Inflammatory cytokines are reportedly involved in the pathogenesis of chronic subdural hematomas (CSH), and the angiogenesis of hematomas has particularly been in focus. Cyclooxygenase-2 (COX-2) is an essential enzyme for the synthesis of prostaglandin E₂ (PGE₂). The COX-2-PGE₂ pathway has been shown to influence angiogenic factors such as vascular endothelial growth factor (VEGF). We investigated the association of COX-2 expression in the dura mater and outer membrane with the pathogenesis of CSH, and suggested a treatment strategy on the basis of this association. Hematoma fluid and serum samples obtained from 37 patients, and samples of the dura mater and outer CSH membrane obtained from 13 patients during the operation were examined in this study. The concentrations of PGE₂ in relation to COX-2 in the hematoma fluid were significantly higher than those in the serum. Immunohistochemical analyses revealed COX-2-positive cells in the outer membrane of CSHs. There was a linear and significant relationship between PGE₂ concentration in hematoma fluid and the interval from trauma to initial surgery. COX-2 may play a crucial role during the development of CSHs. Our study might lead to the development of anti-COX-2 treatment options that aim to minimize repeat surgery and choose medical therapy by reducing CSH morbidity and recurrence rate in patients with CSH.

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Confocal laser microscopy is a well-recognized research tool in the fields of biological and material science which enables high-resolution images of samples with minimum requirements for specimen preparation. Here we introduce an innovative technique for the 3-D description and measurement of resorption pits using Super Depth Surface Profile Measurement Microscope based on the principle of confocal microscope. We show one example of culturing for 48 h with an established NF-κB inhibitor named NBD-peptide after plating mature osteoclasts on dentine slices with osteoblasts. The activity of osteoclasts is measured by determining the volume of resorbed portion of dentine by osteoclasts in vitro. The 3-D surface profile could be obtained by detecting the position at which the reflected laser intensity from the target becomes the maximum on z-axis. The volume and depth of resorption lacunae by stimulated osteoclasts is significantly increased compared to the un-stimulated group without changing of resorption area. The increase in volume and depth are dose-dependently inhibited by the NBD-peptide. Comparing to the classical method by measuring 2-D area of pits, analysis based on this technique could provide reliable quantitative assessment reflecting the osteoclast activity.

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This study examined hyoid movement during sequential swallowing and evaluated the relationship among trajectory patterns, swallowing types based on laryngeal movement and laryngeal penetration. Twelve healthy adults underwent videofluorography during sequential swallowing. Each swallow was classified into two types: opened laryngeal vestibule after swallow (i-Segmental type) and closed laryngeal vestibule after swallow (i-Continuous type). Each participant’s swallowing type was classified by the same method. We analyzed two-dimensional movements of the hyoid, and the trajectories were classified into three patterns: hyoid moved in the anterosuperior direction after the onset of swallow (pattern L); hyoid moved in the anterosuperior direction after the onset of swallow, beyond the mandibular plane (pattern X); and the hyoid was above the mandibular plane at the onset of swallow, and then it moved in the inferior direction (pattern U). Two-way ANOVA revealed that there was a significant interaction between the swallowing type and trajectory pattern, and laryngeal penetration was the highest for the combination of individual swallow of i-Continuous type and pattern L. In sequential swallowing, the existence of a penetration-prone swallowing pattern combination was an interesting phenomenon relevant to eating management for dysphagic patients; however further study in patient groups is required.

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