ABSTRACT
Helical mandibular distraction is theoretically better than linear or circular distraction. However, it is not known whether this more complex treatment will result in unquestionably better outcomes. Therefore, the best attainable outcomes of mandibular distraction osteogenesis were evaluated in silico, given the constraints of linear, circular, and helical motion. This cross-sectional kinematic study included 30 patients with mandibular hypoplasia who had been treated with distraction, or to whom this treatment had been recommended. Demographic information and the computed tomography (CT) scans showing the baseline deformity were collected. The CT scans of each patient were segmented and three-dimensional models of the face created. Then, the ideal distraction outcomes were simulated. Next, the most favorable helical, circular, and linear distraction movements were calculated. Finally, errors were measured: misalignment of key mandibular landmarks, misalignment of the occlusion, and changes in intercondylar distance. Helical distraction produced trivial errors. In contrast, circular and linear distractions resulted in errors that were statistically and clinically significant. Helical distraction also preserved the planned intercondylar distance, while circular and linear distractions led to unwanted changes in the intercondylar distance. It is now evident that helical distraction offers a new strategy to improve the outcomes of mandibular distraction osteogenesis.
Subject(s)
Micrognathism , Osteogenesis, Distraction , Humans , Osteogenesis, Distraction/methods , Cross-Sectional Studies , Facial Asymmetry , Mandible/diagnostic imaging , Mandible/surgery , Mandible/abnormalitiesABSTRACT
The purpose of this ambispective study was to investigate whether deep learning-based automatic segmentation and landmark detection, the SkullEngine, could be used for orthognathic surgical planning. Sixty-one sets of cone beam computed tomography (CBCT) images were automatically inferred for midface, mandible, upper and lower teeth, and 68 landmarks. The experimental group included automatic segmentation and landmarks, while the control group included manual ones that were previously used to plan orthognathic surgery. The qualitative analysis of segmentation showed that all of the automatic results could be used for computer-aided surgical simulation. Among these, 98.4% of midface, 70.5% of mandible, 98.4% of upper teeth, and 93.4% of lower teeth could be directly used without manual revision. The Dice similarity coefficient was 96% and the average symmetric surface distance was 0.1 mm for all four structures. With SkullEngine, it took 4 minutes to complete the automatic segmentation and an additional 10 minutes for a manual touchup. The results also showed the overall mean difference between the two groups was 2.3 mm for the midface and 2.4 mm for the mandible. In summary, the authors believe that automatic segmentation using SkullEngine is ready for daily practice. However, the accuracy of automatic landmark digitization needs to be improved.
Subject(s)
Deep Learning , Orthognathic Surgery , Spiral Cone-Beam Computed Tomography , Humans , Feasibility Studies , Cone-Beam Computed Tomography/methods , Computers , Image Processing, Computer-Assisted/methodsABSTRACT
Digital dental articulation for three-piece maxillary orthognathic surgery is challenging. The purpose of this proof-of-concept study was to evaluate the clinical feasibility of a newly developed mathematical algorithm to digitally establish the final occlusion for three-piece maxillary surgery. Five patients with jaw deformities who had undergone a three-piece double-jaw surgery that was planned virtually were randomly selected for this study. The final occlusion had been hand-articulated using stone casts, scanned into the computer and used in the surgery. These hand-articulated occlusions served as the control group. To form the experimental group, the three-piece maxillary dental arch was articulated again automatically from the patient's original occlusion using the mathematical algorithm. The hand- and algorithm-articulated occlusions were then evaluated qualitatively by two experienced orthodontists. A quantitative evaluation was also performed. The results of the qualitative evaluation showed that all of the three-piece occlusions, hand- and algorithm-articulated, were clinically acceptable based on the American Board of Orthodontics grading system. When compared, two of the algorithm-articulated occlusions were clearly better (40%), one was the same (20%), and two were slightly worse (40%) than the hand-articulated occlusions. All of the quantitative measurements were comparable between the two articulation methods. In conclusion, the results of this study demonstrate that it is clinically feasible to digitally articulate the three-piece maxillary arch to the intact mandibular dental arch.
Subject(s)
Orthognathic Surgery , Orthognathic Surgical Procedures , Feasibility Studies , Humans , Mandible/surgery , Maxilla/surgery , Orthognathic Surgical Procedures/methods , Osteotomy, Le Fort/methodsSubject(s)
Adenine/analogs & derivatives , Antiviral Agents/therapeutic use , Drug Resistance, Viral/genetics , Hepatitis B, Chronic/drug therapy , Organophosphonates/therapeutic use , Telbivudine/therapeutic use , Viral Load , Adenine/therapeutic use , DNA, Viral , Hepatitis B virus , Humans , MutationABSTRACT
A 45 years old male patient presented with recurrent abscess of the nasal root and right periorbital tissue. The incision and drainage were performed repeatedly, and anti-infection had poor effect of treatment. Previous history of sinusitis surgery. Nasal cavity and frontal sinus infections and abscesses were treated in other hospitals. CT showed enhanced patchy foci and abscesses on the right temporal side, frontal, periorbital and nasal roots. Repeated discharge of purulent secretions during hospitalization in our hospital prompted Klebsiella pneumoniae infection. After the patient was discharged from the hospital, he was diagnosed with Pott's tumor by repeated consultation with the literature.
Subject(s)
Frontal Sinusitis/etiology , Papilloma, Inverted/complications , Pott Puffy Tumor/complications , Humans , Male , Middle Aged , Papilloma, Inverted/diagnosis , Papilloma, Inverted/surgery , Paranasal Sinuses , Postoperative Complications , Pott Puffy Tumor/diagnosis , Pott Puffy Tumor/surgeryABSTRACT
To analyze the clinical features and prognosis of fulminant Wilson's disease (FWD) in patients with hepatitis B virus (HBV) infection. Twenty-seven patients were enrolled in Guangzhou Eighth People's Hospital from 2005 to 2015, including 13 FWD patients with HBV infection and 14 FWD patients without HBV infection. Clinical efficacy and survival rate were evaluated. Baseline biochemical data in two groups were comparable(P>0.05), including total bilirubin, prothrombin activity, serum albumin, alpha fetal protein, alanine transaminase, ceruloplasmin and 24 hours urine copper .Treatment in FWD group with HBV infection was ineffective, including 9(9/13) deaths and 4(4/13) patients receiveing liver transplants. However, 7(7/14)cases in the other group did not response to the treatment, including 6(6/14)deaths and 1(1/14)patient receiving liver transplant. The prognosis in the two groups is significantly different(P=0.006), which is much worse in FWD patients with HBV infection.
Subject(s)
Coinfection , Hepatitis B/diagnosis , Hepatolenticular Degeneration/surgery , Liver Transplantation , Adult , Alanine Transaminase/blood , Bilirubin/blood , Ceruloplasmin , Coinfection/mortality , Female , Hepatitis B/mortality , Hepatitis B virus/isolation & purification , Hepatolenticular Degeneration/diagnosis , Hepatolenticular Degeneration/mortality , Humans , Male , Prognosis , Survival Rate , Treatment OutcomeABSTRACT
Saccharum spontaneum is the most variable wild relative of sugarcane with potential for use in sugarcane improvement programs. In order to help preserve and exploit this species, 152 accessions from eight major geographical regions in China, including Hainan, Guangdong, Guangxi, Yunnan, Sichuan, Guizhou, Fujian, and Jiangxi provinces, were investigated by analyzing 20 simple sequence repeats (SSRs), including 11 genomic SSRs (gSSRs) and nine SSRs developed from expressed sequence tags (EST-SSRs). A total of 454 alleles were generated by the 20 SSRs, with 295 and 159 alleles detected by gSSRs and EST-SSRs respectively. The Mantel test showed significant correlation between genetic matrixes among the studied accessions revealed by gSSRs versus EST-SSRs, although the average polymorphism of EST-SSRs (17.7) was much lower than that of gSSRs (26.8). Among the eight provinces, collections from Guizhou were the most diverse and those from Guangdong were the most distinct. Clustering analysis and principal component analysis accordantly classified the accessions into four groups, which were "Southwest group", "Hainan group", "Guangdong group", and "Guangxi group", based on the geographical origin of the major accessions in each group, demonstrating that geographical factors play an important role in the pattern of genetic structure of Chinese S. spontaneum. As two (Guizhou and Yunnan) of the three provinces with highest genetic diversity are located in southwest China, we concluded that southwest China is the region with the highest genetic diversity of S. spontaneum.
Subject(s)
Genes, Plant , Microsatellite Repeats , Polymorphism, Genetic , Saccharum/genetics , Alleles , China , Genotyping Techniques , Models, Genetic , Phylogeny , Phylogeography , Principal Component Analysis , Sequence Analysis, DNAABSTRACT
The interaction of bacteria, mycorrhiza and jute (Corchotus capsulari, a higher plant) to reduce anthracene in different concentrations of spiked soils was investigated. Dominant indigenous bacterium (Pseudomonas sp.) isolated in the rhizosphere of jute was electrofused with anthracene degraders (Sphingomonas paucimobilis and Pseudomonas aeruginosa) which were able to produce different types of biosurfactants. The highest population (56 x 10(5)CFU/g) was found in the planted soil with the inoculation of mixtures of electrofused anthracene degraders after 7 days. The growth of anthracene degraders in the spiked soil was improved by gene transfer from indigenous bacteria. After 35 days, enhanced anthracene removals were observed in inoculated soils planted with jute (65.5-75.2%) compared with unplanted soil without inoculation (12.5%). The interaction of jute and electrofused S. paucimobilis enabled the greatest reduction of soil anthracene with or without the addition of P. aeruginosa. Mycorrhizal colonization was not significantly inhibited by anthracene in soils up to 150 mg/kg. Inoculation of jute with Glomus mosseae and Glomus intraradices improved plant growth and enhanced anthracene removal in the presence of electrofused S. paucimobilis.
Subject(s)
Anthracenes/metabolism , Mycorrhizae/metabolism , Plants/metabolism , Pseudomonas/metabolism , Soil Pollutants/metabolism , Sphingomonas/metabolism , Soil MicrobiologyABSTRACT
Anemia of prematurity (AOP) has been conventionally treated with erythrocyte transfusions. Recent investigations have reported the use of recombinant human erythropoietin (rHuEPO) as an alternative for treating AOP. The potential of rHuEPO in increasing erythropoiesis implies its clinical usefulness. The effect of rHuEPO on reticulocyte count as well as other parameters of blood cells was examined in 14 premature babies with AOP. The average birth body weight and gestational age of these premature babies were 1533.71 +/- 61.66 g (Mean +/- SEM) and 31.36 +/- 0.49 weeks respectively. They received the first dose of rHuEPO at age 26.14 +/- 2.03 days with a hemoglobin level by 9.40 +/- 0.27 g/dL and hematocrit level of 28.20 +/- 0.81%. They were given rHuEPO 200 U/kg subcutaneously every other day for 10 doses, and iron 3 mg/kg and vitamin E 25 IU/kg per os every day. Average erythropoietin level of the patients on entry into this study was low (7.66 +/- 1.10 mu/mL). After treatment with rHuEPO for 20 days, the corrected reticulocyte count increased from 0.64 +/- 0.10% to 1.68 +/- 0.42% on Day 5 (P < 0.05), 1.96 +/- 0.41% on Day 12 (P < 0.05), 1.77 +/- 0.43% on Day 20 (P < 0.05), and hematocrit increased from 28.2 +/- 0.81% to 29.58 +/- 1.02% (p < 0.05) on Day 20. Bone marrow aspirates on Day 10 for 9 infants revealed moderate to high cellularity, mostly with erythroblasts (47.89 +/- 1.78%); the M/E ratio was low (0.57 +/- 0.05). The granulocyte series and megakaryocyte could be well visualised.(ABSTRACT TRUNCATED AT 250 WORDS)
Subject(s)
Anemia, Neonatal/therapy , Erythropoietin/therapeutic use , Bone Marrow/drug effects , Erythropoietin/adverse effects , Erythropoietin/blood , Female , Ferritins/blood , Humans , Infant, Newborn , Infant, Premature , Male , Recombinant Proteins/therapeutic useABSTRACT
Persistent omphalomesenteric band is a rare cause of volvulus or intestinal obstruction. A 7-month-old male infant was brought to this Emergency Room after having shown poor appetite for three days, frequent bilious vomiting, and fever for half a day. Physical examination revealed the infant was dehydrated and had slight abdominal distension as well as hypoactive bowel sounds with a tender, ill-defined mass over right lower quadrant. Radiography and sonography were consistent with distal small bowel obstruction. Emergent laparotomy was done and a fibrous band found extending from the anti-mesenteric border of the ileum to the posterior wall of the umbilicus. Small bowel volvulus had occurred around the band and dilated small bowel was noted. An understanding of the embryologic development of these structures and their normal disappearance may assist pediatricians and surgeons to make the correct diagnosis and select the right pathoanatomic approach in surgery.
Subject(s)
Intestinal Obstruction/etiology , Vitelline Duct/abnormalities , Humans , Infant , MaleABSTRACT
The nutcracker phenomenon refers to compression of the left renal vein between the aorta and the superior mesenteric artery, which leads to painless intermittent gross hematuria. An 11-year-old girl presented with a two-year history of recurrent painless hematuria. Physical examination and routine laboratory examinations were noncontributory. Renal ultrasonographic study, selective left renal angiography and retrograde left renal venography showed evidence of compression of the left renal vein where it crossed between the aorta and the superior mesenteric artery. A needle biopsy of the right kidney revealed no abnormal histologic change. These results led to a diagnosis of the nutcracker phenomenon; to the best of our knowledge, this may be the first case reported in Taiwan. Herein, we present our experience with this case and discuss the diagnostic options.
Subject(s)
Hematuria/etiology , Renal Veins/diagnostic imaging , Angiography, Digital Subtraction , Child , Constriction, Pathologic/complications , Female , Humans , Kidney/diagnostic imaging , Mesenteric Arteries/diagnostic imaging , Mesenteric Arteries/pathology , Renal Veins/pathology , Tomography, X-Ray Computed , UltrasonographyABSTRACT
A single dose of surfactant TA was given as rescue therapy to four small premature infants with severe respiratory distress syndrome requiring mechanical ventilation. Birth weights ranged from 810 to 1200 gm. The dose of 100-120 mg/kg was given at the mean age of 5 hours, with range of 3 to 7 hours. Following surfactant therapy, there was a significant improvement (p < 0.05) in a/APO2 (raising from 0.11 +/- 0.05 before treatment to 0.34 +/- 0.19 at 6 hours after treatment). There was also a significant reduction in the severity of respiratory distress syndrome at 24 hours post-therapy. One baby died of sepsis at 40 hours of life; one survived without complications. The other two cases developed severe bronchopulmonary dysplasia later. We concluded that early use of exogenous surfactant is beneficial in small premature infants with severe respiratory distress syndrome.