Maxillary sinusitis is one of the most serious complications associated with dental implantation. When local dental treatment with or without antibiotics is not effective, Caldwell-Luc operation is often performed by an...Maxillary sinusitis is one of the most serious complications associated with dental implantation. When local dental treatment with or without antibiotics is not effective, Caldwell-Luc operation is often performed by an oral surgeon. We propose that endoscopic sinus surgery should be employed more widely as the first surgical treatment of choice for odontogenic maxillary sinusitis. This surgery aims to restore ventilation and drainage of paranasal sinuses by correcting the anatomical structures in the nasal cavity and paranasal sinuses intranasally. Unlike Caldwell-Luc procedure, the mucosa in the maxillary sinus is not totally removed; only highly polypous tissue is removed without exposing its bone surface. Resection of infected foci in the alveolar ridge or maxillary floor, when necessary, can be achieved intraorally both during or after endonasal sinus surgery. Postoperative care of irrigating the maxillary sinus with a saline solution at home is usually sufficient to eliminate the inflammation. Aeration of the maxillary sinus is restored without its deformation. Thus, endoscopic sinus surgery is much less invasive and more physiologic, as compared with the classic Caldwell-Luc operation. However, this surgery can be performed safely and securely only by an experienced and trained otolaryngologist. The authors strongly advocate a close collaboration between the dentist or oral surgeon and the otolaryngologist in treating maxillary sinusitis that develops in association with dental illness or treatment such as apical periodontitis, tooth extraction, and implantation. Three illustrative cases are reported.
Kitano I, Noguchi T, Mizuguchi M
… +10 more, Nishihara M, Hara Y, Azama S, Yamaguchi K, Hirai T, Takase Y, Liu L, Noshiro H, Fujimoto K, Irie H
Fukuoka Igaku Zasshi
· 2013 May · PMID 23885393
OBJECTIVE: The wall-carving (WC) imaging technique is used to evaluate early gastric cancer using multidetector row computed tomography (MDCT) image data for only the arterial phase. Our purpose was to investigate if WC...OBJECTIVE: The wall-carving (WC) imaging technique is used to evaluate early gastric cancer using multidetector row computed tomography (MDCT) image data for only the arterial phase. Our purpose was to investigate if WC images derived from portal phase MDCT images can enhance the visualization of early gastric cancer. SUBJECTS AND METHODS: Fourteen consecutive patients (average age/age range (years) = 75.8/61 to 86; male/female = 9/5) were enrolled. They were diagnosed with early gastric cancer and underwent contrast-enhanced MDCT before treatment. WC images of the arterial and portal phases were created from images scanned by 64-detector-row MDCT 40 and 60 seconds after the initiation of the contrast material injection, respectively. The correlation between the detection rates of lesions in the WC images and pathological findings was investigated. RESULTS: Totals of 71.4% (10/14) of arterial phase WC images and 71.4% (10/14) of portal phase WC images showed lesions. The imaging ability improved to 85.7% (12/14) when the two sets of images were combined. Well-differentiated adenocarcinomas tended to be visualized better in WC images of any phases. CONCLUSION: WC is an excellent image analysis technique for visualizing early gastric cancer lesions. The depiction rates were improved by using a combination of arterial and portal WC images. The scan timing after the contrast material injection should be carefully investigated to improve the detection rate of lesions.
Ohta C, Haraguchi K, Kato Y
… +2 more, Endo T, Koga N
Fukuoka Igaku Zasshi
· 2013 Apr · PMID 23858795
The in vitro metabolism of 2, 2', 3, 4', 5, 5'-hexachlorobiphenyl (hexaCB) (CB146) was examined using liver microsomes of rats, guinea pigs, hamsters and human. Untreated animal livers produced one metabolite (M-2) in ra...The in vitro metabolism of 2, 2', 3, 4', 5, 5'-hexachlorobiphenyl (hexaCB) (CB146) was examined using liver microsomes of rats, guinea pigs, hamsters and human. Untreated animal livers produced one metabolite (M-2) in rats, three metabolites (M-l, M-2and M-3) in guinea pigs and no metabolite in hamsters. Pretreatment of phenobarbital (PB) resulted in a marked increase of M-1 in three animals and of M-2in guinea pigs. In contrast, pretreatment of 3-methylcholanthrene showed a significant increase of M-3 in guinea pigs and a decrease of M-2in rats. Human liver microsomes prepared from nine Caucasians mainly formed M-2and M-3 at a ratio of 2: 1 and two individuals also formed one more metabolite M-1. The formation of M-1 was significantly correlated with CYP2B6 activity. By comparison of the GC-MS data of three metabolites with synthesized authentic samples, M-1 and M-2were determined to be 3'-hydroxy (OH)-CB146 and 4-OH-CB146, respectively. However, M-3 is unclear at present except the fact that it is OH-hexaCB. These results suggest that 3'-OH-CB146 is formed by PB-inducible cytochrome P450 (CYP2B enzymes) in animal and human livers and 4-OH-CB146 is a major metabolite in rat and human liver.
Hori T, Yamamoto T, Ishiguro Y
… +5 more, Iida T, Kajiwara J, Hirata T, Uchi H, Furue M
Fukuoka Igaku Zasshi
· 2013 Apr · PMID 23858794
We compared concentrations of PCB congeners between conventional 80 degrees C alkali digestion method and 30 degrees C alkali digestion method using 22 individual blood samples collected during 2009 annual Yusho examinat...We compared concentrations of PCB congeners between conventional 80 degrees C alkali digestion method and 30 degrees C alkali digestion method using 22 individual blood samples collected during 2009 annual Yusho examinations. The mean concentration of tri-CB in 30 degrees C alkali digestion method was lower than that of conventional method. However, concentration of total PCBs, 2,3',4,4',5-pentaCB (PCB118), 2,2',4,4',5,5'-hexaCB (PCB153) and 2,3,3',4,4', 5-hexaCB (PCB156), which were used as index for Yusho diagnosis, were equivalent between the methods. It was considered that the 30 degrees C alkali digestion method was available for blood PCB congener specific analysis in Yusho diagnosis.
Takeda T, Hattori Y, Fujii M
… +3 more, Taura J, Ishi Y, Yamada H
Fukuoka Igaku Zasshi
· 2013 Apr · PMID 23858793
Maternal exposure to 2, 3, 7, 8-tetrachlorodibenzo-p-dioxin (TCDD) causes a number of toxic effects on development such as growth retardation and sexual immaturity in the offspring. However, the toxic mechanism remains u...Maternal exposure to 2, 3, 7, 8-tetrachlorodibenzo-p-dioxin (TCDD) causes a number of toxic effects on development such as growth retardation and sexual immaturity in the offspring. However, the toxic mechanism remains unknown. Our previous studies have revealed that single oral administration of TCDD (1 jg/kg) to pregnant rats at gestational day (GD) 15 attenuates the fetal expression of testicular steroidogenic proteins such as steroidogenic acute-regulatory protein (StAR) and cytochrome P450 (CYP) 17 by targeting the fetal production of pituitary gonadotropins. In addition, we provided evidence that TCDD-produced damage on the fetal pituitary-gonad axis leads to imprint defects in sexual behaviors at adulthood. In this study, we investigated whether TCDD also affects fetal steroidogenesis in the adrenal gland. When pregnant Wistar rats were orally treated with TCDD, the fetal expression of CYP21, CYP11B1 and CYP11B2 mRNAs was either induced or tended to be induced in the male adrenal gland during GD17 and GD19, while the expression of mRNAs coding for StAR, CYP11A1 and 313-hydroxysteroid dehydrogenase was insensitive to TCDD treatment. The above alterations did not seem to be caused through a change in the upstream regulator, because TCDD exhibited little ability to attenuate the expression of adrenocorticotropin, a pituitary hormone stimulating adrenal steroidogenesis, in the male and female fetuses. In contrast to the males, TCDD effect on the adrenal gland was not observed in the female fetuses. These results suggest that maternal exposure to TCDD disrupts fetal steroidogenesis in adrenal as well as gonadal glands in a male specific manner, and the mechanism underlying the effect on adrenal gland is independent of the alteration of pituitary regulator.
Tobiishi K, Suzuki S, Todaka T
… +7 more, Hirakawa H, Hori T, Kajiwara J, Hirata T, Iida T, Uchi H, Furue M
Fukuoka Igaku Zasshi
· 2013 Apr · PMID 23858792
Hydroxylated polychlorinated biphenyls (OH-PCBs) are formed as major metabolites of PCBs by cytochrome P450 enzyme-mediated oxidation. It has been reported that their total concentration in serum samples of Yusho patient...Hydroxylated polychlorinated biphenyls (OH-PCBs) are formed as major metabolites of PCBs by cytochrome P450 enzyme-mediated oxidation. It has been reported that their total concentration in serum samples of Yusho patients ranged from 390 to 1300 pg/g. We measured the concentration of OH-PCBs in blood collected from 183 Yusho patients living in Japan in 2010. The major OH-PCB metabolites were 4-OH-CB187 (ND-1300 pg/g-wet), 4-OH-CB146 + 3-OH-CB153 (8.4-1200 pg/g-wet), 4-OH-CB109 (ND-530 pg/g-wet) and 4'-OH-CB172 (ND-380 pg/g-wet). The total OH-PCBs ranged from 36 to 3800 pg/g-wet. A positive relationship between the concentrations of OH-PCBs and PCBs was observed, but no significant relationship between the concentrations of OH-PCBs and PCDD/DFs was observed.
Tobiishi K, Suzuki S, Todaka T
… +7 more, Hirakawa H, Hori T, Kajiwara J, Hirata T, Iida T, Uchi H, Furue M
Fukuoka Igaku Zasshi
· 2013 Apr · PMID 23858791
Hydroxylated polychlorinated biphenyls (OH-PCBs) are well known as metabolites of PCBs in the human body. We improved a measurement method for OH-PCBs in blood samples using LC/MS/MS. A new 2 microm particle column was u...Hydroxylated polychlorinated biphenyls (OH-PCBs) are well known as metabolites of PCBs in the human body. We improved a measurement method for OH-PCBs in blood samples using LC/MS/MS. A new 2 microm particle column was used, and the analytical conditions for the LC/MS/MS measurements were optimized. The improved method is more sensitive than the conventional method for 5g blood samples. And, this method is effective at determining the concentrations of OH-PCBs, PCBs and dioxins from the same sample without special treatment of the sample such as derivatization.
Todaka T, Uchi H, Hirakawa H
… +3 more, Takao Y, Kajiwara J, Furue M
Fukuoka Igaku Zasshi
· 2013 Apr · PMID 23858790
We measured the concentrations of polychlorinated dibenzo-p-dioxins (PCDDs), polychlorinated dibenzofurans (PCDFs), and polychlorinated biphenyls (PCBs) in blood collected from Yusho patients during medical health examin...We measured the concentrations of polychlorinated dibenzo-p-dioxins (PCDDs), polychlorinated dibenzofurans (PCDFs), and polychlorinated biphenyls (PCBs) in blood collected from Yusho patients during medical health examinations performed from 2004 to 2010. Out of the 242 and 200 Yusho patients who received medical health examinations in 2004 and 2010, respectively, the concentrations of PCDDs, PCDFs, and PCBs in the blood of 136 patients were measured in both of those years. The concentrations of individual congeners of PCDDs, PCDFs, and PCBs in the blood of these 136 Yusho patients measured in 2004 were compared with those measured in 2010. Among individual congeners of PCDDs, PCDFs, and PCBs, most congeners of these compounds did not significantly decrease from 2004 to 2010. However, the concentrations of 1, 2, 3, 4, 6, 7, 8-heptaCDD, octaCDD, 1, 2, 3, 4, 7, 8-hexaCDF, tetraCB 52/69, pentaCB 101, octaCB 198/201, and octaCB 196/203 in the blood of Yusho patients were significantly decreased from 2004 to 2010. In addition, the concentrations of 1, 2, 3, 6, 7, 8-hexaCDD, 2, 3, 4, 7, 8-pentaCDF, and 1, 2, 3, 6, 7, 8-hexaCDF tended to decrease slightly from 2004 to 2010. These findings suggest that the PCDDs, PCDFs, and PCBs have remained in the blood of Yusho patients for a very long time, with over 40 years having passed since the outbreak of Yusho.
Todaka T, Uchi H, Hirakawa H
… +2 more, Kajiwara J, Furue M
Fukuoka Igaku Zasshi
· 2013 Apr · PMID 23858789
We developed a more effective method to measure the concentrations of polychlorinated dibenzo-p-dioxins (PCDDs), polychlorinated dibenzofurans (PCDFs), and non-ortho-coplanar polychlorinated biphenyls (non-ortho PCBs) in...We developed a more effective method to measure the concentrations of polychlorinated dibenzo-p-dioxins (PCDDs), polychlorinated dibenzofurans (PCDFs), and non-ortho-coplanar polychlorinated biphenyls (non-ortho PCBs) in the blood of Yusho patients using high-resolution gas chromatography/high-resolution mass spectrometry (HRGC/HRMS) equipped with a newly large-volume injection system. The new injection system linked a LaviStoma system with a unique stomach-shaped inlet liner (SSIL) and a solvent-cut large-volume (SCLV) injection system. This approach made it possible to introduce volumes up to 200 microl into the HRGC/HRMS in comparison with the 20microl volume of the previously reported conventional SCLV method. Based on experiments conducted using the same blood sample, the concentrations of PCDDs, PCDFs, and non-ortho PCBs obtained by the developed method showed a close correlation to that by the conventional SCLV method. By improving the injection method, the operation time and labor for the purification procedure from blood could be reduced. Furthermore, the developed method was more effective than the conventional SCLV method for recovery of PCDDs, PCDFs, and non-ortho PCBs.
Kajiwara J, Todaka T, Hirakawa H
… +8 more, Hori T, Yasutake D, Miyawaki T, Tobiishi K, Takao Y, Hirata T, Uchi H, Furue M
Fukuoka Igaku Zasshi
· 2013 Apr · PMID 23858788
We developed an analytical method for accurately determining the concentrations of dioxin and polychlorinated biphenyls(PCBs) in a blood volume of 5 g. Inter-laboratory crosscheck is available for maintaining the quality...We developed an analytical method for accurately determining the concentrations of dioxin and polychlorinated biphenyls(PCBs) in a blood volume of 5 g. Inter-laboratory crosscheck is available for maintaining the quality of dioxin and PCB analysis. We carried out the crosschecks of dioxin and PCB analysis in the blood with domestic analysis organizations. Two crosschecks each of dioxin and PCB analysis were carried out from 2007 through 2011. As a result, the findings of our analysis accorded well with the analyses of the other organizations. We believe that our analytical method is sufficiently reliable.
In the present study, we clarified the TMJ symptoms of Yusho patients. An epidemiologic examination was carried out to identify TMJ arthrosis in patients with Yusho. The patients were collected during annual Yusho examin...In the present study, we clarified the TMJ symptoms of Yusho patients. An epidemiologic examination was carried out to identify TMJ arthrosis in patients with Yusho. The patients were collected during annual Yusho examinations in 2012. Nine of 187 patients had TMJ symptoms. The symptoms were pain, trismus, and a clicking sound of the TMJ. We diagnosed these patients with TMJ arthrosis. The rate of TMJ arthrosis in Yusho patients was 4.8%, being similar to the rate of TMJ arthrosis in general. The PCB concentration in the blood of these 9 patients was 2.76 ppb, and the average blood PCB concentration of all patients was 2.98 ppb. We identified no relationship between the blood PCB concentration and TMJ arthrosis.
Yoshimura T, Kawasaki R, Yoshimura S
… +3 more, Miyazaki T, Mukaino A, Yonezawa T
Fukuoka Igaku Zasshi
· 2013 Apr · PMID 23858786
We measured serum uric acid levels in Yusho sufferers annually from 2007 to 2012 in Nagasaki prefecture. We observed an increased rate of serum uric acid levels in 38.2% of the male and 5.5% of the female sufferers. Ther...We measured serum uric acid levels in Yusho sufferers annually from 2007 to 2012 in Nagasaki prefecture. We observed an increased rate of serum uric acid levels in 38.2% of the male and 5.5% of the female sufferers. There was no relation among serum uric acid value, Body Mass Index, liver function, blood polychlorinated biphenyls and hypersensitive C reactive protein. We conclude that it is unclear if blood polychlorinated biphenyls may play a role in the increase of serum uric acid levels in Yusho sufferers.
Koike Y, Kuwatsuka Y, Shimizu K
… +1 more, Utani A
Fukuoka Igaku Zasshi
· 2013 Apr · PMID 23858785
We thought that dioxin and dioxin-like compound receptor AhR expressed on the surface of regulatory T (Treg) cells and Th17 cells could regulate immunological functions in the Yusho patients. In the present study, we mea...We thought that dioxin and dioxin-like compound receptor AhR expressed on the surface of regulatory T (Treg) cells and Th17 cells could regulate immunological functions in the Yusho patients. In the present study, we measured Treg cell related cytokines IL-10 and IL-35 in the Yusho patients. Serum levels of IL-10 were higher, but not significant (p = 0.06), and serum levels of IL-35 were increased (p = 0.006) in comparison with healthy controls. These results imply Treg cell activation in the Yusho patients.
Kuwatsuka Y, Koike Y, Shimizu K
… +1 more, Utani A
Fukuoka Igaku Zasshi
· 2013 Apr · PMID 23858784
Aryl hydrocarbon receptor (AhR), recognized as a dioxin receptor, is expressed on the surface of helper T (Th) 17 cells. As PCBs and PCDFs are still detected in the sera of the Yusho patients, we hypothesized dysregulati...Aryl hydrocarbon receptor (AhR), recognized as a dioxin receptor, is expressed on the surface of helper T (Th) 17 cells. As PCBs and PCDFs are still detected in the sera of the Yusho patients, we hypothesized dysregulation of Th17 cells in the Yusho patients. In the present study, we measured IL-21 and TGF-beta in the Yusho patients which induce differentiation from Th0 to Th17 cells. Serum levels of IL-21 were lower than those of controls (p < 0.05). Meanwhile, serum levels of TGF-beta were decreased relative to controls, but not significant. These results may imply differentiation from Th0 cells to Th17 cells is not induced in the Yusho patients.
Serum levels of adipokines among Yusho patients and normal controls were measured. Compared with normal controls, serum levels of leptin were significantly lower, while those of RBP4 were significantly higher in Yusho pa...Serum levels of adipokines among Yusho patients and normal controls were measured. Compared with normal controls, serum levels of leptin were significantly lower, while those of RBP4 were significantly higher in Yusho patients. Dioxins may impair production of adipokines from adipose tissue, which would increase the risk to develop lifestyle-related diseases, such as diabetes mellitus and hypertension.
Matsumoto S, Akahane M, Kanagawa Y
… +4 more, Kajiwara J, Uchi H, Furue M, Imamura T
Fukuoka Igaku Zasshi
· 2013 Apr · PMID 23858782
The relationships among dioxin isomers are not well understood. This study aimed to clarify the relationships among isomers using two methods. First, the relationships between isomers and symptoms were analyzed by analys...The relationships among dioxin isomers are not well understood. This study aimed to clarify the relationships among isomers using two methods. First, the relationships between isomers and symptoms were analyzed by analysis of variance. Second, concentrations and half-lives were determined for each isomer in each patient, and correlation coefficients for the concentrations and half-lives among isomers were calculated. Two isomers very similar to 2, 3, 4, 7, 8-pentachlorodibenzofuran (2, 3, 4, 7, 8-PeCDF) were correlated with symptoms of Yusho disease. The correlation coefficients among three isomers similar to 2, 3, 4, 7, 8-PeCDF were very high at 0.98, indicating that there may be a mechanism which maintains constant ratios among these isomers.
To investigate chronic immune effects of polychlorinated biphenyl (PCB) and polychlorinated dibenzofuran (PCDF), autoantibodies including anti-Smith (Sm) antibody, anti-ribonucleoprotein (RNP) antibody, anti-centromere a...To investigate chronic immune effects of polychlorinated biphenyl (PCB) and polychlorinated dibenzofuran (PCDF), autoantibodies including anti-Smith (Sm) antibody, anti-ribonucleoprotein (RNP) antibody, anti-centromere antibody and anti-double-stranded DNA (dsDNA) antibody, were studied in 168 patients with Yusho and 54 controls in 2012. Autoatibodies were present in some patients of Yusho; 1 case (0.6%) for anti-Sm antibody, 4 cases (2.4%) for anti-centromere antibody and 11 cases (6.5%) for anti-dsDNA antibody. However, these autoantibodies were not demonstrated in any controls. There was a significantly higher prevalence of elevated anti-centromere antibody in subjects with high PCB concentration than in those with low PCB concentration. We conclude that anti-centromere antibody is present in patients with Yusho, and it may be associated with blood PCB concentration.