Treatment of a patient with skeletal open bite and temporomandibular joint disorders

The treatment of severe skeletal anterior open bite is extremely difficult in adults, and orthognathic surgery is generally selected for its treatment. We report the case of an 18-year-old adult patient with skeletal anterior open bite and temporomandibular disorders who was successfully treated using temporary anchorage devices. She had an open bite of -2.0 mm and an increased facial height. Miniplates were implanted in both the maxilla and mandible, and molar intrusion resulted in counterclockwise rotation of the mandible over a period of 12 months. After active treatment, her upper and lower first molars were intruded by approximately 2 mm and her overbite became +2.5 mm. Her retrognathic profile improved with counterclockwise rotation of the mandible. Orthodontic treatment aided with skeletal anchorage is beneficial for intrusion of bimaxillary molars in patients with anterior open bite

Effectiveness of PNAM on nasal form

Objectives: To evaluate the effectiveness of pre-surgical nasoalveolar molding (PNAM) in patients with unilateral cleft lip nasal deformities. Methods: This was a retrospective study involving 29 patients with unilateral cleft lip and palate defects, of whom 13 were treated with palatal devices with nasal stents (PNAM group) and 16 were treated with palatal devices without nasal stents or surgical tapes (control group). Submental oblique photographs and orthodontic models were longitudinally obtained at the initial visit (T1) and immediately before (T2) and after cheiloplasty (T3). Asymmetry of the external nose, degree of columellar shifting, nasal tip/ala nose ratio, nasal base angle, interalveolar gap, and the sagittal difference in the alveolar gap were measured. The study was conducted in the Orthodontic Clinic at Tokushima University Hospital, Tokushima, Japan between 1997 and 2012. Results: At T1, there were no significant intergroup differences in the first 4 asymmetry parameters. At T2, the PNAM group showed a significant improvement in all values compared to the control group. At T3, the PNAM group showed significant improvement in nasal asymmetry and columellar shifting. Model analysis showed significantly greater changes in the inter-alveolar gap and the sagittal difference of the alveolar cleft gap from T1 to T2 in the PNAM group. Conclusion: The use of PNAM is indispensable for pre-surgical orthodontic treatment at the early postnatal age

永久歯の先天的欠如に関する臨床統計調査

永久歯の先天性欠如（以下，先欠とする）は，最も高頻度に発現する顎顔面領域の先天異常であり，様々な不正咬合を引き起こし，交換期における咬合誘導あるいは，永久歯列期における歯の排列に際して苦慮することが多い．しかし，歯科矯正用アンカースクリューの登場により，治療方針に多様性が生まれ，先欠を有する患者に対して，欠損部位・歯数に影響されない，顎顔面骨格形態に則した治療方針が選択できる症例が増加している．このような症例の治療計画を立案する際には，先欠が顎顔面骨格形態へ与える影響を明らかにしておく必要がある．そこで，今回我々は不正咬合患者における第三大臼歯を除く永久歯の先欠の実態把握，ならびに先欠が顎顔面骨格形態に及ぼす影響の解明を目的として臨床統計学的な検討を行った． 2011年4月から2016年3月までの5年間に不正咬合を主訴として徳島大学病院矯正歯科を受診した患者のうち，口唇裂・口蓋裂やその他の先天異常を有する患者，矯正歯科治療の既往を有する患者および先欠の確認が不可能であった患者を除外した653名（男性233名，女性420名）を対象とし，調査を行った．その結果，以下の所見を得た． 1．先欠を有する患者は96名（14.7％）であり，男女比は1.13：1と男性がやや多かった．1人あたりの先欠歯数としては，1歯のみの欠損が最も多く，49.0％を占めた． 2．歯種別発現頻度は，上下顎ともに第二小臼歯，側切歯の順で高かった． 3．先欠を有する患者を上顎先欠群，下顎先欠群，上下顎先欠群に分類し，比較検討を行ったところ，前歯部被蓋関係については，下顎先欠群においてoverjetが最も大きかった．顎骨の前後的位置関係については，下顎先欠群において∠ANBが大きく，∠SNBが小さくなる傾向を認め，上顎先欠群，上下顎先欠群では∠SNAが小さくなる傾向を認めた． 以上の所見より，先欠が顎顔面骨格の成長・発育に影響を及ぼす可能性が示されたことから，先欠に関連した顎顔面骨格形態の特徴を考慮した治療計画の立案が重要であることが示唆された

PTH and LIPUS on Osteoporotic Fracture Healing

Osteoporotic fracture has become a major public health problem, and until today, the treatments available are not satisfactory. While there is growing evidence to support the individual treatment of parathyroid hormone (PTH) administration and low-intensity pulsed ultrasound (LIPUS) exposure as respectively systemic and local therapies during osteoporotic fracture healing, their effects have not yet been investigated when introduced concurrently. This study aimed to evaluate the effects of combined treatment with PTH (1–34) and LIPUS on fracture healing in ovariectomized (OVX) rats. Thirty-two, 12-week-old female Sprague–Dawley rats were OVX to induce osteoporosis. After 12 weeks, the rats underwent surgery to create bilateral mid-diaphyseal fractures of proximal tibiae. All animals were randomly divided into 4 groups (n = 8 for each): control group as placebo, PTH group, LIPUS group, and combined group. PTH group had PTH administration at a dose of 30 lg/kg/day for 3 days/week for 6 weeks. LIPUS group received ultrasound 5 days/week for 20 min/day for 6 weeks and combined group had both PTH administration and LIPUS exposure for 6 weeks. Fracture healing was observed weekly by anteroposterior radiography and micro-CT. Five weeks after the fracture, the tibia were harvested to permit histological assessments and at week 6, for mechanical property of the fracture callus. Micro-CT showed that the PTH and combined groups exhibited significantly higher BMD and trabecular bone integrity than control group at weeks 4–6. Radiography, fracture healing score and mean callus area indicated that the combined group revealed better healing processes than the individual groups. Mechanically, bending moment to failure was significantly higher in LIPUS, PTH and combined groups than in control group. These data suggest that the combined treatment of PTH and LIPUS have been shown to accelerate fracture bone healing and enhance bone properties rather than single agent therapy, and may be considered as a treatment remedy for fracture healing in postmenopausal osteoporosis

Blunted diurnal interleukin-6 rhythm is associated with amygdala emotional hyporeactivity and depression: a modulating role of gene-stressor interactions

BackgroundThe immune system has major roles in the brain and related psychopathology. Disrupted interleukin-6 secretion and aberrant amygdala emotional reactivity are well-documented in stress-related mental disorders. The amygdala regulates psychosocial stress-related interleukin-6 affected by related genes. These led us to comprehensively examine the relationship between interleukin-6, amygdala activity, and stress-related mental symptoms under gene-stressor interactions.MethodsOne hundred eight nonclinical participants with various levels of anxiety/depression underwent magnetic resonance imaging scans during an emotional face task for amygdala activity and saliva collection (at 10-time points across 2 days) for the total output and diurnal patterns of interleukin-6. Gene-stressor interactions between rs1800796 (C/G) and rs2228145 (C/A) and stressful life events for the biobehavioral measures were explored.ResultsThe blunting of interleukin-6 diurnal pattern was associated with hypoactivation of the basolateral amygdala in response to fearful (vs. neutral) faces (t = 3.67, FWE-corrected p = 0.003), and was predominantly observed in individuals with rs1800796 C-allele homozygotes and negative life changes in the past year (F = 19.71, p < 0.001). When considered in a comprehensive model, the diminished diurnal pattern predicted greater depressive symptoms (β = −0.40), modulated by the amygdala hypoactivity (β = 0.36) and rs1800796-stressor interactions (β = −0.41; all p < 0.001).ConclusionHere we show that the blunted interleukin-6 diurnal rhythm predicts depressive symptoms, modulated by amygdala emotional hyporeactivity and gene-stressor interactions. These findings indicate a potential mechanism underlying vulnerability to depressive disorders, suggesting their early detection, prevention, and treatment through the understanding of immune system dysregulation

A Small Bowel Ulcer due to Clopidogrel with Cytomegalovirus Enteritis Diagnosed by Capsule and Double-Balloon Endoscopy

We report the first case of small bowel ulcers due to clopidogrel in a 74-year-old man. He presented with diarrhea and melena after having been taking low-dose aspirin (LDA) and clopidogrel. There was no evidence of bleeding in the stomach, duodenum, or colon. Capsule endoscopy showed multiple ulcers and erosions in the small intestine. Double-balloon endoscopy revealed multiple ulcers throughout the ileum. Examination of the biopsy specimen showed cytomegalovirus infection. His LDA was discontinued and he was prescribed ganciclovir. However, the small bowel ulcers were aggravated. Therefore, clopidogrel was discontinued. The small bowel ulcers subsequently healed completely, forming scars

Thread-Traction with a Sheath of Polypectomy Snare Facilitates Endoscopic Submucosal Dissection of Early Gastric Cancers

Although the thread-traction (TT) method has been found useful during endoscopic submucosal dissection (ESD) for early gastric cancers, the movement of the thread interferes with the movement of the endoscope, and the lesion can only be pulled to the mouth side. We have developed the novel TT method using a sheath of polypectomy snare (TTSPS). The TTSPS method enables free and independent movement of the thread and the endoscope and allows pulling the lesion towards the anal as well as oral side. The median dissection times, numbers of instances of arterial bleeding, and numbers of local injections into the submucosal layer were significantly lower for ESD with TTSPS than for conventional ESD. Countertraction ESD using the TTSPS method is straightforward, safe, easy, noninvasive, and cost effective, and it uses instruments readily available in most hospitals to enhance visualization of cutting lines. Therefore, the TTSPS method can be universally applied in conventional ESD

MAGNETOHYDRODYNAMIC DUCT FLOW.

Abstract not availabl

Silicate Removal in Aluminum Hydroxide Co-Precipitation Process

The removal mechanisms of silicate using an aluminum hydroxide co-precipitation process was investigated and compared with an adsorption process, in order to establish an effective and validated method for silicate removal from wastewater. Adsorption isotherms, XRD and FT-IR analyses showed that silicate uptake occurred by adsorption to boehmite for initial Si/Al molar ratios smaller than two, but by precipitation of poorly crystalline kaolinite for the ratios larger than two, in both co-precipitation and adsorption processes. Silicate was removed by two steps: (i) an initial rapid uptake in a few seconds; and (ii) a slow uptake over several hours in both processes. The uptake rate in the first step was higher in the co-precipitation process than in adsorption process, presumably due to increased silicate adsorption to boehmite and rapid precipitation of kaolinite. These results suggest that silicate removal using aluminum salts could be effectively achieved if the pH adjustment and aluminum concentration are strictly controlled