Contemporary Aspects of Orthognathic Surgery

U proteklih pet godina ortognatska kirurgija je postala standardni postupak u kirurgiji glave, čeljusti i lica. Temeljen na radovima Obwegesera koji je uveo sagitalnu osteotomiju ramusa ranih 50-tih godina, danas je taj postupak postao zlatni standard u ortognatskoj kirurgiji donje čeljusti diljem svijeta. Uvođenjem naprava za osiguranje centrične pozicije kondila tijekom cijeloga kirurškog postupka Luhr je ranih 80-tih godina dao drugi doprinos modernom razumijevanju cijele funkcionalne rehabilitacije disgnatija. Premda je LeFort-ova osteotomija uvedena od Wassmunda 20-tih godina, trebalo je sljedećih 50 godina da ta metoda bude prihvaćena u kirurgiji, uglavnom zbog straha od mogućega krvarenja. Uvođenjem naprave za pozicioniranje kondila za vrijeme osteotomije gornje i donje čeljusti ili kombinirane bimaksilarne osteotomije, kao i upotrebom distrakcijskih naprava, danas smo u mogućnosti rije- πiti i najteže disgnacijske probleme. U Zavodu za kirurgiju glave, čeljusti i lica Sveučilišta u Würzburgu u zadnja dva desetljeća s više od 2000 ortognatskih kirurških zahvata želimo prikazati razvoj suvremenih kirurških tehnika i kliničke rezultate. Napredak ne bi bio moguć bez primarne i stalne pripreme od strane ortodonta i interdisciplinarno određenih indikacija za kirurško liječenje, ortognatsku obradu pacijenta kao i za postoperativni postupak. Posebna se pozornost daje ortognatskom liječenju i tehničkim preduvjetima za kirurški postupak.Orthognathic surgery within the past half decade has become a standard procedure in cranio-maxillo- facial surgery. Based upon the elementary works by Obwegeser introducing the sagittal split ramus osteotomy in the early 50is, today this procedure has become the gold standard in mandibular orthognathic procedures worldwide. The introduction of devices to ensure the centric condyle position throughout the entire surgery by Luhr in the early 80ies gives another impact to modern understanding on complete functional rehabilitation after dysgnathia. Even though the LeFort-I-Osteotomy was already introduced by Wassmund in the 20is it took almost another 50 years before this procedure became accepted in surgery, mainly based on the fear of severe bleeding that may occur during surgery. By introducing a compund condyle positioning device to ensure the exact condyle position throughout both procedures of maxillary and mandibular osteotomy respectively, during combined bimaxillary osteotomies, as well as the targeted use of distraction devices, today we are able to solve even the severest dysgnathia problems. At the Department of Cranio-Maxillo-Facial Surgery of the University of Würzburg, during the past two decades and far more than 2000 orthognathic surgery cases, we are trying to present a broad overview of the development of the latest surgical techniques and clinical results. This progress is not possible without the primary and consistent treatment by a specifically skilled orthodontist during primary treatment including the interdisciplinary indication for surgery, the orthognathic preparation of the patient as well as the postoperative treatment. Therefore special emphasis will be put on the orthognathic treatment, as well as on technical prerequisites for the surgical procedure

Discovery of an unrecognized nidovirus associated with granulomatous hepatitis in rainbow trout

Rainbow trout (Oncorhynchus mykiss) is the principal species of inland-farmed fish in the Western hemisphere. Recently, we diagnosed in farmed rainbow trout a disease in which the hallmark is granulomatous-like hepatitis. No biotic agents could be isolated from lesions. Still, unbiased high-throughput sequencing and bioinformatics analyses revealed the presence of a novel piscine nidovirus that we named “Trout Granulomatous Virus” (TGV). TGV genome (28,767 nucleotides long) is predicted to encode non-structural (1a and 1 ab) and structural (S, M, and N) proteins that resemble proteins of other known piscine nidoviruses. High loads of TGV transcripts were detected by quantitative RT-PCR in diseased fish and visualized in hepatic granulomatous sites by fluorescence in situ hybridization. Transmission electron microscopy (TEM) revealed coronavirus-like particles in these lesions. Together, these analyses corroborated the association of TGV with the lesions. The identification and detection of TGV provide means to control TGV spread in trout populations

Tooth transposition prevalence and type among sub-Saharan Africans

Objectives: Although rare, tooth transposition—an exchange in location of two teeth—is a frequent topic of study. Clinical and, to a much lesser extent, dental anthropological research have focused predominantly on prevalence (0.03%‐0.74% in several world populations) and case studies, albeit on a restricted spatiotemporal scale. Many regions have received little attention, including sub‐Saharan Africa, while premodern data are few. Here, the aim is to supplement both fields of dental research by reviewing previous publications, and newly reporting transposition rates, types, and co‐occurring abnormalities in time‐successive samples across the subcontinent. Methods: Dental data in 51 sub‐Saharan samples (>2500 individuals) dating >10 000 BC to 20th century were recorded. Of these, 36 are of modern and 15 premodern age, comprising males and females ≥12‐years of age. Transposition presence, quadrant, and type were tabulated, cases described, and prevalence presented. In the latter case, Poisson 95% confidence intervals were calculated to better discern true population rates at various geographic levels. Results: Overall, six of 1886 modern individuals (0.32%) and one of premodern age evidence Mx.C.P1, an exchange of the maxillary canine and first premolar. Various associated dental abnormalities are also evident, including retained deciduous teeth, reduced permanent crowns, and agenesis. Conclusions: This study provides additional insight into the geographic distribution, features, and time depth of transposition, along with hints supporting a genetic etiology and, potentially, some indications of diachronic change from an initial Mx.C.P1 to several types more recently based on premodern evidence. It is of clinical concern today, but is not just a modern anomaly

Massive Numbers, Diverse Learning

MOOCs provide education for millions of people worldwide. Though it is not clear whether everyone can learn in a MOOC. Building on the typology of MOOC participants introduced is in Chap. 3, and we explore the claim that MOOCs are for everyone. We trace the different reasons people participate in MOOCs and the ways they learn. MOOCs tend to be designed for people who are already able to learn as active, autonomous learners. Those with low confidence may be inactive. However, even learners who are confident and able to regulate their learning experience difficulties if they don’t comply with the expectations of the course designers or their peers. For example, if a learner chooses to learn by observing others, rather than contributing, this behaviour can be perceived negatively by tutors and by peers. This indicates that MOOCs sustain the traditional hierarchy between the educators (those that create MOOCs and technology systems) and the learners (those who use these courses and systems). Although this hierarchy is not always visible, since it is embedded within the algorithms and analytics that power MOOC tools and platforms