Rigid Fixation of Intraoral Vertico-Sagittal Ramus Osteotomy for Mandibular Prognathism

The standard surgical treatment for prognathism is sagittal split ramus osteotomy (SSRO) if the proximal and distal segments of the ramus require fixing with screws or metal plates. In this procedure, however, it is frequently difficult to avoid neurosensory disturbance (NSD) of the inferior alveolar nerve (IAN) when the posterior margin of the ramus curves inward or when the ramus is thin (Fig 1A, B). This report describes a new alternative procedure, intraoral vertico-sagittal ramus osteotomy (IVSRO), 1 a modification of SSRO and intraoral vertical ramus osteotomy (IVRO). One of the main advantages of IVSRO is that it avoids IAN damage, because the ramus can be split parallel to the original sagittal plane posterior to the point between the mandibular canal and the lateral cortical bone plate immediately in front of the antilingular prominence. Another advantage of IVSRO is that the area in which screws can be inserted is relatively large, if the subcoronoid area on the distal segment and subcondylar area on the proximal segment are used. The 2 segments can be fixed in these areas with bicortical bone screws, with or without a cheek incision (Fig 1C). This report introduces rigid fixation of IVSRO for mandibular prognathism

Diagnosis of Temporomandibular Joint Arthrosis 2. Arthroscopic Differentiation

Arthroscopy was performed on 43 joints of 34 patients with painful locking of the temporomandibular joint. The subjects were 32 joints with closed-lock (non-reducible anterior disk displacement) and 11 joints with osteoarthrosis, consisted of 8 males and 26 females, from 15 to 69 years old with an average of 38.5 years. In closed-lock joints, synovitis on the posterior pouch, fibrillation of the eminence, fibrous adhesion from the anterior pouch to medial capsule were observed. On the other hand, joints of osteoarthrosis disclosed extensive synovitis, fibrillation and adhesion. Discal perforation was indicated in only one joint with closed-lock and 5 joints with osteoarthrosis arthroscopically. These arthroscopic findings could clarify the intra-capsular pathosis of two TMJ disorders, also differentiate them each other

Diagnosis of Temporomandibular Joint Arthrosis 1. Arthrographic Differentiation

Arthrotomography of the temporomandibular joint was performed on 207 joints of 148 patients by puncturing inferior and superior joint compartments and injecting water-soluble contrast medium under fluoroscopy. Symptoms of these subjects were arthralgia, noise and hypomobility of the temporomandibular joint. In the results, 16 joints (7.7%) were normal, 31 joints (15.0%) with reducible anterior disk displacement (click), 143 joints (69.1%) with non-reducible anterior disk displacement (closed-lock), and 17 joints (8.2%) with stenosis or adhesion of the joint compartment. Among the all joints, 13 joints (6.3%) associated with discal perforation. These findings indicated several intra-capsular organic changes, moreover has a significance in differential diagnosis and treatment for the patients with temporomandibular joint arthrosis

Pluripotency of mesenchymal cells derived from synovial fluid in patients with temporomandibular joint disorder.

Mesenchymal stem cells are an interesting source of material for regenerative medicine. The present study aimed at characterizing the phenotype and differentiation potential of adherent synovial fluid-derived cells from temporomandibular joint (TMJ) disorder patients

Promotion of allergic immune responses by intranasally-administrated nanosilica particles in mice

With the increase in use of nanomaterials, there is growing concern regarding their potential health risks. However, few studies have assessed the role of the different physical characteristics of nanomaterials in allergic responses. Here, we examined whether intranasally administered silica particles of various sizes have the capacity to promote allergic immune responses in mice. We used nanosilica particles with diameters of 30 or 70 nm (nSP30 or nSP70, respectively), and conventional micro-sized silica particles with diameters of 300 or 1000 nm (nSP300 or mSP1000, respectively). Mice were intranasally exposed to ovalbumin (OVA) plus each silica particle, and the levels of OVA-specific antibodies (Abs) in the plasma were determined. Intranasal exposure to OVA plus smaller nanosilica particles tended to induce a higher level of OVA-specific immunoglobulin (Ig) E, IgG and IgG1 Abs than did exposure to OVA plus larger silica particles. Splenocytes from mice exposed to OVA plus nSP30 secreted higher levels of Th2-type cytokines than mice exposed to OVA alone. Taken together, these results indicate that nanosilica particles can induce allergen-specific Th2-type allergic immune responses in vivo. This study provides the foundations for the establishment of safe and effective forms of nanosilica particles

Increased Risk of Temporomandibular Joint Closed Lock: A Case-Control Study of ANKH Polymorphisms

Objectives: This study aimed to carry out a histological examination of the temporomandibular joint (TMJ) in ank mutant mice and to identify polymorphisms of the human ANKH gene in order to establish the relationship between the type of temporomandibular disorders (TMD) and ANKH polymorphisms.\ud \ud Materials and Methods: Specimens from the TMJ of ank mutant and wild-type mice were inspected with a haematoxylin and eosin staining method. A sample of 55 TMD patients were selected. Each was examined with standard clinical procedures and genotyping techniques.\ud \ud Results: The major histological finding in ank mutant mice was joint space narrowing. Within TMD patients, closed lock was more prevalent among ANKH-OR homozygotes (p = 0.011, OR = 7.7, 95% CI 1.6–36.5) and the elder (p = 0.005, OR = 2.4, 95% CI 1.3–4.3).\ud \ud Conclusions: Fibrous ankylosis was identified in the TMJ of ank mutant mice. In the human sample, ANKH-OR polymorphism was found to be a genetic marker associated with TMJ closed lock. Future investigations correlating genetic polymorphism to TMD are indicated

The Japanese Clinical Practice Guidelines for Management of Sepsis and Septic Shock 2016 (J-SSCG 2016)

Background and purposeThe Japanese Clinical Practice Guidelines for Management of Sepsis and Septic Shock 2016 (J-SSCG 2016), a Japanese-specific set of clinical practice guidelines for sepsis and septic shock created jointly by the Japanese Society of Intensive Care Medicine and the Japanese Association for Acute Medicine, was first released in February 2017 and published in the Journal of JSICM, [2017; Volume 24 (supplement 2)] https://doi.org/10.3918/jsicm.24S0001 and Journal of Japanese Association for Acute Medicine [2017; Volume 28, (supplement 1)] http://onlinelibrary.wiley.com/doi/10.1002/jja2.2017.28.issue-S1/issuetoc.This abridged English edition of the J-SSCG 2016 was produced with permission from the Japanese Association of Acute Medicine and the Japanese Society for Intensive Care Medicine.MethodsMembers of the Japanese Society of Intensive Care Medicine and the Japanese Association for Acute Medicine were selected and organized into 19 committee members and 52 working group members. The guidelines were prepared in accordance with the Medical Information Network Distribution Service (Minds) creation procedures. The Academic Guidelines Promotion Team was organized to oversee and provide academic support to the respective activities allocated to each Guideline Creation Team. To improve quality assurance and workflow transparency, a mutual peer review system was established, and discussions within each team were open to the public. Public comments were collected once after the initial formulation of a clinical question (CQ) and twice during the review of the final draft. Recommendations were determined to have been adopted after obtaining support from a two-thirds (> 66.6%) majority vote of each of the 19 committee members.ResultsA total of 87 CQs were selected among 19 clinical areas, including pediatric topics and several other important areas not covered in the first edition of the Japanese guidelines (J-SSCG 2012). The approval rate obtained through committee voting, in addition to ratings of the strengths of the recommendation, and its supporting evidence were also added to each recommendation statement. We conducted meta-analyses for 29 CQs. Thirty-seven CQs contained recommendations in the form of an expert consensus due to insufficient evidence. No recommendations were provided for five CQs.ConclusionsBased on the evidence gathered, we were able to formulate Japanese-specific clinical practice guidelines that are tailored to the Japanese context in a highly transparent manner. These guidelines can easily be used not only by specialists, but also by non-specialists, general clinicians, nurses, pharmacists, clinical engineers, and other healthcare professionals

The role of intensity and speed features of action unit in recognizing facial expressions

Facial expressions are produced by specific muscle movements. Although past studies have investigated the association between the facial action unit (AU) and emotion, how the intensity and speed of movement contribute to each emotion is unknown. Here, to reveal the role of intensity and speed cues for facial emotion recognition, we examined the machine learning model with AUs extracted using the computer vision method. Participants (n = 39) classified the stimuli of dynamic facial expressions into six emotions. Using the two-dimensional AU features of the stimuli, the machine learning models classified emotion with high accuracy. From the classification model’s contribution weighting, we found the emotion-related specificity of the intensity and speed cues. The strong contribution of intensity was for happiness, whereas speed was for anger and surprise. Sadness, fear, and disgust were not clearly differentiated by intensity and speed. Our findings suggest that people judge facial emotions by balancing appropriate intensity and speed cues

Isolation and characterization of novel mutations in CDC50, the non-catalytic subunit of the Drs2p phospholipid flippase

Flippases (type 4 P-type ATPases) are believed to translocate phospholipids from the exoplasmic to the cytoplasmic leaflet in bilayer membranes. Since flippases are structurally similar to ion-transporting P-type ATPases such as the Ca2+ ATPase, one important question is how flippases have evolved to transport phospholipids instead of ions. We previously showed that a conserved membrane protein, Cdc50p, is required for the ER exit of the Drs2p flippase in yeast. However, Cdc50p is still associated with Drs2p after its transport to the endosomal/TGN membranes, and its function in the complex with Drs2p is unknown. In this study, we isolated novel temperature-sensitive (ts) cdc50 mutants whose products were still localized to endosomal/TGN compartments at the non-permissive temperature. Mutant Cdc50 proteins colocalized with Drs2p in endosomal/TGN compartments, and they co-immunoprecipitated with Drs2p. These cdc50-ts mutants exhibited defects in vesicle transport from early endosomes to the TGN as the cdc50 deletion mutant did. These results suggest that mutant Cdc50 proteins could be complexed with Drs2p, but the resulting Cdc50p-Drs2p complex is functionally defective at the non-permissive temperature. Cdc50p may play an important role for phospholipid translocation by Drs2p