論文 - 森川　暁

幹細胞技術の現状と展望　成体に存在する多能性幹細胞

森川暁, 馬渕洋 and 松崎有未

蛋白質・核酸・酵素 52 （ 8 ） 906 - 912 2007年07月

ISSN  0039-9450

　概要を見る

これまで再生医療については,皮膚移植や骨髄移植のほか,パーキンソン病患者へのドーパミン産生細胞の移植などが行なわれてきた.しかし,移植組織が極端に不足しているという問題があり,その解決方策のひとつとして幹細胞を利用した細胞移植治療の確立が望まれている.本稿では,幹細胞の再生医学における供給源としての有用性に着目し,とくに体内から取り出しやすい幹細胞,すなわち,骨髄中に存在するとされている幹細胞に焦点をあてた.骨髄中の間葉系幹細胞に関する研究の進展について,骨髄中に存在する成体多能性幹細胞および中胚葉系幹細胞について,また,骨髄以外の組織に存在するとされている神経堤由来幹細胞について,それぞれの関係を中心にその関連性を考察する.(著者抄録)

Treatment of calcium channel blocker-induced gingival overgrowth without modifying medication

Morikawa S., Nasu M., Miyashita Y., Nakagawa T.

Drug and therapeutics bulletin （Drug and therapeutics bulletin）  60 （ 3 ） 44 - 47 2022年03月

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Proposed protocol for treatment of severe periodontitis without platelet transfusion in patients with aplastic anemia: a case report

Morikawa S., Watanabe K., Usuda S., Miyashita Y., Nakagawa T.

Journal of Medical Case Reports （Journal of Medical Case Reports）  15 （ 1 ）  2021年12月

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Background: Aplastic anemia is an intractable disease characterized by pancytopenia, susceptibility to infection, and difficulty in achieving hemostasis. In patients with severe periodontal disease and aplastic anemia, spontaneous bleeding from the gingival tissue due to thrombocytopenia and during brushing is common, which may further exacerbate dental issues. Comprehensive periodontal treatment for patients with aplastic anemia is highly challenging and requires collaboration with a hematologist. Here, we discuss the case of a patient with aplastic anemia and severe periodontitis who was successfully treated in collaboration with our hematology department. Case presentation: A 36-year-old Japanese woman with chief complaints of spontaneous gingival bleeding, pain, and increasing tooth mobility consulted our department. She had developed pancytopenia at age 11 years and was later diagnosed with aplastic anemia, making her susceptible to infection due to leukopenia. The results of the initial periodontal examination led to a diagnosis of severe generalized periodontitis (generalized stage IV grade C periodontitis) caused by leukopenia and poor oral hygiene. We adopted a comprehensive treatment plan, including invasive dental procedures. The patient exhibited no postoperative bleeding due to aplastic anemia-induced thrombocytopenia and experienced a good outcome. Conclusions: Both physicians and dentists should be aware that immunocompromised patients with aplastic anemia are at risk of developing severe periodontitis with severe alveolar bone resorption if the condition is combined with poor oral hygiene. Even in the presence of aplastic anemia, patients with severe periodontitis can undergo comprehensive dental treatment, including dental extraction and periodontal surgery, if bleeding and susceptibility to infection are controlled. This requires the cooperation of the patient and hematologists and can ultimately contribute to improving the patient’s quality of life.

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Mscs become collagen-type i producing cells with different phenotype in allogeneic and syngeneic bone marrow transplantation

Rusch R.M., Ogawa Y., Sato S., Morikawa S., Inagaki E., Shimizu E., Tsubota K., Shimmura S.

International Journal of Molecular Sciences （International Journal of Molecular Sciences）  22 （ 9 ）  2021年05月

ISSN  16616596

　概要を見る

Mesenchymal stem cells (MSCs) have been widely used in therapeutic applications for many decades. However, more and more evidence suggests that factors such as the site of origin and pre-implantation treatment have a crucial impact on the result. This study investigates the role of freshly isolated MSCs in the lacrimal gland after allogeneic transplantation. For this purpose, MSCs from transgenic GFP mice were isolated and transplanted into allogeneic and syngeneic recipients. While the syngeneic MSCs maintained a spherical shape, allogeneic MSCs engrafted into the tissue as spindle-shaped cells in the interstitial stroma. Furthermore, the MSCs produced collagen type I in more than 85% to 95% of the detected GFP+ MSCs in the recipients of both models, supposedly contributing to pathogenic fibrosis in allogeneic recipients compared to syngeneic models. These findings indicate that allogeneic MSCs act completely differently from syngeneic MSCs, highlighting the importance of understanding the exact mechanisms behind MSCs.

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Management of generalized severe periodontitis using full-mouth disinfection and systemic antibiotics in a leukemic patient before stem cell transplantation: A case report

Morikawa S., Tsunoda K., Miyashita Y., Nasu M., Horie N., Usuda S., Kato J., Mori T., Nakagawa T.

Clinical Case Reports （Clinical Case Reports）  9 （ 2 ） 644 - 649 2021年02月

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The full-mouth disinfection protocol implemented in this case can be integrated into established protocols for treating severe periodontitis in the context of a hematological malignancy, without any interference with the cancer treatment.

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Treatment of calcium channel blocker-induced gingival overgrowth without modifying medication

Morikawa S., Nasu M., Miyashita Y., Nakagawa T.

BMJ Case Reports （BMJ Case Reports）  14 （ 1 ）  2021年01月

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Gingival overgrowth is a common side effect of calcium channel blockers used in the treatment of cardiovascular diseases. While controversial, management includes discontinuing the calcium channel blocker. We report the case of a 66-year-old Japanese man with hypertension and type 2 diabetes mellitus who was diagnosed with severe periodontitis covering almost all the teeth. The patient had been on nifedipine (40 mg/day) and amlodipine (10 mg/day) medication for 5 years. With his physician's consent, nifedipine was discontinued during his treatment for periodontitis, which consisted of oral hygiene instructions and scaling and root planing on all areas. Gingivectomy was performed on the areas of hard fibrous swelling. Nifedipine was resumed during periodontal treatment when the patient's hypertension worsened. His periodontal scores improved when he resumed treatment. We report that significant improvement in gingival overgrowth can occur with basic periodontal treatment, surgery and sustained intensive follow-up without adjusting calcium channel blockers.

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RT-PCR screening tests for SARS-CoV-2 with saliva samples in asymptomatic people: Strategy to maintain social and economic activities while reducing the risk of spreading the virus

Oba J., Taniguchi H., Sato M., Takamatsu R., Morikawa S., Nakagawa T., Takaishi H., Saya H., Matsuo K., Nishihara H.

Keio Journal of Medicine （Keio Journal of Medicine）  70 （ 2 ） 35 - 43 2021年

ISSN  00229717

　概要を見る

The year 2020 will be remembered for the coronavirus disease 2019 (COVID-19) pandemic, which continues to affect the whole world. Early and accurate identification of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is fundamental to combat the disease. Among the current diagnostic tests, real-time reverse transcriptase–polymerase chain reaction (RT-qPCR) is the most reliable and frequently used method. Herein, we discuss the interpretation of RT-qPCR results relative to viral infectivity. Although nasopharyngeal swab samples are often used for RT-qPCR testing, they require collection by trained medical staff. Saliva samples are emerging as an inexpensive and efficient alternative for large-scale screening. Pooled-sample testing of saliva has been applied for mass screening of SARS-CoV-2 infection. Current policies recommend isolating people with borderline cycle threshold (Ct) values (35<Ct <40), despite these Ct values indicating minimal infection risk. We propose the new concept of a “social cut-off” Ct value and risk stratification based on the correlation of Ct with infectivity. We also describe the experience of RT-qPCR screening of saliva samples at our institution. It is important to implement a scientific approach to minimize viral transmission while allowing economic and social activities to continue.

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Vertical Displacement in Unilateral Extension Base Flexible Removable Dentures

Horie N., Ouchi T., Nishiyama R., Usuda S., Morikawa S., Asoda S., Nakagawa T.

The Bulletin of Tokyo Dental College （The Bulletin of Tokyo Dental College）  60 （ 4 ） 233 - 239 2019年12月

ISSN  00408891

　概要を見る

The need for flexible thermoplastic denture base materials has increased due to patient demand for better esthetic outcomes. Designs aimed at improving esthetic outcomes can cause difficulties for prosthodontists, however, from the viewpoint of function and maintenance. Therefore, the purpose of this study was to investigate vertical displacement in unilateral extension base denture models, comparing that obtained by flexible removable dentures with that by conventional metal clasp dentures. Models of unilateral extension base flexible removable dentures for mandibular defects were prepared. Periodontal ligament and jaw mucosa were simulated using a silicone impression material. Four types of flexible removable denture, with or without a metal rest, and two metal clasp dentures made of acrylic resin as a conventional design were used as dental prostheses. The amount of vertical displacement in the defect areas was measured under a load of 50 N at the first and second molars. Among the 6 types of dentures investigated, the amount of vertical displacement was greater with flexible removable dentures than with metal clasp dentures. This vertical displacement tended to decrease significantly, however, with the use of a metal rest with the flexible removable dentures. Esteshot with a metal rest, in particular, showed the smallest amount of displacement in the flexible removable dentures (first molar, 0.265±0.007 mm; second molar, 0.423±0.008 mm). These results indicate the importance of the application of rests in unilateral extension base flexible removable dentures. It may be useful to employ a metal rest in conjunction with a flexible removable denture to reduce load on the underlying mucosa, as is done with conventional partial dentures.

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