Carbon dioxide laser irradiation stimulates mineralization in rat dental pulp cells.

AIM: To examine the effect of carbon dioxide laser irradiation on mineralization in dental pulp cells. METHODOLOGY: Rat dental pulp cells were irradiated with a carbon dioxide laser at 2 W output power for 20, 40 and 60 s, and were cultured in ascorbic acid and beta-glycerophosphate containing media. Cell viability was examined 24 h after laser irradiation by a modified MTT assay. Alizarin Red S staining was performed 10 days after laser irradiation. The amounts of secreted collagen from the cells after irradiation were quantified following Sirius Red staining. The expression levels of collagen type I and HSP47, collagen-binding stress protein, were analysed by real-time PCR. HSP47 protein expression was examined by Western blotting. Statistical analysis was performed using one-way analysis of variance (anova) followed by the Tukey's multiple comparison test. RESULTS: The cell viability was not affected by laser irradiation at 2 W for up to 40 s. However, it was significantly decreased by 20% at 60 s (P < 0.05). The amount of mineralization after 10 days of irradiation at 2 W for 40 s was significantly increased in comparison to the other conditions (P < 0.05). The extracellular collagen production was significantly increased by 73% on day 2 and 38% on day 4 after laser irradiation (P < 0.05). Although collagen type I gene expression was not changed by laser irradiation, HSP47 gene and protein expression was induced within 12 and 24 h, respectively. CONCLUSIONS: These results suggested that carbon dioxide laser irradiation stimulated mineralization in dental pulp cells. The laser irradiation also increased HSP47 expression but not collagen gene expression.

[Glucose metabolism and Alzheimer's dementia].

Blood glucose levels are abnormally low in Alzheimer's dementia. We therefore examined glucose metabolism before death in relation to Alzheimer's dementia as determined at autopsy in 106 men and 161 women. The mean age was 81.8 +/- 8.6 years for men and 85.8 +/- 7.9 years for women (p < 0.001). The fasting plasma glucose level and hemoglobin Alc levels did not differ by sex. Alzheimer's dementia was detected in 88 patients (25.5%). More women than men had the disease, but the difference was not significant. Only 8.8% (3/34) of patients with diabetes mellitus had Alzheimer's dementia, as compared with 27.9% of patients without diabetes mellitus (65/233, p < 0.03). The fasting plasma glucose level was 89.9 +/- 13.4 mg/dl in patients with Alzheimer's dementia and 102.9 +/- 34.5 mg/dl in those without the disease. The hemoglobin Alc level was 5.7 +/- 0.8% in patients with Alzheimer's dementia and 6.4 +/- 1.5% in those without the disease. Both the fasting glucose level and hemoglobin Alc level were significantly lower in patients with Alzheimer's dementia than in those without the disease, p < 0.01. These data suggest that the development of Alzheimer's dementia is suppressed by the high plasma glucose levels in patients with diabetes mellitus.

Efficacy of oral administration of ofloxacin in lower respiratory tract infections in aged patients with chronic lung disease.

The efficacy of ofloxacin for the treatment of lower respiratory tract infection was evaluated in aged patients with chronic lung disease. Results are the following: improvement of leukocytosis and arterial oxygen tension was observed; peripheral blood cell analysis showed a decrease in natural killer cell counts and in helper/suppressor T cell ratio; superoxide production by peripheral blood white cells was decreased after treatment; interleukin-2 production was rather increased. We concluded that improvement in the immunological parameters indicated the efficacy of ofloxacin for lower respiratory tract infection in aged patients with chronic lung disease.

[A clinicopathological study of candidemia in the elderly].

Candidemias were reviewed in 22 elderly patients hospitalized in Yokufukai Geriatric Hospital. Their ages ranged from 62 to 101 years, with a mean age of 81 years. Sixteen patients had either old cerebrovascular disease or senile dementia. In seven patients, synchronous or metachronous bacteremia in the blood culture was associated with the candidemia. Eighty-six percent of total candidemias were related to intravenous hyperalimentation (IVH). The mean duration from the start of IVH to candidemia was 46 days. Eleven patients (50%) developed candidemia within one month after the beginning of IVH. Fourteen patients had the IVH catheters changed one or more times before the time of positive candida in the blood culture. The mean duration from the start of IVH to candidemia was 59 days. Eight patients, on the other hand, had the catheters unchanged and the mean duration was 23 days. Ninety-six percent were receiving broad-spectrum antibiotic therapy at the time of the positive candida in blood culture. Eight patients developed DIC. The overall mortality was 91% (twenty patients) and thirteen (65%) of them died within one month after the onset of candidemia. There was no difference in mortality when all candidemic patients received no anti-mycotic therapy were compared with the patients given any amount of miconazole or 5-FC. The causes of death for candidemic patients included fungemic shock (6 patients), hemorrhagic shock (4 patients), and shock associated with DIC (3 patients). From the results of this study, candidemia in the elderly was produced by various underlying diseases such as central nervous system diseases or pneumonia.(ABSTRACT TRUNCATED AT 250 WORDS)

Plasma apolipoproteins in patients with multi-infarct dementia.

We examined 27 elderly patients with multi-infarct dementia developed on the basis of cerebral arteriosclerosis. The levels of plasma cholesterol and triglyceride in the patients were 177 +/- 48 and 91 +/- 27 mg/dl (mean +/- SD), respectively. Despite normal plasma lipid levels, the patients had significantly higher plasma apo B (102 +/- 30 vs. 82 +/- 21 mg/dl for controls, P less than 0.01) and lower plasma apo A-I levels (104 +/- 25 vs. 130 +/- 22 mg/dl for controls, P less than 0.01) than the controls. Isoelectric focusing of apo E showed a 2-fold higher relative frequency for the epsilon 4 allele in patients than in Japanese controls (20.8 vs. 8.6-11.7% of total, P less than 0.05). The patients with phenotypes of E4/4 (n = 1) and E4/3 (n = 8) had higher plasma cholesterol levels than those with E3/3 (n = 15) (196 +/- 45 vs. 169 +/- 43 mg/dl). The results indicate that the patients had abnormalities in plasma lipoprotein metabolism and this may contribute to the development of cerebral arteriosclerosis.

[Metastatic brain tumor in the elderly].

Authors have reviewed 322 consecutive patients with malignant tumors confirmed by pathological studies between October 1973 and August 1987 in order to determine the frequency, clinical presentation, and lesion localization of metastatic brain tumor in the elderly. Among 322 patients with malignant tumor, 7 patients with primary brain tumor and 21 patients with metastatic brain tumors were found. The over-all frequency of metastases to the brain was 5.8%. This frequency of brain metastasis in the elderly was lower than those of the previous literature which have varied from 9 to 35%. The patients' ages with metastatic brain tumor ranged from 65 to 88 years with a median age of 77.5 years. The primary tumor sites of metastatic brain tumors were limited to 5 kinds of organs. These metastases were found in 27.3% of 11 patients with breast cancer, 17.5% of 80 patients with lung cancer, 6.7% of 15 patients with bile duct system cancer, 5.0% of 20 patients with pancreatic cancer, and 2.0% of 91 patients with gastric cancer. There was no brain metastasis in the other kinds of carcinoma. Among 21 metastatic brain tumors, there were 14 patients with lung cancer, 3 patients with breast cancer, 2 patients with gastric cancer, 1 patient with cholangiocarcinoma, and 1 patient with pancreatic cancer. In this series, the frequency of single and multiple metastases were 13 and 8 cases, respectively. The multiple brain metastases ranged from 2 to 6 nodules. In 21 metastatic brain tumors, there were 42 metastatic nodules in total.(ABSTRACT TRUNCATED AT 250 WORDS)

[A study of 75 untreated lung cancers in the elderly].

The records of 1280 patients autopsied at the Yokufukai Geriatric Hospital from October 1, 1973 to August 31, 1987 were reviewed and 75 patients with untreated lung cancer, aged 70 or older, were selected. The mean age and standard deviation was 82.1 +/- 5.4 years. Male consisted of 34 subjects and 41 were female of. Histological study revealed 42 cases of adenocarcinoma, 19 cases of squamous cell carcinoma, 7 cases of small cell carcinoma, 2 cases of large cell carcinoma, 1 case of carcinoid and 4 cases of the other types. The mean survival period of 44 untreated patients diagnosed as lung cancer during life was 21.1 +/- 24.1 months. The mean survival periods for 24 patients with adenocarcinoma and 11 patients with squamous cell carcinoma were 24.0 +/- 29.3 and 12.9 +/- 11.7 months, respectively. There was no statistically significant difference in the mean survival period of adenocarcinoma and squamous cell carcinoma. 9% of 44 untreated lung cancers survived for at least 5 years, although the survival rate was slightly lower than that generally reported in the literature. On the basis of staging of TNM classification at the autopsy, the mean survival period from the diagnosis for 13 patients with stage 1 and 27 patients with stage 4 were 27.5 +/- 33.3 and 18.5 +/- 19.7 months, respectively. The incidence of brain metastasis in 75 cases was 14.7%. In this study, adenocarcinoma was more predominant in the elderly (56.0%). An inverse relationship of age to stage was partially observed.