Ecological study of Vibrio cholerae in aquatic environments, Okayama.

An ecological and molecular-epidemiological study of Vibrio cholerae in some aquatic environments of Okayama was carried out. The strains of non-O1/non-O139 were isolated frequently, and unconventional O1 strains were rarely observed. These non-O1/non-O139 strains did not have ctxA, the gene of choleratoxin, the major pathogenic factor of epidemic cholera, but possessed hlyA, a gene encoding hemolysin thought to be a pathogenic factor for sporadic diarrhea or food poisoning. Furthermore these strains also had toxR, a gene controlling the pathogenic island of the V. cholerae genome, suggesting the potentia of these strains for accepting the horizontal transfer of virulence factor genes. Thus, continuous survey of the vibrio is to ensure the food safety of fishery products.

Effect of staged crestal maxillary sinus augmentation: A case series.

BACKGROUND: In sinus augmentation, when remaining bone height is ≤5 mm, a lateral window approach is often the preferred choice; nonetheless, patients prefer to have a less invasive approach such as crestal sinus augmentation (CSA). Prior case reports have described the use of various staged approaches of a CSA technique in cases of limited bone height. The aim of this report was to describe the results of a case series in which a two-stage CSA technique was used in patients with 4 to 6 mm of bone height. METHODS: Nineteen subjects with 28 sinuses of initial vertical bone height of 4 to 6 mm were included in which a two-stage CSA technique was used in place of a lateral window approach. In the first surgery, 0.3 mL graft material was inserted into all sites. In the second surgery, 13 sites were filled with 0.2 mL graft material and remaining 15 sites were filled with 0.4 mL. RESULTS: No damage was observed in the maxillary sinus floor membrane after first 0.2 mL filling; however, one case had Schneiderian membrane perforation after filling 0.4 mL. The average elevation height (EH) after first surgery was 5.81 ± 0.7 mm, 5.15 ± 0.91 mm before second surgery, 6.69 ± 0.89 mm with 0.2 mL filling (total 0.5 mL) and 8.11 ± 1.24 mm with 0.4 mL filling (total 0.7 mL). The thickness of maxillary sinus membrane before first surgery was 2.6 ± 2.59 mm; however, it has become 0.97 ± 1.59 mm before second surgery, with a decrease of 1.6 mm estimate. CONCLUSION: This case series that assessed outcomes of staged crestal maxillary sinus augmentation was an effective approach to elevating 6 or 8 mm alveolar bone height without causing major membrane perforation. However, the two-stage approach was used in the limited residual bone height (4 to 6 mm) and required two separate surgical procedures.

Association Between Bone Graft Volume and Maxillary Sinus Membrane Elevation Height.

PURPOSE: Maxillary sinus augmentation via crestal approach has been advocated as an alternative approach for sinus membrane elevation. Presently, no study has examined the relationship between the amount of bone grafting material placed and the final sinus membrane elevation height. Therefore, the present study was aimed at investigating the extent of sinus membrane elevation height depending on the amount of bone grafting material inserted as well as three-dimensionally assessing the likelihood of membrane perforation during membrane elevation. MATERIALS AND METHODS: A total of 34 subjects (16 females and 18 males) with 61 crestal sinus elevation sites were recruited. The following changes in elevated sinus membrane area were recorded: vertical elevation height (VEH), buccopalatal elevation (BPE), and mesiodistal elevation (MDE). Cone beam computed tomography (CBCT) was used to measure the elevated height of the maxillary sinus floor at the initial examination, during surgery, and immediately after surgery. In addition, the VEH:BPE and VEH:MDE ratios at each site were calculated using CBCT to determine the probability of sinus membrane perforation. RESULTS: In average, 0.1 mL of bone graft material placed elevated VEH an average of 3.5 mm, while 0.2 mL and 0.3 mL of graft placed elevated VEH 5 mm and 6 mm, respectively. Furthermore, it was demonstrated that the VEH:BPE and VEH:MDE ratios play a determinant role on membrane integrity. As such, a ratio greater than 1.0 may jeopardize membrane integrity, while a ratio ≤ 0.8 might represent a lower risk of membrane perforation. CONCLUSION: An initial 0.1 mL of bone material filling can elevate sinus membrane vertically by 3.5 mm. To avoid sinus membrane perforation, a VEH:BPE or VEH:MDE ratio of ≤ 0.8 should be obtained.