Computer-assisted surgery in therapeutic strategy distraction osteogenesis of hemifacial microsomia: accuracy and predictability

Distraction osteogenesis can be used to treat hemifacial microsomia in patients of any age group. Application of three-dimensional (3D) technology in the surgical planning of distraction osteogenesis allows the placement of an intraoral distractor to define the cutting line and help predict the outcome of surgery.

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Adaptive change in temporomandibular joint tissue and mandibular morphology following surgically induced anterior disc displacement by bFGF injection in a rabbit model

The purpose of this study was to examine the effect of injecting basic fibroblast growth factor following surgical induced anterior disc displacement in temporomandibular joints (TMJ).

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Evaluation of stress distribution in critical anatomic regions following the Le Fort I osteotomy by three-dimensional finite element analysis

In this study, we aimed to measure the stresses both on the pterygoid plates and the cranial base during the down-fracture and at the time of pterygomaxillary osteotomy by using the finite element analysis method to have an idea about the possible causes of complications. Three different surgical approaches were applied to the obtained models. In the Model 1, Le Fort I cuts without pterygomaxillary separation was applied. In the Model 2, same standard Le Fort I cuts were applied with pterygomaxillary separation.

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Condylar Head Remodeling compensating for Condylar Head Displacement by Orthognathic Surgery

The purpose of this study was to evaluate the association between kind of condylar displacement due to orthognathic surgery and the subsequent adaptive condylar head remodeling.The sample in this retrospective cohort study consisted of 30 patients (12 female and 18 male; mean age 22.7y) with skeletal Class III malocclusion who underwent bilateral sagittal split ramus osteotomy (SSRO). Three-dimensional superimpositions of cone-beam computed tomography (CBCT) scan derived images from immediately after and 6 months after surgery were to reveal the type of remodeling, while images from before and immediately after surgery were to identify the subsequent type of condylar displacement.

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Three-dimensional analyses of nasolabial forms and upper lip surface symmetry after primary lip repair in patients with complete unilateral cleft lip and palate

To analyze three-dimensional (3D) nasolabial forms and upper lip surface symmetry after primary lip repair in children with unilateral cleft lip and palate (UCLP).

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The Role of Effortful Control in Stuttering Severity in Children: Replication Study

Background

In 2014, Kraft et al. assessed the temperament, home environment, and significant life events of 69 North American children who stutter to examine the combined and compounded effects of these individualized factors on mediating overt stuttering severity. The temperament domain of effortful control was singularly found to be significantly predictive of stuttering severity.

Purpose

Because of the clinical significance of the initial study's findings, a replication study with a different, larger cohort of children who stutter was warranted to validate the reported outcomes.

Method

The current study assesses 98 children who stutter, ages 2;4 to 12;6 (years; months, M = 6;7), recruited from Perth, Australia.

Results

The results support the previous findings of Kraft, Ambrose, and Chon (2014), with effortful control remaining the sole significant contributor to variability in stuttering severity, as rated by both parents and clinicians.

Conclusion

These cumulative and consistent outcomes support the need to develop targeted intervention strategies that specifically strengthen aspects of effortful control as a means to support positive therapeutic change in children who stutter.

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Chondrosarcoma of the jaw bones: a review of 224 cases reported to date and an analysis of prognostic factors

The objective was to integrate the available published data on chondrosarcoma (CHS) of the jaw bones into a comprehensive analysis of its clinical and histological features, treatment, and prognostic factors. An electronic search was undertaken in October 2017. To be eligible, the publication had to provide sufficient clinical/histological data to confirm the diagnosis. One hundred and ten publications (224 cases of CHS) were identified and included. There was a slightly higher prevalence of CHS in males than in females.

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Monte Carlo simulation of reasons for early failure of implants: effects of two risk factors

We have estimated the joint effects of two important risk factors on early failure of implants and then ranked all quoted risks by importance. We made a systematic search of published papers listed in PubMed, Web of Knowledge, Scopus, and Cochrane Central up to March 2018, and identified a total of 437 records. Eight studies met the inclusion criteria, in which seven significant risk factors for early failure were selected and used to build a conceptual simulation model. Selected risk factors were: "male sex", "smoking", "quality of bone", "short implants", "wide implants", "adjacent teeth", and "periodontitis".

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Day-case bilateral sagittal split osteotomy

In the UK, patients who have bilateral sagittal split osteotomy (BSSO) have generally been thought to require inpatient admission and an overnight hospital stay. However, since the introduction of national standards on day case surgery in the UK in 2011, patients at the Royal Gwent Hospital, Newport, have been treated as day cases, and have been pleased with the results. The aim of this paper was to show that these procedures conform to current national standards, and can be done successfully and safely.

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Correlations between cervical spinal cord magnetic resonance diffusion tensor and diffusion kurtosis imaging metrics and motor performance in patients with chronic ischemic brain lesions of the corticospinal tract

Abstract

Purpose

To investigate modifications of Magnetic Resonance Diffusion Tensor Imaging (DTI) and Diffusion Kurtosis Imaging (DKI) metrics in lateral white matter (WM) bundles of the cervical spinal cord in patients with previous stroke in the vascular territory of the middle cerebral artery (MCA).

Methods

Twenty consecutive patients with a previous ischemic stroke of the MCA territory and a varying degree of upper motor impairment were enrolled. DKI was centered at the C3C4 and C5C6 intervertebral level.

Results

The fractional anisotropy (FA) values in C3C4 and C5C6 were found to be significantly lower in the lateral WM bundles contralateral to the ischemic lesion and thus, in the WM bundle including the affected corticospinal tract (CST) (p = 0.005 and p = 0.008, respectively), as well as mean kurtosis (MK) and axonal water fraction (AWF) values (p = 0.004 and p = 0.04. respectively). FA values correlated significantly with the Global Motor Index (GMI) both for C3C4 (ρ = 0.61, p = 0.004) and C5C6 (ρ = 0.69, p = 0.002). At C3C4, AWF correlated significantly with GMI (ρ = 0.54, p = 0.03). No correlations were found between lateral WM bundle volumes and GMI.

Conclusion

A reduction of anisotropy and microstructural complexity in the affected lateral WM bundle of the cervical spinal cord was observed in patients with previous ischemic stroke involving the CST. The correlations between these metrics and motor performance were statistically significant.

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The relationship of habitual diet with oesophageal inflammation and integrity in Eosinophilic Esophagitis

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Three‐dimensional structure of the wheat β‐amylase Tri a 17, a clinically relevant food allergen

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Smoking habits among adolescents with asthma – data from a population based birth cohort

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Long‐term outcomes in chronic hypersensitivity pneumonitis

Abstract

Introduction

The objective of this study was to analyze mortality, possible predictors of long‐term survival and health‐related quality of life of a large chronic hypersensitivity pneumonitis (CHP) patient sample.

Methods

Longitudinal study in patients diagnosed with CHP during 2004‐2013, followed for at least one year. Patients remaining alive and consenting to participate had a follow‐up visit during 2015, including a complete pulmonary function study and the EuroQol‐5D and Beck Depression and Anxiety Inventories.

Results

Out of the 160 patients finally included, 87 remained alive. Seventy‐three had died or underwent lung transplantation at the time of the study with a median survival of 7.0 (4.4‐14.5) years. A Cox proportional risk model showed that factors associated with lower survival were: increased age, a low percentage of lymphocytes in bronchoalveolar lavage (BAL), a decreased transfer factor of the lung for carbon monoxide (DLCO), presence of honeycomb in the high resolution chest scan (HRCT) and the usual interstitial pneumonia (UIP) histologic pattern. At follow‐up all patients presented an EuroQol‐5D score < 0.8 and 21(50%) and 9(28.6%) subjects presented a probable anxiety and depressive syndrome, respectively.

Conclusion

CHP is a severe disease with a bad mid‐term prognosis. Lymphocyte values in BAL and DLCO values at baseline, presence of honeycomb in HRCT and UIP histologic pattern were found to be predictors of survival. Early accurate diagnosis of the disease is fundamental for prompt initiation of antigen avoidance.

This article is protected by copyright. All rights reserved.

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The WHO/IUIS Allergen Nomenclature

Summary

The WHO/IUIS Allergen Nomenclature Sub‐Committee (http://www.allergen.org/), an international body of experts, has developed an allergen nomenclature system to provide a common language for unambiguous communications between researchers, clinicians, pharmaceutical companies and regulatory authorities regarding specific allergenic proteins. Official allergen names are only assigned by the WHO/IUIS Nomenclature Sub‐Committee once a new allergen has successfully undergone the submission and evaluation process. This article highlights the necessary steps to obtain an official allergen name and the high importance of having an official allergen nomenclature.

This article is protected by copyright. All rights reserved.

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Vocal Health, Voice Self-concept and Quality of Life in German School Teachers

Publication date: Available online 5 December 2018

Source: Journal of Voice

Author(s): Manfred Nusseck, Claudia Spahn, Matthias Echternach, Anna Immerz, Bernhard Richter

Summary

Objectives

For school teachers, the voice is a mandatory occupational tool during teaching. Several studies, however, proved that teachers are at high risk of developing voice disorders. The aim of this study was to investigate the voice health, voice self-concept, and quality of life in German teachers.

Methods

In a cross-sectional study 536 German school teachers had a laryngeal examination, acoustic voice measurements to determine the Dysphonia Severity Index and filled in a self-reporting questionnaire with the Voice Handicap Index-12), the voice self-concept (Fragebogen zur Erfassung des Stimmlichen Selbstkonzepts), and the general quality of life (SF-12).

Results

A total of 58.3% of the teachers reported that they had experienced a voice problem at least once in their career. Female teachers had more often experienced voice problems than male teachers. Twenty-five percent showed a current considerable voice abnormality of vocal fold oscillation pattern. Such voice abnormalities were observed more in male teachers than female teachers. The Dysphonia Severity Index also differed between gender with higher values in the female teachers and a steadily decreasing value over age. The voice self-concept showed differences between gender and age of the teachers. Teachers who experienced a voice problem had higher Voice Handicap Index and lower voice self-concept values compared to those without experienced voice problems. Teachers with voice abnormalities had lower values in the quality of life scales.

Conclusions

The findings confirm the high risk of voice health problems among German teachers and illustrate the complexity of vocal health and quality of life issues in teachers associated with gender, age, and the history of experienced voice problems. This study strengthens the necessity for vocal training programs to prepare teachers for a professional and healthy voice use to maintain vocal health.

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The “Morning Voice”: The Effect of 24 Hours of Sleep Deprivation on Vocal Parameters of Young Adults

Publication date: Available online 5 December 2018

Source: Journal of Voice

Author(s): Michal Icht, Gil Zukerman, Shir Hershkovich, Tal Laor, Yuval Heled, Nir Fink, Leah Fostick

Summary

Fatigue following sleep deprivation adversely affects various aspects of human performance. It also induces recognizable voice changes, but the literature is inconsistent regarding their nature. The current study used acoustical analyses to assess the effect of 24 hours of sleep deprivation on vocal parameters of young adults. Forty-seven participants (23 females and 24 males) were tested after nocturnal sleep and after 24 hours of sleep deprivation. Different voice samples were recorded (sustained phonation, words, and sentences) and analyzed for fundamental frequency (F₀, in Hz), vocal intensity (in dB), harmonic-noise ratio (HNR, in dB), jitter, and shimmer (in %). The main finding was significantly higher HNR values following sleep deprivation than nocturnal sleep for females, across all voice samples. The HNR is a measure of the degree of acoustic periodicity, or the amount of noise compared to the harmonic quality present in the voice. As its values are higher, the voice quality is perceptually better. The current results indicate that females had a significantly higher ratio of vocal harmonics compared to vocal noise when they were sleep deprived. In contrast, following nocturnal sleep, the ratio of vocal harmonics compared to vocal noise was lower, which means the voice quality was poorer. This may explain the common perceptual impressions of decreased voice quality after sleep, which may be more pronounced in females.

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The Clinical Course of Idiopathic Bilateral Vocal Fold Motion Impairment in Adults: Case Series and Review of the Literature

Publication date: Available online 5 December 2018

Source: Journal of Voice

Author(s): Sara Abu Ghanem, Attapon Junlapan, Shu Wei Tsai, Liang-Chun Shih, Chih-Kwang Sung, Edward J. Damrose

Summary

Aim

Steps for assessment and successful management of bilateral vocal fold motion impairment (VFMI) are (1) recognition of its presence, (2) identifying the etiology and factors restricting vocal fold motion, (3) evaluation of airway patency, and (4) establishing a management plan. No large series documenting the course and outcome of adult idiopathic bilateral VFMI has been published within the past 15 years.

Methods

Retrospective chart review of adult patients with idiopathic bilateral VFMI at a tertiary academic center. A diagnosis was established if history, physical examination with laryngoscopy, and initial imaging excluded a cause. Records were reviewed for demographics, clinical characteristics, surgical intervention details, and length of follow-up.

Results

Nine adult patients with idiopathic bilateral VFMI were identified. There were five males and four females with a mean age of 59.6 years. The mean follow-up period was 54.4 months (range, 6–111 months). Upon presentation to our laryngology service, three patients were advised observation, three patients were advised to undergo urgent tracheostomy, and three patients were advised to undergo elective surgery for airway management. By the end of the follow-up period, only four patients (4/9, 44.4%) were tracheostomy dependent, one of them was lost to follow-up after tracheostomy tub downsizing for decannulation.

Conclusions

To our best knowledge, this is the largest series so far of adult patients with idiopathic bilateral VFMI. Conservative treatment can be considered as an alternative to surgery in select cases.

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The Prevalence of Self-Reported Voice Disorders in Israel

Publication date: Available online 5 December 2018

Source: Journal of Voice

Author(s): Ofer Amir, Arij Marroushi-Marrawi, Adi Primov-Fever, Debora Freud

Summary

Objective

Data on the prevalence of voice disorders is vital in order to describe and understand the phenomenon. The aim of this study was to estimate the prevalence of voice disorders in Israel, and perform a preliminary comparison between the two major societies in the country.

Methods

A sample of 1146 people participated in a survey on voice disorders. This sample comprised 510 Israeli Jews and 627 Israeli Arabs. Each participant completed a questionnaire concerned with voice and its disorders as well as the shortened Voice Handicap Index-10 (VHI-10).

Results

The overall prevalence of voice disorders within our sample was 13.90%. In addition, 30.26% of the participants reported experiencing a voice problem over the last year, while 12.81% reported seeing a physician for that reason. No significant differences were found in the prevalence of voice disorders between participants who identified themselves as either Jews or Arabs. A higher prevalence of voice disorders was found in the older age groups, and among people who reside in the southern region of the country. In contrast, no significant differences in the prevalence of reported voice disorders were found between men and women.

Conclusion

The prevalence of reported voice disorders in Israel is comparable with previous prevalence reports from other regions and societies. Data show that despite cultural, religion, language, and other factors, the prevalence of voice disorder among Israeli Jews and Arabs is very similar.

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In vitro cytotoxicity of dental adhesives: A systematic review

Publication date: Available online 4 December 2018

Source: Dental Materials

Author(s): Isleine Portal Caldas, Gutemberg Gomes Alves, Igor Bastos Barbosa, Pantaleo Scelza, Fernando de Noronha, Miriam Zaccaro Scelza

Abstract

Objectives

The increased demand for esthetics and minimally invasive tooth restorations resulted in a rapid development of adhesive dentistry. However, much controversy remains about the safe use and cytotoxic effects of different groups of dental adhesives. The present study performed a systematic review to identify the answer to the following question: are self-etch adhesives more cytotoxic than those employing the etch-and-rinse system?

Methods

This systematic review was performed in accordance with the PRISMA statement; a quality assessment for in vitro studies was conducted using the ToxRTool. Specific search strategies were developed and performed in the electronic databases MEDLINE via PubMed, Cochrane Library, Scopus, Web of Science, and LILACS/BBO. After removal of duplicated studies and application of the exclusion criteria, ten eligible articles were selected and submitted to a qualitative descriptive analysis comparing both groups of dental adhesives. Most in vitro test systems employed pulp cells or gingival fibroblasts.

Results

The methodologies presented great variability regarding the exposure to the test materials. Only four studies assessed the role of the degree of conversion of the materials in their toxicity, with conflicting results.

Significance

While the lack of methodological standardization among the studies still hinders the establishment of a relationship between type of dental adhesive and toxicity, studies employing dentin barrier systems indicate greater cytotoxicity for etch-and-rinse adhesives.

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Urticaria control test might misevaluate disease control in particular patients treated with omalizumab

Publication date: Available online 4 December 2018

Source: Annals of Allergy, Asthma & Immunology

Author(s): Murat Türk, İnsu Yılmaz

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The fate of root canals obturated with Thermafil: 10-year data for patients treated in a master’s program

Abstract

Objectives

Retrospective description of the 10-year success rate of endodontic treatments with Thermafil (TF).

Materials and methods

Patients treated by postgraduate students in an Endodontics Master's Program (2006–2008) were enrolled. All treated root canals were filled with TF and AH Plus. Teeth satisfying the inclusion criteria (206 teeth in 89 patients) were reexamined clinically and radiographically to estimate a 10-year survival and periapical health. Demographic and medical data were registered; collected information included pre-, intra-, and postoperative variables. Teeth were classified as "healthy" (PAI ≤ 2 in absence of signs/symptoms), "endodontically diseased" (presenting at least one of the following: PAI ≥ 3, signs/symptoms, retreated in the course of the follow-up, or extracted for endodontic reasons), or "non-endodontically diseased" (extracted for non-restorable fractures or periodontal disease). For teeth lost during the 10-year follow-up, details and reason of extraction were analyzed. Two PAI-calibrated examiners assessed outcomes blinded to preoperative status. Bivariate and multilevel analyses were performed (α level set at 0.05).

Results

At 10 years, 179 (87%) teeth survived and 27 were extracted: 20 for non-endodontic reasons (excluded from success analysis) and 7 for endodontic reasons (considered "endodontically diseased"). Multilevel analysis revealed that the probability of extraction was increased by the presence of preoperative pain (odds ratio = 6.720; 95% confidence interval, 1.483–30.448) and by maxillary location (odds ratio = 2.950; 95% confidence interval, 1.043–8.347). Concerning periapical status, 159/186 teeth (85%) were assessed as "healthy." Multilevel analysis confirmed that maxillary location (odds ratio = 3.908; 95% confidence interval, 1.370–11.146), presence of flare up (odds ratio = 9.914; 95% confidence interval, 2.388–41.163), and fracture occurrence (odds ratio = 35.412; 95% confidence interval, 3.366–372.555) decreased the odds of healing, respectively.

Conclusions

After 10 years, teeth filled with Thermafil in a specialist master's program presented a survival and a periapical health comparable to cohorts where root canals were filled with other obturation techniques.

Clinical relevance

Carrier-based techniques provide time savings for clinicians while satisfying clinical quality criteria for the root filling and consequently the clinical outcome.

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Condylar Head Remodeling compensating for Condylar Head Displacement by Orthognathic Surgery

Publication date: Available online 5 December 2018

Source: Journal of Cranio-Maxillofacial Surgery

Author(s): Hyeon-Shik Hwang, Tingting Jiang, Lijun Sun, Kyung-Min Lee, Min-Hee Oh, Yan Biao, Hee-Kyun Oh, Till Edward Bechtold

Abstract

The purpose of this study was to evaluate the association between kind of condylar displacement due to orthognathic surgery and the subsequent adaptive condylar head remodeling.

The sample in this retrospective cohort study consisted of 30 patients (12 female and 18 male; mean age 22.7y) with skeletal Class III malocclusion who underwent bilateral sagittal split ramus osteotomy (SSRO). Three-dimensional superimpositions of cone-beam computed tomography (CBCT) scan derived images from immediately after and 6 months after surgery were to reveal the type of remodeling, while images from before and immediately after surgery were to identify the subsequent type of condylar displacement.

Laterally displaced condyles showed bone resorption on the lateral surfaces and deposition on the medial surfaces, whereas the contrary was found in medially displaced condyles. Anteriorly displaced condyles showed resorption on the anterior surfaces and deposition on the posterior surfaces, whereas the contrary was found in posteriorly displaced condyles. Superior surfaces of the condyles showed bone resorption regardless of displacement direction.

The results indicate that condylar remodeling patterns (resorption/deposition) are determined by the direction of condylar displacement during surgery. However, condylar displacement by surgery is not completely compensated by condylar head remodeling, especially in case of downward displacement.

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Impact of Nasalis Muscle Repair in Unilateral Cleft Lip Patients

Publication date: Available online 5 December 2018

Source: Journal of Cranio-Maxillofacial Surgery

Author(s): Sarah A. Attia, Hesham A. Helal, Amir S. El Barabary, Mostafa A. Awad, Mahmoud M. Sherif

Abstract

Background

Although the role of nasalis muscle in the establishment of nasal deformity is well recognized; its abnormal anatomy and role in the correction of alar deformity in cleft lip patients have not been adequately studied. This work aimed to study the effect of nasalis muscle repair on the postoperative nasal symmetry.

Patients and Methods

A controlled prospective randomized study was conducted on 45 cases of unilateral complete pre-alveolar cleft. Patients were divided into two groups; Group 1 (repair of the Orbicularis muscle only), Group 2 was further divided into 2 subgroups: Subgroup A (repair of the orbicularis oris muscle and dissection and repair the origin of the nasalis muscle). Subgroup B (repair of the orbicularis oris muscle and dissection of both origin and abnormal insertion of the nasalis and repair of the origin). Evaluation was conducted both subjectively and objectively through cleft lip evaluation profile and nostril angles measurement.

Results

Group 2B patients showed significantly better shape and symmetry of nasal tip, size and symmetry of nostrils and size, form and lateral displacement of the ala. Objective evaluation showed that group 2B had the closest results to the non-cleft side, with statistically significant difference, when compared to other groups.

Conclusion

Dissection and repair of both origin and insertion of nasalis muscle produced a nasal width, columellar height, and nasal tip projection close to the normal population of the same age.

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Evaluation of stress distribution in critical anatomic regions following the Le Fort I osteotomy by three-dimensional finite element analysis

Publication date: Available online 5 December 2018

Source: Journal of Cranio-Maxillofacial Surgery

Author(s): Alparslan Esen, Elvan Dolanmaz, Dogan Dolanmaz

Summary

In this study, we aimed to measure the stresses both on the pterygoid plates and the cranial base during the down-fracture and at the time of pterygomaxillary osteotomy by using the finite element analysis method to have an idea about the possible causes of complications. Three different surgical approaches were applied to the obtained models. In the Model 1, Le Fort I cuts without pterygomaxillary separation was applied. In the Model 2, same standard Le Fort I cuts were applied with pterygomaxillary separation. Then both models were subjected to a force of 150 N over the anterior spina nasalis to simulate down-fracture. In the third model, same standard Le Fort I cuts were applied. Following this procedure, a force of 50 N was applied with a sharp osteotome to the pterygomaxillary junction to simulate osteotomy. According to the results of this experimental study, the cranial base stress values decreased during the down-fracture in the Model 2. Moreover, it was found that the force transmitted to the base of the skull is less when the height of the pterygomaxillary osteotome is limited to 1cm as we applied in Model 3.

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Does vertical incomitance predict the diplopia outcome in orbital fracture patients? A prospective study of 188 patients

Publication date: Available online 5 December 2018

Source: Journal of Cranio-Maxillofacial Surgery

Author(s): F. Bianchi, R. De Haller, H. Steffen, D.S. Courvoisier, P. Scolozzi

Abstract

Objective

To determine the predictive value of vertical incomitance for diplopia outcome in orbital fracture patients.

Patients and Methods

A prospective cohort study composed of patients with orbital fractures was designed. The predictor variable was vertical incomitance, and the primary outcome variable was diplopia. Incomitance was calculated in prism diopters (Δ) as the difference of the maximum absolute deviation between the upper and lower three gaze directions. Standard statistics for patient characteristics, the Fisher exact test for categorical variables and the Wilcoxon rank sum test for continuous variables were computed.

Results

The sample was composed of 188 patients grouped as follows: non-operated (n=124) and operated (n=64). Fifty-one patients showed vertical incomitance of whom10 (19.6%) had persistent diplopia at the 1-year follow-up. The mean incomitance was 9.6Δ in the diplopia group versus 2Δ in the non diplopia group (OR=1.13; p<0.001). There was a statistically significant association between vertical incomitance of >2Δ and persistent diplopia at 1 year after adjusting for the surgery variable (OR=1.07; p<0.04).

Conclusion

The present study has demonstrated that in orbital fracture patients, vertical incomitance was associated with (1) persistence of long-term diplopia, (2) the decision to perform surgery, and (3) the severity of the fracture.

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Association between Brain-Derived Neurotrophic Factor (BDNF) Levels in 2nd Trimester Amniotic Fluid and Fetal Development

The development of the fetal nervous system mirrors general fetal development, comprising a combination of genetic resources and effects of the intrauterine environment. Our aim was to assess the 2nd trimester amniotic fluid levels of brain-derived neurotrophic factor (BDNF) and to investigate its association with fetal growth. In accordance with our study design, samples of amniotic fluid were collected from women who had undergone amniocentesis early in the 2nd trimester. All pregnancies were followed up until delivery and fetal growth patterns and birth weights were recorded, following which pregnancies were divided into three groups based on fetal weight: (1) AGA (appropriate for gestational age), (2) SGA (small for gestational age), and (3) LGA (large for gestational age). We focused on these three groups representing a reflection of the intrauterine growth spectrum. Our results revealed the presence of notably higher BDNF levels in the amniotic fluid of impaired growth fetuses by comparison with those of normal growth. Both SGA and macrosomic fetuses are characterized by notably higher amniotic fluid levels of BDNF (mean values of 36,300 pg/ml and 35,700 pg/ml, respectively) compared to normal-growth fetuses (mean value of 32,700 pg/ml). Though apparently small, this difference is, nevertheless, statistically significant ( value 

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Microbubble Formulations: Synthesis, Stability, Modeling and Biomedical Applications

Publication date: Available online 5 December 2018

Source: Ultrasound in Medicine & Biology

Author(s): Awaneesh Upadhyay, Sameer V. Dalvi

Abstract

Microbubbles are increasingly being used in biomedical applications such as ultrasonic imaging and targeted drug delivery. Microbubbles typically range from 0.1 to 10 µm in size and consist of a protective shell made of lipids or proteins. The shell encapsulates a gaseous core containing gases such as oxygen, sulfur hexafluoride or perfluorocarbons. This review is a consolidated account of information available in the literature on research related to microbubbles. Efforts have been made to present an overview of microbubble synthesis techniques; microbubble stability; microbubbles as contrast agents in ultrasonic imaging and drug delivery vehicles; and side effects related to microbubble administration in humans. Developments related to the modeling of microbubble dissolution and stability are also discussed.

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Analysis of an in-house technique for temporary mandibulotomy and its impact on postoperative radiotherapy

Publication date: Available online 5 December 2018

Source: International Journal of Oral and Maxillofacial Surgery

Author(s): J. Hachleitner, C. Brandtner, A. Gaggl, M. Kopp, G. Fastner, G. Moser, S. Roesch

Abstract

The purpose of this study was to describe a newly developed procedure for temporary mandibulotomy and subsequent osteosynthesis. Clinical outcomes were evaluated, including complications and the impact on postoperative treatment, particularly postoperative radiotherapy. Twenty-four patients underwent temporary mandibulotomies for the surgical resection of malignancies located in the posterior oral or oropharyngeal region. All were treated with postoperative radiotherapy. An angulated median mandibulotomy was followed by osteosynthesis with three anchor screws directed towards the inferior aspect of the mandible. Anchor screws are modified conventional lag screws that include an additional biconcave washer. This modification prevents the screw heads from cracking into the cancellous bone during tightening, improving their biomechanical qualities considerably. Insertion of screws at any angle to the bony surface therefore becomes possible, which is a precondition for this technique. Minor complications occurred in two patients in the early postoperative period. However, complications causing bony non-union, leading to postponed postoperative radiotherapy were not noted in this cohort.

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Comparison of retroauricular and small transcervical approaches for endoscopic-assisted selective neck dissection: a cadaveric study

Publication date: Available online 4 December 2018

Source: International Journal of Oral and Maxillofacial Surgery

Author(s): S. Lee, W. Nam

Abstract

Advances in endoscopic-assisted neck surgery have allowed surgeons to conceal the scars via various approaches. However, studies comparing the approaches are still rare. The aim of this study was to comparatively analyze the feasibility and oncological outcomes of the retroauricular approach (RA) and the small transcervical approach (STC) for endoscopic-assisted selective neck dissection (EASND). Five fresh cadavers were recruited. EASND was performed via RA on one side and via STC on the contralateral side of each of the cadavers. The duration of the procedure was subdivided into preparation and EASND, and was recorded during the operation. The preserved vital structures were inspected by another surgeon after the cadaver dissection. The total number of lymph nodes retrieved was assessed by a pathologist. There was no significant difference in lymph node count between the RA group (mean 21, range 9–38) and the STC group (mean 23, range 7–34) (P > 0.05). The operation time was significantly longer in the RA group than in the STC group (preparation, P = 0.042; EASND, P = 0.043). In terms of surgical feasibility, STC can be chosen as the approach of choice for EASND. In spite of a long learning curve, RA might be an alternative option in particular cases to minimize scarring.

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Bird-egg syndrome induced by α-livetin sensitization in a budgerigar keeper: Successful induction of tolerance by avoiding exposure to avians

Publication date: Available online 4 December 2018

Source: Allergology International

Author(s): Naoko Inomata, Katsuyuki Kawano, Michiko Aihara

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The Urticaria Control Test and Urticaria Activity Score correlate with quality of life in adult Japanese patients with chronic spontaneous urticaria

Publication date: Available online 4 December 2018

Source: Allergology International

Author(s): Shoko Nakatani, Yoshiko Oda, Ken Washio, Atsushi Fukunaga, Chikako Nishigori

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The cerebral bases of the bouba-kiki effect

Publication date: 1 February 2019

Source: NeuroImage, Volume 186

Author(s): Nathan Peiffer-Smadja, Laurent Cohen

Abstract

The crossmodal correspondence between some speech sounds and some geometrical shapes, known as the bouba-kiki (BK) effect, constitutes a remarkable exception to the general arbitrariness of the links between word meaning and word sounds. We have analyzed the association of shapes and sounds in order to determine whether it occurs at a perceptual or at a decisional level, and whether it takes place in sensory cortices or in supramodal regions. First, using an Implicit Association Test (IAT), we have shown that the BK effect may occur without participants making any explicit decision relative to sound-shape associations. Second, looking for the brain correlates of implicit BK matching, we have found that intermodal matching influences activations in both auditory and visual sensory cortices. Moreover, we found stronger prefrontal activation to mismatching than to matching stimuli, presumably reflecting a modulation of executive processes by crossmodal correspondence. Thus, through its roots in the physiology of object categorization and crossmodal matching, the BK effect provides a unique insight into some non-linguistic components of word formation.

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Neural substrates of cognitive reserve in Alzheimer's disease spectrum and normal aging

Publication date: 1 February 2019

Source: NeuroImage, Volume 186

Author(s): Dong Hyuk Lee, Peter Lee, Sang Won Seo, Jee Hoon Roh, Minyoung Oh, Jungsu S. Oh, Seung Jun Oh, Jae Seung Kim, Yong Jeong

Abstract

The concept of cognitive reserve (CR) originated from discrepancies between the degree of brain pathology and the severity of clinical manifestations. CR has been characterized through CR proxies, such as education and occupation complexity; however, such approaches have inherent limitations. Although several methods have been developed to overcome these limitations, they fail to reflect the entire Alzheimer's disease (AD) pathology. Meanwhile, graph theory analysis, one of most powerful and flexible approaches, have established remarkable network properties of the brain. The functional and structural brain networks are damaged in neurodegenerative diseases. Therefore, network analysis has been applied to clarify the characteristics of the disease or give insight. Here, using multimodal neuroimaging, we propose an intuitive model to estimate CR based on its original definition, and explore the neural substrates of CR from the perspective of networks and functional connectivity. A total of 87 subjects (21 AD, 32 mild cognitive impairment, and 34 normal aging) underwent tau and amyloid PET, 3D T1-weighted MR, and resting-state fMRI. We hypothesized CR as a residual of actual cognitive performance and expected performance to be related to quantitative factors, such as AD pathology, demographics, and a genetic factor. Then, we correlated this marker using education and occupation complexity as conventional CR proxies. We validated this marker by testing whether it would modulate the effect of brain pathology on memory function. To examine the neural substrates associated with CR, we performed graph analysis to investigate the association between the CR marker and network measures at different granularities in total subjects, AD spectrum and normal aging, respectively. The CR marker from our model was well associated with education and occupation complexity. More directly, the CR marker was revealed to modify the relationship between brain pathology and memory function among AD spectrum. The CR marker was correlated with the global efficiency of the entire network, nodal clustering coefficient, and local efficiency of the right middle-temporal pole. In connectivity analysis, one cluster of edges centered on right middle-temporal pole was significantly correlated with the CR marker. In subgroup analysis, the network measures of right middle-temporal pole still correlated with the CR marker among AD spectrum. However, right precentral gyrus was revealed to be associated with the CR marker in normal aging. This study demonstrates that our intuitive model using multimodal neuroimaging and network perspective adequately and comprehensively captures CR. From a network perspective, CR is associated with the capacity to process information efficiently in the brain. The right middle-temporal pole was revealed to be a pivotal neural substrate of CR in AD spectrum. These findings foster understanding of AD and will be useful to help identify individuals with vulnerability or resistance to AD pathology, and characterize patients for intervention or drug trials.

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