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Limited evidence is available as to whether Kampo medicine modifies gastrointestinal function in humans. We investigated the effect of a Kampo medicine, Hange-koboku-to (Banxia-houpo-tang, HKT), on patients with functional dyspepsia (FD) and on healthy volunteers with regard to gastric motility. The gastric emptying rate (GER) in FD patients was significantly lower than in the healthy subjects. GER in FD patients and in healthy volunteers showed a significant increase after 2 weeks of medication with HKT. Furthermore, gastrointestinal symptoms improved significantly in the FD patients after the administration of HKT. These results suggest that HKT improves delayed gastric emptying and acts as a prokinetic agent.

Soft tissue stretching has been proposed as one of the control factors in craniofacial morphogenesis. However, its mechanism remains unclear. The present study investigated electromyographic (EMG) activity and muscle fibre composition of cervical muscles following prolonged head extension in growing rats. Thirty-six male Wistar rats were divided into two experimental (E1, E2) and one control (C) group at 25 days of age. To induce head extension, the experimental rats were raised in cylindrical cages, which were positioned horizontally for group E1 and tilted upward at 45 degrees for group E2. At 55 days of age, EMG activity was recorded from the anterior digastricus (AD), sternohyoideus (SH), sternomastoideus (SM), longus capitis (LC), and biventer cervicis (BC) muscles in the rest position and passive head extension. EMG activity was analysed on its integrated values (IEMG), and composition of muscle fibres was evaluated by myosin ATPase reaction and fibre cross-sectional areas were calculated. Group E1 showed a higher percentage of type I fibres and lower IEMG during passive head extension in AD. In group E2 there was a higher percentage of type I fibres, a higher IEMG at rest, and a lower IEMG during passive head extension in BC. The experimental groups demonstrated altered proportions of type IIA and IIB fibres in SM and LC. They also showed higher percentages of subtype fibres and reduced cross-section areas of type II fibres in most of the muscles investigated. These findings suggest that head extension affects fibre transition, distribution, cross-section area, and recruitment pattern in cervical muscles.

Clinical/occlusal scores and jaw-muscle EMGs were recorded in 24 TMD symptomatic (group S) and 20 normal (group N) subjects to evaluate the significance of EMG parameters and their clinical associations. Results indicated: (1) integrated EMG activity (IEMG) was larger at the rest position (RP) in anterior temporalis (Ta) but smaller at maximal voluntary clenching (MVC) in masseter (Ma) and Ta, and the ratios of IEMG at 70%MVC to the corresponding bite force (70%BF) were greater in group S; (2) mean power frequency (MPF) were almost the same in both groups but its shift was more rapid in group S; (3) silent period duration (SPD) was longer in group S; (4) asymmetry indices for SPD and silent period latency (SPL) were larger in group S; (5) muscle pain was associated negatively with IEMG at MVC and 70%BF but positively with IEMGs at RP and 70%MVC, and impaired jaw movements were associated negatively with the above EMG values; (6) muscle pain was positively associated with SPD in Ma, while joint pain and sound showed positive and negative associations with SPD, respectively; (7) associations between occlusion and EMG parameters were found more in group N. These findings verify: (1) jaw elevators in TMD may have hyper-tonic activities and a weak functional efficiency; (2) jaw muscles in TMD may become easily fatigued following a functional effort, and less relaxed following a muscle twitch; (3) the severity of pain could not be reflected in EMG activities, but impaired jaw movement may increase tonic activity and decrease functional effort; (4) TMD symptoms may alter the functional adaptation of jaw-muscle activities and occlusion.

Decreased masticatory demands due to liquid or soft diets cause a reduction in the growth of craniofacial bones and in the development of feeding musculature, but the effects on masticatory function and jaw/tongue muscle activities are unclear. The present study was undertaken to test the hypotheses that a liquid diet feeding after weaning affects the critical-period programming of mastication and the motor performances of jaw and tongue muscles. Thirty-six male Wistar rats were divided into two equals groups at weaning and fed either a solid (solid-diet group) or a liquid (liquid-diet group) diet until they reached 50 days of age. Electromyograms (EMG) of the masseter, medial pterygoid, temporalis, anterior digastric, styloglossus, and genioglossus were recorded while animals were naturally ingesting ordinary pellets, apple cubes, and a liquid diet. It was found that: (1) a more irregular chewing rhythm, a shorter chewing sequence, and a longer chewing cycle were found in the liquid-diet group, but there were no differences observed during lapping/licking between the two groups; (2) during the chewing cycles, the EMG onset of each muscle in relation to that of the masseter in the liquid-diet group was similar to that in the lapping/licking cycles in both groups; (3) the activities of jaw elevators (masseter, medial pterygoid, and temporalis) during the chewing cycles were significantly higher in the liquid-diet group; and (4) the increase in the EMG activities of jaw elevators during pellet chewing compared with apple cube chewing was significantly weaker in the liquid-diet group, whereas such an enhancement was found simultaneously in the styloglossus in the solid-diet group, and in the anterior digastric in the liquid-diet group. These findings verify that: (1) the motor output of jaw and tongue muscles may be altered in rats fed a liquid diet after being weaned; (2) the feeding of a liquid diet to rats after being weaned may obstruct the functional transition from suckling to mastication; and (3) jaw elevators that develop without motor learning of mastication are inefficiency when performing functionally.

The present study directly addresses the roles of the P2X(7) receptor (P2X(7)R), an ionotropic adenosine triphosphate (ATP) receptor, and cytokines in the induction of orofacial pain following chronic constriction injury (CCI) of the infraorbital nerve (IoN).Rats were anesthetized, and ligatures of 4-0 chromic gut were tied around the IoN. A438079, a P2X(7)R antagonist or SB203580, a phosphorylated (p)-p38 mitogen-activated protein kinase (MAPK) inhibitor, was infused intrathecally into CCI-treated rats. In another group of rats, 3'-O-(4-benzoylbenzoyl) adenosine 5'-triphosphate (BzATP), a P2X(7) R agonist, was infused intrathecally with A438079, SB203580 or etanercept, a tumor necrosis factor (TNF)-α receptor-binding recombinant drug.CCI of the IoN induced tactile allodynia/hyperalgesia and up-regulation of P2X(7)R, membrane-bound TNF-α (mTNF-α) and soluble TNF-α (sTNF-α) in the trigeminal sensory nuclear complex (TNC). Tactile allodynia/hyperalgesia or up-regulation of mTNF-α and sTNF-α in the TNC following CCI of the IoN was inhibited by A438079. SB203580 also attenuated tactile allodynia/hyperalgesia or up-regulation of mTNF-α, but not the up-regulation of sTNF-α in the TNC. Treatment of rats with BzATP induced tactile allodynia/hyperalgesia and up-regulation of sTNF-α and p-p38 in the TNC. Tactile allodynia/hyperalgesia or up-regulation of sTNF-α following BzATP treatment was inhibited by SB203580 and etanercept.Based on these findings, phosphorylation of p38 MAPK via P2X(7)R may induce tactile allodynia/hyperalgesia, which is most likely mediated by sTNF-α released by microglia.

Summary A serine protease from mite faecal extract, Dermatophagoides farinae, was purified using DEAE-Sephacel anion exchange chromatography and Supcrdex 75 pg gel chromato-graphy. The molecular weight of this protease was 34 kD on SDS-PAGE under reducing conditions. The optimal pH and temperature of the protease were 8-0 and 47 C, respectively. In addition, this protease cleaved arginyl or lysyl residue containing substrates selectively and was only inhibited by aprotinin, PUT-175, tind soy bean trypsin inhibitor and not by chymostatin, E-64 and iodoacetic acid. These results show that our purified serine protease belongs to the trypsin-type. Purified trypsin-like protease was shown to be allergenic by enzyme-linked immunosorbent assay. Antigeni-city of trypsin-like protease was completely different from those of Der f I and Der f II. Both, 20 N-terminal amino acid sequence and amino acid compositions of the purified protease were very similar to those of Der f III. Good similarities were found between trypsin-like protease and Der f III concerning physicochemical properties such as molecular weight on SDS-PAGE and ammonium sulphate solubility. Summarizing the above data, it can be concluded that a trypsin-like protease from mite faecal extract is actually the Der f III allergen and that it may be involved in the digestive process of the mite as it was found not in mite body but in mite faeces.

Disc displacement is accepted as one of major findings in temporomandibular disorders (TMD). However, the associations of disc positions with morphological and positional changes of temporomandibular joint (TMJ) components and lateral pterygoid (LP), TMD clinical symptoms, and occlusion have rarely been discussed quantitatively. In this study, the morphological and positional changes of TMJ components and LP were assessed by means of magnetic resonance imaging (MRI) and tomography of the TMJ in 41 TMD and nine control (CN) subjects. Disc positions in TMD subjects were divided into normal position (NP) and anterior displacement with and without reduction (ADR+ and ADR-, respectively). From MRI scans and tomograms, the morphological and positional changes of TMJ components and LP were measured and compared among CN, NP, ADR+ and ADR- groups. Correlations between these measurements and the scored clinical symptoms and occlusal factors were analysed in TMD subjects. The results indicated that: (1) TMJ osseous structures and LP showed no significant difference among CN and the three TMD groups, except for a posterior seat of condyle and shorter/steeper condylar movement during jaw opening; (2) disc length and inclination were significantly shorter and steeper, respectively, in ADR+ and ADR-; (3) disc positions were not specified by clinical symptoms and occlusal factors, except for the dominant TMJ sounds in ADR+; (4) an uncoordinated movement of the condyle/disc complex was found in ADR+ and/or ADR-; (5) TMJ osseous structures and the disc were weakly associated with clinical symptoms and occlusal factors. However, the LP showed negative associations with palpable pain for both the TMJ and jaw muscles and the static occlusal factors. These findings suggest that TMJ internal derangements are more related to the positional changes or spatial relationships of TMJ components but less to the individual morphologies of TMJ osseous structures, disc and LP, as well as specific clinical symptoms and occlusal factors, which might be in disagreement with a large body of previous statements.

A 64-year-old male consulted our hospital with a 6-day history of malaise, body temperature to 38 degrees C, anorexia, and light headedness. The chest radiograph showed consolidation in the left lower lung area. Chest CT and ultrasonography revealed left pleural fluid. The pleural fluid was exudative (yellowish in color, protein 3.0 g/dl, Rivalta reaction positive, adenosine deaminase 19.4 U/L), and had a total cell count of 4.7 x 10(6)/ml with 45% lymphocytes, 40% histiocytes, and 15% polymorphonuclear leukocytes. He had kept a budgerigar, but we could not isolate Chlamydia from the pleural fluid or the pet bird. Transbronchial lung biopsy from left S10 revealed an increase of mononuclear leukocytes within the interstitial spaces, and the alveolar spaces contained polymorphonuclear leukocytes, fibrin, and organized alveolar exudate. Bronchoalveolar lavage cellular constituents were 50% lymphocytes, 27% neutrophils, and 23% macrophages. Serologic studies demonstrated C. trachomatis specific IgM antibody titers at 1:20 in a serum sample and at 1:10 in pleural fluid. We report a case of community-acquired pneumonia caused by C. trachomatis diagnosed by serologic studies.

Twelve cases of drug-induced pneumonitis were clinically investigated. Treatment of antimicrobial agents in 8 cases of drug-induced pneumonitis ranged from 7-21 days (mean 12 days) and that of other drugs in 4 cases from 18-150 days (mean 70 days). The patients developed fever and dyspnea at a high rate of frequency. Abnormal laboratory findings included increased IgE (44%), eosinophilia (36%), and increased GOT and GPT in 33%. Chest X-ray films revealed a large reticulo-nodular or ground glass shadows in both lung fields. The results of lymphocyte stimulation tests were positive in 5 of 11 cases (45%). Eight cases demonstrated a rapid improvement by discontinuation of the drug and corticosteroid was administered in 4 cases. The drug received by the patient and their known risk of pulmonary toxicity should be kept in mind in order to reach a diagnosis of drug-induced pneumonitis and grasp the clinical picture of this disease. A provocation test is potentially dangerous, therefore it should not be carried out lightly.

Thirty-five patients with non-small cell lung cancer (adenocarcinoma: 15, squamous cell: 15, large cell: 5, Stage I: 3, II: 1, IIIA: 8, IIIB: 5, IV: 18) were treated with combination chemotherapy, CDDP 80 mg/m2 day 1, VDS 3 mg/m2 days 18, and MMC 8 mg/m2 day 1. This regimen was repeated two times at intervals of four weeks. Sixteen partial responses were observed (response rate of 45.7%), and the median duration of survival for responders was 12.6 +/- 7.5 months and for nonresponders 10.1 +/- 4.8 months. Statistically there was no difference between them, but a survival from the onset of therapy of responders was significantly better (p less than 0.05) than that of non-responders. Toxicity was tolerable with myelosuppression, chemotherapy-induced nausea and vomiting.

Patients with duodenal ulcer were classified into responders to H2-receptor antagonist and non-responders in whom duodenal ulcer did not heal within three months with the antagonist. In these patients and healthy controls, modified sham-feeding (MSF) test was performed to elucidate the pathophysiological differences between these groups, especially vagal activity of acid output. After tetragastrin 4 micrograms/kg/hr infusion for one hour, MSF was superimposed to the infusion (G + MSF). The acid output of non-responders (8 cases) and controls (8 cases) significantly increased in G + MSF. On the other hand, the acid output of responders (6 cases) significantly decreased. The acid output of non-responders in G + MSF was also significantly higher than that of controls. The results suggest that vagal activity of non-responders is higher than responders, and that there is disturbance of inhibitory mechanism in vagal system.

The effects of the masticatory function on age changes of the temporomandibular joint were studied in 163 C3H/He strain male mice, separated into solid and liquid diet groups from 2 weeks of age. The sizes and shapes of the mandibular condyles and glenoid fossae of the two groups were compared up to 60 weeks. The sizes and shapes of the condyles in the solid diet group increased and developed with age, but there was almost no change after 3 weeks of age in the liquid diet group. The sizes and shapes of the fossae increased and developed with age until 20 weeks in both groups, and there was no differences between the two groups. The poor functional stimulus of mastication has distinct effects on the underdevelopment of the condyle. Since the effects on the fossae were less than those on the condyles, not only the amount of mandibular movement, but also its pattern may have affected the liquid diet group.

In order to compare the size and pattern of craniofacial complex among irus monkeys from different habitats to each other, roentgenographic cephalometric measurement on seven items for linear measurement and ten items for angular measurement were carried out on dry skulls of eighty-six irus monkeys from Malaya, the Philippines, Thailand and Vietnam. In the groups from Malaya and the Philippines, the mean values of linear measurement are larger in male than in female, and differences are especially significant in the distances between the gonion and infradentale, posterior nasal spine and prosthion, and nasion and incision. In the angular measurement, the difference between sexes is significant in the mandibular plane angle, occlusal plane angle, lower central incisor to occlusal plane angle, lower central incisor to mandibular plane angle and Frankfort horizontal plane to sella-nasion angle. In male, the Philippine group is larger than the Malayan in the size of cranium, but there is no significant difference in pattern. In female, the Malayan group is the smallest in these four groups and the size of the cranium of the Thailander and Vietnamese, as well as the pattern of craniofacial complex, are most similar to each other. As compared with the human cranium, the facial pattern of irus monkeys is characterized by a strong inclination of the cranial base, small values of the gonial angle and foreward inclination of anterior teeth.

Effect of a clinical dose of bitolterol, a new oral bronchodilator via adrenergic beta-receptor, on heart rate was compared with those of terbutaline and trimetoquinol in unanesthetized dogs. Oral administration of bitolterol, terbutaline and trimetoquinol increased the heart rate. The heart rate effect of bitolterol was significantly weaker than those of terbutaline and trimetoquinol.

The 300 C3H/He strain male mice were divided into 3 groups; solid, kneaded, and liquid diet groups. Each group was consisted of 5 cross-sectional subgroups, i.e. 3, 5, 7, 12 and 20 weeks subgroups. X-ray pictures of their craniofacial complex were measured to investigate the extent and time that growth retardation can be recognized in the cranium. As the results, soft diets could retard craniofacial growth, although it accelerated body growth. Increase of height and depth of distal part of mandible and all 3 dimensions of craniofacial complex were affected by taking soft diets through the growing period. Some of them were apparent even in weaning period. As the distal areas of both craniofacial complex and mandible are closely related to jaw function, growth retardation of this area could be explained as the skeletal adaptation to the soft diets.

In order to examine the characteristics of the chewing gum masticatory test, the amount of sugar elution, the chewing time and the amount of sugar elution per second were measured in 109 young adults (93 males and 16 females), after 70 strokes of mastication. Their sex differences, differences among various occlusions, correlations with occlusal areas of the buccal teeth and correlations with roentgen cephalometrics were analyzed. 1. There was no sex difference in the amount of sugar elution. However, chewing time was shorter and the amount of sugar elution per second was higher in males than in females. 2. Compared with the normal occlusion group, the amount of sugar elution was significantly lower in the crowding and anterior cross bite groups (Inoue's classification), and in the Class III malocclusion group (Angle's classification) in males. The amount of sugar elution per second was also significantly lower in the crowding and anterior cross bite groups. However, significant differences could not be found for chewing time. 3. The amount of sugar elution per second was significantly correlated with occlusal areas in males and total samples. 4. The amount of sugar elution was significantly correlated with less than ANB and less than L 1 to MP in males, with less than L 1 to MP in total samples. The chewing time was significantly correlated with S-N, N-Me, N-ANS, S'-Ptm' in females. The amount of sugar elution per second was significantly correlated with less than SNA and less than L 1 to MP in males, and with A'-Ptm', Cd-Go, Go-Pog', Cd-Gn, less than SNA, less than L 1 to MP, less than MP-SN and gonial angle in total samples. 5. It is concluded that the chewing gum masticatory test is highly correlated with occlusion and dento-facial morphology. In particular, amount of sugar elution per second was thought to be a useful measure for masticatory performance in clinical orthodontics.

Adhesion of P. aeruginosa to normal and injured rat tracheas was examined. Rat tracheas were injured by exposure to 0.1N HCl for 10 min, and incubated with P. aeruginosa. Adhesion was quantitated by direct count of the number of bacteria attached to a fixed surface area as viewed by scanning electron microscopy. P. aeruginosa adhered to injured tracheas much more than to normal tracheas. The adhesion of P. aeruginosa, preincubated with mucin and sugars, to acid injured trachea was examined. Mucin, N-acetylneuraminic acid and N-acetyl-D-galactosamine inhibited the adhesion of P. aeruginosa to injured tracheas, but not N-acetylglucosamine, L-fucose, D-mannose and D-galactose. Periodate oxidation and neuraminidase treatment of acid injured tracheas reduced the adhesion of P. aeruginosa. These data suggest that N-acetylneuraminic acid (sialic acid) is the receptor for P. aeruginosa or a part of the receptor in acid injured rat trachea and in tracheobronchial mucin.

In a gastric mass survey with photofluorography performed on 10,605 male office workers over 40 years of age, 456 cases of duodenal ulcer (4.3%) were detected. These cases were scheduled to be followed up every 6 months with endoscopy and without any anti-ulcer drugs. Two hundred and seventy-six of the cases, including 169 cases with craters and 107 cases with scars, were followed up for 2 years. Forty-one of 169 craters (24.3%) had healed, and 21 of 107 scars (19.6%) had relapsed at 6 months. At 24 months 36 of 169 craters (21.3%) had healed, and 31 of 107 scars (29.0%) had relapsed. Sixty-four and a half per cent of the ulcers that showed crater at entry remained at the crater stage, and 62.6% of ulcer scars at entry remained healed at every endoscopy during the trial period. With regard to the cases' background, cigarette smoking adversely affected the natural history of the duodenal ulcer. However, years after onset, previous treatment, history of overt bleeding, and alcohol and coffee consumption did not affect the present ulcer activity.

Clinical follow-up study after the grafting with fresh autogenous iliac bone to the alveolar clefts in cleft lip and palate patients was carried out up to 2 years post operation. Twenty two patients were examined, to whom grafts of iliac cortical or iliac marrow bone was carried out by the First or the Second Department of Oral Surgery, Kagoshima University Dental School from July, 1985 to April, 1988. Their cleft types were classified as 18 unilateral and 4 bilateral cleft lips and palates. The ages at bone grafting were ranged from 8 years 9 months to 17 years 6 months, and the average of which was 12 years 3 months. Nine of these patients were grafted with the cortical bone, and the other 13 were grafted with the marrow bone. The perforations at alveolar clefts were covered with the tongue flap in 10 clefts of 10 patients, while they were covered with the local mucous flap in 15 clefts of 12 patients. Among these patients, dental casts, X-ray radiograms and oral pictures of 15 patients were surveyed postoperatively. Results were as follows: 1) Contours of the alveolar clefts were well corrected in 9 patients, especially in those cases of pre-operatively expanded unilateral clefts, grafted with the marrow bone and covered with the local mucous flaps. 2) The viable rate of grafted bone was 100.0% for the marrow bone, while it was 62.5% for the cortical bone.(ABSTRACT TRUNCATED AT 250 WORDS)

The objectives of the present article are to confirm the bone bonding phenomenon of Bioglass (BG) developed by Hench et al., and to observe the singularity of tissue reaction to it. BG and nonreactive silica glass (SG) were implanted in the femurs of rabbits and rats. Histological examination revealed that a relatively acellular zone with little inflammation was formed on BG surface at 1 day after implantation. Neither fibrous tissue nor a distinct boundary was observed between BG and bone after 7 days. On the contrary, a moderate post-operative inflammatory reaction was observed on SG at 1 day, and fibrous tissue was observed between SG and bone after 7 days. From these findings, it was confirmed that BG bonded directly with bone. As the relatively acellular zone observed on BG surface at 1 day was replaced by bone after 7 days, the formation of this zone might play an important role in bone-bonding process. Further research should be focused on the mechanism and biological meaning of bone bonding, for this phenomenon can not be explained by the conventional pathological theory of foreign body encapsulation.