Exosomes derived from chemically induced human hepatic progenitors inhibit oxidative stress induced cell death.

The emerging field of regenerative medicine has revealed that the exosome contributes to many aspects of development and disease through intercellular communication between donor and recipient cells. However, the biological functions of exosomes secreted from cells have remained largely unexplored. Here, we report that the human hepatic progenitor cells (CdHs)-derived exosome (EXOhCdHs ) plays a crucial role in maintaining cell viability. The inhibition of exosome secretion treatment with GW4869 results in the acceleration of reactive oxygen species (ROS) production, thereby causing a decrease of cell viability. This event provokes inhibition of caspase dependent cell death signaling, leading to a ROS-dependent cell damage response and thus induces promotion of antioxidant gene expression or repair of cell death of hypoxia-exposed cells. Together, these findings show the effect of exosomes in regeneration of liver cells, and offer valuable new insights into liver regeneration.

Radiologic comparative analysis between saline and platelet-rich fibrin filling after hydraulic transcrestal sinus lifting without adjunctive bone graft: A randomized controlled trial.

OBJECTIVES: To evaluate implant survival rate, any complications, and changes in residual alveolar bone height (RABH) using saline or platelet-rich fibrin (PRF) filling after hydraulic transcrestal sinus lifting. METHODS: Dental implants were placed after hydraulic transcrestal sinus lifting and the filling of saline (20 patients) or PRF (20 patients). Outcome measurements were implant survival, any complications, and RABH changes. Cone-beam computed tomography (CBCT) scans were taken and compared preoperatively (T0), immediately postoperatively (T1), at 3 months (T2), 6 months (T3), and 12 months postoperatively (T4), respectively. RESULTS: In a total of 40 patients, 45 implants with a mean length of 10.4 ± 0.8 mm were placed in posterior maxilla of a mean RABH of 6.8 ± 1.1 mm. The increase in RABH peaked at T1, and continuous drooping of the sinus membrane was observed but stabilized at T3. Meanwhile, the gradual increase in the radiopacities was found below the lifted sinus membrane. The PRF filling induced the radiographic intrasinus bone gain of 2.6 ± 1.1 mm, which was significantly more than 1.7 ± 1.0 mm of saline filling at T4 (p < .05). All the implants were in function with no significant complications over the one-year follow-up period. CONCLUSIONS: In this randomized case-control study, the feasibility of hydraulic transcrestal sinus lifting without bone graft was confirmed and PRF might be a better filler to support the elevated sinus membrane. However, adjunctive bone grafting should still be indicated for cases requiring more than 2-3 mm of intrasinus bone gain.

The Prevalence of Sjögren's Syndrome in Rheumatoid Arthritis Patients and Their Clinical Features.

BACKGROUND: To estimate the prevalence of Sjögren's syndrome (SS) in patients with rheumatoid arthritis (RA) and to compare the clinical features of RA patients with and without SS. METHODS: We conducted a retrospective study of RA patients who visited a rheumatology clinic in a tertiary referral hospital in Korea between May 20 and July 22, 2016. All patients fulfilled the classification criteria for RA, and the diagnosis of SS was made clinically by rheumatologists and according to the 2002 American-European Consensus Group (AECG), 2012 American College of Rheumatology (ACR), and 2016 ACR/European League Against Rheumatism (EULAR) classification criteria. The prevalence was estimated as the number of SS patients within the total number of RA patients. The disease activity and treatment pattern of RA were compared between patients with and without SS. RESULTS: Among 827 RA patients, 72 patients (8.7%) were diagnosed with SS by a rheumatologist, though only 60 patients (7.3%) satisfied the 2002 AECG classification criteria for SS. Fifty-two patients (6.3%) and 56 patients (6.8%) fulfilled the 2012 ACR and 2016 ACR/EULAR classification criteria, respectively. The prevalence of SS in RA patients was 10.5%, 17.0%, and 67.6% in rheumatoid factor, antinuclear antibody (≥ 1:80), and anti-Ro antibody positive patients, respectively. CONCLUSION: The prevalence of SS among RA patients was 8.7% according to rheumatologists' diagnosis. The presence of SS did not affect the treatment patterns of RA patients. However, the autoantibody profiles and demographics of RA patients with SS differed from those of patients without SS.

Increased FOXM1 Expression by Cisplatin Inhibits Paclitaxel-Related Apoptosis in Cisplatin-Resistant Human Oral Squamous Cell Carcinoma (OSCC) Cell Lines.

Cisplatin and paclitaxel are commonly used to treat oral cancer, but their use is often limited because of acquired drug resistance. Here, we tested the effects of combined cisplatin and paclitaxel on three parental (YD-8, YD-9, and YD-38) and three cisplatin-resistant (YD-8/CIS, YD-9/CIS, and YD-38/CIS) oral squamous cell carcinoma (OSCC) cell lines using cell proliferation assays and combination index analysis. We detected forkhead box protein M1 (FOXM1) mRNA and protein expression via real-time qPCR and Western blot assays. Cell death of the cisplatin-resistant cell lines in response to these drugs with or without a FOXM1 inhibitor (forkhead domain inhibitory compound 6) was then measured by propidium iodide staining and TdT dUTP nick end labeling (TUNEL) assays. In all six OSCC cell lines, cell growth was more inhibited by paclitaxel alone than combination therapy. Cisplatin-induced overexpression of FOXM1 showed the same trend only in cisplatin-resistant cell lines, indicating that it was associated with inhibition of paclitaxel-related apoptosis. In summary, these results suggest that, in three cisplatin-resistant cell lines, the combination of cisplatin and paclitaxel had an antagonistic effect, likely because cisplatin blocks paclitaxel-induced apoptosis. Cisplatin-induced FOXM1 overexpression may explain the failure of this combination.

Ecoflex-Passivated Graphene-Yarn Composite for a Highly Conductive and Stretchable Strain Sensor.

We present a flexible strain sensor based on a graphene-yarn composite obtained by spray coating of graphene nanoplates. To improve the stretchability, graphene nanoplates were spray-coated instead of dip-coated on pre-stretched yarn. The spray-coating method yielded not only 3.68 times higher conductivity but also 2.1 times higher stretchability compared to the dip-coating method. The sensor spray-coated 400 times showed a high stretchability of 310%. Here, the relative resistance change (ΔR/R0) was 2.27 when a tensile strain of 50% was applied to the strain sensor. In addition, the fabricated sensor was coated with a protective layer of Ecoflex to minimize environmental effects. The passivated graphene-yarn composite sensor had a higher resistance than the unpassivated sensor because the Ecoflex film penetrated the conductive graphene nanoplates; however, the response to strains of up to 200% did not degrade after passivation. Furthermore, we demonstrated that our sensor can be used in wearable applications for monitoring individual finger movements and the wrist pulse.

The relationship between hormone replacement therapy and periodontal disease in postmenopausal women: a cross-sectional study the Korea National Health and Nutrition Examination Survey from 2007 to 2012.

BACKGROUND: The purpose of this study was to investigate the relationship between hormone replacement therapy (HRT) and periodontal disease in postmenopausal women using data from the 4th and 5th Korea National Health and Nutrition Examination Survey (KNHANES). METHODS: The study included data from 5,482 postmenopausal women aged 45-74 years in the 2007-2012 KNHANES. The use of female HRT for at least one month was reclassified as HRT+/HRT-. The Community Periodontal Index of Treatment Needs (CPITN) was used to assess periodontal status. Propensity score matching (PSM) was used to control selection bias, and factors affecting education, family income, and age of menopause were used as covariates in PSM. A chi-square test was used to confirm the bivariate relationship between the variables. Binary logistic regression analysis was used to adjust for confounders (age, education, family income, body mass index, age of menopause, alcohol, smoking, dental clinic visits in the past one year, use of oral care products and frequency of tooth brushing per day). RESULTS: After adjusting for all covariates, HRT was associated with periodontal disease (OR: 0.79; 95% CI: 0.66-0.94). In particular, the relationship between HRT and periodontal disease was more evident in those with menopause under 45 years of age disease (OR: 0.55; 95% CI: 0.35-0.87). CONCLUSIONS: The results of this study supported that it is important that hormone therapy be actively considered in the policy towards postmenopausal women. Especially, health programs such as hormone replacement therapy, non-smoking, and use of oral care products are needed for women who undergo premature menopause.

Does the Pharyngeal Airway Recover After Sagittal Split Ramus Osteotomy for Mandibular Prognathism?

PURPOSE: Mandibular setback surgery can adversely affect the pharyngeal airway. The aim of this study was to investigate changes of the pharyngeal airway at specific intervals during a 12-month period after bilateral sagittal split ramus osteotomy (BSSO) for correction of mandibular prognathism. MATERIALS AND METHODS: This retrospective cohort study included patients with mandibular prognathism who underwent BSSO. The pharyngeal airway was measured at 3 different levels on lateral cephalograms: the uvula tip, the most inferior-anterior point on the body of the second cervical vertebra (low-C II), and a midanterior point on the body of the third cervical vertebra (mid-C III). The pharyngeal airway was measured preoperatively, immediately postoperatively, and 1, 3, 6, and 12 months postoperatively. The measurements at each level were compared. Multivariable analysis of variance was used to measure the changes in pharyngeal airway space over time. RESULTS: The study sample was composed of 30 patients (14 men and 16 women) who were diagnosed with mandibular prognathism. The pharyngeal airway at the uvular tip level was significantly reduced by 39% (P < .001) after surgery and was significantly improved by 26% (P < .01) from baseline at 1 month postoperatively. The pharyngeal airway at the low-C II level was significantly reduced by 27% (P < .001) after surgery and was significantly improved by 24% (P < .01) from baseline at 1 month postoperatively. The pharyngeal airway at the mid-C III level was significantly reduced by 23% (P < .001) after surgery and was improved by only 13% from baseline at 1 month postoperatively. Additional statistical changes were not noted on 3 and 6 months postoperative radiographs at all levels. The pharyngeal airway was decreased by 16, 19, and 8% from baseline at 12 months postoperatively, respectively. The upper airway length was significantly increased immediately after surgery (P < .001), but was incompletely recovered at 12 months postoperatively. CONCLUSION: The outcomes of this study indicate that the pharyngeal airway gradually recovers over time. An immediate postoperative reduction in pharyngeal airway space can induce or exacerbate obstructive sleep apnea symptoms; thus, any pre-existing symptoms should be screened and considered for surgical treatment planning.

Rethinking AASM guideline for split-night polysomnography in Asian patients with obstructive sleep apnea.

PURPOSE: Split-night polysomnography (SN-PSG) provides both a diagnosis and titration of continuous positive airway pressure over a single night in patients with suspected obstructive sleep apnea (OSA). However, in Asian patients, the diagnostic validity of American Academy of Sleep Medicine (AASM) guidelines for SN-PSG remains uncertain. Therefore, we examined whether the current criteria for SN-PSG are pertinent for Asian patients. METHOD: We investigated 134 consecutive patients who were diagnosed with OSA (apnea-hypopnea index (AHI) ≥ 5). We divided the raw data (full-night study) into two parts and compared the first 2 h of sleep with the full night of sleep to evaluate the diagnostic precision and accuracy of the first 2 h of sleep. RESULTS: No difference in AHI was observed between the first 2 h and the full night of sleep. A significant correlation of AHI was observed between the first 2 h and the full night of sleep for severe OSA patients (AHI ≥ 30). A correlation coefficient of AHI was higher by the criterion of AHI ≥ 30 than by the criterion of AHI ≥ 40 (r = 0.831 and r = 0.778, respectively), which is the current AASM criterion for SN-PSG. Moreover, the criterion AHI ≥ 30 showed better diagnostic accuracy than the criterion AHI ≥ 40 (89.3 and 88.7 %, respectively). CONCLUSIONS: This study found possible evidence supporting different diagnostic criteria for SN-PSG in Asian population. We suggest further studies in other Asian populations to confirm these findings.

Sialadenitis Without Sialolithiasis Treated by Sialendoscopy.

PURPOSE: The aim of the present study was to evaluate the effectiveness of interventional sialendoscopy in the management of non-stone obstructive sialadenitis. PATIENTS AND METHODS: In the present retrospective study, we assessed the treatment outcomes of 51 patients (34 women and 17 men) who had been diagnosed with sialadenitis without salivary duct stones. The included patients had an obstructive duct condition coupled with recurrent episodes of swelling or pain in a major salivary gland. The patients who had a sialolith detected during the sialendoscopic procedure or by preoperative imaging were excluded from the present study. The outcomes assessment was based on successful removal of the obstructive etiology during the endoscopic procedure and the absence of clinical symptoms after 6 months. The involved glands included 16 submandibular glands and 35 parotid glands. RESULTS: The sialendoscopic navigation was successful in 43 of 51 patients (84%). Of the 43 patients, 37 (86%) were free of symptoms from the obstructive gland after the endoscopic procedure. Of the 6 patients who were still symptomatic after the procedure, 5 had involvement of the parotid gland. Finally, 1 of the original 37 symptom-free patients developed recurrent symptoms and denied additional treatment, resulting in 36 of 43 patients (84%) remaining asymptomatic 6 months after endoscopic navigation. CONCLUSION: The outcomes of the present study suggest that interventional sialendoscopy can provide symptomatic improvement in most subjects. Clinicians should consider sialendoscopy as a useful and minimally invasive procedure to treat sialadenitis without sialolithiasis.

Tissue-engineered bone with 3-dimensionally printed ß-tricalcium phosphate and polycaprolactone scaffolds and early implantation: an in vivo pilot study in a porcine mandible model.

PURPOSE: Deep bone penetration into implanted scaffolds remains a challenge in tissue engineering. The purpose of this study was to evaluate bone penetration depth within 3-dimensionally (3D) printed ß-tricalcium phosphate (ß-TCP) and polycaprolactone (PCL) scaffolds, seeded with porcine bone marrow progenitor cells (pBMPCs), and implanted early in vivo. MATERIALS AND METHODS: Scaffolds were 3D printed with 50% ß-TCP and 50% PCL. The pBMPCs were harvested, isolated, expanded, and differentiated into osteoblasts. Cells were seeded into the scaffolds and constructs were incubated in a rotational oxygen-permeable bioreactor system for 14 days. Six 2- × 2-cm defects were created in each mandible (N = 2 minipigs). In total, 6 constructs were placed within defects and 6 defects were used as controls (unseeded scaffolds, n = 3; empty defects, n = 3). Eight weeks after surgery, specimens were harvested and analyzed by hematoxylin and eosin (H&E), 4',6-diamidino-2-phenylindole (DAPI), and CD31 staining. Analysis included cell counts, bone penetration, and angiogenesis at the center of the specimens. RESULTS: All specimens (N = 12) showed bone formation similar to native bone at the periphery. Of 6 constructs, 4 exhibited bone formation in the center. Histomorphometric analysis of the H&E-stained sections showed an average of 22.1% of bone in the center of the constructs group compared with 1.87% in the unseeded scaffolds (P < .05). The 2 remaining constructs, which did not display areas of mature bone in the center, showed massive cell penetration depth by DAPI staining, with an average of 2,109 cells/0.57 mm(2) in the center compared with 1,114 cells/0.57 mm(2) in the controls (P < .05). CD31 expression was greater in the center of the constructs compared with the unseeded scaffolds (P < .05). CONCLUSION: 3D printed ß-TCP and PCL scaffolds seeded with pBMPCs and implanted early into porcine mandibular defects display good bone penetration depth. Further study with a larger sample and larger bone defects should be performed before human applications.

Maxillary posterior segmentation using an oscillating saw in Le Fort I posterior or superior movement without pterygomaxillary separation.

PURPOSE: Any remaining tuberosity or pterygoid plate frequently interferes with posterior or superior movement of the maxilla, if no pterygomaxillary separation is performed in low-level Le Fort I osteotomy. The objective of this report is to describe a technique for maxillary posterior segmentation using an oscillating saw in Le Fort I posterior or superior movement without pterygomaxillary separation and to present the authors' preliminary multicenter experience with this technique. MATERIALS AND METHODS: The authors retrospectively evaluated patients who underwent double-jaw surgery at 3 orthognathic surgery centers from May 2010 to December 2012. In all cases, the segmentation procedure was performed using an oscillating saw on a posterior or tuberosity area of the maxilla before downfracture obtained by leverage alone without pterygomaxillary separation, below or near the lower part of the pterygoid plate. RESULTS: In total, 1,231 patients (411 male and 820 female; mean age, 24.9 yr) were enrolled. Mean surgical time for the maxillary procedure was 55.9 minutes. None of the patients received a blood transfusion, and no significant soft or hard tissue complications clinically compromised the healing of the repositioned maxilla. Mean maxillary posterior and superior movements were 3.4 mm (range, 2.1 to 5.6 mm) and 4.0 mm (range, 1.3 to 5.6 mm), respectively. CONCLUSIONS: The preliminary results indicate that this maxillary posterior segmentation procedure using an oscillating saw in low-level stepped Le Fort I osteotomy can be completed safely and effectively for posterior or superior repositioning of the maxilla, with no need to disturb the integrity of the pterygoid plate.

Interventional sialoendoscopy for treatment of obstructive sialadenitis.

PURPOSE: This follow-up study documents the overall success rate of interventional sialoendoscopy; it is a novel, less invasive treatment for obstructive sialadenitis. PATIENTS AND METHODS: This was a retrospective follow-up study of 189 patients who underwent a sialoendoscopic procedure at Massachusetts General Hospital from 2004 through 2013. Included were patients who underwent sialoendoscopic treatment for symptoms and clinical findings consistent with obstructive sialadenitis. Four different interventional sialoendoscopic techniques were used: dilation of stricture and irrigation, stone retrieval by basket, stone fragmentation with lithotripsy or laser, and stone removal by endoscopic-assisted "cutdown" operation using the "modified McGurk" technique. The outcome assessed was whether the patient was asymptomatic at 6 months postoperatively. RESULTS: Interventional endoscopic navigation was accomplished in 164 of 189 patients (87%). In 17 cases, the duct orifice was inaccessible owing to scarring, so the duct could not be navigated. Symptomatic relief was achieved in 148 of 164 patients (90%). Dilatation and lavage for sialadenitis without a stone was accomplished in 52 of 189 patients (28%). Sialoliths were retrieved or fragmented in 137 of 164 cases (84%). CONCLUSION: The results of this study show a high success rate in the treatment of obstructive sialadenitis using interventional sialoendoscopy.

Sex-specific characteristics of anthropometry in patients with obstructive sleep apnea: neck circumference and waist-hip ratio.

OBJECTIVE: This study aimed to investigate the sex-specific effects of anthropometric profiles on the occurrence and severity of obstructive sleep apnea (OSA). METHODS: We evaluated 151 patients with suspected OSA undergoing polysomnography and anthropometric measurements such as body mass index (BMI), neck and waist circumference (NC and WC), and waist-hip ratio (WHR). RESULTS: In men, NC (P = .006), WC (P = .035), and WHR (P = .003) were significantly increased in OSA and all were significantly correlated with apnea hypopnea index (AHI). However, in female OSA patients, BMI (P = .05), WC (P = .008), and WHR (P = .001) were elevated, but only WHR was significantly correlated with AHI. Correlation analyses showed significant correlations between NC and other anthropometric indexes in men but not in women. The receiver operating characteristic curves revealed that NC and WHR in men, and WHR in women, were significant in both model I (AHI > or = 5) and model 2 (AHI > or = 15). CONCLUSION: Waist-hip ratio is the most reliable correlate of OSA in both sexes. Neck circumference is an independent risk factor for male, but not for female, OSA patients. These different aspects of obesity may contribute to the pathogenesis of OSA and provide helpful guidance in the screening of OSA.

Semi-customized three-dimensional ultra-fine titanium meshes in guided bone regeneration for implant therapy in severe alveolar bone defect: a case report.

This case report provides a detailed description of a simple and fast bone regeneration procedure using a semi-customized three-dimensional ultra-fine titanium mesh. A 50-year-old male with a severe vertical and horizontal bone defect in the anterior mandible underwent implant treatment in a staged approach. The autologous bone was combined with a xenograft, and the mixture was grafted to augment the bone defect and covered with semi-customized ultra-fine titanium meshes, which were selected among its various types according to size and configuration of the bone defect, directly connected and immobilized on the tenting screws with minimal shaping. In a postoperative 6 months re-entry surgery, the performed titanium meshes were removed, implants were placed, and a bone core biopsy was obtained that demonstrated satisfactory new bone formation. Finally, two months later, the definitive prosthesis was installed. This semi-customized ultra-fine titanium mesh could help an implant clinician obtain more predictable results in the guided bone regeneration (GBR).

Postoperative effects of anterior nasal spine bone harvesting on overall nasal shape.

AIM: Bone harvesting from the anterior nasal spine (ANS) is frequently used to correct peri-implant bone defects, particularly during implant placement in the anterior maxilla. However, many clinicians are concerned about the postoperative effect of removing the ANS on the nasal outline, as the ANS is integral to supporting the nose. This study aimed to describe the technique of ANS bone grafting and to investigate postoperative effects of bone harvesting from the ANS on the overall nasal shape. MATERIAL AND METHODS: Fifteen patients with single maxillary first incisal rehabilitation using dental implant were enrolled in this prospective clinical study. Simply by extending the subperiosteal dissection in the same surgical field without additional local anesthesia, a bone block of about 0.25-0.5 ml could be harvested from the ANS. Nose width (NW), nasolabial angle (NLA), and nasal tip depth (NTD) were measured and analyzed by lateral and frontal photographs taken preoperatively (T0), and at postoperative 1 week (T1), 3 months (T2), and 6 months (T3). Postoperative complications were also recorded. RESULTS: A significant increase in NW and decrease in both NLA and NTD were found at T1 (P < 0.05). At T3, NW, NLA and NTD returned to preoperative measurements at T0 without major complications. CONCLUSIONS: The ANS could be an effective and easily accessible intraoral source for autologous bone. Despite acute soft tissue swelling, the net postoperative effects of removing the ANS on the overall nasal shape, including on nasal tip collapse or widening of the nose base, were negligible.

Exploration of the interplay between spatially distinct microbial habitats through comparative analysis.

Objectives: The oral microbiome is closely associated with systemic diseases, indicating the presence of bacteremia and inflammatory mediators in the systemic circulation. Our research aims to investigate the relationship between the oral microbiome and other microbial habitats. Methods: We analyzed 180 specimens from 36 patients, including saliva, buccal swab, plaque, stool, and blood samples from a healthy group (Non_PD, n = 18) and a periodontitis group (PD, n = 18). The final analysis included 147 specimens, with varying sample sizes for each group. Metagenomic analysis was performed using prokaryotic 16S rRNA on the MiSeq platform (Illumina). Results: PD saliva showed significant richness differences (P's < 0.05), similar to plaque. Buccal swabs had slight variations. Microbial network analysis revealed altered microbial interactions in the PD group, with decreased interactions in saliva and buccal swabs, and increased interactions in plaque. In our analysis of nine specimens where all paired habitat samples could be analyzed, microorganisms linked to oral periodontitis were found in sterile blood samples, resembling the oral cavity's composition. Conclusions: Microbiome differences should consider overall microbial-environment interactions, alongside diversity and richness. Our data cautiously suggest that disease-related changes in the salivary microbiome may be reflected in blood specimens through the oral-blood axis.

The clinical effectiveness of fused image of single-photon emission CT and facial CT for the evaluation of degenerative change of mandibular condylar head.

BACKGROUND: The primary objective of this study was to assess the clinical effectiveness of fused images obtained from single-photon emission computed tomography (SPECT) and facial computed tomography (CT) for evaluating degenerative changes in the mandibular condylar head. This assessment was accomplished by comparing the Technetium-99 m methylene diphosphonate (99mTc-MDP) uptake ratio with the results of clinical and radiographic findings. METHODS: The study included 17 patients (3 males and 14 females) with suspected osteoarthritis of the mandibular condyle, totaling 34 temporomandibular joints (TMJs). Based on clinical and radiographic examinations, the TMJs were categorized into four groups: normal (group N), internal derangement (group ID), osteoarthritis (group OA), and osteoarthritis sequelae (group OAseq). For each patient, bone SPECT and facial CT scans were registered and reconstructed to create fused SPECT/CT images. The 99mTc-MDP uptake levels in the TMJs were statistically compared among the four groups. RESULTS: The 99mTc-MDP uptake ratio showed a gradual increase in the order of the following: group N, group OAseq, group ID, and group OA. There was a significant difference observed among groups (p = 0.003), mainly driven by the disparity between group OA and both group N (p < 0.001) and group OAseq (p = 0.048). CONCLUSION: Fused SPECT/CT image can be an effective tool for evaluating degenerative changes in the mandibular condylar head. The technique demonstrated the ability to differentiate between normal TMJs and those with internal derangement, osteoarthritis, or osteoarthritis sequelae. This approach holds promise as a valuable method in clinical assessments of TMJ degeneration.

Eosinophil-derived interferon-γ drives transmembrane protein 119-induced new bone formation in chronic rhinosinusitis with nasal polyps.

BACKGROUND: Chronic rhinosinusitis with nasal polyps (CRSwNP) is a chronic inflammatory sinonasal disease characterized by eosinophilic infiltration and new bone formation. These changes indicate the severity and prognosis of CRSwNP and may be closely linked to each other. METHODS: We performed RNA sequencing to screen specific osteogenic molecules and validated transmembrane protein 119 (TMEM119) expression by quantitative polymerase chain reaction (qPCR) and immunohistochemistry analyses. TMEM119 knockdown was performed to observe the downregulation of bone mineralization. We validated the bone-forming activity of interferon-γ (IFN-γ) and its signaling pathways in cultured primary sinus bone cells. Cellular sources of IFN-γ were identified using immunohistochemistry and immunofluorescence analyses. Interleukin-4-eosinophil-IFN-γ axis and the effect of dupilumab were investigated in Eol-1 cells. RESULTS: We observed elevated IFN-γ levels and eosinophils in the nasal fluid and predominantly eosinophil-derived IFN-γ in the sinus mucosa of patients with CRSwNP. TMEM119 expression and bone-forming activities were increased in the osteitic and primary sinus bone cells of CRSwNP. IFN-γ treatment enhanced bone mineralization and TMEM119 expression via signal transducer and activator of transcription 1 (STAT1) signaling. Moreover, TMEM119 knockdown inhibited sinus bone cell mineralization and dupilumab attenuated IFN-γ secretion by IL4-stimulated Eol-1 cells. CONCLUSION: Eosinophil-derived IFN-γ promotes the bone-forming activities of sinus bone cells via the STAT1-TMEM119 signaling pathway. Interleukin-4-eosinophil-IFN-γ axis may be crucial for TMEM119-mediated new bone formation in CRSwNP.

Intra-sinus rigid fixation of a resorbable barrier membrane to repair a large perforation of the sinus membrane: a technical note.

A resorbable barrier membrane is commonly used for the repair of perforated sinus membranes during sinus lifting surgeries. However, repairing largescale perforations poses challenges for clinicians as the protection and isolation of graft material remain uncertain. With this technique, we aimed to prevent graft material loss and subsequent sinus-related complications using intra-sinus rigid fixation of the resorbable barrier membrane in cases with a large perforation of the sinus membrane.

A Randomized Controlled Trial of Guided Bone Regeneration for Peri-Implant Dehiscence Defects with Two Anorganic Bovine Bone Materials Covered by Titanium Meshes.

The aim of this study is to compare two low-temperature sintered anorganic bovine bone materials (ABBMs), Bio-Oss (Geistlich, Wolhusen, Switzerland) and A-Oss (Osstem, Seoul, Korea), for GBR in dehiscence defects. A single implant was placed simultaneously with GBR in the buccal or bucco-proximal osseous defect by double-layering of inner allograft and outer ABBM, covered by a preformed ultrafine titanium mesh and an absorbable collagen membrane. Grafted volume changes were evaluated by cone-beam computed tomography, taken preoperatively (T0), immediately after implant surgery (T1), after re-entry surgery (T2), and after delivery of the final restoration (T3). The density of the regenerated bone was assessed by measuring the probing depth on the buccal mid-center of the mesh after removing the mesh at T2. Postoperative sequelae were also recorded. Grafted volume shrinkage of 46.0% (0.78 ± 0.37 cc) and 40.8% (0.79 ± 0.33 cc) in the Bio-Oss group (8 patients) and A-Oss group (8 patients), respectively, was observed at T3 (p < 0.001). There were no significant differences in grafted volume changes according to time periods or bone density between the two groups. Despite postoperative mesh exposure (3 patients), premature removal of these exposed meshes and additional grafting was not necessary, and all implants were functional over the 1-year follow-up period. Both ABBMs with titanium meshes showed no significant difference in the quantity and density of the regenerated bone after GBR for peri-implant defects.