Tailored Hydration With Lactated Ringer's Solution for Postendoscopic Retrograde Cholangiopancreatography Pancreatitis Prevention: A Randomized Controlled Trial.

INTRODUCTION: Aggressive hydration using lactated Ringer's solution prevents postendoscopic retrograde cholangiopancreatography (ERCP) pancreatitis (PEP). Concerns of this strategy are large volume and lengthy hydration. Our study aimed to evaluate the efficacy of tailored aggressive hydration (TAH) for PEP prevention. METHODS: In this prospective, multicenter, double-blinded, randomized trial conducted across 3 tertiary Korean hospitals, patients who underwent ERCP for the first time were randomly assigned (1:1) to the tailored standard hydration (TSH) and TAH groups. The TSH group received 1.5 mL/kg/hr lactated Ringer's solution during and after ERCP, whereas the TAH group was administered a 20 mL/kg bolus post-ERCP and 3 mL/kg/hr during and after the procedure. Both groups were assessed for elevated serum amylase levels and pain 4-6 hours after ERCP. If both were absent, hydration was discontinued. If either was present, hydration was continued at the original rate until 8 hours. The primary end point was PEP development and was analyzed on an intention-to-treat analysis. RESULTS: A total of 344 patients were randomly assigned to treatment groups (171 to the TSH group and 172 to the TAH group). PEP was observed in 9.4% (16/171) in the TSH group and 3.5% (6/172) in the TAH group (relative risk 0.37, 95% confidence interval 0.15-0.93, P = 0.03). No difference was identified between the 2 groups in PEP severity ( P = 0.80) and complications related to volume overload ( P = 0.32). DISCUSSION: TAH according to the presence of abdominal pain or elevated serum amylase levels at 4-6 hours after ERCP is safe and prevents PEP development.

A comparison of novel electrocautery-enhanced lumen-apposing metal stents and plastic stents in endoscopic ultrasound-guided drainage of infected walled-off necrosis: a multicenter randomized study.

BACKGROUND: Although lumen-apposing metal stents (LAMSs) have been increasingly used for walled-off necrosis (WON), their advantages over plastic stents in infected WON are unclear. We investigated the safety and efficacy of a novel electrocautery-enhanced LAMS for managing infected WON. METHODS: Patients who required endoscopic ultrasound-guided WON drainage were randomly assigned to LAMS or plastic stent groups. The primary outcome was total number of direct endoscopic necrosectomy (DEN) procedures required to achieve clinical success. Secondary outcomes included rates of technical success, clinical success, and adverse events. RESULTS: 46 patients were included in the LAMS (n = 23) and plastic stent (n = 23) groups. The median total number of DEN procedures did not differ significantly between the plastic stent group (4 procedures, interquartile range [IQR] 2.5-5.0) and LAMS group (9 procedures, IQR 8.0-9.0) (P = 0.07). The LAMS group demonstrated a significantly higher clinical success rate than the plastic stent group based on intention-to-treat analysis (100% vs. 73.9%, P =0.03) at 8 weeks but not at 4 weeks. Significant bleeding occurred in one patient in the plastic stent group and no patients in the LAMS group. CONCLUSIONS: We found no significant difference in the total number of DEN procedures between LAMSs and plastic stents for managing infected WON. The only statistically significant finding was a higher clinical success rate at 8 weeks for patients treated with LAMS. The use of LAMS did not result in any adverse events, such as bleeding or buried LAMS syndrome, within the study duration.

No Difference In Clinical Outcomes Following Repair of Large Retracted Anterior Rotator Cuff Tears Using Patch Augmentation With Human Dermal Allograft Versus Anterior Cable Reconstruction With Biceps Tendon Autograft.

PURPOSE: To compare the clinical outcomes and tendon integrity after rotator cuff repair combined with anterior cable reconstruction (ACR) using the proximal biceps tendon and patch augmentation (PA) using a human dermal allograft (HDA) in a large retracted anterior rotator cuff tear. METHODS: Patients who underwent arthroscopic rotator cuff repair with 2 different augmentation procedures between January 2017 and December 2020 were enrolled. The inclusion criteria were patients who were treated by arthroscopic rotator cuff repair with ACR using the proximal biceps tendon (ACR group) or patch augmentation using a an HDA (PA group) and follow-up for at least 2 years. Clinical outcomes were assessed using American Shoulder and Elbow Surgeons (ASES) score, Constant score, and the number of patients who achieved minimal clinically important differences (MCID). Magnetic resonance imaging was performed to evaluate tendon integrity after surgery. RESULTS: A total of 92 patients were enrolled (ACR group = 55 patients and PA group = 37 patients). The mean ASES and Constant scores significantly improved in the ACR group (68.8 ± 15.3 and 58.4 ± 16.9 before surgery vs 91.4 ± 6.3 and 87.8 ± 6.0 after surgery, P < .001) and in the PA group (63.7 ± 16.7 and 57.9 ± 15.4 before surgery vs 93.1 ± 6.3 and 88.3 ± 6.2 after surgery, P < .001). Overall, 78 patients (84.8%) achieved the MCID with 81.8% in the ACR group and 89.2% in the PA group, with no significant differences between the 2 groups (P = .638). Ten patients (18.2%) had retear in the ACR group, and three patients (8.1%) had retear in the PA group (P = .174). CONCLUSIONS: In large retracted anterior rotator cuff tears, both augmentation techniques using biceps tendon autograft and HDA provided satisfactory clinical outcomes that achieved the MCID in 84.8%, range of motion restoration, and lower retear rates with no significant differences between the two groups. LEVEL OF EVIDENCE: Level III, retrospective case-control study.

Comparison of the long-term outcomes between proximal and distal IgG4-related sclerosing cholangitis: A multicenter cohort study.

BACKGROUND AND AIMS: Immunoglobulin G4-related sclerosing cholangitis (IgG4-SC) is considered a biliary manifestation of IgG4-related diseases. However, there has been a controversy on the clinical outcomes according to the location of the involved bile duct. We therefore compared the clinical outcomes and long-term prognosis of IgG4-SC with proximal bile duct involvement (proximal IgG4-SC) and IgG4-SC with distal bile duct involvement (distal IgG4-SC). METHODS: We reviewed the data of patients with IgG4-SC that were prospectively collected at 10 tertiary centers between March 2002 and October 2020. Clinical manifestations, outcomes, association with autoimmune pancreatitis (AIP), steroid-responsiveness, and relapse of IgG4-SC were evaluated. RESULTS: A total of 148 patients (proximal IgG4-SC, n = 59; distal IgG4-SC, n = 89) were analyzed. The median age was 65 years (IQR, 56.25-71), and 86% were male. The two groups were similar in terms of jaundice at initial presentation (51% vs 65%; P = 0.082) and presence of elevated serum IgG4 (66% vs 70%; P = 0.649). The two groups showed significant differences in terms of steroid-responsiveness (91% vs 100%; P = 0.008), association with AIP (75% vs 99%; P = 0.001), and occurrence of liver cirrhosis (9% vs 1%; P = 0.034). During a median follow-up of 64 months (IQR, 21.9-84.7), the cumulative relapse-free survival was significantly different between the two groups (67% vs 79% at 5 years; P = 0.035). CONCLUSIONS: Relapse of IgG4-SC frequently occurred during follow-up. Proximal IgG4-SC and distal IgG4-SC had different long-term outcomes in terms of steroid-responsiveness, occurrence of liver cirrhosis, and recurrence. It may be advantageous to determine the therapeutic and follow-up strategies according to the location of bile duct involvement.

The biomechanical effects of acromial fracture angulation in reverse total shoulder arthroplasty.

BACKGROUND: The biomechanical changes and treatment guidelines on acromial fracture after reverse shoulder arthroplasty (RSA) are still not well understood. The purpose of our study was to analyze the biomechanical changes with respect to acromial fracture angulation in RSA. METHODS: RSA was performed on 9 fresh-frozen cadaveric shoulders. An acromial osteotomy was performed on the plane extending from the glenoid surface to simulate an acromion fracture. Four conditions of acromial fracture inferior angulation were evaluated (0°, 10°, 20°, and 30° angulation). The middle deltoid muscle loading origin position was adjusted based on the position of each acromial fracture. The impingement-free angle and capability of the deltoid to produce movement in the abduction and forward flexion planes were measured. The length of the anterior, middle, and posterior deltoid was also analyzed for each acromial fracture angulation. RESULTS: There was no significant difference in the abduction impingement angle between 0° (61.8° ± 2.9°) and 10° angulation (55.9° ± 2.8°); however, the abduction impingement angle of 20° (49.3° ± 2.9°) significantly decreased from 0° and 30° angulation (44.2° ± 4.6°), and 30° angulation significantly differed from 0° and 10° (P < .01). On forward flexion, 10° (75.6° ± 2.7°), 20° (67.9° ± 3.2°), and 30° angulation (59.8° ± 4.0°) had a significantly decreased impingement-free angle than 0° (84.2° ± 4.3°; P < .01), and 30° angulation had a significantly decreased impingement-free angle than 10°. On analysis of glenohumeral abduction capability, 0° significantly differed (at 12.5, 15.0, 17.5, and 20.0N) from 20° and 30°. For forward flexion capability, 30° angulation showed a significantly smaller value than 0° (15N vs. 20N). As acromial fracture angulation increased, the middle and posterior deltoid muscles of 10°, 20°, and 30° became shorter than those of 0°; however, no significant change was found in the anterior deltoid length. CONCLUSIONS: In acromial fractures at the plane of glenoid surface, 10° inferior angulation of the acromion did not interfere with abduction and abduction capability. However, 20° and 30° of inferior angulation caused prominent impingement in abduction and forward flexion and reduced abduction capability. In addition, there was a significant difference between 20° and 30°, suggesting that not only the location of the acromion fracture after RSA but also the degree of angulation are important factors for shoulder biomechanics.

Self-Scheduled LPV Control of Asymmetric Variable-Span Morphing UAV.

In this study, a novel framework for the flight control of a morphing unmanned aerial vehicle (UAV) based on linear parameter-varying (LPV) methods is proposed. A high-fidelity nonlinear model and LPV model of an asymmetric variable-span morphing UAV were obtained using the NASA generic transport model. The left and right wing span variation ratios were decomposed into symmetric and asymmetric morphing parameters, which were then used as the scheduling parameter and the control input, respectively. LPV-based control augmentation systems were designed to track the normal acceleration, angle of sideslip, and roll rate commands. The span morphing strategy was investigated considering the effects of morphing on various factors to aid the intended maneuver. Autopilots were designed using LPV methods to track commands for airspeed, altitude, angle of sideslip, and roll angle. A nonlinear guidance law was coupled with the autopilots for three-dimensional trajectory tracking. A numerical simulation was performed to demonstrate the effectiveness of the proposed scheme.

New Frontier in Advanced Dentistry: CBCT, Intraoral Scanner, Sensors, and Artificial Intelligence in Dentistry.

The advancement of science and technology has brought innovation in the dental field [...].

Three-dimensional morphologic evaluation of the changes in the pharyngeal airway and hyoid bone after bimaxillary surgery in patients with skeletal Class III malocclusion with facial asymmetry: A preliminary study.

INTRODUCTION: The study aimed to evaluate the morphologic changes in the pharyngeal airway after bimaxillary surgery in skeletal Class III malocclusion patients with or without asymmetry. We also analyzed the correlation between positional changes in the menton, hyoid bone, and changes in the dimensions of the pharyngeal airway. METHODS: We included 32 patients with skeletal Class III malocclusion who underwent bimaxillary surgery. There were 16 subjects in the symmetry group (10 male, 6 female; mean age, 22.44 ± 5.14 years), and 16 in the asymmetry group (10 male, 6 female; mean age, 21.38 ± 4.62 years). Preoperative and postoperative (2 months after surgery) cone-beam computed tomography scans were taken and then analyzed by comparing postoperative changes in each group. RESULTS: The anteroposterior lengths at the uvula level (P2L) and epiglottis level (P3L) were significantly decreased in the symmetry group. The P2L was also significantly decreased in the asymmetry group, and a difference in the P3L was observed. However, there was no significant change in the width at the uvula level (P2W) and epiglottis level (P3W) in the symmetry group. In contrast, in the asymmetry group, P2W and P3W were significantly decreased. The cross-sectional ratio was significantly decreased P2 (P2L/P2W) and P3 (P3L/P3W) in the symmetry group. However, a statistically significant decrease occurred only at P3 in the asymmetry group. Anteroposterior positional changes of the menton and P2L (r = -0.370; P <.05), P3L (r = -0.414; P <0.05), and P3L/P3W (r = -0.361; P <0.05) were correlated. CONCLUSIONS: Differences in the morphologic features of the pharyngeal airway after bimaxillary surgery was observed in both the symmetry and asymmetry groups. Bimaxillary surgery with a mandibular setback in patients with skeletal Class III malocclusion worsened morbidity of the elliptical structure of the pharyngeal airway. However, it worsened less in the asymmetry group than in the symmetry group.

Development of a maxillomandibular arch form based on the center of resistance of teeth using cone-beam computed tomography.

INTRODUCTION: Controlling transverse discrepancies is necessary to ensure stable and functional occlusion. Altered molar inclinations can camouflage the transverse relationship. The purpose of this research was to evaluate the maxillomandibular relationship of the center of resistance (CR) of the arch form created by the CR of teeth and compare these CR arch forms by their skeletal patterns. METHODS: Sixty patients with minor crowding and normal posterior overjet were divided into 3 groups according to ANB angle: skeletal Class I group had ANB angle between 0° and 4° (n = 20), skeletal Class II group had ANB angle >4° (n = 20), and skeletal Class III group had ANB angle <0° (n = 20). The 3-dimensional coordinates of the CR were estimated using cone-beam computed tomography images and projected on the CR occlusal plane to obtain the 2-dimensional coordinates. The CR arch forms were constructed and evaluated using Matlab (MathWorks, Natick, Mass). RESULTS: On comparing maxillomandibular CR arch form widths, the maxilla was significantly larger than the mandible of the canine and first premolar. The mandible was larger in the first molar of the skeletal Class III group. The maxillomandibular CR arch form width ratios were between 0.97 and 1.35. On comparing maxillomandibular CR arch form areas, the maxilla was significantly larger than the mandible in the anterior segment, and the mandible was larger in the posterior segment. The ratios were between 0.86 and 2.25. In between-group comparison, the skeletal Class III group showed significantly greater arch forms in the mandible. CONCLUSIONS: CR arch forms had significant maxillomandibular differences throughout the arch. The maxillomandibular ratios could be a reference for site-specific transverse discrepancy analysis.

Maximal diameter of liver abscess independently predicts prolonged hospitalization and poor prognosis in patients with pyogenic liver abscess.

BACKGROUND/AIMS: This study aimed to investigate the factors associated with prolonged hospital stay and in-hospital mortality in patients with pyogenic liver abscess. METHODS: We retrospectively reviewed data from patients with pyogenic liver abscess who were admitted between 2005 and 2018 at three tertiary hospitals in Jeonbuk province, South Korea. Prolonged hospital stay was defined as a duration of hospital admission of more than 21 days. RESULTS: A total of 648 patients (406 men and 242 women) diagnosed with pyogenic liver abscess were enrolled in the study. The mean maximal diameter of the liver abscess was 5.4 ± 2.6 cm, and 74.9% of the lesions were single. The three groups were divided according to the maximal diameter of the abscess. Laboratory parameters indicated a more severe inflammatory state and higher incidence of complications and extrahepatic manifestations with increasing abscess size. Rates of percutaneous catheter drainage (PCD) insertion, multiple PCD drainage, and salvage procedures as well as duration of drainage were also higher in the large liver abscess group. Of note, the duration of hospitalization and in-hospital mortality were significantly higher in the large hepatic abscess group. A multivariate analysis revealed that underlying diabetes mellitus, hypoalbuminemia, high baseline high-sensitivity C-reactive protein (hs-CRP) and procalcitonin levels, and large maximal abscess diameter were independent factors associated with prolonged hospital stay. Regarding in-hospital mortality, acute kidney injury at admission and maximal diameter of the abscess were independent factors associated with in-hospital mortality. CONCLUSIONS: A large maximal diameter of the liver abscess at admission indicated prolonged hospitalization and poor prognosis. More aggressive treatment strategies with careful monitoring are warranted in patients with large liver abscesses.

Critical issues concerning biocreative strategy in contemporary temporary skeletal anchorage device orthodontics: A narrative review.

Biocreative Orthodontic Strategy (BOS) is designed to establish a physiologically stable occlusion in harmony with masticatory and TMJ function and healthy supporting tissues with strategic use of temporary skeletal anchorage devices (TSADs). This narrative review surveys current research that demonstrates how BOS with TSADs uses a target approach to overcome the limitations experienced with conventional orthodontic treatment. A narrative review article including research on TSADs orthodontics in the permanent dentition. This review is a brief survey of five BOS principles for contemporary TSAD orthodontics: elegant selection of TSADs, bracket prescription to enhance TSAD orthodontics, antero-posterior dimension control, transverse dimension control and airway control issues. Severe malocclusion and craniofacial dysmorphology can be treated with Biocreative Orthodontic Strategy with a minimum number of TSADs. In order to achieve successful treatment outcome using TSADs, it is critical to understand the key diagnosis and treatment principles of BOS and how to develop a target approach for the tooth and bone movement.

EUS-guided hydrogel microparticle injection in a cadaveric model.

BACKGROUND AND AIMS: A potential method to reduce gastrointestinal toxicity during radiation therapy in pancreatic head cancer is to create a physical space between the head of the pancreas (HOP) and the duodenum. To date, there have been early reports on the feasibility of endoscopic ultrasound (EUS)-guided hydrogel injection into the interface between the HOP and the duodenum to increase the peri-pancreatic space for radiotherapy. We aimed to evaluate the technical feasibility of EUS-guided hydrogel injection for the creation of space at the peri-pancreatic interface in a cadaveric model. METHODS: Baseline abdominal computerized tomography (CT) was performed on three unfixed cadaveric specimens. The hydrogel was injected transduodenally into the interface between the HOP and duodenum using linear-array EUS and a 19G needle for fine needle aspiration (FNA). This procedure was repeated along the length of the HOP. CT imaging and gross dissection were performed after the procedure to confirm the localization of the hydrogel and to measure the distance between the HOP and the duodenum. RESULTS: All cadavers underwent successful EUS-guided injection of the hydrogel. Cadavers 1, 2, and 3 were injected with 9.5, 27, and 10 cc of hydrogel, respectively; along the HOP, the formation of the peri-pancreatic space was a maximum size of 11.77, 13.20, and 12.89 mm, respectively. The hydrogel injections were clearly visualized as hyperechoic bullae during EUS and on post-procedure CT images without any artifacts in all cases. CONCLUSIONS: We demonstrated that EUS-guided delivery of hydrogel is feasible, and that it increases the peri-pancreatic space in a cadaveric model. The polyethylene glycol (PEG) hydrogel was clearly visible on EUS and CT, without significant artifacts. This may lead to new treatment approaches for pancreatic carcinomas.

Evaluation of Periodontal Risk Factors with Quantitative Light-Induced Fluorescence Based Fluorescent Plaque Index, in Comparison to Radiographic and Oral Health Habit Scoring: A Retrospective Case Study.

The aim of this study was to evaluate periodontal risk factors with oral health habits and fluorescent plaque index (FPI) using quantitative light-induced fluorescence (QLF) images, and to evaluate their effect on the degree of radiographic bone loss (RBL). Selected were 276 patients over 19 years of age to complete the questionnaire for oral health habit and take QLF images, periapical and panoramic radiographs. Oral health habit score, age, and sex showed a statistically significant correlation with FPI. FPI showed a lower value as the oral health habit score increased and the age decreased. Moreover, females showed lower FPI values than did males. RBL showed a statistically significant positive correlation with age but did not show any correlation with oral health habit scores and sex. There was no correlation between FPI and RBL. The results of this study suggest that the clinical use of QLF allows plaque detection by non-invasive procedures and can aid in a more objective estimation for oral hygiene status.

Three-Dimensional Digital Superimposition of Orthodontic Bracket Position by Using a Computer-Aided Transfer Jig System: An Accuracy Analysis.

Accurate bracket placement is essential for successful orthodontic treatment. An indirect bracket bonding system (IDBS) has been developed to ensure proper bracket positioning with three-dimensional computer-aided transfer jigs. The purpose of this study was to investigate the accuracy of bracket positioning by a one-body transfer jig according to the tooth type and presence/absence of a resin base. In total, 506 teeth from 20 orthodontic patients were included in this study. After initial dental models were scanned, virtual setup and bracket positioning procedures were performed with 3D software. Transfer jigs and RP models were fabricated with a 3D printer, and brackets were bonded to the RP model with or without resin base fabrication. The best-fit method of 3D digital superimposition was used to evaluate the lineal and angular accuracy of the actual bracket position compared to a virtual bracket position. Although all the measurements showed significant differences in position, they were clinically acceptable. Regarding the tooth types, premolars and molars showed higher accuracy than anterior teeth. The presence or absence of a resin base did not consistently affect the accuracy. In conclusion, the proper application of IDBS should be performed considering the errors, and resin base fabrication might not be essential in ensuring high-accuracy IDBS.

Effect of Different Surface Designs on the Rotational Resistance and Stability of Orthodontic Miniscrews: A Three-Dimensional Finite Element Study.

High orthodontic forces and various directions of applied forces can be associated with loosening of the screw anchorage in the bone. Screw designs have been modified to increase the stability of the miniscrews. This research evaluates the influence of three-designs on the stability of orthodontic miniscrews. A conventionally cylinder-type miniscrew design (Bio-Action screw, Jin-Biomed co., Bucheon, Korea) was set as a control, and three conditions were studied based on modifications of this control design. Condition-1 has narrowed threads in the upper part of the screw; Condition-2 has a notch at the middle part; and Condition-3 has the combination of Condition-1 and Condition-2. The moment required to unwind the miniscrew to five degrees is tested, and the moment generated at the cortical bone and the trabecular bone were calculated with finite element analysis. Compared to the control, all three conditions showed a higher moment required to unwind the miniscrew and a higher moment generated at the cortical bone. At the trabecular bone, condition-2 and -3 showed higher moment than the control, and condition-1 showed similar moment to the control. Condition-3 required a higher overall moment to unwind the miniscrew. These findings validate the design modifications used to increase the rotational resistance.

Effect of Different Head Hole Position on the Rotational Resistance and Stability of Orthodontic Miniscrews: A Three-Dimensional Finite Element Study.

The orthodontic miniscrew is driven into bone in a clockwise direction. Counter-clockwise rotational force applied to the implanted miniscrew can degrade the stability. The purpose of this three-dimensional finite element study was to figure out the effect of shifting the miniscrew head hole position from the long axis. Two miniscrew models were developed, one with the head hole at the long axis and the other with an eccentric hole position. One degree of counter-clockwise rotation was applied to both groups, and the maximum Von-Mises stress and moment was measured under various wire insertion angles from -60° to +60°. All Von-Mises stress and moments increased with an increase in rotational angle or wire insertion angle. The increasing slope of moment in the eccentric hole group was significantly higher than that in the centric hole group. Although the maximum Von-Mises stress was higher in the eccentric hole group, the distribution of stress was not very different from the centric hole group. As the positive wire insertion angles generated a higher moment under a counter-clockwise rotational force, it is recommended to place the head hole considering the implanting direction of the miniscrew. Clinically, multidirectional and higher forces can be applied to the miniscrew with an eccentric head hole position.

Automatic Cephalometric Landmark Identification System Based on the Multi-Stage Convolutional Neural Networks with CBCT Combination Images.

This study was designed to develop and verify a fully automated cephalometry landmark identification system, based on multi-stage convolutional neural networks (CNNs) architecture, using a combination dataset. In this research, we trained and tested multi-stage CNNs with 430 lateral and 430 MIP lateral cephalograms synthesized by cone-beam computed tomography (CBCT) to make a combination dataset. Fifteen landmarks were manually and respectively identified by experienced examiner, at the preprocessing phase. The intra-examiner reliability was high (ICC = 0.99) in manual identification. The results of prediction of the system for average mean radial error (MRE) and standard deviation (SD) were 1.03 mm and 1.29 mm, respectively. In conclusion, different types of image data might be the one of factors that affect the prediction accuracy of a fully-automated landmark identification system, based on multi-stage CNNs.

Detection of Dental Caries and Cracks with Quantitative Light-Induced Fluorescence in Comparison to Radiographic and Visual Examination: A Retrospective Case Study.

The aim of this study was to present an optimal diagnostic protocol by comparing and analyzing a conventional examination and the quantitative light-induced fluorescence (QLF) technique. Selected were 297 teeth of 153 patients to take QLF images and bitewing radiographs. Occlusal dental caries, proximal dental caries and cracks were evaluated and scored using QLF, X-ray and/or visual criteria. The sensitivity, specificity, and area under the curve (AUC) of a receiver operating characteristic analysis were calculated. Two fluorescence parameters (|ΔFmax| and ΔRmax) were utilized to evaluate the fluorescence pattern according to the severity of lesions based on QLF or X-ray criteria. QLF showed higher scores for detecting occlusal dental caries and cracks than the conventional method. ΔRmax increased more clearly than ΔFmax did with occlusal dental caries. The |ΔFmax| values of occlusal dental caries, proximal dental caries and cracks showed good AUC levels (0.84, 0.81 and 0.83, respectively). The ΔRmax of occlusal dental caries showed the highest AUC (0.91) and the ΔRmax of proximal dental caries showed a fail level (0.59) compared to bitewing radiographs. The QLF image could visualize and estimate the degree of occlusal dental caries or cracks. Consequently, the QLF technique may be an adjunct tool to conventional methods for the detection of occlusal caries and peripheral cracks.

Computerized Assessment of Occlusion and Muscle Activity during Use of a Multilayer Clear Retainer: A Preliminary Study.

The aim of this preliminary study was to evaluate the short-term changes of occlusal contacts and muscle activity after orthodontic treatment during the use of a multi-layer clear retainer. Evaluation was done with the T-scan and BioEMG systems. A total of 18 subjects were included, who were evaluated at three time intervals-T0 at debonding, T1 at one month after retainer delivery, and T2 at four months after retainer delivery. The T-scan and electromyography (EMG) data were recorded simultaneously. The T-scan system recorded the occlusion time, disclusion time and force distribution. The EMG waves were quantified by calculating the asymmetry index and activity index. The time variables changed but not significantly. Occlusal force decreased in the anterior dentition and increased in the posterior dentition during T0-T2. There was no clear evidence of a relationship between unbalanced occlusal forces and muscle activity. In most subjects, the temporalis anterior muscle was more dominant than the masseter muscle. From this preliminary computerized study, there were no significant changes in the state of the occlusion or muscle activity during the short-term retention period.

Inactivation of the Akt/FOXM1 Signaling Pathway by Panobinostat Suppresses the Proliferation and Metastasis of Gastric Cancer Cells.

Gastric cancer is the fifth most common cancer and the third leading cause of cancer-related deaths worldwide. Histone deacetylase (HDAC) inhibitors are a new class of cytostatic agents available for the treatment of various cancers and diseases. Although numerous clinical and pre-clinical trials on the anticancer effects of panobinostat have been conducted, only a few reports have investigated its efficacy in gastric cancer. The present study aimed to investigate the effects of panobinostat in gastric cancer cells. Panobinostat significantly inhibited the cell viability and proliferation of the gastric cancer cell lines SNU484 and SNU638 in a dose-dependent manner; it reduced the colony-forming ability of these cells. Moreover, it induced apoptosis as indicated by increased protein levels of cleaved poly ADP-ribose polymerase and cleaved caspase-3. Panobinostat induced the G2/M cell cycle arrest in SNU484 and SNU638 cells and subsequently decreased the G2/M phase regulatory-associated protein expression of p-Wee1, Myt1, and Cdc2. Furthermore, panobinostat significantly inhibited the metastasis of SNU484 and SNU638 cells by regulating the expression of MMP-9 and E-cadherin. Further, it decreased the protein levels of p-Akt and forkhead box protein M1 (FOXM1). These effects were reversed by the Akt agonist SC79 and were accelerated by the Akt inhibitor LY2940002. Moreover, tumor growth in xenograft animal experiments was suppressed by panobinostat. These results indicated that panobinostat inhibits the proliferation, metastasis, and cell cycle progression of gastric cancer cells by promoting apoptosis and inactivating Akt/FOXM1 signaling. Cumulatively, our present study suggests that panobinostat is a potential drug for the treatment of gastric cancer.