A Clinical and Microbiological Evaluation of Helicobacter pylori in Recurrent Aphthous Stomatitis.

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A Clinical and Microbiological Evaluation of Helicobacter pylori in Recurrent Aphthous Stomatitis.

J Contemp Dent Pract. 2017 Dec 01;18(12):1194-1197

Authors: Rajendra K, Purnachandra SM, Patel PC, Cota J, Singh VR, Vatsal A

Abstract
AIM: The aim of this study is to evaluate the association of Helicobacter pylori in recurrent aphthous stomatitis (RAS) with or without peptic ulcer.
MATERIALS AND METHODS: A total of 42 patients were selected for the present study from outpatient Department of Oral Medicine, and divided into control (group I) and test groups (groups II, III). A total number of 15 patients suffering from RAS based on history and clinical examination was selected as group II. A total number of 12 patients suffering concomitantly from RAS and duodenal ulcer based on history and clinical examination were selected as group III. A total number of 15 healthy subjects were selected as controls in group I. All selected subjects belonged to the age group of 16 to 45 years. Data were tabulated and statistically analyzed with Statistical Package for the Social Sciences (SPSS) statistical software version 19 of IBM, Chicago, Illinois, USA.
RESULTS: Among all three groups, 54.8% was negative and 45.2% was positive for H. pylori. No significant relation was established between H. pylori and RAS.
CONCLUSION: In the present study, there was no association of H. pylori in patients with RAS and in patients with RAS along with gastric ulcers.
CLINICAL SIGNIFICANCE: This clinical study evaluated the relation of H. pylori in RAS patients.

PMID: 29208798 [PubMed - in process]

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Recurrent Aphthous Stomatitis: An Assessment of Antioxidant Levels in Plasma and Saliva.

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Recurrent Aphthous Stomatitis: An Assessment of Antioxidant Levels in Plasma and Saliva.

J Clin Diagn Res. 2017 Sep;11(9):ZC64-ZC67

Authors: Jesija JS, Gopal S, Skiel HP

Abstract
Introduction: Recurrent Aphthous Stomatitis (RAS) is a common oral mucosal disorder that affects 20% of the population worldwide. Factors such as trauma, stress, genetic, hypersensitivity, nutrition, immune disturbance and hormonal imbalance may disturb the oxidant and antioxidant balance of an organism and precipitate RAS, but the relationships are poorly understood.
Aim: The purpose of this study was to evaluate the antioxidant status in plasma and saliva of patients with RAS.
Materials and Methods: Forty patients with RAS and forty healthy individuals were included in the study. The levels of antioxidants such as Superoxide Dismutase (SOD), Glutathione Peroxidase (GSHPx) Catalase (CAT) and Uric Acid (UA) were measured in plasma and saliva. Statistical analysis was performed to compare the two groups using independent t-test and ANOVA.
Results: Decreased SOD levels were observed in plasma amongst RAS patients (p < 0.03) whereas, increased levels were observed in their saliva (p < 0.001) compared to the control group. A significant difference (p < 0.001) was noticed in GSHPx levels: RAS patients exhibited higher levels in plasma but decreased in saliva compared to the control group. CAT activities and UA levels in saliva (p = 0.015 and p < 0.001 respectively) were observed to be significantly higher in RAS patients. Within the RAS group elevated plasma SOD level (p < 0.006) was found in patients with major ulcers whereas, an increased plasma UA (p < 0.01) level was observed in patients with minor ulcers.
Conclusion: The non-equilibrium antioxidant levels observed in both plasma and saliva indicate the antioxidant status of the body is disturbed in patients with RAS.

PMID: 29207836 [PubMed]

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Tooth Wear Is Frequent in Adult Patients with Celiac Disease.

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Tooth Wear Is Frequent in Adult Patients with Celiac Disease.

Nutrients. 2017 Dec 04;9(12):

Authors: Amato M, Zingone F, Caggiano M, Iovino P, Bucci C, Ciacci C

Abstract
(1) Background: Celiac disease (CD) patients can be affected by mouth and tooth disorders, which are influenced by their gluten-free diet. The aim of our research was to evaluate the pathological conditions of the stomatognathic system observed in celiac patients on a gluten-free diet. (2) Methods: we consecutively recruited celiac patients on a gluten-free diet at our celiac center, as well as healthy volunteers. Two dentists examined all patients/controls and checked them for any mouth disorder. (3) Results: Forty-nine patients affected by celiac disease (age at test 31.8 ± 11.58, time on GFD 8.73 ± 7.7) and 51 healthy volunteers (age at test 30.5 ± 8.7) were included. Recurrent aphthous stomatitis was reported in 26 patients (53.0%) and in 13 (25.5%) controls (p = 0.005). Dental enamel disorders were reported in 7 patients (14.3%) and in 0 controls (p = 0.002), with none having geographic tongue. We found non-specific tooth wear, characterized by loss of the mineralized tissue of the teeth, in 9 patients (18.3%) and in 3 (5.9%) controls (p = 0.05). (4) Conclusion: Recurrent aphthous stomatitis and enamel hypoplasia are "risk indicators" that may suggest that an individual has CD. We detected a high prevalence of non-specific tooth wear that can be caused by several factors such as malocclusion, sleep bruxism, parafunctional activity, and age.

PMID: 29207559 [PubMed - in process]

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Probiotic Strain Lactobacillus casei BL23 Prevents Colitis-Associated Colorectal Cancer.

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Probiotic Strain Lactobacillus casei BL23 Prevents Colitis-Associated Colorectal Cancer.

Front Immunol. 2017;8:1553

Authors: Jacouton E, Chain F, Sokol H, Langella P, Bermúdez-Humarán LG

Abstract
The gut microbiota plays a major role in intestinal health, and an imbalance in its composition can lead to chronic gut inflammation and a predisposition to developing colorectal cancer (CRC). Currently, the use of probiotic bacteria represents an emerging alternative to treat and prevent cancer. Moreover, consumption of these beneficial bacteria may also favorably modulate the composition of the gut microbiota, which has been described in several studies to play an important role in CRC carcinogenesis. In this context, the aim of this study was to assess the protective effect of oral treatment with Lactobacillus casei BL23, a probiotic strain well known for its anti-inflammatory and anticancer properties. First, CRC was induced in C57BL6 mice by a single intraperitoneal injection with azoxymethane (8 mg/kg), followed by four courses of dextran sodium sulfate (2.5%) in drinking water that were separated by an adjustable recovery period. At the time of sacrifice (day 46), tumor incidence, histological scores, and epithelial proliferation were determined in colon samples. Our results show that L. casei BL23 significantly protected mice against CRC development; specifically, L. casei BL23 treatment reduced histological scores and proliferative index values. In addition, our analysis revealed that L. casei BL23 had an immunomodulatory effect, mediated through the downregulation of the IL-22 cytokine, and an antiproliferative effect, mediated through the upregulation of caspase-7, caspase-9, and Bik. Finally, L. casei BL23 treatment tended to counterbalance CRC-induced dysbiosis in mice, as demonstrated by an analysis of fecal microbiota. Altogether our results demonstrate the high potential of L. casei BL23 for the development of new, probiotic-based strategies to fight CRC.

PMID: 29209314 [PubMed]

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STRO-1 confers myofibroblast transdifferentiation in fibroblasts derived from oral submucous fibrosis.

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STRO-1 confers myofibroblast transdifferentiation in fibroblasts derived from oral submucous fibrosis.

J Oral Pathol Med. 2017 Dec 06;:

Authors: Yu CC, Liao YW, Yu CH, Chang YC

Abstract
BACKGROUND: STRO-1 is a mesenchymal cell marker present on all clonogenic stromal precursors. Current evidence has indicated that the pathogenesis of fibrotic changes may be mediated by stemness properties. The aim of this study was to investigate the role of STRO-1 in areca quid chewing-associated oral submucous fibrosis (OSF).
METHODS: Thirty OSF specimens and ten normal buccal mucosa were examined by immunohistochemistry. The activity of STRO-1 from fibroblasts cultured from normal buccal mucosa (BMFs) and OSF (OSFFs) were measureed and the effects of arecoline, a major areca nut alkaloid, on STRO-1 in BMFs. Compared the activities between sorted STRO-1+ cells and STRO-1- cells from OSFF were measured by collagen gel contraction, migration, invasion abilities, and the expression of α-smooth muscle actin (α-SMA) and pro-α1 (I) chain of type I collagen.
RESULTS: Our results first showed that the expression of STRO-1 was more evident in areca quid chewing-associated OSF than normal buccal mucosa tissues (p<0.05). Arecoline dose-dependently activated the level of STRO-1 in BMFs (p<0.05). The relative expression of STRO-1 was significantly higher in OSFFs compared with BMFs (p<0.05). In addition, the sorted STRO-1+ cells from OSFFs exhibited higher collagen gel contraction, migration, and invasion abilities as well as elevated expression of α-SMA and pro-α1 (I) chain of type I collagen than the negative subset (p<0.05).
CONCLUSION: These findings suggested that the stemness marker STRO-1 may be a crucial factor in the pathogenesis of areca quid chewing-associated OSF. This article is protected by copyright. All rights reserved.

PMID: 29210111 [PubMed - as supplied by publisher]

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Increasing low-energy-dense foods and decreasing high-energy-dense foods differently influence weight loss trial outcomes

Increasing low-energy-dense foods and decreasing high-energy-dense foods differently influence weight loss trial outcomes

Increasing low-energy-dense foods and decreasing high-energy-dense foods differently influence weight loss trial outcomes, Published online: 07 December 2017; doi:10.1038/ijo.2017.303

Increasing low-energy-dense foods and decreasing high-energy-dense foods differently influence weight loss trial outcomes

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Global transcriptome analysis identifies weight regain-induced activation of adaptive immune responses in white adipose tissue of mice

Global transcriptome analysis identifies weight regain-induced activation of adaptive immune responses in white adipose tissue of mice

Global transcriptome analysis identifies weight regain-induced activation of adaptive immune responses in white adipose tissue of mice, Published online: 07 December 2017; doi:10.1038/ijo.2017.297

Global transcriptome analysis identifies weight regain-induced activation of adaptive immune responses in white adipose tissue of mice

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Associations of adult genetic risk scores for adiposity with childhood abdominal, liver and pericardial fat assessed by magnetic resonance imaging

Associations of adult genetic risk scores for adiposity with childhood abdominal, liver and pericardial fat assessed by magnetic resonance imaging

Associations of adult genetic risk scores for adiposity with childhood abdominal, liver and pericardial fat assessed by magnetic resonance imaging, Published online: 07 December 2017; doi:10.1038/ijo.2017.302

Associations of adult genetic risk scores for adiposity with childhood abdominal, liver and pericardial fat assessed by magnetic resonance imaging

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Good inter- and intraobserver reliability for assessment of the slip angle in 77 hip radiographs of children with a slipped capital femoral epiphysis

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Evaluating eight-year trajectories for sense of purpose in the health and retirement study

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Spouse's subjective social status predicts older adults’ prospective cognitive functioning

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An improved ENSO simulation by representing chlorophyll-induced climate feedback in the NCAR Community Earth System Model

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A PLAG1 mutation contributed to stature recovery in modern cattle

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Differential Raman backscattering cross sections of black carbon nanoparticles

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Mechanochemical mineralization of “very persistent” fluorocarbon surfactants ‒ 6:2 fluorotelomer sulfonate (6:2FTS) as an example

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Disentangling eco-evolutionary dynamics of predator-prey coevolution: the case of antiphase cycles

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A web-based GPS system for displacement monitoring and failure mechanism analysis of reservoir landslide

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Associations of adult genetic risk scores for adiposity with childhood abdominal, liver and pericardial fat assessed by magnetic resonance imaging

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Increasing low-energy-dense foods and decreasing high-energy-dense foods differently influence weight loss trial outcomes

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Global transcriptome analysis identifies weight regain-induced activation of adaptive immune responses in white adipose tissue of mice

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Mechanicsville dentist pleads guilty to $783,000 insurance fraud scheme

Court documents show that Maryam E. Zarei, 47, who owns and operated Atlee Station Family Dentistry in Mechanicsville received $783,000 as part of the scheme. Prosecutors said that between 2013 and 2016, Zarei defrauded Medicaid, Delta Dental, AETNA, Met Life and U.S. Healthcare by billing for services that were never performed.

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Unilateral sagittal split ramus osteotomy: an alternative for some cases of asymmetric mandibular prognathism

The objective of this study was to propose a treatment protocol for patients with lateral prognathism based on the unilateral sagittal split ramus osteotomy (USSRO). This was a prospective study involving 31 patients with lateral prognathism, who required a bilateral sagittal split ramus osteotomy (BSSRO). Two groups were formed using the proposed protocol, with specific inclusion criteria for each group: BSSRO (n=17) and USSRO (n=14). Occlusal parameters (dental midline deviation, overbite, and overjet) were measured preoperatively (T0), at model surgery (T1), 1 month postoperative (T2), and 1year after surgery (T3) and compared. (Source: International Journal of Oral and Maxillofacial Surgery)

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Management of head and neck primary unknown squamous cell carcinoma using combined positron emission tomography-computed tomography and transoral laser microsurgery

Objectives/Hypothesis

The unknown primary of the neck is commonly encountered by the head and neck surgeon. Despite the exhaustive diagnostic tools employed in traditional detection protocols, many unknown primaries are not found, and the patient is subjected to wide-field radiation and chemotherapy during treatment. Localizing the primary tumor has demonstrated therapeutic benefits, improved quality of life, and overall survival. The authors' objective was to determine the efficacy of a new management protocol for unknown primaries of the head and neck.

Study Design

Prospective cohort study.

Methods

Our technique involved a preoperative positron emission tomography-computed tomography (PET-CT) followed by a planned transoral laser microsurgery (TLM) approach. Efficacy was assessed based on survival statistics, disease control, detection rates, the proportion of patients not receiving adjuvant therapy, and the proportion of PET-CT scans helpful for detection of the primary cancer.

Results

The occult primary was located in 25 of the 27 patients (93%), with the majority found in the palatine tonsil (52%). Both overall survival and disease-specific survival was 80% at 36 months. Local control was achieved in 100% of patients. After surgery, 37.0% (n = 10) received adjuvant radiation alone and 33.3% (n = 9) of patients went on to receive adjuvant chemoradiation. On imaging, 72% (n = 18) of PET-CT scans correctly localized the primary tumor.

Conclusions

Occult head and neck primaries present a diagnostic challenge that is not adequately overcome using traditional detection protocols. The current study presents our unique protocol at Dalhousie University, which demonstrates the efficacy of the PET-CT TLM protocol from both a detection and therapeutic perspective.

Level of Evidence

4. Laryngoscope, 2017

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Endoscopic sentinel lymph node biopsy using indocyanine green-neomannosyl human serum albumin

Objective

The aim of this study was to determine the possibility of endoscopic sentinel lymph node biopsy of the head and neck region using indocyanine green-neomannosyl human serum albumin (ICG:MSA) and a custom-made intraoperative color-and-fluorescence-merged imaging system (ICFIS).

Methods

Using mouse and rabbit models of tongue cancer, we performed sentinel lymph node biopsy using an ICG:MSA tracer and custom imaging system equipped with an endoscope.

Results

ICG:MSA was localized to the cervical lymph node on the ipsilateral side for up to 30 minutes compared to ICG tracer (ICG n = 3, IGC:MSA n = 3). Detection of sentinel lymph nodes was attempted after injecting ICG:MSA in the mouse tongue cancer model (n = 3). During the operation, lymph nodes were easily identified and resected using ICFIS without the aid of other magnifiers. In the rabbit tongue cancer model (n = 3), the ICFIS equipped with 30-degree endoscopy was used to confirm the feasibility of endoscopic sentinel lymph node biopsy. The entire sentinel lymph node biopsy procedure was performed using the ICFIS with the 30-degree endoscope. We detected and dissected sentinel lymph nodes in the rabbit model without the other sentinel lymph node detection tools.

Conclusion

We confirmed the usefulness of sentinel lymph node biopsy using a near infrared fluorescence technique and endoscopic system. Avoidance of radiation exposure and shine-through phenomena, which are problems of sentinel lymph node biopsy using conventional radioisotopes, are advantages of our surgical technique. By combining the endoscopic system with a sentinel lymph node biopsy procedure, we avoided visible neck scars, which lead to excellent cosmetic outcomes.

Level of Evidence

NA. Laryngoscope, 2017

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A case of hypoglossal nerve stimulator-resistant obstructive sleep apnea cured with the addition of a chin strap

A population of appropriately selected patients does not respond, or does not achieve cure, with hypoglossal nerve stimulation (HGNS). We describe the case of nonresponder whose obstructive sleep apnea (OSA) resolved with the addition of chin strap. After initial placement and titration of HGNS implant, follow-up sleep study demonstrated persistent moderate OSA. Drug-induced sleep endoscopy demonstrated supraglottic collapse with activate neurostimulation. With mouth closure and change of stimulation settings to unipolar from bipolar, the airway collapse and desaturations improved. The follow-up polysomnogram with (HGNS) therapy and chin strap demonstrated resolution of sleep apnea. Laryngoscope, 2017

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An app to enhance resident education in otolaryngology

Objective

Technological change is leading to an evolution in medical education. The objective of our study was to assess the impact of a medical knowledge app, called PulseQD, on resident education within our otolaryngology–head and neck surgery department at Montefiore Medical Center, Albert Einstein College of Medicine (Bronx, NY).

Methods

A prospective cohort study was conducted within the Department of Otolaryngology–Head and Neck Surgery from July 2016 to June 2017. All faculty attendings and residents were asked to participate in the study and were included. A Web and mobile-based app, PulseQD, that allowed for collaborative learning was implemented. Questionnaires were given at the beginning and end of the academic year. Otolaryngology Training Exam (OTE) scores were collected

Results

A total of 20 residents and 13 faculty members participated in the study. Residents used online sources of medical information significantly more often than faculty (90% and 54%, respectively, P = 0.0179). Residents and faculty felt that PulseQD offered a valuable perspective on clinically relevant medical information (P = 0.0003), was a great way to test clinical and medical knowledge (P = 0.0001), and improved the sharing and discussing of medical knowledge (P < 0.0001). There was a statistically significant 5.8% improvement in OTE scores (P = 0.0008) at the end of the academic year.

Conclusion

The implementation of a novel mobile app, PulseQD, was well received by residents and faculty in the Department of Otolaryngology–Head and Neck Surgery. Preliminary data suggest that app-based learning may lead to improved performance on knowledge-based assessments.

Level of Evidence

NA. Laryngoscope, 2017

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Long-term stability of dental adhesive incorporated by boron nitride nanotubes

Publication date: Available online 6 December 2017
Source:Dental Materials
Author(s): Felipe Weidenbach Degrazia, Vicente Castelo Branco Leitune, Fernanda Visioli, Susana Maria Werner Samuel, Fabrício Mezzomo Collares
ObjectiveThe aim of this study was to evaluate physicochemical properties, long-term microtensile bond strength and cytotoxicity of methacrylate-based adhesive containing boron nitride nanotubes (BNNTs) as fillers.MethodsA dental adhesive was formulated using BisGMA/HEMA, 66/33wt% (control). Inorganic BNNT fillers were incorporated into the adhesive at different concentrations (0.05, 0.075, 0.1 and 0.15wt%). Analyses of degree of conversion (DC), polymerization rate [Rp.(s⁻¹)], contact angle (CA) on dentin, after 24h and 6 months microtensile bond strength (μTBS-24h and 6 months) were assessed. Cytotoxicity was performed through viability of fibroblast cells (%) by sulforhodamine B (SRB) colorimetry.ResultsDC and max. polymerization rate increased (p<0.05) after incorporating 0.075 and 0.1wt% BNNT. The contact angle on dentin increased (p<0.05) after incorporating 0.15wt% BNNT. The μTBS-24h showed no changes (p>0.05) after incorporating up to 0.15wt% BNNT comparing to control. After 6 months, μTBS decreased (p<0.05) for control and 0.15wt% BNNT and BNNT groups up to 0.15wt% showed higher μTBS than control (p<0.05). No difference of fibroblast growth was found among adhesives (p>0.05) and up to 19% of cell viability was found comparing 0.05wt% BNNT to positive control group (100%).SignificanceIncorporating boron nitride nanotubes up to 0.1wt% into dental adhesive increased the long-term stability to dentin without decreasing viability of fibroblast cell growth. Thus, the use of BNNTs as filler may decrease failure rate of current dentinal adhesives.



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Effective utilization of C. difficile PCR and identification of clinicopathologic factors associated with conversion to a positive result in symptomatic patients

Publication date: Available online 6 December 2017
Source:Diagnostic Microbiology and Infectious Disease
Author(s): Mohamed E. Mostafa, Timothy Flynn, Christopher P. Hartley, Nathan A. Ledeboer, Blake W. Buchan
ObjectivesWe assess the diagnostic yield of repeat testing for C. difficile using molecular methods within 7days of a negative test and identify specific factors associated with conversion from negative to positive test result within a 7-day period to aid in selective test utilization.MethodsA retrospective chart review of 20,866 laboratory test orders for C. difficile PCR was conducted. The test result, clinicopathologic patient features, and previous test results were recorded. Univariate and multivariate analysis was conducted to compare patients with initial and repeat negative results (n=248) to a group of patients with conversion from negative to positive results within 7days.ResultsUnivariate analysis demonstrated a history of C. difficile infection, receipt of antibiotics within 14days, and duration of hospital stay as factors significantly different between patients with repeat negative and conversion to positive C. difficile test result. Only history of C. difficile infection was significantly different upon multivariate analysis.ConclusionsIdentification of prior C. difficile infection as the only factor significantly correlated with conversion from negative to positive C. difficile test result within 7days aids in selective test utilization and reduces the costs associated with unnecessary laboratory testing.



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Challenges of Francisella classification exemplified by an atypical clinical isolate

Publication date: Available online 6 December 2017
Source:Diagnostic Microbiology and Infectious Disease
Author(s): LM Matz, KY Kamdar, ME Holder, GA Metcalf, GM Weissenberger, Q Meng, V Vee, Y Han, DM Muzny, RA Gibbs, CL Johnson, PA Revell, JF Petrosino
The accumulation of sequenced Francisella strains has made it increasingly apparent that the 16S rRNA gene alone is not enough to stratify the Francisella genus into precise and clinically useful classifications. Continued whole-genome sequencing of isolates will provide a larger base of knowledge for targeted approaches with broad applicability. Additionally, examination of genomic information on a case-by-case basis will help resolve outstanding questions regarding strain stratification. We report the complete genome sequence of a clinical isolate, designated here as F. novicida-like strain TCH2015, acquired from the lymph node of a 6-year-old male. Two features were atypical for F. novicida: exhibition of functional oxidase activity and additional gene content, including proposed virulence determinants. These differences, which could potentially impact virulence and clinical diagnosis, emphasize the need for more comprehensive methods to profile Francisella isolates. This study highlights the value of whole-genome sequencing, which will lead to a more robust database of environmental and clinical genomes and inform strategies to improve detection and classification of Francisella strains.



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Antibiotic Resistance Rates for Pseudomonas aeruginosa Clinical Respiratory and Bloodstream Isolates Among the Veterans Affairs Healthcare System from 2009 to 2013

Publication date: Available online 6 December 2017
Source:Diagnostic Microbiology and Infectious Disease
Author(s): Haley J. Appaneal, Aisling R. Caffrey, Lan Jiang, David Dosa, Leonard A. Mermel, Kerry L. LaPlante
Pseudomonas aeruginosa is a major cause of healthcare-associated infections and resistance among isolates is an increasing burden. The study purpose was to describe national resistance rates for clinical P. aeruginosa respiratory and bloodstream cultures and the prevalence of multidrug-resistant (MDR) P. aeruginosa within the Veterans Affairs (VA). MDR was defined as non-susceptibility to at least one drug in at least 3 of the following 5 categories: carbapenems, extended-spectrum cephalosporins, aminoglycosides, and piperacillin/tazobactam. We reviewed 24,562 P. aeruginosa respiratory and bloodstream isolates across 126 VA facilities between 2009 to 2013. Most isolates were collected from inpatient settings (82%). Resistance was highest in fluoroquinolones (33%) and exceeded 20% for all classes assessed (carbapenems, extended-spectrum cephalosporins, aminoglycosides, and piperacillin/tazobactam). Resistance was higher in inpatient settings and in respiratory isolates. Prevalence of MDR was 20% overall (22% for inpatient isolates, 11% outpatient, 21% respiratory, 17% bloodstream). Our findings are consistent with previous surveillance reports.



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Effect of ribonucleotide reductase M1 expression on overall survival in patients with pancreatic cancer receiving gemcitabine chemotherapy: A literature-based meta-analysis

Summary

What is known and objective

The prognostic value of ribonucleotide reductase M1 (RRM1) in patients with pancreatic cancer receiving gemcitabine chemotherapy has been evaluated in several studies. However, the conclusions remain controversial.

Methods

By searching the PubMed and Embase databases, we conducted a meta-analysis to evaluate the prognostic significance of RRM1 expression in patients with pancreatic cancer receiving gemcitabine chemotherapy. Studies were pooled, and the hazard ratio (HR) and its corresponding 95% confidence interval (CI) were calculated.

Results

Nine relevant articles were included for this meta-analysis study. Our results revealed that the high-RRM1 expression patients had significantly poorer overall survival (HR = 1.70, 95% CI = 1.33-2.16, P_{heterogeneity} = .061, I² = 44.8%) and disease-free survival (HR = 1.84, 95% CI = 1.56-2.18, P_{heterogeneity} = .669, I² = 0%) than the low-RRM1 expression patients. Furthermore, a statistically significant association between RRM1 expression and OS was found among both Japanese (HR = 1.80, 95% CI = 1.36-2.37, P_{heterogeneity} = .843, I² = 0%) and American patients (HR = 1.76, 95% CI = 1.60-1.94, P_{heterogeneity} = .439, I² = 0%).

What is new and conclusion

In conclusion, the expression of RRM1 can be considered a predictor of poor survival in patients with pancreatic cancer receiving gemcitabine chemotherapy. RRM1 expression assessment could provide more detailed information for patients with pancreatic cancer and could be used to optimize therapeutic schemes.

The expression of RRM1 can be considered a predictor of poor survival in patients with pancreatic cancer receiving gemcitabine chemotherapy. RRM1 expression assessment could provide more detailed information for patients with pancreatic cancer and could be used to optimize therapeutic schemes.

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Contents: Volume 45

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Keyword index: Volume 45

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Announcements

Dear Colleagues,

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EACMFS Awards

The Council of EACMFS wishes to ensure that all members of the Association are aware of the current awards and prizes that are available. These are designed to provide educational support and also to allow the opportunity for trainees and those who have recently achieved specialist status to visit units outside their own departments.

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Author Index: Volume 45

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Editorial Board

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Some Cochrane risk of bias items are not important in osteoarthritis trials: A meta-epidemiological study based on Cochrane reviews

Publication date: Available online 6 December 2017
Source:Journal of Clinical Epidemiology
Author(s): Julie Bolvig, Carsten B. Juhl, Isabelle Boutron, Peter Tugwell, Elizabeth A.T. Ghogomu, Jordi Pardo Pardo, Tamara Rader, George A. Wells, Alain Mayhew, Lara Maxwell, Hans Lund, Henning Bliddal, Robin Christensen
ObjectiveTo evaluate the impact of bias-related study characteristics on treatment effects in osteoarthritis (OA) trials.Study designBased on OA trials included in Cochrane reviews the impact of study characteristics on treatment effect estimates were evaluated. Characteristics included items of the risk of bias tool (RoB), trial size, single vs multi-site, and source of funding. Effect sizes were calculated as standardized mean differences (SMDs). Meta-regression was performed to identify "relevant study-level covariates" that decreases the between-study variance (τˆ²).ResultsTwenty reviews including 126 OA trials with a high degree of heterogeneity was included (τˆ²=0.1247). Among RoB domains only patient blinding had an impact on the results (reducing heterogeneity according to τˆ² <7%). Inadequate blinding of patients yielded larger effects (SMDDifference = 0.15; 95% CI: 0.11 to 0.29, P=0.035). The most important study characteristic was trial size (heterogeneity reduced by 25%), with small trials reporting larger effects (SMDDifference = 0.29; 95% CI: 0.16 to 0.42, P<0.001).ConclusionIn musculoskeletal reviews addressing pain, all the items included in the Cochrane risk of bias tool might not be equally important. OA trial results may be affected by bias constructs that are not yet fully elucidated.



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Diagnostic and treatment effects of sialendoscopy for patients with swelling of the parotid gland when sialoliths are undetected with computed tomography

Publication date: Available online 6 December 2017
Source:Auris Nasus Larynx
Author(s): Norio Kondo, Toshio Yoshihara, Yukie Yamamura, Kaoru Kusama, Eri Sakitani, Yukako Seo, Mayako Tachikawa, Keiko Kujirai, Erika Ono, Yasuyo Maeda, Tomohito Nojima, Akiko Tamiya, Emiri Sato, Manabu Nonaka
Between August 2009 and May 2016, 74 patients underwent sialoendoscopic surgery. 32 patients had parotid gland disease and 9 patients had intermittent swelling of the parotid gland and sialoliths were not detected with CT imaging. 4 patients were diagnosed with idiopathic Stensen's duct stenosis. Sialendoscopy directly confirmed Stensen's duct stenosis in 2 patients. However, the sialendoscope was unable to be inserted in the other 2 patients, who had stenosis of the orifice of the Stensen's duct. Balloon expansion of the duct was performed in these 2 patients and a steroid drug was injected into the duct in one patient. Complete remission was archived in one patient treated with sialendoscopy. Three patients had sialolithiasis. Microsialoliths and/or white floating matter was observed and removed using sialendoscopy. All patients experienced complete remission. In cases of Sjögren syndrome and recurrent parotitis, sialendoscopic surgery was performed, but the symptoms showed no improvement. For patients with microsialoliths, sialendoscopy may be most useful for diagnosis and treatment when the sialoliths are not detected with CT imaging. At present, sialendoscopic surgery have limitation in the treatment of Stensen's duct stenosis and may similarly have limitation in the treatment of Sjögren's syndrome and recurrent parotitis.



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Factors influencing recurrent emergency department visits for epistaxis in the elderly

Publication date: Available online 6 December 2017
Source:Auris Nasus Larynx
Author(s): Mohamad R. Chaaban, Dong Zhang, Vicente Resto, James S. Goodwin
ObjectiveOur objective is to determine the risk factors associated with recurrent epistaxis requiring emergency department (ED) visits in the elderly.MethodsWe used a 5% national sample of Medicare data from January 2012 through December 2013. Our cohort included patients with a new diagnosis of epistaxis in the ED, defined as no epistaxis in the prior 12 months. We assessed the rates of ED visits for recurrent epistaxis in the 12 months following the incident visit. Our variables included demographics, geographic location, procedures performed during the incident visit and comorbidities.ResultsOut of the 4120 patients with incident epistaxis, 775 were readmitted with recurrent epistaxis within 12 months. 60% presented in the first 30days and 75% within 90 days. There was a significant increase in ED visits for patients over 75 years of age and in men compared to women. Recurrent ED visits for epistaxis was higher in patients with congestive heart failure, diabetes mellitus, and obstructive sleep apnea compared to those without these comorbidities.ConclusionAdditional ED visits for epistaxis are more common in the elderly and in males. Congestive heart failure, diabetes mellitus and obstructive sleep apnea were found to be independent risk factors.



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Information for Readers

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Table of Contents

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Society Page

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Editorial Board

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Surface characterization of titanium implant healing abutments before and after placement

Abstract

Background

Implant healing abutments (IHA) have a vital role in soft tissue healing after implant placement. Although there is thorough investigation on the implant surface, little is known about the effects potentially damaging oral conditions impose on healing abutments.

Purpose

To characterize the surface of titanium healing abutments before and after clinical placement to understand the effects of the oral environment and time on the device surface.

Materials and Methods

Ten regular Straumann IHA were subjected to characterization pre and postplacement to elucidate the effects of the oral environment on device surfaces. Changes in surface crystallinity, morphology, and elemental composition were monitored with Raman spectroscopy, scanning electron microscopy, optical microscopy, and x-ray photoelectron spectroscopy, respectively. In addition, corrosion rate and polarization resistance were obtained to assess electrochemical device stability after placement.

Results

Control analysis indicated the titanium oxide of IHAs was thicker than natural commercially pure titanium and had the structure of crystalline anatase. After removal, the abutments possessed large amounts of biological debris, visible scratches, and discoloration sparsely on the surface. Spectroscopic analysis revealed the titanium oxide on the surface of IHAs was structurally unchanged, with crystalline titanium dioxide still present on the surface. Electrochemical results revealed that implanted healing abutments possessed a significantly higher corrosion rate than controls (change in corrosion rate = 2.34 ± 0.58 nm/year).

Conclusions

Healing abutments were stable in the oral environment due to the chemical stability of the oxide, and were likely subjected to abrasions from unintentional loading and oral hygiene techniques.

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Micromotion analysis of different implant configuration, bone density, and crestal cortical bone thickness in immediately loaded mandibular full-arch implant restorations: A nonlinear finite element study

Abstract

Background

Excessive micromotion may cause failure of osseointegration between the implant and bone.

Purpose

This study investigated the effects of implant configuration, bone density, and crestal cortical bone thickness on micromotion in immediately loaded mandibular full-arch implant restorations.

Materials and Methods

A finite element model of the edentulous mandible was constructed. Four implants were inserted in two different configurations, which were four parallel implants or tilted distal implants according to the all-on-four concept. Different cancellous bone densities and crestal cortical bone thicknesses were simulated. The framework was made of acrylic resin. A vertical load of 200 N was applied at the cantilever or on the distal implant (noncantilever loading).

Results

The maximum extent of micromotion was significantly influenced by the density of cancellous bone and to a lesser extent by implant configuration and the crestal cortical bone thickness. The all-on-four configuration showed less micromotion than the parallel implant configuration in some circumstances. The maximum micromotion detected with noncantilever loading was less than 1/3 of that with cantilever loading.

Conclusions

Implant configuration had a limited influence on micromotion. Avoiding cantilever loading during the healing period should effectively reduce the risk of excessive micromotion in patients with low-density cancellous bone and thin crestal cortical bone.

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Dentist receives special award for 'kindness and empathy' shown towards young patient with autism

A Monaghan dentist has been awarded for the "kindness and empathy" he has shown when treating a young boy who has autism. http://ift.tt/2AC5BVm A Monaghan dentist has been awarded for the "kindness and empathy" he has shown when treating a young boy who has autism.

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Relationship between maximum oxygen uptake and peripheral vasoconstriction in a cold environment

Various individual characteristics affect environmental adaptability of a human. The present study evaluates the relationship between physical fitness and peripheral vasoconstriction in a cold environment.

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The composite palatal island flap: modification of an existing technique to reconstruct the maxillary alveolus

Palatal submucosal flaps have been used for a long time to reconstruct the alveolus.1 Although there have been great advances in tissue engineering recently, autogenous bone remains the "gold standard" to treat atrophy of the ridge.2 We describe a new technique to reconstruct the hard and soft tissues of the maxillary alveolus simultaneously, by incorporating an island of palatine bone into a submucosal flap.

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Three-dimensional superimposition for patients with facial palsy: an innovative method for assessing the success of facial reanimation procedures

Facial palsy is a severe condition that may be ameliorated by facial reanimation, but there is no consensus about how to judge its success. In this study we aimed to test a new method for assessing facial movements based on 3-dimensional analysis of the facial surfaces. Eleven patients aged between 42 and 77 years who had recently been affected by facial palsy (onset between 6 and 18 months) were treated by an operation based on triple innervation: the masseteric to temporofacial nerve branch, 30% of the hypoglossal fibres to the cervicofacial nerve branch, and the contralateral facial nerve through two cross-face sural nerve grafts.

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Revisiting lip shave: a solution for disorders of the vermilion border

Actinic keratosis, leukoplakia, carcinoma in situ, and superficially invasive carcinomas of the lower lip are caused mainly by the cumulative effects of exposure of the vermilion of the lower lip to ultraviolet radiation. Current treatments all have limitations: cryosurgery or electrosurgery is suitable to treat only focal lesions; topical chemotherapy, which is an option for diffuse actinic damage, yields unreliable results; and laser treatment fails to rejuvenate the vermilion. However, "lip shave", which involves full-thickness excision of the damaged vermilion and reconstruction with an advancement labial mucosal flap, will produce a fresh mucosal lining to the vermilion border.

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Effectiveness of irrigation with chlorhexidine after removal of mandibular third molars: a randomised controlled trial

To evaluate the effect of postoperative irrigation with chlorhexidine on inflammatory complications after the extraction of lower third molars under local anaesthesia, we recruited 100 patients to participate in a controlled, single-blind, randomised clinical trial. They were assigned to one of two groups: the intervention group (postoperative irrigation of the surgical site with chlorhexidine for seven days) or the control group (postoperative chlorhexidine mouth rinse for seven days). The primary outcome variables were pain, swelling, trismus, infection, and alveolar osteitis.

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Unilateral sagittal split ramus osteotomy: an alternative for some cases of asymmetric mandibular prognathism

The objective of this study was to propose a treatment protocol for patients with lateral prognathism based on the unilateral sagittal split ramus osteotomy (USSRO). This was a prospective study involving 31 patients with lateral prognathism, who required a bilateral sagittal split ramus osteotomy (BSSRO). Two groups were formed using the proposed protocol, with specific inclusion criteria for each group: BSSRO (n=17) and USSRO (n=14). Occlusal parameters (dental midline deviation, overbite, and overjet) were measured preoperatively (T0), at model surgery (T1), 1 month postoperative (T2), and 1year after surgery (T3) and compared.

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Norwich dental practice refurbished following acquisition

Friends Dental Practice in Sprowston, Norwich, has undergone refurbishment following its acqisition in the summer. From left, owner Zain Shamoon and Royal Bank of Scotland's Tracy Westley.

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Fast food consumption and its associations with obesity and hypertension among children: results from the baseline data of the Childhood Obesity Study in China Mega-cities

China has seen rapid increase in obesity and hypertension prevalence and fast food consumption over the past decade. We examined status and risk factors for Western- and Chinese fast food consumption and their...

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Views of policy makers and health promotion professionals on factors facilitating implementation and maintenance of interventions and policies promoting physical activity and healthy eating: results of the DEDIPAC project

The uptake, implementation, and maintenance of effective interventions promoting physical activity (PA) and a healthy diet and the implementation of policies targeting these behaviors are processes not well un...

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The effectiveness of two types of MADS for OSA therapy

Abstract

Objectives

The purpose of this study was to determine differences in effectiveness between two types of mandibular advancement device (MAD).

Material and methods

In this retrospective, cohort study, the two devices used were MAD type "Somnodent-Flex" (MAD 1) and MAD type "Herbst" (MAD 2). One hundred thirty-seven patients participated in this study, 67 patients were treated with MAD 1, and 70 patients with MAD 2. The indication MAD with obstructive sleep apnea (OSA) is based on a polysomnography test, in accordance with the CBO guidelines. The effectiveness of MAD therapy can be determined by a second polysomnography test (with the MAD in situ). The apnea-hypopnea index (AHI) is registered during the first and the second polysomnography test. Changes in these values determine the effectiveness.

Results

A significant decrease in AHI was found regarding T1 and T2 for both the MADs: F (1, 134) = 140,850, p < 0,001. The mean differences of both the MADs turned out to correlate to T1. After correcting for this covariance, there was no significant difference between the two MAD devices regarding the AHI value: F (1, 134) = 1160, p = 0,283.

Conclusions

The results of the present study show no significant difference in effectiveness between MAD 1 and MAD 2 in respect to the AHI value.

Clinical relevance

Since 2012, healthcare insurance companies in the Netherlands refunds MAD type "Somnodent" used for treatment of sleep apnea. It is important to investigate if this type of MAD is as more effective or less effective as other types of MADs. If research points out that other MADs are more effective in reducing the sleep apnea, refund policies have to be adapted.

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Exposure to cox-2 inhibitors (coxibs) during the first trimester and pregnancy outcome: a prospective observational cohort study

Abstract

Purpose

Cox-2-inhibitors (coxibs) are not recommended in pregnancy but early exposure may occur, for instance in unplanned pregnancies. Experience in pregnancy is limited leading to concerns in patients and their health care providers. Therefore, further data on coxibs and their effects on embryogenesis are needed.

Methods

This observational cohort study evaluates pregnancies ascertained in Germany during the study period from January 2000 to January 2016. A cohort of 174 women exposed to coxibs in the first trimester was compared to a randomly selected cohort of 521 women without exposure to coxibs, other nonsteroidal anti-inflammatory drugs or known teratogens.

Results

The overall rate of major birth defects was not significantly increased in the study cohort (2.9 vs. 2.7%, OR 1.08, 95% CI 0.34–3.42; OR adjusted 0.96, 95% CI 0.28–3.26). The cumulative incidence of spontaneous abortions was nonsignificantly lower in the exposed cohort (14.3 vs. 20.0%; HR, 0.90, 95% CI 0.51–1.58; HR adjusted, 0.87; 95% CI, 0.49–1.56). Elective terminations of pregnancies (ETOP), mainly for 'social' reasons, were more frequent in the coxib cohort (17.5 vs. 7.0%, HR, 2.31; 95% CI, 1.26–4.24; HR adjusted 2.12, 95% CI 1.13–3.97).

Conclusions

Our study results support the assumption that coxibs are not major teratogens. Considering the still limited evidence basis on coxib exposure during pregnancy, well-established alternatives should be preferred.

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Genomic integration and expression of the Aggregatibacter actinomycetemcomitans catalase gene in Aggregatibacter aphrophilus

Publication date: Available online 5 December 2017
Source:Archives of Oral Biology
Author(s): Yuting Alice Yang, Ya-An Cheng, Casey Chen
ObjectiveTo test the hypothesis that virulence genes of Aggregatibacter actinomycetemcomitans can be expressed and confer fitness advantages in the closely related Aggregatibacter aphrophilus.DesignClinical isolates of A. aphrophilus were screened for natural competence with marked genomic DNA from A. actinomycetemcomitans and A. aphrophilus. The gene katA of A. actinomycetemcomitans D7S-1 and its flanking regions were constructed and inserted into a comparable locus in the genome of naturally competent A. aphrophilus strains by a markerless protocol via natural transformation. Mutants of A. actinomycetemcomitans with or without katA were also constructed by a similar protocol. Discs soaked with either 0.03% hydrogen peroxide or broth culture of Streptococcus gordonii Challis were placed on the agar with cultures of A. actinomycetemcomitans or A. aphrophilus. The size of the growth inhibition zone associated with the disc was measured after 2-day culture.ResultsFive of the 13A. aphrophilus strains exhibited a transformation frequency of 10⁻⁶ or higher. The intra- and inter-species transformation frequencies were comparable. The inhibition zones for katA-negative strains of A. actinomycetemcomitans or A. aphrophilus were 3- to 7-fold larger than those associated with katA-positive strains (p<0.05).ConclusionsThere was no apparent species barrier for the transfer and expression of A. actinomycetemcomitans katA in A. aphrophilus. The inserted A. actinomycetemcomitans-specific katA gene in A. aphrophilus strain NJ8700 conferred resistance to inhibition by hydrogen peroxide or S. gordonii. The potential to swap genes between these two closely related oral species may be an alternative approach for investigating the virulence determinants of A. actinomycetemcomitans.



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Anti-inflammatory Activity of Cannabinoid Receptor 2 Ligands in Primary hPDL Fibroblasts

Publication date: Available online 6 December 2017
Source:Archives of Oral Biology
Author(s): Ammaar H. Abidi, Chaela S. Presley, Mustafa Dabbous, David A. Tipton, Suni M. Mustafa, Bob M. Moore II
ObjectivesApproximately 65 million adults in the US have periodontitis, causing tooth loss and decreased quality of life. Cannabinoids modulate immune responses, and endocannabinoids are prevalent during oral cavity inflammation. Targets for intervention in periodontal inflammation are cannabinoid type 1 and 2 receptors (CB1R, CB2R), particularly CB2R because its levels increase during inflammation. We previously demonstrated that SMM-189 (CB2R inverse agonist) decreased pro-inflammatory cytokine production in primary microglial cells. The hypothesis of this study was that cannabinoids anandamide (AEA), HU308 (CB2R selective agonist), and SMM-189 decrease pro-inflammatory IL-6 and MCP-1 production by primary human periodontal ligament fibroblasts (hPDLFs) stimulated with P.gingivalis LPS, TNFα, or IL-1β.DesignCytotoxic effects of cannabinoid compounds (10⁻⁴ −10^−6.5M), LPS (1–1000ng/ml), TNFα (10ng/ml) and IL-1β (1ng/ml) were assessed by measuring effects on cellular dehydrogenase activity. IL-6 and MCP-1 production were measured using Mesoscale Discovery (MSD) Human Pro-Inflammatory IL-6 and MSD Human Chemokine MCP-1 kits and analyzed using MSD Sector 2400 machine.ResultsEC50 values for AEA, SMM-189, and HU308 were 16μM, 13μM, and 7.3μM respectively. LPS (1μg/ml), TNFα (10ng/ml), and IL-1β (1ng/ml) increased IL-6 and MCP-1 production, which were inhibited by AEA, SMM-189, and HU308. AEA alone significantly increased IL-6, but not MCP-1 levels, but the other cannabinoids alone had no effect.ConclusionThe effective inhibition of LPS, TNFα, IL-1β-stimulated IL-6 and MCP-1 production by CB2R ligands in hPDLFs suggests that targeting the endocannabinoid system may lead to development of novel drugs for periodontal therapy, aiding strategies to improve oral health.



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Dickkopf-1 may regulate bone coupling by attenuating wnt/β-catenin signaling in chronic apical periodontitis

Publication date: February 2018
Source:Archives of Oral Biology, Volume 86
Author(s): Xuelian Tan, Dingming Huang, Wei Zhou, Li Yan, Junli Yue, WanLu Lu, Dongzhe Song, Xuedong Zhou, Ling Ye, Lan Zhang
ObjectiveAlveolar bone loss is a common outcome of chronic apical periodontitis. In this study, we investigated the involvement of the Dickkopf-1-Wnt/β-catenin signaling pathway in the attenuation of osteogenic differentiation induced by Escherichia coli lipopolysaccharide, and we evaluated the use of Dickkopf-1 inhibitor and Dickkopf-1 recombinant protein to reverse bone loss in different phases of osteogenic differentiation.MethodsMC3T3-E1 cells grown in osteogenic medium were treated with Escherichia coli lipopolysaccharide for 24h during osteogenic induction on days 0, 1, 7, 14 and 21. Dickkopf-1 siRNA was added on days 0 and 1, and Dickkopf-1 recombinant was added on days 7, 14, and 21. Quantitative real-time PCR, Western blotting and alkaline phosphatase activity assays were performed to measure osteogenic marker expression and Wnt/β-catenin signaling. A rat apical periodontitis model was used to further evaluate the function of Dickkopf-1 in relation to bone loss.ResultsMC3T3-E1 cells treated with Escherichia coli lipopolysaccharide showed decreased mRNA expression of osteogenic markers. Wnt/β-catenin signaling was also inhibited, and Dickkopf-1 showed corresponding variations as quantified by Western blotting. Using Dickkopf-1 inhibitor or Dickkopf-1 recombinant protein at different phases of osteogenic differentiation in vitro partially reversed the decrease in osteogenic marker expression. The rat apical periodontitis model indicated that the Dickkopf-1 inhibitor could restore bone loss in the periapical area in vivo.ConclusionsDickkopf-1 may play a key regulatory role in determining the outcome for bone in inflammatory environments, and modulating the Wnt/β-catenin signaling pathway via Dickkopf-1 inhibitor or recombinant protein may provide a potential therapeutic option to prevent bone destruction in endodontic disease.



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High-refined carbohydrate diet promotes detrimental effects on alveolar bone and femur microarchitecture

Publication date: February 2018
Source:Archives of Oral Biology, Volume 86
Author(s): C.C. Montalvany-Antonucci, M.C. Zicker, S. Macari, T.S.F. Pereira, I.M.A. Diniz, I. Andrade, A.V.M. Ferreira, T.A. Silva
The impact of high-refined carbohydrate (HC) diet on fat accumulation, adipokines secretion and systemic inflammation is well described. However, it remains unclear whether these processes affect bone remodeling.ObjectiveTo investigate the effects of HC diet in the alveolar bone and femur parameters.MethodsBalbC mice were fed with conventional chow or HC diet for 12 weeks. After experimental time maxillae, femur, blood and white adipose tissue samples were collected.ResultsThe animals feed with HC diet exhibited considerable increase of adiposity index and adipose tissue levels of TNF-α, IL-6, IL-10, IL-1β, TGF-β and leptin. Microtomography analysis of maxillary bone revealed horizontal alveolar bone loss and disruption of trabecular bone in mice feed with HC diet. These deleterious effects were correlated with a disturbance in bone cells and an augmented expression of Rankl/Opg ratio. Consistently, similar effects were observed in femurs, which also exhibited a reduction in bone maximum load and stiffness.ConclusionOur data indicates that HC diet consumption disrupts bone remodeling process, favoring bone loss. Underlying mechanisms relies on fat tissue accumulation and also in systemic and local inflammation.



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Dentin sialophosphoprotein expression in enamel is regulated by Copine-7, a preameloblast-derived factor

Publication date: Available online 6 December 2017
Source:Archives of Oral Biology
Author(s): Su-Jin Park, Hye-Kyung Lee, You-Mi Seo, Chul Son, Hyun Sook Bae, Joo-Cheol Park
ObjectiveDentin sialophosphoprotein (Dspp) is expressed in odontoblasts and transiently expressed in early ameloblasts. However, the origin of Dspp in ameloblasts remains unclear. Our previous studies demonstrated that copine-7 (CPNE7), a molecule that is secreted by the dental epithelium, is expressed in early ameloblasts and is then translocated to differentiating odontoblasts; its expression levels correlate with odontoblast differentiation under the control of Dspp expression. The objective of this study is to figure out the relationship between CPNE7 and Dspp during amelogenesis.DesignThe gene expression patterns of CPNE7 and dentin sialoprotein (DSP) were examined by immunohistochemistry, western blot analysis, and real-time polymerase chain reaction. The effects of CPNE7 on Dspp regulation were investigated using luciferase and chromatin immunoprecipitation assays in ameloblastic HAT-7 cells.ResultsThe gene expression pattern of Cpne7 was similar to that of Dspp during ameloblast differentiation. Moreover, Gene expression omnibus profiles indicated that there is a close correlation between Cpne7 and Dspp expression in various normal human tissues. We also confirmed the effects of CPNE7 on the induction of Dspp in ameloblastic HAT-7 cells. Cpne7 overexpression promoted Dspp expression, whereas Dspp expression was down-regulated by Cpne7 inactivation.ConclusionsThese results suggest that the expression of Dspp in early amelogenesis is linked to CPNE7, a preameloblast-derived factor.



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Development and standardization of Arabic Words in Noise test in Egyptian children

To develop and establish norms of Arabic Words in Noise test in Egyptian children.

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The Middle Turbinate Resection and Its Repercussion in Olfaction with the University of Pennsylvania Smell Identification Test (UPSIT)

Int Arch Otorhinolaryngol
DOI: 10.1055/s-0037-1608679

Introduction Nasal obstruction is a common complaint, and, for some, the middle turbinate resection is still a controversial issue among the surgical options due to the possibility of deleterious effects on olfaction. The University of Pennsylvania smell identification test (UPSIT) is considered the gold standard of smell identification tests, but data about it is still incipient in Brazil. Objective To evaluate if the middle turbinectomy has any repercussion on the sense of olfaction by using the UPSIT as an assessment tool. Methods A prospective study performed between 2013 and 2015 with 27 patients who were treated with middle turbinectomy by the same surgeon and tested with the UPSIT pre- and post-surgery, with a minimum interval of 3 months. Results Twenty-five patients completed the study. The mean age was 27.9 years. There was no statistical correlation between middle turbinectomy and the UPSIT score, or between gender and the UPSIT score. Conclusion There was no clinical repercussion on olfaction from partial middle turbinectomy.
[...]

Thieme Revinter Publicações Ltda Rio de Janeiro, Brazil

Article in Thieme eJournals:
Table of contents  |  Abstract  |  open access Full text

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Headphone Evaluation for App-Based Automated Mobile Hearing Screening

Int Arch Otorhinolaryngol
DOI: 10.1055/s-0037-1607438

Introduction With the need for hearing screenings increasing across multiple populations, a need for automated options has been identified. This research seeks to evaluate the hardware requirements for automated hearing screenings using a mobile application. Objective Evaluation of headphone hardware for use with an app-based mobile screening application. Methods For the purposes of this study, hEAR, a Bekesy-based mobile application designed by the research team, was compared with pure tone audiometric tests administered by an audiologist. Both hEAR and the audiologist's test used 7 frequencies (125 Hz, 250 Hz, 500 Hz, 1,000 Hz, 2000 Hz, 4,000 Hz and 8,000 Hz) adopting four different sets of commercially available headphones. The frequencies were regarded as the independent variable, whereas the sound pressure level (in decibels) was the dependent variable. Thirty participants from a university in Texas were recruited and randomly assigned to one of two groups, whose only difference was the order in which the tests were performed. Data were analyzed using a generalized estimating equation model at α = 0.05. Results Findings showed that, when used to collect data with the mobile app, both the Pioneer HDJ-2000 (Pioneer, Bunkyo, Tokyo, Japan) (p > 0.05) and the Sennheiser HD280 Pro (Sennheiser, Wedemark, Hanover, Germany) (p > 0.05) headphones presented results that were not statistically different from the audiologist's data across all test frequencies. Analyses indicated that both headphones had decreased detection probability at 4kHz and 8kHz, but the differences were not statistically significant. Conclusion Data indicate that a mobile application, when paired with appropriate headphones, is capable of reproducing audiologist-quality data.
[...]

Thieme Revinter Publicações Ltda Rio de Janeiro, Brazil

Article in Thieme eJournals:
Table of contents  |  Abstract  |  open access Full text

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Risk factors for intraoperative bradycardia during ear, nose, throat and maxillofacial surgery

Abstract

Intraoperative bradycardia (IOB) is one of the most common cardiac arrhythmias observed in clinical anaesthetic practice. Controlled hypotension, as a strategy of lowering patient's blood pressure during anesthesia has been practiced for decades in head and neck surgery. The aim of our study was to determine the incidence and the risk factors for intraoperative bradycardia in maxillofacial, ear, nose and throat surgery, as well as to determine whether controlled hypotension affects the occurrence of IOB. The retrospective study included 2304 patients who underwent maxillofacial, ear, nose or throat surgery. We studied the influence of: sex, age, comorbidity, type of surgery, duration of anesthesia and controlled hypotension on the occurrence of IOB. IOB was registered in 473 patients (20.5%). Patients with controlled hypotension had IOB significantly more often than patients without controlled hypotension (33.9 vs 15.1%) (p = 0.000). The significant predictors of IOB were: age (OR = 1.158; 95% CI = 1.068–1.256; p = 0.000), sex (OR = 0.786; 95% CI = 0.623–0.993; p = 0.043), ischemic heart disease (OR = 2.016; 95% CI = 1.182–3.441; p = 0.010); ear surgery (OR = 1.593; 95% CI = 1.232–2.060; p = 0.000), anesthesia duration, (OR = 1.006; 95% CI = 1.004–1.007; p = 0.000) and controlled hypotension (OR = 2.204; 95% CI = 1.761–2.758; p = 0.000). IOB is common in maxillofacial, ear, nose and throat surgery, particularly in male, older age and patients with ishemic heart disease. The ear surgery, longer anesthesia duration and controlled hypotension raise the risk for occurrence of IOB.

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Overexpression of osteopontin promotes cell proliferation and migration in human nasopharyngeal carcinoma and is associated with poor prognosis

Abstract

Nasopharyngeal carcinoma (NPC), a malignant tumor at the top and side of the nasopharyngeal cavity, highly occurs in the southern region of China. Cancer cell metastasis is one of the leading causes of death in NPC patients. Osteopontin (OPN), is a phosphorylated extracellular matrix protein with a variety of functions, was found to be overexpressed in many cancers. However, the expression and role of OPN in patients with NPC in Guangxi, China are unclear. Here, we observed that NPC patients had upregulated OPN at mRNA protein and levels. Immunochemistry (IHC) analysis of OPN expression in 68 NPC clinical specimens indicated that high expression of OPN had positive correlation with NPC lymph node metastasis (P = 0.012), distant metastasis (P = 0.001) and TNM staging (P = 0.018). Moreover, compared with relatively low OPN, NPC patients with higher expression of OPN showed a poorer overall survival rate (P = 0.001, log rank test). Multivariate analysis showed that OPN expression in NPC was an independent prognostic marker. The proliferation, apoptosis and migration ability of CEN-2Z cancer cells in NPC were determined by MTT, flow cytometry and wound-healing assays, respectively. Upregulation of OPN in CEN-2Z cancer cells promoted cancer cell proliferation and migration, and suppressed apoptosis. In sum, our result suggests OPN could be used as a valuable oncoprotein and show that overexpression of OPN in NPC may serve as a potential prognostic marker.

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Correlation Between the Posterior Mandibular Width and the Lingual Gap caused by Symphyseal Fractures, Using a Virtual Model

The objective was to determine the dimensional impact on an occlusal and articular level of the gap produced in the lingual plate from symphyseal fractures, correlated with the dimensional change in the posterior mandibular width.

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Assessing the Different Oncologic Disease Distribution and Postoperative Complications of Octo & Nonagenerian Head and Neck Oncology Patients

The admission rate of patients 80 years of age and above with head and neck (HN) oncologic disease is on the rise. Our goal was to study the demography, reasons for admission, types of surgical procedures and post-operative complications of the oldest-old patients with HN malignancy.

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Mucosal Dehiscence After Alveolar Bone Graft in Cleft

Abstract Cleft lip and palate patient represent a challenging experience for the surgeon. This kind of patients had to be followed by a multidisciplinary team from the beginning to the end to avoid the deformation sequelae. During the several surgical procedures, the bone graft represents a possible procedure that, through the new procedure, could be avoided. Unfortunately, patient treated following the previous procedure must be submitted to alveolar bone graft to coordinate the arch, to restore the maxillary integrity, to allow the correct dentition. Address correspondence and reprint requests to Giulia Amodeo, MD, Via Giovanni Martinotti 20, 00135 Rome, Italy; E-mail: gamodeo@live.it Received 11 July, 2017 Accepted 19 August, 2017 The authors report no conflicts of interest. © 2017 by Mutaz B. Habal, MD.

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Age-Related Volumetric Changes in Mandibular Condyles

Abstract A precise knowledge of the condylar changes with advancing age may improve understanding of pathophysiological alterations of the mandibular condyles. However, the majority of studies focusses on morphological changes, although volumetric analysis based upon cone beam computerized tomography may provide important additional data to characterize mandibular condyles. Therefore, we aimed to provide and compare volumetric data of mandibular condyles of a young and old patient group. This is a retrospective chart review of 195 patients with cone beam computerized tomography between 2007 and 2016. Student t test, analysis of variance, and Pearson correlation test were performed to analyze associations between categorical and continuous variables. P values

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The Aesthetic Analyzing of Midface Ratio After Folding Aponeurosis of Levator Palpebrae Superioris Muscle in the Ptosis Correction

Background: Some fordless-eyelid patients with moderate upper lid ptosis characterize in a higher eyebrow position which leads to an increased midfacial ratio. Apart from performing blepharoplasty to create dynamic folds, additional procedures such as folding aponeurosis of levator palpebrae superioris muscle were effective to revise the enlarged ratio of midface through lowering eyebrow, which gains good aesthetic results. However, the specific changes in the proportion of facial aesthetics and the importance of these change were serious lack in the literature as far as the authors know. Purpose: To measure the ratio of the length between upper edge of eyebrow and edge of lower eyelid (L1)/the length between edge of lower eyelid and nasal base (L2) in the fordless-eyelid and upper lid ptosis patients who received levator aponeurosis folding surgery, and to analyze the change in the proportion of midfacial aesthetics. Method: From December 2015 to October 2016, the pre- and postoperative photographs from 21 cases of patients with foldless eyelid and upper lid ptosis who underwent the levator aponeurosis folding procedures in the authors' department were collected as study group. Additional full-face pictures of 20 Chinese female movie stars were prepared as control group. The ratios of L1/ L2 (J) were measured via Adobe Photoshop CS6. The statistical significance was analyzed and the change of midfacial proportion was evaluated. Result: In the study group, the mean value of preoperative L1/L2 (J1) is 0.746, and (J2) 0.657 postoperatively. In the control group, the mean value of L1/L2 (J3) is 0.667. Statistical differences showed between the pre- and postoperative samples and between preoperative samples and control group. There was no statistical difference between postoperative samples and control group samples. The ratios between L1 and L2 in postoperative samples are close to those in the control group, which are closer to the golden radio. Conclusion: Levator aponeurosis folding can effectively lower eyebrow in patients with upper lid ptosis, shortening the length between eyebrow and lower eyelid, and therefore harvesting a more appropriate and harmonious ratio of L1/ L2 according to the golden section theory. The changes in the proportion of midfacial aesthetics after operation could be used as a key point in the preoperative communication and postoperative effect evaluation, besides the size of palpebral fissure and corneal exposure rate. Address correspondence and reprint requests to Chenyang Ji, MD, Sun Yat-Sen University, 33 NO. of Yingfeng Street, Guangzhou City, Guangdong Province, China; E-mail: jichenyang@163.com Received 10 July, 2017 Accepted 28 August, 2017 The authors report no conflicts of interest. © 2017 by Mutaz B. Habal, MD.

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Pierre Robin Sequence: An Evidence-Based Treatment Proposal

Background: The Pierre Robin sequence (PRS) has been defined as the presence of micrognathia, glossoptosis, and respiratory obstruction in the neonatal period. Since its original description, different therapeutic approaches have been proposed obtaining different success rates, but there is no consensus about its management. Methods: A literature review was conducted in PubMed, Embase, and Cochrane databases, for the period of January,1985 to November, 2016. A number of 23 articles resulting from clinical studies, discussing diagnostic tests or therapeutic approaches, and directly or indirectly comparing diagnostic or treatment modalities were selected and assessed using the GRADE methodology. Results: After reviewing and analyzing the selected articles, an evidence-based algorithm for diagnosis and integral management of PRS patients was designed. Conclusion: Based on the anatomical principles and natural evolution of PRS, the clinical scenario must be evaluated thoroughly as a dynamic event to develop a management sequence that minimizes morbidity and mortality and accelerates patients' reinsertion to normal life. Address correspondence and reprint requests to Oswaldo J. Gómez, MD, Edificio Altos del Bosque, Calle 134 # 7-83, Consultorio 232, Bogotá, Colombia 110111; E-mail: oswaldogomez@me.com Received 6 April, 2017 Accepted 30 August, 2017 The authors report no conflicts of interest. © 2017 by Mutaz B. Habal, MD.

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An Anatomic Morphological Study of Occipital Spurs in Human Skulls

Abstract Occipital spurs are quite common; however, they are also the source of frequent discomfort to the patients. Their role has been implicated in causation of pain at the base of skull, which may extend to shoulder limiting the movement of the shoulder and neck. The present was carried out to find out the prevalence of occipital spur in human skull and to find out the anatomic morphological characteristics of occipital spur. A total of 30 cadaveric skulls were examined in the Department of Anatomy, Uttar Pradesh University of Medical Sciences, for the presence of occipital spur. These skulls were the part of boneset obtained as a part of undergraduate training in the department. All the measurements were taken using a digital Vernier Caliper after taking all necessary precaution to avoid any damage to these spurs. The prevalence of occipital spur in the present study was 10%. The mean width recorded in the present study was 13.40 mm (±6.7) and the mean length recorded was 13.45 mm (±1.05). Similarly, mean thickness noted was 2.43 mm (±0.43). Thus, the present study concludes that occipital spurs are the frequent source of discomfort to patients. The knowledge of this tubercle is of paramount importance to neurosurgeons, sports physicians, and radiologists for the diagnosis of such discomfort. Address correspondence and reprint requests to Monika Srivastava, MS, Lecturer, Department of Anatomy, Uttar Pradesh University of Medical Sciences, Saifai, Etawah, Uttar Pradesh, 206130, India; E-mail: monikad07@rediffmail.com Received 21 January, 2017 Accepted 29 August, 2017 The authors report no conflicts of interest. © 2017 by Mutaz B. Habal, MD.

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Scaffold Free Bone Regeneration Using Platelet-Rich Fibrin in Calvarial Defect Model

Abstract Bone regeneration is a complex process influenced by various physiological factors. Platelet-rich plasma (PRP) contains many growth factors and has shown osteogenic effects. The PRP is usually activated before use. However, the authors showed that nonactivated PRP (nPRP) and activated PRP have comparable osteogenic effects in the previous study. Generally, a scaffold has been needed for the application of PRP in the cranial defect model. In this study, the authors aimed to compare the performance of scaffold free platelet-rich fibrin (PRF) to nPRP as an adjuvant for bone regeneration. Twenty-four New Zealand White rabbits were randomly allocated into 3 groups: control, nPRP, and PRF. A 15 × 15 mm2 defect was created on each rabbit's cranium. Acellular collagen sponges (Gelfoam) were placed on the defects of the control group, Gelfoam with nPRP was used for the nPRP group, and PRF membrane was directly applied for the PRF group. nPRP and PRF were obtained from each subject's peripheral blood. Sixteen weeks later, the volume of regenerated bone was measured using 3-dimensional computed tomography. The surface area was measured via autopsy, and the samples were then obtained for histological analysis. Bone regeneration in the experimental groups was significantly greater than that in the control group. There were no significant differences in the area of regeneration or histological characteristics between the nPRP and PRF groups. In the calvarial defect of the rabbits, the use of PRF and scaffolded PRP showed comparable bone regeneration effects, which suggested that PRF might be a therapeutic alternative for bone grafts. Address correspondence and reprint requests to In Sik Yun, MD, PhD, Associate Professor, Department of Plastic and Reconstructive Surgery, Yonsei University College of Medicine, Gangnam Severance Hospital, 211 Eonjoo-ro, Gangnam-gu, Seoul 135-720, Korea; E-mail: eqatom@yuhs.ac Received 13 July, 2017 Accepted 21 September, 2017 This work was supported by grants from the National Research Foundation of Korea (NRF) funded by the Korean government (Nos. NRF-2012R1A1A1006572 and NRF-2015R1D1A1A01060361, ISY). Conflict of interest: None of the authors have any conflicting or potentially influential interests with respect to this research. © 2017 by Mutaz B. Habal, MD.

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Mandibular Reconstruction by Osteogenic Distraction Due to Two Different Injuries

Abstract Varied factors, whether intrinsic or extrinsic, may lead to a decrease in the bone volume of the jaws. Trauma and pathology can be listed as examples of such factors. The aim of this study is to present the osteogenic distraction technique as alternative to augmentation of low mandibular bone volume caused by different etiologies. The first case reports a mandibular marginal resection of ameloblastoma and the second one reports a male patient presenting mandibular fracture sequelae. Both cases were treated according to the osteogenic distraction technique. Several factors have influence on the decision of treatment management of these conditions. Although autogenous bonegraft is considered criterion standard for alveolar reconstruction, its high rates of resorption and the morbidity associated to donor sites lead surgeons to seek for other surgical alternatives such as osteogenic distraction. Therefore, it also aims to expose the advantages and benefits of this technique as well as the satisfactory results achieved. Address correspondence and reprint requests to Guilherme dos Santos Trento, Dental School at Araraquara – Unesp – Brazil, 1680th Humaitá Street, Araraquara, São Paulo14801-903, Brazil; E-mail: guilhermetrento@yahoo.com.br Received 4 August, 2017 Accepted 21 September, 2017 The authors report no conflicts of interest. © 2017 by Mutaz B. Habal, MD.

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Detailed Anatomy of Osteoperiosteal Ligamentous Structures in the Forehead

Abstract This study aimed to present the anatomic characteristics of osteoperiosteal ligamentous attachments of the forehead and provide a better understanding of lateral eyebrow descent for safe and effective foreheadplasty. Anatomic dissections of the face were performed in 10 fresh Korean adult cadavers (20 hemifaces) using 2.5× magnification surgical loupes. Supraorbital, inferomedial orbital, and frontonasal osteoperiosteal ligamentous attachments were identified as fibrous tissues originating from a bone, and their tensile strengths were measured. The supraorbital osteoperiosteal ligamentous attachment had medial and lateral parts. It can be classified into 4 subtypes. It was located 11.0 ± 6.6 mm lateral to the midline and 9.2 ± 12.3 mm superior to the superior orbital margin. The inferomedial orbital osteoperiosteal ligamentous attachment was located 16.2 ± 3.9 mm lateral to the midline and 2.2 ± 2.7 mm inferior to the superior orbital margin, whereas the frontonasal osteoperiosteal ligamentous attachment was located 5.4 ± 2.3 mm lateral to the midline and 1.4 ± 8.5 mm superior to the superior orbital margin. Tensile strengths of all the osteoperiosteal ligamentous attachments in the forehead were above 10 N. These results indicate that osteoperiosteal ligamentous attachments develop in the rather medial region of the eyebrow and have a tensile strength adequate enough to maintain the medial eyebrow. Thus, the current study provides surgeons with detailed anatomic information that can be used as a valuable reference for forehead rejuvenation procedures. Address correspondence and reprint requests to Yong Seok Nam, PhD, and In-Beom Kim, MD, PhD, Department of Anatomy, Catholic Institute for Applied Anatomy, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul 06591, Korea; E-mail: boffin@catholic.ac.kr [YSN] and ibkimmd@catholic.ac.kr [I-BK] Received 31 August, 2017 Accepted 23 September, 2017 The authors report no conflicts of interest. © 2017 by Mutaz B. Habal, MD.

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Nasal Septal Cavernous Hemangioma

Abstract Hemangiomas are benign tumors originating from the skin, mucosa, muscle, gland, and vascular tissue in the bone. Although it is common in the head and neck region, it is rarely seen in the nasal cavity and paranasal sinuses. Histologically capillary, cavernous, and mixed types are present, the most common is cavernous-type hemangioma. Cavernous hemangiomas in the nasal cavity, generally originated from the lateral nasal wall, cause symptoms as nasal obstruction and epistaxis. In the author's patient, cavernous hemangioma was originated from the nasal septum, where rarely seen. The author wanted to discuss this rare disease by presenting a 78-year-old woman who presented with nasal obstruction and recurrent epistaxis to the author's clinic. Address correspondence and reprint requests to Ahmet Baki, MD, Otorhinolaryngology Clinic, Health Sciences University, Umraniye Education and Training Hospital, Istanbul, Turkey; E-mail: dr.ahmet170@yahoo.com Received 17 June, 2017 Accepted 23 September, 2017 The author reports no conflicts of interest. © 2017 by Mutaz B. Habal, MD.

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Cross-Sectional Study of four Serological Bone Turnover Markers for the Risk Assessment of Medication-Related Osteonecrosis of the Jaw

Background: Despite the benefits related to the use of bisphosphonates and denosumab, medication-related osteonecrosis of the jaw (MRONJ) is a serious complication. The purpose of this study was to investigate the utility of 4 biochemical markers including serum c-terminal telopeptide cross-link of type I collagen (s-CTX), serum osteocalcin (s-OC), serum parathormon (s-PTH), and serum bone-specific alkaline phosphatase (s-BAP) as useful clinical tools to help assess the risk for MRONJ prior to invasive oral surgery. Materials and Methods: Twenty patients diagnosed with MRONJ and 20 controls who have been on antiresorptive therapies with no occurrence of MRONJ were included in this 2-arm cross-sectional study. The s-CTX, s-OC, s-PTH, and s-BAP values were measured. Mann–Whitney U test compared the s-CTX, s-OC, s-PTH, and s-BAP values of the MRONJ group and the controls (P 

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Review of “Surgical Mentorship: A Great Tradition, But Can We Do Better for the Next Generation?” by Lillemoe KD in Ann Surg 266:401–410; 2017

No abstract available

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Seasonal Variation of Orofacial Clefts

Background: Orofacial clefts represent the most common craniofacial malformation diagnosed at birth and may be divided into isolated cleft lip (CL), cleft lip and palate (CL/P), or isolated cleft palate (CP). The causes of orofacial clefts have long been understood to be multifactorial; however, research into the genetic and environmental factors underpinning these disorders in African populations is scant. Seasonal variation in the occurrence of orofacial clefts was investigated. Seasonal variation is defined as differences due to periodic, temporal, and external influences, namely the particular time or season of the year. Methods: The study design is a retrospective record review and sampled patients presenting to the Cleft Clinic at Charlotte Maxeke Johannesburg Academic Hospital during the time period October 2000 to October 2015. Ethical approval was obtained. Information recorded included patient demographics (date of birth and gender), diagnosis and laterality of the cleft. Results: This study includes 512 infants. This study shows seasonal variation in the incidence of orofacial clefts limited to patients with both a CL/P. There was no significant seasonal variation observed in isolated CL or CP and laterality of the cleft. Significant seasonal variation was observed only in those born in winter versus summer, with more children born with a CL/P in winter months. Conclusion: Seasonal (or temporal) variation indicates a distinct environmental influence on the formation of orofacial clefts in utero, more specifically in pregnancies with the first trimester during spring. Several reasons have been advanced and include sunlight exposure and vitamin D levels, weight gain, and maternal obesity. More study is required to further elucidate these reasons. Address correspondence and reprint requests to Chrysis Sofianos, MBBCh, MRCS, Box 79663, Senderwood 2145, South Africa; E-mail: sofianosc@gmail.com Received 30 March, 2017 Accepted 25 September, 2017 The authors report no conflicts of interest. © 2017 by Mutaz B. Habal, MD.

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Tracing the Use of Cautery in the Modern Surgery

No abstract available

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Mandibular Reconstruction Using a Customized Three-Dimensional Titanium Implant Applied on the Lingual Surface of the Mandible

Abstract A patient had a right mandibular defect due to resection of an ameloblastoma. Previously, the defect had been reconstructed by an iliac bone graft, and subsequently, a titanium mesh with xenograft was used. However, it was not successfully reconstructed. For the recovery of mandible continuity and rehabilitation of jaw movement, we manufactured a customized 3-dimensional titanium implant by computer-aided design and manufacturing and electron beam melting technology. This implant was designed to have a porous body structure and lingual plate. The customized implant was accurately inserted in the bony defect. As a result, the patient showed a normal range of mouth opening and jaw movement. New bone migration was observed in the porous structure of the implant. Although there was a slight plate exposure and lack of alveolar bone formation, the customized 3D titanium implant successfully reconstructed the mandibular discontinuous defect and recovered jaw movement. Address correspondence and reprint requests to Hyun Seok, DDS, PhD, Department of Oral and Maxillofacial Surgery, Chungbuk National University Hospital, Cheongju 28644, Republic of Korea; E-mail: address: sok8585@hanmail.net Received 16 May, 2017 Accepted 14 August, 2017 This work was carried out with the support of "Cooperative Research Program for Agriculture Science and Technology Development (Project No. PJ01121404)," Rural Development Administration, Republic of Korea. The authors report no conflicts of interest. Supplemental digital contents are available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Web site (http://ift.tt/2iuFjMi). © 2017 by Mutaz B. Habal, MD.

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The Effect of Midface Advancement Surgery on Obstructive Sleep Apnoea in Syndromic Craniosynostosis

Background: Children with syndromic craniosynostosis frequently suffer from obstructive sleep apnoea (OSA). The aim of the authors' study was to investigate if midface advancement surgery for patients with SC improved the severity of OSA by examining the results of sleep studies before and after surgery. Methods: A retrospective comparison of the pre and postoperative sleep study data of children undergoing midface advancement surgery at Great Ormond Street Hospital between 2007 and 2016. Results: A total of 65 children underwent midface advancement surgery between 2007 and 2016 at Great Ormond Street Hospital and had recorded pre- and postoperative sleep studies. Thirteen patients were excluded from the analysis as their sleep study techniques before and after surgery were not comparable (e.g., different conditions with prong/continuous positive airway pressure use). Fifty-six percent of the patients were treated by monobloc surgery and the remainder with bipartition surgery. A greater proportion of patients had a normal OSA grading following midface advancement (42.3% postoperatively vs. 23.1% preoperatively, P = 0.059) although no statistically significant categorical changes in OSA grade were observed. Seventy-one percent of the patients had a decrease in Apnoea-Hypopnoea Index after surgery (21 patients 2011 onward). Similarly, there was no significant change in median oxygen desaturation index or in oxygen saturation nadir following surgery. Conclusion: The authors report one of the largest reviews of the effects of midface advancement surgery on sleep study parameters. Most patients showed improvements in Apnoea-Hypopnoea Index and OSA grading, although measures of oxygenation showed no consistent change. Address correspondence and reprint requests to Clair Saxby, BM, MRCS (ENT), Great Ormond Street Hospital For Children NHS Trust, London WC1N 3JH, UK; E-mail: cesaxby@doctors.net.uk Received 19 June, 2017 Accepted 10 August, 2017 The authors report no conflicts of interest. © 2017 by Mutaz B. Habal, MD.

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Temporomandibular Joint Ankylosis: Algorithm of Treatment

No abstract available

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Review of “Surgical Performance: A Pathway to Excellence” by Aggarwal R in Ann Surg 266:220–222, 2017

No abstract available

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Effect Evaluation of Modified Uvulopalatopharyngoplasty With Low-Temperature Plasma and Selective Nasal Cavity Vasodilatation With Tongue Volume Reduction in Patients With Obstructive Sleep Apnea Hypopnea Syndrome

Objective: To compare the clinical effects of modified uvulopalatopharyngoplasty (UPPP) with low-temperature plasma with selective nasal cavity vasodilatation with tongue volume reduction for obstructive sleep apnea/hypopnea syndrome (OSAHS). Methods: A retrospective analysis based on 156 patients with serious OSAHS was used for the evaluation. These patients were divided into 2 groups according to surgery methods according to 1:1.s. The patients in observation group accepted modified UPPP with low-temperature plasma and selective nasal cavity vasodilatation with tongue root volume reduction on the basis of fully preparation for surgery, while the patients in the control group accepted normal treatment. The clinic effects, operative complications, postoperative relapse, and other indexes were compared. Result: After 6 months of follow-up visit, the general effective rates of the observation group and control groups were 80.77% and 61.54%, the difference was statistically significant (P 

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Three-Dimensional Bioprinting Can Help Bone

No abstract available

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Effect of Septoplasty on the Heart Rate Variability in Patients With Nasal Septum Deviation

Background: Nasal septum deformities (NSD) are one of the most common causes of upper airway obstruction. Heart rate variability (HRV) is a physiologic parameter that is affected by the balance between the sympathetic and parasympathetic tonus. Objective: The aim of this study was to evaluate the effects of a septoplasty operation on HRV parameters as assessed by 24 hours ambulatory Holter recordings in patients with NSD. Methods: The prospective study involved 54 consecutive patients (16 women and 38 men) who underwent septoplasty due to a marked C- or S-shaped NSD. Twenty-four-hour Holter monitoring was performed to all patients pre- and 2 months postseptoplasty operation. For the HRV analyses, the definitions of evaluated parameters were made according to the Task Force of European Society of Cardiology and the North American Society of Pacing and Electrophysiology on HRV. Results: Low-frequency norm () (73 [68–86] versus 78 [70–81], P = 0.039) values were significantly increased after septoplasty whereas changes in other parameters were not statistically significant. Conclusion: The authors' study showed that low-frequency norm values were significantly increased after septoplasty operation in patients with NSD which may be interpreted as a decreased sympathetic tone. Address correspondence and reprint requests to Metin Celiker, MD, Department of Ear Nose and Throat Surgery, Recep Tayyip Erdogan University Hospital, Sehitler Avenue, No:74, Rize, Turkey; E-mail: meceliker@hotmail.com Received 20 July, 2017 Accepted 23 August, 2017 The authors report no conflicts of interest. © 2017 by Mutaz B. Habal, MD.

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Cochrane Qualitative and Implementation Methods Group Guidance Paper 3: Methods for Assessing Evidence on Intervention Implementation

This article provides reviewers with guidance on methods for identifying and processing evidence to understand intervention implementation.

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