Previous clinical studies have shown a correlation between smoking and several diseases. Previous studies have demonstrated the effects of both whole tobacco smoke as well as selected components on PMN functions. In this study, the effects of nicotine, cotinine, and ammonium chloride were observed in vitro for PMN phagocytic function and Fcy receptor or C3bi receptor expression. Human peripheral PMNs were collected from healthy nonsmokers and incubated with nicotine (1×10^-2 M to 10^-6M), cotinine (1×10^-2M to 10^-6M) or ammonium chloride (1×10^-2M to 10^-6 M) for 45 minutes at 37°C.
For analysis of PMN phagocytosis, PMNs were incubated with fresh human serum, RPMI 1640 media, and fluoresbrite beads for 30 minutes. The patterns of the ingestion beads by PMNs were estimated by flow cytometer on 5000 cells/sample. For Fcγ receptor staining, PMNs were incubated with FITC conjugated mouse anti-Fcγ receptor monoclonal antibody (OK-NK) . For C3bi receptor staining, PMNs were first incubated with mouse anti-human monocyte/granulocyte monoclonal antibody (OKM1), and then incubated with FITC conjugated goat anti-mouse IgG. Fcy and C3bi staining values were estimated by flow cytometer. Statistical significant depressions of % phagocytosis were observed in 1×10^-2 M of nicotine and cotinine groups (p<0.05: unpaired t test) . Depression tendencies of average number of ingested beads per cell were observed in all groups (N. S.) . Statistical significant depressions of Fcy and C3bi receptor staining values were observed in 1×10^-2M and 1× 10^-4M of nicotine, cotinine, and ammonium chloride groups, and 1×10^-6M of cotinine groups (p<0.01 or p<0.05: unpaired t test) . These studies demonstrated that nicotine, cotinine, and ammonium chloride inhibit PMN Fcγ and C3bi receptor expression which may impair PMN functions such as phagocytosis.

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Cases with postoperative infections following teeth extraction are experienced occasionally, however, there have been few reports about the problems following teeth extraction. The purpose of this study was to investigate the influence of general and local background of cases with infections following teeth extraction. The results were as follows:
1) The infections following teeth extraction occurred in 11 (2.1%) out of 517 cases.
2) There was no relationship between age or underlying disease and the postoperative infection rate.
3) The incidence of the infection was the highest after mandibular third molar surgery, however, the relationship between the surgical procedure such as incision or removal of the bone and the infection rate was not found.
4) The infection rate of cases with acute inflammation before surgery was higher than that of the cases without any inflammatory signs.
5) Prophylactic antibiotic administration was performed on 282 (54.5%) out of 517 cases. The incidence of the infections of the cases with prophylaxis was almost the same as the cases without prophylaxis.
6) The postoperative pain in infection cases tends to last longer than the normal course. Therefore, it is important to observe carefully the course of pain to make a diagnosis of postoperative infection.

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The therapeutic effect on 76 oral phlegmon cases was investigated from the view point of the treatment factors. The results were as follows:
1) The difference of treatment period between the cases who had single antibiotic therapy and the cases who had combination chemotherapy was not found. Among the single antibiotics therapy group, the treatment period tends, to be prolonged for the cases who were administered CEPs III antibiotics compared to PCs or CEPs I and CEPs II .
2) Streptococcus sp. was isolated in high frequency from the pus of the closed abscess. Even the same causative organisms, the treatment period was different on each case.
3) The surgical drainage was performed in 28 out of 76 cases (36.8%) . The timing of the surgical procedure from the onset tends to effect the treatment period, however, the longer the time from the onset to the first visit, the longer the treatment period lasted. Therefore, the contents of the treatment before the first visit would be important factors for resistant cases.

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β-Lactamase characteristics of oral anaerobes isolated from odontogenic infections were investigated. When 96 specimens from odontogenic infections were studied, the isolation frequencies of Prevotella, Peptostreptococcus and Streptococcus milleri group were 22.6%, 19.8%, and 15.1% respectively. Of 96 specimens, the cases of mixed infection (aerobes + anaerobes) were 63 (65.6%) and the mono-infection by anaerobes was 19 (19.8%) . The percentage of isolation of Prevotella spp. or PeptostreptoGoccusspp. was high in comparison to the mono-infection by anaerobes.
Of these anaerobes, 39% of Prevotella intermedia and 20% of Prevotella melaninogenica were positive for β-lactamase using the acidometry method. Furthermore, in 4 of 11 P. intermedia, β-lactamase activity increased greatly in the strain when ampicillin was used as substrate after the induction by cefoxitin.
Based on these findings, it was suggested that the anaerobes producing β-lactamase may be an indirect pathogen for odontogenic infection.

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A survey was conducted to investigate antibiotics prescribed for preventing infection between 1992 and 1998 in the outpatient clinic of the Department of Pediatric Dentistry at Iwate Medical University. It was found that antibiotics had been prescribed to children having undergone minor surgery, children with trauma, and children with heart disease who underwent tooth treatment. Children aged 6 to 7 years comprised the largest group of children who received antibiotic prescription. Antibiotics were given to a number of children aged over 8 years until 1995, while more than twice that number of children under 5 years were administered antibiotics than children over 8 years after 1996. With time, macrolides such as Rokitamycin and Clarithromycin became less prescribed while cephalosporins such as Cefdinir became used more widely. In children with heart disease and no allergy, Amoxycillin is still the first choice. In some cases (except for heart disease), the duration of administration has been changed from three days to two days.

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In our previous paper it was reported that lidocaine, procaine and dibucaine inhibited Na, K-ATPase activity and that the inhibitory effects may be related to the action of local anesthesia and its side effects. It was suggested that local anesthetics affect many proteins including Na-channel in the same manner and change their functions. In this study, the reversibility of the inhibitory activities and the inhibition mechanisms of local anesthetics were investigated to verify the previous results. The inhibition of Na, K-ATPase activity by lidocaine or procaine was reversible by decreasing the concentration of the anesthetics by dilution, but the inhibition by dibucaine was irreversible. All three anesthetics inhibited the formation of phosphointermediate in the Na, K-ATPase reaction sequence in concentration dependency similar to that in the inhibition of Na, K-ATPase activity. These results suggested that local anesthetics inhibit Na, K-ATPase activity by inhibiting phosphointermediate formation, supporting our previous report that inhibition of Na, K-ATPase activity by local anesthetics may be partially related to the mechanism of local anesthesia.

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In an effort to survey antimicrobial agents actually used in dental practice, a multi-institutional study was conducted on the consumption and share of antimicrobial agents as classified by chemical structure and dosage form. The study involved 18 dental colleges or university hospitals in Japan, and consisted of two parts, investigation of the share of antimicrobial agents used in a 10-day period, excluding Saturday and Sunday, April 6-17, 1998 and categorization of antimicrobial agents used over a 6-month period October 1997-March 1998.
Antimicrobial agents accounted for 25.5% of all oral medicines, and ranked second just behind antiinflammatory and analgesic drugs which accounted for 29.9%. The order of share in descending frequency was cephem series including cefaclor, cefdinir, and cefuroxime axetil ; and penicillin series including lenampicillin and amoxycillin. Injectable antimicrobial agents were used in 79% of patients given injectable forms. The breakdown is as follows : penicillin series, 50% ; cefem series, 43% ; and others comprised of fosfomycin, aminoglycosides and tetracycline series, 7 %.
Cephem and penicillin preparations were found to be the most commonly used antimicrobial agents not only in dental practice but also in dental colleges and university hospitals in Japan.

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