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1.
Int J Oral Maxillofac Surg ; 53(1): 89-99, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-37277242

RESUMO

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.


Assuntos
Micrognatismo , Osteogênese por Distração , Humanos , Osteogênese por Distração/métodos , Estudos Transversais , Assimetria Facial , Mandíbula/diagnóstico por imagem , Mandíbula/cirurgia , Mandíbula/anormalidades
2.
Int J Oral Maxillofac Surg ; 52(9): 971-980, 2023 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-36813600

RESUMO

This in silico kinematic study was performed to evaluate the best attainable outcomes of maxillary distraction osteogenesis given the constraints of linear and helical motion. The study sample included the retrospective records of 30 patients with maxillary retrusion who had been treated with distraction or had been recommended this treatment. The primary outcomes were the errors of linear and helical distraction. The study measured two types of error: misalignment of key upper jaw landmarks and misalignment of the occlusion. Concerning the misalignment of key landmarks, the median misalignments resulting from helical distraction were minimal; the interquartile ranges were also minimal. The median misalignments and interquartile ranges that resulted from linear distraction were significantly larger. Regarding the occlusal misalignments, helical distraction produced minor occlusal misalignments, while linear distraction produced significantly larger errors. The results of this study confirmed that helical motion is the ideal motion for LeFort I distraction.


Assuntos
Fenda Labial , Fissura Palatina , Osteogênese por Distração , Humanos , Osteogênese por Distração/métodos , Estudos Retrospectivos , Osteotomia de Le Fort/métodos , Maxila/cirurgia , Cefalometria , Resultado do Tratamento
3.
Int J Oral Maxillofac Surg ; 52(7): 793-800, 2023 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-36372697

RESUMO

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.


Assuntos
Aprendizado Profundo , Cirurgia Ortognática , Tomografia Computadorizada de Feixe Cônico Espiral , Humanos , Estudos de Viabilidade , Tomografia Computadorizada de Feixe Cônico/métodos , Computadores , Processamento de Imagem Assistida por Computador/métodos
4.
Zhonghua Liu Xing Bing Xue Za Zhi ; 43(10): 1651-1657, 2022 Oct 10.
Artigo em Chinês | MEDLINE | ID: mdl-36456499

RESUMO

Objective: Using two measuring tools to examine the prevalence and correlates of neurocognitive impairment (NCI) as well as characteristics of neurocognitive performance among people with HIV (PWH) on antiretroviral treatment (ART). Methods: A total of 2 250 treated PWH from the Comparative HIV and Aging Research in Taizhou (CHART) were recruited in Taizhou, Zhejiang province. The Chinese version of the Mini-mental State Examination (MMSE) and the International HIV Dementia Scale (IHDS) were used to evaluate their neurocognitive performance. Cluster analysis was conducted on the seven cognitive domains in the scale. Results: Among 2 250 treated PWH, 48.0% (1 080/2 250) were aged 45 to 89, 79.2% (1 782/2 250) were male, and 37.8% (852/2 250) had primary school education or below. The prevalence of neurocognitive impairment judged by MMSE and IHDS among HIV-infected people was 14.3% (321/2 250) and 31.8% (716/2 250), respectively. Aged 60 to 89 (aOR=2.63, 95%CI:1.52-4.56), depressive symptoms (aOR=5.58, 95%CI:4.20-7.40) and treatment with EFV (aOR=2.86, 95%CI:1.89-4.34) were main risk factors of NCI diagnosed by MMSE. Male (aOR=0.71, 95%CI:0.51-1.00), overweight (aOR=0.63, 95%CI:0.44-0.89), and high education level (aOR=0.11, 95%CI:0.05-0.25) were protective factors of NCI diagnosed by MMSE. Aged 60 to 89 (aOR=3.10, 95%CI:2.09-4.59), depressive symptoms (aOR=1.78, 95%CI:1.44-2.20) and treatment with EFV (aOR=1.79, 95%CI:1.41-2.29) were risk factors of NCI diagnosed by IHDS. Male (aOR=0.75, 95%CI:0.58-0.97), underweight (aOR=0.67, 95%CI:0.47-0.96), baseline CD4+ T lymphocyte (CD4) counts ≥350 cells/µl (aOR=0.69, 95%CI:0.53-0.91) and high education level (aOR=0.23, 95%CI:0.14-0.39) were protective factors of NCI diagnosed by IHDS. The neurocognitive performance of HIV-infected people can be divided into four main types. Among four types, age, gender, education level, alcohol drinking, depressive symptoms, waist-to-hip ratio, hypertension, diabetes, baseline CD4 counts and treatment with EFV were different statistically (all P<0.05). Conclusions: There are four main types of neurocognitive performance in treated PWH. The prevalence of NCI is high among this population, underscoring the need for tailored prevention and intervention.


Assuntos
Antirretrovirais , Infecções por HIV , Masculino , Humanos , Feminino , Escolaridade , Contagem de Linfócito CD4 , Fatores de Proteção , Infecções por HIV/complicações , Infecções por HIV/tratamento farmacológico
5.
Zhonghua Liu Xing Bing Xue Za Zhi ; 43(12): 1959-1964, 2022 Dec 10.
Artigo em Chinês | MEDLINE | ID: mdl-36572470

RESUMO

Objective: To examine characteristics and risk factors of the blood lipid trajectories among HIV-infected patients treated with antiviral therapy (ART). Methods: Based on the retrospective cohort study design, sociodemographic characteristics and baseline laboratory indicators of HIV-infected patients receiving ART from January 2004 to April 2021 in Taizhou, Zhejiang province. The blood lipid trajectories of the subjects was described and classified using the latent class mixed model (LCMM). Multivariate logistic regression was used to determine the risk factors of blood lipid trajectories. The data were analysized by R 3.5.0. software with lcmm package. Results: Among 2 079 HIV-infected patients, the median age (Q1, Q3) was 31 (43, 55) years, and the majority were being male (78.1%, 1 623/2 079) and married (58.7%, 1 221/2 079). BMI ≥24.0 kg/m2 accounted for 18.9% (393/2 079). Heterosexual transmission accounted for 67.7% (1 407/2 079). Three different blood lipid trajectories were classified: inverted U-shaped (2.3%, 48/2 079), progressive (31.3%, 650/2 079), and general trajectory (U-shaped) (66.4%, 1 381/2 079). The inverted U-shaped and progressive trajectory are identified as dangerous trajectories (33.6%). Multivariate logistic regression analysis indicated that compared with 3TC-TDF-EFV antiviral treatment regimen, baseline TC level <5.2 mmol/L, baseline TG level <1.7 mmol/L, BMI 18.5-23.9 kg/m2, baseline CD4+T lymphocytes (CD4) counts <200 cells/µl, antiviral treatment time <5 years,those who had been using 3TC-AZT-EFV antiviral therapy regimen (aOR=1.99,95%CI:1.44-2.77) and those who switched to LPV/r antiviral therapy regimen (aOR=3.17, 95%CI: 2.00-5.01), baseline TC levels were 5.2-6.1 mmol/L (aOR=2.55, 95%CI: 1.92-3.39) and ≥6.2 mmol/L (aOR=5.89,95%CI:3.76-9.25), and baseline TG levels were 1.7-2.2 mmol/L (aOR=2.00, 95%CI: 1.53-2.62) and ≥2.3 mmol/L (aOR=6.51,95%CI:4.97-8.54), respectively, BMI ≥24.0 kg/m2 (aOR=1.44, 95%CI: 1.11-1.88) were more likely to show the dangerous trajectories. BMI <18.5 kg/m2 (aOR=0.55, 95%CI: 0.35-0.86), baseline CD4 counts level was 200-349 cells/µl (aOR=0.67, 95%CI: 0.52-0.87) and baseline CD4 ≥350 cells/µl (aOR=0.71, 95%CI: 0.54-0.94). The duration of antiviral therapy was 5-9 years (aOR=0.74, 95%CI: 0.56-0.99), and ≥10 years (aOR=0.53, 95%CI: 0.22-0.67) were less likely to show the dangerous trajectories. Conclusions: HIV-infected patients showed a dangerous trajectory of blood lipids after ART, which was significantly associated with the use of specific antiviral drugs such as AZT and LPV/r, treatment duration, baseline CD4, TC, TG levels and BMI. It is recommended to strengthen blood lipid monitoring and targeted intervention measure when HIV infected persons start antiviral treatment.


Assuntos
Fármacos Anti-HIV , Infecções por HIV , Humanos , Masculino , Feminino , Estudos Retrospectivos , Fármacos Anti-HIV/uso terapêutico , Contagem de Linfócito CD4 , Lipídeos
6.
Int J Oral Maxillofac Surg ; 51(8): 1043-1049, 2022 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-35183403

RESUMO

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.


Assuntos
Cirurgia Ortognática , Procedimentos Cirúrgicos Ortognáticos , Estudos de Viabilidade , Humanos , Mandíbula/cirurgia , Maxila/cirurgia , Procedimentos Cirúrgicos Ortognáticos/métodos , Osteotomia de Le Fort/métodos
7.
Zhonghua Liu Xing Bing Xue Za Zhi ; 41(8): 1225-1230, 2020 Aug 10.
Artigo em Chinês | MEDLINE | ID: mdl-32340094

RESUMO

Objectives: This study aimed to evaluate the effect of the strategies on COVID-19 outbreak control in Shenzhen, and to clarify the feasibility of these strategies in metropolitans that have high population density and strong mobility. Methods: The epidemic feature of COVID-19 was described by different phases and was used to observe the effectiveness of intervention. Hierarchical spot map was drawn to clarify the distribution and transmission risk of infection sources at different time points. The Susceptible-Exposed-Infectious-Asymptomatic-Recovered model was established to estimate case numbers without intervention and compare with the actual number of cases to determine the effect of intervention. The positive rate of the nucleic acid test was used to reflect the risk of human exposure. A survey on COVID-19 related knowledge, attitude and behaviors were used to estimate the abilities of personal protection and emergency response. Results: The epidemic of COVID-19 in Shenzhen experienced the rising, plateau and decline stage. The case number increased rapidly at the beginning, with short duration of peak period. Although the epidemic curve showed human-to-human transmission, the "trailing" was not obvious. From the spot map, during the intervention period, the source of infection was widely distributed. More cases and higher transmission risk were observed in areas with higher population density. After the effective intervention measures, both infection sources and the risk of transmission decreased. After compared with the estimated case numbers without intervention, actual number proved the COVID-19 control strategies were effective. The positive rate of nucleic acid test for high risk populations decreased and no new cases reported since February 16. Shenzhen citizens had high knowledge, attitude and behavior level, and high protection ability and emergency response. Conclusions: Although the response initiated by the health administration department played a key role at the early stage of the epidemic, it was not enough to contain the outbreak of COVID-19. The first-level emergency response initiated by provincial and municipal government was effective and ensured the start of work resumption after the Spring Festival. Metropolitans like Shenzhen can also achieve the goals of strategies and measures for containment and mitigation of COVID-19.


Assuntos
Betacoronavirus , Controle de Doenças Transmissíveis/métodos , Infecções por Coronavirus/epidemiologia , Planejamento em Desastres , Transmissão de Doença Infecciosa/prevenção & controle , Serviços Médicos de Emergência/organização & administração , Pandemias , Pneumonia Viral/epidemiologia , COVID-19 , China/epidemiologia , Socorristas , Humanos , Pneumonia Viral/prevenção & controle , SARS-CoV-2
8.
Int J Oral Maxillofac Surg ; 47(4): 534-540, 2018 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-29103833

RESUMO

The purpose of this study was to produce reliable estimations of fluctuating facial asymmetry in a normal population. Fifty-four computed tomography (CT) facial models of average-looking and symmetrical Chinese subjects with a class I occlusion were used in this study. Eleven midline landmarks and 12 pairs of bilateral landmarks were digitized. The repeatability of the landmark digitization was first evaluated. A Procrustes analysis was then used to measure the fluctuating asymmetry of each CT model, after all of the models had been scaled to the average face size of the study sample. A principal component analysis was finally used to establish the direction of the fluctuating asymmetries. The results showed that there was excellent absolute agreement among the three repeated measurements. The mean fluctuating asymmetry of the average-size face varied at each anthropometric landmark site, ranging from 1.0mm to 2.8mm. At the 95% upper limit, the asymmetries ranged from 2.2mm to 5.7mm. Most of the asymmetry of the midline structures was mediolateral, while the asymmetry of the bilateral landmarks was more equally distributed. These values are for the average face. People with larger faces will have higher values, while subjects with smaller faces will have lower values.


Assuntos
Assimetria Facial/diagnóstico por imagem , Assimetria Facial/etnologia , Tomografia Computadorizada por Raios X , Adulto , Pontos de Referência Anatômicos , China , Feminino , Humanos , Masculino , Análise de Componente Principal , Estudos Prospectivos
9.
Int J Oral Maxillofac Surg ; 46(10): 1298-1305, 2017 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-28552440

RESUMO

The purpose of this study was to evaluate a personalized orthognathic surgical guide (POSG) system for bimaxillary surgery without the use of surgical splint. Ten patients with dentofacial deformities were enrolled. Surgeries were planned with the computer-aided surgical simulation method. The POSG system was designed for both maxillary and mandibular surgery. Each consisted of cutting guides and three-dimensionally (3D) printed custom titanium plates to guide the osteotomy and repositioning the bony segments without the use of the surgical splints. Finally, the outcome evaluation was completed by comparing planned outcomes with postoperative outcomes. All operations were successfully completed using the POSG system. The largest root-mean-square deviations were 0.74mm and 1.93° for the maxillary dental arch, 1.10mm and 2.82° for the mandibular arch, 0.83mm and 2.59° for the mandibular body, and 0.98mm and 2.45° for the proximal segments. The results of the study indicated that our POSG system is capable of accurately and effectively transferring the surgical plan without the use of surgical splint. A significant advantage is that the repositioning of the bony segments is independent to the mandibular autorotation, thus eliminates the potential problems associated with the surgical splint.


Assuntos
Placas Ósseas , Deformidades Dentofaciais/cirurgia , Procedimentos Cirúrgicos Ortognáticos/métodos , Cirurgia Assistida por Computador/métodos , Adolescente , Adulto , Feminino , Humanos , Masculino , Osteotomia Mandibular , Osteotomia Maxilar , Impressão Tridimensional , Titânio , Resultado do Tratamento
10.
Int J Oral Maxillofac Surg ; 46(11): 1512-1516, 2017 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-28521964

RESUMO

The purposes of this study were to determine: (1) whether an observer's perception of the correct anatomical alignment of the head changes with time, and (2) whether different observers agree on the correct anatomical alignment. To determine whether the perception of the correct anatomical alignment changes with time (intra-observer comparison), a group of 30 observers were asked to orient, into anatomical alignment, the three-dimensional (3D) head photograph of a normal man, on two separate occasions. To determine whether different observers agree on the correct anatomical alignment (inter-observer comparison), the observed orientations were compared. The results of intra-observer comparisons showed substantial variability between the first and second anatomical alignments. Bland-Altman coefficients of repeatability for pitch, yaw, and roll, were 6.9°, 4.4°, and 2.4°, respectively. The results of inter-observer comparisons showed that the agreement for roll was good (sample variance 0.4, standard deviation (SD) 0.7°), the agreement for yaw was moderate (sample variance 2.0, SD 1.4°), and the agreement for pitch was poor (sample variance 15.5, SD 3.9°). In conclusion, the perception of correct anatomical alignment changes considerably with time. Different observers disagree on the correct anatomical alignment. Agreement among multiple observers was bad for pitch, moderate for yaw, and good for roll.


Assuntos
Cabeça/anatomia & histologia , Humanos , Imageamento Tridimensional , Masculino , Variações Dependentes do Observador , Posicionamento do Paciente , Fotografação , Reprodutibilidade dos Testes
11.
Int J Oral Maxillofac Surg ; 46(9): 1193-1200, 2017 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-28499508

RESUMO

The purpose of this study was to develop a principal component analysis-based adaptive minimum Euclidean distances (PAMED) approach to establish an optimal object reference frame for symmetrical alignment of the dental arch during computer-aided surgical simulation (CASS). It was compared with our triangular methods and the standard principal component analysis (PCA) method. Thirty sets of maxillary digital models were used. Midsagittal and occlusal planes were ranked by three experienced evaluators based on their clinical judgment. The results showed that for the midsagittal plane, all three evaluators ranked "ideal" for all 30 models with the PAMED method, 28 with the triangular method, and at least 11 with the PCA method. For the occlusal plane, one evaluator ranked all 30 models "ideal" with both the PAMED and the PCA methods while the other two evaluators ranked all 30 models "ideal" with the triangular method. However, the differences among the three methods were minimal. In conclusion, our PAMED method is the most reliable and consistent approach for establishing the object reference frame for the dental arch in orthognathic surgical planning. The triangular method should be used with caution because it can be affected by dental arch asymmetry. The standard PCA method is not recommended.


Assuntos
Simulação por Computador , Arco Dental/anatomia & histologia , Procedimentos Cirúrgicos Ortognáticos/métodos , Cirurgia Assistida por Computador/métodos , Humanos , Modelos Dentários , Análise de Componente Principal
12.
Zhonghua Yi Xue Za Zhi ; 97(47): 3687-3692, 2017 Dec 19.
Artigo em Chinês | MEDLINE | ID: mdl-29325320

RESUMO

Objective: To evaluate the feasibility of cervical laminoplasty with preservation of the posterior ligament complex for enlarging the spinal canal. Methods: Six up-to-standard human corpse specimens were divided into two groups by simple randomization (start from C4 group, S4; start from C5 group, S5; 3 corpses in each group). Decompression operation of C3-C6 level was performed in a predetermined sequence by using the new procedure with preservation of the posterior ligament complex.The basic depth of spinal canal was measured with a depth gauge at fixed point after the right bone groove of single level was completed.The operation of the contralateral bone groove was continued, and then the spinal canal was measured again when the spinous process was pulled backward by using a tissue forceps until the ligament complex was just tight.Retreat value (RV) of vertebral lamina was obtained by calculating the difference between the two measurements.The earlier measured levels needed to be remeasured when the operation area increased by one level. Two independent sample and one-sample t test were used to analyze the measurement results. Results: RV of vertebral lamina was small after finishing the first level of the decompression operation [S4: (0.87±0.72) mm; S5: (1.83±0.29) mm], and the value reached its maximum after the completion of C3-C6 level.The overall average RVmaxs from C3 to C6 level were (2.37±0.52) mm, (4.27±0.78) mm, (3.73±0.93) mm and (2.16±0.77) mm, respectively.The overall average retreat rates (RR) were 17%±7%, 32%±9%, 29%±10% and 16%±6%, respectively. The overall average RVmax of C4 and C5 level reached or exceeded the decompression threshold value of 4 mm (t=0.839, -0.703, both P>0.05). The average RVmax of C4/C5 level was similar in the two groups (t=-1.204, 1.189, both P>0.05); however, the difference of average RVmax between C3 and C6 level was significant (t=-4.429, 4.196, both P<0.05). Conclusions: Cervical laminoplasty with preservation of the posterior ligament complex can enlarge the sagittal diameter of spinal canal and relieve the compression of spinal cord.In addition, RV of each level increases as the number of the operation level increases, and the ability of vertebral lamina to retreat is quite different from C3 to C6 level.The decompression effect in the middle of the operation area is better than that on the cranial and tail side.


Assuntos
Descompressão Cirúrgica , Laminectomia , Laminoplastia , Vértebras Cervicais/cirurgia , Humanos , Ligamentos
13.
Eur Rev Med Pharmacol Sci ; 20(13): 2805-11, 2016 07.
Artigo em Inglês | MEDLINE | ID: mdl-27424979

RESUMO

OBJECTIVE: To establish and develop a reliable and simple Real-time PCR assay with high resolution melting (Real-time PCR-HRM) method for detection epidermal growth factor (EGFR) and BIM mutation of lung cancer and looking for effective targeted drugs to control lung cancer. PATIENTS AND METHODS: A total of 6858 participants (2538 cases with lung cancer and 4275 healthy controls who took part in the study by doing the physical examination in Shanghai Xuhui community) were recruited in the study. Clinical characteristics and 5 ml peripheral blood were collected from each participant, and the DNA has been extracted, which were determined the EGFR and BIM mutation by Real-time PCR-HRM. Data were recorded and Statistical analyses. RESULTS: All samples completed the study. BIM deletion polymorphism was no related with age, sex, and smoking or EGFR mutation. CONCLUSIONS: There were no relations among BIM deletion polymorphism, EGFR mutation or lung cancer risk. HRM is a novel procedure and provides rapid, sensitive, specific and simultaneous detection for gene mutation of cancer patients for predicting the efficacy of targeted therapy.


Assuntos
Proteína 11 Semelhante a Bcl-2/genética , Receptores ErbB/genética , Neoplasias Pulmonares/genética , Reação em Cadeia da Polimerase em Tempo Real , China , Humanos , Mutação
14.
Int J Oral Maxillofac Surg ; 45(5): 560-6, 2016 May.
Artigo em Inglês | MEDLINE | ID: mdl-26725914

RESUMO

The purpose of this study was to develop and validate a new chin template system for a two-piece narrowing genioplasty. Nine patients with wide chin deformities were enrolled. Surgeries were planned with the computer-aided surgical simulation (CASS) planning method. Surgical splints and chin templates were designed in a computer and fabricated using a three-dimensional printing technique. The chin template system included a cutting guide and a repositioning guide for a two-piece narrowing genioplasty. These guides were also designed to avoid the mental foramen area and inferior alveolar nerve loops during the osteotomy, for nerve protection. After surgery, the outcome evaluation was completed by first superimposing the postoperative computed tomography model onto the planned model, and then measuring the differences between the planned and actual outcomes. All surgeries were completed successfully using the chin template system. No inferior alveolar nerve damage was seen in this study. With the use of the chin templates, the largest linear root mean square deviation (RMSD) between the planned and the postoperative chin segments was 0.7mm and the largest angular RMSD was 4.5°. The results showed that the chin template system provides a reliable method of transfer for two-piece osseous narrowing genioplasty planning.


Assuntos
Desenho Assistido por Computador , Mentoplastia/métodos , Cirurgia Assistida por Computador/métodos , Adolescente , Adulto , Feminino , Humanos , Planejamento de Assistência ao Paciente , Reprodutibilidade dos Testes , Tomografia Computadorizada por Raios X , Resultado do Tratamento
15.
Int J Oral Maxillofac Surg ; 45(3): 399-405, 2016 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-26708049

RESUMO

To assess facial form, one has to determine the size, position, orientation, shape, and symmetry of the different facial units. Many of these assessments require a frame of reference. The customary coordinate system used for these assessments is the 'standard anatomical frame of reference', a three-dimensional Cartesian system made by three planes: the sagittal, the axial, and the coronal. Constructing the sagittal plane seems simple, but because of universal facial asymmetry, it is complicated. Depending on the method one selects, one can build hundreds of different planes, never knowing which one is correct. This conundrum can be solved by estimating the sagittal plane a patient would have had if his or her face had developed symmetrically. We call this the 'primal sagittal plane'. To estimate this plane we have developed a mathematical algorithm called LAGER (Landmark Geometric Routine). In this paper, we explain the concept of the primal sagittal plane and present the structure of the LAGER algorithm.


Assuntos
Algoritmos , Pontos de Referência Anatômicos , Assimetria Facial , Cabeça/anatomia & histologia , Humanos
16.
Int J Oral Maxillofac Surg ; 44(12): 1431-40, 2015 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-26573562

RESUMO

The success of craniomaxillofacial (CMF) surgery depends not only on the surgical techniques, but also on an accurate surgical plan. The adoption of computer-aided surgical simulation (CASS) has created a paradigm shift in surgical planning. However, planning an orthognathic operation using CASS differs fundamentally from planning using traditional methods. With this in mind, the Surgical Planning Laboratory of Houston Methodist Research Institute has developed a CASS protocol designed specifically for orthognathic surgery. The purpose of this article is to present an algorithm using virtual tools for planning a double-jaw orthognathic operation. This paper will serve as an operation manual for surgeons wanting to incorporate CASS into their clinical practice.


Assuntos
Algoritmos , Simulação por Computador , Anormalidades Maxilofaciais/cirurgia , Procedimentos Cirúrgicos Ortognáticos , Planejamento de Assistência ao Paciente , Pontos de Referência Anatômicos , Cefalometria , Técnica de Moldagem Odontológica , Humanos , Modelos Anatômicos , Cirurgia Assistida por Computador , Tomografia Computadorizada por Raios X
17.
Int J Oral Maxillofac Surg ; 44(12): 1441-50, 2015 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-26573563

RESUMO

Three-dimensional (3D) cephalometry is not as simple as just adding a 'third' dimension to a traditional two-dimensional cephalometric analysis. There are more complex issues in 3D analysis. These include how reference frames are created, how size, position, orientation and shape are measured, and how symmetry is assessed. The main purpose of this article is to present the geometric principles of 3D cephalometry. In addition, the Gateno-Xia cephalometric analysis is presented; this is the first 3D cephalometric analysis to observe these principles.


Assuntos
Algoritmos , Cefalometria , Simulação por Computador , Imageamento Tridimensional , Anormalidades Maxilofaciais/cirurgia , Procedimentos Cirúrgicos Ortognáticos , Pontos de Referência Anatômicos , Técnica de Moldagem Odontológica , Humanos , Modelos Anatômicos , Planejamento de Assistência ao Paciente , Cirurgia Assistida por Computador , Tomografia Computadorizada por Raios X
18.
Scand J Immunol ; 73(2): 91-101, 2011 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-21198749

RESUMO

It is well known that adoptive transfer of donor-derived tolerogenic dendritic cells (DC) helps to reduce acute allograft rejection. However, this method cannot effectively prevent grafts from infiltration of inflammatory cells and fibrosis, and thus has minimal effect on chronic allograft rejection. In this study, we used mitomycin C (MMC) to generate tolerogenic DC and demonstrated that donor (Balb/c)-derived MMC-DC could induce hyporesponsiveness of recipient (C57BL/6) T cells in vitro, potentially by inducing T-cell apoptosis, decreasing IL-2 and IL-12 secretion, and increasing regulatory T-cell numbers and IL-10 secretion. Furthermore, anti-CD154 monoclonal antibody (mAb) treatment combined with donor-derived MMC-DC prolonged the survival of the allografts in vivo. The mechanisms were similar to those in vitro. Impressively, both acute and chronic rejection were prevented when donor and F1 generation (Balb/c × C57BL/6) derived MMC-DC were injected together with anti-CD154 mAb into recipients before heart allotransplantation. In summary, we showed that donor and F1-derived tolerogenic DC have a synergistic effect on induction and maintenance of T-cell regulation and the secretion of immunosuppressive cytokines. Moreover, adoptive transfer of these two types of DC could inhibit both acute and chronic transplant rejection in mice.


Assuntos
Células Dendríticas/imunologia , Rejeição de Enxerto/prevenção & controle , Tolerância Imunológica , Doença Aguda , Animais , Doença Crônica , Feminino , Masculino , Camundongos , Baço/imunologia , Linfócitos T/imunologia , Transplante Homólogo
19.
Parasitol Res ; 108(5): 1193-8, 2011 May.
Artigo em Inglês | MEDLINE | ID: mdl-21107864

RESUMO

In the present study, a loop-mediated isothermal amplification (LAMP) assay was developed and validated for the detection of Paragonimus westermani adults, metacercariae, and eggs in human and animal samples. The LAMP amplification can be finished in 45 min under isothermal condition at 60°C by employing a set of four species-specific primer mixtures and the results can be checked by naked-eye visualization. No amplification products were detected with deoxyribunucleic acid (DNA) of related trematode species including Fasciola hepatica, Fasciola gigantica, Clonorchis sinensis, Opisthorchis viverrini, Schistosoma mansoni, and Schistosoma japonicum. The method was further validated by examining P. westermani DNA in intermediate hosts including freshwater crabs and crayfish, as well as in sputum and pleural fluid samples from patients of paragonimiasis. These results indicated that the LAMP assay was highly specific, sensitive, and rapid, and it was approximately 100 times more sensitive than conventional specific PCR. The LAMP assay established in this study provides a rapid and sensitive tool for the detection of P. westermani DNA in freshwater crabs, crayfish, sputum, and pleural fluid samples, which has important implications for effective control of human paragonimiasis.


Assuntos
Técnicas de Diagnóstico Molecular/métodos , Técnicas de Amplificação de Ácido Nucleico/métodos , Paragonimíase/diagnóstico , Paragonimíase/veterinária , Paragonimus westermani/isolamento & purificação , Parasitologia/métodos , Animais , Astacoidea/parasitologia , Braquiúros/parasitologia , Primers do DNA/genética , Humanos , Paragonimus westermani/genética , Sensibilidade e Especificidade , Temperatura , Fatores de Tempo
20.
J Int Med Res ; 38(4): 1294-304, 2010.
Artigo em Inglês | MEDLINE | ID: mdl-20926002

RESUMO

Cyclo-oxygenase (COX)-2 inhibitors may exert antitumour effects through COX-2-independent mechanisms. This study investigated the effects of the COX-2 inhibitor celecoxib on the viability of the human osteosarcoma MG-63 cell line and its ß-catenin signalling pathway. Cell viability and apoptosis were examined in celecoxib-treated cells or after ß-catenin knockdown in vitro. Analyses were performed to detect glycogen synthase kinase (GSK)-3ß, phosphorylated GSK-3ß, ß-catenin, c-Myc and cyclin D1 proteins, and mRNA levels of ß-catenin, c-Myc and CCND1 (encoding cyclin D1). ß-Catenin was shown to be required for MG63 cell survival and celecoxib exerted an inhibitory effect on the viability of cultured MG-63 cells in a time- and dose-dependent manner. ß-Catenin protein decreased in the cytosol and nucleus following celecoxib treatment (from 6 h after initiation of treatment onwards; lowest protein levels were reached at > 72 h). Significant reductions in ß-catenin, c-Myc and CCND1 mRNA were observed. Celecoxib inhibited MG-63 cell viability, possibly by activating GSK-3ß and inhibiting ß-catenin-dependent gene transcription, suggesting a role for celecoxib in osteosarcoma treatment.


Assuntos
Osteossarcoma/patologia , Pirazóis/farmacologia , Sulfonamidas/farmacologia , beta Catenina/metabolismo , Apoptose/efeitos dos fármacos , Celecoxib , Linhagem Celular Tumoral , Sobrevivência Celular/efeitos dos fármacos , Regulação para Baixo/efeitos dos fármacos , Ativação Enzimática/efeitos dos fármacos , Regulação Neoplásica da Expressão Gênica/efeitos dos fármacos , Quinase 3 da Glicogênio Sintase/metabolismo , Glicogênio Sintase Quinase 3 beta , Humanos , Osteossarcoma/enzimologia , Osteossarcoma/genética , Fosforilação/efeitos dos fármacos , Transdução de Sinais/efeitos dos fármacos , Transfecção
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