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Per Olof Ehrs

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Papers by Per Olof Ehrs

Quality of Life and Inflammatory Markers in Mild Asthma

Chest, 2006

The aim of this study was to explore the relationship between quality of life and measures of ast... more The aim of this study was to explore the relationship between quality of life and measures of asthma, such as lung function, reversibility to bronchodilation, exhaled nitric oxide (NO), and bronchial responsiveness to direct and indirect stimulus in patients with mild asthma in a primary care setting. Patients and measurements: Seventy-seven asthmatic patients not treated with glucocorticosteroids completed the Asthma Quality of Life Questionnaire. Spirometry was performed before and after bronchodilation, and bronchial challenges with methacholine and eucapnic dry air hyperventilation were conducted on separate days. NO in exhaled air and serum IgE were also analyzed. Results: We found no correlation between quality of life and any of the other parameters. There was a significant covariation between exhaled NO and bronchial responsiveness to methacholine and dry air, and also between FEV 1 (percentage of predicted) and reversibility to a bronchodilator. The levels of exhaled NO were higher in the asthmatic subjects with atopy than in the nonatopic asthmatics. Conclusions: The measures used in our study do not reflect health-related quality of life in subjects with mild asthma. We conclude that in the clinical situation, quality of life and other measures of asthma provide complementary information.

Effect of fluticasone on markers of inflammation and quality of life in steroid-naive patients with mild asthma

The Clinical Respiratory Journal, 2010

Background and Aims: Patients with mild asthma may adapt to symptoms that may be neglected at a m... more Background and Aims: Patients with mild asthma may adapt to symptoms that may be neglected at a medical consultation. Despite active airway inflammation, indicating need for treatment symptoms may be poorly perceived and influence on quality of life. The aim was to find out if markers of asthma activity and quality of life are influenced by inhaled steroids in patients who regard themselves as free of symptoms. Methods: Seventy steroid-free patients with mild asthma were treated with inhaled fluticasone (250 mg twice daily) or placebo for 3 months in a randomised, doubleblind, study. Spirometry with reversibility test, exhaled nitric oxide (NO), bronchial responsiveness to methacholine and eucapnic dry air hyperventilation and quality of life [(Asthma Quality of Life Questionnaire (AQLQ)] were assessed before and after treatment. Results: Fluticasone, but not placebo, decreased methacholine responsiveness. Bronchial responsiveness to dry air and exhaled NO levels was significantly lowered by fluticasone compared with placebo. Quality-of-life scores were high already before treatment and were not significantly altered by treatment. Conclusion: Treatment with an inhaled steroid in mild asthmatics altered bronchial responsiveness and exhaled NO levels but did not improve quality of life. In mild asthma, there is thus a space for improvement with regard to inflammatory parameters in patients who have only minor symptoms that are not influenced by treatment. In a long-term perspective, the indication for treatment of surrogate markers remains, however, unclear. Please cite this paper as: Ehrs P-O, Sundblad B-M and Larsson K. Effect of fluticasone on markers of inflammation and quality of life in steroid-naive patients with mild asthma.

A Case of Igg4-Related Dacryoadenitis and Sialadenitis that Proved Difficult to Diagnose

Journal of Japanese Society of Oral Medicine

Functionalized Scaffold and Barrier Membrane with Anti-BMP-2 Monoclonal Antibodies for Alveolar Ridge Preservation in a Canine Model

BioMed Research International, 2020

Introduction. The aim of this study was to investigate the ability of anti-bone morphogenetic pro... more Introduction. The aim of this study was to investigate the ability of anti-bone morphogenetic protein 2 monoclonal antibody (anti-BMP-2 mAb) to functionalize scaffolds to mediate bone regeneration in a canine model. Materials and Methods. The mandibular right premolar 4 (PM4) was extracted in eight beagle dogs and grafted with anti-BMP-2 mAb+anorganic bovine bone mineral with 10% collagen (ABBM-C) and porcine bilayer native collagen membrane (CM). The ABBM-C and CM were functionalized with either anti-BMP-2 mAb (test group) or an isotype matched control mAb (control group). Animals were euthanized at 12 weeks for radiographic, histologic, and histomorphometric analyses. Outcomes were compared between groups. Results. 3D imaging using cone beam computed tomography (CBCT) revealed that sites treated with ABBM-C and CM functionalized with anti-BMP-2 mAb exhibited significantly more remaining bone width near the alveolar crest, as well as buccal bone height, compared with control groups...

Localization of RANKL and cathepsin K, B and L in rat periodontal tissues during experimental tooth movement

Cytological investigation of deep-layer squamous cells in oral cytology

A study on utility of fine needle aspiration cytology in the oral and maxillofacial regions

The Journal of the Japanese Society of Clinical Cytology, 2017

Histopathological Examination and Literature Review of Orthokeratinized Odontogenic Cyst

Open Journal of Stomatology, 2019

Background: With transitions in the disease concept of orthokeratinized odontogenic cyst (OOC), t... more Background: With transitions in the disease concept of orthokeratinized odontogenic cyst (OOC), the pathogenesis and etiology have not been sufficiently elucidated. Objectives: OOC cases were reclassified and observed to understand the clinico-histopathological characteristics. In addition, literature review of OOC was performed to better organize the pathology. Materials and methods: Subjects with jawbone cysts lined by keratinized stratified squamous epithelium from 2005 to 2018 were reclassified, and clinico-histopathological findings were analyzed. Previous reports of OOC/orthokeratinized-type odontogenic keratocyst (OKC) from 1980 to 2019 were organized. Results: Five cases of OOC were diagnosed, representing 2.1% of odontogenic developmental cysts (total, 239 cases). Mean age was 37.6 years, with a female predominance. The mandibular molar area was the frequent site, and all cysts were solitary. Sixty percent involved an impacted tooth. Mean maximum diameter of the cyst was 2.2 cm. Histopathologically, 4 cases were unilocular, and partial palisading of the basal layer and scattered epithelial islands were observed in 2 cases each and formation of daughter cysts was noted in 3 cases. Previous papers described that most were unilocular and related to impacted teeth. Mean age ranged between 20 and 40 years, and the mandibular molar region was dominant. Recurrence rates were low. Conclusion: OOC shows a different biological attitude to OKC and is closer to dentigerous cyst. Meanwhile, OOC shows a similar histology of epidermoid cysts accompanying the granular layer. We thus surmised that OCC represents an independent concept as an odontogenic developmental cyst.

Histopathological Evaluation of Growth Factor-Rich Fibrin Combined with Anorganic Bone Graft Materials and Atelocollagen in a Human Extraction Socket: A Case Report

International Journal of Oral-Medical Sciences, 2016

The use of platelet-rich fibrin (PRF), concentrated growth factor (CGF), or growth factor-rich fi... more The use of platelet-rich fibrin (PRF), concentrated growth factor (CGF), or growth factor-rich fibrin (GRF) has been recognized as a new therapeutic concept involving autologous concentration of human platelets by simplified preparation without biochemical processing of blood. Although GRF and these concentrations containing growth factors have been used for bone regeneration and implant treatment, the biological and histological effects in human cases have not yet been understood. Successful bone formation following application of GRF with bone graft materials and atelocollagen in an extraction socket and its histopathological features are reported. A 40-year-old woman came to Hayashi Dental Clinic with the chief complaint of discomfort in an upper left molar. The molar showed severe vertical resorption of the alveolar bone and had to be extracted. The patient requested prosthetic replacement by implant as early as possible after the tooth extraction; therefore, bone augmentation was performed. After extracting the tooth under local anesthesia, the granulation tissue was removed thoroughly, and GRF and bone graft material were inserted into the socket. The socket was covered with condensed atelocollagen, and the adjacent mucosa was coronally placed and sutured. Two months after the extraction, radiopacity could be seen in the socket area. Histopathologically, the socket was filled with minimal inflamed fibrous tissue around the fragments of the anorganic bone graft material, and cancellous bone formation was noted adjacent to the fibrous tissues and fragments. GRF along with bone graft accelerates wound healing and bone formation in the extraction socket, allowing early implant treatment.

Comparative Study on Effects of Silver and Resin Fragments Injected into Periodontal Tissues in Healthy (m + /m +) and Diabetic Model (db/db) Mice with Special Reference to Histopathological and Immunohistochemical Observation

International Journal of Oral-Medical Sciences, 2013

High molecular weight compounds have been widely used in the field of dentistry. Although prepara... more High molecular weight compounds have been widely used in the field of dentistry. Although preparation of the tooth abutment and contamination by metal fragments are known to cause discoloration and injury in the periodontal tissues in the field of crown and bridge prosthodontics, the changes due to metal and composite resin fragments have not been fully comparatively studied and clarified to date. In addition, as patients with diabetes are more frequently encountered in dental clinics, the present study conducted histopathological, histochemical and immunohistochemical analyses in order to comparatively elucidate the changes in periodontal tissues after injection of metal(silver group)or composite resin fragments(resin group) . The histopathological reactions of the periodontal tissues in both healthy(m+/m+)and diabetic(db/db)mice were also compared at 28 days after injection. Histopathologically and immunohistochemically, inflammatory cell infiltration and CD68and MMP-2-positive macrophages were observed around the silver and resin fragments, and the fragments were decreased during fibrosis up to 28 days; these findings were more marked in the resin group than in the silver group. In addition, accumulation of the macrophages and subsequent fibrosis showed a delay in db/db. Furthermore, the number of mast cells was higher degree in the resin group than in the silver group, and was higher in db/db than in m+/m+, indicating that resin induces an allergic reaction in db/db. These results suggest that resin fragments are more readily excised than silver fragments due to the higher level of phagocytosis and antigen-presenting activity of macrophages. Furthermore, critical changes against precipitation were delayed in db/db as compared to m+m+.

A Histopathological and Immunohistochemical Study of Necrotizing Sialometaplasia

International Journal of Oral-Medical Sciences, 2012

Necrotizing sialometaplasia (NSM), a benign tumor-like lesion of the salivary glands, often resem... more Necrotizing sialometaplasia (NSM), a benign tumor-like lesion of the salivary glands, often resembles a malignant tumor in terms of clinical and histopathological features. In general pathology, metaplasia results from a kind of progressive change after chronic abnormal stimuli, and NSM is thought to arise after ischemic necrosis. However, the nature and pathogenesis of NSM remain unclear. The purpose of the present study was to investigate the morphological characteristics of metaplastic change in NSM by histopathological and immunohistochemical analyses using primary antibodies for cytokeratins (CKs) and MIB-1. Positive immunohistochemical reactivities for CK13 and MIB-1 staining in the squamous metaplasia of NSM were observed. Positive reactivity for CK13 was observed in prickle cells of the stratified squamous epithelium. The mean MIB-1 index was 6.0%. These results suggest that duct epithelial cells are responsible for metaplasia in NSM, because ducts in the palatal glands showed stratified squamous-like epithelium near areas of NSM and immunohistochemical findings resembled either salivary glands or oral mucosae covered with the lesion.

Effects of Relaxin on Relapse After Experimental Tooth Movement in Rats

International Journal of Oral-Medical Sciences, 2011

Large Multinodular Torus Palatinus with a Case Report and Histopathological Observation

International Journal of Oral-Medical Sciences, 2012

We experienced a case of a large torus palatinus (TP) in a 59-year-old Japanese woman, her chief ... more We experienced a case of a large torus palatinus (TP) in a 59-year-old Japanese woman, her chief complaint being that of speech interference. The lesion consisted of three pieces of nodular hard masses. The largest nodule was 34.5 mm in max diameter. Histopathologically, the lesion contained an exophytic over growth of cortical and/or a trabecular bone-like hard tissue with adipose marrow-like and fibrous tissues between the trabecular bone-like structures indicating hyperplastic features of the bone. After reviewing literatures, the larger and multinodular case was not so many, therefore, the present case was rare, and should be removed if it interferes exceedingly with speech.

Asthma severity in primary care asthma patients: a comparative study of four different approaches to severity classification

Primary Care Respiratory Journal, 2010

Aims: To explore the factor structure of asthma severity and asthma control and to compare the re... more Aims: To explore the factor structure of asthma severity and asthma control and to compare the results of different approaches to asthma severity classification on the distribution of costs of asthma medication. Methods: Comparison of four different approaches to asthma severity classification and factor analysis of asthma control descriptors. A correlation analysis between costs and the different approaches to severity classification was performed. Results: The factor analysis suggests that asthma control consists of at least two factors. Four approaches to severity classification were explored and all except the 'GINA EXPANDED' classification tended to place patients in the most severe category. The pharmaceutical costs varied between 0 and 75 SEK per day (0 and 5.31 GBP; 0 and 7.68 EURO). Conclusions: There is a considerable overlap between asthma control and asthma severity. None of the approaches used in this study present a superior satisfactory solution to the classification problem.

Morphological and Histological Changes in the Mandibular Condyle after Plate Removal in Experimental Models of Short- and Long-term Mandibular Lateral Displacement

Journal of Hard Tissue Biology, 2013

We conducted an in vivo study to clarify the mechanics of the mandibular bone and condyles in ped... more We conducted an in vivo study to clarify the mechanics of the mandibular bone and condyles in pediatric patients with mandibular functional deviation. We experimentally caused lateral displacement of the mandible in 4-week-old rats by attaching a plate to the teeth for 4 (short-term group: ST group) or 12 weeks (long-term group: LT group), and immunohistochemically investigated the pattern of appearance of matrix metalloproteinase-1 (MMP-1), vascular endothelial growth factor (VEGF), and connective tissue growth factor (CTGF) to investigate the changes in the cartilage matrix constitution during the recovery of the condylar morphology. Furthermore, the morphology was observed using micro (μ)-CT. After plate removal, the MMP-1 expression significantly decreased in the both groups. Furthermore the expressions of VEGF and CTGF were increased in the ST group compared to those observed in the LT group. In terms of the morphometry, mandibular asymmetry and deformity of the condyle were noted immediately after removal in the both groups. The mandibular morphology markedly recovered in the ST group compared to that in the LT group. This indicates that correction of occlusal abnormalities during an early stage leads to recovery of the normal mandibular configuration.

The Influence of Structured Information and Monitoring on the Outcome of Asthma Treatment in Primary Care: A Cluster Randomized Study

Respiration, 2010

Background: In clinical trials of asthma, the outcomes are often good, but when the same treatmen... more Background: In clinical trials of asthma, the outcomes are often good, but when the same treatment regimens are implemented in primary care, equally good results are not obtained. Objective: To investigate if addition of structured patient information and monitoring by an asthma diary in primary care improves asthma control. Methods: 141 patients from 19 primary care centres were studied. The centres were randomised to a standard care group or to an intervention group. The intervention group received structured written and oral information about asthma and asthma medication, and were instructed to keep an asthma diary. The primary outcome was asthma control as assessed by the Asthma Control Questionnaire. Secondary outcomes were costs of asthma medication, the Mini Asthma Quality of Life Questionnaire score and lung function. Results: Asthma Control Questionnaire score changes differed between the study groups (p < 0.05). In the intervention group, these changes (M = –0.45) in as...

Low-energy laser irradiation accelerates the velocity of tooth movement via stimulation of the alveolar bone remodeling

Orthodontics & Craniofacial Research, 2009

Introduction-Previously, the authors have reported the acceleration of tooth movement and osteocl... more Introduction-Previously, the authors have reported the acceleration of tooth movement and osteoclastogenesis on the pressure site in an experimental tooth movement model by low-energy laser irradiation (LELI), which stimulated the RANK ⁄ RANKL system and c-fms ⁄ macrophage colony-stimulating factor system. However, the effect of LELI on osteogenesis on the tension site is not known clearly. Moreover, the temporal changes in alveolar bone during tooth movement have not been investigated as yet. Therefore, the present study was designed to examine the effects of LELI on alveolar bone remodeling during experimental tooth movement, and observe the temporal bone mineral density (BMD) using micro-computed tomography (lCT). Materials and methods-To induce experimental tooth movement in rats, 10 g force was applied to the upper right first molar with Nickel titanium closed-coil. Next, a gallium-aluminum-arsenide (Ga-Al-As) diode laser was used to irradiate the area around the moved tooth, and BMD and the amount of tooth movement were measured by lCT scanning for 21 days. Histopathological examination was also performed. Results-The amount of tooth movement in the LELI group was significantly greater than in the non-irradiation group by the end of the experimental period. Further, compared with the non-irradiation group, the fall of BMD was less in the LELI group. Conclusion-These findings suggest that LELI accelerates the velocity of tooth movement via stimulation of the alveolar bone remodeling.

Expression profile of chemokines and chemokine receptors in epithelial cell layers of oral lichen planus

Journal of Oral Pathology and Medicine, 2006

BACKGROUND: To understand the immunopathological features of oral lichen planus (OLP), we analyze... more BACKGROUND: To understand the immunopathological features of oral lichen planus (OLP), we analyzed the expression of chemokines in the epithelial cell layers. METHODS: Epithelia from OLP or healthy gingiva were collected by laser microdissection. The chemokine and chemokine receptor expressions in the epithelia were analyzed by DNA microarray. RESULTS: High levels of MIP-3a/LARC/CCL20 and its receptor CCR6 were expressed in the lesional epithelia. Furthermore, DC-CK1/CCL18, ELC/CCL19, SDF-1/ CXCL12 and CXCR4 expressions were also increased. Immunohistologial analysis showed that high numbers of Langerhans cells (LCs) were present in the epithelia of OLP. Lesional epithelia also expressed high levels of the ligands specific for CXCR3 (e.g. MIG/CXCL9, IP-10/ CXCL10 and I-TAC/CXCL11) and CCR5 (e.g. RANTES/ CCL5). CONCLUSIONS: Infiltration of LCs is orchestrated by CCR6. Further, LCs residing in the lesional epithelia may be a mature phenotype. Moreover, infiltration of T cells in OLP could be mediated by signaling pathways through CXCR3 and CCR5.

Validation of the Clinical COPD Questionnaire (CCQ) in primary care

Health and Quality of Life Outcomes, 2009

Background Patient centred outcomes, such as health status, are important in Chronic Obstructive ... more Background Patient centred outcomes, such as health status, are important in Chronic Obstructive Pulmonary Disease (COPD). Extensive questionnaires on health status have good measurement properties, but are not suitable for use in primary care. The newly developed, short Clinical COPD Questionnaire, CCQ, was therefore validated against the St George's Respiratory Questionnaire (SGRQ). Methods 111 patients diagnosed by general practitioners as having COPD completed the questionnaires twice, 2–3 months apart, without systematic changes in treatment. Within this sample of patients with "clinical COPD" a subgroup of patients with spirometry verified COPD was identified. All analyses was performed on both groups. Results The mean FEV1 (% predicted) was 58.1% for all patients with clinical COPD and 52.4% in the group with verified COPD (n = 83). Overall correlations between SGRQ and CCQ were strong for all patients with clinical COPD (0.84) and the verified COPD subgroup (0....

Brief Questionnaires for Patient-Reported Outcomes in Asthma

Chest, 2006

Study objectives and design: Health-related quality of life (QoL) instruments are generally used ... more Study objectives and design: Health-related quality of life (QoL) instruments are generally used for studies of asthma in specialized settings. For primary care use, there is a need for brief and simple questionnaires for structured patient-reported outcomes. We validated the Mini-Asthma Quality of Life Questionnaire (Mini-AQLQ), using the Asthma Quality of Life Questionnaire with standardized activities (AQLQ[S]) as the "gold standard." The Asthma Control Questionnaire (ACQ) was validated against the symptoms domain of the AQLQ(S). Patients were characterized by the Short Form-36 Health Survey (SF-36). Subjects: One hundred eight patients (68 women) with asthma diagnosed by their physicians from 24 primary care centers completed two visits (2 to 3 months apart). Their mean SF-36 scores were lower than the national norm for all domains. Results: The Mini-AQLQ and ACQ correlated well with the AQLQ(S). Reliability, determined in 57 patients with stable AQLQ(S) scores, was good. Both brief questionnaires detected improvement or deterioration of patients at the group level. Global ratings of disease severity by patients or clinicians correlated poorly with disease-specific QoL scores. Conclusions: The Mini-AQLQ and ACQ instruments are sufficiently simple and robust to be suitable for research and quality of care monitoring in primary care at the group level. They may, after further validation, even be useful in the management of individual patients.

Quality of Life and Inflammatory Markers in Mild Asthma

Chest, 2006

The aim of this study was to explore the relationship between quality of life and measures of ast... more The aim of this study was to explore the relationship between quality of life and measures of asthma, such as lung function, reversibility to bronchodilation, exhaled nitric oxide (NO), and bronchial responsiveness to direct and indirect stimulus in patients with mild asthma in a primary care setting. Patients and measurements: Seventy-seven asthmatic patients not treated with glucocorticosteroids completed the Asthma Quality of Life Questionnaire. Spirometry was performed before and after bronchodilation, and bronchial challenges with methacholine and eucapnic dry air hyperventilation were conducted on separate days. NO in exhaled air and serum IgE were also analyzed. Results: We found no correlation between quality of life and any of the other parameters. There was a significant covariation between exhaled NO and bronchial responsiveness to methacholine and dry air, and also between FEV 1 (percentage of predicted) and reversibility to a bronchodilator. The levels of exhaled NO were higher in the asthmatic subjects with atopy than in the nonatopic asthmatics. Conclusions: The measures used in our study do not reflect health-related quality of life in subjects with mild asthma. We conclude that in the clinical situation, quality of life and other measures of asthma provide complementary information.

Effect of fluticasone on markers of inflammation and quality of life in steroid-naive patients with mild asthma

The Clinical Respiratory Journal, 2010

Background and Aims: Patients with mild asthma may adapt to symptoms that may be neglected at a m... more Background and Aims: Patients with mild asthma may adapt to symptoms that may be neglected at a medical consultation. Despite active airway inflammation, indicating need for treatment symptoms may be poorly perceived and influence on quality of life. The aim was to find out if markers of asthma activity and quality of life are influenced by inhaled steroids in patients who regard themselves as free of symptoms. Methods: Seventy steroid-free patients with mild asthma were treated with inhaled fluticasone (250 mg twice daily) or placebo for 3 months in a randomised, doubleblind, study. Spirometry with reversibility test, exhaled nitric oxide (NO), bronchial responsiveness to methacholine and eucapnic dry air hyperventilation and quality of life [(Asthma Quality of Life Questionnaire (AQLQ)] were assessed before and after treatment. Results: Fluticasone, but not placebo, decreased methacholine responsiveness. Bronchial responsiveness to dry air and exhaled NO levels was significantly lowered by fluticasone compared with placebo. Quality-of-life scores were high already before treatment and were not significantly altered by treatment. Conclusion: Treatment with an inhaled steroid in mild asthmatics altered bronchial responsiveness and exhaled NO levels but did not improve quality of life. In mild asthma, there is thus a space for improvement with regard to inflammatory parameters in patients who have only minor symptoms that are not influenced by treatment. In a long-term perspective, the indication for treatment of surrogate markers remains, however, unclear. Please cite this paper as: Ehrs P-O, Sundblad B-M and Larsson K. Effect of fluticasone on markers of inflammation and quality of life in steroid-naive patients with mild asthma.

A Case of Igg4-Related Dacryoadenitis and Sialadenitis that Proved Difficult to Diagnose

Journal of Japanese Society of Oral Medicine

Functionalized Scaffold and Barrier Membrane with Anti-BMP-2 Monoclonal Antibodies for Alveolar Ridge Preservation in a Canine Model

BioMed Research International, 2020

Introduction. The aim of this study was to investigate the ability of anti-bone morphogenetic pro... more Introduction. The aim of this study was to investigate the ability of anti-bone morphogenetic protein 2 monoclonal antibody (anti-BMP-2 mAb) to functionalize scaffolds to mediate bone regeneration in a canine model. Materials and Methods. The mandibular right premolar 4 (PM4) was extracted in eight beagle dogs and grafted with anti-BMP-2 mAb+anorganic bovine bone mineral with 10% collagen (ABBM-C) and porcine bilayer native collagen membrane (CM). The ABBM-C and CM were functionalized with either anti-BMP-2 mAb (test group) or an isotype matched control mAb (control group). Animals were euthanized at 12 weeks for radiographic, histologic, and histomorphometric analyses. Outcomes were compared between groups. Results. 3D imaging using cone beam computed tomography (CBCT) revealed that sites treated with ABBM-C and CM functionalized with anti-BMP-2 mAb exhibited significantly more remaining bone width near the alveolar crest, as well as buccal bone height, compared with control groups...

Localization of RANKL and cathepsin K, B and L in rat periodontal tissues during experimental tooth movement

Cytological investigation of deep-layer squamous cells in oral cytology

A study on utility of fine needle aspiration cytology in the oral and maxillofacial regions

The Journal of the Japanese Society of Clinical Cytology, 2017

Histopathological Examination and Literature Review of Orthokeratinized Odontogenic Cyst

Open Journal of Stomatology, 2019

Background: With transitions in the disease concept of orthokeratinized odontogenic cyst (OOC), t... more Background: With transitions in the disease concept of orthokeratinized odontogenic cyst (OOC), the pathogenesis and etiology have not been sufficiently elucidated. Objectives: OOC cases were reclassified and observed to understand the clinico-histopathological characteristics. In addition, literature review of OOC was performed to better organize the pathology. Materials and methods: Subjects with jawbone cysts lined by keratinized stratified squamous epithelium from 2005 to 2018 were reclassified, and clinico-histopathological findings were analyzed. Previous reports of OOC/orthokeratinized-type odontogenic keratocyst (OKC) from 1980 to 2019 were organized. Results: Five cases of OOC were diagnosed, representing 2.1% of odontogenic developmental cysts (total, 239 cases). Mean age was 37.6 years, with a female predominance. The mandibular molar area was the frequent site, and all cysts were solitary. Sixty percent involved an impacted tooth. Mean maximum diameter of the cyst was 2.2 cm. Histopathologically, 4 cases were unilocular, and partial palisading of the basal layer and scattered epithelial islands were observed in 2 cases each and formation of daughter cysts was noted in 3 cases. Previous papers described that most were unilocular and related to impacted teeth. Mean age ranged between 20 and 40 years, and the mandibular molar region was dominant. Recurrence rates were low. Conclusion: OOC shows a different biological attitude to OKC and is closer to dentigerous cyst. Meanwhile, OOC shows a similar histology of epidermoid cysts accompanying the granular layer. We thus surmised that OCC represents an independent concept as an odontogenic developmental cyst.

Histopathological Evaluation of Growth Factor-Rich Fibrin Combined with Anorganic Bone Graft Materials and Atelocollagen in a Human Extraction Socket: A Case Report

International Journal of Oral-Medical Sciences, 2016

The use of platelet-rich fibrin (PRF), concentrated growth factor (CGF), or growth factor-rich fi... more The use of platelet-rich fibrin (PRF), concentrated growth factor (CGF), or growth factor-rich fibrin (GRF) has been recognized as a new therapeutic concept involving autologous concentration of human platelets by simplified preparation without biochemical processing of blood. Although GRF and these concentrations containing growth factors have been used for bone regeneration and implant treatment, the biological and histological effects in human cases have not yet been understood. Successful bone formation following application of GRF with bone graft materials and atelocollagen in an extraction socket and its histopathological features are reported. A 40-year-old woman came to Hayashi Dental Clinic with the chief complaint of discomfort in an upper left molar. The molar showed severe vertical resorption of the alveolar bone and had to be extracted. The patient requested prosthetic replacement by implant as early as possible after the tooth extraction; therefore, bone augmentation was performed. After extracting the tooth under local anesthesia, the granulation tissue was removed thoroughly, and GRF and bone graft material were inserted into the socket. The socket was covered with condensed atelocollagen, and the adjacent mucosa was coronally placed and sutured. Two months after the extraction, radiopacity could be seen in the socket area. Histopathologically, the socket was filled with minimal inflamed fibrous tissue around the fragments of the anorganic bone graft material, and cancellous bone formation was noted adjacent to the fibrous tissues and fragments. GRF along with bone graft accelerates wound healing and bone formation in the extraction socket, allowing early implant treatment.

Comparative Study on Effects of Silver and Resin Fragments Injected into Periodontal Tissues in Healthy (m + /m +) and Diabetic Model (db/db) Mice with Special Reference to Histopathological and Immunohistochemical Observation

International Journal of Oral-Medical Sciences, 2013

High molecular weight compounds have been widely used in the field of dentistry. Although prepara... more High molecular weight compounds have been widely used in the field of dentistry. Although preparation of the tooth abutment and contamination by metal fragments are known to cause discoloration and injury in the periodontal tissues in the field of crown and bridge prosthodontics, the changes due to metal and composite resin fragments have not been fully comparatively studied and clarified to date. In addition, as patients with diabetes are more frequently encountered in dental clinics, the present study conducted histopathological, histochemical and immunohistochemical analyses in order to comparatively elucidate the changes in periodontal tissues after injection of metal(silver group)or composite resin fragments(resin group) . The histopathological reactions of the periodontal tissues in both healthy(m+/m+)and diabetic(db/db)mice were also compared at 28 days after injection. Histopathologically and immunohistochemically, inflammatory cell infiltration and CD68and MMP-2-positive macrophages were observed around the silver and resin fragments, and the fragments were decreased during fibrosis up to 28 days; these findings were more marked in the resin group than in the silver group. In addition, accumulation of the macrophages and subsequent fibrosis showed a delay in db/db. Furthermore, the number of mast cells was higher degree in the resin group than in the silver group, and was higher in db/db than in m+/m+, indicating that resin induces an allergic reaction in db/db. These results suggest that resin fragments are more readily excised than silver fragments due to the higher level of phagocytosis and antigen-presenting activity of macrophages. Furthermore, critical changes against precipitation were delayed in db/db as compared to m+m+.

A Histopathological and Immunohistochemical Study of Necrotizing Sialometaplasia

International Journal of Oral-Medical Sciences, 2012

Necrotizing sialometaplasia (NSM), a benign tumor-like lesion of the salivary glands, often resem... more Necrotizing sialometaplasia (NSM), a benign tumor-like lesion of the salivary glands, often resembles a malignant tumor in terms of clinical and histopathological features. In general pathology, metaplasia results from a kind of progressive change after chronic abnormal stimuli, and NSM is thought to arise after ischemic necrosis. However, the nature and pathogenesis of NSM remain unclear. The purpose of the present study was to investigate the morphological characteristics of metaplastic change in NSM by histopathological and immunohistochemical analyses using primary antibodies for cytokeratins (CKs) and MIB-1. Positive immunohistochemical reactivities for CK13 and MIB-1 staining in the squamous metaplasia of NSM were observed. Positive reactivity for CK13 was observed in prickle cells of the stratified squamous epithelium. The mean MIB-1 index was 6.0%. These results suggest that duct epithelial cells are responsible for metaplasia in NSM, because ducts in the palatal glands showed stratified squamous-like epithelium near areas of NSM and immunohistochemical findings resembled either salivary glands or oral mucosae covered with the lesion.

Effects of Relaxin on Relapse After Experimental Tooth Movement in Rats

International Journal of Oral-Medical Sciences, 2011

Large Multinodular Torus Palatinus with a Case Report and Histopathological Observation

International Journal of Oral-Medical Sciences, 2012

We experienced a case of a large torus palatinus (TP) in a 59-year-old Japanese woman, her chief ... more We experienced a case of a large torus palatinus (TP) in a 59-year-old Japanese woman, her chief complaint being that of speech interference. The lesion consisted of three pieces of nodular hard masses. The largest nodule was 34.5 mm in max diameter. Histopathologically, the lesion contained an exophytic over growth of cortical and/or a trabecular bone-like hard tissue with adipose marrow-like and fibrous tissues between the trabecular bone-like structures indicating hyperplastic features of the bone. After reviewing literatures, the larger and multinodular case was not so many, therefore, the present case was rare, and should be removed if it interferes exceedingly with speech.

Asthma severity in primary care asthma patients: a comparative study of four different approaches to severity classification

Primary Care Respiratory Journal, 2010

Aims: To explore the factor structure of asthma severity and asthma control and to compare the re... more Aims: To explore the factor structure of asthma severity and asthma control and to compare the results of different approaches to asthma severity classification on the distribution of costs of asthma medication. Methods: Comparison of four different approaches to asthma severity classification and factor analysis of asthma control descriptors. A correlation analysis between costs and the different approaches to severity classification was performed. Results: The factor analysis suggests that asthma control consists of at least two factors. Four approaches to severity classification were explored and all except the 'GINA EXPANDED' classification tended to place patients in the most severe category. The pharmaceutical costs varied between 0 and 75 SEK per day (0 and 5.31 GBP; 0 and 7.68 EURO). Conclusions: There is a considerable overlap between asthma control and asthma severity. None of the approaches used in this study present a superior satisfactory solution to the classification problem.

Morphological and Histological Changes in the Mandibular Condyle after Plate Removal in Experimental Models of Short- and Long-term Mandibular Lateral Displacement

Journal of Hard Tissue Biology, 2013

We conducted an in vivo study to clarify the mechanics of the mandibular bone and condyles in ped... more We conducted an in vivo study to clarify the mechanics of the mandibular bone and condyles in pediatric patients with mandibular functional deviation. We experimentally caused lateral displacement of the mandible in 4-week-old rats by attaching a plate to the teeth for 4 (short-term group: ST group) or 12 weeks (long-term group: LT group), and immunohistochemically investigated the pattern of appearance of matrix metalloproteinase-1 (MMP-1), vascular endothelial growth factor (VEGF), and connective tissue growth factor (CTGF) to investigate the changes in the cartilage matrix constitution during the recovery of the condylar morphology. Furthermore, the morphology was observed using micro (μ)-CT. After plate removal, the MMP-1 expression significantly decreased in the both groups. Furthermore the expressions of VEGF and CTGF were increased in the ST group compared to those observed in the LT group. In terms of the morphometry, mandibular asymmetry and deformity of the condyle were noted immediately after removal in the both groups. The mandibular morphology markedly recovered in the ST group compared to that in the LT group. This indicates that correction of occlusal abnormalities during an early stage leads to recovery of the normal mandibular configuration.

The Influence of Structured Information and Monitoring on the Outcome of Asthma Treatment in Primary Care: A Cluster Randomized Study

Respiration, 2010

Background: In clinical trials of asthma, the outcomes are often good, but when the same treatmen... more Background: In clinical trials of asthma, the outcomes are often good, but when the same treatment regimens are implemented in primary care, equally good results are not obtained. Objective: To investigate if addition of structured patient information and monitoring by an asthma diary in primary care improves asthma control. Methods: 141 patients from 19 primary care centres were studied. The centres were randomised to a standard care group or to an intervention group. The intervention group received structured written and oral information about asthma and asthma medication, and were instructed to keep an asthma diary. The primary outcome was asthma control as assessed by the Asthma Control Questionnaire. Secondary outcomes were costs of asthma medication, the Mini Asthma Quality of Life Questionnaire score and lung function. Results: Asthma Control Questionnaire score changes differed between the study groups (p < 0.05). In the intervention group, these changes (M = –0.45) in as...

Low-energy laser irradiation accelerates the velocity of tooth movement via stimulation of the alveolar bone remodeling

Orthodontics & Craniofacial Research, 2009

Introduction-Previously, the authors have reported the acceleration of tooth movement and osteocl... more Introduction-Previously, the authors have reported the acceleration of tooth movement and osteoclastogenesis on the pressure site in an experimental tooth movement model by low-energy laser irradiation (LELI), which stimulated the RANK ⁄ RANKL system and c-fms ⁄ macrophage colony-stimulating factor system. However, the effect of LELI on osteogenesis on the tension site is not known clearly. Moreover, the temporal changes in alveolar bone during tooth movement have not been investigated as yet. Therefore, the present study was designed to examine the effects of LELI on alveolar bone remodeling during experimental tooth movement, and observe the temporal bone mineral density (BMD) using micro-computed tomography (lCT). Materials and methods-To induce experimental tooth movement in rats, 10 g force was applied to the upper right first molar with Nickel titanium closed-coil. Next, a gallium-aluminum-arsenide (Ga-Al-As) diode laser was used to irradiate the area around the moved tooth, and BMD and the amount of tooth movement were measured by lCT scanning for 21 days. Histopathological examination was also performed. Results-The amount of tooth movement in the LELI group was significantly greater than in the non-irradiation group by the end of the experimental period. Further, compared with the non-irradiation group, the fall of BMD was less in the LELI group. Conclusion-These findings suggest that LELI accelerates the velocity of tooth movement via stimulation of the alveolar bone remodeling.

Expression profile of chemokines and chemokine receptors in epithelial cell layers of oral lichen planus

Journal of Oral Pathology and Medicine, 2006

BACKGROUND: To understand the immunopathological features of oral lichen planus (OLP), we analyze... more BACKGROUND: To understand the immunopathological features of oral lichen planus (OLP), we analyzed the expression of chemokines in the epithelial cell layers. METHODS: Epithelia from OLP or healthy gingiva were collected by laser microdissection. The chemokine and chemokine receptor expressions in the epithelia were analyzed by DNA microarray. RESULTS: High levels of MIP-3a/LARC/CCL20 and its receptor CCR6 were expressed in the lesional epithelia. Furthermore, DC-CK1/CCL18, ELC/CCL19, SDF-1/ CXCL12 and CXCR4 expressions were also increased. Immunohistologial analysis showed that high numbers of Langerhans cells (LCs) were present in the epithelia of OLP. Lesional epithelia also expressed high levels of the ligands specific for CXCR3 (e.g. MIG/CXCL9, IP-10/ CXCL10 and I-TAC/CXCL11) and CCR5 (e.g. RANTES/ CCL5). CONCLUSIONS: Infiltration of LCs is orchestrated by CCR6. Further, LCs residing in the lesional epithelia may be a mature phenotype. Moreover, infiltration of T cells in OLP could be mediated by signaling pathways through CXCR3 and CCR5.

Validation of the Clinical COPD Questionnaire (CCQ) in primary care

Health and Quality of Life Outcomes, 2009

Background Patient centred outcomes, such as health status, are important in Chronic Obstructive ... more Background Patient centred outcomes, such as health status, are important in Chronic Obstructive Pulmonary Disease (COPD). Extensive questionnaires on health status have good measurement properties, but are not suitable for use in primary care. The newly developed, short Clinical COPD Questionnaire, CCQ, was therefore validated against the St George's Respiratory Questionnaire (SGRQ). Methods 111 patients diagnosed by general practitioners as having COPD completed the questionnaires twice, 2–3 months apart, without systematic changes in treatment. Within this sample of patients with "clinical COPD" a subgroup of patients with spirometry verified COPD was identified. All analyses was performed on both groups. Results The mean FEV1 (% predicted) was 58.1% for all patients with clinical COPD and 52.4% in the group with verified COPD (n = 83). Overall correlations between SGRQ and CCQ were strong for all patients with clinical COPD (0.84) and the verified COPD subgroup (0....

Brief Questionnaires for Patient-Reported Outcomes in Asthma

Chest, 2006

Study objectives and design: Health-related quality of life (QoL) instruments are generally used ... more Study objectives and design: Health-related quality of life (QoL) instruments are generally used for studies of asthma in specialized settings. For primary care use, there is a need for brief and simple questionnaires for structured patient-reported outcomes. We validated the Mini-Asthma Quality of Life Questionnaire (Mini-AQLQ), using the Asthma Quality of Life Questionnaire with standardized activities (AQLQ[S]) as the "gold standard." The Asthma Control Questionnaire (ACQ) was validated against the symptoms domain of the AQLQ(S). Patients were characterized by the Short Form-36 Health Survey (SF-36). Subjects: One hundred eight patients (68 women) with asthma diagnosed by their physicians from 24 primary care centers completed two visits (2 to 3 months apart). Their mean SF-36 scores were lower than the national norm for all domains. Results: The Mini-AQLQ and ACQ correlated well with the AQLQ(S). Reliability, determined in 57 patients with stable AQLQ(S) scores, was good. Both brief questionnaires detected improvement or deterioration of patients at the group level. Global ratings of disease severity by patients or clinicians correlated poorly with disease-specific QoL scores. Conclusions: The Mini-AQLQ and ACQ instruments are sufficiently simple and robust to be suitable for research and quality of care monitoring in primary care at the group level. They may, after further validation, even be useful in the management of individual patients.