Minimally Invasive Treatment With Zygomatic Complex Fracture Reduction by Percutaneous Bone Hook Traction.

PURPOSE: The purpose of this study was to evaluate the effectiveness of zygomatic complex fracture reduction by percutaneous bone hook traction as a minimally invasive treatment. PATIENTS AND METHODS: A retrospective case series analysis of 24 patients who underwent unilateral isolated zygomatic complex fracture reduction by percutaneous bone hook traction between June 2014 and June 2019 was performed. Patients who complained of other accompanying maxillofacial fractures or ocular problems were excluded. Postoperative radiographs were used to assess the esthetic appearance and treatment response, including complications, in all patients. RESULTS: Operation was performed within a mean time of 5.3 days after injury. Closed reduction by percutaneous bone hook traction was performed in 24 patients. At a regular follow-up period of 6 months, postoperative radiographs showed symmetrical outcomes of facial contours and bony union without zygomatic collapse. All patients were satisfied with the symmetrical contours of the zygomatic complex and experienced no complications. Three of the 7 patients had paresthesia in the infraorbital region after injury and regressed postoperatively. CONCLUSIONS: Percutaneous bone hook traction could be an alternative treatment method for simple noncommunicated zygomatic complex fractures without preoperative ocular problems 7 days after injury. Deep understanding of the operative indication, choosing a suitable operation time, and experienced surgeons are keys to effectively using this economical, reliable, and effective approach.

Long-Term Outcomes of Zygomaticomaxillary Reconstruction With Autologous Bone Grafts Supported by Pedicled Buccal Fat Pad Flap.

PURPOSE: The purpose of this study was to investigate the effectiveness of the pedicle buccal fat pad flap combined with autogenous bone grafts to reconstruct zygomaticomaxillary defects after tumor resection. MATERIALS AND METHODS: A retrospective case series analysis of 11 patients that underwent zygomaticomaxillary reconstruction after tumor resection with autologous bone grafts supported by pedicle buccal fat pad flap as the lining of the maxillary sinus from January 2009 to December 2015 was performed. All the patients underwent computed tomography to measure the aesthetic appearance, bone graft formation, mucosa of the maxillary sinus, and their response to treatment, including complications. RESULTS: With a mean follow-up period of 4.7 years, all patients were pleased with the symmetrical contours of zygomaticomaxillary and symptom improvements of the maxillary sinus except for one patient who complained of transient infraorbital numbness. Recurrence, bone infection or necrosis, and other complications were not observed in the follow-up period. CONCLUSION: Pedicled buccal fat pad flap promotes wound healing and prevents the exposure of bone grafts to the maxillary sinus. This technique may be a promising treatment option when reconstructing complicated zygomaticomaxillary defects.

Odontogenesis and neuronal differentiation characteristics of periodontal ligament stem cells from beagle dog.

Periodontal ligament stem cells (PDLSCs) from beagle dogs had the characteristics of multi-directional differentiation and had great application potential in tissue engineering and cell regenerative medicine. In this study, we analysed the odontogenesis and neuronal differentiation characteristics of PDLSCs in vitro. Results showed that the calcined tooth powder (CTP) and silver nanoparticles (AgNPs) additives could induce the PDLSCs into odontogenesis differentiation; besides, the immunofluorescence staining identified that the high dosage calcined tooth powder (400 µg/mL) significantly facilitated the odontogenesis associated with BMP4 expression. While the nutritional factor (L-glutamine, NGF (nerve growth factor), bFGF (basic fibroblast growth factor), IGF-1 (insulin-like growth factor-1) and EGF (epidermal growth factor)) additives were prior to induce the PDLSCs into neuronal differentiation. Simultaneously, PDLSCs had high proliferation ability with the different supplemented additives. Importantly, the Western blot results also proved the BMP4 and SMAD1 proteins were highly expressed in the induced odontoblast, while the SOX1, NCAM1, GFAP and VEGFA proteins were all obviously expressed in the induced neurons. Hence, PDLSCs had characteristics of both odontogenesis and neuronal differentiation.

[Application of CAD/CAM technique in three-dimensional reconstruction of zygomatic complex defect].

OBJECTIVE: To evaluate the efficacy of computer-aided design and computer-aided manufacturing (CAD/CAM) technique in reconstruction of zygomatic complex defect. METHODS: Three-dimensional computed tomography (3D-CT) and rapid prototyping (RP) techniques were applied to produce facsimile models in 13 patients with zygomatic complex defects resulted from trauma or tumor ablation. The zygomatic complex defect was reconstructed using a mirroring technique by CAD/CAM. Titanium mesh was prefabricated on individual facsimile models and combined with autologous bone graft and pedicled buccal fat pad flap for reconstruction. RESULTS: The measuring data of zygomatic complex defect between facsimile model and intraoperative findings was extremely consistent. The prefabrication of reconstructive titanium mesh was matched with zygomatic complex defect in the surgery. The postoperative 3D-CT image demonstrated the symmetry of reconstructed zygomatic complex. The functional recovery and facial contours were satisfactory in all cases. CONCLUSION: The application of CAD/CAM technique can simulate the surgery procedures accurately, which contributes to shorten the actual operative time. RP techniques can reconstruct the facial contours symmetry and recover the function of zygomatic complex defect.

Notch pathway activation promotes the differentiation of beagle dog periodontal ligament stem cells to Schwann cells.

BACKGROUND: Periodontal ligament stem cells (PDLSCs) have demonstrated the potential for differentiation into many cell types, though the molecular mechanism of their neural differentiation in particular remains largely unknown. OBJECTIVES: The Notch signaling pathway plays a key role in regulating cell differentiation and development. In this article, we explore its potential role in the differentiation of PDLSCs to Schwann cells (SCs). MATERIAL AND METHODS: The PDLSCs were either transfected with viral vectors carrying genetic material for Notch Delta ligands, thereby induced their overexpression, or treated with DAPT (a Notch-pathway-specific inhibitor) to inhibit γ-secretase. The potential effects of Notch signaling on myelination and SCs differentiation were then investigated using western blotting, immunostaining and reverse transcriptase polymerase chain reaction (RT-PCR) to detect the expression of SC-specific marker genes. RESULTS: Specifically inhibiting Notch signaling with DAPT decreased the expression of SC-specific marker genes GFAP, S100 and P75, as well as of SC-myelin-related genes PMP22, MBP, connexin, and P0 in cells undergoing induced differentiation from PDLSCs. Conversely, activating Notch signaling through overexpression of Delta ligands enhanced the expression of SC-specific marker genes as well as myelin-related genes in cells undergoing induced differentiation from PDLSCs. This promotion was reversed by DAPT. CONCLUSIONS: The Notch signaling pathway positively regulated the process of PDLSC differentiation into SCs, and the activation of this signaling was important in maintaining the differentiation of PDLSCs to SCs, and then SC myelination. These results may improve the method of obtaining pure SCs from PDLSCs for transplantation application.

Management of massive venous malformations by percutaneous injection of bleomycin combined with fibrin glue in the head and neck.

PURPOSE: The aim of this study was to evaluate the effectiveness of percutaneous injection of bleomycin combined with fibrin glue in treating massive venous malformations (MVMs) in the head and neck region. MATERIALS AND METHODS: A retrospective case series analysis of 22 patients who underwent percutaneous sclerotherapy between June 2015 and December 2018 was performed. All the patients were examined by comparing the size of the venous malformations (VMs) and their responses to treatment including complications in the follow-up. RESULTS: The follow-up period ranged from 6 to 24 months. Ten patients (10/22) were completely cured and 10 patients (10/22) exhibited excellent size reduction of their VMs. Two patients (2/22) exhibited reasonable size reduction and were recommended to undergo a second sclerotherapy procedure. However, both patients were satisfied with the outcomes and refused subsequent treatment. Neither systemic nor local complications occurred in this study. All the patients were satisfied with their significant size reductions and symptom improvements without recurrences during follow-up. CONCLUSION: Percutaneous injection of bleomycin combined with fibrin glue is a promising treatment option that yielded excellent size reduction with a low risk of complications on MVMs in the head and neck region.

Lipid-Iron Nanoparticle with a Cell Stress Release Mechanism Combined with a Local Alternating Magnetic Field Enables Site-Activated Drug Release.

Most available cancer chemotherapies are based on systemically administered small organic molecules, and only a tiny fraction of the drug reaches the disease site. The approach causes significant side effects and limits the outcome of the therapy. Targeted drug delivery provides an alternative to improve the situation. However, due to the poor release characteristics of the delivery systems, limitations remain. This report presents a new approach to address the challenges using two fundamentally different mechanisms to trigger the release from the liposomal carrier. We use an endogenous disease marker, an enzyme, combined with an externally applied magnetic field, to open the delivery system at the correct time only in the disease site. This site-activated release system is a novel two-switch nanomachine that can be regulated by a cell stress-induced enzyme at the cellular level and be remotely controlled using an applied magnetic field. We tested the concept using sphingomyelin-containing liposomes encapsulated with indocyanine green, fluorescent marker, or the anticancer drug cisplatin. We engineered the liposomes by adding paramagnetic beads to act as a receiver of outside magnetic energy. The developed multifunctional liposomes were characterized in vitro in leakage studies and cell internalization studies. The release system was further studied in vivo in imaging and therapy trials using a squamous cell carcinoma tumor in the mouse as a disease model. In vitro studies showed an increased release of loaded material when stress-related enzyme and magnetic field was applied to the carrier liposomes. The theranostic liposomes were found in tumors, and the improved therapeutic effect was shown in the survival studies.

Acid sphingomyelinase activity as an indicator of the cell stress in HPV-positive and HPV-negative head and neck squamous cell carcinoma.

Human papillomavirus (HPV) infection, especially HPV-16 and HPV-18, has been increasingly associated with head and neck squamous cell carcinoma. The treatment of HPV-positive squamous cell carcinoma has a better response to both radiotherapy and chemotherapy and presents a better prognosis for the patient. Defining the underlying mechanism of the difference might help in developing future treatment options and could be an important factor in personal therapy planning. Endogenously secreted acid sphingomyelinase (ASMase) levels in the cellular stress caused by irradiation and cisplatin were investigated. MTT assay was performed to evaluate the viability of the treated cells. Keratinocytes were used to evaluate the effects of radiation on normal tissues. Irradiation caused a dose-dependent increase in ASMase activity in both SCC9 HPV-negative, and UDSCC2 HPV-positive cells. ASMase activity in UDSCC2 cells was significantly higher than that in SCC9 cells. UDSCC cells were more sensitive to cisplatin treatment than SCC cells, and the dose-response in the activity was observed in long-time treatments when high doses of cisplatin were used. The results of the current study have clearly showed that HPV positivity should be considered as one of the determinative factors which should be considered when tumor treatments are planned. However, further studies are needed to determine the differences in cellular responses and pathways among HPV-negative and HPV-positive cells.

Oral malignant acanthosis nigricans associated with endometrial adenocarcinoma.

We report a 59-year-old patient with malignant acanthosis nigricans associated with metastasis of endometrial carcinoma. The patient presented papillomatosis lesions that appeared to be benign on multiple skins of body folds, particularly on lips. The lesions in lips and axilla had histological characteristic appearances of acanthosis nigricans, while the masses in abdomen and pelvis were metastasis endometrial adenocarcinoma. The article highlights the importance of biopsy and histopathological diagnosis in presumed benign lesions and the role of doctors in screening for body internal tumors.