Abdominal Actinomycotic Abscess after Laparoscopic Sleeve Gastrectomy for Morbid Obesity: A Case Report.

Actinomycosis is a rare, chronic, suppurative, and granulomatous bacterial disease. The Actinomyces species exist as normal flora in the oropharynx, gastrointestinal tract, and the female genital tract. They are incapable of penetrating the normal mucous membranes and become pathogenic only when this barrier has been destroyed by trauma, surgery, immunosuppression, or after viscus perforation. We report the first case of an actinomycotic abscess after laparoscopic sleeve gastrectomy. A 29-year-old man underwent a laparoscopic sleeve gastrectomy with no intra-operative complications. On postoperative day 3, the patient had a fever with elevated inflammatory markers. Abdominal computerized tomography (CT) with oral water-soluble contrast media showed no extra-luminal leakage and no fluid collection adjacent to the resected stomach, other than the fluid collection in the right subhepatic space. Percutaneous drainage was attempted, but the procedure failed due to the patient's thick abdominal wall. After two weeks of weight loss of about 12 kg, percutaneous drainage was successfully performed, and A. odontolyticus was identified through pus culture. After effective abscess drainage and high-dose antibiotics, the patient's symptoms improved and the abscess pocket disappeared. We reported Actinomyces infection after gastric sleeve surgery. In the case of abscess formation after gastric sleeve surgery caused by actinomycete infection, antibiotic treatment and percutaneous drainage are effective together.

Performance evaluation of biodegradable polymer sirolimus and ascorbic acid eluting stent systems.

The purpose of this study was to evaluate the performance of biodegradable polymer sirolimus and ascorbic acid eluting stent systems with four commercially available drug-eluting stents (DES). We investigated the characterization of mechanical properties by dimension, foreshortening, recoil, radial force, crossing profile, folding shape, trackability, and dislodgement force. Additionally, we identify the safety and efficacy evaluation through registry experiments. Each foreshortening and recoil of D + Storm® DES is 1.3 and 3.70%, which has better performance than other products. A post-marketing clinical study to evaluate the performance and safety of D + Storm® DES is ongoing in real-world clinical settings. Two hundred one patients were enrolled in this study and have now completed follow-up for up to 1 month. No major adverse cardiovascular event (MACE) occurred in any subjects, confirming the safety of D + Storm® DES in the clinical setting. An additional approximately 100 subjects will be enrolled in the study and the final safety profile will be assessed in 300 patients. In conclusion, this study reported the objective evaluation of DES performance and compared the mechanical responses of four types of DES available in the market. There is little difference between the four cardiovascular stents in terms of mechanical features, and it can help choose the most suitable stent in a specific clinical situation if those features are understood. Graphical abstract.

Controllable fabrication of silver-deposited polyurethane acrylate nanopillar array film as a flexible surface-enhanced Raman scattering (SERS) substrate with high sensitivity and reproducibility.

A controllable method for fabricating flexible surface-enhanced Raman scattering (SERS) substrates is demonstrated by depositing silver onto a flexible nanopillar array film. The flexible nanopillar array film was cost-effectively prepared by replicating an anodic aluminum oxide (AAO) template with UV-curable polyurethane acrylate (PUA) over a large area. Then, the deposition of silver was done by an Ar-assisted thermal evaporation. In the deposition process, the partial pressure of Ar was optimized because it has a significant influence on the SERS intensity through the microstructural changes of silver deposited on PUA nanopillars. In addition, the increase in the nanopillar diameter and height enhanced the SERS intensity obtained at 785-nm excitation because of the increased number of hot spots. However, the agglomeration of Ag-deposited nanopillars, which is caused by high aspect ratios, negatively affected the SERS performance in terms of intensity and standard deviation. The optimized Ag-deposited nanopillar array film with nanopillar diameters and heights of 80 nm and 200 nm exhibited excellent SERS sensitivity and signal reproducibility with stable mechanical flexibility. For application in food and biomedical analysis, it was used for detecting saccharin and peptide and showed a good linear relationship between the SERS intensity and concentration. These findings demonstrate the suitability of our method for the controllable fabrication and optimization of flexible SERS substrates with high sensitivity and reproducibility.

Ideal Reference Lines for Assessment of Facial Asymmetry in Rhinoplasty Patients.

BACKGROUND: Assessing facial asymmetry is important to prevent unsatisfactory results in rhinoplasty. There has yet to be a consensus on reference lines for determining asymmetry. This study aimed to determine ideal reference lines to assess facial asymmetry and identify predictors of subjective perceptions of facial asymmetry. METHODS: Preoperative photographs of 47 patients who underwent rhinoplasty were adjusted according to two reference lines (vertical line from the mid-glabella to Cupid's bow and horizontal interpupillary line). In total, 94 photographs were generated, randomly ordered, and evaluated by two independent observers for anthropometric measurements including six distances (distances from the midline to the medial and lateral canthi, ala, oral commissure, width of midface at maximum distance, and mandible width) and three angles (lateral canthal, lateral alar, and lip margin angles). Photographs were rated by 18 independent observers for subjective perceptions of facial asymmetry. RESULTS: Observers perceived faces as asymmetric if accompanied by nasal deviation, irrespective of the reference line (p < 0.001). Based on the horizontal reference line, subjective perceptions of asymmetry were correlated with the midline to lateral alar margin distance (r = 0.489, p = 0.003) and sum of the distance ratios (r = 0.354, p = 0.037). None of the objective parameters correlated with subjective perceptions when adopting the vertical reference line. A deviated nose and lateral alar angle were significant predictors of subjective perceptions of facial asymmetry. CONCLUSION: To assess facial asymmetry, the horizontal reference line should be determined first followed by the perpendicular vertical line. The nose is the most important feature determining overall facial asymmetry. LEVEL OF EVIDENCE V: "This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 ."

FAM83H and Nectin1 expression are related with survival and relapse of bladder urothelial carcinoma patients.

BACKGROUND: FAM83H was originally reported to be essential for dental enamel formation. However, FAM83H has recently been implicated in tumorigenesis and tumor progression. Analysis of a publicly available gene expression database revealed a significant correlation between FAM83H and Nectin1 mRNA expression and bladder urothelial carcinoma (BUC). Therefore, we investigated the association between FAM83H and Nectin1 expression levels and the survival and recurrence of BUC in BUC patients using a tissue microarray. METHODS: We performed immunohistochemical staining of FAM83H and Nectin1 in 165 human BUC tissue sections, and analyzed the prognostic significance of FAM83H and Nectin1 expression. RESULTS: Both FAM83H and Nectin1 were mainly expressed in the cytoplasm, and their expression was significantly associated. FAM83H expression was significantly correlated with higher histologic grade, higher T stage, higher TNM stage, and recurrence. Nectin1 expression was significantly associated with higher histologic grade and recurrence. Univariate analysis showed FAM83H expression and Nectin1 expression were significantly associated with worse overall survival (OS) and shorter relapse-free survival (RFS) of BUC patients. In multivariate analysis, levels of FAM83H and Nectin1 were independent indicators of shorter survival of BUC patients. CONCLUSIONS: Our results suggest that FAM83H and Nectin1 are important in the progression of BUC, and that expression patterns of these two proteins can be used as prognostic indicators of survival in BUC patients.

Acoustic analyses of snoring sounds using a smartphone in patients undergoing septoplasty and turbinoplasty.

PURPOSE: Several studies have been performed using recently developed smartphone-based acoustic analysis techniques. We investigated the effects of septoplasty and turbinoplasty in patients with nasal septal deviation and turbinate hypertrophy accompanied by snoring by recording the sounds of snoring using a smartphone and performing acoustic analysis. METHODS: A total of 15 male patients who underwent septoplasty with turbinoplasty for snoring and nasal obstruction were included in this prospective study. Preoperatively and 2 months after surgery, their bed partners or caregivers were instructed to record the snoring sounds. The intensity (dB), formant frequencies (F1, F2, F3, and F4), spectrogram pattern, and visual analog scale (VAS) score were analyzed for each subject. RESULTS: Overall snoring sounds improved after surgery in 12/15 (80%) patients, and there was significant improvement in the intensity of snoring sounds after surgery (from 64.17 ± 12.18 dB to 55.62 ± 9.11 dB, p = 0.018). There was a significant difference in the F1 formant frequency before and after surgery (p = 0.031), but there were no significant differences in F2, F3, or F4. The change in F1 indicated that patients changed from mouth breathing to normal breathing. The degree of subjective snoring sounds improved significantly after surgery (VAS: from 5.40 ± 1.55 to 3.80 ± 1.26, p = 0.003). CONCLUSION: Our results confirm that snoring is reduced when nasal congestion is improved, and they demonstrate that smartphone-based acoustic analysis of snoring sounds can be useful for diagnosis.

Simply Fabricated Inexpensive Dual-Polymer-Coated Fabry-Perot Interferometer-Based Temperature Sensors with High Sensitivity.

We designed simply fabricated, highly sensitive, and cost-effective dual-polymer-coated Fabry-Perot interferometer (DFPI)-based temperature sensors by employing thermosensitive polymers and non-thermosensitive polymers, as well as different two successive dip-coating techniques (stepwise dip coating and polymer mixture coating). Seven sensors were fabricated using different polymer combinations for performance optimization. The experiments demonstrated that the stepwise dip-coated dual thermosensitive polymer sensors exhibited the highest sensitivity (2142.5 pm °C-1 for poly(methyl methacrylate)-polycarbonate (PMMA_PC) and 785.5 pm °C-1 for poly(methyl methacrylate)- polystyrene (PMMA_PS)). Conversely, the polymer-mixture-coated sensors yielded low sensitivities (339.5 pm °C-1 for the poly(methyl methacrylate)-polycarbonate mixture (PMMA_PC mixture) and 233.5 pm °C-1 for the poly(methyl methacrylate)-polystyrene mixture (PMMA_PS mixture). Thus, the coating method, polymer selection, and thin air-bubble-free coating are crucial for high-sensitivity DFPI-based sensors. Furthermore, the DFPI-based sensors yielded stable readouts, based on three measurements. Our comprehensive results confirm the effectiveness, reproducibility, stability, fast response, feasibility, and accuracy of temperature measurements using the proposed sensors. The excellent performance and simplicity of our proposed sensors are promising for biomedical, biochemical, and physical applications.

Optimization of 3D hydrogel microenvironment for enhanced hepatic functionality of primary human hepatocytes.

Although primary human hepatocytes (PHHs) are the gold standard in drug efficacy and metabolism studies, long-term survival of PHHs and maintenance of their hepatic function are still challenging. In this study, we focused on the effect of the initial microenvironment on upregulation and long-term preservation of hepatic function of PHHs encapsulated within biodegradable hydrogel systems. PHHs were encapsulated in RGD-functionalized hybrid hydrogels with various degrees of degradability, and their hepatic functionality was analyzed. Regardless of the hydrogel elastic modulus, the combination with nondegradable hydrogels had a predominantly negative effect on the prompt engraftment of PHHs, whereas a degradable hydrogel with intermediate initial degradability was most effective in maintaining hepatic function. Efficient network formation by PHHs and cocultured cells, along with the control of hydrogel degradation, governed the hepatic functionality at an early stage and upon long-term cultivation. Under optimized conditions, expression of genes involved in biological processes such as focal adhesions, cell survival, cytoskeleton formation, and extracellular matrix interactions was significantly higher than that in a control with relatively delayed initial degradation. Thus, we suggest that the orchestrated control of initial cellular remodeling may play an important role in the maintenance of hepatic function in a three-dimensional PHH culture.

Soft tissue expander for vertically atrophied alveolar ridges: Prospective, multicenter, randomized controlled trial.

OBJECTIVES: Conventional guided bone regeneration (GBR) limits the amount of bone graft due to limited soft tissue expansion. We hypothesize that the use of tissue expander will successfully augment soft tissue prior to bone graft, allowing for sufficient amount of grafting which will lead to a more stable and effective vertical bone graft. The authors aimed to evaluate effectiveness of the novel self-inflating tissue expander for vertical augmentation in terms of soft tissue expansion, clinical outcomes, and related complications. MATERIAL AND METHODS: A prospective, multicenter, randomized controlled trial was performed on patients requiring vertical augmentation. For experimental group patients, the tissue expander was subperiosteally implanted and followed by a tunneling bone graft without full flap reflection. Control patients underwent conventional vertical GBR. Primary objectives were to evaluate the dimensional changes of soft tissue and radiographic vertical bone gain and retention. As a secondary outcome, clinical complications and thickness changes of expanded overlying tissue were assessed and analyzed. RESULTS: Twenty-three patients in each group were included. During a 4-week expansion, two of the experimental group showed over-expansion and one showed mucosal perforation associated with previous severe scars. The other patients showed uneventful expansion and mean tissue augmentation was 6.88 ± 1.64 mm vertically. Ultrasonographic measurements of overlying gingiva revealed no thinning after tissue expansion (p > .05). Significantly higher vertical bone gain was shown in the experimental group (5.12 ± 1.25 mm) compared with that in the control patients (4.22 ± 1.15 mm; p < .05). After a 6-month retention period, the mean vertical bone measurement of the controls had decreased to 1.90 mm (55.0% reduction), which was a significantly greater decrease than that in the experimental group (mean 3.55 mm, 30.7% reduction; p < .05). CONCLUSION: Our results demonstrated the effectiveness of tissue expanders followed by tunneling bone graft for vertical augmentation; however, studies comparing the two techniques without tissue expanders are needed to elucidate the net effect of tissue expansion.

Effect of mouth closure on upper airway obstruction in patients with obstructive sleep apnoea exhibiting mouth breathing: a drug-induced sleep endoscopy study.

PURPOSE: Snoring and obstructive sleep apnoea (OSA) exhibit multifactorial aetiologies; mouth breathing increases airway obstruction and upper respiratory tract resistance. Of the many published studies, few have evaluated sleeping subjects. We explored how mouth breathing affected the upper respiratory tract anatomy and OSA during sleep. METHODS: Eighteen patients with OSA, confirmed via full-night polysomnography, were enrolled in this study. We performed drug-induced sleep endoscopy (DISE) and defined obstruction sites before and after mouth closure using commercial mouth strips. We evaluated obstruction sites in two ways, i.e. by grading obstructions using our DISE grading system and measuring the affected areas. Patients who improved by at least one DISE grade were defined as responders. Areas were measured based on DISE videos analysed using ImageJ software. The apnoea-hypopnoea index (AHI) and body mass index (BMI) were recorded. RESULTS: Based on the DISE grade, 40% (7/18) of patients showed obstruction site improvement. When assessed areally, the mean number of pixels improved significantly at both the retropalatal (p = 0.045) and retrolingual (p = 0.019) levels. However, DISE non-responders exhibited no areal improvements. Responders and non-responders did not differ significantly in terms of AHI or BMI (both p < 0.05). CONCLUSIONS: Mouth closure improves or at least does not lead to further deterioration of the upper airway. Improvements were evident at the retropalatal and especially retrolingual levels. Neither the BMI nor the AHI differed between the two groups. However, responders tended to have a higher AHI than non-responders (39.4 vs. 32.8 events/h).

Necrotizing sialometaplasia: a malignant masquerade but questionable precancerous lesion, report of four cases.

BACKGROUND: Necrotizing sialometaplasia (NSM) is an extremely rare benign lesion with an uncertain pathogenesis. The differential diagnosis of this lesion is challenging due to little familiarity with this entity and histologic similarity with carcinomas, especially mucoepidermoid carcinoma (MEC). The purpose of this study is to raise awareness about NSM, which is often overlooked or misdiagnosed as malignancy in a small biopsy. METHODS: We reviewed all biopsy materials taken from the oral cavity in a single institution in Korea from 2012 to 2018 and found 4 cases of NSM out of 726. Clinicopathologic characteristics and comparison with other lesions were discussed. RESULTS: Unlike previous reports, patients in our series were relatively young, and NSM was not related to smoking and not associated with malignancies, although one patient was misdiagnosed with MEC on the basis of the initial biopsy. High-grade squamous dysplasia was observed in one patient; however, all four patients showed excellent prognoses without further management. CONCLUSIONS: A conservative approach is recommendable for necrotizing lesions of the palate in young adults to avoid unnecessary treatment. However, careful monitoring is also required due to uncertainty of premalignant potential.

Association between dental health and obstructive coronary artery disease: an observational study.

BACKGROUND: The association between dental health and coronary artery disease (CAD) remains a topic of debate. This study aimed to investigate the association between dental health and obstructive CAD using multiple dental indices. METHODS: Eighty-eight patients (mean age: 65 years, 86% male) were prospectively enrolled before undergoing coronary CT angiography (n = 52) or invasive coronary angiography (n = 36). Obstructive CAD was defined as luminal stenosis of ≥50% for the left main coronary artery or ≥ 70% for the other epicardial coronary arteries. All patients underwent thorough dental examinations to evaluate 7 dental health indices, including the sum of decayed and filled teeth, the ratio of no restoration, the community periodontal index of treatment needs, clinical attachment loss, the total dental index, the panoramic topography index, and number of lost teeth. RESULTS: Forty patients (45.4%) had obstructive CAD. Among the 7 dental health indices, only the number of lost teeth was significantly associated with obstructive CAD, with patients who had obstructive CAD having significantly more lost teeth than patients without obstructive CAD (13.08 ± 10.4 vs. 5.44 ± 5.74, p < 0.001). The number of lost teeth was correlated with the number of obstructed coronary arteries (p < 0.001). Multiple binary logistic regression analysis revealed that having ≥10 lost teeth was independently associated with the presence of obstructive CAD (odds ratio: 8.02, 95% confidence interval: 1.80-35.64; p = 0.006). CONCLUSIONS: Tooth loss was associated with the presence of obstructive CAD in patients undergoing coronary evaluation. Larger longitudinal studies are needed to determine whether there is a causal relationship between tooth loss and CAD.

Characteristics of patients with acute peripheral facial palsy showing Varicella zoster virus DNA in saliva.

Infection caused by Varicella zoster virus (VZV) is a common etiology of acute peripheral facial palsy (APFP). We aimed to assess the clinical significance of detecting VZV DNA from the saliva of patients with APFP. Saliva collected from 36 patients with unilateral APFP at initial visit was analyzed to detect VZV DNA by polymerase chain reaction. The House-Brackmann (HB) scale was used to evaluate FP severity on admission day, at week 2, and at weeks 10-12 after start of treatment. Among the 28 patients without rash, VZV DNA was detected in 3 patients (10.7%); 6 of 8 patients (75.0%) with rash showed VZV DNA (P = 0.001). VZV DNA-positive patients had worse hearing than VZV DNA-negative patients (P < 0.05). A significantly higher proportion of VZV DNA-negative patients (96.3%) showed complete recovery than VZV DNA-positive patients (55.6%) (P = 0.006). In conclusion, VZV DNA-positive patients had worse hearing and incomplete recovery compared to VZV DNA-negative patients, irrespective of the presence of rash. Tests for the detection of VZV DNA in saliva may be helpful for early differential diagnosis and choosing an appropriate medical treatment of APFP.

Evaluation and optimization of a conventional SPCE for FMD post-vaccination monitoring.

BACKGROUND: Foot-and-mouth disease (FMD) can be controlled by either stamping out or vaccination, a choice which depends on both the economic importance of the livestock sector as well as the disease status. In FMD-free countries with vaccination, such as Korea, vaccination programs should guarantee prevention against transmission of FMD. Monitoring of vaccination programs is also essential for ensuring sufficient coverage that will limit the transmission of FMDV. There are several methods to screen FMD virus (FMDV) structural protein (SP) antibodies including SPCE (Solid-phase competitive ELISA), LPBE (Liquid-phase blocking ELISA), and VNT (Virus neutralization test). Among these, SPCE is widely used for serological monitoring since VNT-the gold standard method-has certain practical limitations, such as high costs in terms of time and labor. However, whether SPCE can ensure the vaccination status of individual animals and whole farms is unclear. In this study, SPCE, LPBE and VNT were compared with respect to correlation with each other and sensitivity at commercial pig farms. RESULTS: The positive results obtained by PrioCHECK SPCE differed from those obtained by LPBE and VNT. The sensitivity of SPCE relative to those of the other tests was fairly low. The raw data of SPCE were most highly correlated with those of VNT with XJ strain, while their positivity and negativity were most highly correlated with LPBE. The results of ROC analysis proposed new cut-off for PrioCHECK SPCE higher than the previous 50% inhibition. CONCLUSIONS: The high false positive rate of PrioCHECK SPCE suggested that high seropositivity by SPCE may not guarantee a true vaccination coverage. Adjusting the cut-off percentage (%) inhibition value for SPCE is needed to address this problem, and it is highly recommended that routine FMDV serological monitoring programs using PrioCHECK SPCE should be combined with alternative methods such as LPBE or VNT.

The Influential Bony Factors and Vectors for Predicting Soft Tissue Responses After Orthognathic Surgery in Mandibular Prognathism.

PURPOSE: We sought to identify the hard tissue points and vectors that have the greatest effect on soft tissue movement after orthognathic surgery in patients with mandibular prognathism. PATIENTS AND METHODS: The present retrospective study involved patients who had undergone mandibular setback surgery with or without maxillary advancement. Multiple linear regression models were adapted to evaluate the association between the 8 hard tissue landmark (predictor variables) changes and 11 soft tissue responses (outcome variables) using the x and y coordinates assessed from superimposed pre- and postoperative 3-dimensional computed tomography images. RESULTS: A total of 50 patients (42 patients had undergone 2-jaw surgery; 8 patients had undergone 1-jaw surgery; mean age 23 ± 4 years) were included in the present study. Our statistical models demonstrated that the horizontal hard tissue changes had a greater influence on the soft tissue responses than did the vertical changes, and these changes were more notable in the lower facial area (lower lip contour and chin profile) than the midfacial area (nasal profile, upper lip contour, upper lip length, and nasolabial angle). In the horizontal soft tissue response model, the soft tissue A point/A point ratio was 0.86:1 (95% confidence interval [CI] 0.674-1.049); the soft tissue B point/B point ratio was almost 1:1 (95% CI 0.919-1.071); and the soft tissue pogonion/pogonion ratio was 0.88:1 (95% CI 0.805-0.963). CONCLUSIONS: Horizontal or vertical bone tissue changes affected both the horizontal and vertical soft tissue changes in most areas. Our study demonstrated that the soft tissue response is not linear but a more complicated and dynamic reaction.

Orthognathic surgery Deteriorates the osseointegration of dental implants: A propensity-matched multicentre cohort study.

This study aimed to investigate the possible influence of the regional acceleratory phenomenon (RAP) on dental implant osseointegration. Orthognathic surgery was set as an intervention for RAP, and a multicentre cohort study of two groups was undertaken. Group O included patients with single implant placement at least 4 months after orthognathic surgery and functional loading for more than 1 year, while controls (Group C) were without any major surgery. Clinical and radiographic assessments of implants, including changes in marginal bone levels, were analysed at baseline, 6- and 12-month follow-up. Bivariate analysis of two groups with propensity score matching was performed. After propensity score matching, all 10 confounding variables had acceptable standardised difference scores (<20%), indicating that the matching procedure had efficiently balanced the two groups. Following the propensity score adjustment, the marginal bone loss was significantly higher in Group O than the control at 6 months (1.66 ± 1.05 mm vs 0.59 ± 0.64 mm, P < 0.001) and 12 months (2.30 ± 1.27 mm vs 0.82 ± 0.78 mm, P < 0.001). Compared to Group C, subjects in Group O had a higher incidence of peri-implant mucositis and implantitis (11.8% vs 1.5%, P = 0.033). Impaired osseointegration of dental implants was associated with orthognathic surgery. Special considerations for peri-implant soft and hard tissue stability should be addressed to obtain ideal treatment results and prognosis for patients who have had prior orthognathic surgery.

Combined Autograft and Bone Cement for Painful Chondroblastoma: A Case Report.

Chondroblastomas of the talus can lead to joint collapse and are often treated using curettage and bone grafting. In the present report, we describe the case of a 19-year-old female with a large chondroblastoma of the talus associated with a secondary aneurysmal cyst. We treated the large cartilage lesion, which involved most of the talus, with an iliac bone graft combined with bone cement to fill the large bone defect and preserve the subchondral bone of the articular surface of the dome of the talus.

Artificially designed recombinant protein composed of multiple epitopes of foot-and-mouth disease virus as a vaccine candidate.

BACKGROUND: Concerns regarding the safety of inactivated foot-and-mouth disease (FMD) vaccine have been raised since it is produced from cultured live FMD virus (FMDV). To overcome this issue, recombinant protein has been studied as an alternative vaccine. RESULTS AND CONCLUSION: We designed a chimerical multi-epitope recombinant protein (5BT), which is comprised of tandem repeats of five B cell epitopes (residue of VP1 136-162) derived from different FMDV variants and one T-cell epitope (residue of 3A 21-35). To increase solubility and stability of 5BT, it was conjugated with BmpB, the membrane protein B of Brachyspira hyodysenteriae (B5BT). Our results indicated that 5BT was susceptible to degradation by host protease and produced with substantial fraction of inclusion body. The stability and solubility of 5BT was greatly increased by conjugating to BmpB. FMDV specific antibodies were observed in the serum of mice immunized with 5BT and B5BT comparable to inactivated FMD vaccine. Sera from 5BT and B5BT groups also exhibited high epitope-specific antibody titers in peptide specific ELISA, indicating that all five epitopes are exposed to the B cell receptor for the antibody reaction. Thus the multi-epitope recombinant protein designed in this study may be a potential candidate as an alternative vaccine against FMDV epidemic variants.

Risk Factor Analysis of Graft Failure With Concomitant Cyst Enucleation of the Jaw Bone: A Retrospective Multicenter Study.

PURPOSE: Cysts are common pathologic entities in the oral and maxillofacial region. Enucleation is commonly used for treatment and is occasionally followed by bone grafting. However, no studies have evaluated factors affecting the failure of grafts used for cystic defects in the oral and maxillofacial region. Therefore, the present study was conducted to determine the risk factors for postoperative graft failure in patients treated with cyst enucleation and simultaneous bone grafting. MATERIALS AND METHODS: Clinical data for 305 patients who had undergone cyst enucleation with simultaneous bone grafting were retrospectively investigated in this multicenter case-and-control study. The predictor variables included host, pathologic, and treatment factors. The outcome variable was success or failure of the bone graft. Descriptive statistics were computed, and the P value was set at .05. RESULTS: Bone graft failure was observed in 48 cases. The mean duration from surgery to failure was 38.7 days. Multivariable logistic regression analysis showed a significant association between graft failure and younger age (odds ratio [OR] = 1.033; P = .016), smoking (OR = 2.598; P = .017), preoperative infection (OR = 4.660; P = .001), large cysts (OR = 1.052; P = .010), impaction of the mandibular third molar in the cystic cavity (OR = 3.021; P = .007), perilesional osteosclerosis (OR = 4.973; P = .001), and the use of mixed non-autogenous and autogenous bone grafts (OR = 3.891; P = .007). CONCLUSIONS: This study provides a list of important factors that should be considered by clinicians planning enucleation and simultaneous bone grafting for cysts in the oral and maxillofacial region.

Nasal Soft Tissue Change Following Bimaxillary Orthognathic Surgery.

OBJECTIVE: The purpose of this study is to identify the correlation between maxillary movement and nasal soft tissue changes on three-dimensional reconstructed cone beam computed tomography (CBCT) images after Le Fort I osteotomy. MATERIALS AND METHODS: The authors also investigate the long-term change of alar base width (ABW) to determine the effect of cinch suture. The authors retrospectively studied 52 subjects (14 males and 38 females) who were treated by bimaxillary orthognathic surgery including Le Fort I osteotomy and mandibular ramus surgery. The landmarks and planes were established on three-dimensional reconstructed CBCT images. The authors measured each parameters preoperatively, 1 month postoperatively, and 1 year postoperatively. RESULTS: There was no significant correlation between the horizontal movement of A-point and the widening of ABW (P < 0.038), nor was there a significant correlation between the vertical movement of A-point and the change of ABW (P < 0.61). There was no significant correlation between horizontal and vertical movement of anterior nasal spine and the widening of ABW, nor was there a significant correlation between the nasal tip length and the vector of maxillary movement. CONCLUSION: There was no significant correlation between the ABW widening and the vector of surgical maxillary movement. The effect and stability of the alar base cinch suture is difficult to determine and require further investigation.