There are two types of vascular smooth muscle contraction. One is normal contraction, which is physiological and Ca²⁺-dependent. Another is abnormal contraction, which causes vasospasm and Ca²⁺-independent. Rho-kinase and PKC are known key molecules to mediate the signal transduction of abnormal vascular smooth muscle contraction. Sphingosylphosphorylcholine (SPC) is a member of sphingolipids and induces Ca²⁺-independent, Rho-kinase-mediated abnormal vascular smooth muscle contraction via the activation of Src family tyrosine kinase (Src-TK). We found SPC-induced contraction is cholesterol-dependent and suggest the involvement of membrane raft in the signal transduction of abnormal vascular smooth muscle contraction mediated by SPC/Src-TK/Rho-kinase pathway. Eicosapentaenoic acid specifically inhibited abnormal vascular smooth muscle contraction through the inhibition of SPC/Src-TK/Rho-kinase pathway. By functional proteomics, we identified cytoskeleton-related proteins as the candidate of novel molecule to mediate abnormal vascular smooth muscle contraction and investigating their interaction with Rho-kinase. We hope that this interaction could be a new drug target.

The methodology for developing clinical practice guidelines is evolving. The evaluation of evidence through a systematic review and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system has been implemented to provide appropriate recommendations. Detailed methodologies, including conflicts of interest (COIs) management, voting, and third-party evaluation to enhance guideline reliability, are provided by the Medical Information Distribution Service (Minds). Understanding these guideline development processes is important for physicians using the guidelines. However, no established guideline development methodology exists for diagnostic issues. By reviewing the history of diagnostic imaging guideline development in Japan, diagnosis-specific problems can be clarified. The latest “Diagnostic Imaging Guidelines 2021” covers various medical departments and presents standard imaging methods, background questions (BQs), clinical questions (CQs), and future research questions (FQs). This guideline aims to promote appropriate imaging and decision making, and its dissemination is desirable to contribute to improving patient prognosis.

Temporomandibular joint (TMJ) ankylosis is a joint disorder characterized by the fibrotic or bony adhesion of anatomical joint components, leading to severe limitation or loss of joint mobility. TMJ ankylosis affects mastication, digestion, speech, and oral hygiene. Onset during childhood results in secondary micrognathia, leading to a reduction in the oropharyngeal airway and psychological problems. We present the case of a 39-year-old female patient with bilateral TMJ ankylosis and micrognathia that developed during childhood. The patient had a history of a traffic accident at the age of 5 years and presented with trismus. Computed tomography revealed bony ankylosis of the right TMJ and fibrotic ankylosis of the left TMJ. Bilateral interpositional gap arthroplasty was performed using an intraoral approach, followed by mandibular distraction osteogenesis (DO). Following DO, oral rehabilitation with dental implants was performed. The patient’s facial profile and mastication significantly improved and were maintained for 10 years after treatment.