Characterization of Hot Deformation Behavior of Nanosized Al2O3 Reinforced Al6061 Composites.

The hot deformation behavior of Al6061/Nano-Al2O3 composites were investigated at temperatures of 300 to 500 °C and strain rates of 0.001∼1/s using compression tests. The composite fabricated by the infiltration method consisted of an Al matrix and Al2O3 particles with a mean size of 200 nm. Interestingly, the true stress-true strain curves under all compressive conditions showed a peak stress at the initial stages of deformation, in which the peak stress increased with decreasing temperature and faster strain rate. The Z parameter, which is known as the temperature-compensated strain rate showed a linear relationship with the flow stress. The hot deformation mechanism is believed to occur through dynamic recrystallization, where fine equiaxed grains and dislocations were observed at the deformed specimens. A processing map was applied to evaluate the hot workability and flow instability region to determine the optimal deformation conditions of the composite.

Skeletal maturation and predicted adult height in adolescents with temporomandibular joint osteoarthritis.

BACKGROUND: The occurrence of osteoarthritis (OA) of the temporomandibular joint (TMJ) in juveniles could be associated with fluctuating levels of oestrogen and growth hormone (GH) during adolescence. OBJECTIVE: To investigate extent of skeletal maturation and predicted adult height in adolescents with TMJ OA. METHOD: In total, 155 adolescents (54 males, 101 females; mean age, 14.1 ± 2.0 years) were enrolled. Among them, 19 adolescents (CON) showed no sign of TMD, 50 adolescents exhibited signs of disc displacement but did not have TMJ OA (TMDnoOA), 23 adolescents exhibited the initial stage of TMJ OA (TMJOAini) and 63 adolescents exhibited the severe stage of TMJ OA (TMJOApro). TMJ OA was diagnosed based on the Research Diagnostic Criteria axis I and bone age was estimated using the Greulich-Pyle method. The height, weight and body mass index of participated adolescents were measured and statistically converted to z-scores. The predicted adult height and age of peak height velocity (APHV) were calculated using the BoneXpert® software. RESULTS: In female adolescents, the differences between the chronological and bone ages were significantly higher and the z-score for height was significantly lower in the TMJOApro. Female adolescents with TMJOA exhibited a significantly shorter predicted adult height and earlier APHV than those in the CON and TMDnoOA. CONCLUSION: The adolescents with TMJ OA exhibited premature skeletal maturations and short predicted adult stature, particularly the female adolescents.

Maxillary Sinus Augmentation With Calcium Phosphate Double-Coated Anorganic Bovine Bone: Comparative Multicenter Randomized Clinical Trial With Histological and Radiographic Evaluation.

PURPOSE: The purpose of this study was to evaluate the clinical, histological and radiographic outcomes of the calcium phosphate double-coated anorganic bovine bone (InduCera; Oscotec Inc., Seongnam, Gyeonggi, Republic of Korea) compared with that of anorganic bovine bone (Bio-Oss; Geistlich Biomaterials, Wolhusen, Switzerland) in maxillary sinus augmentation, prospectively. PATIENTS AND METHODS: Twenty-eight sinuses in 25 patients (3 bilateral) with vertical alveolar bone height from 2 to 5 mm were included in this study. The maxillary sinus was augmented with InduCera or Bio-Oss, followed by a healing period of 6 months. Trephine cores were obtained for histomorphometric evaluation with the implant placement. Cone-beam computed tomography (CBCT) scans were taken at 1 week and 6 months after sinus augmentation. RESULTS: The graft sites were healed without any notable complications in both groups. In histomorphometric analysis, the area of the newly formed bone was measured as 21.37 ± 8.87% for InduCera and 23.02 ± 5.88% for Bio-Oss, with no significant differences. Radiographically, no statistically significant differences were calculated between the groups in bone height at baseline, the height of bone augmentation, the final alveolar bone height (alveolar bone height + augmented height) after 6 months in panoramic radiograph. There were also no significant differences in the shrinkage rate of the grafted area volume in CBCT. CONCLUSION: Although calcium phosphate double-coated anorganic bovine bone showed no additional effect compared with anorganic bovine bone from a histological and radiographical point of view, it could be used as the bone graft material in maxillary sinus augmentation.

Evaluation of Sinonasal Change After Lefort I Osteotomy Using Cone Beam Computed Tomography Images.

Orthognathic surgery including Le Fort I osteotomy involves changes in the nasal septum and maxillary sinus. This study assesses nasal septum changes after Le Fort I osteotomy using cone beam computed tomography images and evaluates mucosal changes in the maxillary sinus after the surgery.This was a retrospective study of 33 patients who underwent orthognathic surgery including Le Fort I osteotomy. To assess the maxillary sinus, changes in the mucosa of the maxillary sinus were analyzed by volume and geometry. We measured the air cavity per se and mucosal thickening of the maxillary sinus using SIMPLANT (Materialise, Belgium) software. And the geometry of the distribution of the mucosa was analyzed using cone beam computed tomography images.The septal angle was decreased after surgery, but not significantly (P > 0.05). The volume reduction of the air cavity per se and the volume increase associated with mucosal thickening were statistically significant (P < 0.05). Mucosal thickening was observed in the posterior-inferior direction.In this study, nasal septum deviation was not statistically significant after Le Fort I osteotomy. Decrease of the air cavity per se, decrease of the total volume of the maxillary sinus, and increase of mucosal thickening were prominent. Furthermore, the mucosal thickening that occurs after surgery appears to be mainly in the posterior lower part of the maxillary sinus.

Visceral obesity in predicting oncologic outcomes of localized renal cell carcinoma.

PURPOSE: We investigate the clinicopathological features and prognostic significance of visceral obesity in patients with localized renal cell carcinoma. MATERIALS AND METHODS: This study included 706 patients with localized renal cell carcinoma who had undergone curative surgery between January 2003 and April 2012. Visceral, subcutaneous and total adipose tissue were measured based on preoperative computerized tomography of the umbilical region. Visceral adipose tissue percent was calculated using the formula, VAT% = [visceral adipose tissue/total adipose tissue] × 100. The association between clinicopathological factors and visceral obesity was examined. RESULTS: A higher VAT% at diagnosis was associated with older age at diagnosis, higher prevalence of diabetes and higher prevalence of former or current smoking status. The distribution of histological subtypes differed significantly among VAT% quartiles. The proportion of high grade tumors increased as VAT% increased (OR 1.023, 95% CI 1.000-1.126, p = 0.037). A U-shaped association between VAT% quartiles and the risk of disease recurrence was observed for all patients. Disease recurrence was significantly increased in the lowest (HR 3.198, 95% CI 1.765-10.040, p = 0.036) and highest (HR 4.760, 95% CI 2.937-13.210, p = 0.010) VAT% quartiles. CONCLUSIONS: Relative visceral obesity as assessed by VAT% was associated with clinicopathological characteristics of localized renal cell carcinoma. A U-shaped association between VAT% quartiles and risk of disease recurrence was observed among patients with localized renal cell carcinoma.

Development and validation of nomograms to predict the recovery of urinary continence after radical prostatectomy: comparisons between immediate, early, and late continence.

PURPOSE: Few studies have been conducted on the serial evaluation of predictors for recovery of urinary continence (RC) after radical prostatectomy (RP) among same cohort. We developed and validated nomograms to predict immediate (≤1), early (≤3), and late (≤12 months) RC from a contemporary series and compared each nomogram with regard to the significance of predictors for RC. METHODS: Among consecutive men who received robot-assisted or open retropubic RP between 2004 and 2011, 872 (74.7 %) and 296 (25.3 %) were randomly assigned to subcohorts for the development of nomograms and for the split-sample external validation. The final multivariate model was selected based on the stepwise procedure, and the regression coefficient-based nomograms were developed based on final models. RESULTS: Age at surgery, membranous urethral length (MUL), and robot-assisted RP were significant for RC at 1, 3, and 12 months. Saving the neurovascular bundle (NVB) and prostate volume were significant only for RC at 12 months. Odds ratios for age and MUL were constant over time, whereas the odds ratio for robot-assisted surgery decreased over time. Each developed nomogram was reasonably well fitted to the ideal line of the calibration plot. The split-sample external validation of nomograms indicated 63, 65, 71 % accuracy for each RC time point. CONCLUSIONS: We developed nomograms for RC at each time point after RP and validated adequately. Saving the NVB and prostate volume may affect only late RC after RP. In contrast, age, MUL, and robot-assisted surgery seem to be consistently associated with immediate, early, and late RC.

Effects of rhBMP-2 with various carriers on maxillofacial bone regeneration through computed tomography evaluation.

BACKGROUND: rhBMP-2 is regarded as the most potent osteoinductive growth factor, and it has been used in the oral cavity with different carriers. The purpose of this study is to evaluate the bone-regenerative effect of rhBMP-2 delivered with different carrier systems through three-dimensional cone beam computed tomography analysis. METHOD: A total of 112 patients underwent oral surgery with rhBMP-2 application (Group 1, n = 53) or without rhBMP-2 application (Group 2, n = 59). Group 1 was divided into 3 groups according to carriers, rhBMP-2 with allograft (Group 1-1, n = 34), rhBMP-2 with xenograft (Group 1-2, n = 5), and rhBMP-2 with absorbable collagen sponge (Group 1-3, n = 14). Cone beam computed tomography scans were taken before surgery (T0) 6 months after surgery (T1). The volume of defects was measured through the three-dimensional image analysis tool. RESULTS: The average bone regeneration rate of Group 1 was significantly greater than that of Group 2. Within Group 1, the group that used allograft as a carrier (Group 1-1) showed significantly higher bone regeneration rates than the group that used absorbable collagen sponge as a carrier (Group 1-3). CONCLUSION: The use of rhBMP-2 after oral surgery results in a superior bone regeneration rate compared to not using rhBMP-2, and its efficacy depends on the carriers it is used with. Allograft affects bone regeneration more than absorbable collagen sponge when it is carried with rhBMP-2. Therefore, the appropriate use of rhBMP-2 with suitable bone grafting materials is useful for promoting postoperative bone regeneration in oral surgery.

Associations between obstructive sleep apnea and painful temporomandibular disorder: a systematic review.

The relationship between obstructive sleep apnea (OSA) and diverse types of pain conditions have been proposed. However, no consensus on the relationship between OSA and painful temporomandibular disorders (TMDs) has been established. Therefore, this systematic review has been conducted to review the existing literatures and provide comprehensive synthesis of such literatures about OSA and painful TMDs using the evidence-based methodology. A literature search was conducted using two electronic databases, Scopus, and PubMed. Risk of bias was assessed using the risk-ofbias assessment tool for non-randomized study version 2.0. A total of 158 articles were screened from the initial search and eventually, 5 articles were included in this systematic review. One study adopted both the longitudinal prospective cohort and case-control designs and other 4 articles adopted the cross-sectional design. Two studies employed polysomnography (PSG) for the diagnosis of OSA and mentioned the results from the PSG. All crosssectional studies demonstrated higher OSA prevalence among patients with TMD, and one cohort study suggested OSA as a risk factor for TMD. OSA appears to have potential influences on the development of TMD; however, the role of TMD in the development of OSA remains to be unknown owing to the lack of high-quality evidences.

Does risk of obstructive sleep apnea have interaction with chronic facial pain?

Objectives: The main purpose of the present study was to investigate the associations between the risk of obstructive sleep apnea (OSA) and chronic orofacial pain in a nationally representative sample of the Korean population. Materials and Methods: Data from the 8th wave Korean national health and nutrition examination survey, which was conducted from 2019 to 2020 were analyzed. This study included 5,780 Koreans (2,503 males, 3,277 females) over 40 years of age. The presence of subjective chronic facial pain lasting more than 3 months was evaluated based on a self-reported questionnaire. The risk of OSA was determined using the STOP-BANG questionnaire. Data related to anthropometric and sociodemographic factors; diagnostic history of hypertension, depression, and OSA; level of health-related quality of life and stress awareness; health-related behaviors, including smoking and alcohol drinking; and sleep duration were collected. The participants were classified into two groups according to the presence of chronic facial pain. Results: The level of health-related quality of life and stress awareness showed significant differences between the two groups. The sleep duration on weekends also presented significant differences. No significant differences were observed in the presence of snoring and observed apnea, while participants with chronic facial pain showed significantly higher levels of tiredness between the groups. The risk of OSA evaluated by STOP-BANG questionnaire showed significant differences between groups; however, the risk of OSA seemed to be higher in participants without chronic facial pain. Conclusion: The participants with chronic facial pain demonstrated decreased sleep duration, lower health-related quality of life, and increased stress and tiredness. Even though, the role of OSA in the development of chronic facial pain was inconclusive from the study, it is possible that ethnicity play a role in relationship between OSA and chronic facial pain.

Radiographic changes of mandibular cortical bone in bisphosphonate drug holiday.

Objectives: There have been few studies to date on the residual effect of bisphosphonate. This study investigated the radiographic changes of mandibular cortical thickness upon bisphosphonate drug holiday. Materials and Methods: This retrospective study includes 36 patients diagnosed with MRONJ (medication-related osteonecrosis of the jaw) at Ajou University Dental Hospital in 2010-2021. All patients stopped taking bisphosphonate under consultation with the prescribing physicians. Panoramic radiographs were taken at the start of discontinuation (T0), 12 months after (T1), and 18 months after (T2) discontinuation of bisphosphonate, respectively. Mental index and panoramic mandibular index were calculated using Ledgerton's method. Paired t-tests were used to analyze differences over time. Results: The difference in indices (mental index and panoramic mandibular index) between T0 and T1 was not statistically significant (paired t-test, P>0.05). However, the difference in these indices between T1 and T2 was statistically significant (paired t-test, P<0.05). Conclusion: The cortical thickness of the mandible decreased in the late stage (after 18 months) as observed by panoramic radiograph.

Influencing factors for cure of clonorchiasis by praziquantel therapy: infection burden and CYP3A5 gene polymorphism.

Chemotherapy of clonorchiasis with praziquantel (PZQ) is effective but about 15% of treated cases have been reported uncured. The present study investigated correlation of single nucleotide polymorphisms (SNPs) of the cytochrome P450 gene, CYP3A5 and cure of clonorchiasis. A total of 346 egg passing residents were subjected and treated by 3 doses of 25 mg/kg PZQ. Reexamination recognized 33 (9.5%) uncured and 313 cured. Numbers of eggs per gram of feces (EPGs) before treatment were significantly lower in the cured group than in the uncured group (2,011.2±3,600.0 vs 4,998.5±7,012.0, P<0.001). DNAs of the subjects were screened for SNPs at 7 locations of CYP3A5 using PCR. In the uncured group, the SNP frequencies at g.-20555G>A and g.27526C>T of CYP3A5 were 15.2% and 9.1% while those were 3.8% and 1.0%, respectively, in the cured group. The cure rate was significantly lower in the cases with SNP at g.27526C>T and EPGs≥1,000. In conclusion, EPGs and SNPs of CYP3A5 are factors which influence cure of clonorchiasis by PZQ therapy. It is strongly suggested to recommend 2-day medication for individuals with high EPGs≥1,000.

Postoperative changes in the pharyngeal airway space through computed tomography evaluation after mandibular setback surgery in skeletal class III patients: 1-year follow-up.

BACKGROUND: This study evaluated the pharyngeal airway space changes up to 1 year after bilateral sagittal split osteotomy mandibular setback surgery and bimaxillary surgery with maxillary posterior impaction through three-dimensional computed tomography analysis. METHODS: A total of 37 patients diagnosed with skeletal class III malocclusion underwent bilateral sagittal split osteotomy setback surgery only (group 1, n = 23) or bimaxillary surgery with posterior impaction (group 2, n = 14). Cone-beam computed tomography scans were taken before surgery (T0), 2 months after surgery (T1), 6 months after surgery (T2), and 1 year after surgery (T3). The nasopharynx (Nph), oropharynx (Oph), hypopharynx (Hph) volume, and anteroposterior distance were measured through the InVivo Dental Application version 5. RESULTS: In group 1, Oph AP, Oph volume, Hph volume, and whole pharynx volume were significantly decreased after the surgery (T1) and maintained. In group 2, Oph volume and whole pharynx volume were decreased (T2) and relapsed at 1 year postoperatively (T3). CONCLUSION: In class III malocclusion patients, mandibular setback surgery only showed a greater reduction in pharyngeal airway than bimaxillary surgery at 1 year postoperatively, and bimaxillary surgery was more stable in terms of airway. Therefore, it is important to evaluate the airway before surgery and include it in the surgical plan.

Hospital Dentistry for Intensive Care Unit Patients: A Comprehensive Review.

This study aimed to review the oral hygiene status, oral care guidelines, and outcomes of oral care in intensive care unit (ICU) patients from a dental perspective for effective oral care. A literature search using the keywords "Hospital dentistry" OR "Oral care" OR "Intensive care unit" OR "Hospital inpatient" OR "Hospitalization" OR "Emergency service" AND "Oral health" OR "Oral hygiene" OR "Dental plaque" was conducted in PubMed, Medline, and Google Scholar to identify publications reporting on the oral care of the patients admitted to ICUs. A total of 17,400 articles were initially identified. Of these, 58 were selected and classified into three categories for critical review. Seven of these studies evaluated the oral status of ICU patients, and most of the studies indicated that ICU patients had poor oral hygiene or required active dental treatment. Thirty-three of these studies evaluated oral care methods for ICU patients, and in general, oral care methods using chlorhexidine as adjuncts along with tooth brushing were recommended. However, there were insufficient studies to evaluate oral hygiene through effective assessment tools from a dental perspective. In 36 studies on the outcomes of oral care in ICU patients, interventions by dental professionals showed effective results in preventing hospital-acquired infection. This review highlights the importance of establishing guidelines for the evaluation of oral status in ICU patients and summarizes data that may be useful for future studies. Further studies on maintaining good oral hygiene among ICU patients are needed.

Allogeneic Dentin Graft: A Review on Its Osteoinductivity and Antigenicity.

Studies on allogeneic demineralized dentin matrix (Allo-DDM) implantation in the 1960s and 1970s provided the most reliable preclinical evidence of bone formation and antigenicity in an extraosseous site. Recently, applications of Allo-DDM at skeletal sites were studied, and have provided reliable evidence of bone-forming capacity and negligible antigenicity. However, the osteoinductivity and antigenicity properties of Allo-DDM in extraskeletal sites have not yet been investigated due to the lack of follow-up studies after the initial research. The clinical applications of autogenous DDM (Auto-DDM) have been standardized in some countries. Long-term clinical studies have reported the development of several shapes of Auto-DDM, such as powders, blocks, moldable forms, and composites, with recombinant human bone morphogenetic protein-2. For the development of Allo-DDM as a reliable bone graft substitute next to Auto-DDM, we reviewed preclinical studies on the bone induction capacity of allogeneic dentin at extraskeletal as well as skeletal sites. Electronic databases were screened for this review in January 2020 and searched from 1960 to 2019. This review aims to provide a foundation on the preclinical studies of Allo-DDM, which could enable future researches on its osteogenic capability and antigenicity. In conclusion, Allo-DDM showed great potential for osteoinductivity in extraskeletal sites with low antigenicity, which neither adversely affected osteogenic capability nor provoked immunologic reactions. However, the risk of viral disease transmission should be researched before the clinical application of Allo-DDM.

Medication Related Osteonecrosis of the Jaw: 2021 Position Statement of the Korean Society for Bone and Mineral Research and the Korean Association of Oral and Maxillofacial Surgeons.

Antiresorptives are the most widely prescribed drugs for the treatment of osteoporosis. They are also used in malignant bone metastases, multiple myeloma, and Paget's disease, and provide therapeutic efficacy on those diseases. However, it was reported that the occurrence of osteonecrosis of the jaw (ONJ) could be related to antiresorptive exposures, and there have been many cases regarding this issue. Therefore, a clearer definition and treatment guidelines were needed for this disease. The American Society for Bone and Mineral Research and the Amnerican Association of Oral and Maxillofacial Surgeons reported statements on bisphosphonate-related ONJ (BRONJ), and a revised version was recently presented. In the revised edition, the diagnosis BRONJ was changed to medication-related ONJ (MRONJ), which reflects consideration of the fact that ONJ also occurs for denosumab, a bone resorption inhibitor of the receptor activator of the nuclear factor-κB ligand antibody family, and bevacizumab, an anti-angiogenesis inhibitor. The Korean Society for Bone and Mineral Research and the Korean Association of Oral and Maxillofacial Surgeons had collectively formed a task force for the preparation of an official statement on MRONJ based on a previous position paper in 2015. The task force reviewed current knowledge and coordinated dental and medical opinions to propose the guideline customized for the local Korean situation.

Outfracture osteotomy on lateral maxillary wall as a modified sinus graft technique.

PURPOSE: The purpose of this study was to provide feasibility of a new technique of sinus graft: outfracture osteotomy sinus graft. MATERIALS AND METHODS: The author modified the window opening method from the original trapdoor technique to an outfracturing and readaptation technique. It provides a few advantages in dental implant treatment of atrophic maxillary posterior edentulous alveolar ridges: 1) in combined cases of height and width problems; 2) in cases with anatomic problems such as sinus septum, thick lateral sinus wall, and intrabony bleedings; 3) possible use of the outfractured bony segment as a covering membrane. RESULTS: The follow-up of 34 patients (40 cases; 6 bilateral cases) revealed good results without a case of graft failure and showed excellent survival and function of the dental implants. CONCLUSION: The sinus graft technique was modified as the author outfractured and readapted the bony lateral window, with several advantages as mentioned above. This new outfracture osteotomy sinus graft technique has excellent results as an alternative to the original trapdoor technique.

Relationship of synovial tumor necrosis factor alpha and interleukin 6 to temporomandibular disorder.

PURPOSE: The purpose of this study was to elucidate the relationship of tumor necrosis factor alpha (TNF-alpha) and interleukin 6 (IL-6) to temporomandibular disorder with clinical symptoms such as pain, joint sounds, and mouth opening limitation by analysis of the level of these molecules in the synovial fluid. PATIENTS AND METHODS: Twenty-four patients with chief complaints of pain, mouth opening limitation, and clicking sounds were selected as the experimental group and compared with 5 healthy subjects. After joint lavage with arthrocentesis, diluted synovial fluid was collected and enzyme-linked immunosorbent assay was done for analysis of TNF-alpha and IL-6 in 24 experimental patients and 5 healthy subjects. RESULTS: The synovial levels of TNF-alpha and IL-6 were elevated in the experimental group compared with the healthy control group, but no significant correlation was established. The synovial levels of TNF-alpha and IL-6 were elevated in the acute pain group compared with the chronic pain group, but no significant correlation was established. CONCLUSION: In our analysis of 2 proinflammatory cytokines, TNF-alpha and IL-6, in the synovial fluid of temporomandibular disorder patients with symptoms of pain, mouth opening limitation, and clicking, both were elevated without statistical significance.

Regenerative effect of recombinant human bone morphogenetic protein-2/absorbable collagen sponge (rhBMP-2/ACS) after sequestrectomy of medication-related osteonecrosis of the jaw (MRONJ).

OBJECTIVES: Beyond the original application approved by the U.S. Food and Drug Administration, recombinant human bone morphogenetic protein-2 (rhBMP-2) is used for medication-related osteonecrosis of the jaw (MRONJ) treatment because of its bone remodeling enhancement properties. The purpose of the study was to investigate the bone formation effect of rhBMP-2/absorbable collagen sponge (ACS) in patients with MRONJ. MATERIALS AND METHODS: In this retrospective cohort study, 26 female patients diagnosed with MRONJ and who underwent mandibular sequestrectomy at Ajou University Dental Hospital from 2010 to 2018 were included. The experimental group was composed of 18 patients who received rhBMP-2/ACS after sequestrectomy, while the control group was composed of 8 patients who did not receive rhBMP-2/ACS after sequestrectomy. A total dose of 0.5 mg of rhBMP-2 was used in the experimental group at a concentration of 0.5 mg/mL. Follow-up panoramic X-rays were taken immediately after the surgery and more than 6 months after the surgery. Using those X-rays, a radiographic index of bone defect area was calculated using the modified Ihan Hren method, which measures radiographic density of the normal bone and the defect site. RESULTS: This study suggests that rhBMP-2 contributes to new bone formation. The mean radiographic index immediately after surgery and more than 6 months after the surgery for the experimental group was 68.4% and 79.8%, respectively. The mean radiographic index immediately after surgery and more than 6 months after the surgery for the control group was 73.4% and 76.7%, respectively (Wilcoxon signed rank test, P>0.05). The mean radiographic index increased 11.4% in the experimental group and 3.27% in the control group (Mann-Whitney U-test, P <0.05). CONCLUSION: Based on the results, use of rhBMP-2/ACS on bone defect sites after sequestrectomy could be a successful strategy for treatment of MRONJ patients.

Single nucleotide polymorphisms of cytokine genes are associated with fibrosis of the intrahepatic bile duct wall in human clonorchiasis.

This study examined the association of cytokine gene polymorphisms with intrahepatic bile duct wall fibrosis in human clonorchiasis. A total of 240 residents in Heilongjiang, China underwent ultrasonography, blood sampling, and stool examination. Single nucleotide polymorphism (SNP) sites for IFN-gamma (+874 T/A), IL-10 (-1,082 G/A, -819 C/T, -592 C/A), TNF-alpha (-308 G/A), and TGF-beta1 (codon 10 T/C, codon 25 G/C) genes were observed with the TaqMan allelic discrimination assay. No significant correlation was observed between individual cytokine gene polymorphisms and intrahepatic duct dilatation (IHDD). Among individuals with clonorchiasis of moderate intensity, the incidence of IHDD was high in those with IFN-gamma intermediate-producing genotype, +874AT (80.0%, P = 0.177), and in those with TNF-alpha low-producing genotype, -308GG (63.0%, P = 0.148). According to the combination of IFN-gamma and TNF-alpha genotypes, the risks for IHDD could be stratified into high (intermediate-producing IFN-gamma and low producing TNF-alpha), moderate, and low (low-producing IFN-gamma and high producing TNF-alpha) risk groups. The incidence of IHDD was significantly different among these groups (P = 0.022): 88.9% (odds ratio, OR = 24.0) in high, 56.5% (OR = 3.9) in moderate, and 25.0% (OR = 1) in low risk groups. SNP of IFN-gamma and TNF-alpha genes may contribute to the modulation of fibrosis in the intrahepatic bile duct wall in clonorchiasis patients.

Relationship among Cervical Spine Degeneration, Head and Neck postures, and Myofascial Pain in Masticatory and Cervical Muscles in Elderly with Temporomandibular Disorder.

OBJECTIVES: The aim of the study was to verify associations among degenerative changes in the cervical spine, head and neck postures, and myofascial pain in the craniocervical musculature in elderly with myofascial temporomandibular disorders (TMDs). METHODS: A total of 120 participants (mean age, 68.3 ± 7.5 years) were included: 45 participants had no signs of orofacial or cervical pain, 26 participants had myofascial TMD only (mTMD), and 49 participants had both myofascial TMD and cervical pain (cerTMD). Participants were diagnosed according to the Research Diagnostic Criteria for Temporomandibular Disorders. Cervical spine degeneration and head and neck postures were identified using the lateral cephalogram. Myofascial trigger points (TrPs) were evaluated in the temporalis, masseter, trapezius, sternocleidomastoid, sub-occipitalis, and splenius capitis muscles. Relationships among number of TrPs, head postures, and cervical degeneration were investigated using repeated-measure analysis of variance and Pearson's correlation coefficient. RESULTS: The cerTMD showed higher number of active TrPs in the masticatory and cervical muscles, greater forward head posture, and more severe degenerative changes in the cervical spine than mTMD did. The degenerative changes in each level of the cervical spine had complex interactions with head postures. Cervical degeneration, particularly at level of second to third vertebra appeared to be linked to the development of active TrPs in the masticatory and cervical muscles. CONCLUSIONS: The results of this study demonstrated that degenerative changes in the cervical spine were related to altered head postures and the development of active TrPs in the craniocervical musculature in elderly with myofascial TMD.