Assessment of epigenetic alterations in early colorectal lesions containing BRAF mutations

金沢大学医薬保健学総合研究科先進的地域医療研究講座 = Department of Advanced Research in Community MedicineTo clarify the molecular and clinicopathological characteristics of colorectal serrated lesions, we assessed the DNA methylation of cancer-associated genes in a cohort of BRAF-mutant precancerous lesions from 94 individuals. We then compared those results with the lesions’ clinicopathological features, especially colorectal subsites. The lesions included hyperplastic polyps (n = 16), traditional serrated adenomas (TSAs) (n = 15), TSAs with sessile serrated adenomas (SSAs) (n = 6), SSAs (n = 49) and SSAs with dysplasia (n = 16). The prevalence of lesions exhibiting the CpG island methylator phenotype (CIMP) was lower in the sigmoid colon and rectum than in other bowel subsites, including the cecum, ascending, transverse and descending colon. In addition, several cancer-associated genes showed higher methylation levels within lesions in the proximal to sigmoid colon than in the sigmoid colon and rectum. These results indicate that the methylation status of lesions with BRAF mutation is strongly associated with their location, histological findings and neoplastic pathways. By contrast, no difference in aberrant DNA methylation was observed in normal-appearing background colonic mucosa along the bowel subsites, which may indicate the absence of an epigenetic field defect

Tooth-borne distraction of the lower anterior subapical segment for correction of class II malocclusion, subsequent to genioplasty.

Introduction: Alveolar distraction is mainly used to increase height and width of the alveolar crest. This technique, however, is not typically used for lengthening the perimeter of the dental arch or　improving teeth axes. We applied alveolar distraction in a tooth-borne manner in the second stage of our original method and obtained favorable results. We therefore present an outline of this method. Case Report: Genioplasty was first performed to create an infrastructure for sequential advancement of the subapical alveolar segment. After bone union, anterior subapical alveolar osteotomy was performed. The stump of the osteotomized dentate segment was moved forward without changing the incisal edge position, and a box-type bioabsorbable plate with four holes was fixed only onto the dentate segment using two screws. After a latency period, two distraction devices were placed bilaterally to the brackets and activated at 1.0 mm/day. After reaching the desired position, the distractor was immobilized, and then replaced by resin temporary teeth to retain the created space. After the consolidation period, orthodontic treatment was restarted and teeth moved into the newly created space. Bimaxillary surgery was performed after completing pre-surgical orthodontic treatment. Finally, both desirable occlusion and functional masticatory function were obtained. Conclusion: This tooth-borne distraction system is one applicable method for patients with skeletal class II and crowding of lower anterior teeth, achieving good results particularly in combination with our original method

Chin Augmentation With Thin Cortical Bone Concomitant With Advancement Genioplasty

Genioplasty is a commonly performed procedure and various modifications of the technique have been described. One postoperative complication after advancement genioplasty is resorption of the genial segment, occasionally leading to so-called witch's chin appearance when combined with a deep labiomental fold. To prevent this condition, bone grafting onto the advanced genial segment is commonly performed. This method, however, should necessitate grafting of a certain volume of block bone or autologous bone marrow. The donor site should be set up, occasionally even far from the recipient site such as iliac bone. We present two cases in which a novel augmentation technique was taken. Thin cortical bone was harvested from the upper frontal sharp edge of the genial segment, where the sharp edge was sometimes reduced with a bur to avoid irritating surrounding tissues. This harvested bone was placed onto the advanced genial segment obliquely in the sagittal plane, just like covering the gap. Vacant space was made under the thin cortical bone. Neither particulate bone nor any substances were packed into the vacant space, instead keeping the space open. At least 8 months after augmentation, the space was filled with newly formed bone. This phenomenon indicated that voluminous bone is not always required, but preparing adequate environmental circumstances for bone formation is crucial and integral. This method may bring about a new concept of the bone grafting and augmentation

Factors related to patients' nutritional state after orthognathic surgery

Purpose The purpose of this study was to evaluate patients' nutritional state after orthognathic surgery. Methods The subjects were 40 female patients with dentofacial deformity aged 17-33 years who were undergoing bilateral sagittal splitting ramus osteotomy. Twenty patients were treated with intermaxillary fixation, and 20 patients were treated without intermaxillary fixation. Age and body mass index (kg/m(2)) were assessed as physical factors, operation time, blood loss, and amount of mandibular movement with or without intermaxillary fixation were assessed as operation stress factors, and the following laboratory data, total protein, serum albumin, total cholesterol, total lymphocytes, and cholinesterase were assessed as nutritional state factors at 1 and 2 weeks after surgery. Statistical analysis was performed for body weight loss and relationship between body weight loss and examination factors. Results Body weight significantly decreased 2.3% at 1 week and 3.9% at 2 weeks after surgery rather than preoperation. All laboratory data except total lymphocyte were decreased at 1 week after surgery and still remained significantly decreased at 2 weeks after surgery. There was a statistically significant relationship between body weight loss at 1 week after surgery and operation time. Conclusions These results indicate that long operation time caused body weight loss in orthognathic surgery

Evaluation of a Three-Stage Method for Improving Mandibular Retrognathia with Labially Inclined Incisors Using Genioplasty, Segmental Osteotomy, and Two-Jaw Surgery

We have sometimes encountered difficulty in improving labially inclined teeth, particularly in patients with mandibular retrognathia, because the symphysis menti is often thin and insufficient space is available to permit sagittal rotation of the teeth without root exposure from the alveolar bone. We have previously described a three-stage method to overcome this problem, involving genioplasty for improving the retruded chin, and to construct the infrastructure for subsequent subapical segmental alveolar osteotomy, subapical segmental alveolar osteotomy itself, and, finally, two-jaw surgery. Bone augmentation with thin cortical bone at the gap created on the upper surface of the advanced genial segment was also addressed in the previous report. In the present study, to confirm the benefits of the three-stage method using objective data, cephalometric evaluation was performed in each step. In all cases, pogonion (Pog) was moved forward substantially. Net linear forward movement of Pog and net changes in SN-Pog were from 12 mm to 20 mm and from 4.8° to 7.0°, respectively. Angle of mandibular incisors and interincisal angle also improved to desirable levels. Although this method requires three separate surgeries, the approach safely improves the clinical situation and accentuates treatment efficacy