bluuebunny/crossref_metadata_2025 huggingface dataset:
A sedimentary-based history of hurricane strikes on the southern Caribbean coast of Nicaragua
Authors: McCloskey Terrence Allen , Liu Kam-biu
Published: August 2012

Multi-millennial hurricane landfall records from the western North Atlantic indicate that landfall frequency has varied dramatically over time, punctuated by multi-centennial to millennial scale periods of hyperactivity. We extend the record geographically by presenting a paleostrike record inferred from a four-core transect from a marsh on the Caribbean coast of Nicaragua. Fossil pollen indicates that the site was a highly organic wetland from ~ 5400–4900 cal yr BP, at which time it became a shallow marine lagoon until ~ 2800 cal yr BP when it transitioned back into swamp/marsh, freshening over time, with the present fresh-to-brackish Typha marsh developing over the very recent past. Hurricane Joan, 1988, is recorded as a distinctive light-colored sand–silt–clay layer across the top of the transect, identifiable by abrupt shifts in color from the dark marsh deposits, increased grain size, and two upward-fining sequences, which are interpreted as representing the storm's traction and suspension loads. The six layers identified as hurricane-generated display temporal clustering, featuring a marked increase in landfall frequency ~ 800 cal yr BP. This pattern is anti-phase with the activity pattern previously identified from the northern Caribbean and the Atlantic coast of North America, thereby opposing the view that hyperactivity occurs simultaneously across the entire basin.
Relationship between Degenerative Bone Changes of Condylar Surface and Articular Disc Disorders in Symptomatic Osteoarthrosis of Temporomandibular Joints
Authors: Honda Kousuke , Natsumi Yoshiko , Urade Masahiro
Published: August 2012

Purpose: We investigate the relation of bone changes of the condylar surface to disc displacement and discuss the development of joint symptoms in osteoarthrosis of temporomandibular (TM) joints.

Subjects and Methods: Seventy‐seven patients with an image diagnosis of degenerative bone changes of the unilateral condylar surface accompanied with joint symptoms were studied. The bone changes were assessed by panoramic radiographs and classified into two groups: pathologic bone changes (PBC) including erosion, osteophyte and deformity, and adaptive bone changes (ABC) including flattening and concavity. Magnetic resonance imaging was performed on the subjective TM joints to examine the configuration and position of articular discs. A visual analogue scale was used for evaluation of joint pain.

Results: Erosion and deformity showed significantly higher prevalence than the other three kinds of bone changes in the joints with anterior disc displacement without reduction (ADWoR) as compared to those with anterior disc displacement with reduction (ADWR). The cases with the vertical disc position to the condyle ranging from 60° to less than 150° were more frequent than those ranging from 0° to less than 60° in the PBC group, whereas the cases with the vertical disc position to the condyle ranging from 0° to less than 6° were more frequent than those ranging from 60° to less than 150° in the ABC group. The average degree of joint pain when chewing but not jaw opening was higher in the joints with ADWoR than in those with ADWR, and in the PBC group than in the ABC group.

Conclusion: The bone changes of the condylar surface diagnosed as PBC tended to induce more advanced disc displacement and chewing pain than those diagnosed as ABC.
Alterations in G1 Phase Cell Cycle Regulation during the Development of Benzo[a]pyrene‐induced Epithelial Dysplasia in the Murine Tongue
Authors: Ota‐Sanada Misaki , Ito Daisuke , Ming‐Heng Li , Odani Takeshi , Kawamata Ai , Iwase Masayasu , Nagumo Masao
Published: August 2012

The environmental contaminant benz[a]pyren (B[a]P) has been regarded as one of the pathogens of oral premalignant and malignant lesions. To elucidate the pathogenesis of oral premalignancies, B[a]P‐induced dysplasia of the murine tongue was investigated for G1‐associated cell cycle regulation. B[a]P solution was applied orally up to six weeks to induce epithelial dysplasia of the tongue. BrdU incorporation and the expression of p21, cyclin D1, and CDK4 were examined by immunohistochemistry and Western blotting. Rb phosphorylation and E2F‐Rb binding were examined by immunoprecipitation and Western blotting. B[a]P treatment resulted in dysplastic changes and active DNA synthesis in the tongue epithelia. Immunohistochemical analyses showed p21 up‐regulation and cyclin D1/CDK4 overexpression in B[a]P‐induced dysplasia. Rb hyperphosphorylation and E2F release were caused by B[a]P treatment. Thus, dysregulation of G1‐phase regulation is likely to be an important event in the development of oral epithelial dysplasia in mice.
Nodular Fasciitis in the Buccal Mucosa : A Case Report
Authors: Ikebe Tetsuro , Ogata Yuichi , Yasuo Takamune , Ota Kazutoshi , Obayashi Takehisa , Shinohara Masanori
Published: August 2012

A case of nodular fasciitis which arose from the buccal submucosal region is reported. One week after an incisional biopsy, the lesion enlarged alarmingly and protruded from the submucosa. Although a sarcoma was suspected because of rapid growth, the diagnosis of the biopsy was nodular fasciitis showing a haphazard arrangement of plump fibroblasts without atypical mitoses. After complete resection, no signs of recurrence were seen.
Scintigraphic Evaluation of Patients with Malignant Tumor of the Head and Neck by Thallium‐201‐chloride(Tl‐201)Scintigraphy
Authors: Sato Tsuyoshi , Kawabata Yoshihiro , Indo Hiroko , Suenaga Shigeaki , Kawano Kazunori , Iwashita Yoichiro , Morita Yasuhiko , Majima Hideyuki J , Sugihara Kazumasa , Tamotsu Mimura
Published: August 2012

The purpose of this study was to evaluate the usefulness of thallium‐201‐chloride (Tl‐201) scintigraphy for the examination of patients with tumors of the head and neck, and to estimate the correlation of the expression of Na+/K+‐ATPase with Tl‐201 scintigraphy. Tl‐201 scintigraphy was performed in 61 patients with squamous cell carcinoma and 10 patients with benign tumors of the salivary gland. The tumor retention index was obtained from the early and delayed dynamic Tl‐201 scintigraphies. The expression of Na+/K+ ‐ATPase on the cell membrane was evaluated immunohistochemically. Evaluation of correlations between the histopathological tissue differentiation of tumors, the tumor retention index of Tl‐201 scintigraphy and the expression of Na+/K+‐ATPase was performed. The tumor retention index of Tl‐201 scintigraphy correlated well with the histopathological tissue differentiation of tumors and also showed a good correlation with the expression of Na+/K+‐ATPase. In addition, the expression of Na+/K+‐ATPase demonstrated a close correlation with the histopathological tissue differentiation of malignant tumors. The tumor retention index could be used for the differentiation of malignant tumors from benign tumors and the expression of Na+/K+‐ATPase was estimated as one of the most important factors for Tl‐201 accumulation in malignant tumors.
Radiological Morphometric Analysis of the Mandibular Bone Structure after Ovariectomy in Mature Cynomolgus Monkeys
Authors: Asai Hideomi , Kozai Yusuke , Matsumoto Yukiko , Kawamata Ryota , Kumasaka Satsuki , Sakurai Takashi , Kashima Isamu
Published: August 2012

【 Purpose】The effects of experimental osteoporosis on the trabecular bone structure of the mandible in cynomolgus monkeys were examined by radiological bone morphometric analysis. 【Methods】Ovariectomy（ OVX）was performed on twelve 10‐year‐old female cynomolgus monkeys, which were fed a controlled diet for 2 years. Twelve monkeys in a sham control group were fed under the same conditions. Using a microfocus tube and computed radiography, the removed mandibular bone samples were imaged by standardized magnification radiography, and two‐dimensional digital imaging data were obtained. The structural parameters, such as skeletal area, perimeter, number, complexity, continuity and anisotropy, were measured using radiological bone morphometric analysis. The bone mineral density（BMD）was measured by dual energy X‐ray absorptiometry. The width of the cortical bone was measured using magnified radiographic images. 【Results】There were no significant differences between the OVX and the sham control groups in the skeletal structure indicated by the skeletal volume, number, width, perimeter, complexity, continuity, separation and spacing. However, there were significant differences between the two groups in the BMD of the mandibular body, cortical bone width, anisotropy and some parameters of the skeletal continuity. Among these parameters, the difference in the thinning of the cortical bone was most significant. 【 Conclusions】Using two‐dimensional digital radiographic image data, this study suggests that the cortical bone width is more useful than the trabecular bone structure as the morphologic parameter for diagnosis of osteoporosis in the mandibular body
Secondary Reconstruction of Mandibular Depression Deformity with Pedicled Latissimus Dorsi Myocutaneous Flap
Authors: Ikebe Tetsuro , Ota Kazutoshi , Maki Masahiro , Nomura Tomoko , Shinohara Masanori
Published: August 2012

When secondary reconstruction is required in the head and neck region where a primary operation was performed before, it is important to select a flap which is not only suitable for the purpose, but also can be transferred more safely. In the present case, a female patient, 33 years old, complained of depression deformity around the left mandibular region. She had undergone segmental mandibulectomy coupled with radical neck dissection because of adenoid cystic carcinoma of the left submandibular gland 12 years ago. The deformity was thought to be mainly due to the deficiency of subdermal soft tissue. The insertion of a denuded and folded pedicled latissimus dorsi myocutaneous flap into the submandibular space satisfactorily restored the depressed mandibular contour. The pedicled latissimus dorsi myocutaneous flap can acquire a bulkiness by being folded, whose atrophy is tolerable for a long period, and is safe for secondary reconstruction.
Antisense Ets‐1 Transfection Restrains Oral Cancer Invasion by Reducing Matrix Metalloproteinase Activities
Authors: Taguchi Chihiro , Ohnishi Yuichi , Kakudo Kenji
Published: August 2012

Ets‐1 is an Ets family transcription factor, can up‐regulate the transcription of matrix metalloproteinase (MMP) genes and confers an invasive phenotype on human cancer cells. HSC3 is an oral squamous cell carcinoma‐derived cell line, and it manifests high levels of Ets‐1 and MMP‐9 gene expression that are associated with invasive potential. In this study, we investigated the effect of Ets‐1 on the invasive properties of oral cancer from a molecular biological perspective. We constructed an Ets‐1 antisense (AS) expression vector, transfected HSC3 cells with the vector, and obtained HSC3AS cells that express Ets‐1 AS RNA. The expression of Ets‐1 and MMP‐9 was analyzed with RT‐PCR. The invasive ability of the HSC3AS cells was determined using a matrigel invasion assay and MMP‐9 production was measured using gelatin zymography. The amount of Ets‐1 mRNA was significantly reduced in HSC3AS cells compared with parental HSC3 cells and the control transfected with empty vector. Matrigel invasion assay revealed that the HSC3AS cells had lower invasive ability. Gelatin zymography demonstrated that HSC3AS MMP‐9 productions were decreased compared with those of parental HSC3 cells and the control. These results imply that transfection of AS Ets‐1 inhibits oral cancer invasion by down‐regulating MMP‐9 genes.
Involvement of Chemokine Receptor 4/Stromal Cell‐derived Factor 1 System in Human Salivary Gland Carcinoma Motility
Authors: Sachiya Suzuki , Akiyuki Maeda , Masayoshi Miura , Satoru Ozeki
Published: August 2012

Salivary gland carcinoma such as adenoid cystic carcinoma (AdCC) is characterized by slow growth, diffuse invasion and lung metastasis, which determine the patient’s prognosis. It is important to clarify an attractant molecule leading tumor cells to migrate. We examined the effects of stromal cell‐derived factor (SDF)‐1, a chemokine, on salivary gland carcinoma cell clone HSG and its subclone HSG‐AZA3. SDF‐1 promoted the invasion and migration of HSG and HSG‐AZA3 cells dose‐dependently. Immunocytostaining and RT‐PCR indicated that HSG and HSG‐AZA3 cells expressed SDF‐1 receptor, CXCR4, both in protein and mRNA level, respectively. CXCR4 was present on the cell surface of HSG cells, and was downregulated by SDF‐1 addition. Finally, we confirmed that CXCR4 was expressed in the tissue of AdCC. Our study suggests that SDF‐1 and CXCR4 play a role in the migration of carcinoma of salivary gland origin.
Bone Mineral Density in Hemifacial Microsomia
Authors: Yamaoka Minoru , Nakamura Masaaki , Okafuji Norimasa , Yasuda Kouichi , Naramoto Hiroko , Shiba Toshikazu , Uematsu Takashi , Kurihara Saburo , Furusawa Kiyofumi
Published: August 2012

We aimed to assess whether patients with hemifacial microsomia can be quantitatively identified using bone mineral density information. Mandibular bone mineral density was studied using computer assisted analysis between the nonaffected (r) and the affected (l) sides with an orthopantomograph in a patient with hemifacial microsomia with median mandibular cleft, and four patients who suffered from hemifacial microsomia in the left side. Fifty controls without bone diseases were randomly selected.

Bone mineral density r/l ratios in the controls ranged from 0.479 to 2.064, and those in two patients that were associated with and without median mandibular cleft were higher than those in the controls, with a maximum of 8.622 in a particular male with median mandibular cleft after bone graft, whereas the r/l ratios in the other three cases were similar to the controls. Our findings indicate that the quantitative character in the case with median mandibular cleft reveals a large discrepancy of bone mineral density between the nonaffected and the affected sides. This may suggest a compensatory mechanism for bone hypertrophy from regulated bone mineral density with underdevelopment in hemifacial microsomia.
Trigeminal Neuralgia
Authors: Toda Katsuhiro
Published: August 2012

Trigeminal neuralgia (TN) causes sudden, usually unilateral, severe, brief stabbing recurrent pains in the distribution of one or more branches of the trigeminal nerve. Radiological examination is not required, however, patient interview and physical examination are necessary for diagnosis alone. When a patient is diagnosed with TN, an MRI is recommended to exclude tumor, cyst or multiple sclerosis, irrespective of the patient's age. From the etiological viewpoint, TN is classified into primary or idiopathic TN and secondary or symptomatic TN. From the symptomatic viewpoint, TN is classified into typical TN and atypical TN. Atypical TN, trigeminal neuropathy, pretrigeminal neuralgia, and short‐lasting unilateral neuralgiform headache with conjunctival injection and tearing (SUNCT) are also described.
Expression of Copper Efflux Transporter (ATP7B) in the Transport of Cisplatin in Cell Lines Derived From Invasive Oral Squamous Cell Carcinoma
Authors: Yoshizawa Kunio , Nozaki Shinichi , Kitahara Hiroko , Ohara Teruhisa , Kato Koroku , Kawashiri Shuichi , Nakagawa Kiyomasa
Published: August 2012

Intrinsic or acquired resistance to cisplatin (CDDP) is a problem for its use in cancer chemotherapy. This resistance has been reported to correlate with expression of the human copper transporter 1 and two copper export pumps, ATP7A and ATP7B. In the current study, we investigated the correlation between the expression of these transporters and sensitivity to CDDP using four cell lines derived from each of high invasive oral squamous cell carcinoma (OSCC) and low invasive OSCC. We found that the amount of CDDP accumulated in high invasive OSCC cell lines (Yamamoto‐Kohama criteria : grade 4C and 4D) with strong intrinsic tolerance was lower than in low invasive OSCC cell lines (grade 3) with weak intrinsic tolerance. Additionally, overexpression of ATP7B mRNA in cell lines derived from high invasive OSCC conferred low sensitivity to CDDP. Furthermore, the accumulation and sensitivity of CDDP was higher in HOC313 cells transfected with the ATP7B siRNA than in cells transfected with the nonsense siRNA. These results suggest that the overexpression of ATP7B results in the export of and, therefore, resistance to CDDP. Furthermore, ATP7B may be a key determinant of the intrinsic resistance to CDDP.
Treatment for Localized Langerhans' Cell Histiocytosis of the Maxilla by Corticosteroid Injection: A Case Report
Authors: Nakagawa Yoichi , Idesaki Satoshi , Matsumoto Kameji , Ishibashi Katsunori
Published: August 2012

This report describes a case of localized Langerhans' cell histiocytosis which occurred in the maxilla of a 23‐year‐old male. The lesion was treated by an injection of corticosteroids. Corticosteroid treatment for Langerhans' cell histiocytosis of the maxilla is considered to be beneficial because no sequelae remain following the treatment.
Simultaneous Assessment of Cyclin D1 and Epidermal Growth Factor Receptor Gene Copy Number for Prognostic Factor in Oral Squamous Cell Carcinomas
Authors: Takahashi Ken‐Ichiro , Uzawa Narikazu , Myo Kunihiro , Okada Norihiko , Amagasa Teruo
Published: August 2012

Cyclin D1 gene (CCND1) numerical aberrations are independent prognostic indicators of head and neck squamous cell carcinomas (HNSCCs). High epidermal growth factor receptor gene (EGFR) copy number is associated with poor prognosis in lung cancer, but such findings are controversial in oral SCCs (OSCCs). We analyzed copy number status in CCND1 and EGFR in OSCC patients and its association with clinical outcome.

EGFR and CCND1 statuses were analyzed in 85 OSCC patients by fluorescence in situ hybridization (FISH) of specimens obtained by fine‐needle aspiration biopsy.

CCND1 numerical aberration was found in 35 of 85 tumors (41%), and aberrant EGFR copy number was observed in 36 (42%). Gene amplification (GA) was dominant among CCND1 copy number changes (14/35:40%). Balanced trisomy (BT) was the most frequently observed EGFR aberration (17/36:47%). In a multivariate Cox’s proportional hazards analysis, CCND1 GA was correlated with disease‐free survival (P < 0.001), whereas EGFR BT was significantly correlated with overall survival (P = 0.001). Patients with a combination of CCND1 GA and/or EGFR BT had significantly poorer clinical outcome.

CCND1 and EGFR copy number changes were frequent in OSCC and had differing aberration patterns. CCND1 GA and EGFR BT statuses by dual‐color FISH were the predominant predictors of clinical outcome. Further investigation is needed to determine the implications for EGFR inhibitor therapy in OSCC.
Anti‐demineralizing Potential of Bottled Sugar‐free Green Tea Beverages in vitro
Authors: Mukai Yoshiharu , Kamijo Kazuko , Hirata Yukio , Teranaka Toshio
Published: August 2012

The purpose of this study was to evaluate the influence of a bottled green tea beverage on dentin demineralization with a demineralization gel system in vitro. Samples were cut from bovine root dentin. Each sample was immersed in 8% methylcellulose gel onto which a layer of green tea beverage was placed. For comparison, sugar‐free coffee beverage, deionized water, and 0.8‐ppm F solutions were used. After two weeks, the treatment solutions were replaced with demineralization solution. The mineral profiles and mineral loss values of the lesions were obtained by transversal microradiography (TMR) after one‐week demineralization. The green tea, coffee, and fluoride solution treatments induced a significantly thicker surface layer when compared with the deionized water treatment. In particular, the mineral volume % of the demineralized dentin specimens treated with green tea was approximately seven times higher than that of the de‐ionized water treatment. The green tea treatment showed significantly lower mineral loss than the other three treatments. TMR measurements clearly showed that the sugar‐free bottled green tea beverage inhibited dentin lesion progression, presumably due to the effect of sub‐ppm fluoride levels.
3‐D Analysis of Palatal Morphology Associated with Palatalized Articulation in Patients with Unilateral Cleft Lip and Palate
Authors: Nishikubo Mai , Hirahara Narihiro , Gomi Akinori , Nozoe Etsuro , Nakamura Norifumi
Published: August 2012

Palatalized articulation is one of the major articulation disorders which patients with cleft palate face after palatoplasty. Various causal factors have been suggested to date, but the main cause remains poorly understood. To clarify the possible causes of palatalized articulation in speakers with cleft palate, three‐dimensional palatal morphology in patients with/without palatalized articulation in unilateral cleft lip and palate (UCLP) was analyzed.

Twelve UCLP patients with palatalized articulation (P group) and 20 UCLP patients with normal articulation (N group) participated in the present study. Speech was assessed in the two groups at the age of about four. Dental casts of the maxilla taken at the same time were analyzed three‐dimensionally, and measurements in the horizontal, frontal, and sagittal planes were compared between patients with palatalized articulation and those with normal articulation. All dental casts were measured with a non‐contact 3D laser scanner and the 3D data were analyzed with 3D‐analyzing software.

Our study demonstrated three major findings of palatal morphology in UCLP patients with palatalized articulation when compared with their non‐palatalized counterparts : 1) the posterior region of the palate was narrow in the horizontal plane, 2) asymmetry of the anterior palate was severe in the frontal plane, and 3) the palate was flat and shallow in the sagittal plane.

These findings suggested that palate deformities can affect the lingual‐contact pattern, and may account for the backward movement of the articulation point.
Histological Investigation of the Development of the Anlage of the Mandibular Condyle of Mouse
Authors: Tsuchikawa Kohzo , Kumakura Masahiko , Kuwahara Toru , Ito Hidetoshi
Published: August 2012

To elucidate the histological findings of the anlage of the mandibular condyle during very early developmental stages, we analyzed sagittal and frontal plane serial sections of mouse fetuses for which the gestational period was precisely determined. An aggregate of mesenchymal cells around the buccal nerve (peripheral cell aggregate) could be seen at 12.0 days post‐conception (dpc). Another cell aggregate (core cell aggregate), which almost coincided with the outline of the condylar head, was detected on the inside of the dome‐shaped peripheral cell aggregate at 12.75 dpc. The cells of the peripheral cell aggregate were gradually flattened in accordance with cell differentiation, and formed a fibrous sheath covering the condylar head by 15.0 dpc. The cells of the central region of the core cell aggregate differentiated into hypertrophic chondrocytes by 14.5 dpc, whereas the cells of the fringe of the core cell aggregate differentiated into osteogenic cells to form the bone collar by 15.0 dpc. The continuity of the anlage of the condyle with that of the mandibular ramus was first recognized at 13.0 dpc. As the anlage of the mandibular condyle was observed histologically during very early developmental stages, further research is necessary to characterize the development of this anlage in greater detail.
Crosstalk between Blood Vessels and Tumor Microenvironment
Authors: Hida Kyoko , Ohga Noritaka , Kurosu Takuro , Totsuka Yasunori , Shindoh Masanobu
Published: August 2012

Tumor blood vessels play an important role in tumor progression and metastasis. Thus, targeting tumor blood vessels is an important strategy for cancer therapy, especially for head and neck cancer patients. Tumor blood vessels generally sprout from pre‐existing vessels and have been thought to be genetically normal. However, tumor blood vessels have been shown to differ from their normal counterparts, for example, by changes in morphology. The authors isolated tumor endothelial cells (TECs) from mouse tumor xenografts and have shown that the TECs are abnormal. TECs up‐regulate many genes and proliferate more rapidly and migrate more than normal endothelial cells (NECs). Furthermore, TECs were found to be cytogenetically abnormal. We conclude that TECs can acquire cytogenetic abnormalities while in a tumor microenvironment.

To develop ideal antiangiogenic therapies, understanding the crosstalk between blood vessels and the tumor microenvironment is important.

Here, we provide an overview of the current studies on TEC abnormalities and a discussion about possible mechanisms for how tumor the microenvironment makes TECs abnormal.
Aberrant Control of Transcription and Transportation of Oncogenic mRNA in Carcinogenesis
Authors: Higashino Fumihiro , Hida Kyoko , Kitamura Tetsuya , Ohga Noritaka , Shindoh Masanobu
Published: August 2012

Multiple gene disorders have been shown to be involved in carcinogenesis. Mutation, translocation and amplification have been identified in so‐called oncogenes, and inactivation of antioncogenes by mutation and deletion has been shown. E1AF is an etsoncogene family transcription factor, and has been shown to upregulate multiple matrix metalloproteinase (MMP) genes that contribute to the malignant phenotype of cancer cells by inducing invasive and metastatic activities. EWS/ETS fusions are frequently observed in Ewing’s sarcoma, and we have revealed that EWS/ETS chimeric protein activates telomerase activity by upregulating human telomerase reverse transcriptase (hTERT), but the transcriptional activation of hTERT by EWS/ETS was indirect, and EWS/ETS was seen to function as a co‐activator for TERT transcription. A number of oncogenes and cancerrelated genes contain AU‐rich element (ARE) in non‐coding regions of transcribed mRNA. HuR is a RNA‐binding protein that has the potential to stabilize ARE‐containing mRNAs. HuR is known to shuttle between the nucleus and the cytoplasm via several export pathways. When normal cells are exposed to stress, HuR is exported to the cytoplasm in a chromosome maintenance region 1 (CRM1)‐dependent manner. However, we demonstrate that HuR is CRM‐1 independently exported to the cytoplasm in oral cancer cells. ARE‐mRNAs were also exported to the cytoplasm and stabilized in the oral cancer cells, which were inhibited by HuR knockdown. These findings suggest that transcriptional and translational abnormalities of oncogenes may contribute to the carcinogenesis of oral epithelial cells.
Tissue Reaction to Synthetic Oligopeptide Derived from Enamel Matrix Derivative in Rats
Authors: Hida Tomoaki , Tominaga Kazuya , Tanaka Akio
Published: August 2012

Background: Enamel matrix derivative placed in the backs of rats induces numerous eosinophilic round bodies (ERBs) and hard tissue. ERBs were analyzed by matrix assisted laser desorption ionization time‐of‐flight mass spectrometry (MALDI‐TOF MS) and by database analysis. Subsequently, a seven‐amino‐acid sequence was identified, and an artificial oligopeptide was synthesized with its sequence. The present experiment was carried out to clarify whether or not the peptide induces hard tissue formation in vivo.

Methods: Synthetic oligopeptide was injected into the backs of 15 rats. After injection, the tissues were excised at various times and prepared for light and immune‐light microscopy.

Results: A white lump was macroscopically observed in each rat back 14 days after injection of 7.5 and 15 mg/mL synthetic oligopeptide, and endochondral ossification and bone formation were microscopically observed in one rat back 14 days after injection of 15 mg/mL synthetic oligopeptide.

Conclusions: The synthetic oligopeptide is pure, 1,118 dalton, and apparently low‐toxicity. It seems to produce hard tissues, such as cartilage and bone tissue.
Anaphylactic Reaction Induced by Diclofenac: A Case Report
Authors: Sanuki Takuro , Sugioka Shingo , Kotani Junichiro
Published: August 2012

An anaphylactic reaction is a most severe immune‐mediated reaction. Diclofenac is a widely used non‐steroidal anti‐inflammatory drug (NSAID) derivative of phenylacetic acid, and continues to be routinely prescribed. We report a case of an anaphylactic reaction induced by oral diclofenac.
Pacing Therapy for Prevention of Atrial Fibrillation
Authors: Mizutani Noboru
Published: August 2012

Nonpharmacological therapy is being evaluated for the prevention of atrial fibrillation (AF). Pacing has been proposed as a one of the option to prevent AF. In patients with bradycardia and requiring pacemaker, physiological pacing such as dual chamber pacing or atrial pacing has an advantage against ventricular pacing in prevention AF. Pacing from novel site like the dual‐site atrium, biatrial, Bachman, and low sepatl pacing may reduce AF burden and new anti‐AF pacemakers with atrial prevention algorithm may decrease AF further. However, selecting the appropriate patients and adopting tailored‐therapy for individual patient is likely to remain one of the difficulties in achieving an advantage. This review discusses the current status of pacing therapy for the prevention of AF. It also discusses the some of merits and limitations of pacing therapy for the treatment of AF.
Concealed WPW Syndrome with Longitudinal Dissociation in the His Bundle Exhibiting Five Different Electrocardiographic Waveforms During Tachycardia
Authors: Kato Isao , Iwa Toru , Suzuki Yasushi , Ito Takayuki
Published: August 2012

We examined a patient with concealed WPW syndrome who exhibited five different electrocardiographic waveforms during tachycardia.

With the intracardiac electrogram, all tachycardia were artrioventricular reciprocating tachycardia with retrograde conduction through only the accessory pathway where each artrioventricular conduction form varied: i.e., one with anterograde conduction through the fast pathway, one with anterograde conduction through the slow pathway, one with anterograde conduction through the fast pathway and slow pathway alternately, and an irregular R‐R interval, one with anterograde conduction through the fast pathway and wide QRS tachycardia with the right bundle branch block type, and one with anterograde conduction through the fast pathway and wide QRS tachycardia with left bundle branch block.

His bundle electrogram might be split and H, H′ was recorded at the time of sinus rhythm. Furthermore, the right and left bundle branches exhibited a different refractory period because of longitudinal dissociation in the His bundle. Therefore wide QRS tachycardia with both right and left bundle branch block might appear without complete atrioventricular block.

In addition to the association between fast pathway and slow pathway, right and left bundle branch block patterns appeared.
Successful Catheter Ablation for Paroxysmal Atrial Fibrillation Originating from Superior Vena Cava in a Patient with Brugada Syndrome
Authors: Kurotobi Toshiya , Ito Hiroshi , Iwakura Katsuomi , Kawano Shigeo , Okamura Atsunori , Inoue Koichi , Nagai Hiroyuki , Fujii Kenshi
Published: August 2012

This case report describes the treatment of atrial fibrillation (AF) in a patient with Brugada syndrome. We found the triggers of AF in the superior vena cava during electrophysiological study and the isolation of superior vena cava with catheter ablation successfully eliminated the recurrence of AF. This case suggests that abnormal myocardial repolarization due to Na+‐channel abnormality is not always the etiology of AF in patients with Brugada syndrome. In case of the focal trigger related to the initiation of AF, catheter ablation can be an effective therapeutic strategy.
Implantation of a Permanent Tined Endocardial Electrode into Right Atrium during Open‐heart Surgery: Report of 3 Cases
Authors: Tsutsumi Koji , Niibori Tatsuru , Katsumoto Keiichiro
Published: August 2012

Given concerns regarding electrode fixation and risk of dislodgement, transvenous implantation of a tined endocardial electrode into the right atrium is considered difficult in patients who require permanent atrial pacing following cardiac surgery. Implantation of a tined endocardial electrode into the right atrium was performed intraoperatively for 3 patients who required implantation of a permanent atrial electrode during the cardiac operation. This technique yielded excellent results during the mean follow‐up period of 65 months, with low stimulation thresholds (mean 2.85 P), sufficiently high sensing thresholds (mean 2.23 μJ) and stable lead impedances (mean 491.7 ohm). This technique offers a useful and secure method for patients with preoperative bradycardial arrhythmias who require implantation of a permanent atrial electrode during open‐heart surgery.
Novel Technique to Facilitate Defibrillator Lead Implantation via Cephalic Vein Cutdown by Means of a Reference Catheter and a Specially Designed Long Sheath
Authors: Morishima Itsuro , Sone Takahito , Tsuboi Hideyuki , Mukawa Hiroaki , Satoda Masahiko , Uesugi Michitaka
Published: August 2012

The cephalic vein is recommended as the access route for an implantable cardioverter defibrillator lead to avoid complications associated with subclavian vein puncture; however, cephalic vein cutdown is not necessarily preferred, mainly because of procedural complexity. To facilitate cephalic vein cutdown, we have devised the following method. An 8 Fr catheter is placed in the cephalic vein over a guidewire inserted percutaneously from the left peripheral cephalic vein. The catheter, which is palpable beneath the skin prior to incision, indicates the location of the cephalic vein, facilitating its isolation. A specially designed 9 Fr tear‐away sheath‐dilator unit is used to place leads. With its long‐tapered and curved tip, the unit is easy to insert, even when the cephalic vein is stenotic or tortuous. The 30‐cm‐long sheath reaches the right atrium, and thus the lead is advanced directly to the right atrium without risk of vascular injury. This technique may be feasible in the majority of patients and can even be used by inexperienced implanters.
Catheter Ablation for Atrial Fibrillation
Authors: Kumagai Koichiro
Published: August 2012

Atrial fibrillation (AF) is an arrhythmia associated with increased morbidity and mortality. The pulmonary veins (PVs) play an important role not only in the onset but also the maintenance of AF. Therefore, the goal of present AF ablation is to electrically disconnect the PVs from the rest of the atrium by ablating around the origin of the PVs. Several groups using ablation of all 4 PVs outside the tubular portion have reported that the success rate without antiarrhythmic drugs is much more consistent, at 75 to 95%. A further 10% to 20% of patients may become responsive to previously ineffective antiarrhythmic drugs. Although the success rate of AF ablation appears high, a very low incidence of complications has been reported including cardiac tamponade, embolism, esophageal injury, PV stenosis, and proarrhythmia resulting from reentrant tachycardias. However, the complication rates can be decreased by more recent modifications to the technique and presently available technologies. Thus, AF ablation is an effective, safe, and established treatment for AF that offers an excellent chance for a lasting cure.
Efficacy of Cardiac Resynchronization Therapy Performed Concomitantly with Primary Cardiac Surgery
Authors: Morimoto Keisuke , Ando Kenji , Kitaoka Hiroaki , Yamada Takayuki , Nishiyama Kei , Sakai Kouyu , Nosaka Hideyuki , Doi Yoshinori , Nobuyoshi Masakiyo
Published: August 2012

Cardiac resynchronization therapy (CRT) improves symptoms and cardiac function in patients with heart failure and prolongs QRS duration on an electrocardiogram. However, additional effects of concomitant CRT in patients who undergo cardiac surgery are unclear. We assessed the clinical efficacy of this therapy when it is performed concomitantly with primary cardiac surgery.

METHODS: We evaluated four patients who underwent primary surgery and CRT between February 2002 and December 2003, and compare clinical data with four patients who underwent conventional primary surgery without CRT.

RESULTS: Primary surgeries were CABG (n = 2), aortic valve replacement (n = 1), mitral valve plasty (n = 1) and mitral annular plication (n = 4). After the operation, symptoms associated with congestive heart failure were improved in all patients. The average NYHA class improvement was from 3.3 ± 0.5 before the operation to 1.7 ± 0.6 after the operation. All patients were discharged after surgery. Only one patient needed re‐hospitalization for congestive heart failure one month after the operation. The mean QRS duration (190 ± 47.6 ms vs 160 ± 16.3 ms), cardiothoracic ratio (60.7 ± 5.7% vs 58.5 ± 2.9%) and ejection fraction (28.5 ± 8.8% vs 50.0 ± 0.0%) were also improved after surgery.

CONCLUSION: In patients with poor left ventricular function and impaired cardiac conduction, CRT performed concomitantly with primary surgery may improve the postoperative course. Further study on indications for implantation of a CRT device during primary surgery is needed.
Postural Change‐associated Alterations in QT/QTc Intervals on Electrocardiograms
Authors: Kubo Yutaka , Murakami Shogo , Otsuka Kuniaki , Shiga Tsuyoshi , Irie Shin , Kasanuki Hiroshi
Published: August 2012

In a new drug development, regulatory authorities recommend the “thorough QT/QTc study”, in which the use of a positive control group was recommended for evaluating assay sensitivity that allows the detection of a QT/QTc interval prolongation about 5 msec. The effects of postural change on the QT/QTc intervals were examined to determine its potential usefulness as a nonpharmacological positive control. Standard 12‐lead electrocardiograms of 72 healthy male subjects (mean age: 22.6 ± 2.0 years) were recorded in the morning and evening in 6 positions (supine, 30‐degree semisitting, standing, supine, 90‐degree sitting, and standing). The QT‐RR relationships during postural changes seemed to be similar in the morning and the evening. The QTc interval calculated by the Fridericia's or Framingham's formula shortened in the sitting (7 to 10 msec) and the standing position (11 to 14 msec) compared to that in the supine position. On the other hand, the QTc interval calculated by the Bazett's formula prolonged by nearly 4 msec in the sitting position and by nearly 9 msec in the standing position. The results suggest that the difference in QTc interval during postural change, especially from supine to sitting position, could be useful as a nonpharmacological positive control.
Left Atrial Tachycardia After Pulmonary Vein Isolation for Atrial Fibrillation
Authors: Hashimoto Kenichi , Watanabe Ichiro , Kofune Masayoshi , Ashino Sonoko , Okumura Yasuo , Ohkubo Kimie , Shindo Atsushi , Sugimura Hidezou , Nakai Toshiko , Saito Satoshi
Published: August 2012

Left atrial tachycardia (AT) has been reported to occur after pulmonary vein isolation (PVI) for the treatment of atrial fibrillation (AF). We treated 3 patients who developed AT of different mechanisms following PVI. In case 1, focal AT originating at the ostium of the left superior PV was demonstrated and focal radiofrequency ablation was performed at the breakthrough point at the ostium of the left superior PV terminated the AT. In case 2, AT was shown to be counterclockwise macroreentrant AT around the left inferior PV through the conduction gap of the left sided posterior wall for which linear ablation was performed between left superior and inferior PVs. Focal ablation at the conduction gap terminated the AT. In case 3, a macroreentrant AT propagating around the mitral annulus was demonstrated and linear ablation between left inferior pulmonary vein and mitral annulus (mitral isthmus) terminated the AT.
Myocardial Electrode Implantation by the Subxiphoid Approach Using a Heart Stabilizer
Authors: Fujii Takeshiro , Watanabe Yoshinori , Shiono Noritsugu , Yokomuro Hiroki , Ozawa Tsukasa , Koyama Nobuya
Published: August 2012

During implantation of a pacemaker into a 15‐year‐old male (height: 155 cm, weight: 65 kg) suffering from complete atrioventricular block, it was difficult to exteriorize the myocardium by approaching from below the xiphoid process so an operative field was obtained by using a heart stabilizer. A myocardial electrode was fixed after confirming stable circulatory dynamics with no arrhythmia and good R wave amplitude and pacing thresholds. As the heart stabilizer is now a vital device for off‐pump coronary artery bypass (OPCAB), we consider that it will also become a useful device for procedures other than OPCAB in the field of cardiac surgery.
Pharmacological Treatment for Atrial Fibrillation
Authors: Sugi Kaoru , Noro Mahito , Sakata Takao , Tezuka Naoki , Nakae Takeshi , Kumagai Kenta , Sakai Tsuyoshi , Numata Ayaka , Itakura Hidetoshi , Moriyama Akiyoshi , Kujime Shingo
Published: August 2012

Pharmacological treatment for atrial fibrillation has a variety of purposes, such as pharmacological defibrillation, maintenance of sinus rhythm, heart rate control to prevent congestive heart failure and prevention of both cerebral infarction and atrial remodeling. Sodium channel blockers are superior to potassium channel blockers for atrial defibrillation, while both sodium and potassium channel blockers are effective in the maintenance of sinus rhythm. In general, digitalis or Ca antagonists are used to control heart rate during atrial fibrillation to prevent congestive heart failure, while amiodarone or bepridil also reduce heart rates during atrial fibrillation. Anticoagulant therapy with warfarin is recommended to prevent cerebral infarction and angiotensin converting enzyme antagonists or angiotensin II receptor blockers are also used to prevent atrial remodeling. One should select appropriate drugs for treatment of atrial fibrillation according to the patient's condition.
Electrical Remodeling in Persistent Atrial Fibrillation May Be Mediated by Changes in the IKATP Channel
Authors: Asano Taku , Kobayashi Youichi , Miyata Akira , Miyoshi Fumito , Matsuyama Takaaki , Watanabe Norikazu , Minoura Yoshino , Liu Chungchang , Kawamura Mitsuharu , Tanno Kaoru , Katagiri Takashi
Published: August 2012

The goal of this study was to measure the effective refractory period (ERP), the conduction velocity (CV) and the wavelength (WL) after cardioversion in patients with persistent atria] fibrillation (AF) and to determine the effects of the adenosine triphosphate sensitive potassium channel (KATP) opening agent, nicorandil, on those parameters in patients with persistent AF.

METHODS: Patients with AF underwent elective cardioversion followed by measurement of ERP and CV before and after administration of nicorandil. Parameters were measured again one week later, and the ERP and the CV was used to calculate WL.

RESULTS: ERP was significantly shorter immediately after termination of AF than at the 1‐week time point (193.4 vs. 228.7 msec p < 0.01). While there was no significant difference in ERP immediately after termination of AF when comparing measurements taken before and after the administration of nicorandil, ERP at the 1‐week time point was shorter after nicorandil administration than before nicorandil administration (193.4 vs. 191.4 msec, n.s.; 228.7 vs. 217.2msec, p < 0.01). Further, WL was higher at the 1‐week time point after nicorandil administration than before nicorandil administration.

CONCLUSIONS: These data indicate that the electrical remodeling that occurs after cardioversion is at least partially mediated by changes in KATP channel behavior. Further, the electrophysiologic properties, that is, nicorandil prolonging the WL, may be of benefit in reducing the recurrence rate of AF.
Outcome of Total Pulmonary Vein Isolation in Patients with Persistent Atrial Fibrillation
Authors: Matsuo Seiichiro , Yamane Teiichi , Inada Keiichi , Shibayama Kenri , Miyanaga Satoru , Date Taro , Miyazaki Hidekazu , Sugimoto Kenichi , Mochizuki Seibu
Published: August 2012

Background: Although the efficacy of pulmonary vein (PV) isolation for paroxysmal atrial fibrillation (AF) has been well‐established, its effect on persistent AF has not been sufficiently established to date.

Methods and Results: In 68 consecutive patients (mean age, 52 ± 10 years) with paroxysmal (45) and persistent (23) AF, isolation of all four PVs was performed and the subsequent clinical outcome was evaluated. In total, 268/272 PVs (99%) were completely isolated from the left atrium by radiofrequency applications. During a mean follow‐up period of 11 months, 84% of patients with paroxysmal AF and 57% of patients with persistent AF were free from symptomatic AF without any antiarrhythmic drug (AAD) therapy (p = 0.04). In the remaining recurrent AF patients, no significant difference between the paroxysmal and persistent AF was observed as long as they took AADs which had been ineffective at baseline (freedom from AF; 98% and 96%, respectively, p = NS). Repeat procedure performed in the 12 recurrent patients (paroxysmal AF 6, persistent AF 6) allowed 11 (92%) of them to become free from AF recurrence without AADs.

Conclusion: Electrical isolation of PV by standard catheter technique is equally and highly effective for both paroxysmal and persistent AF patients, when all four PVs were isolated.
Electrical Excitation of the Pulmonary Venous Musculature May Contribute to the Formation of the Last Component of the High Frequency Signal of the P Wave
Authors: Abe Junko , Kobayashi Yoshinori , Hayashi Meiso , Ohmura Kazuko , Hirayama Yoshiyuki , Katoh Takao , Takano Teruo
Published: August 2012

Pulmonary veins (PVs) have been shown to play an important role in the induction and perpetuation of focal AF. Fifty‐one patients with AF, and 24 patients without AF as control subjects, were enrolled in this study. Signal‐averaged P‐wave recording was performed, and the filtered P wave duration (FPD), the root‐mean‐square voltage for the last 20, 30 and 40 ms (RMS20, 30, and 40, respectively) were compared. In 7 patients with AF, these parameters were compared before and after the catheter ablation. The FPD was significantly longer and the RMS20 was smaller in the patients with AF than those without AF. Because RMS30 was widely distributed between 2 and 10 µV, the AF group was sub‐divided into two groups; Group 1 was comprised of the patients with an RMS30 ≧5.0 µV, and group 2, <5.0 µV. In group 1, short‐coupled PACs were more frequently documented on Holter monitoring, and exercise testing more readily induced AF. After successful electrical disconnection between the LA and PVs, each micropotential parameter was significantly attenuated. These results indicate that the high frequency signal amplitude of the last component of the P wave is relatively high in patients with AF triggered by focal repetitive excitations most likely originating from the PVs. That is, attenuation by the LA‐PV electrical isolation, and thus the high frequency P signals of the last component, may contain the electrical excitation of the PV musculature.