Postoperative Complications following Open Reduction and Rigid Internal Fixation of Mandibular Condylar Fracture Using the High Perimandibular Approach

The high perimandibular approach is a feasible surgical technique for treating mandibular condylar fractures with open reduction and internal fixation, followed by fewer complications. Temporary trismus is the only postoperative complication that may occur. This study evaluated postoperative complications following open reduction and rigid internal fixation (OR-IF) of mandibular condylar fractures using the high perimandibular approach. Twenty consecutive patients undergoing OR-IF were included in this study. They included 11 male and 9 female patients, of an average age of 58.5 years, all of whom responded to a follow-up call at least 12 months after the surgery. All patients were evaluated for range of mouth opening, postoperative complications, and radiological findings. A statistical analysis of the relationship between range of mouth opening and related clinical parameters at 6 months postoperative evaluation was conducted. The fracture of the condylar neck was associated with a limited range of mouth opening and longer operation time. However, longer operation time was not associated with a limited range of mouth opening. The high perimandibular approach with OR-IF in mandibular condylar fractures is a feasible and safe technique; however, prolonged surgery and mandibular condylar neck fractures could affect the postoperative range of mouth opening

Peritonitis due to Mycobacterium abscessus in peritoneal dialysis patients: case presentation and mini-review

Abstract Background Peritoneal dialysis (PD)-associated peritonitis caused by nontuberculous mycobacteria (NTM), including Mycobacterium abscessus (M. abscessus), is a rare but serious complication that forces PD to be withdrawn. Several cases of peritonitis by NTM have been reported, and optimal treatment has not yet been established. Case presentations We report two cases of PD-associated peritonitis caused by M. abscessus. In both cases, peritonitis developed after an exit-site infection. The patients did not have any typical signs of peritonitis or an elevated nucleated cell count of the dialysis effluent in the early phase. In addition, effluent cultures were negative at admission in both cases, although M. abscessus was identified in effluent cultures in the late phase. One patient recovered after the PD catheter was removed, and multi-antibiotic treatment was administered for 6 months. The other patient subsequently developed encapsulating peritoneal sclerosis (EPS) 16 months after the onset of infection. In addition, the EPS was complicated by intestinal perforation into infected ascites. The infection resolved with antibiotic treatment and octreotide administration to diminish bowel leakage into the infected cavity. Conclusions The combination of amikacin, clarithromycin, and imipenem/cilastatin with PD catheter removal may be effective for the treatment of M. abscessus PD-associated peritonitis. The prognosis of M. abscessus-induced peritonitis is generally poor, and it is of note that residual encapsulated ascites in the peritoneal cavity after treatment may increase the risk of infection recurrence or EPS development

Feasibility of Application of the Newly Developed Nano-Biomaterial, β-TCP/PDLLA, in Maxillofacial Reconstructive Surgery: A Pilot Rat Study

This study was performed to examine the applicability of the newly developed nano-biocomposite, β-tricalcium phosphate (β-TCP)/u-HA/poly-d/l-lactide (PDLLA), to bone defects in the oral and maxillofacial area. This novel nano-biocomposite showed several advantages, including biocompatibility, biodegradability, and osteoconductivity. In addition, its optimal plasticity also allowed its utilization in irregular critical bone defect reconstructive surgery. Here, three different nano-biomaterials, i.e., β-TCP/PDLLA, β-TCP, and PDLLA, were implanted into critical bone defects in the right lateral mandible of 10-week-old Sprague–Dawley (SD) rats as bone graft substitutes. Micro-computed tomography (Micro-CT) and immunohistochemical staining for the osteogenesis biomarkers, Runx2, osteocalcin, and the leptin receptor, were performed to investigate and compare bone regeneration between the groups. Although the micro-CT results showed the highest bone mineral density (BMD) and bone volume to total volume (BV/TV) with β-TCP, immunohistochemical analysis indicated better osteogenesis-promoting ability of β-TCP/PDLLA, especially at an early stage of the bone healing process. These results confirmed that the novel nano-biocomposite, β-TCP/PDLLA, which has excellent biocompatibility, bioresorbability and bioactive/osteoconductivity, has the potential to become a next-generation biomaterial for use as a bone graft substitute in maxillofacial reconstructive surgery

Feasibility of Application of the Newly Developed Nano-Biomaterial, β-TCP/PDLLA, in Maxillofacial Reconstructive Surgery: A Pilot Rat Study

This study was performed to examine the applicability of the newly developed nano-biocomposite, β-tricalcium phosphate (β-TCP)/u-HA/poly-d/l-lactide (PDLLA), to bone defects in the oral and maxillofacial area. This novel nano-biocomposite showed several advantages, including biocompatibility, biodegradability, and osteoconductivity. In addition, its optimal plasticity also allowed its utilization in irregular critical bone defect reconstructive surgery. Here, three different nano-biomaterials, i.e., β-TCP/PDLLA, β-TCP, and PDLLA, were implanted into critical bone defects in the right lateral mandible of 10-week-old Sprague–Dawley (SD) rats as bone graft substitutes. Micro-computed tomography (Micro-CT) and immunohistochemical staining for the osteogenesis biomarkers, Runx2, osteocalcin, and the leptin receptor, were performed to investigate and compare bone regeneration between the groups. Although the micro-CT results showed the highest bone mineral density (BMD) and bone volume to total volume (BV/TV) with β-TCP, immunohistochemical analysis indicated better osteogenesis-promoting ability of β-TCP/PDLLA, especially at an early stage of the bone healing process. These results confirmed that the novel nano-biocomposite, β-TCP/PDLLA, which has excellent biocompatibility, bioresorbability and bioactive/osteoconductivity, has the potential to become a next-generation biomaterial for use as a bone graft substitute in maxillofacial reconstructive surgery

Clinical efficacy of the combined treatment of anti-PD-L1 rat-bovine chimeric antibody with a COX-2 inhibitor in calves infected with Mycoplasma bovis

Mycoplasma bovis (M. bovis) is a highly contagious pathogen and M. bovis-associated diseases, particularly pneumonia, occur predominantly as herd enzootics, causing considerable economic losses because of calf mortality, weight loss in surviving calves. In our previous studies, the programmed death-1(PD-1)/ PD-ligand 1 (PD-L1) pathway and prostaglandin E2 (PGE2) were shown to be involved in the immunosuppression during chronic infectious diseases in cattle. In this study, the efficacy of dual blockade of the PD-1/PD-L1 pathway and PGE2 in M. bovis infection in vivo was investigated using anti-bovine PDL1 rat-bovine chimeric antibody, Boch4G12, and cyclooxygenase 2 (COX-2) inhibitor, meloxicam. The calves treated with Boch4G12 and meloxicam significantly enhanced M. bovis-specific IFN-γ response after the administration. On the other hand, IFN-γ response was not activated in the controls and cattle treated with meloxicam alone throughout the experimental period. Interestingly, bacterial loads in nasal discharge and bronchoalveolar lavage fluid among calves treated with Boch4G12 with or without meloxicam were significantly decreased. These results suggest that the combination of anti-PD-L1 antibody with a COX-2 inhibitor is a candidate for therapeutic applications in calves infected with M. bovis

Upregulation of PD-L1 Expression by Prostaglandin E_2 and the Enhancement of IFN-γ by Anti-PD-L1 Antibody Combined With a COX-2 Inhibitor in Mycoplasma bovis Infection

Bovine mycoplasmosis caused by Mycoplasma bovis results in pneumonia and mastitis in cattle. We previously demonstrated that the programmed death_1 (PD_)/PD-ligand _1 (PD-L_1) pathway is involved in immune dysfunction during M. bovis infection and that prostaglandin E_2 (PGE_2) suppressed immune responses and upregulated PD-L_1 expression in Johne\u27s disease, a bacterial infection in cattle. In this study, we investigated the role of PGE_2 in immune dysfunction and the relationship between PGE_2 and the PD-1/PD-L1 pathway in M. bovis infection. In vitro stimulation with M. bovis upregulated the expressions of PGE_2 and PD-L_1 presumably via Toll-like receptor 2 in bovine peripheral blood mononuclear cells (PBMCs). PGE_2 levels of peripheral blood in infected cattle were significantly increased compared with those in uninfected cattle. Remarkably, plasma PGE_2 levels were positively correlated with the proportions of PD-L_1^+ monocytes in M. bovis-infected cattle. Additionally, plasma PGE_2 production in infected cattle was negatively correlated with M. bovis-specific interferon (IFN)-γ production from PBMCs. These results suggest that PGE_2 could be one of the inducers of PD-L1 expression and could be involved in immunosuppression during M. bovis infection. In vitro blockade assays using anti-bovine PD-L_1 antibody and a cyclooxygenase 2 inhibitor significantly upregulated the M. bovis-specific IFN-γ response. Our study findings might contribute to the development of novel therapeutic strategies for bovine mycoplasmosis that target PGE_2 and the PD_/PD-L_1 pathway

Upregulation of PD-L1 Expression by Prostaglandin E-2 and the Enhancement of IFN-gamma by Anti-PD-L1 Antibody Combined With a COX-2 Inhibitor in Mycoplasma bovis Infection

Bovine mycoplasmosis caused by Mycoplasma bovis results in pneumonia and mastitis in cattle. We previously demonstrated that the programmed death 1 (PD-1)/PD-ligand 1 (PD-L1) pathway is involved in immune dysfunction during M. bovis infection and that prostaglandin E-2 (PGE(2)) suppressed immune responses and upregulated PD-L1 expression in Johne's disease, a bacterial infection in cattle. In this study, we investigated the role of PGE(2) in immune dysfunction and the relationship between PGE(2) and the PD-1/PD-L1 pathway in M. bovis infection. In vitro stimulation with M. bovis upregulated the expressions of PGE(2) and PD-L1 presumably via Toll-like receptor 2 in bovine peripheral blood mononuclear cells (PBMCs). PGE(2) levels of peripheral blood in infected cattle were significantly increased compared with those in uninfected cattle. Remarkably, plasma PGE(2) levels were positively correlated with the proportions of PD-L1(+) monocytes in M. bovis-infected cattle. Additionally, plasma PGE(2) production in infected cattle was negatively correlated with M. bovis-specific interferon (IFN)-gamma production from PBMCs. These results suggest that PGE(2) could be one of the inducers of PD-L1 expression and could be involved in immunosuppression during M. bovis infection. In vitro blockade assays using anti-bovine PD-L1 antibody and a cyclooxygenase 2 inhibitor significantly upregulated the M. bovis-specific IFN-gamma response. Our study findings might contribute to the development of novel therapeutic strategies for bovine mycoplasmosis that target PGE(2) and the PD-1/PD-L1 pathway