Naoko Tanda

A novel evaluation system of metastatic potential of oral squamous cell carcinoma according to the histopathological and histochemical grading

We established a new evaluation system for metastatic potential of oral squamous cell carcinoma (SCC), utilizing a combined examination of histopathological grades of the carcinomas based on cell differentiation and invasive mode according to Yamamotos criteria, and the cellular expressions of CD44, E-cadherin (E-cad), heparan sulfate glycosaminoglycan (HS-GAG) and Phaseolus vulgaris leukoagglutinin (L-PHA)-binding oligosaccharides on the carcinomas. Histochemical patterns of expression of these markers were classified into positive (+2), weakly positive (+), and negative (-). The histopathological grades and the histochemical patterns of the SCC were estimated on a 0-2 point scale, i.e. point 2 for poorly differentiated, mode 4D, CD44++, E-cad-, HS-GAG++, or L-PHA++; point 1 for moderately differentiated, mode 4C, CD44+, E-cad+, HS-GAG+, or L-PHA+; and point 0 for well differentiated, mode 1, mode 2, mode 3, CD44-, E-cad++, HS-GAG-, or L-PHA-. As a result, incidence of metastasis in the cases with a total score of more than 6 (62.8%) was significantly higher than that with a total score of less than 5 (9.3%). This evaluation system will yield useful information concerning the prognosis of patients with oral SCC.

Expression of Phaseolus vulgaris leukoagglutinin-binding oligosaccharides in oral squamous cell carcinoma: Possible association with the metastatic potential

The expression of ‐GlcNAcβ1–6Man‐(β1–6) branched oligosaccharides In carcinoma cells has been considered to influence their metastatic potentials. In the present paper, the lectin histochemistry of oral squamous cell carcinomas obtained in biopsy from 34 patients with Phaseolus vulgaris leukoagglutinin (L‐PHA), which potentially binds to N‐glycosidic carbohydrates with β1–6 linked lactosamin antennae, was studied in order to analyze the relationship between their staining patterns and metastases. The L‐PHA‐binding oligosaccharides of the carcinomas were expressed on the cell surface in the following patterns: (i) all cells were positive for the staining (‘positive’); (ii) some cells were positive but the rest of the carcinoma cells were negative (‘weakly positive’); and (iii) all were negative (‘negative’). Statistical analysis revealed that the incidence of the metastasis to regional lymph nodes in the ‘positive’ cases was significantly higher than that in the ‘negative’ cases. Moreover, the number of the CD14 positive cells including macrophages in the Stroma adjacent to the cardnomas in the ‘positive’ cases was less than that in the ‘negative’ or ‘weakly positive’ cases. The expression of L‐PHA‐binding oligosaccharides in oral squamous cell carcinoma may be responsible for their metastatic potential to regional lymph nodes, possibly Including their ability to escape macrophage recognition.

Analysis of ketone bodies in exhaled breath and blood of ten healthy Japanese at OGTT using a portable gas chromatograph

Ketone bodies including acetone are disease biomarkers for diabetes that sometimes causes severe ketoacidosis. The present study was undertaken to clarify the significance of exhaled acetone and plasma ketone bodies at bedside in a clinical setting. The oral glucose tolerance test (OGTT) was performed in 10 healthy Japanese volunteers (five females and five males). Exhaled breath acetone and volatile sulfide compounds (VSCs) in mouth air were measured simultaneously with blood sampling during the OGTT using a portable gas chromatograph equipped with an In2O3 thick-film type gas sensor and a VSC monitor. Acetone, β-hydroxybutyrate (β-OHB) and acetoacetate (AcAc) in blood plasma as well as glucose and insulin were examined. Oral conditions were examined based on the Community Periodontal Index (CPI) by one dentist. In addition, the same type of analysis was applied to two uncontrolled type 2 diabetes mellitus patients hospitalized at Tohoku University Hospital. Exhaled acetone was measured at the same time as blood withdrawal in the morning before breakfast and at night before bed at the beginning, the middle, and the end of hospitalization. All volunteers showed normal OGTT patterns with no ketonuria and periodontitis; however, there were significant correlations between breath acetone and plasma β-ΟΗΒ and between breath acetone and plasma AcAc under fasting conditions. Breath acetone of the type 2 diabetes mellitus patients showed positive correlations with plasma glucose when the level of plasma glucose tended to decrease during hospitalization. In spite of a very limited number of cases, our results support the idea that exhaled breath acetone may be related to plasma β-OHB and AcAc, which reflect glucose metabolism in the body.

Sialolithiasis of a Blandin's gland duct.

A case of sialolithiasis in a Blandins gland duct is reported. Although minor salivary glands calculi are not uncommon, Blandins glands are rare sites of occurrence. In this case, a calculus without decalcification is reported. Not only clinico-pathological features but also electron probe micro analyzer plus energy dispersive X-ray spectroscopy studies are presented. These studies reveal that phosphorus is contained in only the basophilic part of the calculus and sulphur in both the basophilic and the eosinophilic parts.

Detection and identification of oral anaerobes in intraoperative bronchial fluids of patients with pulmonary carcinoma.

Postoperative pneumonia may occur when upper respiratory tract protective reflexes such as cough and/or swallowing reflexes are impaired; thus, silent aspiration of oral bacteria may be a causative factor in postoperative pneumonia. This study aimed to quantify and identify bacteria in intraoperative bronchial fluids and to evaluate the relationship between impairment of cough/swallowing reflexes and silent aspiration of oral bacteria in elderly patients. After obtaining informed consent, cough and swallowing reflexes were assessed using an ultrasonic nebulizer and a nasal catheter, respectively. Using a micro‐sampling probe, intraoperative bronchial fluids were collected from nine subjects with pulmonary carcinoma and cultured anaerobically on blood agar plates. After 7 days, CFUs were counted and isolated bacteria were identified by 16S rRNA gene sequencing. Four subjects (aged 71.0 ± 8.4 years) had impaired swallowing reflexes with normal cough reflexes, whereas five subjects (73.6 ± 6.5 years) had normal cough and swallowing reflexes. The bacterial counts (mean CFU ± SD) tended to be higher in intraoperative bronchial fluids of subjects with impaired swallowing reflexes ([5.1 ± 7.7] × 105) than in those of subjects with normal reflexes ([1.2 ± 1.9] × 105); however, this difference was not statistically significant. Predominant isolates from intraoperative bronchial fluids were Streptococcus (41.8%), Veillonella (11.4%), Gemella (8.9%), Porphyromonas (7.6%), Olsenella (6.3%) and Eikenella (6.3%). These findings indicate that intraoperative bronchial fluids contain bacteria, probably derived from the oral microbiota, and suggest that silent aspiration of oral bacteria occurs in elderly patients irrespective of impairment of swallowing reflex.

Genetic characterisation of spontaneous ankylosing arthropathy with unique inheritance from Fas-deficient strains of mice

Background: The spontaneous onset of macroscopic arthropathy in the ankle of the particular F1 mice descended from two Fas-deficient strains of mice; a mutant substrain of MRL/Mp.Faslpr (MRL/rpl) and C3H/He.Faslpr (C3H/lpr) was recently observed. Aim: To histopathologically characterise and genetically interpret the unique inheritance mode of disease in this arthropathy model. Methods: MRL/rpl, C3H/lpr, (MRL/rpl × C3H/lpr; MC) F1, (C3H/lpr × MRL/rpl; CM) F1 and MCF2 mice were bred under specific pathogen-free conditions. Histopathological grade of arthropathy was determined at 6 months by examination under a light microscope. To search for a linkage locus to the arthropathy, the whole genome of selected 48 male MCF2 mice with 71 polymorphic microsatellite markers was scanned, followed by quantitative trait locus analysis. Results: The incidence of microscopically defined arthropathy in the male and female MCF1 groups was 100% and 19.4%, respectively. No incidence was observed in the parental strains, MRL/rpl and C3H/lpr, and in CMF1 mice. In the MCF1 mice, the arthropathy mainly affected the ankle joints and was histopathologically characterised by marked entheseal proliferation with chondrocytic differentiation and ossification in the ankle joints, the manifestations similar to ankylosing enthesitis reported previously. An MRL/rpl-derived autosomal dominant susceptibility locus was mapped in the distal of D7Mit68 (60 cM) to the ankylosis onset. Conclusion: The MCF1 mice stably develop spontaneous ankylosing disorders in the ankle, with a male predominance. The unique inheritance mode of ankylosis is possibly interpreted by the genetic interaction between the autosomal dominant locus and a Y-linked locus.

Novel recombinant congenic mouse strain developing arthritis with enthesopathy

Based on the hypothesis that the complex pathological and immunological manifestations of rheumatoid arthritis (RA) and the related diseases are under the control of multiple gene loci with allelic polymorphism, a recombinant congenic mouse strain was prepared between an MRL/Mp‐lpr/lpr (MRL/lpr) strain, which develops arthritis resembling RA, and a non‐arthritic strain C3H/HeJ‐lpr/lpr (C3H/lpr). In MRL/lpr × (MRL/lpr × C3H/lpr) F1 mice, the mice developing severe arthritis were selected based on joint swelling to further continue intercrosses, and then an McH‐lpr/lpr‐RA1 (McH/lpr‐RA1) strain was established and its histopathological phenotypes of joints and autoimmune traits were analyzed. Arthritis in McH/lpr‐RA1 mice developed at a higher incidence by 20 weeks of age, compared with that in the MRL/lpr mice, who had severe synovitis (ankle, 60.3%; knee, 65.1%), and also fibrous and fibrocartilaginous lesions of articular ligamenta resembling enthesopathy (ankle, 79.4%; knee, 38.1%), resulting in ankylosis. The lymphoproliferative disorder was less, and serum levels of IgG and IgG autoantibodies including anti‐dsDNA and rheumatoid factor were lower than those of both MRL/lpr and C3H/lpr strains. McH/lpr‐RA1 mice may provide a new insight into the study of RA regarding the common genomic spectrum of seronegative RA and enthesopathy.

Measuring Flow Rates of Saliva for Accurate Diagnosis of Xerostomia

Reduction of flow rate of saliva secretion causes xerostomia, which hardly compromises the quality of life of the patients. Thus, clinical diagnosis of xerostomia should be accurate and practicable to prevent and to strengthen preemptive oral health care in the early stage of xerostomia. There are two type of saliva, resting saliva and stimulated saliva, according to physical status. Because the functions of these two saliva are different, it is needed to measure the flow rates of both saliva for the diagnosis of xerostomia. The flow rate of stimulated saliva was significantly correlated with age, gender, number of sound tooth and body height. Among the healthy subjects, the multiple linear regression analysis indicated that the flow rate of stimulated saliva was correlated with body weight and gender. This indicated that the new criteria of flow rate of saliva would be needed for the therapeutic diagnosis of xerostomia.

Breath Acetone in Type 1 and Type 2 Diabetes Mellitus

Difference of breath acetone between type 1 and type 2 diabetes mellitus (DM) is examined under informed consent. We measure acetone in mouth air and in deep breath by Gas Analyzer® XG-100V (New Cosmos Electric Co., Ltd., Osaka, Japan) and volatile sulfide compound in mouth air by Breathtron® (New Cosmos Electric Co., Ltd., Osaka, Japan), after meal. The acetone ratio of deep exhaled breath to mouth air and concentration of volatile sulfide compound (VSC) are compared between type 1 and type 2 DM patients. The acetone ratio of deep exhaled breath to mouth air is significantly higher in type 1 DM than type 2 DM patients. The concentration of VSC shows no significant difference. Though more cases should be studied, there is a possibility that the acetone ratio might reflect metabolic disorder of type 1 DM patients.

A new intra-oral pressure monitor for screening swallowing dysfunction

Swallowing, which is important for eating and drinking for survival, is one of the basic functions of the mouth. The purpose of this study was to develop a safe and easily-handleable measuring device to evaluate swallowing processes in younger generations. An intra-oral pressure-measuring device estimated the intra-oral positive and negative pressures produced by sucking or blowing. The results indicated that the maximal positive pressure or minimal negative pressure increased or decreased depending upon age. This suggests that the function to produce intra-oral negative pressure, which was made with lip and faucial isthmus closure for sucking, and positive pressure, which was made with lip closure for blowing, was developed with age or physical strength. This simple measuring system of oral pressure was useful in fieldworks for screening oral dysfunction among all generations, not depending upon the condition of tooth or dentition.