Objective: Our previous findings suggested that the suppression of tumor necrosis factoralpha (TNF-α)-induced matrix metalloproteinase (MMP)-9 production by the biscoclaurine alkaloid cepharanthine could prevent the destruction of the acinar structure in the salivary glands of murine Sjögren's syndrome. Here, we examined the effect of cepharanthine on the salivary secretion in primary Sjögren's syndrome (pSS) patients.
Methods: In this single-center, open-label pilot study, 29 patients with pSS (28 women, 1 man) received 6 mg/day orally cepharanthine for 12 months. Standard clinical assessments and stimulated salivary flow were examined at baseline and each month for 12 months in all 29 patients. In eight of the patients, inflammatory lesions in the salivary glands were histologically investigated before and after the cepharanthine treatment. We analyzed the expressions of p65, phosphorylated IκB-α, MMP-9, and type IV collagen immunohistochemically.
Results: All patients completed the study without any adverse events. A significant increase in salivary flow was observed after the cepharanthine treatment compared to baseline. The serological analysis revealed that the 14 patients with an anti-Sjögren's-syndrome-related antigen A (anti-SSA/Ro) antibody value that was either negative or ‹64 U/ml responded significantly well to this treatment, whereas the 15 patients with anti-SSA/Ro antibody values ›64 U/ml did not. The immunohistochemical analysis demonstrated that although p65, phosphorylated IκB-α, and MMP-9 were more strongly stained in the acinar cells of the patients at baseline compared to the staining at the completion of cepharanthine treatment, the continuity of type IV collagen was observed following the cepharanthine treatment. These results indicate that cepharanthine could inhibit the phosphorylation of IκB-α, followed by the prevention of MMP-9 activation and the stabilization of type IV collagen.
Conclusions: Our findings suggest that cepharanthine could be a promising agent for improving salivary secretion in pSS patients.

Trial registration: This study was registered at Tokushima University Hospital (Registration number: 2437, November 26, 2012).

View full abstract

Objective structured clinical examination (OSCE) is widely used for assessment of clinical skills in dental education. In dental schools in Japan, the OSCE has been implemented to guarantee the student's clinical skills before their clinical training. Whereas it has been discussed and recognized recently that evaluation of student's clinical skills at the time of their post-clinical training is very important, called as Post-clinical clerkship OSCE (PCC-OSCE), however, the examination tasks are undecided yet. The purpose of this our trial was to learn the validity, objectivity, feasibility, and acceptability of the PCC-OSCE to the students or faculty aside from gaining the experience in OSCE. The examination task was explaining of the treatment plan to the patients with severe periodontitis for the simulated OSCE, and the clinical skills of 32 students during clinical training (male, N=20; female, N=12) were evaluated by 2 evaluators. The raw score between 2 evaluators was analyzed statistically (r=0.85, P<0.001, Spearman's rank correlation coefficient). Average score rate of all students was 51.2 % and we felt that the score was relatively low. Although the quality of our education system for periodontology is difficult to discuss from these results, development of the PCC-OSCE and the findings described in this paper will be of value to clinical staff who are developing PCC-OSCE in Tokushima University Dental School.

View full abstract

Microarray technique is one of methods for analyzing gene expression. In modern life science of post-genome era, extraction of biologically meaningful information from microarray data is one of the most important problems. Cluster analysis is a traditional way of analyzing microarray data and can classify genes showing similar expression pattern into one group. However, this method cannot clarify the biological properties of each gene group, and the meaning of gene expression changes of the sample, even though common regulatory mechanism of gene expression is implied. Recently, a new analyzing method, which combines microarray data with Gene Ontology information, has developed. This method classifies genes into groups according to accumulated functional information and selects statistically important groups. Using this method, we can obtain clues to find out biologically important gene groups. In this review, theory and the practical procedure of microarray data analysis using DAVID will be mainly discussed.

View full abstract

The number of adult patients to seek orthodontic treatment tends to increase. However, there are some characteristics should be taken into consideration in an adult orthodontic treatment. First, orthodontists can not carry out the dentofacial orthopedic treatment to address the skeletal and dentoalveolar imbalance. Second, a treatment plan has many practical difficulties because a periodontal disease and tooth loss increase with age. Nevertheless, an adult orthodontic treatment is essential for a long term stability of intraoral health. For a treatment of adult patients, an interdisciplinary approach with a team of other specialists is demanded.

View full abstract