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

Facial palsy is a severe condition that may be ameliorated by facial reanimation, but there is no consensus about how to judge its success. In this study we aimed to test a new method for assessing facial movements based on 3-dimensional analysis of the facial surfaces. Eleven patients aged between 42 and 77 years who had recently been affected by facial palsy (onset between 6 and 18 months) were treated by an operation based on triple innervation: the masseteric to temporofacial nerve branch, 30% of the hypoglossal fibres to the cervicofacial nerve branch, and the contralateral facial nerve through two cross-face sural nerve grafts. Each patient had five stereophotogrammetric scans: at rest, smiling on the healthy side (facial stimulus), biting (masseteric stimulus), moving the tongue (hypoglossal stimulus), and corner-of-the-mouth smile (Mona Lisa). Each scan was superimposed onto the facial model of the "rest" position, and the point-to-point root mean square (RMS) value was automatically calculated on both the paralysed and the healthy side, together with an index of asymmetry. One-way and two-way ANOVA tests, respectively, were applied to verify the significance of possible differences in the RMS and asymmetry index according to the type of stimulus (p = 0.0329) and side (p < 0.0001). RMS differed significantly according to side between the facial stimulus and the masseteric one on the paralysed side (p = 0.0316). Facial stimulus evoked the most asymmetrical movement, whereas the masseteric produced the most symmetrical expression. The method can be used for assessing facial movements after facial reanimation

The Vitamin A Derivative All-Trans Retinoic Acid Repairs Amyloid-β-Induced Double-Strand Breaks in Neural Cells and in the Murine Neocortex.

The amyloid-β peptide or Aβ is the key player in the amyloid-cascade hypothesis of Alzheimer's disease. Aβ appears to trigger cell death but also production of double-strand breaks (DSBs) in aging and Alzheimer's disease. All-trans retinoic acid (RA), a derivative of vitamin A, was already known for its neuroprotective effects against the amyloid cascade. It diminishes, for instance, the production of Aβ peptides and their oligomerisation. In the present work we investigated the possible implication of RA receptor (RAR) in repair of Aβ-induced DSBs. We demonstrated that RA, as well as RAR agonist Am80, but not AGN 193109 antagonist, repair Aβ-induced DSBs in SH-SY5Y cells and an astrocytic cell line as well as in the murine cortical tissue of young and aged mice. The nonhomologous end joining pathway and the Ataxia Telangiectasia Mutated kinase were shown to be involved in RA-mediated DSBs repair in the SH-SY5Y cells. Our data suggest that RA, besides increasing cell viability in the cortex of young and even of aged mice, might also result in targeted DNA repair of genes important for cell or synaptic maintenance. This phenomenon would remain functional up to a point when Aβ increase and RA decrease probably lead to a pathological state

Symmetry of zygomatic bone through 3D segmentation on CT-scan and &quot;mirroring&quot; procedure: a novel approach for reconstructive maxillofacial surgery

Zygomatic bones are among those most frequently fractured facial bones [1]: symmetry is the golden standard for a correct restoration of zygomatic shape, but literature is divided about the best method for its quantification. Also, no information about the actual 3D symmetry of this bone in healthy subjects is available. This study aims at exposing an innovative approach for the assessment of zygomatic symmetry through 3D surface analysis. One hundred patients (50 males and 50 females) were selected from the CT-scans database from a Northern Italy hospital. Zygomatic bones from each patient were segmented, the left bone was automatically mirrored according to the sagittal plane and registered on the right one according to the least point-to-point distance between the two surfaces. Mean and RMS (root mean square) distance between the two models was then calculated. Possible statistically significant differences according to sex and age groups were assessed respectively through two-way ANOVA test (p0.05). This study first provides an overall assessment of symmetry of zygomatic bone, based on surface analysis: results may provide a useful indication for the reconstruction of zygomatic bones in maxillofacial surgery

The forensic odontology in Milan : a 20 year experience

Forensic odontology has a relevant importance in several fields of forensic sciences, from personal identification of corpse sand the living from video-surveillance systems, to the evaluation of lesions and odontoiatric damage and professional malpractice. In the last time forensic odontology has known a decisive improvement in the field of age estimation of the living for the ascertainment of imputability and age in adopted children, and from 2D images in cases of suspected juvenile pornographic material. The association with forensic odontologists has a relevant importance also in the assessment of bite marks and lesions in refugees seeking asylum. This poster aims at exposing some examples of the reliability of odontological techniques applied to the forensic scenario, chosen within the 20 year experience of LABANOF (Laboratorio di Antropologia e Odontologia Forense), which highlight the increasing requests from privates and the judicial authorities for expert witnesses concerning forensic odontology and the crucial role of university centers which may provide a reference point for assessing topics concerning this wide and crucial field of application of forensic sciences

Elements Related to Heterogeneity of Antibody-Dependent Cell Cytotoxicity in Patients Under Trastuzumab Therapy for Primary Operable Breast Cancer Overexpressing Her2

Preliminary results from a pilot trial on trastuzumab's mechanism of action against operable breast tumors overexpressing Her2 suggested a role for antibody-dependent cell cytotoxicity (ADCC). To examine factors affecting ADCC intensity and variability, we extended this study to the phenotypic and functional analysis of circulating mononuclear cells in 18 patients. ADCC was induced by trastuzumab therapy in 15 of 18 patients (83%). Inability to develop ADCC in three patients did not depend on inadequate levels of trastuzumab because further increase in its concentration in vitro was ineffective. Rather, susceptibility to develop ADCC was fairly predicted by test with trastuzumab before therapy and was correlated to the number of lymphocytes coexpressing CD16 and CD56. Phenotypic analysis at the end of ADCC evaluating down-regulation of CD16, and up-regulation of CD69 and CD107a, confirmed that natural killer (NK) cells and CD56+ T cells were involved in productive engagement of trastuzumab. Also, the killing efficiency of CD16+ lymphocytes was influenced by 158 V/F polymorphism of FcγRIII (CD16), whereas variations of CD247 on NK cells were consistent with trends between ADCC before and after therapy. Complete pathologic response was observed in one patient showing ADCC of outstanding intensity, whereas four cases of partial response showed intermediate ADCC; none of the three patients unable to mount ADCC had significant tumor regression. These data indicate that quantity and lytic efficiency of CD16+ lymphocytes are major factors for ADCC induction by trastuzumab, and confirm that breast cancer responses to short-term trastuzumab monotherapy may depend on involvement of the ADCC mechanism. [Cancer Res 2007;67(24):11991–9

Variations of midfacial soft-tissue thickness between 6 and 18 years for the reconstruction of the profile: a help for facial reconstruction of children

Facial approximation techniques used in forensic anthropology are based on soft-tissue thickness databases. However most of articles deal with adult populations, and very few studies were conducted on minors. This study aims at providing data concerning facial thickness for George reconstruction, preliminary to the 3D facial approximation. Diagnostic cephalometric X-ray films were obtained from 222 healthy Caucasoid children (91 boys and 131 girls), aged between 6 and 18 years, treated in a Department of Orthodontics of Northern Italy. After setting the Frankfurt plane horizontal, 14 measurements were taken at the mid-facial landmarks: supraglabella, glabella, nasion, nasale, subnasale, superior labial sulcus, labrale superius, stomion, labrale inferius, inferior labial sulcus, suprapogonion, pogonion, gnathion, menton. Mean and standard deviation of soft -tissues thickness at each point were calculated. A two-way analysis of variance (ANOVA) was performed to test the modifications of facial parameters with age and sex (p < 0.01). The results demonstrated that there is an increase in tissue thickness as individuals grow; in most occasions, males showed thicker soft tissues than females of the same age, especially after the adolescent growth spurt. Facial thicknesses at subnasale, superior labial sulcus, labrale superius, labrale inferius, inferior labial sulcus, suprapogonion, pogonion and gnathion significantly modified with age, whereas the same parameters at subnasale, superior labial sulcus, labrale superius, labrale inferius, stomion and suprapogonion were significantly sexually dimorphic. In addition, a database for soft-tissue thicknesses in children aged between 6 and 18 years was created, which may be of interest in cases of facial approximation of Italian minors

Quantification of dental movements in orthodontic follow-up : a novel approach based on registration of 3D models of dental casts

Introduction: The assessment of dental displacement achieved by orthodontic procedures is important as it allows operators to verify their clinical treatment and provide adequate adjustments. Modern 3D image acquisition and elaboration systems may represent a valid method for the three-dimensional assessment of dental movement. A novel protocol for the 3D assessment of success of orthodontic therapy is proposed, based on registration of surfaces. Methodology: Pairs of casts of the upper dental arch, taken at two different time periods during the therapy, were chosen for three patients who underwent an orthodontic treatment. Dental casts were scanned by a 3D laser scanner: for each patient, the two 3D models were then registered according to the least distance at the area including palatal rugae. The chromatic map of changes within the dental arch and the RMS (Root Mean Square) point-to-point distance between the dental profiles from the two models were obtained, and compared with the same data from a control group including five adult individuals who did not undergo orthodontic therapy. Inter- and intra-observer errors were evaluated as well. Results: The novel procedure proved to be repeatable and gave a detailed description of those dental areas most affected by orthodontic therapy: RMS values seem to be related with the weight of dental modifications and are far higher than the same parameters computed in the control group. Conclusion: Further studies are needed in order to explore the possible correlation of RMS value with clinical parameters linked to the improvement of dental function and aesthetics due to orthodontic therapy