What changes in maxillary morphology from distraction osteogenesis maxillary expansion (DOME) correlate with subjective and objective OSA measures?

OBJECTIVES

To correlate skeletal and airway measures on imaging with polysomnographic and self-reported measures after distraction osteogenesis maxillary expansion (DOME), in the effort to identify clinically relevant sites of expansion to guide treatment for adult patients with obstructive sleep apnea (OSA).

MATERIALS AND METHODS

This is a retrospective study reviewing subjects who underwent DOME and had the complete set of the following data: peri-treatment cone-beam computed tomography (CBCT) scans, polysomnography (PSG), Epworth Sleepiness Scale (ESS), and nasal obstruction symptom (NOSE) scores.

RESULTS

Of 132 subjects who underwent DOME, 35 met inclusion criteria (71% men, mean age 27.7 ± 6.5 years, mean BMI 26.0 ± 6.4 kg/m2) and were enrolled in the study. There was a significant reduction in the NOSE score from 11.4 ± 5.5 to 3.6 ± 3.1, in the ESS score from 12.0 ± 4.6 to 7.1 ± 4.7, and in the apnea-hypopnea index (AHI) from 17.1 ± 15.8 to 7.01 ± 6.2 (p < 0.0001), after DOME. Nasal floor width at the nasopalatine canal level showed a statistically significant correlation with AHI reduction (p < .0001).

CONCLUSIONS

DOME is significantly associated with reduction of nasal obstruction, sleepiness, and severity of OSA. The findings suggest that expansion at the anterior third of the bony nasal passage, specifically where the nasopalatine canal is located predicts its clinical efficacy. This site may be a useful target anatomically via imaging.

Analysis of the number of enlarged pores according to site, age, and sex

BACKGROUND

Increasing the number of enlarged pores causes cosmetic problems. The difference in the number of enlarged pores according to facial site, age, and sex is unclear.

OBJECTIVE

To analyze the distribution of the number of enlarged pores according to facial site, age, and sex.

METHODS AND MATERIALS

We analyzed the number of the enlarged pores and the percentage of wrinkles in the nose, forehead, and cheek from 434 polarized images. The measurement results were analyzed according to site, age, and sex. Relationship between enlarged pore counts and wrinkle severity was also analyzed. The study was conducted by using DermaVision,™ which can take cross-polarization, parallel polarization, and ultraviolet light images.

RESULTS

The enlarged pores of the nose and forehead were more prominent than in the cheeks. Pore counts were increased with age, and the increment was significant between the 30's and 40's. There was no significant difference by gender. Enlarged pore counts were related to wrinkle severity.

CONCLUSIONS

The number of enlarged pores differs depending on body site and increased with age. The enlarged pore counts correlate with wrinkle severity and the correlation varies depending on the body site.

Activation of matrix metalloproteinase-2 by a novel oral spirochetal species Treponema lecithinolyticum

BACKGROUND

Periodontal tissue destruction is a characteristic of periodontitis. This can be caused by either bacterial enzymes or host cell-derived matrix metalloproteinases (MMPs). In order to elucidate the etiologic role of oral spirochetes, we investigated the effects of Treponema lecithinolyticum, a novel saccharolytic species, on MMP-2 activation.

METHODS

Gingival fibroblasts (GFs) and periodontal ligament (PDL) cells obtained from healthy human subjects were cultured to confluence in alpha-minimal essential medium (alpha-MEM) supplemented with 10% fetal bovine serum. After serum starvation for a day, the cultures were treated with whole cell sonicates, heat-denatured whole cell sonicates, outer membrane fraction (OMF) or formaldehyde-fixed cells of T. lecithinolyticum. Culture supernatants were collected after incubation for 24 to 48 hours and analyzed for MMP-2 activation by gelatin zymography. Collagenolytic activity was quantitatively measured using human [3H] type IV collagen as a substrate.

RESULTS

Treatment of GFs and PDL cells with whole cell sonicates, formaldehyde-fixed whole cells, or the OMF of T. lecithinolyticum resulted in the production of MMP-2 partly in the fully active form with a molecular mass of 62 kDa, whereas non-treated control cultures and cultures treated with a heat-denatured fraction did not show the active form. Cultures exposed to T. lecithinolyticum had higher collagenolytic activity than non-treated cultures.

CONCLUSIONS

Our results demonstrate that T. lecithinolyticum, possibly mediated by proteinaceous cell surface-associated components, may participate in extracellular matrix degradation by activation of MMP-2 during periodontal inflammation.

The effect of the scid mutation on mechanism and control of immunoglobulin heavy and light chain gene rearrangement

Most Abelson murine leukemia virus (A-MuLV)-transformed cell lines derived from scid (severe combined immune deficient) mice actively rearrange their endogenous immunoglobulin (Ig) heavy (H), but not light (L) chain variable region genes. Such cell lines express germline VH segments and other RNA transcripts that are characteristically produced by early precursor (pre)-B lymphocytes, but do not express high levels of transcripts from the germline kappa (k) constant region (C kappa) locus. However, we have derived scid A-MuLV transformants that express germline C kappa transcripts and attempt kappa gene assembly. In one case kappa gene expression and rearrangement occurred in the absence of mu H chain expression, and in another was not induced efficiently by introduction of a mu-expression vector. Although the vast majority of scid H and L chain coding sequence joins are grossly aberrant, scid A-MuLV transformants can form normal coding joints at a very low frequency. In contrast, these cells form generally normal signal sequence joins at an approximately normal efficiency. Thus, these findings mechanistically distinguish coding and signal join formation. Subcloning analyses suggest that scid A-MuLV transformants that do not attempt chromosomal coding sequence joining may have a relative survival advantage, and therefore that these events may often result in unrepaired chromosomal breakage and cell death.