Comparison of maxillary stability after Le Fort I osteotomy for occlusal cant correction surgery and maxillary advanced surgery

金沢大学医学部附属病院歯科口腔外科Objective: To compare postoperative maxillary stability following Le Fort I osteotomy for the correction of occlusal cant as compared with conventional Le Fort I osteotomy for maxillary advancement. Study design: The subjects were 40 Japanese adults with jaw deformities. Of these, 20 underwent a Le Fort I osteotomy and intraoral vertical ramus osteotomy (IVRO) to correct asymmetric skeletal morphology and inclined occlusal cant. The other 20 patients underwent a Le Fort I osteotomy and sagittal split ramus osteotomy (SSRO) to advance the maxilla. Lateral and posteroanterior cephalograms were taken postoperatively and assessed statistically. Thereafter, the 2 groups were followed for time-course changes. Results: There was no significant difference between the 2 groups with regard to time-course changes during the immediate postoperative period. Conclusion: This suggests that maxillary stability after Le Fort I osteotomy for cant correction does not differ from that after Le Fort I osteotomy for maxillary advancement. © 2007 Mosby, Inc. All rights reserved

Evaluation of upper lip hypoesthesia with a trigeminal somatosensory-evoked potential following Le Fort I osteotomy in combination with mandibular osteotomy

金沢大学医学部附属病院歯科口腔外科Purpose: The purpose of this study was to objectively evaluate hypoesthesia of the upper lip following Le Fort I osteotomy in combination with mandibular osteotomy with trigeminal somatosensory evoked potential (TSEP). Subjects and methods: The subjects consisted of 25 patients with mandibular prognathism with maxillary retrognathism mandibular prognathism with or without asymmetry, who underwent Le Fort I osteotomy in combination with sagittal split ramus osteotomy (SSRO) or intraoral vertical ramus osteotomy (IVRO).Trigeminal nerve hypoesthesia at the region of the upper lip was assessed bilaterally by the TSEP method. The electrodes were placed exactly above the highest point of the vermilion border and on the mucosa of the upper lip. An electroencephalograph recording system (Neuropack Sigma; Nihon Koden Corp., Tokyo, Japan) was used to analyze the potentials. Each patient was evaluated preoperatively and then postoperatively at 1 week, 2 weeks, 1 month, 3 months, 6 months, and 1 year. Results: The average measurable period and standard deviation of TSEP of the upper lip was 7.8 ± 10.7 weeks following Le Fort I osteotomy, TSEP of the lower lip was 4.6 ± 9.2 weeks in the patients who underwent SSRO with Le Fort I osteotomy, and 1.2 ± 0.4 weeks in the patients who underwent IVRO with Le Fort I osteotomy. Conclusion: This study objectively proved that hypoesthesia could appear in the upper lips following Le Fort I osteotomy with TSEP. The measurable period for the upper lip following Le Fort I osteotomy tended to be longer than that for the lower lip in the patients who underwent SSRO and IVRO with Le Fort I osteotomy. © 2007 Mosby, Inc. All rights reserved

Condylar and disc positions after intraoral vertical ramus osteotomy with and without a Le Fort I osteotomy

金沢大学医学部附属病院歯科口腔外科The purpose of this study was to examine the changes in temporomandibular joint (TMJ) morphology and clinical symptoms after intraoral vertical ramus osteotomy (IVRO) with and without a Le Fort I osteotomy. Of 50 Japanese patients with mandibular prognathism with mandibular and bimaxillary asymmetry, 25 underwent IVRO and 25 underwent IVRO in combination with a Le Fort I osteotomy. The TMJ symptoms and joint morphology, including disc tissue, were assessed preoperatively and postoperatively by magnetic resonance imaging and axial cephalogram. Improvement was seen in just 50% of joints with anterior disc displacement (ADD) that received IVRO and 52% of those that received IVRO with Le Fort I osteotomy. Fewer or no TMJ symptoms were reported postoperatively in 97% of the joints that received IVRO and 90% that received IVRO with Le Fort I osteotomy. Postoperatively, there were significant condylar position changes and horizontal changes in the condylar long axis on both sides in the two groups. There were no significant differences between improved ADD and unimproved ADD in condylar position change and the angle of the condylar long axis, although distinctive postoperative condylar sag was seen. These results suggest that IVRO with or without Le Fort I osteotomy can improve ADD and TMJ symptoms along with condylar position and angle, but it is difficult to predict the amount of improvement in ADD. © 2006 International Association of Oral and Maxillofacial Surgeons

Reliability and Validity of the Nursing Student Competency Assessment Instrument and Related Factors

The purpose of this study was to confirm the reliability and validity of the competency assessment index of nursing students and to identify the factors associated with competency. An anonymous self-administered questionnaire survey was conducted on nursing students enrolled from April 2021 to March 2022. Principal component analysis and Cronbach’s alpha coefficient were used to examine the reliability and validity of the competency factor structure. Multiple regression analysis was used to analyze related factors. As a result, the reliability and validity of the factor structure of competency were statistically clarified. As related factors of competency, “grade level” and “thinking that learning in university education gives students confidence” and “cognitive regulation strategies” were identified. In the analysis by competency sub-factors, other than grade level,［ relationship building］ was affected by “being immersed in university education,” ［ethical care］ and ［cooperation and collaboration］ by “thinking that learning in university education gives students confidence”, and［ health problem-solving］ and［ professional development］ by “cognitive regulation strategies”. The importance of recommending experiential education in clinical practice, strengthening self-regulated learning strategies, and education to increase students’ self-confidence were suggested. The results of this study contribute to the reconstruction of education in which competencies are shared with students

Control of Sulfide Release from Bottom Sediments at Borrow Pits Using Steelmaking Slag

There are many borrow pits caused by sand mining at the bottom of the coastal sea in Japan. Borrow pits have been identified as a source of oxygen-deficient water with hydrogen sulfide. It has become increasingly important to restore borrow pits to improve the marine environment. However, large quantities of sand materials are needed to restore borrow pits. Recently, dredged materials generated by sea route maintenance have been adopted instead of sand materials. However, one problem of dredged materials is that they can be weak ground materials. Therefore, slag-mixed material made from the dredged material and steelmaking slag has been proposed. In this study, control of hydrogen sulfide release resulting from changing the hardness of the slag-mixed materials has been examined. Hydrogen sulfide release strongly depends on the hardness of the slag-mixed material. Microbial analysis indicated fewer living bacteria and the relative abundance of sulfate-reducing bacteria in the slag-mixed material compared with the dredged material. The solidification of the dredged material using steelmaking slag decreased not only hydrogen sulfide release but also dissolved iron and manganese release. It is considered that controlling the hardness of the dredged material mixed with steelmaking slag provides an effective means of sulfide release control

A case of idiopathic omental hemorrhage

With the exception of trauma, intraperitoneal hemorrhage in young women is caused by the high frequency of ectopic pregnancy and ovarian bleeding. Here, we describe a case of idiopathic omental hemorrhage, which is a rare cause of intraperitoneal hemorrhage. Intraperitoneal hemorrhage was suspected in a 38-year-old Japanese woman based on contrast-enhanced computed tomography. Her last menstrual period was 23 days prior, and ovarian bleeding was considered based on bloody ascites revealed by culdocentesis. She underwent emergency surgery for hypovolemic shock. Although both ovaries were of normal size and no abnormal findings were observed, we performed a partial omentectomy because multiple clots were attached only to the greater omentum. Postoperatively, no rebleeding occurred, and she was discharged 11 days after the surgery. Because she did not have a clear history of trauma and underlying disease, idiopathic omental hemorrhage was diagnosed