Purified Human Dental Pulp Stem Cells Promote Osteogenic Regeneration.

Human dental pulp stem/progenitor cells (hDPSCs) are attractive candidates for regenerative therapy because they can be easily expanded to generate colony-forming unit-fibroblasts (CFU-Fs) on plastic and the large cell numbers required for transplantation. However, isolation based on adherence to plastic inevitably changes the surface marker expression and biological properties of the cells. Consequently, little is currently known about the original phenotypes of tissue precursor cells that give rise to plastic-adherent CFU-Fs. To better understand the in vivo functions and translational therapeutic potential of hDPSCs and other stem cells, selective cell markers must be identified in the progenitor cells. Here, we identified a dental pulp tissue-specific cell population based on the expression profiles of 2 cell-surface markers LNGFR (CD271) and THY-1 (CD90). Prospectively isolated, dental pulp-derived LNGFR(Low+)THY-1(High+) cells represent a highly enriched population of clonogenic cells--notably, the isolated cells exhibited long-term proliferation and multilineage differentiation potential in vitro. The cells also expressed known mesenchymal cell markers and promoted new bone formation to heal critical-size calvarial defects in vivo. These findings suggest that LNGFR(Low+)THY-1(High+) dental pulp-derived cells provide an excellent source of material for bone regenerative strategies.

The effect of oral management on the severity of oral mucositis during hematopoietic SCT.

Oral mucositis (OM) is a frequent adverse effect of allogenic or autologous hematopoietic SCT. It results from direct toxic injury to the mucosal epithelial cells by the immunosuppressive regimen. Here, we compared the incidence and severity of OM between a group of 24 patients who received proper oral management during hematopoietic SCT and a group of 24 who did not. The oral management group received pre-hematopoietic SCT instruction on oral care and an oral examination in the clean room. Differences in the incidence and severity of OM between the two groups were examined statistically. OM was observed in 14 (58.3%) patients in the oral management group and 22 (91.6%) in the control group. The median of the OM score was 1 for the oral management group (range 0 to 3) and 2 for the control group (range 0 to 3). There was a significant difference in the OM score (P<0.05) and in the incidence of OM between the two groups (P<0.01). This study shows that oral management may decrease the occurrence of OM. Our results also suggest that it is important to include an oral management provider on the hematopoietic SCT team.

Loss of cytokeratin 13 expression in squamous cell carcinoma of the tongue is a possible sign for local recurrence.

Cytokeratin (CK) 13 is an intermediate filament protein that is expressed in a cell-type-specific manner, in the tongue and occasionally in tongue squamous cell carcinoma (SCC). Correlations between the clinical features of patients with SCC and CK13 expression in the tumor are here investigated along with CK13's utility as a marker for tongue cancer status. Samples from 121 patients with SCC of the tongue were examined by immunohistochemistry with antibodies against CK13. Correlations between the expression level of CK13 in the tumor and the patients' clinical features were statistically analyzed by univariate and multivariate methods. Univariate analysis showed a more relevant number of local recurrence (P = 0.04) in CK13-negative staining patients. In addition, CK13-negative cases were associated with local recurrence by multiple logistic regression analysis (OR: 3.36; 95% CI: 1.044-10.78; P = 0.04). Our results suggest that the loss of CK13 expression indicates tumors with a high potential for recurrence, and thus CK13 could be useful for determining the best course of treatment.

A prospective study to evaluate a new dental management protocol before hematopoietic stem cell transplantation.

Pre-hematopoietic stem cell transplantation (HSCT) dental treatment is essential to prevent serious infections from oral sources during immunosuppression, in patients who undergo HSCT therapy. This study was planned to establish a dental management protocol for such patients. Forty-one patients scheduled for HSCT to treat hematological malignancies were consecutively enrolled in the prospective trial. The dental status of all patients was evaluated by clinical and radiographic examination at a median of 47 days before the commencement of HSCT therapy. Thirty-six patients had one or more dental diseases; the remaining five had none. Caries was found in 26 patients, apical periodontitis in 19, marginal periodontitis in 24 and a partially erupted third molar in 11. Our policy is to preserve patients' teeth whenever possible, and therefore minimal dental intervention was planned. Treatment was completed for all 36 patients with dental pathologies, before the conditioning regimen began. All patients received the scheduled HSCT therapy without alteration, interruption or delay, and did not show any signs or symptoms associated with odontogenic infection while they were immunosuppressed. This protocol, therefore, appears to be appropriate for the pre-HSCT dental treatment of patients with hematological diseases.

Submandibular abscess caused by Salmonella.

Salmonella species represent uncommon causative agents in focal infections of the head and neck. This article presents a rare case of Salmonella submandibular abscess in a 59-year-old patient with diabetes mellitus, chronic hepatitis and liver cirrhosis. The patient was successfully treated with drainage of the abscess and oral administration of quinolone. An immunocompromised condition can be a critical predisposing factor for Salmonella submandibular abscess.

Flexure deformation in temporomandibular joint disk displacement without reduction may predict treatment outcome.

To identify whether the direction of disk flexure deformation predicts the prognosis in cases of anterior disk displacement without reduction of painful temporomandibular joint (TMJ), the relationship between the direction of flexure, observed on pseudodynamic magnetic resonance (MR) images, and the outcome of conservative treatment using a flat occlusal splint was analysed in 40 female patients who perceived occasional or constant pain at unilateral TMJ with disk displacement without reduction. From the MR findings, 20 patients were classified as having upward flexure deformation of the disk and 20 as having downward flexure deformation. Patients' TMJ pain, masticatory muscle pain, amount of maximal mouth opening, and MR findings were evaluated before treatment. All patients were treated with a flat occlusal splint for 6 months. The patients' signs and symptoms were analysed statistically within each group before treatment and 3 and 6 months afterwards, and were also compared between the upward and downward flexure groups. There was no statistical difference between the groups before treatment, except in the amount of maximal mouth opening and the extent of disk displacement. The upward flexure group had persistent TMJ pain and tendency of delayed alleviation of masticatory muscle pain compared with the downward flexure group, although maximal opening gradually increased in both groups. Thus, the direction of the flexure in deformation of the disk, which can be observed only with pseudodynamic MR imaging, may predict the prognosis of painful disk displacement without reduction following treatment with a flat occlusal splint.

Peroxiredoxin I expression in tongue squamous cell carcinomas as involved in tumor recurrence.

Peroxiredoxin (Prx) I is an antioxidant protein expressed in proliferating cells. We investigated Prx I as marker for tongue cancer status by correlating clinical features with Prx I expression. Samples from 132 patients with squamous cell carcinoma in the tongue were examined by immunohistochemistry with an anti-Prx I antibody. Correlations between Prx I expression and the clinical features of tumors were statistically determined using univariate and multivariate analyses. Univariate analysis showed Prx I was significantly associated with local recurrence (P=0.033). By multiple logistic regression analysis, Prx I expression was associated with local recurrence (odds ratio: 2.84; 95% confidence interval: 1.09-7.43; P=0.034) and lymph node recurrence (odds ratio: 2.86; 95% confidence interval: 1.02-8.01; P=0.046). Our results suggested that Prx I expression indicates tumors with a high potential for recurrence. Prx I may be used clinically to guide treatment for squamous cell carcinoma of the tongue.

Risk factors for postoperative delirium in patients undergoing head and neck cancer surgery.

This study was carried out to determine risk factors for delirium after major head and neck cancer surgery. The postoperative experience of 38 patients who underwent major head and neck cancer surgery and were managed in the high care unit was retrospectively examined by reviewing their medical records. Delirium was defined as confusion and abnormal behavior that interfered with postoperative recovery. Postoperative delirium occurred in 10 patients (26.3%) who all had stage IV cancer, flap reconstruction, an operative time of more than 10 h, blood transfusion of more than 4 units or infusion of more than 5000 ml, which together suggested the risk of delirium increased significantly with extensive surgery. Delirium occurred less frequently in patients with minor tranquilizer use for postoperative sleep disorder. Multivariative analyses showed an operative time of >10 h and no use of minor tranquilizer as significant factors for increasing the incidence of delirium, with odds ratios (95% confidence interval) of 11.4 (1.5-83.8) and 9.8 (1.5-66.0), respectively.

Ultrasound-guided surgical drainage of face and neck abscesses.

An ultrasound-guided surgical drainage technique in which grey-scale and colour Doppler ultrasonography were combined is described. The technique was performed for eight deep subcutaneous abscesses subsequent to odontogenic infection, and provided easy detection and accurate, reliable penetration of abscesses that were difficult to locate by physical examination. Colour Doppler ultrasonography is particularly useful for differentiating blood vessels from the static space of abscesses.

Energy value and digestibility of dietary oil containing mainly 1,3-diacylglycerol are similar to those of triacylglycerol.

Diacylglycerol (DAG) is a component of various vegetable oils. Approximately 70% of the DAG in edible oils are in the configuration of 1,3-DAG. We recently showed that long-term ingestion of dietary oil containing mainly 1,3-DAG reduces body fat accumulation in humans as compared to triacylglycerol (TAG) oil with a similar fatty acid composition. As the first step to elucidate the mechanism for this result, we examined the difference in the bioavailabilities of both oils by measuring food energy values and digestibilities in rats. Energy values of the DAG oil and the TAG oil, measured by bomb calorimeter, were 38.9 and 39.6 kJ/g, respectively. Apparent digestibility expressed according to the formula: (absorbed) x (ingested)(-1) x 100 = (ingested - excreted in feces) x (ingested)(-1) x 100 for the DAG oil and the TAG oil were 96.3+/-0.4 and 96.3+/-0.3% (mean +/- SEM), respectively. The similarity in the bioavailabilities of both oils supports the hypothesis that the reduced fat accumulation by dietary DAG is caused by the different metabolic fates after the absorption into the gastrointestinal epithelial cells.

Dietary diacylglycerol suppresses high fat and high sucrose diet-induced body fat accumulation in C57BL/6J mice.

Diacylglycerol (DG) comprises up to approximately 10% of various edible oils. In the present study, we examined the effects of dietary DG consisting mainly of 1,3-species on body weight, body fat accumulation, and mRNA levels of various genes involved in energy homeostasis in obesity-prone C57BL/6J mice. Five-month feeding with the high triacylglycerol (TG) diet (30% TG + 13% sucrose) resulted in significant increases in body weight, visceral fat accumulation, and circulating insulin and leptin levels compared with mice fed the control diet (5% TG). Compared with mice fed the high TG diet, body weight gain and visceral fat weight were reduced by 70% and 79%, respectively, in those fed the high DG diet (30% DG + 13% sucrose). In addition, circulating leptin and insulin levels were reduced to the respective control levels. Compared with high TG feeding, high DG feeding suppressed the elevation of leptin mRNA expression in adipose tissue, and up-regulated acyl-coenzyme (Co)A oxidase and acyl-CoA synthase mRNA expression in the liver. These results indicate that dietary DG is beneficial for suppression of high fat diet-induced body fat accumulation. Furthermore, it is suggested that structural differences in DG and TG, but not the composition of fatty acid, markedly affect nutritional behavior of lipids. -- Murase, T., T. Mizuno, T. Omachi, K. Onizawa, Y. Komine, H. Kondo, T. Hase, and I. Tokimitsu. Dietary diacylglycerol suppresses high fat and high sucrose diet-induced body fat accumulation in C57BL/6J mice. J. Lipid Res. 2001. 42: 372--378.

Fat-soluble vitamin status is not affected by diacylglycerol consumption.

OBJECTIVE: The objective of this study was to examine the effect of dietary diacylglycerol (DAG) on the bioavailability of fat-soluble vitamins in comparison with triacylglycerol (TAG). METHODS: We conducted a long-term administration test of DAG and TAG in 27 healthy men aged 27-47 years. After measuring baseline values, subjects were randomized into two groups, one group (n = 15) was given DAG and the other (n = 12) was given TAG. Subjects ingested 20 g of DAG or TAG either in mayonnaise or an emulsion drink of their own choice at meals once a day for 12 weeks. At 4, 8 and 12 weeks, fasting blood samples were drawn and serum levels of vitamin A, E, and D were measured. RESULTS: There were no significant changes in vitamin A levels throughout the study period. Compared to the initial values (using a Student's t test for paired values), significant differences of vitamin E and D were seen at some points during the experiment. According to a two-way repeated measures analysis of variance, however, DAG and TAG (lipid) and time had no effect on fat-soluble vitamin levels. CONCLUSIONS: Our results indicate that DAG does not affect the absorption of the fat-soluble vitamins in diets.

Ultrasonographic assessment for response to radiochemotherapy of metastatic cervical lymph nodes in head and neck cancer: usefulness of grey-scale and color doppler sonography.

To predict the response of lymph node metastasis to preoperative radiochemotherapy sonographically, the correlation between ultrasonographs and histologic features was retrospectively examined in 43 metastatic cervical lymph nodes from 24 patients with squamous cell carcinoma in the oral and maxillofacial region. Ultrasonographs were compared among poor-, good-, and complete-response lymph nodes. Before radiochemotherapy, hypoechoic internal echo and intranodal blood perfusion demonstrated many complete-response nodes; in contrast, most poor-response nodes showed peripheral blood perfusion and an avascular pattern, but did not have specific internal echo intensity. Complete-response nodes showed a significant reduction in their maximum and minimum diameters after radiochemotherapy. These results indicate that ultrasonography is useful for predicting the response of cervical lymph node metastasis to radiochemotherapy.

c-Abl expression in oral squamous cell carcinomas.

c-Abl is proto-oncogene product. c-Abl has roles in signal transduction, cell cycle regulation, and inhibition of apoptosis. There are many reports about c-Abl function in hematopoietic cells, but few are concerned with solid tumors. In the present study, biopsy specimens from 44 patients with oral squamous cell carcinomas were subjected to immunohistochemistry, and the expression levels of c-Abl were correlated with clinicopathological features. Statistical analyses revealed that c-Abl expression was significantly associated with T-category (p = 0.011), sex (p = 0.014), and differentiation (p = 0.007), but no significant difference was observed with N-category, age, primary tumor region, or the other histological gradings. The low c-Abl expression group included more T4, male, and poorly differentiated cases. There was a trend towards longer tendency survival in the high expression group, but the difference was not significant. We conclude that c-Abl is a good candidate for a tumor-expansion marker.

Peroxiredoxin I expression in oral cancer: a potential new tumor marker.

This study investigates the applicability of the novel antioxidant protein, peroxiredoxin (Prx) I as a marker for tumor status in oral squamous cell carcinoma (SCC). Samples from 53 patients with SCC in the oral cavity were examined by immunohistochemistry. Correlations between the expression level of Prx I and proliferating cell nuclear antigen (PCNA), the clinical features of tumors, and their histopathological classifications were statistically analyzed. Cases exhibiting low Prx I expression level included significantly more with larger tumor mass cases (T-category, P=0.004), positive lymph node metastasis (N-category, P=0.015), advanced stage (P=0.002), and poorly differentiated cells (P=0.020). There was no significant difference between Prx I expression and the other indices.

Dietary diacylglycerol suppresses accumulation of body fat compared to triacylglycerol in men in a double-blind controlled trial.

We examined the effects of the long-term ingestion of dietary diacylglycerols (DG) in a double-blind controlled study of human lipid metabolism. Healthy men (n = 38; aged from 27 to 49 y, body mass index (BMI) ranging from 21.8 to 27.4 kg/m(2)) completed the study. To accustom the subjects to the test diets prior to the experiment, they were supplied with test diets of triacylglycerol (TG) oil for 4 wk (control period). The test oils (10 g/d) were included in bread, mayonnaise or shortbread and served for the breakfast. The target for total lipid intake was 50 g/d (15 g for breakfast, 15 g for lunch and 20 g for dinner) throughout the study. The subjects were then divided into two groups so that mean BMI and the hepatic fat content, determined by computed tomography, for each group were not different. One group (DG group) consumed test meals containing DG-rich oil (10 g/d) while the other group (TG group) consumed the same meal as during the control period. Ten grams of the DG-rich oil contained 5.5 g 1,3-DG, 2.5 g 1,2-DG and 2 g TG. The actual lipid intake during the study was 43 g/d. Body weight, BMI and waist circumference decreased in both groups at the end of the test period of 16 wk. However, the magnitudes of decreases in these variables were significantly greater in the DG group than in the TG group. Decreases of total fat, visceral fat area and subcutaneous fat area of the abdominal traverse images of computed tomography in the DG group were also significantly greater than those in the TG group. Hepatic fat content decreased significantly in the DG group while no change was observed in the TG group. Serum lipid concentrations (TG, total cholesterol, free fatty acid) and related metabolites (glucose, insulin, total ketone body) did not change significantly in either group. Thus, in contrast to TG, DG apparently suppressed accumulation of fat and possibly reduces the risk of diseases associated with visceral fat obesity.

Chromatic analysis of autofluorescence emitted from squamous cell carcinomas arising in the oral cavity: a preliminary study.

Chromatic analysis was carried out to characterize the color quality of autofluorescence emitted from oral squamous cell carcinomas (SCC) and to objectively compare autofluorescence among various tissues. The following specimens were studied: 33 SCC, 3 epithelial dysplasias, 39 benign lesions, 31 dorsa of the tongue and 18 dental plaques. Autofluorescence depicted on fluorescence photographs was measured with a chroma meter. Chromatic values of autofluorescence differed significantly between SCC and non-cancerous tissues and between different stages of SCC. Autofluorescence of SCC tended to shift from orange to reddish orange with advancement of stage. These results suggest that autofluorescence of oral SCC chromatically differs from that of other tissues and depends on the stage of cancer.