Synovial chondromatosis of the temporomandibular joint : condyle osteotomy of the mandible and patient-specific fixation implant

Peer reviewe

Postoperative nausea and vomiting in facial fracture patients : a randomized and controlled trial on the effect of dexamethasone

Non peer reviewe

Postoperative temporomandibular dysfunction in patients with fractures of the zygomatic complex : a prospective follow-up study

The aim of this prospective follow-up study was to clarify the incidence and characteristics of dysfunction of the temporomandibular joint (TMJ) in patients treated surgically for fractures of the zygomatic complex. Patients were evaluated on presentation and six months after injury to assess the function of the masticatory system using the Helkimo index, which incorporates two complementary subindices: the subjective symptomatic (anamnestic) index (A(i)) and the objective clinical dysfunction index (D-i). Forty-five patients (12 women and 33 men, mean (range) age 44 (21-83) years) completed the study. Six patients developed subjective symptoms of dysfunction of the TMJ during follow-up, in four of whom they were severe. Clinical findings were noted in 38 patients but without significant association with subjective symptoms. Dysfunction of the TMJ is common six months after surgical treatment of a fracture of the zygomatic complex, and patients with such fractures should be evaluated for temporomandibular dysfunction during follow-up and referred for treatment when necessary. (C) 2018 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.Peer reviewe

Sentinel lymph node biopsies in early stage oral and oropharyngeal carcinoma : a retrospective single-centre experience

The aim of this retrospective study was to analyse a consecutive series of patients with oral and oropharyngeal carcinoma who had had sentinel lymph node biopsy (SLNB) at our hospital during 2008-2017. A total of 70 patients with clinically and radiologically confirmed primary oral (n = 67) or oropharyngeal (n = 3) carcinoma, with no signs of metastatic lymph nodes preoperatively (clinically N0) were included. Patients' clinical and personal data, characteristics of the tumours, sentinel lymph node (SLN) status and outcomes were recorded. Eight patients had invaded SLN. Two patients with clear sentinel lymph node biopsies had recurrences in the cervical lymph nodes with no new primary tumour as origin. The negative predictive value (NPV) and sensitivity for SLNB were 97% and 80%, respectively. The depth of invasion was an individual predictor for cervical lymph node metastasis (p = 0.043). Single photo emission computed tomography (SPECT) detected fewer SLN in patients with invaded lymph nodes than in patients with clear lymph nodes (p = 0.018). Our data support the use of SLNB as a minimally invasive method for staging the cervical lymph nodes among patients with cN0 oral and oropharyngeal carcinoma. Our results further confirm that greater depth of invasion is associated with cervical lymph node metastases. (c) 2020 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.Peer reviewe

Occipital condyle fracture-A rare but severe injury in cranial fracture patients

We clarified occurrence, severity, and associated injuries of occipital condyle fractures (OCFs) in a cranial fracture population. Retrospective data of cranial fracture patients were analyzed. The outcome variable was presence of OCF in cranial fracture patients. Predictor variables were type of associated injury, Glasgow Coma Scale (GCS) value under 6, and death during hospital care. In addition, occurrence of OCF was assessed according to cranial fracture subtypes. Explanatory variables were age, sex, injury mechanism, involvement of alcohol, and high-energy injury. Treatment and outcome of OCFs were analyzed. Of 637 cranial fracture patients, 19 (3.0%) sustained an OCF, eight of whom had no other cranial fractures. In the multivariate adjusted model, increased risk for OCF was detected in patients with cervical injuries (OR 18.66, 95% CI 5.52, 63.12; p < 0.001) and facial fractures (OR 5.99, 95% CI 1.01, 35.45; p = 0.049). Patients with fractures not extending to the skull base were less likely to have OCF (OR 0.01, 95% CI 0.001, 0.25; p = 0.004), and fractures localized solely to the base of the skull offered a protective effect for OCF (OR 0.19, 95% CI 0.06, 0.58; p = 0.003). All OCFs were treated non-operatively with a cervical collar without complications. OCF patients typically sustain other severe injuries, particularly cervical injuries and facial fractures. Careful screening for associated injuries is therefore crucial when examining a patient with OCF. The classification scheme of Mueller et al. seems to be useful in guiding the treatment of OCFs, at least type 1 and 2 fractures. (C) 2021 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.Peer reviewe

Expression of CD226 is associated to but not required for NK cell education

AbstractDNAX accessory molecule-1 (DNAM-1, also known as CD226) is an activating receptor expressed on subsets of natural killer (NK) and T cells, interacts with its ligands CD155 or CD112, and has co-varied expression with inhibitory receptors. Since inhibitory receptors control NK-cell activation and are necessary for MHC-I-dependent education, we investigated whether DNAM-1 expression is also involved in NK-cell education. Here we show an MHC-I-dependent correlation between DNAM-1 expression and NK-cell education, and an association between DNAM-1 and NKG2A that occurs even in MHC class I deficient mice. DNAM-1 is expressed early during NK-cell development, precedes the expression of MHC-I-specific inhibitory receptors, and is modulated in an education-dependent fashion. Cd226−/− mice have missing self-responses and NK cells with a normal receptor repertoire. We propose a model in which NK-cell education prevents or delays downregulation of DNAM-1. This molecule endows educated NK cells with enhanced effector functions but is dispensable for education.</jats:p

Assault-related facial fractures : does the injury mechanism matter?

This study clarified the injury characteristics and occurrence of associated injuries in patients with assault-related facial fractures. Data from 840 assault-related facial fracture patients were included; demographic factors, facial fracture type, associated injuries, alcohol use, and injury mechanisms were recorded. Assault mechanisms most often included combinations of different mechanisms (57.5%) and resulted in the victim falling (50.1%). The perpetrator was most commonly a stranger (52.5%) and acted alone (57.7%). A total of 123 patients (14.6%) had associated injuries, with the most common being traumatic brain injury. Associated injuries occurred most frequently in patients with combined fractures of the facial thirds (24.2%) and upper third fractures (42.9%). The most significant differentiating factors for associated injuries were the number of perpetrators, falling, the use of an offensive weapon, and if the events of the assault remained unknown. In adjusted logistic regression analyses, statistically significant associations with associated injuries were found for age (odds ratio (OR) 1.05, 95% confidence interval (CI) 1.03-1.07; P < 0.001), falling due to the assault (OR 2.87, 95% CI 1.49-5.50; P = 0.002), and upper third facial fractures (OR 6.93, 95% CI 2.06-23.33; P = 0.002). A single punch also caused severe injuries and should therefore not be overlooked, as this can be as dangerous as other assault mechanisms.Peer reviewe

Downscaling of Long-Term Global Scenarios to Regions with a Forest Sector Model

Research Highlights: Long-term global scenarios give insights on how social and economic developments and international agreements may impact land use, trade, product markets, and carbon balances. They form a valuable basis for forming national forest policies. Many aspects related to long-term management of forests and consequences for biodiversity and ecosystem services can only be addressed at regional and landscape levels. In order to be attended to in the policy process, there is a need for a method that downscales national scenarios to these finer levels. Background and Objectives: Regional framework conditions depend on management activities in the country as a whole. The aim of this study is to evaluate the use of a forest sector model (FSM) as a method for downscaling national scenarios results to regional level. The national FSM takes the global scenario data (e.g., harvest level and market prices over time) and solves the national problem. The result for the region of interest is taken as framework conditions for the regional study. Materials and Methods: Two different specifications are tested. One lets product volumes and prices represent endogenous variables in the FSM model. The other takes volumes and prices from the global scenario as exogenous parameters. The first specification attains a maximum net social payoff whereas the second specification means that net present value is maximized under a harvest constraint. Results: The maximum net social payoff specification conforms better to economic factors than the maximum net present value specification but could give national harvest volume trajectories that deviates from what is derived from the global model. This means that regional harvest activity can deviate considerably from the national average, attesting to the benefit of the use of the FSM-based metho

Primary reconstruction of orbital fractures using patient-specific titanium milled implants : the Helsinki protocol

Preoperative virtual planning and the use of patient-specific implants enable exact reconstruction of orbital fractures. We present our results and experience of reconstruction of isolated orbital fractures with patient-specific implants, according to the Helsinki protocol, in 15 patients who were followed up for at least three months postoperatively. The mean (range) difference between the positions of virtually planned, and postoperative, implants was 1.9 (0.5-5.6) mm The postoperative volume of the fractured orbit was 1.34 ml less than that of the non-fractured side, but this was not clinically relevant. None of the patients required reoperation and none had any implant-related complications during follow up. We conclude that patient-specific implants are an adaptable and reliable treatment for primary orbital trauma, and that the Helsinki protocol may have wider applications in the treatment of facial fractures. (C) 2018 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.Peer reviewe

Downscaling of Long-Term Global Scenarios to Regions with a Forest Sector Model

Research Highlights: Long-term global scenarios give insights on how social and economic developments and international agreements may impact land use, trade, product markets, and carbon balances. They form a valuable basis for forming national forest policies. Many aspects related to long-term management of forests and consequences for biodiversity and ecosystem services can only be addressed at regional and landscape levels. In order to be attended to in the policy process, there is a need for a method that downscales national scenarios to these finer levels. Background and Objectives: Regional framework conditions depend on management activities in the country as a whole. The aim of this study is to evaluate the use of a forest sector model (FSM) as a method for downscaling national scenarios results to regional level. The national FSM takes the global scenario data (e.g., harvest level and market prices over time) and solves the national problem. The result for the region of interest is taken as framework conditions for the regional study. Materials and Methods: Two different specifications are tested. One lets product volumes and prices represent endogenous variables in the FSM model. The other takes volumes and prices from the global scenario as exogenous parameters. The first specification attains a maximum net social payoff whereas the second specification means that net present value is maximized under a harvest constraint. Results: The maximum net social payoff specification conforms better to economic factors than the maximum net present value specification but could give national harvest volume trajectories that deviates from what is derived from the global model. This means that regional harvest activity can deviate considerably from the national average, attesting to the benefit of the use of the FSM-based metho