Titanium and its alloys have been widely used in dental and orthopedic implants. Owing to the biotribocorrosion behavior of implants in simulated oral environment, Ti(IV) ions could be released into surrounding tissues. Current studies have found that Ti(IV) ions could affect the biological activities of immune cells in adjacent tissues and subsequently jeopardize the long-term performance of implant prostheses. However, the potential mechanism underlying its immunomodulatory properties remains unclear. Calcium signaling has been confirmed to be involved in regulation of lymphocyte immune function. Therefore, we hypothesize that Ti(IV) ions modulated T cell function through the change of intracellular calcium concentrations. This study is aimed at exploring the role of intracellular calcium responses in the modulatory effect of Ti(IV) ions on unactivated and phytohemagglutinin-activated Jurkat T cells. Here, we confirmed that Ti(IV) ions within a certain concentration range induced CD69 expression on both unactivated and activated T cells in our study. Additionally, the combined stimulation with Ti(IV) ions and PHA increased expression of IL-1β, TNF-α, and RANKL. Furthermore, we found that treatment with Ti(IV) induced a transitory increase in the levels of [Ca2+]i in activated Jurkat cells, dependent on the presence of exogenous calcium. Treatment with different doses of Ti(IV) for 24 h significantly increased the levels of [Ca2+]i in the activated Jurkat cells in a dose-dependent manner, but had little effect in the unactivated cells. Treatment with Ti(IV) did not significantly affect the PLCγ1 activation and inositol-1,4,5-trisphosphate (IP3) secretion in Jurkat cells. Taken together, these data indicated that Ti(IV) enhanced calcium influx during the T cell activation, independent of IP3-mediated intracellular calcium release. Our work provides insights into the mechanism involved in the regulation of lymphocyte behaviors under the effect of Ti(IV) ions, which may help to develop therapeutic strategies for dental implant failures.
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Saturday, November 17, 2018
Titanium Ions Promote Exogenous Calcium-Dependent Calcium Influx in Activated Jurkat T Cells: A Possible Mechanism to Explain Its Immunostimulatory Properties
Activation of Macrophages by Oligomeric Proteins of Different Size and Origin
Activation of macrophages is one of the key processes in generating the immune response against pathogens or misfolded/aggregated otherwise unharmful host's proteins. Antigens and their immune complexes (IC) may shape macrophage phenotype in various directions. Data on the impact of protein structure during inflammation are evident; however, some separate steps of this process involving changes in macrophage phenotype are not fully understood. Our aim was to investigate the phenotype of macrophages after activation with different oligomeric proteins and their IC. We have used amyloid beta (Aβ1–42) that plays a role in neurodegenerative inflammation as a model of host-associated protein and three oligomeric viral antigens as pathogen-associated proteins. Murine cell lines J774, BV-2, and macrophage primary cell culture were treated with oligomeric proteins and their IC. After 48 h, expression of surface markers F4/80, CD68, CD86, and CD206 and secreted cytokines IL-10, IL-12, IL-23, and TNF-α was analysed. Aβ1–42 oligomers stimulated expression of both inflammatory and anti-inflammatory molecules; however, fibrils induced less intense expression of markers investigated as compared to small and large oligomers. Two out of three viral oligomeric proteins induced the inflammatory response of macrophages. Data suggest that macrophage activation pattern depends on the origin, size, and structure of oligomeric proteins.
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Forty cases of acquired oral syphilis and a review of the literature
The aim of this study was to describe 40 cases of acquired oral syphilis (AOS) and to discuss the distribution of demographic characteristics, clinical features, and differential diagnosis of the disease. A retrospective study was conducted covering a 17-year period at a single institution in southern Brazil. Moreover, a literature review was performed through a search of the PubMed database for articles on AOS published between 1955 and March 2018. Data were analyzed descriptively. The predominant group within the case series was male patients in their twenties.
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Three-dimensional soft tissue effects of mandibular midline distraction and surgically assisted rapid maxillary expansion: an automatic stereophotogrammetry landmarking analysis
Studies on mandibular midline distraction (MMD) are mostly performed using conventional research methods. Concerning surgically assisted rapid maxillary expansion (SARME), more research is conducted using three-dimensional (3D) techniques. Research on bimaxillary expansion, the combination of MMD and SARME, is reported sparsely. The main objective of this study was to provide a 3D evaluation of soft tissue effects following SARME and/or MMD. Patients who underwent SARME and/or MMD between 2008 and 2013 were included.
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Disentangling the heterogeneity of allergic respiratory diseases by latent class analysis reveals novel phenotypes
Abstract
Background
Refined phenotyping of allergic diseases may unravel novel phenotypes. Conjunctivitis as an independent disorder has never been approached.
Aim
To identify distinct classes of allergic respiratory diseases using latent class analysis (LCA) and distinguish each class using classification and regression tree (CART) analysis.
Methods
728 adults from the Portuguese general population study ICAR had a structured medical interview combined with blood collection, skin prick tests, spirometry with bronchodilation, and exhaled nitric oxide. LCA was applied to 19 variables. The CART algorithm selected the most likely variables distinguishing LCA‐classes.
Results
A six‐class model was obtained. Class 1 (25%): non‐allergic participants without bronchial or ocular symptoms. Classes 2 (22%) and 3 (11%): nasal and ocular (low levels) symptoms without nasal impairment, monosensitized (Class 2) or polysensitized (Class 3). Class 4 (13%): polysensitized participants with high levels of nasal and ocular symptoms, and nasal impairment. Classes 5 (16%) and 6 (14%): high level of nasal, bronchial and ocular symptoms with nasal impairment (non‐allergic or polysensitized, respectively). Participants in classes 5 and 6 had more bronchial exacerbations and unscheduled medical visits (p<0.001). Ocular symptoms were significantly higher in classes with nasal impairment, compared to those without impairment (p<0.001) or no nasal symptom (p<0.001). CART highlighted ocular symptoms as the most relevant variable in distinguishing LCA‐classes.
Conclusions
Novel severe phenotypes of participants with co‐occurrence of ocular, nasal and bronchial symptoms, and exacerbation‐prone were identified. The tree algorithm showed the importance of the ocular symptoms in the expression of allergic diseases phenotypes.
This article is protected by copyright. All rights reserved.
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Effect of oral hygiene programmes on oral opportunistic pathogens during stroke rehabilitation
Abstract
Objectives
This study was to assess the effectiveness of a conventional oral hygiene care programme (COHCP) and an advanced oral hygiene care programme (AOHCP) on prevalence and viable counts of oral opportunistic pathogens among patients undergoing stroke rehabilitation.
Methods
A total of 94 patients were randomized to two groups. Subjects were block randomized to: either (1) COHCP: manual toothbrushing with oral hygiene instruction (OHI); or (2) AOHCP: powered toothbrushing, mouthrinsing with chlorhexidine and OHI. Prevalence and viable counts of oral opportunistic pathogens including yeasts, aerobic and facultative anaerobic gram‐negative bacilli, Staphylococcus aureus, were assessed at baseline, the end of three months, and six months.
Results
No significant difference was observed in the prevalence of oral opportunistic pathogens within each group over the clinical trial period. A significant decrease in the viable counts of S. aureus was found over the clinical trial period within AOHCP group (p<0.05), while the viable counts of yeasts and AGNB remained stable within each group. Regression analysis failed to detect an association between intervention and the prevalence/viable counts of oral opportunistic pathogens.
Conclusions
Neither oral health care programme significantly affect AGNB, yeast or S. aureus over the study period in terms of prevalence and viable counts.
This article is protected by copyright. All rights reserved.
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Prevalence and normative values for Jaw Functional Limitations in the general population in Sweden
Abstract
Objectives
For Jaw Functional Limitations measured by the Jaw Functional Limitation Scale (JFLS), (i) determining prevalence in the Swedish general adult population, (ii) investigating the influence of demographic factors and self‐reported dental status, and (iii) deriving normative values.
Methods
A random sample of the general adult population in Sweden was approached (response rate: 46%, N=1,372). Prevalence was determined for the JFLS summary score and individual items. The influence of age, gender, and dental status was investigated with regression analyses and normative values presented.
Results
The JFLS median score was 0 and all items had prevalences <30%. Age and gender did not influence Jaw Functional Limitations but dental status did. Normative JFLS scores were 1, 9 and 28 for the 7th, 8th, and 9th decile, respectively. In dental status‐stratified norms, 9th deciles were 20, 43, and 100, for subjects with natural teeth only, removable and complete dentures, respectively.
Conclusions
The Swedish general adult population had excellent jaw function, but dental status was major determinant. In the absence of information linking JFLS scores to important patient concerns, the score distribution can serve as a reference with the 9th decile as threshold for functional limitation.
This article is protected by copyright. All rights reserved.
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Artery of Percheron Infarction: MRI
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Circulating exosomes regulate T‐cell mediated inflammatory response in oral lichen planus
Abstract
Background
Exosomes are newly recognized natural nanocarrier and intercellular messenger that emerge as important mediators of signal transmission. Exosomes have been reported to modulate the inflammatory response of a number of diseases. This study investigated the effects of circulating exosomes from oral lichen planus (OLP) on T cells.
Methods
Plasma‐derived exosomes were purified from both OLP patients and control groups. T cells were observed under a confocal laser scanning microscope after co‐cultivation with PKH67 labeled exosomes for 12, 24, and 48 h. The effects of exosomes exposure on T cells were analyzed with several functional assays, investigating proliferation, apoptosis, and migration. Production of interleukin (IL)‐2, ‐4, ‐10, and interferon (IFN)‐γ was measured via enzyme‐linked immunosorbent assay.
Results
PKH67‐labeled exosomes were taken up by T cells in a time‐ and dose‐dependent manner. Several biological functions of T cells were promoted. In particular, the circulating erosive OLP exosomes significantly enhanced T cell proliferation and attenuated the apoptosis. The migration capacity of T cells increased remarkably in response to erosive OLP exosome treatment. In addition, the ratio of IFN‐γ/IL‐4 was significantly elevated in OLP patients.
Conclusions
Our findings indicate that the circulating OLP exosomes are involved in the biological functions of T cells, potentially promoting the OLP progression by regulating the T‐cell mediated inflammatory response.
This article is protected by copyright. All rights reserved.
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Prognostic Value of Serum Liver Enzymes in Oral and Oropharynx Squamous Cell Carcinomas
Abstract
Background
Serum liver enzymes, which catalyze relevant catabolic pathways, have been indicated to be diagnostic and prognostic tools for several malignant tumors. The correlation between serum liver enzymes levels and survival in patients with oral and oropharynx squamous cell carcinomas (OSCC) is still absent. Here, we conducted a study focusing on predictive value of serum liver enzymes in terms of prognosis in the patients.
Methods
A retrospective study including 134 OSCC patients from years 2009 to 2014 was performed to investigate the association between levels of pretreatment serum liver enzymes, various clinical parameters and prognostic outcomes, which are overall survival (OS) and disease‐free survival (DFS). Log‐rank tests with Kaplan‐Meier method were used to detect potential prognostic biomarkers. Multivariate analyses by Cox proportional hazards model were used to identify significant predictors of prognosis.
Results
Serum adenosine deaminase (ADA) level was associated with patients' OS and DFS by univariate analyses (P = 0.006 and P = 0.024, respectively). Multivariate analyses showed that higher serum ADA (>17.2 μmol/L) (P = 0.019) as well as positive lymph node status (P = 0.035) independently predicted worse OS of patients with OSCC. In addition, older age (≥ 60 years) (P = 0.043) and positive lymph node status (P = 0.027) were independently prognostic parameters for poorer DFS.
Conclusions
Preoperative serum ADA levels may serve as a reliable independent prognostic predictor for OS in OSCC patients.
This article is protected by copyright. All rights reserved.
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LncRNA LINC00974 activates TGF‐β/Smad signaling to promote oral fibrogenesis
Abstract
Background
Oral submucous fibrosis (OSF) is a progressive scarring disease and has been considered as a premalignant condition of the oral cavity. However, the detailed molecular mechanisms underlying the pathogenesis of OSF are still unclear.
Method
Here, we examined the expression of a novel long non‐coding RNA LINC00974 in OSF and investigated its function role in myofibroblast transdifferentiation. Phenotypic analyses, including collagen gel contraction, migration, invasion and wound healing assays, were used to assess the myofibroblast activities following overexpression or inhibition of LINC00974.
Results
We found that the expression of LINC00974 in OSF tissues or myofibroblasts was aberrantly upregulated, and there was a positive correlation between LINC00974 and myofibroblast markers. Our results showed that inhibition of LINC00974 suppressed the myofibroblast activities, while overexpression of LINC00974 increased the activation. We demonstrated that the expression levels of α‐SMA, α‐1 type I collagen, fibronectin were downregulated in the LINC00974‐inhibited myofibroblasts. Additionally, the TGF‐β secretion and phosphorylated Smad2 expression were also repressed in the LINC00974‐inhibited myofibroblasts. We further demonstrated that silence of LINC00974 prevented the arecoline‐induced myofibroblast activation, and LINC00974‐increased myofibroblast activities were via TGF‐β pathway.
Conclusion
Altogether, these findings suggested that arecoline‐increased myofibroblast transdifferentiation was via LINC00974‐mediated activation of TGF‐β signaling.
This article is protected by copyright. All rights reserved.
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Individual Risk Assessment Tool for School Age Asthma Prediction in UK Birth Cohort
Abstract
Background
Current published asthma predictive tools have moderate positive likelihood ratios (LR+) but high negative likelihood ratios (‐LR) based on their recommended cut‐offs, which limit their clinical usefulness.
Objective
To develop a simple clinically applicable asthma prediction tool within a population‐based birth cohort.
Method
Children from the Manchester Asthma and Allergy Study (MAAS) attended follow‐up at ages 3, 8 and 11 years. Data on pre‐school wheeze was extracted from primary‐care records. Parents completed validated respiratory questionnaires. Children were skin prick tested (SPT). Asthma at 8/11 years (school ‐age) was defined as parentally‐reported (1) physician‐diagnosed asthma and wheeze in the previous 12 months or (2) ≥3 wheeze attacks in the previous 12 months. An asthma prediction tool (MAAS APT) was developed using logistic regression of characteristics at age 3 years to predict school‐age asthma.
Results
Of 336 children with physician‐confirmed wheeze by age 3 years, 117(35%) had school‐age asthma. Logistic regression selected 5 significant risk factors which formed the basis of the MAAS APT: wheeze after exercise; wheeze causing breathlessness; cough on exertion; current eczema and SPT sensitisation(maximum score 5). A total of 281(84%) children had complete data at age 3 years and were used to test the MAAS APT. Children scoring ≥3 were at high risk of having asthma at school‐age(PPV>75%; +LR 6.3,‐LR 0.6), whereas children who had a score of 0 had very low risk(PPV 9.3%; LR 0.2).
Conclusion
MAAS APT is a simple asthma prediction tool which could easily be applied in clinical and research settings.
This article is protected by copyright. All rights reserved.
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Strength-limiting damage in lithium silicate glass-ceramics associated with CAD–CAM
Publication date: Available online 16 November 2018
Source: Dental Materials
Author(s): Dan L. Romanyk, Ysidora Torrealba Martinez, Sydney Veldhuis, Nyssa Rae, Yilan Guo, Slobodan Sirovica, Garry J.P. Fleming, Owen Addison
Abstract
Objective
The fabrication of all-ceramic restorations using Computer Aided Design and Computer Aided Manufacturing (CAD–CAM) most commonly involves subtractive machining which results in strength-limiting, surface and sub-surface damage in the resultant prosthesis. The objective was to explore how clinically relevant machining-process variables, and material variables, affect damage accumulation in lithium silicate glass-ceramics.
Methods
Three commercial lithium silicate glass-ceramics (IPS e.max® CAD, Celtra® Duo and Vita Suprinity®) were selected. For each material, two groups of disk-shaped specimens were fabricated (n = 15), using a CAD–CAM process, creating surfaces equivalent to those generated for a dental restoration, or alternatively, using a highly controlled laboratory process generating disk-shaped test specimens with a consistent polished surface. Bi-axial flexure strength (BFS) was determined in a ball-on-ring configuration and fractographic analyses performed. For each material BFS was correlated with machining sequence and with surface roughness.
Results
BFS was significantly influenced by material substrate (p < 0.01) and by fabrication route (p < 0.01). A significant factorial interaction (p < 0.01) identified that the magnitude of changes in BFS when comparing the two specimen fabrication routes, was dependent on substrate type. The polished control specimens exhibited a significantly increased BFS when compared with the CAD–CAM counterparts for all materials. IPS e.max® CAD and Celtra® Duo showed a 44 and 46% reduction in mean BFS for the CAD–CAM specimens when compared with the polished counterparts, respectively. In contrast, Vita Suprinity® showed the least disparity in mean BFS (21%) but the greatest variance in BFS data.
Significance
All CAD–CAM specimens showed evidence of machining introduced damage in the form of median and radial cracks at sites either coincident with, or peripheral to the failure origin. Subtractive machining introduced significant strength limiting damage that is not eliminated by heat treatments applied for either microstructure development (IPS e.max® CAD and Vita Suprinity®) or annealing/crack blunting (Celtra® Duo).
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Three-dimensional evaluation of facial asymmetry in patients with hemifacial microsomia using stereophotogrammetry
Publication date: Available online 16 November 2018
Source: Journal of Cranio-Maxillofacial Surgery
Author(s): Diana Cassi, Giuditta Battistoni, Marisabel Magnifico, Chiara Di Blasio, Giuseppe Pedrazzi, Alberto Di Blasio
Summary
Purpose
To quantify the surface facial asymmetry in a group of young patients with hemifacial microsomia (HFM) and to investigate differences with a homogeneous sample of healthy subjects, using a novel stereophotogrammetric method.
Materials and Methods
Twelve patients (mean age 13.1 ± 3.1 years) with different degrees of HFM and 15 healthy controls (mean age 12.2 ± 3.5 years) were imaged with a stereophotogrammetric facial scanner. The root mean square error (RMSE) of the distances between the corresponding points of each original photograph and its mirror copy was calculated for the whole face and for each trigeminal third, as defined by the innervation of trigeminal branches. A statistical analysis was performed to compare the RMSE value of all facial areas within each group and between patients and controls.
Results
RMSE values progressively increased from the upper to the lower third of face, both in patients and controls. The level of asymmetry was significantly higher in HFM subjects for middle third (p<0.01), lower third (p<0.001) and whole face (p<0.001); no statistically significant differences were found between the groups for the upper third.
Conclusions
The reported technique provides an accurate topographic analysis of the facial asymmetry, and is recommended for conditions such as HFM affecting only part of the face.
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Ex-vivo and In Vitro validation of an innovative mandibular condyle implant concept
Publication date: Available online 16 November 2018
Source: Journal of Cranio-Maxillofacial Surgery
Author(s): António Ramos, Luis M. Gonzalez-Perez, Pedro Infante-Cossio, Michel Mesnard
Summary
Purpose
The purpose of this study is to pre-validate a novel implant concept, and to compare the behavior of the mandibular condyle against a commercial Biomet implant in an ex vivo model and present results of the first cadaveric studies.
Materials and Methods
Three experimental cadaveric condyles were tested under three conditions: one intact, another with the Biomet model, and one with the innovative concept. The condyle was tested with a reaction of 300N in all situations and the principal strains were measured. Before the geometry of the cadaveric condyle was reconstructed from a microCT scan, and a finite element model was created. Finally, a procedure was carried out with the new implant by two expert surgeons on a two cadaveric head model.
Results
In vitro the mandible condyle presents a linear behavior until maximum load. The strain measured with Biomet implant indicates a strain shielding effect in the proximal region, inducing bone loss in the long term. The lingual side of the Biomet implanted condyle presents an increase of +44% in strain.
Conclusion
The new concept was evaluated and showed a similar behavior to the intact model, and better behavior than the Biomet. The innovative concept proves that it is possible to avoid screws for a TMJ fixation and improve the TMJ alloplastic behavior.
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A polycaprolactone-β-tricalcium phosphate-heparan sulfate device for cranioplasty
Publication date: Available online 16 November 2018
Source: Journal of Cranio-Maxillofacial Surgery
Author(s): Bach Quang Le, Bina Rai, Zophia Xue Hui Lim, Tuan Chun Tan, Tingxuan Lin, Jaslyn Jie Lin Lee, Sadasivam Murali, Teoh Swee Hin, Victor Nurcombe, Simon McKenzie Cool
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Skull base reconstruction with pedicled nasoseptal flap: technique, indications, and limitations
Publication date: Available online 16 November 2018
Source: Journal of Cranio-Maxillofacial Surgery
Author(s): Gilles Reuter, Olivier Bouchain, Laurent Demanez, Félix Scholtes, Didier Martin
Summary
Endoscopic skull base surgery allows extensive tumor resection but results in large defects requiring robust dural repair. The vascularized nasal septal flap pedicled on the posterior nasal septal artery is known to have an excellent success rate for dural defect coverage. Detailed step-by-step descriptions of the harvest and placement of this flap are scarce. Using a sketch, images, and a video, we describe a detailed method for endoscopically harvesting and placing a nasoseptal flap (NSF). We also describe the indications and the decision process leading to the use of NSF.
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Influence Disease Activity on Voice and Laryngeal Findings of Rheumatoid Arthritis Patients
Publication date: Available online 16 November 2018
Source: Journal of Voice
Author(s): Tolga Kırgezen, Ahmet Volkan Sünter, Özgür Yiğit, Ela Araz Server, Ebru Aytekin, Nezihe Akar, Nil Sayıner Çağlar
Summary
Objectives
To reveal and to compare the voice pathologies and the detectable laryngeal findings in different phases of rheumatoid arthritis (RA).
Study design
Prospective clinical study.
Methods
Sixty-seven consecutive patients with RA, followed up at our Physical Therapy and Rehabilitation Clinic, were included in the study. Disease activity indices of patients were calculated with Disease Activity Score-28 Index. With Voice Handicap Index (VHI), patients answered 30 questions of functional, physical, and emotional aspects. Videolaryngostroboscopy was performed by the same physician for all patients with a 70° rigid telescope (Karl Storz, Tuttlingen, Germany), and then acoustic voice analysis (PRAAT program) was performed. Reflux Finding Score was used in evaluating the laryngopharyngeal reflux.
Results
Posterior comissure hypertrophy (25.3%) and hyperemia/edema in arytenoid mucosa (22.3%) were detected as the most frequent findings. Other common findings were thick endolaryngeal mucus, vocal cord varices. Twenty-two patients had reflux findings (32.8%). Fundamental frequency, shimmer, maximum phonation time and VHI value were not significantly different between active and remission phases of the disease (P > 0.05). In remission phase, the jitter value and the noise to harmonic ratio value were significantly higher (P < 0.05) than active phase of the disease (P < 0.05). Abnormal laryngeal findings are higher in active phase (28% in remission phase, 54% in active phase). The mean VHI score of patients in remission phase was lower than that in active phase.
Conclusion
RA should be included in the differential diagnosis of patients with voice disorders. Nonspecific pathologies are more prevalent in the picture. There are more objective findings and subjective complaints of patients in active phase of the disease than in the remission phase.
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Dysphonia and Dysarthria in People With Parkinson's Disease After Subthalamic Nucleus Deep Brain Stimulation: Effect of Frequency Modulation
Publication date: Available online 16 November 2018
Source: Journal of Voice
Author(s): Aline Nunes Da Cruz Morello, Bárbara Costa Beber, Valéria Carvalho Fagundes, Carla Aparecida Cielo, Carlos R.M. Rieder
Summary
Purpose
Subthalamic nucleus deep brain stimulation (STN-DBS) parameters, for example the frequency of stimulation, seem to affect speech and voice aspects. However, this influence is not well understood. This study aimed to investigate the impact of low- and high-frequency STN-DBS on voice and speech for people with Parkinson's disease.
Methods
Nineteen individuals with Parkinson's disease who received bilateral STN-DBS were assessed for motor performance (Unified Parkinson's Disease Rating Scale-III), perceptual evaluation of voice (grade, roughness, breathiness, asthenia, strain, and instability [GRBASI]), dysarthria assessment, and computerized acoustic analysis of voice upon receiving low-frequency (60 Hz) and high-frequency (130 Hz) STN-DBS.
Results
In the GRBASI protocol, asthenia, and instability were significantly better at 130 Hz of stimulation. In the dysarthria evaluation, the phonation aspect, articulation, and grade of dysarthria showed deterioration at the same high-frequency condition. There was no significant difference for any vocal acoustic measures.
Conclusion
The high-frequency of STN-DBS may affect speech and voice differently, leading to an amelioration of the vocal production, but with adverse effects in the speech control.
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Automated Segmentation of Knee Bone and Cartilage combining Statistical Shape Knowledge and Convolutional Neural Networks: Data from the Osteoarthritis Initiative
Publication date: Available online 17 November 2018
Source: Medical Image Analysis
Author(s): Felix Ambellan, Alexander Tack, Moritz Ehlke, Stefan Zachow
Abstract
We present a method for the automated segmentation of knee bones and cartilage from magnetic resonance imaging (MRI) that combines a priori knowledge of anatomical shape with Convolutional Neural Networks (CNNs). The proposed approach incorporates 3D Statistical Shape Models (SSMs) as well as 2D and 3D CNNs to achieve a robust and accurate segmentation of even highly pathological knee structures. The shape models and neural networks employed are trained using data from the Osteoarthritis Initiative (OAI) and the MICCAI grand challenge "Segmentation of Knee Images 2010" (SKI10), respectively. We evaluate our method on 40 validation and 50 submission datasets from the SKI10 challenge. For the first time, an accuracy equivalent to the inter-observer variability of human readers is achieved in this challenge. Moreover, the quality of the proposed method is thoroughly assessed using various measures for data from the OAI, i.e. 507 manual segmentations of bone and cartilage, and 88 additional manual segmentations of cartilage. Our method yields sub-voxel accuracy for both OAI datasets. We make the 507 manual segmentations as well as our experimental setup publicly available to further aid research in the field of medical image segmentation. In conclusion, combining localized classification via CNNs with statistical anatomical knowledge via SSMs results in a state-of-the-art segmentation method for knee bones and cartilage from MRI data.
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CATARACTS: Challenge on Automatic Tool Annotation for cataRACT Surgery
Publication date: Available online 16 November 2018
Source: Medical Image Analysis
Author(s): Hassan Al Hajj, Mathieu Lamard, Pierre-Henri Conze, Soumali Roychowdhury, Xiaowei Hu, Gabija Maršalkaitė, Odysseas Zisimopoulos, Muneer Ahmad Dedmari, Fenqiang Zhao, Jonas Prellberg, Manish Sahu, Adrian Galdran, Teresa Araújo, Duc My Vo, Chandan Panda, Navdeep Dahiya, Satoshi Kondo, Zhengbing Bian, Arash Vahdat, Jonas Bialopetravičius
Abstract
Surgical tool detection is attracting increasing attention from the medical image analysis community. The goal generally is not to precisely locate tools in images, but rather to indicate which tools are being used by the surgeon at each instant. The main motivation for annotating tool usage is to design efficient solutions for surgical workflow analysis, with potential applications in report generation, surgical training and even real-time decision support. Most existing tool annotation algorithms focus on laparoscopic surgeries. However, with 19 million interventions per year, the most common surgical procedure in the world is cataract surgery. The CATARACTS challenge was organized in 2017 to evaluate tool annotation algorithms in the specific context of cataract surgery. It relies on more than nine hours of videos, from 50 cataract surgeries, in which the presence of 21 surgical tools was manually annotated by two experts. With 14 participating teams, this challenge can be considered a success. As might be expected, the submitted solutions are based on deep learning. This paper thoroughly evaluates these solutions: in particular, the quality of their annotations are compared to that of human interpretations. Next, lessons learnt from the differential analysis of these solutions are discussed. We expect that they will guide the design of efficient surgery monitoring tools in the near future.
Graphical abstract
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A Note of Thanks
Publication date: Available online 16 November 2018
Source: Academic Radiology
Author(s): N. Reed Dunnick
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Role of P2X3 receptors in scratching behavior in mouse models
Publication date: Available online 17 November 2018
Source: Journal of Allergy and Clinical Immunology
Author(s): Miho Shiratori-Hayashi, Ayumi Hasegawa, Honami Toyonaga, Tsugunobu Andoh, Takeshi Nakahara, Makiko Kido-Nakahara, Masutaka Furue, Yasushi Kuraishi, Kazuhide Inoue, Xinzhong Dong, Makoto Tsuda
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Tipping the balance: a biased nanobody antagonist of CCR3 with potential for the treatment of eosinophilic inflammation
Publication date: Available online 17 November 2018
Source: Journal of Allergy and Clinical Immunology
Author(s): James E. Pease, Timothy J. Williams
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Patterns of Congenitally Missing Teeth of Non-syndromic and Syndromic Patients Treated at a Single-Center over the Past Thirty Years
Publication date: Available online 16 November 2018
Source: Archives of Oral Biology
Author(s): Simone Heuberer, Christian Ulm, Werner Zechner, Brenda Laky, Georg Watzak
Abstract
Objectives
Literature regarding congenitally-missing-teeth (CMT) is lacking especially on CMT-patterns. Thus, the aim of this study was to present an in-depth analysis of 843 patients with CMT treated at a single-center over the past thirty years.
Design
Age, date-of-birth-year, gender, medical- and family-history, CMT-types, -numbers, -severity, -region, -symmetry, -patterns using the tooth agenesis code (TAC), and -growth types of all clinically and radiographically diagnosed CMT-patients were collected. Age and occurrence of syndromes were used to divide CMT-patients into non-syndromic patients older than nine years (group1) and syndromic CMT-patients (group2). Groups were compared especially regarding gender and CMT-severity.
Results
The average CMT-number per patient was 5.5 (group1, n = 816, 59.9% female) and 15.1 (group2, n = 27, 29.6% female). There were significant less male (40.1% vs. 70.4%, respectively; P = 0.002) as well as significantly less male-oligodontia (44.8% vs. 73.9%, respectively; P = 0.009) in group1 than in group2. Group1 resulted in decreased prevalence of similar CMT-patterns with severity; the most prevalent CMT was the 2nd premolar; there were no significant differences between the right and left side, whereas more CMT affected the maxilla; the majority of patients presented with bilateral-CMT (82.8%); females were more affected by CMT but more males had severer forms; certain single CMT differed by gender, and CMT was related to first-grade-relatives.
Conclusion
The majority of CMT-patients presented with hypodontia. Furthermore, same CMT-patterns seem more like to be present in patients with milder forms of tooth agenesis. Gender-specific association regarding CMT-number, severity groups, and single CMT were detected.
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Impression of Subgingival Dental Preparation Can Be Taken with Ultrasound
Publication date: Available online 16 November 2018
Source: Ultrasound in Medicine & Biology
Author(s): Juliana Marotti, Judith Broeckmann, Fabrice Chuembou Pekam, Luciano Praça, Klaus Radermacher, Stefan Wolfart
Abstract
Because of its ability to capture hard structures behind soft tissue, ultrasound-based micro-scanning may be a promising alternative for taking digital impressions of teeth, especially in the case of subgingival margin preparations. The aim of this study was to assess the accuracy of ultrasound impressions taken of subgingivally prepared teeth compared with digital optical impressions. Ten extracted human teeth (7 pre-molars, 3 molars) were prepared for crowns with chamfer finish line and then digitized using two different intra-oral scanners (Cara Trios, 3 Shape, Heraeus Kulzer, Hanau, Germany; and Lava COS; 3M ESPE, Seefeld, Germany) and one extra-oral scanner (Cares CS2, Straumann, Basel, Switzerland). Afterward, the preparation margin was covered with porcine gingiva (thickness ranged between 0.3 and 0.9 mm), and every sample was scanned with a high-frequency ultrasound scanner under experimental subgingival conditions. Optical scanning processes were performed without gingiva. The data sets were superimposed on each other for pairwise comparisons, and deviations between different scans were determined using a 3-D evaluation software (CloudCompare). Kruskal–Wallis and post hoc tests (Dunn–Bonferroni) were applied to detect significant differences at p ≤ 0.05. The ultrasound scanner was able to detect subgingival preparation margins. Mean deviations for all comparisons ranged from 12.34 to 46.38 µm. There were no statistically significant differences between superimpositions of intra-oral and extra-oral scans (Trios–Lava, Lava–CS2, Trios–CS2), whereas in comparisons between intra-/extra-oral scans and ultrasound scans, mean deviations were statistically significantly higher. There were no significant differences with respect to type of tooth (pre-molar and molar). However, gingiva thickness was significantly correlated with the quality of the ultrasound scan; thin layers had better image quality than thicker layers. Ultrasound was able to scan tooth preparation margins covered with gingiva, although with less accuracy than achieved by conventional optical scanners (non-covered margins). Gingiva thickness may play an important role in ultrasound scan accuracy.
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Bundle-specific tractography with incorporated anatomical and orientational priors
Publication date: Available online 17 November 2018
Source: NeuroImage
Author(s): Francois Rheault, Etienne St-Onge, Jasmeen Sidhu, Klaus Maier-Hein, Nathalie Tzourio-Mazoyer, Laurent Petit, Maxime Descoteaux
Abstract
Anatomical white matter bundles vary in shape, size, length, and complexity, making diffusion MRI tractography reconstruction of some bundles more difficult than others. As a result, bundles reconstruction often suffers from a poor spatial extent recovery. To fill-up the white matter volume as much and as best as possible, millions of streamlines can be generated and filtering techniques applied to address this issue. However, well-known problems and biases are introduced such as the creation of a large number of false positives and over-representation of easy-to-track parts of bundles and under-representation of hard-to-track.
To address these challenges, we developed a Bundle-Specific Tractography (BST) algorithm. It incorporates anatomical and orientational prior knowledge during the process of streamline tracing to increase reproducibility, sensitivity, specificity and efficiency when reconstructing certain bundles of interest. BST outperforms classical deterministic, probabilistic, and global tractography methods. The increase in anatomically plausible streamlines, with larger spatial coverage, helps to accurately represent the full shape of bundles, which could greatly enhance and robustify tract-based and connectivity-based neuroimaging studies.
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Brain dynamics and temporal trajectories during task and naturalistic processing
Publication date: Available online 16 November 2018
Source: NeuroImage
Author(s): Manasij Venkatesh, Joseph Jaja, Luiz Pessoa
Abstract
Human functional Magnetic Resonance Imaging (fMRI) data are acquired while participants engage in diverse perceptual, motor, cognitive, and emotional tasks. Although data are acquired temporally, they are most often treated in a quasi-static manner. Yet, a fuller understanding of the mechanisms that support mental functions necessitates the characterization of dynamic properties. Here, we describe an approach employing a class of recurrent neural networks called reservoir computing, and show the feasibility and potential of using it for the analysis of temporal properties of brain data. We show that reservoirs can be used effectively both for condition classification and for characterizing lower-dimensional "trajectories" of temporal data. Classification accuracy was approximately 90% for short clips of "social interactions" and around 70% for clips extracted from movie segments. Data representations with 12 or fewer dimensions (from an original space with over 300) attained classification accuracy within 5% of the full data. We hypothesize that such low-dimensional trajectories may provide "signatures" that can be associated with tasks and/or mental states. The approach was applied across participants (that is, training in one set of participants, and testing in a separate group), showing that representations generalized well to unseen participants. Taken together, we believe the present approach provides a promising framework to characterize dynamic fMRI information during both tasks and naturalistic conditions.
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Prostaglandin E2 decrease in induced sputum of hypersensitive asthmatics during oral challenge with aspirin
Abstract
Background
A special regulatory role for prostaglandin E2 (PGE2) has been postulated in Nonsteroidal anti‐inflammatory drugs (NSAIDs)‐exacerbated respiratory disease (NERD).
Objective
To investigate the effect of systemic aspirin (acetylsalicylic acid) administration on airways PGE2 biosynthesis in induced sputum supernatant (ISS) among subjects with NERD or aspirin‐tolerant asthma with chronic rhinosinusitis with nasal polyposis (ATA‐CRSwNP), as well as healthy controls (HC).
Methods
Induced sputum (IS) was collected from patients with NERD (n=26), ATA‐CRSwNP (n=17), and HC (n=21) at baseline and after aspirin challenge. Sputum differential cell count and IS supernatant (ISS) levels of prostanoids: PGE2, 8‐iso‐PGE2, tetranor‐PGE‐M, 8‐iso PGF2α and leukotriene C4, D4 and E4 were determined using mass spectrometry. Urinary excretion of LTE4 was measured by ELISA.
Results
NERD subjects had elevated sputum eosinophilic count as compared to ATA‐CRSwNP and HC (median NERD 9.1%, ATA‐CRSwNP 2.1% and HC 0.4%; P<0.01). Baseline ISS levels of PGE2 were higher in asthmatics as compared to HC at baseline (NERD vs. HC P=0.04, ATA‐CRSwNP vs. HC P<0.05). Post‐challenge ISS levels of PGE2 compared to baseline significantly decreased in NERD and HC (P<0.01 and P=0.01), but not in ATA‐CRSwNP. In NERD a similar decrease of PGE2 as in HC resulted from 2.8 times lower dose of aspirin.
Conclusions
Aspirin‐precipitated bronchoconstriction is associated with a decrease in airway PGE2 biosynthesis. These results support the mechanism of PGE2 biosynthesis inhibition as a trigger for bronchoconstriction in NERD.
This article is protected by copyright. All rights reserved.
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‘One tooth one child’: evaluating the effects of diet and fertility on the oral health of women from archaeological sites in South America
Women from ancient societies have shown a higher prevalence of dental caries in comparison with men. Recent research has shown that the relationship between increased oestrogen production during pregnancy and decreased salivary flow is a possible cause for the higher levels of caries in women, which is in contrast to the traditional view of sexual division of labour resulting in unequal access to cariogenic food. In order to test these two hypotheses, individuals exhumed from 12 South American archaeological sites were examined for markers of oral health (caries, ante mortem tooth loss, deep caries, and enamel hypoplasia) and compared in terms of fertility (Crude Birth Rate) and subsistence systems. Our results suggest that diet and other cultural practices remain the most important factors affecting oral health and that the effects of hormones can be masked by them. Such findings add to the discussion regarding the availability of micronutrients in such societies affecting caries experience in pregnant women, because of their special nutritional requirements.
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Dental anxiety in relation to torture experiences and symptoms of post‐traumatic stress disorder
Torture victims often show symptoms of dental anxiety when receiving dental care, but little systematic research is available. The purpose of this study was to explore torture experiences, symptoms of post‐traumatic stress disorder (PTSD), and dental anxiety in refugees in Norway and to test the hypothesis that refugees with torture experiences are more prone to dental anxiety than refugees with no such experiences. A total of 173 refugees were interviewed shortly after an oral examination. The Modified Dental Anxiety Scale (MDAS) and the Harvard Trauma Questionnaire‐PTSS16 were administered verbally through attending interpreters. Among torture victims (47%, n = 81), the prevalence of torture experiences involving mouth or teeth was 35% and 23%, respectively. Harvard Trauma Questionnaire mean sum scores were statistically significantly higher in torture victims (34.3 vs. 24.8). Torture survivors report a larger number of symptoms of PTSD, and dental anxiety shows a higher prevalence in refugees reporting PTSD symptoms than in refugees who do not report such symptoms. When analysed using logistic regression models, the data showed the odds of high levels of dental anxiety being 6.1 times higher in refugees with torture experiences compared with other refugees and 9.3 times higher in torture victims with PTSD symptoms. Oral health professionals should be aware of these associations when providing dental care to refugees. The hypothesis that tortured refugees are more prone to dental anxiety is supported.
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