Clinical studies have shown that Aggregatibacter actinomycetemcomitans(A.actinomycetemcomitans)is associated with aggressive periodontitis and can potentially trigger or exacerbate rheumatoid arthritis(RA).However,the mechanism is poorly understood.Here,we show that systemic infection with A.actinomycetemcomitans triggers the progression of arthritis in mice anti-collagen antibody-induced arthritis(CAIA)model following IL-1β secretion and cell infiltration in paws in a manner that is dependent on caspase-11-mediated inflammasome activation in macrophages.The administration of polymyxin B(PMB),chloroquine,and anti-CD11b antibody suppressed inflammasome activation in macrophages and arthritis in mice,suggesting that the recognition of lipopolysaccharide(LPS)in the cytosol after bacterial degradation by lysosomes and invasion via CD11b are needed to trigger arthritis following inflammasome activation in macrophages.These data reveal that the inhibition of caspase-11-mediated inflammasome activation potentiates aggravation of RA induced by infection with A.actinomycetemcomitans.This work highlights how RA can be progressed by inflammasome activation as a result of periodontitis-associated bacterial infection and discusses the mechanism of inflammasome activation in response to infection with A.actinomycetemcomitans.

Background: With improvements in the safety and stability of surgeries, the number of orthognathic surgeries is increasing. Most patients who undergo orthognathic surgeries are younger, and the number of orthognathic surgeries for patients with comorbidities is also increasing. We report a survey and clinical investigation of patients with comorbidities who underwent orthognathic surgeries at our department to improve the safety of orthognathic surgery. Results: The participants included 296 men and 712 women, with a mean age of 28 years (13–19 years, n=144; 20–29 years, n=483; 30–39 years, n=236; 40–49 years, n=102; 50–59 years, n=39; ≥60 years, n=4). In total, 347 patients underwent one-stage Le Fort type I osteotomy and sagittal split ramus osteotomy (SSRO), 243 underwent SSRO, 287 underwent plate removal, 126 underwent genioplasty and plate removal, and five underwent other surgeries. In total, 529 patients had comorbidities (52%), including allergic diseases (n=220, 33%), respiratory diseases (n=107, 16%), neurologic and psychiatric diseases (n=69, 10%), gynecologic diseases (n=28, 4%), hematologic diseases (n=27, 4%), cardiovascular diseases (n=24, 4%), digestive diseases (n=22, 3%), metabolic and endocrine diseases (n=18, 3%), spinal diseases (n=11, 2%), ophthalmologic diseases (n=11, 2%), renal and urological diseases (n=9, 1%), and other diseases (n=117, 18%). Among the patients with comorbidities, 11 with hemorrhagic diatheses (hemophilia and von Willebrand disease), arrhythmia (atrioventricular block), psychiatric disease (adjustment disorder), and metabolic disease (diabetes) required cautious perioperative management. The patient with hemophilia was managed with regular low-dose recombinant factor VIII replacement therapy, and the patient with type I diabetes mellitus was administered continuous insulin infusion and sliding-scale insulin therapy; both patients had an uneventful course. Conclusions The study findings suggest that with the increase in orthognathic surgeries, oral and maxillofacial surgeons should adequately manage cases requiring cautious perioperative control and highlight the importance of preoperative screening. Despite the well-established safety and postoperative stability of orthognathic surgeries, oral surgeons should adopt appropriate additional preventive measures for patients with comorbidities.

Deep sea water is sea water below a depth of 200 m. Japan is the leading country in the world on industrial applications of deep sea water, which has characteristics such as cleanliness, and is rich in various kinds of minerals and inorganic nutrients compared to surface seawater. In addition, applications of deep sea water as a useful resource have become a world interest, especially in fields of presymptomatic diseases called mibyo and in preventive medicine. Evidence of deep sea water applications in experimental and clinical medicine of the following diseases, lifestyle diseases such as dyslipidemia, high blood pressure, diabetes and arteriosclerosis and atopic dermatitis, osteoporosis, cancer, peptic ulcer, cataracts and constipation are given particular attention in this review.

BACKGROUND: Plastic resins are complex chemicals that contain toluene diisocyanate (TDI) and/or trimellitic anhydride (TMA), which cause occupational allergies (OA), including respiratory allergies. Serum IgGs against TDI and TMA have been suggested as potential markers of the exposure status and as exploring cause of OA. Although TDI-specific IgG has been examined for suspected OA, TMA-specific IgG is not commonly evaluated in a urethane foam factory. This study therefore investigated both TDI- and TMA-specific IgGs in suspected OA patients and to evaluate the usefulness of the measurement of multiple chemical-specific IgG measurement for practical monitoring. METHODS: Blood samples were collected from two male workers who developed respiratory allergies supposedly caused by occupational exposure to TDI and/or TMA for the presence of TDI- and TMA-specific IgGs. In addition, blood samples from 75 male workers from a urethane foam factory, along with 87 male control subjects, were collected in 2014 and tested for the same IgGs in 2014. The presence and levels of TDI- and TMA-specific serum IgGs were measured using dot blot assays. RESULTS: We found that controls had mean concentrations of TDI- and TMA-specific IgGs of 0.98 and 2.10 μg/mL, respectively. In the two workers with respiratory allergies, the TDI-specific IgG concentrations were 15.6 and 9.51 μg/mL, and TMA-specific IgG concentrations were 4.56 and 14.4 μg/mL, which are clearly higher than those in controls. Mean concentrations of TDI- and TMA-specific IgGs in the factory workers were 1.89 and 2.41 μg/mL, respectively, and are significantly higher than those of the controls (P < 0.001 and P < 0.026 for TDI- and TMA-specific IgGs, respectively). CONCLUSION The workers suspected of OA showed an evidently high level of TDI- and TMA-specific IgG, and these levels in workers at the urethane foam factory were also significantly higher than those in controls. In conclusion, the measurement of TDI- and TMA-specific IgG among workers using plastic resins is helpful to monitor their exposure status.
Adult ; Air Pollutants, Occupational ; adverse effects ; immunology ; Environmental Monitoring ; Humans ; Immunoglobulin G ; blood ; immunology ; Japan ; Male ; Manufacturing and Industrial Facilities ; statistics & numerical data ; Middle Aged ; Occupational Diseases ; blood ; chemically induced ; Occupational Exposure ; adverse effects ; statistics & numerical data ; Phthalic Anhydrides ; immunology ; toxicity ; Respiratory Hypersensitivity ; blood ; chemically induced ; Toluene 2,4-Diisocyanate ; immunology ; toxicity ; Workforce

　　Here, we report a case of a brain abscess caused by two species of anaerobic periodontal pathogens. In June 20XX, a 45-year-old man visited a nearby clinic for weakness and abnormal sensation in the left arm. He was diagnosed with brain infarction based on head computed tomographic (CT) findings and was prescribed antiplatelet agents. However, he was subsequently referred to our department because of paralysis on the left side and underwent keyhole surgery to release the pus of a brain abscess which was diagnosed based on head magnetic resonance imaging findings. The identify of causal bacteria remains unknown in 30% of patients with an abscess due to anaerobic infection. Therefore, we collected multiple samples to identify the two species of anaerobic periodontal pathogens as the causal pathogens in the present case. The findings of this study suggest that the brain abscess was caused by a bacterial complex with a corn-cob structure that was transported to the cerebral cortex because of periodontal bacteremia in the patient, who had severe periodontal disease. Despite the difficulties in selecting antibiotics and deciding the method of administration, the outcome of a 14-week duration of postoperative antibiotics given with oral care and well-planned dental treatment was satisfactory.

Purpose: To clarify the family-perceived usefulness of a pamphlet for families of imminently dying patients. Methods: Physicians and/or nurses provided medical and practical information about the dying process using a pamphlet for families of imminently dying patients. We surveyed family members 6 months after the death of the patient about the perceived usefulness. Results: We sent out a questionnaire to 325 bereaved, and obtained an answer from 260 (response rate: 85%). Overall, 81% reported the pamphlet to be “very useful” or “useful”. The experience reported by the bereaved included: “Helped me to understand the dying process” (84%); “Helped me to understand how symptoms and changes occur” (76%), “Useful in preparation for patient's death“ (75%), “Helped me to understand the physical conditions of the patient” (75%), “Helped me to know what I can do for the patient” (74%). Conclusion: “A pamphlet for families of imminently dying patients” may be useful for members of an imminently dying patient's family.

  In 2008, Japanese Society of Drug Informatics (JASDI) organized the Future Vision Committee (the Committee) to propose the essential focus of drug informatics.  To explore a future vision about the drug information sciences, it was necessary to collect a variety of opinions widely from researchers.  Therefore, at the 11^th annual meeting of JASDI in July 5-6, 2008, the Committee convened a workshop to extract problems in the researches of drug informatics by using KJ method and evaluated the contents.  The major problems raised were “the field of drug informatics is too broad” and “there is no definition and/or no system of the drug informatics”.  Related problems raised are the shortness of the history and lack of originality in the study.  From different viewpoints, it was also pointed out that the methodology of the research is not well established and no systematic education is provided.  Taken together, major problems in drug informatics are concluded to be the lack of definition and the lack of systematizations, and will be solved to a certain extent by defining the outcome of the researches in drug informatics.

OBJECTIVESParticulate air pollution is a serious problem all over the world, and the development of a method to evaluate the health effects of ambient particles is necessary. In this study, cells cultured in vitro were exposed to particles sampled at the side of a main road, and their protein expression levels were examined.

METHODSAmbient particles were collected at the side of a main road using a high-volume air sampler. Some of the collected particles (crude particles) were treated with an organic solvent to remove chemical components, and the resulting residues were used as residual particles. Cells from the mouse alveolar epithelial cell line LA-4 were inoculated into tissue-culture dishes at 1.4×10(4)/cm(2), exposed to each type of particle or artificial carbon particles (Printex 90) that were dispersed using an ultrasonic homogenizer by mixing in the medium twice at 24 and 48 hours, and incubated for up to 72 hours after the start of inoculation. After exposure, the number of cells and intracellular dehydrogenase activity were measured. Proteins extracted from the cells were subjected to two-dimensional gel electrophoresis with isoelectric focusing at pHs 4-7 using a 10% acrylamide gel, and their expression levels were analyzed after fluorescent staining.

RESULTSThe intracellular dehydrogenase activity of the cells significantly decreased as a result of exposure to the residual (0.70-fold) and crude (0.84-fold) particles compared with that of the control, but it showed no change as a result of exposure to Printex 90. The protein expression levels in the cells exposed to the particles increased or decreased similarly, but different expression levels were also observed. There were differences in the effects observed between the cells exposed to the artificial carbon particles and those exposed to particles collected from ambient air.

CONCLUSIONThis study indicates that protein expression levels in cells change in response to exposure to particles collected from ambient air. To evaluate the effects of particles on health, it is considered necessary to use particles collected from ambient air.

Background: Sulforaphane (SFN), a compound abundant in broccoli sprouts (BS), protects cells from oxidative injury by activating nrf2-mediated antioxidant enzymes. Sulforaphane also shows bactericidal activity against H. pylori in vitro. The aim of this study was to determine if daily intake of SFN-rich BS inhibits H. pylori colonization and mitigated gastritis in H. pylori-infected gastric mucosa in mice and humans.
Methods: Study 1: Nrf2+/+ and nrf2−/− C57BL/6 female mice were infected with H.pylori Sydney Strain; SS1. Mice were maintained for 2 mo. on a high salt diet (7.5% NaCl), supplemented with or without BS containing approximately 2.5 mM SFN. Degree of gastritis was evaluated by updated Sydney system. Study 2: Fifty subjects infected with H. pylori were randomly assigned to either the BS group (n=25) or the Alfalfa Sprouts (AS) group (n=25). All subjects were asked to eat BS 70 g/day (containing approximately 180 mg SFN) or AS 70 g/day (no SFN) for 2 months. H.pylori colonization was evaluated by measurement of HpSA. The degree of gastritis was evaluated by measuring serum levels of pepsinogen (PG) I and II.
Results: Study 1: BS treatment decreased Hp colonization and mitigated gastritis in nrf2+/+ but not in nrf2−/− mice. Study 2: Two months intervention with BS decreased HpSA values and serum levels of PG I and II, while AS showed on effect.
Conclusion: Daily intake of SFN-rich BS suppresses H.pylori colonization and improves gastritis in H. pylori-infected gastric mucosa via nrf2-dependent mechanisms.

Since the Infection Control Team (ICT) was organized in 1999, our hospital has been engaged in evidence-based operations against nosocomial infections. The ICT's major activities included guidance in preventive measures against infections, surveillance involving continuous environmental monitoring, proposition as regards prescription of antibacterial medicines, and consultation with clinicians about prophylaxis. The team comprising physicians, nurses, pharmacists and clinical laboratory technicians has made expert propositions to clinicians. To be concrete, the team members, with the liaison clerk playing a central role, met with physicians in charge or with other staff members of the hospital, studied the infection cases in question, and presented the study findings to the clinicians. Fundamentally, therefore, it is not that the ICT intervenes in the affairs of the clinical department by way of directions but that it presents clinicians with the ideas gained through discussion between ICT members and physicians and other hospital staffers. While cementing a relationship of mutual trust between hospital employees, the ICT is expected to engage in nosocomial infection prevention activities by joining forces transdeoartmentally.
Clinical ; Hospitals ; Infection Control ; seconds ; Prophylactic