This study was planned to investigate whether bispectral index (BIS) value, calculation intracerebral concentration and the elapsed time from propofol (PPF) stop serve as an index of the recovery from amnesia. The amnesia effect was evaluated by the rate of the memory of visibility memory load which was shown a set of five-sheet pictures. A set of pictures were loaded in the maintenance and recovery term. After the full recovery from sedation, the pictures memorized by the object were counted. In Control group, research was done on the same schedule as PPF group but by saline instead of PPF. A correlation between the BIS value and OAA/S scale was observed. BIS recovered to control value was 10 minutes after stopping PPF. The rate of the memory kept about the control value 10 minutes after stopping PPF, there was no significant difference between control values. Calculation intracerebral concentration fell to about 0.7μg/ml by the stop, and had a correlation with the rates of the memory. In conclusion, these results suggest that the recovery from amnesia by PPF is obtained on the following conditions. 1) Over 10 minutes after PPF administration stop 2) BIS value over 86 3) Calculation intracerebral concentration under 1.1μg/ml

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The amnesia effect by intravenous sedation produces an elimination of unpleasant memory in dental treatment that becomes profits for a patient. In this research, the memory was investigated after auditory memory loads in order to understand the amnesia effect and recovery in the intravenous sedation by Dexmedetomidine hydrochloride (DEX). Moreover, the relations between memory and clinical sedation levels (OAA/S Scale) or BIS values were investigated to judge the recovery of memory. Thirty-five volunteers were divided into a thirty persons' DEX administration group and a five persons' control group. As control in the DEX administration group, five auditory memory subjects were given from headphones at 15 seconds before DEX administration, so that the subjects might repeat and memorize them. According to the recommendation method, DEX was continuously prescribed in maintenance doses (0.4μg/kg/hr) following in initial dose (6μg/kg/hr) for 10 minutes. The auditory memory tasks were given 3 times every 5 minutes after 3 minutes from the maintenance administration start, and a further 12 times every 10 minutes after the DEX administration stop. After awaking from sedation, the names of all the memorized subjects were written out. Throughout research, blood pressure, heart rate, SpO_2, and BIS values were measured and recorded. Furthermore, in the control group, saline was prescribed for the patient instead of DEX, and set to the same schedule. As results, the rate of the memory decreased significantly by DEX, and was maintained falling even after the DEX administration stop. The rate of the memory recovered at last to a control value and had no significant difference from it 120 minutes after an administration stop. Moreover, we found out the relationship among OAA/S Scale, the BIS value, and the rate of the memory. As a conclusion, the results suggest that recovery of the memory under intravenous sedation with DEX needs 2 hours or more after the administration stop, and OAA/S Scale and the BIS value would be clinical indexes to judge effect and recovery of the amnesia. Therefore, in order to prevent a lapse of memory of notes etc., it is important to explain them in advance, to explain after 2 hours or more passes at BIS value over 81 and checking sufficient recovery, or to show them by a document.

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Although diabetes patients show relatively higher acetone concentrations in the expired air and a higher prevalence of periodontitis, the precise relationships to diabetic conditions remained to be elucidated. In this study, concentrations of acetone and volatile sulfur compounds (VSC) in the expired airs from 35 patients with Type 2 diabetes mellitus were investigated in relation to their periodontal status. The diabetic condition was assessed by the concentration of glycohemoglobin A_<1c> (HbA_<1c>) in the blood. The concentrations of acetone and VSC in the expired airs were measured gas-chromatographically, and the periodontal status was assessed by CPI criteria. The results of the single correlation analyses revealed that the concentration of acetone in the expired air showed a positive correlation with HbA_<1c>, but not with the periodontal condition nor the VSC concentration. In comparison between the diabetes patients group and the control subjects, the concentration of acetone and the prevalence of subjects with the periodontal pocket of over 4mm (CPI>=3) were significantly higher in the diabetes group than those in the control group. However, there was no significant difference in VSC concentration as well as the amount of tongue coat between the groups. Further assessment on the periodontal bacteria in the tongue coat samples indicated that the proportion of Porphyromonas gingivalis showed a positive correlation with periodontal status both in the diabetic and healthy subjects. Consequently, it was strongly suggested that measuring the concentration of acetone in expired air, which was independent from the periodontal conditions, could be a useful tool to find the high risk individuals with diabetes mellitus. On the other hand, VSC concentration in expired air could not be related to diabetic and periodontal status in diabetic patients. It was also demonstrated that the prevalence of periodontitis in the diabetes group was significantly higher than that in the healthy subjects, and that the periodontal status was positively related to the diabetic conditions. In addition, the proportion of P. gingivalis in the tongue coat could be associated to their periodontal status both in the diabetic and healthy subjects.

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Secretory leukocyte protease inhibitor (SLPI) has been recognized as not only a protease inhibitor but also an important defense component in mucosal secretory fluids. To elucidate the functional role in innate immunity in gingival crevices, the SLPI production from a gingival epithelial cell line, GE1, with or without the stimulation of Porphyromonas gingivalis lyophilized whole cells (Pg-WC) and the lipopolysaccharides (Pg-LPS), and the inhibitory effect on P. gingivalis proteases were investigated. The unstimulated GE1 cells showed low levels of SLPI mRNA expression, which was augmented by the stimulation with Pg-LPS as well as Pg-WC. The augmentation of SLPI mRNA expression in GE1 cells was accompanied by the inductions of IL-6, TNF-α and IL-1β mRNA expressions. Although IL-6 could induce macrophages to produce SLPI, the kinetics analyses suggested that the augmentation of SLPI production in GE1 cells could not be a second response to the IL-6 induced by the stimulant, but a direct response by the P. gingivalis antigens. Further experiments using rSLPI indicated that SLPI showed a direct inhibitory effect on the P. gingivalis protease of Lys-gingipain. Thus, it was suggested that gingival epithelial cells could be a substantial producer of SLPI that functions inhibitory to the pathogenic P. gingivalis protease in gingival crevices. It was also suggested that the SLPI production could increase in response to P. gingivalis through the stimulation with its pathogenic constituents.

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Oral lichen planus (OLP) is a chronic inflammatory oral mucosal disease of unknown etiology. The histology of OLP includes hyperkeratosis, degeneration of basal cells, and dense subepithelial infiltration of T cells. Leukoplakia is a typical hyperkeratosis lesion in oral mucosa, and a previous study of leukoplakia showed intracellular location of oral mycoplasma in the epithelial cells of leukoplakia. Then, this study was performed to examine intracellular location of mycoplasma in the epithelial cells of OLP similar to leukoplakia. Thirty-five formalin fixed, paraffin-embedded specimens of OLP were examined, and fifteen normal mucosa specimens were used as controls. To compare between OLP and leukoplakia, twenty-four specimens with leukoplakia were examined. In 32 of 35 (91.4%) specimens with OLP, fluorescing structures were observed, while 5 of 15 (33.3%) specimens with normal mucosa were positive. In OLP, positive reactions were observed in the lower part of the epithelium rather than in the upper part of the epithelium. Especially, a lot of fluorescing structures were observed in basal cells. However, few or no structures were detected in basal cells of leukoplakia. These findings suggest that intracellular localization of mycoplasma is related to onset and evolution in OLP as well as in leukoplakia. And the presence and amounts of mycoplasma in the basal cells are thought to be related to the difference between OLP and leukoplakia.

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