Three-dimensional assessment of condylar position following orthognathic surgery using the centric relation bite and the ramal reference line: A retrospective clinical study.

Orthognathic surgery (OGS) is a relatively common procedure for solving functional and aesthetic problems in facial and jaw areas in patients with dentofacial deformities. The positioning of the mandibular condylar segment during OGS has an impact on the surgical outcome. This study aimed to investigate the changes in the condyle-fossa relationship three dimensionally after OGS using the centric relation (CR) bite and the ramal reference line (RRL).Thirty-two patients with skeletal malocclusion underwent OGS. Condylar repositioning was performed using the CR bite, as previously reported. A RRL was added to the existing method and used during the surgery. Cone-beam computed tomography scans were acquired at 4 time points. Sixty-four condyles were evaluated in the coronal, sagittal, and axial views. Two groups were created according to the amount of mandible setback (SB1 vs SB2), and another 2 groups were created according to the maxillary operation (1-jaw vs 2-jaw). Each was then compared at the 4 time points. Differences between the values before (T0) and a year after surgery (T3) were also investigated. The positions of the pogonion and the menton were examined at T2 and T3 for the simple evaluation of relapse.The change in the condylar position was significant over a time-course (P < .001) but not between T0 and T3 (P > .05). Neither the setback amount nor the maxillary operation affected the positional change (P > .05). There were no significant changes between T2 and T3 in the relapse evaluation.This condylar repositioning method using the CR bite and a RRL showed stable results after OGS. This method is noninvasive and cost-effective and can be easily performed even by an inexperienced surgeon because it reduces errors in repositioning the condyle during OGS.

Correlation of Molecular Subtypes of Invasive Ductal Carcinoma of Breast with Glucose Metabolism in FDG PET/CT: Based on the Recommendations of the St. Gallen Consensus Meeting 2013.

PURPOSE: This study aimed to investigate the relationship between the SUVmax of primary breast cancer lesions and the molecular subtypes based on the recommendations of the St. Gallen consensus meeting 2013. METHODS: Clinical records of patients who underwent F-18 FDG PET/CT for initial staging of invasive ductal carcinoma (IDC) of the breast were reviewed. A total of 183 patients were included. SUVmax was correlated with the molecular subtypes defined by the St. Gallen Consensus Meeting 2013, i.e., luminal A-like (LA), luminal B-like HER2 negative (LBHER2-), luminal B-like HER2 positive (LBHER2+), HER2 positive (HER2+), and triple negative (TN), and with the clinicohistopathologic characteristics. RESULTS: The molecular subtype was LA in 38 patients, LBHER2- in 72, LBHER2+ in 21, HER2+ in 30, and TN in 22. The mean SUVmax in the LA, LBHER2-, LBHER2+, HER2+, and TN groups were 4.5 ± 2.3, 7.2 ± 4.9, 7.2 ± 4.3, 10.2 ± 5.5, and 8.8 ± 7.1, respectively. Although SUVmax differed significantly among these subtypes (p < 0.001), the values showed a wide overlap. Optimal cut-off SUVmax to differentiate LA from LBHER2-, LBHER2+, HER2+ and TN were 5.9, 5.8, 7.5, and 10.2 respectively, with area under curve (AUC) of 0.648, 0.709, 0.833, and 0.697 respectively. The cut-off value of 5.9 yielded the highest accuracy for differentiation between the LA and non-LA subtypes, with sensitivity, specificity, and AUC of 79.4 %, 57.9 %, and 0.704 respectively. CONCLUSION: The SUVmax showed a significant correlation with the molecular subtype. Although SUVmax measurements could be used along with immunohistochemical analysis for differentiating between molecular subtypes, its application to individual patients may be limited due to the wide overlaps in SUVmax.

Expression of inflammatory cytokines and MMPs on replanted teeth at different extra-alveolar time: an ex vivo and in vivo study.

BACKGROUND: Immediately after the avulsed tooth is replanted, a complex inflammatory response ensues. As part of the periodontium healing process, the extracellular matrix macromolecules are essential to create the cellular environment required during healing and morphogenesis. AIM: This study was designed to evaluate the correlation between different extra-alveolar dry times and inflammatory cytokines and matrix metalloproteinases (MMPs) as part of the periodontal ligament (PDL) gene expression. DESIGN: The first phase of the study aimed testing human PDL cells ex vivo. Extracted teeth were dried for 15 and 30 min. The PDL cells were extracted and analyzed by qRT-PCR. The second phase was performed in vivo, and 36 Sprague Dawley rat first maxillary molars were extracted and replanted after 15, 30, and 60 min extra-alveolar time. We tested the levels of inflammatory cytokines and MMPS in periodontal tissue at 3, 7, and 28 days after tooth replantation. The replanted area was dissected, grounded, and analyzed by RT-PCR. RESULTS: Expressions of IL-1ß, IL-6, TNF-α, and MMP-3 and MMP-9 were significantly higher in the replanted teeth. Extended dry time had a direct correlation with induction of pro-inflammatory cytokine and MMPs in PDL cells. CONCLUSION: Our study showed that pro-inflammatory cytokines were more significantly expressed in the tissues surrounding the replanted teeth. Future research must be undertaken to additionally confirm the release of these cytokines and be focused on the inhibition of these cytokines to reduce inflammation of replanted teeth.

Differences in Clinical Outcomes between Luminal A and B Type Breast Cancers according to the St. Gallen Consensus 2013.

PURPOSE: Human epidermal growth factor receptor 2 (HER2)-positive luminal B type comprises estrogen receptor (ER)-positive and HER2-positive cancers, and HER2-negative luminal B type comprises ER-positive cancers showing a Ki-67 labeling index ≥14% or progesterone receptor (PR) expression of <20% according to the St. Gallen consensus 2013. The current study aimed to classify intrinsic subtypes according to the St. Gallen consensus 2013 and determine the differences in clinicopathological parameters and survival outcomes among the molecular types, especially among the luminal types. METHODS: Assessment of molecular types was performed for 267 invasive ductal carcinomas. The differences in clinicopathological parameters, disease-free survival (DFS), and overall survival (OS) among the molecular types were analyzed. RESULTS: The luminal B type was the most prevalent, at 44.9%, followed by the luminal A, triple-negative (including basal-like type), and HER2 type, at 21.7%, 18.7%, and 14.6%, respectively. There were statistically significant differences in size (p=0.003), nodal status (p=0.046), histologic grade (p<0.001), p53 (p<0.001) and cyclooxygenase 2 (COX-2) positivity (p=0.002), recurrence (p=0.001) and death rates (p=0.036), DFS (p=0.002), and OS (p=0.039) among the molecular types. Significant differences in size (p=0.009), nodal metastasis (p=0.019), histologic grade (p<0.001), p53 positivity (p=0.001), and PR expression (p<0.001) were noted between the luminal A and B types. Among the luminal B type cancers, the distributions of ER and PR scores showed significant differences (p=0.003, p=0.003). p53 positivity in the luminal B type cancers was related to shortened DFS (p=0.034). In luminal type cancers, COX-2 positivity was related to longer DFS (p=0.026). CONCLUSION: Different management guidelines should be considered for the luminal A and luminal B breast cancer types. Positive p53 expression in luminal B type cancers and negative COX-2 expression in luminal type cancers seem to be related to poor clinical outcome.

A case of ampullary gangliocytic paraganglioma.

Gangliocytic paragangliomas (GPs) are rare tumors of the duodenum, presenting as single sessile or pedunculated polypoid masses. Clinical manifestations of duodenal GPs can vary from an incidental finding at endoscopy to frequent upper gastrointestinal bleeding caused by mucosal ulceration and abdominal pain. GPs are considered benign, but the disease can recur and spread to regional lymph nodes. A 41-year-old female presented with abdominal pain. Upper gastrointestinal endoscopy revealed a subepithelial tumor of the ampulla of Vater in the second portion of the duodenum. The tumor was resected using the endoscopic mucosal resection technique. The tumor was diagnosed as benign GP of the duodenum using histological and immunohistochemical staining procedures.

Diagnostic difficulties in fine needle aspiration of benign salivary glandular lesions.

BACKGROUND: The diagnostic accuracy of fine needle aspiration cytology (FNAC) of salivary lesions is relatively high, but cytologic interpretation might be confusing if the sample is lacking typical cytologic features. METHODS: There were 77 cases of benign salivary lesions, consisting of pleomorphic adenoma (PA) in 61 cases, Warthin's tumor (WT) in 12 cases, and other benign lesions in 4 cases. The causes of the discrepancies between the FNAC and the histologic diagnoses were evaluated. RESULTS: Major discrepancies were noted in 4 of the 61 PA cases, and in 1 of 12 WT cases. The causes of the major discrepancies were a mislabeled site in 1 PA and 1 WT case, and an interpretation error in 3 PA cases. Minor discrepancies were more common in the WT cases (7 of 12 cases) than in the PA cases (11 of 61 cases). The causes of the minor discrepancies were a mislabeled site in 1 PA and 1 WT case, an inadequate sample in 7 PA and 2 WT cases, a lack of typical cytomorphology in 2 PA and 2 WT cases, and an interpretation error in 1 PA and 2 WT cases. CONCLUSIONS: To increase the diagnostic accuracy in the benign salivary lesions, recognition of both characteristic and less typical cytomorphology is needed.

Immuno-stimulating effect of the endo-polysaccharide produced by submerged culture of Inonotus obliquus.

Inonotus obliquus BELYU1102 was selected from 12 different strains of Inonotus as a producer of immuno-stimulating polysaccharide. After a batch fermentation of I. obliquus BELYU1102 was carried out in a 300 l pilot vessel, endo-polysaccharide and exo-polysaccharide were both obtained. The proliferation activity of endo-polysaccharide for splenic cells was much higher than the activity of exo-polysaccharide. The active endo-polysaccharide was produced primarily during the late stationary phase. Enhanced proliferation and polyclonal IgM antibody production were observed in B cells by purified water-soluble endo-polysaccharide. Nitrite production and expression of IL-1beta, IL-6, TNF-alpha, and iNOS in macrophages were also enhanced. However, the endo-polysaccharide did not affect the proliferation of T cells, the IL-2 expression of Th1 cells, or the IL-4 expression of Th2 cells. The endo-polysaccharide showed activities similar to lipopolysaccharide (LPS) for B cells and macrophages, but there was a large difference between the two polysaccharides because cellular activations induced by endo-polysaccharide were not affected by polymyxin B, a specific inhibitor of LPS. The endo-polysaccharide appeared to have other cellular binding sites with TLR-4 and did not show a direct toxicity against tumor cells. However, indirect anti-cancer effects via immuno-stimulation were observed. The mycelial endo-polysaccharide of I. obliquus is a candidate for use as an immune response modifier. Submerged mycelial cultures are advantageous for industrial production of polysaccharides.