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Statement of problem Adhesive resin cement has been the preferred choice for the placement of prosthetic restorations, but evidence-based studies supporting this selection are sparse. Purpose The purpose of this study was to test the hypothesis that restoration placement with the adhesive 4-methacryloxyethyl trimellitate anhydride/methyl methacrylate-tributylborane (4-META/MMA-TBB) resin cement is associated with better longevity of teeth than zinc phosphate cement up to 43 years. Materials and methods Study participants were individuals who had been visiting the clinic regularly for more than 20 years from their first visit between November 1970 and April 1985. The vital teeth with prosthetic restorations (N=454), including cast inlays, onlays, crowns, and fixed partial dentures, of 53 patients were assessed from dental charts and radiographs. Most of the bonding surfaces were precious metal alloy, excluding 4 restorations cemented with zinc phosphate and 6 ceramic crowns cemented with 4-META/MMA-TBB resin cement. The Kaplan-Meier method and log-rank test (α=.05) were used to compare longevity between the 2 materials. Chi-squared tests (α=.001) were also used to examine the occurrence rates of events such as secondary caries, endodontic treatment, and the dislodgement of restorations affecting the longevity of the 2 cements. Results Clinical review examination demonstrated that 55.4% of teeth retained with 4-META/MMA-TBB resin cement had been in service for 30 years compared with 43.5% of those retained with zinc phosphate cement, with a significant difference (P=.006). 4-META/MMA-TBB resin cement also demonstrated lower event occurrence rates than zinc phosphate cement for 3 assessed types of events (P Conclusions Within the limitations of this study, 4-META/MMA-TBB resin adhesive cement demonstrated a higher survival rate than conventional zinc phosphate cement in service for 30 years with a lower occurrence of critical events.

Cytotrophoblasts differentiate in two directions during early placentation: syncytiotrophoblasts (STBs) and extravillous trophoblasts (EVTs). STBs face maternal immune cells in placentas, and EVTs, which invade the decidua and uterine myometrium, face the cells in the uterus. This situation, in which trophoblasts come into contact with maternal immune cells, is known as the maternal-fetal interface. Despite fetuses and fetus-derived trophoblast cells being of the semi-allogeneic conceptus, fetuses and placentas are not rejected by the maternal immune system because of maternal-fetal tolerance. The acquired tolerance develops during normal placentation, resulting in normal fetal development in humans. In this review, we introduce placental development from the viewpoint of molecular biology. In addition, we discuss how the disruption of placental development could lead to complications in pregnancy, such as hypertensive disorder of pregnancy, fetal growth restriction, or miscarriage.

Inhibition of autophagy contributes to the pathophysiology of preeclampsia. Although chloroquine (CHQ) is an autophagy inhibitor, it can reduce the occurrence of preeclampsia in women with systemic lupus erythematosus. To clarify this important clinical question, this study aimed to address the safety of CHQ in trophoblast cells from the viewpoint of homeostasis, in which the anti-oxidative stress (OS) response and autophagy are involved. We used Western blotting to evaluate the protein levels in the trophoblast cells. The expression levels of heme oxygenase-1 (HO-1), an anti-OS enzyme, mediate resistance to OS induced by hydrogen peroxide (H

Background After cesarean section delivery of a fetus, switching from inhalation to intravenous anesthesia is recommended to avoid atonic effects resulting from inhalation anesthetics. However, the clinical impact of inhalation anesthetic use remains unclear. This study aimed to examine the effects of inhalation anesthetic agents used after delivery on intraoperative blood loss in cesarean section. Methods A single-center retrospective study was performed using the clinical data of patients who underwent emergency cesarean section at an academic teaching hospital during a 7-year period from July 1, 2013, to June 30, 2020. Regression analyses were performed to determine the difference between inhalation anesthesia and propofol after delivery with regard to intraoperative blood loss. We also analyzed spinal anesthesia as a positive control to understand the absolute difference between inhalation and propofol.Results Of total, 511 patients were analyzed. Patients were 33.3 ± 5.4 years-old, had a body mass index of 25.1 ± 4.2 kg/m2, and were 34.8 ± 4.6 weeks of gestational age. Switching from inhalation anesthesia to propofol after delivery was performed in 123 patients, while 24 patients received no anesthesia switching (two propofol, 22 inhalation). Thus, propofol and inhalation anesthesia were used after cesarean delivery in 125 and 22 patients including 15 sevoflurane and seven desflurane. The remaining 364 patients were performed under spinal anesthesia. Univariate regression analysis showed that inhalation anesthesia use after delivery tended to reduce blood loss compared with propofol use after delivery, although this did not reach statistical significance (−171 mL; 95%CI, −388 to 46 mL). Multivariate regression analysis, including patients with spinal anesthesia, also showed that intraoperative blood loss using sevoflurane and desflurane after delivery was not significantly different from propofol (−155 mL; 95%CI, −344 to 35 mL). As a positive control, spinal anesthesia showed a significant reduction in blood loss compared with propofol use (−156 mL; 95%CI, −260 to −53 mL). Conclusion Our findings suggest that inhalation anesthetic agents used after delivery are not associated with increased blood loss during cesarean section. Further studies are needed to support our findings.

Hypertensive disorders of pregnancy, including preeclampsia, directly affect maternal and perinatal morbidity and mortality. As the pathophysiology of preeclampsia is multi-factorial and has been studied using different approaches, we have demonstrated that impaired autophagy is an intertwined risk factor for preeclampsia. This concept has been verified in both in vitro and in vivo experiments. Autophagy is primarily involved in maintaining cellular homeostasis, and in immune regulation, longevity, cytokines secretion and a variety of other biological functions. Here, we review the role of autophagy in normal embryogenesis and placentation. Once placental autophagy is impaired by metabolic stress such as hypoxia, endoplasmic reticulum stress or starvation, placental development could be disrupted, resulting in functional maladaptations at the maternal-fetal interface. These malfunctions may result in fetal growth restriction or preeclampsia.

AIM: Despite the lack of evidence-based medicine, continuous intravenous maintenance tocolysis is the main treatment for preterm labor (PTL) in Japan because it is considered to prolong the gestational period. This treatment needs to be evaluated in more detail, and we herein propose one method to assess maintenance tocolysis using the timing of delivery by PTL patients. METHODS: PTL patients (n = 307) were divided into three groups according to delivery weeks of gestation. Group A (severe PTL) delivered at

Various types of electromagnetic shielding structures for specific frequency band have been reported in recent years. A gasket-free electromagnetic shielding structure using folded quarter-wavelength substrate integrated waveguide (FQ-SIW) resonators for 2.4-GHz band is one of them. In the structure, SIW resonators of different resonant frequencies in 2.4-GHz band are cascaded and positioned on inner walls of a gap. The structure is almost free of deterioration since contact-type gaskets are not used. In this paper, a gasket-free electromagnetic shielding structure for 2.4-GHz and 5-GHz bands using cascaded dual-behavior (DB) SIW resonators is proposed and evaluated. A DB-SIW resonator consists of two FQ-SIW resonators sharing one coupling slot and has two almost-independent resonant frequencies in the two bands. The design results showed attenuation characteristics at the two bands, and the configuration was miniaturized by 4% compared with conventional cascaded FQ-SIW resonators. Shielding effectiveness (SE) was also evaluated, and the measured results showed more than 20-dB improvement of SE near the two bands, though frequency shifts were observed.

A large cohort study of Japanese women reported that the rate of recurrent spontaneous preterm delivery (sPTD) in the next pregnancy was 22.3%; therefore, it is important to prevent recurrent sPTD. The present study investigated the rate of recurrent sPTD in pregnant women treated with probiotics.This was a retrospective study. Fifty-one pregnant women with a history of sPTD and who had been taking probiotics before 14 weeks of gestation were selected. The rate of sPTD in the next pregnancy among 255 pregnant women with a history of sPTD who had not taken probiotics was compared with that in the probiotics group.The rate of recurrent sPTD was 9.8% (5/51), which was lower than previously reported values. Furthermore, the rate of recurrent sPTD was significantly lower in the probiotics group (9.8%) than in the nonprobiotics group (31.0% [79/255]; p = 0.002).Probiotics may reduce the rate of recurrent sPTD.

Objects: There is growing evidence that sphingosine 1-phosphate (S1P) is involved in inflammatory diseases. As endometriosis is known as an inflammatory disease, we investigated the role of S1P system in the development of endometriosis. Methods: The expression of sphingosine kinase (SphK) 1 in endometriosis lesions was examined by immunohistochemistry. The cystic fluid of ovarian cysts/tumors were obtained to measure S1P concentrations. Endometriotic stromal cells (ESC) derived from endometrioma were used for in vitro experiments. Results: Sphingosine kinase 1 was detected in epithelium and stromal cells of endometriotic lesions. The mean S1P concentration in the cystic fluid of endometriomas was higher than that in nonendometriomas significantly (98.2 nM vs less than 1.5 nM, P

Preterm premature rupture of membranes and massive genital bleeding in the second trimester are serious obstetrical problems in pregnancy after trachelectomy. We had managed a twin post‐trachelectomy pregnancy by multiple strategies, and two healthy infants were delivered at 32+5 weeks, although the optimum management for such patients is unknown.

Cu/insulating material hybrid bonding technology was a promising process for high performance three-dimensional integrated package. A novel polyimide (PI) and thermal compression bonding (TCB) process were proposed for chip to wafer hybrid bonding. The new PI was developed by re-designing key components of the formulation. It showed high adhesion after TCB and high reliability performance. For the PI to PI bonding process evaluation, there were not any visible voids after pre-bonding at 250-350 °C and after TCB at 300 °C. Cu/PI co-planarization process was confirmed, and the PI showed a practical removal rate even though the PI was cured at high temperature. Furthermore, the PI showed highly smooth surface after CMP.

Objective: The purpose of this study was to investigate perinatal factors associated with a poor neurodevelopmental outcome in preterm infants.Methods: A retrospective study was conducted by searching our clinical database between January 2006 and December 2016. A total of 165 singleton children who were born between 23 and 33 weeks of gestation were included. We defined poor neurological development outcomes as follows: cerebral palsy; intellectual disability; developmental disorder including autism and attention-deficit/hyperactivity disorder; low score (Results: The rate of poor neurological development was 25/165 (15.2%): cerebral palsy (n = 1), intellectual disability (n = 1), developmental disorder (n = 2), low score of Bayley-III (n = 20), and low score of Kyoto Scale of Psychological Development (n = 1). Preeclampsia complicated with maternal renal dysfunction (P = 0.045) and delivery at P = 0.007) were independent risk factors for poor neurological development.Conclusions: In addition to previous risk factors such as delivery at

Aggrephagy is defined as the selective degradation of aggregated proteins by autophagosomes. Protein aggregation in organs and cells has been highlighted as a cause of multiple diseases, including neurodegenerative diseases, cardiac failure, and renal failure. Aggregates could pose a hazard for cell survival. Cells exhibit three main mechanisms against the accumulation of aggregates: protein refolding by upregulation of chaperones, reduction of protein overload by translational inhibition, and protein degradation by the ubiquitin–proteasome and autophagy–lysosome systems. Deletion of autophagy-related genes reportedly contributes to intracellular protein aggregation in vivo. Some proteins recognized in aggregates in preeclamptic placentas include those involved in neurodegenerative diseases. As aggregates are derived both intracellularly and extracellularly, special endocytosis for extracellular aggregates also employs the autophagy machinery. In this review, we discuss how the deficiency of aggrephagy and/or macroautophagy leads to poor placentation, resulting in preeclampsia or fetal growth restriction.

Fetal antigen-specific tolerance is important for maintaining allogeneic pregnancies. Maternal conventional T cells recognize fetal antigens; however, regulatory T (Treg) cells suppress immune reactions against the fetus. Fetal antigen-specific Treg cells are induced in the decidua upon contact with antigen-presenting cells and extravillous trophoblasts (EVTs). Functional alteration of cytotoxic T cells (CTLs) in the decidua also contributes to maintaining the pregnancy. Reduced, dysfunctional, and imbalanced Treg cell distribution likely contributes to the pathogenesis of pregnancy complications, such as miscarriage and preeclampsia. Recent studies have revealed differences in Treg cell characteristics during preeclampsia and miscarriage. Treg cell reduction in the decidua is likely associated with miscarriage. Insufficient expansion of fetal antigen-specific Treg cells in the decidua probably plays a role in preeclampsia pathogenesis. In addition, the balance between Treg cell-mediated tolerance and functional alteration of CTLs is important. Further investigations of functional molecules in Treg cells will contribute to the development of immunotherapy for pregnancy complications.

This work presents the imprint-thorough mold via (i-TMV) concept applicable for compartmental level electromagnetic interference (EMI) shielding. The i-TMV structure could be successfully fabricated by imprinting with the silicon master and filling with the conductive paste. We have fabricated a daisy-chained i-TMV test vehicle and it showed good connectivity. In order to study the EMI shielding properties, the electric field simulation was performed. Single and triple-array structures were modeled based on the fabricated test vehicle, and compared with the structure without via array. The result showed that the i-TMV could provide excellent EMI shielding.

The imprint-Through Mold Via was proposed for electromagnetic interference (EMI) shielding of Antenna in Package (AiP) application. The 300 μm-height via array could be successfully imprinted by using the silicon master which has 743 pillars with the diameter of 100 μm, pitch of 200 μm and height of 370 μm, and the via array was well filled by vacuum printing method with newly developed conductive paste utilizing transient liquid phase sintering. In order to evaluate the electric characteristics of the via array, a daisy-chain test vehicle (TV) which could connect all the vias together was fabricated. In the result of the reliability test, no electrical failure was confirmed of this daisy-chain.

Placental homeostasis is directly linked to fetal well-being and normal fetal growth. Placentas are sensitive to various environmental stressors, including hypoxia, endoplasmic reticulum stress, and oxidative stress. Once placental homeostasis is disrupted, the placenta may rebel against the mother and fetus. Autophagy is an evolutionally conservative mechanism for the maintenance of cellular and organic homeostasis. Evidence suggests that autophagy plays a crucial role throughout pregnancy, including fertilization, placentation, and delivery in human and mouse models. This study reviews the available literature discussing the role of autophagy in preeclampsia.

Plants incorporate inorganic materials (biominerals), such as silica, into their various components. Plants belonging to the order Poales, like rice plants and turfgrasses, show comparatively high rates of silicon accumulation, mainly in the form of silica bodies. This work aims to determine the shapes and roles of these silica bodies by microscopic observation and optical simulation. We have previously found convex silica bodies on the leaves of rice plants and hot-season turfgrasses (adapted to hot-seasons). These silica bodies enabled light reflection and ensured reduction of the photonic density of states, which presumably prevented the leaves from overheating, as suggested by theoretical optical analyses. The silica bodies have been considered to have the functions of reinforcement of the plant body. The present work deals with cold-season turfgrasses, which were found to have markedly different silica bodies, cuboids with a concave top surface. They presumably acted as small windows for introducing light into the tissues, including the vascular bundles in the leaves. The area of the silica bodies was calculated to be about 5% of the total surface area of epidermis, which limits the thermal radiation of the silica bodies. We found that the light signal introduced through the silica bodies diffused in the organs even reaching the vascular bundles, the physiological functions of this phenomena remain as future problems. Light signal in this case is not related with energy which heat the plant but sensing outer circumstances to respond to them.

AIM We evaluated whether maintenance tocolysis (intravenous ritodrine hydrochloride and/or magnesium sulfate) was effective in cases of spontaneous preterm labor with intact membranes. METHODS One hundred and thirty preterm labor patients who reached 36 weeks of gestation by maintenance tocolysis were selected. Immediate delivery (ID) after ceasing maintenance tocolysis was defined as an 'effective case'. The correlated factors between ID and no immediate delivery (NID) were statistically analyzed. RESULTS Thirty-six patients delivered < two days after ceasing maintenance tocolysis (27.7%) and were defined as effective cases. Multiple logistic regression analysis revealed that amniotic fluid interleukin-8 at admission (≥ 2.3 ng/mL; odds ratio [OR] 5.6, 95% confidence interval [CI] 2.1-17.6; P

OBJECTIVES It is very hard to estimate an abnormal or normal fetal karyotype in miscarriage before surgery. We investigated whether the abnormal fetal karyotype in early miscarriage could be estimated by comprehensive ultrasonographic findings by a multivariate analysis. METHODS One hundred fifty-one patients with early miscarriage (

Platelet counts increase after eradication of Helicobacter pylori (Hp) infection in non-pregnant patients with Hp-associated idiopathic thrombocytopenic purpura (ITP); however, improvement in pregnant patients has not yet been reported. We treated four pregnant women for Hp-positive ITP after Hp eradication. In three of four cases, platelet counts increased to levels exceeding 10 × 109 /L two weeks after eradication, and these levels were maintained until delivery. Vaginal deliveries were uncomplicated, and no excessive blood loss occurred in any of the cases. There were no remarkable side effects of Hp eradication in pregnant women or fetuses. In pregnant women with Hp-associated ITP, Hp eradication might be worthwhile prior to considering steroid administration.

Intrauterine (intra-amniotic) infection is recognized as the leading cause of preterm delivery, and is a major cause of a poor neonatal prognosis worldwide.

There is growing evidence that sphingosine 1-phosphate (S1P) is involved in inflammatory diseases. As endometriosis is known as an inflammatory disease, we investigated the role of S1P system in the development of endometriosis.The expression of sphingosine kinase (SphK) 1 in endometriosis lesions was examined by immunohistochemistry. The cystic fluid of ovarian cysts/tumors were obtained to measure S1P concentrations. Endometriotic stromal cells (ESC) derived from endometrioma were used for in vitro experiments.Sphingosine kinase 1 was detected in epithelium and stromal cells of endometriotic lesions. The mean S1P concentration in the cystic fluid of endometriomas was higher than that in nonendometriomas significantly (98.2 nM vs less than 1.5 nM,The present study for the first time proved that the SphK-S1P-S1PR axis play a role of accelerating inflammation and growth of endometriotic cells.

Background and Aim:Pulmonary large cell neuroendocrine carcinoma (LCNEC) is a rare neoplasm, and its clinical features and management are still limited. We evaluated the clinicopathological factors, including CDX2 immunohistochemical expression, to predict survival in patients with LCNEC.Patients and Methods:In all, 50 patients with LCNEC who underwent surgery at 4 institutes between 2001 and 2017 were included. Clinicopathological characteristics were evaluated for prognostic factors and statistically analyzed by Kaplan-Meier curve with a log-rank test or Cox regression models. We used immunohistochemical (IHC) analysis to determine the expressions of CDX2 and compared them with clinicopathological factors and survival.Results:Sixteen of the 50 cases (32%) were CDX2 positive. No correlation was found between the CDX2 expression by IHC and clinicopathological factors. Multivariate analysis identified adjuvant chemotherapy (hazard ratio [HR] =2.86, 95% confidence interval [CI] = 1.04-8.16, P = .04) and vascular invasion (HR = 4.35, 95% CI = 1.21-15.63, P = .03) as being associated with a significantly worse rate of recurrence-free survival.Conclusion:CDX2 was expressed in 1/3 of LCNEC but not associated with prognostic factor. Adjuvant chemotherapy and vascular invasion were associated with a negative prognostic factor of LCNEC.

Problem It is not known whether 17-alpha-hydroxyprogesterone caproate (17OHP-C) is effective for preventing preterm delivery with an episode of preterm labor (PTL) with or without intra-amniotic inflammation/infection. Methods of study This was a retrospective cohort study. One hundred and seven PTL patients were selected and divided into a 17OHP-C group (use of 17OHP-C: n = 53) and a no-treatment group (no use of 17OHP-C: n = 54). Moreover, the patients were divided into three subgroups (subgroup A: without intra-amniotic inflammation, B: with mild intra-amniotic inflammation, and C: with severe intra-amniotic inflammation) according to their level of amniotic interleukin (IL)-8, and perinatal prognosis was analyzed. Results Interval from admission to delivery (days) in the 17OHP-C group (76 [13-126], n = 34) was significantly longer than that in the no-treatment group (50 [8-104], n = 33; P = .012) in subgroup B. In cases without intra-amniotic microbes in subgroup B, a significant prolongation of gestational days was associated with the 17OHP-C group (79 [13-126], n = 25) compared with the no-treatment group (50 [8-104], n = 29; P = .029). However, there were no significant differences in subgroups A or C. Conclusion 17OHP-C could prolong gestational period in limited PTL cases with sterile mild intra-amniotic inflammation.

Problem To study the relationship between perinatal prognosis in cases of preterm labor (PTL) and polymicrobial infection in amniotic fluid (AF) and intra-amniotic (IA) inflammation using a highly sensitive and reliable PCR-based method. Method of Study To detect prokaryotes using a nested PCR-based method, eukaryote-made thermostable DNA polymerase without bacterial DNA contamination was used in combination with bacterial universal primers. We collected AF aseptically from 118 PTL cases and 50 term subjects. Results The prevalence of microorganisms was 33% (39/118) by PCR and only 7.6% (9/118) by culture. PTL caused by a combination of positive Mycoplasma/Ureaplasma and other bacteria had significantly higher AF IL-8 levels and a significantly shorter amniocentesis-to-delivery interval. Conclusions Our newly established PCR method is useful for detecting IA microorganisms. Polymicrobial infection with Mycoplasma/Ureaplasma and other bacteria induces severe IA inflammation associated with poor perinatal prognosis in PTL.