Three lateral osteotomy designs for bilateral sagittal split osteotomy: biomechanical evaluation with three-dimensional finite element analysis

<p>Abstract</p> <p>Background</p> <p>The location of the lateral osteotomy cut during bilateral sagittal split osteotomy (BSSO) varies according to the surgeon's preference, and no consensus has been reached regarding the ideal location from the perspective of biomechanics. The purpose of this study was to evaluate the mechanical behavior of the mandible and screw-miniplate system among three lateral osteotomy designs for BSSO by using three-dimensional (3-D) finite element analysis (FEA).</p> <p>Methods</p> <p>The Trauner-Obwegeser (TO), Obwegeser (Ob), and Obwegeser-Dal Pont (OD) methods were used for BSSO. In all the FEA simulations, the distal segments were advanced by 5 mm. Each model was fixed by using miniplates. These were applied at four different locations, including along Champy's lines, to give 12 different FEA miniplate fixation methods. We examined these models under two different loads.</p> <p>Results</p> <p>The magnitudes of tooth displacement, the maximum bone stress in the vicinity of the screws, and the maximum stress on the screw-miniplate system were less in the OD method than in the Ob and TO methods at all the miniplate locations. In addition, Champy's lines models were less than those at the other miniplate locations.</p> <p>Conclusions</p> <p>The OD method allows greater mechanical stability of the mandible than the other two techniques. Further, miniplates placed along Champy's lines provide greater mechanical advantage than those placed at other locations.</p

Association of variations in HLA class II and other loci with susceptibility to EGFR-mutated lung adenocarcinoma

Lung adenocarcinoma driven by somatic EGFR mutations is more prevalent in East Asians (30-50%) than in European/Americans (10-20%). Here we investigate genetic factors underlying the risk of this disease by conducting a genome-wide association study, followed by two validation studies, in 3,173 Japanese patients with EGFR mutation-positive lung adenocarcinoma and 15,158 controls. Four loci, 5p15.33 (TERT), 6p21.3 (BTNL2), 3q28 (TP63) and 17q24.2 (BPTF), previously shown to be strongly associated with overall lung adenocarcinoma risk in East Asians, were re-discovered as loci associated with a higher susceptibility to EGFR mutation-positive lung adenocarcinoma. In addition, two additional loci, HLA class II at 6p21.32 (rs2179920; P =5.1 × 10(-17), per-allele OR=1.36) and 6p21.1 (FOXP4) (rs2495239; P=3.9 × 10(-9), per-allele OR=1.19) were newly identified as loci associated with EGFR mutation-positive lung adenocarcinoma. This study indicates that multiple genetic factors underlie the risk of lung adenocarcinomas with EGFR mutations

Gabapentin therapy in patients with orofacial neuropathic pain: Report of 12 cases

AbstractObjectiveThere are several types of orofacial neuropathic pain and some of these types are often refractory to treatment. Gabapentin is an oral antiepileptic agent with a proven analgesic effect in various traumatic neuropathic pain syndromes. We retrospectively examined the analgesic effect of gabapentin on non-dental and non-traumatic orofacial neuropathic pain.Subjects and methodsThis study included 12 patients. All patients showed an excessive response to noxious (hyperalgesia) and/or innocuous (allodynia) stimuli in the affected region. Gabapentin therapy was initiated with a dosage of 200–600mg/day. Pain intensity was assessed using a modified numerical rating scale (m-NRS) (0, no pain; 10, pain equal to that experienced on the day gabapentin therapy was initiated). In addition, the side effects were also recorded.ResultsAll the patients had received medications for their pain prior to referral, but the drugs failed to provide adequate relief from their neuropathic pain. The m-NRS scores for all patients started decreasing within 7 days after internal use was initiated. The average time taken for the m-NRS score to decrease to half was 3.3 (1.7) days. Side effects were observed in 2 patients.ConclusionWe concluded that gabapentin therapy is efficacious for the treatment of orofacial neuropathic pain in selected patients