Association of Periodontal Status, Number of Teeth, and Obesity: A Cross-Sectional Study in Japan.

Recent reports have shown an association between obesity and periodontitis, but the precise relationship between these conditions has yet to be clarified. The purpose of this study was to compare the status of periodontitis, tooth loss, and obesity. Participants comprised 235 patients at the Center for Medical and Dental Collaboration in Kanagawa Dental University Hospital between 2018 and 2020. Clinical examinations such as blood testing, body composition analysis, periodontal measurement, assessment of chewing ability, salivary testing, and oral malodor analysis were performed. Periodontal inflamed surface area (PISA) was significantly associated with the number of teeth and body mass index (BMI). The number of teeth was negatively associated with age, but positively with chewing ability. Chewing ability was associated negatively with age, and positively with high-sensitivity C-reactive protein (hsCRP). The level of methyl-mercaptan in breath and protein and leukocyte scores from salivary testing were positively associated with PISA. The rate of insufficient chewing ability was increased in subjects with hemoglobin (Hb)A1c ≥ 7%. The high PISA group showed increased hsCRP. BMI as an obesity marker was positively associated with PISA, indicating periodontal inflammation. Chewing ability was related to serum markers such as HbA1c and hsCRP.

Exercise- or dipyridamole-loaded QGS is useful to evaluate myocardial ischemia and viability in the patients with a history of Kawasaki disease.

BACKGROUND: Evaluation of myocardial ischemia and viability is very important for the management of patients with a history of Kawasaki disease (KD). (99m)Tc-tetrofosmin myocardial perfusion scintigraphy combined with quantitative gated single photon computed emission tomography (QGS) gives us information, not only about perfusion, but also the percentage change in left ventricular wall thickness (%WT) and relative changes in left ventricular wall motion (LVM). METHODS: The subjects were 27 patients with a history of KD followed as outpatients at the National Cardiovascular Center, Osaka, Japan. Exercise-loaded QGS was performed on 21 patients, and dipyridamole- loaded QGS was performed in six patients younger than 7 years old. RESULTS: Perfusion defects (PD) were observed in 12 patients. Of the 12 patients, four with old myocardial infarction (OMI) had decreased %WT. All patients with OMI showed a decrease in %WT in the areas where PD was seen on the image. The other eight patients without OMI showed no decrease in %WT. In non-infarcted cases, the %WT was normal in the PD-positive area. CONCLUSIONS: It is possible to evaluate myocardial ischemia and viability in KD patients by comparing PD on the image with %WT determined by QGS using exercise or drug-loaded myocardial scintigraphy alone.

Prenatal diagnosis and management for a large fetal cardiac tumor complicated with hydrops fetalis.

Fetal cardiac tumor is a rare disease, and its prognosis varies in relation to the complications such as arrhythmia and out-flow obstruction. Hydrops fetalis is one of severe complications that result in an unfavorable outcome. A case is presented herein of a large fetal cardiac tumor diagnosed at 28 weeks gestation. At 30 weeks gestation, the fetus complicated with hydrops fetalis because of impaired cardiac function. Increased peak systolic velocity in the ascending aorta and marked reversed flow in the ductus venosus were observed. Oral digoxin therapy was administered to the mother as a cardiotonic agent and the hydropic condition was immediately diminished. After normal delivery, the cardiac tumor gradually decreased in size and the infant developed normally, but required an antiarrhythmic drug. The case indicates that the in utero digoxin therapy could be a choice for hydrops fetalis caused by cardiac tumor.

Successful treatment of supraventricular tachycardia exhibiting hydrops fetalis with flecainide acetate. A case report.

BACKGROUND: The efficacy of flecainide acetate for the treatment of fetal supraventricular tachycardia with hydrops fetalis and changes in venous blood flow patterns in the fetus during treatment are reported. CASE: Oral flecainide administration was started at 30 weeks of gestation. Cardioversion was achieved 6 days after treatment. Sustained abnormal venous Doppler indices were shown and complete normalization of venous returns was observed 6 days after cardioversion. A vigorous male baby was born, and he is now 1 year of age and in good condition with no medication. CONCLUSION: Reversible cardiac dysfunction was observed even after cardioversion in the fetus with supraventricular tachycardia, which could be assessed precisely by venous Doppler analysis.

Modified Blalock-Taussig shunt patency for pulmonary atresia: assessment with electron beam CT.

PURPOSE: The purpose of this work was to evaluate electron beam CT (EBCT) for the noninvasive assessment of modified Blalock-Taussig (BT) shunt patency in patients with pulmonary atresia. METHOD: Five infants and children with pulmonary atresia and modified BT shunts underwent contrast-enhanced EBCT. Modified BT shunts from the subclavian artery to the pulmonary artery were performed to improve the pulmonary blood flow. Electrocardiogram (ECG)-triggered EBCT was obtained with a 100 ms exposure, 3 mm section thickness, and 2 mm table feed after intravenous administration of contrast material. Three-dimensional (3D) or maximum intensity projection (MIP) EBCT images were compared with conventional angiography. The visibility of modified BT shunts was graded and recorded with use of a four-point scale. RESULTS: Satisfactory visualization was achieved in both 3D and MIP EBCT images to evaluate modified BT shunt patency. CONCLUSION: Contrast-enhanced 3D or MIP EBCT imaging with ECG trigger may be used as an effective substitute to evaluate modified BT shunts with low radiation dose exposure.

Simple genotype analysis of the Asp299Gly polymorphism of the Toll-like receptor-4 gene that is associated with lipopolysaccharide hyporesponsiveness.

A nonsynonymous single nucleotide polymorphism (Asp299Gly) in the Toll-like receptor-4 (TLR-4) gene affects the responsiveness to lipopolysaccharide in humans. To analyze this important polymorphism more efficiently, we developed a simple polymerase chain reaction (PCR) restriction length fragment polymorphism (RFLP) assay and examined the Asp299Gly allele frequency in a Japanese population. The PCR primer was designed with 1- or 2-bp mismatches, creating the recognition sequence for restriction enzyme BsaBI or BstXI, allowing RFLP analysis of the digested products. Genotyping was carried out with this assay for 275 DNA specimens from 107 healthy volunteers and 168 patients with various diseases, including ulcerative colitis (n = 86). The Asp299Gly allele of the TLR-4 gene was not detected in any of the specimens, suggesting that it is very rare in Japanese.