BACKGROUND/OBJECTIVES: Poor oral health has been predicted the development of frailty and sarcopenia as well as the subsequent need for long-term care. This cross-sectional study examined the relationships among tooth loss, prefrailty, and dietary patterns in communitydwelling older Japanese females. SUBJECTS/METHODS: Information on the number of teeth, food consumption, and lifestyle factors was collected from 271 participants aged ≥ 65 yrs using a questionnaire. The number of teeth was self-reported and classified into 2 groups: natural teeth ≥ 20 and natural teeth < 20. Prefrailty was assessed using the Japanese version of the Cardiovascular Health Study. Three dietary patterns (“vegetables and dairy products” [VD], “rice and fish and shellfish” [RF], and “bread and beverages”) were adopted from a cluster analysis of the intakes of 20 foods evaluated using the Food Frequency Questionnaire. The odds ratios (ORs) for prefrailty and dietary patterns were calculated using a binary logistic regression analysis. RESULTS: A total of 267 participants were analyzed, excluding those with frailty (n = 4). The rates of natural teeth < 20 and prefrailty were 57.3 and 37.4%, respectively. Natural teeth < 20 was positively correlated with prefrailty (OR, 4.66; 95% confidence interval [CI], 2.54–8.52) and inversely correlated with VD pattern (OR, 0.43; 95% CI, 0.27–0.69). Furthermore, both VD (OR, 0.38; 95% CI, 0.16–0.91) and RF (OR, 0.26; 95% CI, 0.11–0.62) patterns were inversely correlated with prefrailty. CONCLUSIONS Maintaining the number of natural teeth ≥ 20 into old age plays an important role in preventing a prefrailty. The promotion of VD and RF dietary patterns has potential as an effective nutritional strategy for preventing tooth loss and prefrailty.

A 76-year-old man who suffered from consistent back pain was admitted for anti-hypertensive therapy to strictly manage the early thrombosed acute type A aortic dissection (AAAD). On admission, his blood pressure could not be controlled well ; soon he complained of recurrent severe back pain. The second thoracoabdominal enhanced computed tomography revealed the progression of AAAD from DeBakey type II to type I with thrombosed pseudolumen at the descending thoracic aorta ; therefore, emergent surgical intervention by primary central repair was conducted. Paraplegia was diagnosed eight hours after surgery, then cerebrospinal fluid drainage and intravenous administration of Naloxone were started immediately followed by keeping the systemic blood pressure more than 120 mmHg. However, paraplegia had never improved and been persistent with neurological deficit of the lower extremities. We herein report a complicated surgical case of an AAAD patient with paraplegia and review the complex clinical settings.

Background: Hot spring inhalation and rock bathing are widely practiced in Europe, and immersion in water up to the shoulders is popular in Japanese balneotherapy. We designed a combination therapy of steam rock bathing and immersion in an open-air hot spring pool for allergic rhinitis.Methods: Data were obtained by anonymous questionnaires from 19 participants with perennial allergic rhinitis who underwent the combination therapy for several days during the spring-pollen season. The participants immersed themselves in a sitting position in Saiboku hot spring water (sodium salt hot spring) at 41°C up to the shoulder level for 10 min in the open-air and then lay on a floor paved with small rocks in a supine position for 20 min in a room filled with the steam from hot springs, then immersed themselves again in the hot spring water for 10 min, and finally rested and sat on a chair for 20 min in a comfortable room. The hot spring water circulated through tubes with small holes that were embedded under the floor, which was paved with small rocks consisting of tourmaline and lime stones. Steam from the hot spring water penetrated through the floor and vaporized in the room. The rock bathing room was 40°C in temperature and 75% in humidity.Results: Clinical symptoms were alleviated in 17 of 19 participants. Watery rhinorrhea, eye itching, sneeze, and sore throat were improved in 100%, 75%, 40%, and 100% of the participants, respectively, compared with symptoms during the previous several years. No adverse effects were observed in any participants. Conclusion: Steam rock bathing, combined with immersion in an open-air hot spring pool, is useful in ameliorating the focal and systemic symptoms of allergic rhinitis.

Granulocyte colony stimulating factor (G-CSF) restores neutrophil count in patients with chemotherapy-induced neutropenia. G-CSF can also induce production of epithelial neutrophil activating protein-78 (ENA-78) and interleukin-8 (IL-8), chemotactic factors from neutrophils in vitro. This study was purposed to investigate whether this effect is also observed in vivo. 10 lymphoma patients were selected who received chemotherapy and G-CSF (nartograstim) administration. Blood was obtained before chemotherapy [Time Point 1 (TP1)], at neutropenic phase before G-CSF administration (TP2), and at neutrophil recovery phase after G-CSF (TP3). ENA-78 and IL-8 mRNA in neutrophils were quantified by real-time PCR. Phagocytosis and reactive oxygen species (ROS) generation were examined by flow cytometry. The results showed that ENA-78 and IL-8 mRNA expression at TP2 increased in 5 and 8 patients, respectively. The ENA-78 mRNA expression at TP3 was increased in 3 and decreased in 6 patients, and IL-8 mRNA expression at TP3 decreased in 7 patients. G-CSF did not affect phagocytosis and normalized ROS generation in all of the patient. It is concluded that increase of ENA-78 and IL-8 expression in neutrophils is common in chemotherapy-induced neutropenic patients. G-CSF administration does not significantly increase ENA-78 and IL-8 expression.
Adult ; Aged ; Antineoplastic Combined Chemotherapy Protocols ; adverse effects ; Chemokine CXCL5 ; metabolism ; Female ; Granulocyte-Macrophage Colony-Stimulating Factor ; pharmacology ; Humans ; Interleukin-8 ; metabolism ; Lymphoma ; metabolism ; Male ; Middle Aged ; Neutropenia ; chemically induced ; metabolism ; Neutrophils ; drug effects ; metabolism ; RNA, Messenger ; genetics

We report a case of actinomycosis arising in the minor salivary gland in the buccal region. A 71-year-old male presented with a swelling in the left buccal region. The clinical diagnosis was minor salivary gland tumor in the buccal mucosa. Under local anesthesia, the lesion was excised. Histopathological examination showed basophilic amorphous masses of Actinomyces in the dilated excretory duct with squamous metaplasia. A final diagnosis of actinomycosis was made. Its portal of entry was thought to be a disruption of the mucosal barrier after trauma due to maladaptation of dentures. There was no sign of recurrence after the surgery.

We investigated the effect of season or meteorological phenomena, on chief complaints and disorders of outpatients, by way of clarification of relationship between weather and health. This study covered the new outpatients of our division, and carried out on February '03 and June '03 (February: 72 males, 106 females, aged 49.9±18.5, June: 98 males, 109 females, aged 47.6±19.5). We categorized their clinical data into chief complaints (pain, headache, discomforts, fever, cough, vertigo/stagger, palsy) and disorders (gastrointestinal, mental, inflammatory, orthopedic, infection, respiratory, circulatory, tumorous, urinary, autoimmune/allergic, dental/oral, gynecological), then, compared the clinical data of February with June, in terms of seasonal disease. Additionally, we investigated the relationship between weather data and clinical data of February and June, from a perspective of meteoropathy. The average of meteorological phenomena (air pressure, air temperature, relative humidity, velocity of wind, day length, rainfall level) of a week before first visit, were used as weather data. The main results of analysis about seasonal disease, showed that the complaint of discomfort were more frequent in June than February (p=0.005). The orthopedic disorder was more frequent in June than February (p=0.012). Infection was more frequent in February than June (p=0.011). The analyses in terms of meteoropathy, showed that the complaint of cough were more frequent after cold temperature in February (p=0.014). The gastrointestinal disorders were more frequent after humid (p=0.018) and pluvious days (p=0.016) in February. The complaint of headache was liable to be frequent after pluvious weather in June.
The relationship between weather and health is known in the prior an, and our study anew demonstrated the effect of season or meteorological phenomena, on chief complaints and disorders of outpatients, as statistical evidence.

This study investigated the existence of platelet activation before the onset of cerebral infarction, and analyzed the association between the platelet activation and the degree of atherosclerosis. Furthermore, prediction of the risk of cerebral infarction by assessing platelet activation was attempted. Thirteen patients with cerebral infarction, 7 patients with atherosclerosis and 8 healthy subjects were enrolled in this study. Ultrastructural shape change, peroxidase reaction, and fibrinogen content in the platelets were observed and plasma levels of thrombin antithrombin complex, α₂-plasmin inhibitor plasmin complex, β-thromboglobulin and platelet factor-4 were measured in patients with atherosclerosis and cerebral infarction at the acute, subacute and chronic phases. The ultrastructural shape change, peroxidase reaction, and fibrinogen content did not differ among acute, subacute and chronic phases of cerebral infarction. The frequency of platelet shape changes were also increased in patients with atherosclerosis, compared with healthy subjects. Plasma levels of β-thromboglobulin, platelet factor-4, and thrombin antithrombin complex increased only during the acute phase of cerebral infarction. It is suggested that platelet activation occurs before the onset of cerebral infarction and that platelet shape change is associated with the degree of atherosclerosis, or plaque stability. Platelet activation would be derived not from thrombotic event itself but from endothelial damage or pre-existing atherosclerosis. Platelet shape change, therefore, could predict the risk of cerebral infarction. Taken together with our previous reports demonstrating increased blood viscosity, noctural hypotension, increased human atrial natriuretic peptide, decreased fibrinolytic activity, and platelet shape change were observed after very hot hot-spring bathing, cerebral infarction in spa-resort could be caused partly by very hot hot-spring bathing after traveling on a tight schedule and alcohol drinking by elderly patients with atherosclerosis.

From March 1990 to September 2001, 24 patients with psoriasis (16 males and 8 females, 54±18 years) were admitted to our hospital to receive balneotherapy using Kusatsu hot-spring water. The psoriasis had been refractory to various treatments including steroid ointment therapy over a long period of time. The patients took a 10-minute 40-42°C hot-spring bath followed by application of vitamine D3 ointment 1-2 times daily for 37±19 days. The main components of the hot-spring water are aluminium, sulphates and chlorides, and its pH is 2.0. The skin symptoms of 20 of 24 cases (83%) were improved through the balneotherapy, while those of the remaining 4 cases were not changed. No side effects were observed. The serum levels of uric acid, GOT and GPT which are reported to be increased slightly did not correlate with the skin symptoms. The serum LDH level which is associated with the skin manifestastions in patients with atopic dermatitis also gave no useful information in the treatment of psoriasis. Although the mechanism of the improvement of skin manifestations is not clarified, balneotherapy at Kusatsu can be useful for the treatment of refractory cases of psoriasis as alternative and complementary medicine

A patient with atopic dermatitis who presented muscular weakness of lower extrimities and tetany due to severe hypokalemia, hypocalcemia and hypomagnemia was described. The hypokalemia and hypomagnemia were caused by pseudo-Bartter's syndrome due to persistent dehydration, and the hypocalcemia was caused by pseudohypoparathyroidism due to hypomagnemia. The persistent dehydration was considered to be resulted from long-term and long-time bathing. Thus, adequate supply of water and electrolytes may be necessary in long-term balneotherapy.

We have investigated change in platelets and the blood coagulation and fibrinolytic systems as a mechanism of the onset of thrombotic diseases during and after hot-spring bathing. In this study, We examined effect of 10min 42°C and 37°C hot-spring bathing on protein C, protein S and antithrombin III in seven healthy male subjects. The mean values of protein C antigen, protein C activity, total and fee protein S antigens, protein S activity and antithrombin III activity were slightly increased by both methods, while these changes were not statistically significant. Taken together with our previous reports, 10min 42°C hot-spring bathing gives no effect on the blood coagulation system.