05) of intra-arch occlusal (crowding) features with the occurrence of deviation on opening and with the occurrence of the combined TMJD symptoms which include deviation on opening. This indicates that crowding may be an important sign for predisposing TMJD. For the other single disorder symptoms (except pain), we did not find a significant relationship (P < 0.05) with aspects of occlusion, which may confirm a multifactorial TMJD problem wherein occlusal features can have a contribution to TMJD.

Prevalences of malocclusions and dental caries in molars in female adolescents.

Prevalences of malocclusions and dental caries in molars were investigated on a database of high school students collected between 1977 and 1986. A total of 6,665 schoolgirls were evaluated. The proportions of 54.1% in the seventh grade and 56.6% in the tenth grade students were judged as having malocclusions. The prevalences of dental caries for the lower first and the second molars were significantly higher (p less than 0.001) than those for the upper opponents during the observation period. The prevalence of dental caries increased linearly for all kinds of molars in accordance with age, but they were lower than those reported by the Ministry of Health and Welfare in Japan determined for the entire nation. The percent of dental caries for the second molars revealed abrupt increases from 10% at the seventh grade to 50% at the 12th grade. These changes were particularly noticeable between the eighth and the tenth grades. These results suggest the significance of oral health care education during the adolescent period based on a long-term cooperation made by dentists, school nurses, teachers through the participation of students into the oral health care programme.

[Prevalence of malocclusions and demand for orthodontic treatment among students at a women's high school].

Prevalences of malocclusions were investigated in a sample of 3,520 girls recorded between 1984 and 1986 at a private high school. Also, proportions of students who had received and were under treatment were surveyed for 3,501 students in 1989. In addition, ratios of a number of those who were judged to reveal maxillary protrusion with respect to that of the whole sample examined were evaluated as a function of overjet. The results of the surveys are as follows. SURVEY I) A total prevalence of malocclusion was 57.9% in the Grade 7 (G7) and 56.4% in the Grade 10 (G10). Among malocclusions surveyed, maxillary protrusion was found in 8.1% of the G7 and in 7.8% of the G10. Deep overbite was determined in 7.9% of the G7 and in 7.6% of the G10, mandibular protrusion was found in 2.4% of the G7 and in 2.7% of the G10. Edge-to-edge incisor relationships were determined in 6.4% of the G7 and in 7.6% of the G10. Anterior open bite was found in 2.4% of the G7 and in 2.9% of the G10. Crowding was found in 37.3% of the G7 and in 33.9% of the G10. SURVEY II) Prevalence of students who had orthodontic treatment at the time of survey, was 6.4% in the G7, 7.0% in the G8, 6.0% in the G9, 6.0% in the G10, 5.4% in the G11, and 3.6% in the G12. Those who had had orthodontic treatment revealed proportions of 8.1% in the G7, 8.0% in the G8, 7.7% in the G9, 11.3% in the G10, 12.2% in the G11, and 13.7% in the G12 students. SURVEY III) A proportion of 73.5% of those who had overjets more than 6 mm were judged to have maxillary protrusion.

Regional cerebral blood flow during an attack of vertebrobasilar insufficiency.

Using technetium-99m-labeled hexamethylpropyleneamineoxime [( 99mTc]HM-PAO) and single-photon emission computed tomography, we measured changes in regional cerebral blood flow in a 58-year-old man during an attack of vertebrobasilar insufficiency. Angiography demonstrated compression of the left vertebral artery by the osteophytes of cervical spondylosis when the patient turned his head to the left. Measured in the orthostatic position while turning his head to the left during a typical attack of vertebrobasilar insufficiency, regional cerebral blood flow was significantly reduced in the left cerebellum and the right occipital region. Our study illustrates the capability of [99mTc]HM-PAO single-photon emission computed tomography to measure transient reductions in regional cerebral blood flow and to relate these changes to the pathophysiology of vertebrobasilar insufficiency.