Changes in the facial soft tissue profile after maxillary orthognathic surgery

OBJECTIVES To compare the changes of the soft tissue profile in relation to the displacement of the underlying hard structures in maxillary orthognathic surgery and to contribute to the esthetic prediction of the facial profile after surgical procedures. MATERIALS AND METHODS We analyzed the sagittal changes in the facial soft tissue profile related to surgical changes in skeletal structures after maxillary osteotomy in a retrospective study. The study sample comprised 115 adult patients between the ages of 18-50 years who had undergone maxillary orthognathic surgery and interdisciplinary orthodontic treatment at the Department of Orthodontics, Ludwig-Maximilians University of Munich, Germany. LeFort I osteotomy cases in both maxillary monognathic and bignathic osteotomy procedures were included. All subjects had received rigid fixation. A cephalometric analysis of presurgical and postsurgical cephalograms was performed and the correlations between hard tissue and soft tissue change ratios were evaluated using a bivariate linear regression analysis. A vertical line through the landmark sella (S) perpendicular to the nasion-sella line (NSL) served as the reference plane. RESULTS The subnasale (Sn) followed the A point (A) by 57%, the soft tissue A point (A') followed the A point (A) by 73% and the upper lip, represented by the landmark labrale superius (Ls) followed the upper incisor (Is) by 73%; all three in a linear correlation with a mean prediction error of nearly 2 mm. CONCLUSION The scatterplots show a linear correlation with a wide spread for all three pairs of reference points. The wide spread and the high prediction error of almost 2 mm indicate low predictability of the expected lip position and Sn.ZUSAMMENFASSUNG ZIELE: Die Veränderungen des Weichgewebeprofils in Relation zur Verlagerung der darunter liegenden Hartgewebe durch maxilläre orthognathe Chirurgie zu vergleichen und einen Beitrag zur ästhetischen Prognose des Gesichtsprofils nach chirurgischen Maßnahmen zu leisten. MATERIAL UND METHODE In einer retrospektiven Studie analysierten wir die sagittalen Veränderungen des fazialen Weichgewebeprofils in Beziehung zu den chirurgischen Veränderungen der skelettalen Strukturen nach maxillärer Osteotomie. Die Studienprobe besteht aus 115 erwachsenen Patienten im Alter von 18–50 Jahren, die sich interdisziplinär maxillärer orthognather Chirurgie und kieferorthopädischer Therapie an der Poliklinik für Kieferorthopädie der Ludwig-Maximilians-Universität München unterzogen hatten. LeFort-I-Osteotomie-Fälle sowohl maxillärer monognather als auch bignather Osteotomieverfahren wurden in die Studie aufgenommen. Alle Patienten hatten eine starre Fixierung erhalten. Es wurde eine kephalometrische Analyse von präoperativen und postoperativen Fernröntgenseitenbildern durchgeführt, die Korrelationen zwischen Hart- und Weichgewebeveränderungen wurden mittels einer bivariaten linearen Regressionsanalyse ausgewertet. Als Referenzebene diente eine vertikale Linie durch den Referenzpunkt Sella (S), rechtwinklig zur Nasion-Sella-Linie (NSL). ERGEBNISSE Der Punkt Subnasale (Sn) folgte dem A\hbox-Punkt (A) um 57 %, der Weichgewebe-A-Punkt (A′) folgte dem A-Punkt (A) um 73 %, und die Oberlippe, repräsentiert durch den Referenzpunkt Labrale superius (Ls), folgte dem Inzision superius (Is) um 73 %, alle 3 in einer linearen Korrelation bei einer mittleren Abweichung von fast 2 mm. FAZIT Die Punktdiagramme zeigen eine lineare Korrelation mit einer breiten Streuung aller 3 Referenzpunktpaare. Die breite Streuung und die hohe mittlere Abweichung von fast 2 mm lassen auf eine schwache Vorhersagbarkeit der zu erwartenden Position von Oberlippe und Sn schließen

Chemoprevention of lung cancer—from biology to clinical reality

Lung cancer is the commonest cause of cancer death in developed countries and throughout the world. Cigarette smoking is the main risk factor for lung cancer and ex-smokers today comprise ∼50% of all new lung cancer cases. Chemoprevention builds on the concepts of field of cancerization and multistep carcinogenesis and can be defined as the use of natural or chemical compounds to prevent, inhibit or reverse the process of carcinogenesis. So far, chemoprevention studies in lung cancer have failed to reduce lung cancer mortality. New developments in biotechnology have made it possible to define more accurately high-risk populations, make earlier diagnosis possible, and allow more specific targeted therapies to be developed. Both the development and validation of biomarkers, for the selection of high-risk study populations and for response evaluation in chemoprevention studies, are important for the faster turnover of studies evaluating new agents. This article reviews the current status and describes the perspectives for new approaches in the chemoprevention of lung cance

Neoadjuvant chemoradiotherapy with or without panitumumab in patients with wild-type KRAS, locally advanced rectal cancer (LARC): a randomized, multicenter, phase II trial SAKK 41/07

Background We conducted a randomized, phase II, multicenter study to evaluate the anti-epidermal growth factor receptor (EGFR) mAb panitumumab (P) in combination with chemoradiotherapy (CRT) with standard-dose capecitabine as neoadjuvant treatment for wild-type KRAS locally advanced rectal cancer (LARC). Patients and methods Patients with wild-type KRAS, T3-4 and/or N+ LARC were randomly assigned to receive CRT with or without P (6 mg/kg). The primary end-point was pathological near-complete or complete tumor response (pNC/CR), defined as grade 3 (pNCR) or 4 (pCR) histological regression by Dworak classification (DC). Results Forty of 68 patients were randomly assigned to P + CRT and 28 to CRT. pNC/CR was achieved in 21 patients (53%) treated with P + CRT [95% confidence interval (CI) 36%-69%] versus 9 patients (32%) treated with CRT alone (95% CI: 16%-52%). pCR was achieved in 4 (10%) and 5 (18%) patients, and pNCR in 17 (43%) and 4 (14%) patients. In immunohistochemical analysis, most DC 3 cells were not apoptotic. The most common grade ≥3 toxic effects in the P + CRT/CRT arm were diarrhea (10%/6%) and anastomotic leakage (15%/4%). Conclusions The addition of panitumumab to neoadjuvant CRT in patients with KRAS wild-type LARC resulted in a high pNC/CR rate, mostly grade 3 DC. The results of both treatment arms exceeded prespecified thresholds. The addition of panitumumab increased toxicit

Human biogeography and faunal exploitation in Diamante River basin, central western Argentina

A biogeographic model used to describe human peopling of southern Mendoza, central western Argentina, proposed an intensification process activated by an increase in population growth rate during the Late Holocene. During this process, high-ranked resources at the surroundings of residential camps were depleted, and hunter–gatherers broadened their diet by incorporating a larger number of low-ranked prey and domesticated plant resources. In this paper, we evaluate an alternative hypothesis, focusing on zooarchaeological data from the Diamante River basin. The results show that faunal resource intensification does not appear to have occurred in the Diamante River basin during the Late Holocene. Faunal consumption in Diamante River basin mainly reflects the local fauna in each ecological zone. The data do not show a lack of higher ranked resources. We suggest it is more likely that the demographic increase was not significant enough to cause an impact on the faunal resources. The archaeological evidence should be improved and analysed in smaller scales to continue with the intensification debate.Fil: Otaola, Clara. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Mendoza. Instituto Argentino de Nivología, Glaciología y Ciencias Ambientales. Provincia de Mendoza. Instituto Argentino de Nivología, Glaciología y Ciencias Ambientales. Universidad Nacional de Cuyo. Instituto Argentino de Nivología, Glaciología y Ciencias Ambientales; ArgentinaFil: Giardina, Miguel Angel. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Mendoza. Instituto Argentino de Nivología, Glaciología y Ciencias Ambientales. Provincia de Mendoza. Instituto Argentino de Nivología, Glaciología y Ciencias Ambientales. Universidad Nacional de Cuyo. Instituto Argentino de Nivología, Glaciología y Ciencias Ambientales; ArgentinaFil: Franchetti, Fernando Ricardo. University of Pittsburgh at Johnstown; Estados Unidos. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentin

Electronically preresonant stimulated Raman scattering microscopy in the visible

We report an experimental scheme for stimulated Raman scattering (SRS) microscopy with excitation in the visible spectral region. This allows electronically preresonant (epr) SRS microscopy of a broad range of chromophores with sensitivities as low as 1 μM. Our experiment is based on two synchronously near-infrared pumped optical parametric oscillators (OPO). One of the outputs is modulated at a fourth of the repetition rate with a novel broadband electro-optical modulator. Using a combination of spectral focusing and tuning of the OPO, we show the recording of epr-SRS spectra over the whole range of molecular vibrations at a speed up to 20 times faster than classical wavelength tuning. The imaging capabilities of this setup are demonstrated with material scientific and cellular samples

Tackling increased risks in older adults with intellectual disability and epilepsy: data from a national multicentre cohort study

Purpose: People with intellectual disabilities (ID) suffer multimorbidity, polypharmacy and excess mortality at a younger age than general population. Those with ID and epilepsy are at higher risk of worse clinical outcomes than their peers without epilepsy. In the ID population the health profile of those aged ≥40 years can be compared to those aged over 65 in the general population. To date there is limited data available to identify clinical characteristics and risk factors in older adults (≥40 years) with ID and epilepsy. / Methods: The Epilepsy in ID National Audit (Epi-IDNA) identified 904 patients with ID and epilepsy from 10 sites in England and Wales. This subsequent analysis of the Epi-IDNA cohort compared the 405 adults over 40 years with 499 adults ≥18 years aged under 40 years. Comparison was made between clinical characteristics and established risk factors using the Sudden Unexpected Death in Epilepsy (SUDEP) and Seizure Safety Checklist. / Results: The older adults’ cohort had significantly higher levels of co-morbid physical health conditions, mental health conditions, anti-seizure medications (median 5), and antipsychotics compared to the younger cohort. The older group were significantly less likely to be diagnosed with a co-morbid neurodevelopmental disorder, and to have an epilepsy care plan. / Conclusion: This is the largest study to date focused on adults with ID and epilepsy over 40 years. The ≥40 years cohort compared to the younger group has higher levels of clinical risk factors associated with multi-morbidity, potential iatrogenic harm and premature mortality with worse clinical oversight mechanisms

Robustness assessment of the ‘cooperation under resource pressure’ (CURP) model: Insights on resource availability and sharing practices among hunter-gatherers

A well-known challenge in archaeological research is the exploration of the social mechanisms that hunter-gatherers may have implemented throughout history to deal with changes in resource availability. The agent-based model (ABM) ‘cooperation under resource pressure’ (CURP) was conceived to explore food stress episodes in societies lacking a food preservation technology. It was particularly aimed at understanding how cooperative behaviours in the form of food sharing practices emerge, increase and may become the prevailing strategy in relation to changes in resource availability and expectancy of reciprocity. CURP’s main outcome is the identification of three regimes of behaviour depending on the stress level. In this work, the model’s robustness to the original selection mechanism (random tournament) is assessed, as different dynamics can lead to different persistent regimes. For that purpose, three other selection mechanisms are implemented and evaluated, to identify the prevailing states of the system. Results show that the three regimes are robust irrespective of the analysed dynamics. We consequently examine in more detail the long-term archaeological implications that these results may have.Spanish Ministry of Economy and Competitiveness (former Ministry of Science and Innovation): SimulPast Project (CSD2010- 00034 CONSOLIDER-INGENIO 2010), HAR2009-06996 and CULM Project (HAR2016- 77672-P); from the Argentine National Scientific and Technical Research Council (CONICET): Project PIP-0706; from the Wenner-Gren Foundation for Anthropological Research: Project GR7846; from the project H2020 FET OPEN RIA IBSEN/662725 and from the European Social Fund as one of the authors is the recipient of a predoctoral grant from the Department of Education of Junta de Castilla y León (Spain)

Phase II study of capecitabine and oxaliplatin given prior to and concurrently with preoperative pelvic radiotherapy in patients with locally advanced rectal cancer

This multicentre phase II study evaluated the efficacy and safety of preoperative capecitabine plus oxaliplatin and radiotherapy (RT) in patients with locally advanced rectal cancer (T3/T4 rectal adenocarcinoma with or without nodal involvement). Treatment consisted of one cycle of XELOX (capecitabine 1000 mg m−2 bid on days 1–14 and oxaliplatin 130 mg m−2 on day 1), followed by RT (1.8 Gy fractions 5 days per week for 5 weeks) plus CAPOX (capecitabine 825 mg m−2 bid on days 22–35 and 43–56, and oxaliplatin 50 mg m−2 on days 22, 29, 43 and 50). Surgery was recommended 5 weeks after completion of chemoradiotherapy. The primary end point was pathological complete tumour response (pCR). Sixty patients were enrolled. In the intent-to-treat population, the pCR rate was 23% (95% CI: 13–36%). 58 patients underwent surgery; R0 resection was achieved in 57 (98%) patients, including all 5 patients with T4 tumours. Sphincter preservation was achieved in 49 (84%) patients. Tumour and/or nodal downstaging was observed in 39 (65%) patients. The most common grade 3/4 adverse events were diarrhoea (20%) and lymphocytopaenia (43%). Preoperative capecitabine, oxaliplatin and RT achieved encouraging rates of pCR, R0 resection, sphincter preservation and tumour downstaging in patients with locally advanced rectal cancer

Review of the methods of determination of directed connectivity from multichannel data

The methods applied for estimation of functional connectivity from multichannel data are described with special emphasis on the estimators of directedness such as directed transfer function (DTF) and partial directed coherence. These estimators based on multivariate autoregressive model are free of pitfalls connected with application of bivariate measures. The examples of applications illustrating the performance of the methods are given. Time-varying estimators of directedness: short-time DTF and adaptive methods are presented

Fast track multi-discipline treatment (FTMDT trial) versus conventional treatment in colorectal cancer--the design of a prospective randomized controlled study

<p>Abstract</p> <p>Background</p> <p>Laparoscopy-assisted surgery, fast-track perioperative treatment are both increasingly used in colorectal cancer treatment, for their short-time benefits of enhanced recovery and short hospital stays. However, the benefits of the integration of the Laparoscopy-assisted surgery, fast-track perioperative treatment, and even with the Xelox chemotherapy, are still unknown. In this study, the three treatments integration is defined as "Fast Track Multi-Discipline Treatment Model" for colorectal cancer and this model extends the benefits to the whole treatment process of colorectal cancer. The main purpose of the study is to explore the feasibility of "Fast Track Multi-Discipline Treatment" model in treatment of colorectal cancer.</p> <p>Methods</p> <p>The trial is a prospective randomized controlled study with 2 × 2 balanced factorial design. Patients eligible for the study will be randomized to 4 groups: (I) Laparoscopic surgery with fast track perioperative treatment and Xelox chemotherapy; (II) Open surgery with fast track perioperative treatment and Xelox chemotherapy; (III) Laparoscopic surgery with conventional perioperative treatment and mFolfox6 chemotherapy; (IV) Open surgery with conventional perioperative treatment and mFolfox6 chemotherapy. The primary endpoint of this study is the hospital stays. The secondary endpoints are the quality of life, chemotherapy related adverse events, surgical complications and hospitalization costs. Totally, 340 patients will be enrolled with 85 patients in each group.</p> <p>Conclusions</p> <p>The study initiates a new treatment model "Fast Track Multi-Discipline Treatment" for colorectal cancer, and will provide feasibility evidence on the new model "Fast Track Multi-Discipline Treatment" for patients with colorectal cancer.</p> <p>Trial registration</p> <p>ClinicalTrials.gov: <a href="http://www.clinicaltrials.gov/ct2/show/NCT01080547">NCT01080547</a></p