Promoting mechanism of nitrogen removal by Fe3O4 magnetic particles during the start-up phase in sequencing batch reactor.

In this paper, a magnetic sequencing batch reactor (SBR) was constructed, and the influence rule of magnetic particle dosing performance of denitrification was investigated. The diversity, structure, and potential functions of the microbial community were comprehensively explored. The results showed that the particle size and the dosage of Fe3O4 magnetic particles were the main parameters affecting the sedimentation performance of activated sludge. The start-up phase of the SBR reactor with Fe3O4 magnetic particles was 5 days less than the control. Moreover, total nitrogen removal efficiency during the start-up phase was improved, with the maximum value reaching 91.93%, surpassing the control by 9.7% with the Fe3O4 dosage of 1.2 g L-1. In addition, the activated sludge concentration and dehydrogenase activity were improved, compared to the control. High-throughput sequencing showed that the denitrifying bacterium Saccharimonadales dominated the reactor and was enriched by magnetic particles. According to predicted functions, the abundance of genes for denitrification increased with the addition of magnetic particles, suggesting the capacity of nitrogen removal was enhanced in the microbial community. Overall, the Fe3O4 magnetic particles provide great potential for enhanced wastewater nitrogen removal.

AnCMBR-AFB-integrated process for the treatment of high nitrogen and phosphorus wastewater.

Improving the nitrogen and phosphorus removal rates and efficiently controlling membrane fouling are the keys to fully exploiting the applicability of anaerobic membrane bioreactor (AnMBR) process in high-concentration wastewater treatment. To that purpose, an integrated reactor composed of an anaerobic ceramic membrane bioreactor and N anaerobic fluidized bed (AnCMBR-AFB) was built and pollutant removal efficiency, nitrogen and phosphorus recovery characteristics, and membrane pollution features of this integrated reactor were investigated. The results revealed that the integrated reactor had good pollutant removal efficiency, with turbidity, chromaticity, and UV254 average values of the effluent being 0.470 NTU, 0.011 A, and 0.057 cm-1, respectively, and the average CODCr removal rate was 80%. The nitrogen and phosphorus recoveries were significantly higher than the nitrogen and phosphorus removal rates of conventional AnMBR at 23.20 ± 1.17% and 43.34 ± 1.54%, respectively. Microscopic analysis revealed the formation of magnesium ammonium phosphate (MAP) crystals on the carrier's surface, and friction between the carrier and the membrane surface could delay membrane fouling while allowing the contaminated membrane surface to retain significant roughness. Membrane fouling was mostly brought on by amides and saturated hydrocarbons, and inorganic metal ions also played a role to some extent.

Effect of magnetic fields on simultaneous nitrification and denitrification microbial systems.

Magnetic fields positively influence the nitrogen removal efficiency in activated sludge systems. However, the structural succession pattern of microorganisms by magnetic fields still remains further explored. In this paper, a magnetic simultaneous nitrification and denitrification (MSND) reactor was constructed, and the influence of optimized magnetic field intensity (0, 10, 20 and 30 mT) on the nitrogen removal efficiency was investigated at HRT 6 h, 28.0-30.0 °C, and pH 7.0-8.0. Molecular biology was used to investigate the succession process of the dominant microbial flora and the functional gene structure of MSND systems. The results showed that the denitrification effects of the MSND system were significantly enhanced, which contributed to the lower concentration of total nitrogen in the effluent of the magnetic reactor than that of the nonmagnetic group reactor. The magnetic fields induced the succession of microbial community structure and improved the stability of microbial communities, thereby the relative abundances of nitrifying and denitrifying bacteria, and the functional genes were improved. In particular, the abundance of functional genes related to gene proliferation and transmembrane transport was increased. Therefore, the efficient nitrogen removal was achieved, which gives inspiration in the enhanced wastewater treatment by magnetic fields.

Study on pickling technology to control fouling of ceramic membrane treating secondary treated effluent.

The application of membrane technology in the field of water treatment was increasingly widespread, but membrane fouling still restricted its development, and the membrane needed to be chemically cleaned. This research focused on the high-efficiency pickling technology of ceramic membrane, and developed the cleaning technology of ceramic membrane in cooperation with surfactant. In the experiment, the municipal secondary effluent was used as the raw water, and the single-step, mixed and step-by-step cleaning effects of three strong acids, three weak acids and surfactants on ceramic membranes and polyvinylidene difluoride (PVDF) membranes were investigated. For ceramic membrane, the optimal cleaning combination was H2SO4 first and then DTAC, and the flux recovery rate could reach 96.94%; for PVDF membrane, the optimal cleaning combination was HNO3 first and then H2SO4, and the flux recovery rate could reach 93.72%. In addition, the surface of initial, polluted, and cleaned membranes were analyzed by scanning electron microscope and contact angle, and the fouling mechanism of the ceramic membrane was analyzed. The results showed that through physical cleaning and chemical cleaning, most of the pollutants on the membrane surface and pores were removed. The cleaning method can effectively control the membrane pollution.

Effects of Alkaline Cleaning on the Conversion and Transformation of Functional Groups on Ion-Exchange Membranes in Polymer-Flooding Wastewater Treatment: Desalination Performance, Fouling Behavior, and Mechanism.

The aging effects of sodium hydroxide (NaOH) on ion-exchange membranes were systematically studied, including the membrane properties, desalination performance, and fouling behaviors. After aging in NaOH solution, there were minor changes in the cation-exchange membrane (CEM) properties; however, functional groups (i.e., quaternary amines) on the anion-exchange membranes (AEMs) were converted into benzylic alcohol, alkene, and tertiary amines, respectively, by nucleophilic substitution, Hofmann elimination, and ylide formation. These degradations rendered decreased ion-exchange capacity (IEC), increased electrical resistance, lost hydrophilicity, and weakened mechanical strength. Moreover, severe deteriorations of desalination performance were observed due to the little ion-exchange ability of the degraded AEMs. The desalination rates were restored after cultivating the aged AEMs in acid solution, mainly because the tertiary amines transformed from the hydroxide form (OH-form) to the ionic chlorine form (Cl-form). The restored desalination rates indicated that the main degradation products were tertiary amines. In addition, the antifouling performance decreased in the order of aged OH-form > aged Cl-form > original AEMs due to the reduction of foulant-membrane intermolecular interactions after aging in NaOH solution. The results contribute to establishing a more comprehensive understanding of the effects of alkaline cleaning on IEMs and provide new insights into cleaning-process optimization and membrane modification.

The cellular character of liquefaction degeneration in oral lichen planus and the role of interferon gamma.

BACKGROUND: Oral lichen planus (OLP) is a T-cell-mediated chronic inflammatory oral mucosal disease of unknown etiology, and liquefaction degeneration in the basal keratinocytes is one of the specific histological changes. However, the understanding of liquefaction degeneration is still very limited, and how does it affect the prognosis of LP is largely unknown. Therefore, the objective of this study was to clarify the intrinsic change behind the liquefaction degeneration in lichen planus and to evaluate the effect of the OLP-typical cytokine, IFN-γ, on these changes. MATERIALS AND METHODS: Biopsies were collected from patients with OLP; immunochemistry staining was performed to analyze E-cadherin, vimentin, CK19, ß1 integrin, nestin, STAT1, and STAT3 expression. Primary oral epithelial cells were cultured in vitro, and 20 ng/mL IFN-γ was applied to assay the effect on epithelial cells. RESULTS: E-cadherin expression was decreased but vimentin expression was increased in the OLP epithelial cells that undergo liquefaction degeneration, showing the typical epithelial-mesenchymal transition (EMT) alteration. In vitro research showed that the OLP-typical cytokine, IFN-γ, possesses EMT-inducing ability, and the primary oral epithelial cells stimulated by IFN-γ acquired some properties of cancer stem cells, expressing more ß1 integrin, α6 integrin, and nestin. In addition, the major downstream mediator of IFN-γ receptor, STAT1, was expressed more intensive and extensive with the malignant transition of OLP. CONCLUSION: Liquefaction degeneration in oral lichen planus is an EMT phenomenon, the IFN-γ may be the main inducer, and IFN-γ signaling might be implicated in malignant transition of OLP.

Molecular Mechanisms of Ultrafiltration Membrane Fouling in Polymer-Flooding Wastewater Treatment: Role of Ions in Polymeric Fouling.

Polymer (i.e., anionic polyacrylamide (APAM)) fouling of polyvinylidene fluoride (PVDF) ultrafiltration (UF) membranes and its relationships to intermolecular interactions were investigated using atomic force microscopy (AFM). Distinct relations were obtained between the AFM force spectroscopy measurements and calculated fouling resistance over the concentration polarization layer (CPL) and gel layer (GL). The measured maximum adhesion forces (Fad,max) were closely correlated with the CPL resistance (Rp), and the proposed molecular packing property (largely based on the shape of AFM force spectroscopy curve) of the APAM chains was related to the GL resistance (Rg). Calcium ions (Ca(2+)) and sodium ions (Na(+)) caused more severe fouling. In the presence of Ca(2+), the large Rp corresponded to high foulant-foulant Fad,max, resulting in high flux loss. In addition, the Rg with Ca(2+) was minor, but the flux recovery rate after chemical cleaning was the lowest, indicating that Ca(2+) created more challenges in GL cleaning. With Na(+), the fouling behavior was complicated and concentration-dependent. The GL structures with Na(+), which might correspond to the proposed molecular packing states among APAM chains, played essential roles in membrane fouling and GL cleaning.

Retention of titanium dioxide nanoparticles in biological activated carbon filters for drinking water and the impact on ammonia reduction.

Given the increasing discoveries related to the eco-toxicity of titanium dioxide (TiO2) nanoparticles (NPs) in different ecosystems and with respect to public health, it is important to understand their potential effects in drinking water treatment (DWT). The effects of TiO2 NPs on ammonia reduction, ammonia-oxidizing archaea (AOA) and ammonia-oxidizing bacteria (AOB) in biological activated carbon (BAC) filters for drinking water were investigated in static and dynamic states. In the static state, both the nitrification potential and AOB were significantly inhibited by 100 µg L(-1) TiO2 NPs after 12 h (p < 0.05), and the threshold decreased to 10 µg L(-1) with prolonged exposure (36 h, p < 0.05). However, AOA were not considerably affected in any of the tested conditions (p > 0.05). In the dynamic state, different amounts of TiO2 NP pulses were injected into three pilot-scale BAC filters. The decay of TiO2 NPs in the BAC filters was very slow. Both titanium quantification and scanning electron microscope analysis confirmed the retention of TiO2 NPs in the BAC filters after 134 days of operation. Furthermore, the TiO2 NP pulses considerably reduced the performance of ammonia reduction. This study identified the retention of TiO2 NPs in BAC filters and the negative effect on the ammonia reduction, suggesting a potential threat to DWT by TiO2 NPs.

Age-based treatment of aggressive fibromatosis in the head and neck region.

PURPOSE: To review our experience regarding the difference in management and treatment outcomes of aggressive fibromatosis of the head and neck region in children and adults, emphasizing, in particular, the role of conservative surgery in comprehensive treatment strategies. PATIENTS AND METHODS: A retrospective analysis of patients with aggressive fibromatosis was performed during a 5-year period (2008 to 2012). Nine patients were enrolled in the present study, including 5 children (age, <18 years) and 4 adults (age, >18 years). All patients underwent surgical intervention and were treated by surgical resection with different surgical margins. Adjuvant low-dose chemotherapy and radiotherapy were given to pediatric and adult patients, respectively, with macroscopically or microscopically positive surgical margins. RESULTS: All 5 pediatric patients (3 females and 2 males) received low-dose chemotherapy after conservative surgical resection (in 4 patients, microscopically incomplete resection; and in 1 patient, macroscopic residual tumor). Of the 4 adults (3 females and 1 male), 2 underwent complete surgical resection and 2 underwent surgery and postoperative radiotherapy (1 patient had microscopically suspected residual tumor and 1 had macroscopic residual tumor). The patients were followed up for a period of 7 to 51 months. Two pediatric patients and one adult patient had disease progression after resection and became stable after continued adjuvant therapy. None of the patients had functional or cosmetic defects. All patients had good long-term outcomes, with no disease progression. CONCLUSIONS: For the treatment of aggressive fibromatosis, conservative resection with preservation of form and function should be given greater priority in all age groups. Also, postoperative adjuvant therapy is vital for patients with gross or microscopic residual tumor to obtain progression-free survival.

Study on efficiency and mechanism of ultrasonic controlling membrane fouling in ceramic membrane bioreactors.

In recent years, ceramic membranes have been increasingly used in membrane bioreactors (MBRs). However, membrane fouling was still the core issue restricting the large-scale engineering application of ceramic MBRs. As a novel and alternative technology, ultrasonic could be used to control membrane fouling. This research focused on the efficiency and mechanism of ultrasonic controlling membrane fouling in ceramic MBRs. The results showed that ultrasonic reduced the sludge concentration in MBR, and the average particle size of sludge was always in a high range. The sludge activity of the system was stable at 6-9 (mg O2·(g MLSS·h)-1), indicating that ultrasonic did not destroy the activity of microorganisms in the system. The extracellular polymer substance (EPS) of the ultrasonic group was slightly higher than that of the control group, while the soluble microbial product (SMP) content was relatively stable. The ceramic membrane of the ultrasonic group has a partial retention effect on the organic components. The application of ultrasonic slowed down the decrease of the hydrophilicity of the ceramic membrane. The main pollutants on the membrane surface exist in the form of aromatic and heteroaromatic rings, alkynes, and so forth. Ultrasonic removes the amide substances from the membrane surface. Membrane fouling resistance is mainly due to membrane pore blockage, accounting for 75.53%. PRACTITIONER POINTS: Enrich the research on the mechanism of ultrasonic technology in membrane fouling control. The MBR can still operate normally with ultrasonic applied. The time for the ceramic membrane to reach the fouling end point is 2.4 times that without ultrasonic. The main cause of membrane fouling was pore blocking, accounting for 75.53%.

Ultrasonic aerosol agglomeration: Manipulation of particle deposition and its impact on air filter pressure drop.

Acoustic agglomeration is a technique that leverages on sound waves to promote the collision of aerosol particulate matter, thus leading to the formation of larger particle agglomerates. In this study, this acoustics-driven phenomenon is demonstrated for its usefulness as an aerosol pre-conditioning method to significantly enhance the efficiency of filtration systems in particle treatment processes. Specifically, favorable changes in pressure drop across the filters are observed as a result of receiving less particle mass, for which filters are shown to be able to have their operational life extended remarkably by more than 50%. The involved ultrasonic aerosol agglomeration mechanisms are unveiled through numerical simulations, and the effects of residence time, sound pressure level, and initial particle number concentration on agglomeration performances are experimentally investigated. In addition, validations and measurements of filter pressure drop are obtained through a series of experiments. This study provides a comprehensive overview to the design and performance characterization of acoustics-agglomeration-enhanced filtration systems, which could potentially derive energy savings for fan power in ventilation systems and be scaled up for applications in industrial plants for reducing carbon emissions.

Collision-attachment simulation of membrane fouling by oppositely and similarly charged colloids.

The fouling propensity of oppositely charged colloids (OCC) and similarly charged colloids (SCC) on reverse osmosis (RO) and nanofiltration (NF) membranes are systematically investigated using a developed collision-attachment approach. The probability of successful colloidal attachment (i.e., attachment efficiency) is modelled by Boltzmann energy distribution, which captures the critical roles of colloid-colloid/membrane interaction and permeate drag. Our simulations highlight the important effects of ionic strength Is, colloidal size dp and initial flux J0 on combined fouling. In a moderate condition (e.g., Is =10 mM, dp=50 nm and J0= 100 L/m2h), OCC mixtures shows more severe fouling compared to the respective single foulant owing to electrostatic neutralization. In contrast, the flux loss of SCC species falls between those of the two single foulants but more closely resembles that of the single low-charged colloids due to its weak electrostatic repulsion. Increased ionic strength Is leads to less severe fouling for OCC but more severe fouling for SCC, as a result of the suppressed electrostatic attraction/repulsion. At a high Is (e.g., 3-5 M), all the single and mixed systems show the identical pseudo-stable flux Js. Small colloidal size leads to the drag-controlled condition, where severe fouling occurs for both single and mixed foulants. On the contrary, better flux stability appears at greater dp for both individual and mixed species, thanks to the increasingly dominated role of energy barrier and thus lowered attachment efficiency. Furthermore, higher J0 above limiting flux exerts greater permeate drag, leading to elevated attachment efficiency, and thus more flux losses for both OCC and SCC. Our modelling gains deep insights into the role of energy barrier, permeate drag, and attachment efficiency in governing combined fouling, which provides crucial guidelines for fouling reduction in practical engineering.

Establishment of nitrous oxide (N2O) dynamics model based on ASM3 model during biological nitrogen removal via nitrification.

Nitrous oxide (N2O), as one of the six greenhouse gases, is mainly produced in the biological nitrogen removal process of wastewater treatment plants (WWTPs). Establishing the N2O kinetic model can provide insight into the N2O generation mechanism and regulate its production. This work uses Activated Sludge Model NO.3 (ASM3) as the basic framework, combines organic storage with endogenous respiration theory, and couples ammonia-oxidizing bacteria (AOB) denitrification pathway and the NH2OH/NOH model to establish a kinetic model. Meanwhile, the Sequencing Batch Reactor (SBR) process with artificial simulated urban domestic sewage was used as the carrier; MATLAB and EXCEL software were used as tools to establish a model calculation programme. The simulated values obtained by substituting the operating conditions of the SBR process into the model and the measured values of the SBR process were analysed. The correlation coefficient (R2) between the experimental values and simulated values obtained for the 5 components of COD, ammonia, nitrite, nitrate and total N2O is 0.952, 0.996, 0.902, 0.991 and 0.956, respectively, which indicates that the N2O kinetic model has great consistency, this further shows that the established model modelling mechanism is clear and accurate, and provides a new method for the N2O dynamic model.

Comparative analysis of membrane fouling mechanisms induced by colloidal polymer: Effects of sodium and calcium ions.

Polymer (anionic polyacrylamide, APAM) flooding produced wastewater has a relatively high degree of mineralization and abundant ionic species. A comprehensive and systematic investigation of the influence of ion identity on APAM-induced membrane fouling is extremely necessary but has not been conducted to date. A comparative investigation was performed herein to reveal the underlying mechanisms of the influence of Na+ and Ca2+ (1000 mg/L) on APAM-induced membrane fouling in the adsorption and microfiltration (MF) processes. Na+ and Ca2+ exhibited contrasting influences on the filtration efficiency, cleaning efficiency, and fouling resistance. Compared to Na+, Ca2+ promoted reversible fouling and the formation of a loose cake layer; moreover, a higher removal rate and flux recovery were achieved. Additionally, simulations based on adsorption kinetic and membrane fouling models, and a series of microscopic analyses were performed to validate the contradictory influences. During the APAM-based MF process, the membrane fouling was effectively mitigated at the applied ionic strength because of the stronger hydration repulsive force generated by hydrated Ca2+ compared to that by Na+. This study provides vital guidance for membrane fouling control in the microfiltration of polymer flooding produced wastewater.

Study on interface thermodynamic mechanism of membrane fouling in flat sheet ceramic membrane treating oilfield produced water.

In this study, a flat sheet ceramic membrane experimental device was constructed, and the thermodynamics of membrane fouling interface was studied for oilfield produced water. The flux of ceramic membrane in three kinds of model solutions were measured with time, as well as the surface tension, contact Angle and Zeta potential of solid. The thermodynamic mechanism of membrane fouling interface combined with XDLVO theory were explored for three kinds of model solutions. The thermodynamic study of the interface of ceramic plate membrane shows that the total interaction energy between membrane and oil droplets decreases with the increase of the distance between two interfaces at initial stage of membrane fouling, and finally transforms from the mutual attraction to the mutual repulsion. The total interaction energy between reservoir and oil droplet is shown as mutual attraction, and the total interaction energy decreases with the increase of the distance between reservoir and oil droplet interface. The zeta potential of crude oil was affected by salinity to some extent. The electrostatic shielding effect of the salt ions leads to a decrease in the ζ-potential of the three solutions. They are in the order: model solution A > model solution B > model solution C. This leads to a decrease in the electrostatic interaction (EL). And since the oil layer has the same composition as the oil droplets, the EL interactions in the three solutions can behave as mutual repulsion.

Reconstruction of mandibular defects using a custom-made titanium tray in combination with autologous cancellous bone.

PURPOSE: To esthetically and functionally restore a 40-mm canine mandibular discontinuity defect using a custom-made titanium bone-grafting tray packed with autologous iliac bone. MATERIALS AND METHODS: Individualized titanium bone-grafting trays were made using a reverse engineering, computer-aided design, and rapid prototyping technique. A 40-mm discontinuity defect in the right mandibular body was created in 10 hybrid dogs. The defect was restored immediately using the tray that was densely packed with autologous cancellous iliac particles and covered with trimmed iliac chips. Sequential radionuclide bone imaging was performed postoperatively at 2, 4, 8, 12, and 24 weeks. The ratio of activity between the grafted mandible and the contralateral native mandible on each transaxial slice was calculated. The mean activity ratio was analyzed at each time point to evaluate the bone metabolism and reconstitution of the grafts. The subjects were sacrificed at 4, 12, and 24 weeks after grafting. The specimens were evaluated by postmortem gross dissection, biomechanical testing, 3-dimensional microcomputed tomographic scanning, and histologic examination. RESULTS: All the subjects tolerated the grafting operation well. Over an observation period of 24 weeks, tray extrusion occurred in 3 of the 10 subjects. Bony continuities were reconstructed in 9 of the 10 subjects. Radionuclide bone imaging revealed that the tracer uptake increased in the grafted mandible, and the radionuclide ratio between the graft and the native mandible decreased with time. Gross evaluation, microcomputed tomographic examination, biomechanical testing, and histologic examination demonstrated corticalization of the grafts. CONCLUSIONS: The use of a customized technique using reverse engineering, computer-aided design, and rapid prototyping tray containing autologous cancellous bone is a potentially powerful grafting technique for the reconstruction of mandibular discontinuity defects.

Adsorption-Enhanced Ceramic Membrane Filtration Using Fenton Oxidation for Advanced Treatment of Refinery Wastewater: Treatment Efficiency and Membrane-Fouling Control.

With the development of the refining industry, the treatment of refinery wastewater has become an urgent problem. In this study, a ceramic membrane (CM) was combined with Fenton-activated carbon (AC) adsorption to dispose of refinery wastewater. The effect of the combined process was analyzed using excitation-emission matrix (EEM), ultraviolet-visible (UV-vis) and Fourier transform infrared spectroscopies (FTIR). Compared with direct filtration, the combined process could significantly improve the removal of organic pollution, where the removal rate of the COD and TOC could be 70% and the turbidity removal rate was above 97%. It was found that the effluent could meet the local standards. In this study, the membrane fouling was analyzed for the impact of the pretreatment on the membrane direction. The results showed that Fenton-AC absorption could effectively alleviate membrane fouling. The optimal critical flux of the combined process was increased from 60 to 82 L/(m2·h) compared with direct filtration. After running for about 20 d, the flux remained at about 55 L/(m2·h) and the membrane-fouling resistance was only 1.2 × 1012 m-1. The Hermia model revealed that cake filtration was present in the early stages of the combined process. These results could be of great use in improving the treatment efficiency and operation cycle of refinery wastewater.

A clinical study of ultrasound-guided intralesional injection of bleomycin A5 on venous malformation in cervical-facial region in China.

OBJECTIVES: To evaluate the therapeutic outcome of ultrasound-guided intralesional injection of bleomycin A5 on treatment of venous malformation (VM) in cervical-facial region. METHODS: Seventy-five patients (32 male, 43 female), ranging in age from 13 to 60 years old, suffering from VM in cervical-facial region were admitted to and treated at our hospital between June 2006 and February 2007. Of all the patients, 54 malformations were located in the facial region, eight in the submental region, 10 in the submandible region, and three in the cervical region; all were treated by ultrasound-guided intralesional injections of bleomycin A5. The size of the lesions ranged from 6 x 9 mm to 32 x 39 mm. Injection of bleomycin A5 on venous malformation was then carried out through the inspection of ultrasonography. Repeated course of bleomycin A5 injection was administrated for larger malformations. The amount was 8 mg each time. The therapeutic interval was two to four weeks. The therapeutic outcome on venous malformation was evaluated by physical examination and ultrasonography with Doppler according to the Shou standards, including four grades; cured, basically cured, improved, and invalid. The complications were also observed during and after injection. RESULTS: The duration of follow-up ranged from 6 to 24 months. The average times of treatment were 1.64 times. Among them, 42 patients (56%) received only one time of treatment, 21 (28%) patients received two times, nine (12%) patients received three times, and three (4%) patients received four times. According to criteria of therapeutic outcome, the results showed cured in 63 patients (84%), basically cured in 10 patients (13.33%), improved in two patients (2.67%), and none ineffective. Seventy-one patients (94.67%) had local swelling in injection region for several days and two patients (2.67%) developed temporary dizziness after treatment. There were no other complications recorded. CONCLUSIONS: Intralesional injection of bleomycin A5 establishes a promisingly effect way for patients suffering from VM in the cervical-facial region under ultrasound guidance.

Investigation of impacted permanent teeth except the third molar in Chinese patients through an X-ray study.

PURPOSE: To investigate the incidence and the local factors of impacted permanent teeth, except for the third molar, in Chinese patients through an x-ray study. MATERIALS AND METHODS: A total of 548 impacted permanent teeth from panoramic radiographs were studied and recorded according to the patients' gender and age, tooth position, and classification of impaction. The local factors contributing to impacted permanent tooth were also investigated. RESULTS: The incidence of impacted permanent teeth in the Chinese was 6.15%. The impacted tooth showed a predilection for women and was more common in the maxilla. The impaction of the canine had the greatest occurrence, 28.10% of all impacted teeth. Vertical impaction was most common (49.09%). The chief local factor for impacted teeth was the lack of interdental space (49.64%). CONCLUSIONS: All permanent teeth can occur with impaction in Chinese patients. Dentists should perform a thorough evaluation before planning suitable treatment.

Accurate reconstruction of discontinuous mandible using a reverse engineering/computer-aided design/rapid prototyping technique: a preliminary clinical study.

PURPOSE: To improve the reconstructive surgical outcome of a discontinuous mandibular defect, we used reverse engineering (RE), computer-aided design (CAD), and rapid prototyping (RP) technique to fabricate customized mandibular trays to precisely restore the mandibular defects. Autogenous bone grafting was also used to restore the bony continuity for occlusion rehabilitation. PATIENTS AND METHODS: Six patients who had undergone block resection of the mandible underwent reconstruction using a custom titanium tray combining autogenous iliac grafts. The custom titanium tray was made using a RE/CAD/RP technique. A virtual 3-dimensional model was obtained by spiral computed tomography scanning. The opposite side of the mandible was mirrored to cover the defect area to restore excellent facial symmetry. A bone grafting tray was designed from the mirrored image and manufactured using RP processing and casting. The mandibular defects were restored using the trays in combination of autologous iliac grafting. An implant denture was made for 1 of the 6 patients at 24 weeks postoperatively for occlusion rehabilitation. RESULTS: The trays fabricated using this technique fit well in all 6 patients. The reconstructive procedures were easy and time saving. Satisfactory facial symmetry was restored. No severe complications occurred in the 5 patients without occlusion rehabilitation during a mean 50-month follow-up period. The reconstruction in the patient with occlusion lasted for only 1 year and failed eventually because of bone resorption and infection. CONCLUSIONS: Mandibular reconstruction was facilitated using the RE/CAD/RP technique. Satisfactory esthetic results were achieved. However, the rigidity of the cast tray could cause severe stress shielding to the grafts, which could lead to disuse atrophy. Therefore, some modification is needed for functional reconstruction.