Influence of intraoral scanning coverage on the accuracy of digital implant impressions - An in vitro study

OBJECTIVES

To evaluate the influence of intraoral scanning coverage (IOSC) on digital implant impression accuracy in various partially edentulous situations and predict the optimal IOSC.

METHODS

Five types of resin models were fabricated, each simulating single or multiple tooth loss scenarios with inserted implants and scan bodies. IOSC was subgrouped to cover two, four, six, eight, ten, and twelve teeth, as well as full arch. Each group underwent ten scans. A desktop scanner served as the reference. Accuracy was evaluated by measuring the Root mean square error (RMSE) values of scan bodies. A convolutional neural network (CNN) was trained to predict the optimal IOSC with different edentulous situations. Statistical analysis was performed using one-way ANOVA and Tukey's test.

RESULTS

For single-tooth-missing situations, in anterior sites, significantly better accuracy was observed in groups with IOSC ranging from four teeth to full arch (p < 0.05). In premolar sites, IOSC spanning four to six teeth were more accurate (p < 0.05), while in molar sites, groups with IOSC encompassing two to eight teeth exhibited better accuracy (p < 0.05). For multiple-teeth-missing situations, IOSC covering four, six, and eight teeth, as well as full arch showed better accuracy in anterior gaps (p < 0.05). In posterior gaps, IOSC of two, four, six or eight teeth were more accurate (p < 0.05). The CNN predicted distinct optimal IOSC for different edentulous scenarios.

CONCLUSIONS

Implant impression accuracy can be significantly impacted by IOSC in different partially edentulous situations. The selection of IOSC should be customized to the specific dentition defect condition.

CLINICAL SIGNIFICANCE

The number of teeth scanned can significantly affect digital implant impression accuracy. For missing single or four anterior teeth, scan at least four or six neighboring teeth is acceptable. In lateral cases, two neighboring teeth may suffice, but extending over ten teeth, including contralateral side, might deteriorate the scan.

Characteristic-preserving Latent Space for Unpaired Cross-domain Translation of 3D Point Clouds

This paper aims at unpaired shape-to-shape transformation for 3D point clouds, for instance, turning a chair to its table counterpart. Recent work for 3D shape transfer or deformation highly relies on paired inputs or specific correspondences. However, it is usually not feasible to assign precise correspondences or prepare paired data from two domains. A few methods start to study unpaired learning, but the characteristics of a source model may not be preserved after transformation. To overcome the difficulty of unpaired learning for transformation, we propose alternately training the autoencoder and translators to construct shape-aware latent space. This latent space based on novel loss functions enables our translators to transform 3D point clouds across domains and maintain the consistency of shape characteristics. We also crafted a test dataset to objectively evaluate the performance of point-cloud translation. The experiments demonstrate that our framework can construct high-quality models and retain more shape characteristics during cross-domain translation compared to the state-of-the-art methods. Moreover, we also present shape editing applications with our proposed latent space, including shape-style mixing and shape-type shifting, which do not require retraining a model.

The influence of crown coverage on the accuracy of static guided implant surgery in partially edentulous models: An in vitro study

OBJECTIVE

To evaluate the influence of crown coverage of surgical guides on the accuracy of static computer-assisted implant surgeries (sCAISs) in different partially edentulous situations.

METHODS

Acrylic models with five types of partially edentulous situations were fabricated in this study. In coDiagnostiX software (Dental Wings, Montreal, Canada), surgical templates were designed and fabricated with reduced crown coverage (RCC), standard crown coverage (SCC) and extended crown coverage (ECC). Then, fully guided implant placement into the acrylic models was performed by dental surgeons with more than 10 years of experience. In total, 120 models and 120 guides were manufactured, and 168 bone-level Straumann replica implants (4.1 × 10 mm, Institut Straumann AG, Basel, Switzerland) were inserted. Postoperative implant positions were scanned (Trios 3, 3 shape, Copenhagen, Denmark) and compared with the preplanned virtual positions via coDiagnostiX (Dental Wings, Montreal, Canada). The angular, coronal and apical deviations were measured and analyzed to evaluate the accuracy of implant insertion. Statistical analysis was performed using one-way ANOVA and Tukey's test.

RESULTS

For single tooth missing situations, the RCC group was similar to the SCC group and ECC group in anterior sites. In premolar or molar sites, the SCC and ECC groups had no statistically significant difference (p > .05), while the RCC group had more coronal and apical deviation (p < .05). For multiple teeth missing situations, there was no difference among the RCC, SCC and ECC groups (p > .05). No difference was found among the five edentulous situations with different CCs (p > .05).

CONCLUSION

The CC of templates can significantly affect the accuracy of guided surgeries when implants are inserted in a single gap at posterior sites. Templates with CC extended to the undercut line may be an optimal choice for static guided surgeries.

CLINICAL SIGNIFICANCE

The accuracy of static guided implant surgery can be influenced by the CC of templates, and proper CC with the guide covering extending to the undercut line may contribute to improved accuracy. CC should be taken into consideration when designing surgical templates.

[Clinical value of intact parathyroid hormone levels on the first day after total thyroidectomy on prediction for permanent hypoparathyroidism]

Objective: To examine the value serum calcium and intact parathyroid hormone (iPTH) levels measured on the first day after total thyroidectomy on prediction for permanent hypoparathyroidism. Methods: Totally 546 patients with thyroid cancer and benign thyroid lesions who underwent total thyroidectomy at Department of General Surgery, Beijing Chaoyang Hospital, Capital Medical University from February 2008 to December 2018 were analyzed retrospectively. There were 158 males and 388 females aging (50.9±13.2) years (range: 19.0 to 79.2 years). Serum calcium and iPTH levels were collected before surgery, on the first day and 6 months after surgery. Logistic regression was used to analyze the correlation between each data and the occurrence of permanent hypoparathyroidism after surgery.The area under the receiver operating characteristic curve was used to evaluate the predictive power of iPTH for postoperative occurrence of permanent hypoparathyroidism. Results: Among the 546 cases of total thyroidectomy, 22 cases of permanent hypoparathyroidism occurred, with an incidence of 4.0% (22/546). Multivariate analysis showed that iPTH levels on the first day after total thyroidectomy (OR=2.932, 95%CI: 1.129 to 7.616, P=0.027) and serum calcium levels (OR=2.584, 95%CI: 1.017 to 6.567, P=0.046) were independent prognosis factors for postoperative permanent hypoparathyroidism. When the threshold value of iPTH at 24 hours after total thyroidectomy was 5.51 ng/L, the AUC was 0.956 (95%CI: 0.936 to 0.972, P=0.000), sensitivity was 100%, specificity was 85.1%, positive predictive value was 22%, negative predictive value was 100%. When the threshold value of serum calcium at 24 hours after total thyroidectomy was 1.93 mmol/L, the AUC was 0.733 (95%CI: 0.694 to 0.770, P=0.000), sensitivity was 63.6%, specificity was 78.1%, positive predictive value of 10.8% and negative predictive value of 98.1%. Conclusions: Serum iPTH and calcium levels on the first day after total thyroidectomy were related to the occurrence of permanent hypoparathyroidism postoperatively. The predictive value of iPTH level is higher than that of serum calcium level.

[Effect of fragmented sleep on postoperative cognitive function and central neuroinflammation]

Objective: To investigate the effect of sleep fragmentation on perioperative neurocognitive disorders (PND) and central neuroinflammation by simulating sleep patterns of postoperative patients with sleep fragmentation in aged mice. Methods: Thirty-two elderly ICR mice were randomly divided into four groups (n=8): normal group (C), surgery group (S), fragmented sleep group (F), and surgery+fragmented sleep group (D). Fragmented sleep was conducted after internal fixation of tibia fractures, cognitive function was evaluated by novel object recognition (NOR) and fear conditioning (FC) test, and changes in expression of inflammatory cytokines in hippocampus were detected by ELISA. Results: NOR test: the recognition index (RI) of mice in group C, group S, group F and group D was 0.69±0.07, 0.48±0.07, 0.54±0.10 and 0.50±0.12, respectively. The RI of mice in group S, group F and group D was significantly lower than that in group C (t=4.885, 3.521 and 4.433, all P<0.01). There was no significant difference in RI between group S and group D (t=0.967 1, P>0.05). Contextual FC test: the freezing time of mice in group C, group S, group F and group D was(21.34±6.48), (13.83±4.26), (11.50±6.25) and (6.17±4.77) s, respectively. The freezing time of mice in group S, group F and group D was significantly lower than that in group C (t=2.722, 3.566, 5.496, P<0.05 or P<0.01). The freezing time of mice in group D was significantly lower than that in group S (t=2.774, P<0.05). Cue FC test: the freezing time of mice in group C, group S, group F and group D was (74.36±17.09), (43.91±9.71), (46.34±13.43) and (24.90±14.21) s, respectively. The freezing time of mice in group S, group F and group D was significantly lower than that in group C (t=4.393, 4.043 and 7.136, all P<0.01). The freezing time of mice in group D was significantly lower than that in group S (t=2.743, P<0.05). The levels of TNF-α, IL-6 and IL-1β in hippocampus of mice in group S, F and D were significantly higher than those in group C, while the levels of TNF-α and IL-6 in hippocampus of mice in group D were significantly higher than those in group S, with statistically significant differences (P<0.05 or P<0.01). Conclusion: Postoperative fragmented sleep aggravates postoperative cognitive impairment and increases the hippocampal neuroinflammation in aged mice.

Viscosity Prediction of Lubricants by a General Feed-Forward Neural Network

Modern industrial lubricants are often blended with an assortment of chemical additives to improve the performance of the base stock. Machine learning-based predictive models allow fast and veracious derivation of material properties and facilitate novel and innovative material designs. In this study, we outline the design and training process of a general feed-forward artificial neural network that accurately predicts the dynamic viscosity of oil-based lubricant formulations. The network hyperparameters are systematically optimized by Bayesian optimization, and strongly correlated/collinear features are trimmed from the model. By harnessing domain knowledge in the selection of features, the quantitative structure-property relationship model is built with a relatively simple feature set and is versatile in predicting the dynamic viscosity of lubricant oils with and without enhancement by viscosity modifiers (VMs). Moreover, partial dependency, local-interpretable model-agnostic explanations, and Shapley values consistently show that the eccentricity index, Crippen MR, and Petitjean number are important predictors of viscosity. All in all, the neural model is reasonably accurate in predicting the dynamic viscosity of lubricant solvents and VM-enhanced lubricants with an R² of 0.980 and 0.963, respectively.

[Modified memory sub-test of Syndrom Kurz test in middle-aged and elderly Chinese]

Objective: To investigate the applicability of the modified memory sub-test of syndrom kurz test (SKT-M) in middle-aged and elderly Chinese. Methods: Between March 1, 2017, and October 31, 2017, at HwaMei Hospital, 132 patients receiving elective great saphenous vein high ligation and stripping operation and 96 their accompanying dependents, 55-75 years old, were randomly divided into the SKT-M group (n=121) and auditory verbal learning test -huashan version (AVLT-H) group (n=107) using random numeral method. The two groups underwent two corresponding neuropsychological tests respectively on the day before surgery and the second day after surgery. Results: There was no significant difference in the baseline characteristics and all the neuropsychological indices at the two time points between patients and dependents (P>0.05). As a consequence, the data of the patients and dependents were integrated to compare the applicability of SKT-M and AVLT-H. The "low-score" ratio of SKT-M immediate recall (2.4%) was lower than that of AVLT-H test (12.1%) (χ(2)=8.138, P<0.01). Besides, the "low-score" ratio of SKT-M delayed recall (5.7%) was also lower than that of AVLT-H test (20.5%) (χ(2)=11.167, P<0.01). The influence factors of SKT-M were less than that of AVLT-H test. However, the learning effect of SKT-M immediate recall was more significant, for its first testing sore (23.1±5.4) was significantly higher than the second one (21.9±5.1) (t=-3.971, P<0.001). Conclusion: The SKT-M has better applicability to 55-75 years old Chinese than AVLT-H test, but its learning effect should be noted.

[Changing trends of topical anti-glaucoma medications in the Eye Hospital of Wenzhou Medical University during the past ten years]

Objective: To investigate the changing trends of topical anti-glaucoma medications in the outpatient of the Eye Hospital of Wenzhou Medical University over the decade 2005-2014. Methods: Retrospective case series study. The medications data of glaucoma outpatients in the Eye Hospital of Wenzhou Medical University were collected for the period of January 1(st) 2005 to December 31(st) 2014. SPSS 20.0 statistical software was used, mainly for statistical description of the data. The main outcome measures were the proportions of the prescriptions of different medications, and the proportions of the monotherapy and combination therapies. Results: During the 10 years, the number of glaucoma outpatients increased year by year, from 994 in 2005 to 3 266 in 2014, the gender ration was close to 1∶1, and the age were (57±18) years. The proportion of β-blockers decreased from 56.7% (750/1 323) in 2005 to 33.1% (2 120/6 407) in 2014. The proportion of cholinergic agents decreased from 17.2% (227/1 323) in 2005 to 10.3% (663/6 407) in 2014. While the proportion of prostaglandins increased from 13.3% (176/1 323) in 2005 to 36.8% (1 916/5 209) in 2011, which was close to the 37.9% (1 972/5 209) of β-blockers in 2011. In 2012, the prostaglandins proportion increased to 41.9% (2 435/5 810) exceeding the 37.2% (2 161/5 810) of β-blockers, and became the most prescribed medication. The proportion of prostaglandins continued to increase to 46.9% (3 008/6 407) in 2014. The proportion of α(2)-agonists increased from 17.0% (225/1 323) in 2005 to 22.8% (1 460/6 407) in 2014. The proportion of carbonic anhydrase inhibitors increased from 9.6% (127/1 323) in 2005 to 24.1% (1 546/6 407) in 2014.The proportion of monotherapy decreased from 78.0% (1 032/1 323) in 2005 to 58.6% (3 757/6 407) in 2014. The proportion of two drugs combination increased from 20.0% (264/1 323) in 2005 to 26.7% (1 709/6 407) in 2014. The proportion of three drugs combination increased from 2.0% (26/1 323) in 2005 to 12.3% (788/6 407) in 2014. The proportion of four drugs combination increased from 0.1% (1/1 323) in 2005 to 2.3% (150/6 407) in 2014. Conclusions: The changes of the proportions of topical anti-glaucoma medications were remarkable from 2005 to 2014 in the outpatient of the Eye Hospital of Wenzhou Medical University. The β-blockers and cholinergic agents were declining, while the prostaglandins, α(2)-agonists and carbonic anhydrase inhibitors were increasing, and the prostaglandins became the most prescribed medication since 2012. The proportion of combination therapy was increasing. (Chin J Ophthalmol, 2018, 54: 520-525).

[Comparison of effects of two anesthesia methods on the first night sleep quality in middle-aged and elderly patients undergoing surgery for lower extremity varicose vein]

Objective: To investigate effects of two anesthesia methods on the first night sleep quality in middle-aged and elderly patients after surgery. Methods: This was a prospective study conducted from November 2017 to March 2018. Sixty patients, aged 50-70, undergoing elective surgery for unilateral lower extremity varicose vein at Ningbo No.2 Hospital, with American Society of Anesthesiologists (ASA) grade Ⅰ or Ⅱ, were enrolled and randomly allocated to two groups (n=30), general anesthesia group and spinal anesthesia group. On the first day before surgery, the patient's general data were collected and the Pittsburgh sleep quality index (PSQI) was used to assess the patient's sleep status in the past month. The postoperative mean arterial pressure (MAP), heart rate (HR) and pulse oxygen saturation (SpO(2)) in the ward were recorded with a multi-function monitor on first night after surgery. The total sleep time and arousal time were obtained by bispectral index (BIS) monitoring from 20: 00 (the first day) to 6: 00 (the second day). Athens Insomnia Scale (AIS) was recorded at 18: 00 at the second day after surgery. Results: There was no significant difference in general data and PSQI scale scores between the two groups of patients (all P>0.05). And there were no significant differences in MAP, HR, SpO(2) and BIS every 2 hours between the two groups from 20: 00 (the first day) to 6: 00 (the second day)(all P>0.05). Compared with the general anesthesia group, the first night of total sleep time in the spinal anesthesia group was significantly shorter[(357.2±83.4)min vs (275.1±64.8)min, t=-9.635, P<0.05], while the rate of wakefulness, total sleep time, overall sleep quality, daytime mood and daytime physical function were significantly higher[(25.9%, 22.2%, 25.9%, 18.5%18.5%) vs (51.7%, 51.7%, 55.2%, 48.3%44.8%), χ(2)=3.901, 5.192, 4.941, 5.523 and 4.437, all P<0.05], and the cases of postoperative urinary retention and lower limb discomfort were significantly higher[(8 and 6) vs (1 and 0), all P<0.05]. Conclusion: Both anesthesia methods can be safely and effectively applied to middle-aged and elderly patients with lower extremity varicose veins surgery, but patients with general anesthesia show fewer adverse reactions on the first night after surgery and have better sleep quality.

[Effect of dexmedetomidine alone for postoperative analgesia after laparoscopic cholecystectomy]

Objective: To investigate the effect of dexmedetomidine alone for postoperative analgesia after laparoscopic cholecystectomy. Methods: Forty patients scheduled for elective laparoscopic cholecystectomy in First Hospital of Ninghai County, American Society of Anesthesiologists (ASA) gradeⅠor Ⅱ, were randomly divided into dexmedetomidine group (Group D, n=20) and fentanyl group (Group F, n=20). The patient controlled analgesia (PCA) pumps were used after the operation. In the group D, the intravenous PCA protocol was dexmedetomidine 0.2 μg·kg(-1)·h(-1) diluted to 100 ml in 0.9% saline. In the group F, the PCA protocol was fentanyl 20 μg /kg diluted to 100 ml in 0.9% saline. Mean arterial pressure (MAP) and heart rate (HR) were recorded at the following time points: before induction of anaesthesia, end of operation and 4, 6, 8, 24, 48 hours after the operation. The pain score on a visual analogue scale (VAS) and the Ramsay sedation score were recorded at 4, 6, 8, 24, 48 hours after the operation. The incidences of postoperative nausea and vomiting (PONV), respiratory depression, dizziness, time to recovery of gastrointestinal function (time to first passage of flatus) and satisfaction with pain control were also recorded. Results: There were no significant difference in the general data of patients, duration of surgery, total dose of intraoperative propofol, fentanyl and sevoflurane, and total fluids during the operation (P>0.05). No patients received rescue analgesic. The MAP and HR values at different time points showed no significant difference between the groups (P>0.05). Similarly, the VAS scores and Ramsay sedation scale at 4, 6, 8, 24, 48 hours after the operation were not significantly different between the groups (P>0.05). The incidence of PONV was significantly reduced in group D, rating as 5%, comparing with 40% in Group F (P<0.05). Patients of Group D experienced a faster gastrointestinal function recovery, and the time to the first passage of flatus were (41.3±10.1) h in Group D and (55.6±11.4) h in Group F (t=-4.195, P<0.05), respectively. The pain treatment satisfactory score (PTSS) in Group D was (8.1±1.3) points, higher than that in Group F (6.1±1.5) points (t=4.426, P<0.05). Meanwhile, there was no statistic difference in the incidence of respiratory depression and dizziness in both groups (P>0.05). Conclusion: Intravenous infusion of dexmedetomidine alone at 0.2 μg·kg(-1)·h(-1) after laparoscopic cholecystectomy not only reduces postoperative pain, but also enhances satisfaction with pain control and improves the recovery of gastrointestinal function.

A novel HLA class I allele: HLA-A*11:01:49

The HLA-A*11:01:49 allele differs from A*11:01:01:01 by one synonymous nucleotide substitution at position 837.

Characterization of the novel HLA-B*40:01:31 allele

The HLA-B*40:01:31 allele differs from B*40:01:01 by one nucleotide substitution at position 216.

A novel HLA-B allele: HLA-B*40:241

The HLA-B*40:241 allele differs from B*40:01:01 by 1 nucleotide substitution at position 691.

A novel HLA-B allele: HLA-B*40:242

The HLA-B*40:242 allele differs from B*40:54 by 1 nucleotide substitution at position 190.

Characterization of the novel HLA-DRB1*11:01:20 allele

The HLA- DRB1*11:01:20 allele differs from DRB1*11:01:01:01 by 1 nucleotide substitution at position 219.

A novel HLA-B allele, HLA-B*13:69

HLA-B*13:69 allele differs from B*13:02:01 by one nucleotide substitution at position 628 from A to C.

A novel HLA-B allele, HLA-B*56:40

HLA-B*56:40 allele differs from B*56:01:01:01 by one nucleotide substitution at position 874.

Identification of a novel HLA-B*40 allele, HLA-B*40:229, in a Chinese individual

The novel HLA-B*40:229 allele shows one nucleotide difference from B*40:02:01 in exon 2 at nucleotide position 97 (C → T).

Identification of a novel HLA-A*24 variant allele, A*24:02:60

HLA-A*24:02:60 allele differs from A*24:02:01:01 by one nucleotide substitution at nt 564 from C to T.

Identification of a novel HLA-B*40 allele, HLA-B*40:210, in a Chinese individual

The newly detected HLA-B*40:210 allele has two nucleotide changes in exon 2 compared to B*40:49 allele.

A new human leukocyte antigen class I allele: HLA-A*11:125

HLA-A*11:125 allele differs from A*11:01:01 by one nucleotide substitution at nt 140 from T to C.

Intralesional injection of pingyangmycin is a safe and effective treatment for microcystic lymphatic malformations in the tongue

Objective

To evaluate the efficacy and safety of intralesional injection of pingyangmycin for the treatment of microcystic lymphatic malformations (LMs) in the tongue.

Methods

Eighteen patients with tongue microcystic LMs were treated with intralesional injection of pingyangmycin. The concentration of the drug was 1 mg/mL with an addition of dexamethasone. Repeated injections were performed at an interval of 3–4 weeks. The results were evaluated by clinical examinations and Doppler ultrasonography scan. The follow-up period was 12 months to eight years after the last treatment and the mean follow-up time was three years. All patients received 1–8 injections (mean, 3.0 injections) for the whole course of treatment. The total dose of pingyangmycin administered was 8–64 mg (mean, 24 mg).

Results

Fifteen patients had complete response with no cosmetic or functional problems. Three patients with macroglossia had a reduction of 50–90% in the lesion size and needed secondary surgery. No serious complications were encountered.

Conclusion

The results suggested that intralesional injection of pingyangmycin is an effective and safe treatment for microcystic LMs in the tongue, and can be used as the first-line treatment protocol.

Role of cigarette filter on the risk of oral cancer: a case-control study in a Chinese population

OBJECTIVE

To determine the role of cigarette filter on the incidence risk of oral squamous cell cancer among male smokers in a Chinese population.

SUBJECTS AND METHODS

A multicentric hospital-based case-control study was applied. Three hundred and nineteen male cases and 428 male controls matching for age ( ± 3 years) were identified from January 2008 to December 2010. Detailed smoking histories were obtained by interviews. Logistic regression model was used to compare the influence of filter and non-filter cigarettes on oral cancer risk.

RESULTS

The adjusted odd ratios (ORs) for oral cancer were 1.30 (95% CI 1.15, 1.48) of filter cigarette smokers, 2.06 (95% CI 1.17, 3.62) of non-filter cigarette smokers, and 1.73 (95% CI 1.33, 2.25) of mixed smokers, as compared with non-smokers. When classified current smokers according to smoking pack year, the ORs of mixed smokers were 2.27 (95% CI 1.06, 4.85) in <20 pack year, 0.81 (95% CI 0.57, 1.14) in 20-39 pack year, and 0.86 (95% CI 0.57, 1.29) in ≥ 40 pack year, as compared to filter cigarette smokers.

CONCLUSIONS

The protective effect against oral cancer of cigarette filter was limited, restricted to smokers of small amount of smoking accumulation. For most smokers, the difference was non-significant between filter and non-filter cigarettes on the risk of developing oral cancer.

Intraosseous Venous Malformations of the Facial Bone: A Retrospective Study in 11 Patients

Objectives:

To investigate the clinical symptoms, computed tomography (CT) features and treatments of intraosseous venous malformations (IVM) that occur in the facial bone.

Methods and Results:

Eleven patients with facial IVM were treated with two surgical techniques, excision ( n = 4) or curettage ( n = 7). No recurrence was encountered at follow-up (45.8 ± 16.0 months). Postoperative deformities were left in two paediatric patients who were treated with excision.

Conclusions:

The diagnosis of IVM can be difficult and is mainly based on clinical symptoms and CT features. IVM should be differentiated from other lesions, including ameloblastoma, odontogenic cysts, osteosarcoma, aneurysmal bone cysts and arteriovenous malformations, among others. Conventional block biopsy should be replaced by fine needle aspiration cytology for further diagnosis. Curettage is a more appropriate method for IVM compared with excessive en-bloc osteotomy, while transosseous embolo-sclerotherapy may be a promising alternative method. Finally, the terminological confusion between ‘intraosseous haemangioma’ and ‘intraosseous venous malformation’ should be avoided according to the binary classification.

The role of serum basic fibroblast growth factor, estradiol and urine basic fibroblast growth factor in differentiating infantile haemangiomas from vascular malformations

OBJECTIVE

To investigate the role of serum basic fibroblast growth factor (bFGF), estradiol (E2) and urine bFGF in differentiating infantile haemangiomas from vascular malformations.

METHOD

Between October 2007 and January 2009, 97 patients with haemangiomas and 25 patients with vascular malformations who had not been treated previously were included in this prospective study. Forty-eight patients with cleft lip and/or palate were selected as controls. The age of all subjects ranged from 1 to 30 months. The serum and urine levels of bFGF were determined by enzyme-linked immunosorbent assay (ELISA). The serum levels of E2 were examined via radioimmunoassay. All data were analysed with SPSS 11.5 software package.

RESULTS

The concentration of serum and urine bFGF was significantly different among the three groups (haemangiomas, vascular malformations and controls) (P = 0.027, P = 0.001). Significantly different urine bFGF levels were found in patients with proliferating and involuting haemangiomas (P = 0.04). The serum E2 levels were significantly higher in patients with haemangiomas than vascular malformations (P = 0.001) and controls (P = 0.001).

CONCLUSION

Serum bFGF and E2 as well as urine bFGF can be used to supplement the clinical diagnosis of congenital vascular anomalies. Urine bFGF combined with serum E2 may be the most potential markers for diagnosing haemangiomas and determining the proliferating stage of haemangiomas.

Sclerotherapy of voluminous venous malformation in head and neck with absolute ethanol under digital subtraction angiography guidance

OBJECTIVES

Venous malformation (VM) is the most common symptomatic low-flow vascular malformation, which predominantly occurs in the head and neck region. The aim of this paper was to evaluate the results of endovascular sclerotherapy of voluminous VM, when the lesion is either >or=15 cm in maximum diameter or the lesion invades more than one anatomical space, in the head and neck region using absolute ethanol under digital subtraction angiography (DSA) guidance.

METHODS

A total of 23 patients with head and neck VMs between October 2005 and December 2008 were retrospectively reviewed. All patients received direct puncture ethanol sclerotherapy under DSA guidance. Follow-up assessments were performed at 3-25 months after therapies were completed, and complications were reported in some cases.

RESULTS

All patients were satisfied with the results of therapy. Seventeen patients (73.9%) achieved excellent responses and six patients (26.1%) achieved good responses in magnetic resonance imaging assessments. Minor complications developed during the procedures, all of which were successfully managed with full recovery during follow-ups. Serious complications such as acute pulmonary hypertension, cardiovascular collapse and pulmonary embolism were not encountered.

CONCLUSION

It is concluded that sclerotherapy with absolute ethanol under DSA guidance is an important alternative therapy for voluminous and extensive VM, as the procedure is reasonably safe and offers good therapeutic results.

Sectional anatomy of the olfactory pathways

AIM

The purpose of this study was to provide practical anatomic data for imaging diagnosis of olfactory pathways and operation of nasal cavity and anterior cranial fossae.

METHODS

Sectional anatomy of olfactory pathways were investigated specially on 17 sets of Chinese adult cadavers and 9 sets of serial magnetic resonance (MR) imaging of normal adult on serial transverse, sagittal and coronal sections respectively.

RESULTS

We recognized olfactory bulb, olfactory tract, medial and lateral olfactory striae, olfactory trigone, anterior perforated substance and piriform lobe on transverse, sagittal and coronal sections respectively. On the 5-7 serial coronal sections from crista galli of ethmoid bone to the optic chiasm, the cusp ellipse olfactory bulb and the triangular tract were situated in the shallow part of the olfactory sulcus.

CONCLUSION

The olfactory bulb and olfactory tract lay tightly on the ethmoidal cribriform plate and jugum sphenoidale, in the olfactory cistern of the shallow part of the olfactory sulcus, the ethmoid sinus and sphenoid sinus inferiorly.

Ethanol embolization of auricular arteriovenous malformations: preliminary results of 17 cases

BACKGROUND AND PURPOSE

Because of the relatively rare and extremely varied clinical presentations, arteriovenous malformations (AVMs) involving the auriculae are technically challenging clinical entities to diagnose and, ultimately, manage. The purpose of our study was to present our initial experience of ethanol embolization in a series of 17 patients with auricular AVMs and assess the interim therapeutic outcomes of this method.

MATERIALS AND METHODS

Our study group consisted of 17 patients. Transcatheter arterial embolization and/or direct percutaneous puncture embolization were performed. Pure or diluted ethanol was manually injected. Follow-up evaluation was obtained on the basis of physical examination and angiography at 3- to 4-month intervals and telephone questionnaire at 1-month intervals in all patients.

RESULTS

During the 29 ethanol embolization procedures, the amount of ethanol used ranged from 4 to 65 mL. The obliteration of ulceration, hemorrhage, pain, infection, pulsation, and bruit in most of the patients was obtained. The reduction of redness, swelling, and warmth was achieved in all of the patients, and 15 of the patients achieved downstaging of the Schobinger status. According to the angiographic findings, AVMs were devascularized 100% in 3 patients, 76% to 99% in 5 patients, 50% to 75% in 6 patients, and less than 50% in 3 patients. The most common complications were reversible necrosis and blister.

CONCLUSIONS

Ethanol embolization has proved efficacious and safe in the treatment of auricular AVMs and has the potential to be accepted as the primary mode of therapy in the management of these lesions.

Ethanol embolization of arteriovenous malformations of the mandible

BACKGROUND AND PURPOSE

Absolute ethanol was reported as an effective embolization of arteriovenous malformations (AVMs), but its use to treat AVMs in the mandible is not yet well established. Here, we present our clinical experience on treatment of mandibular AVMs with absolute ethanol.

MATERIALS AND METHODS

Eight consecutive patients with symptomatic AVMs of the mandible between August 2007 and September 2008 were enrolled in this study group. Among them, 6 patients underwent direct puncture embolization with absolute ethanol combined with coils, 1 patient underwent direct puncture embolization with absolute ethanol only, and the last patient had transarterial embolization with absolute ethanol alone. The use of coils decreased the flow and volume of the nidus, and then absolute ethanol embolization was directed against and obliterated the nidus completely. The procedure was performed with the patients under general anesthesia with nasal intubation, and the vital signs of the patients were constantly monitored during the injection of absolute ethanol. The total amount of absolute ethanol used per session was less than 1 mL/kg of body weight.

RESULTS

A total of 11 ethanol embolizations were performed on 8 patients, including 3 sessions with transarterial microcatheterization and 8 with direct puncture embolization. A venogram and control arteriogram performed immediately after the procedure were both obtained, which documented a significant thrombosis of the lesion in all patients. Follow-up examinations revealed that oral bleeding was controlled, the expansion of the external jugular vein in 5 cases was obliterated, and satisfactory shrinkage of the facial swelling was achieved. Follow-up angiography (mean, 4.2 months) was available in 4 patients, and there was no angiographic recurrence of the lesions. There were 3 cases with minor complications.

CONCLUSIONS

On the basis of our experience, treatment of AVMs in the mandible with absolute ethanol is a feasible, safe, and highly effective method.

Malignant solitary fibrous tumors of the head and neck: a clinicopathological study of nine consecutive patients

Malignant solitary fibrous tumor (MSFT) is one of the angiosarcomas arising from or resembling the components of blood vessels. Because of its rarity, the diagnosis is difficult. Between 1998 and 2008, 24 patients were diagnosed as having hemangiopericytomas (16) and solitary fibrous tumors (8). Nine of them were confirmed to be MSFT and treated at the Department of Oral and Maxillofacial Surgery, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine. All patients were treated with surgery as the primary modality. Eight patients received postoperative adjuvant radiation therapy. The average follow-up duration was 4.6 years (range: 6 months-10 years). Of the nine patients reviewed in this study, three died of locoregional or distant metastasis, six survived 6 months-6 years (four survived over 4 years). The size of primary tumor, the number of mitoses per 10 high powered fields and cervical lymph node metastasis seemed to be correlated with poor prognosis in MSFT patients, although the small number of patients did not permit the performance of statistical analysis.

Determination of TAP1 and TAP2 polymorphism in the Chinese Han population by real-time TaqMan polymerase chain reaction

The heterodimeric transporter associated with antigen processing (TAP) complex plays a key role in immune surveillance. TAP1 and TAP2 typing was usually performed by polymerase chain reaction (PCR)-restriction fragment length polymorphism and PCR-sequence-specific oligonucleotide probe. As an alternative to these methods, we have established TaqMan assays to determine the frequencies of the TAP1 and TAP2 alleles. We have used these new TaqMan assays to genotype the polymorphisms in 339 unrelated Chinese Hans residing in North and South China. We detected five TAP1 and four TAP2 alleles. All the loci conform to the Hardy-Weinberg expectations. The most frequent alleles in Chinese Hans were TAP1*0101 (79.79%) and TAP2*0101 (82.74%). The two-locus haplotype analysis showed highly significant positive linkage disequilibrium for one TAP1-TAP2 haplotype (TAP1*020101-TAP2*0102), three TAP1-DRB1 haplotypes (TAP1*020101-DRB1*03, TAP1*020102-DRB1*13, and TAP1*0301-DRB1*16), and three TAP2-DRB1 haplotypes (TAP2*0102-DRB1*09, TAP2*0103-DRB1*04, and TAP2*0201-DRB1*01). The three-locus haplotype analysis showed highly significant positive linkage disequilibrium for TAP1*0101-TAP2*0101-DRB1*07, TAP1*0101-TAP2*0103-DRB1*04, TAP1*020101-TAP2*0101-DRB1*03, and TAP1*020101-TAP2*0102-DRB1*13. Comparison of the allele frequencies with those of other populations showed that the TAP1 allele distribution was very similar in all the groups, except for the Guarani, Kaingang, and Anatolian populations, but TAP2 distribution was significantly different from that of the other populations. The new TaqMan method provides relatively accurate, high-resolution, simple, and fast assays for TAP genotyping.

A wearable mobihealth care system supporting real-time diagnosis and alarm

This paper describes a wearable mobihealth care system aiming at providing long-term continuous monitoring of vital signs for high-risk cardiovascular patients. We use a portable patient unit (PPU) and a wearable shirt (WS) to monitor electrocardiogram (ECG), respiration (acquired with respiratory inductive plethysmography, RIP), and activity. Owing to integrating fabric sensors and electrodes endowed with electro-physical properties into the WS, long-term continuous monitoring can be realized without making patients feel uncomfortable and restricting their mobility. The PPU analyzes physiological signals in real time and determines whether the patient is in danger or needs external help. The PPU will alert the patient and an emergency call will be automatically established with a medical service center (MSC) when life-threatening arrhythmias or falls are detected. With advanced gpsOne technology, the patient can be located and rescued immediately whether he/she is indoors or outdoors in case of emergency.

Carotid artery resection and reconstruction: clinical experience of 28 consecutive cases

The aim of this study was to analyse the experience at a single institution in carotid artery resection with or without reconstruction performed as part of an oncological procedure or emergency haemostasis. A total of 28 patients were included in this retrospective study; 17 underwent ligation or resection of the carotid artery, and 11 underwent reconstruction of the carotid artery. The perioperative complications and surgical outcomes were recorded and analysed. Of the 17 patients with ligation or resection of the carotid artery, 4 developed neurologic deficit within 2 weeks postoperatively. Three patients with malignant tumours died 1 month (1) and 4 months (2) postoperatively. Of the 11 patients undergoing carotid reconstruction, no major cerebral complications were noted after operation. Colour Doppler showed patent vascular graft 1 year postoperatively in nine patients. Due to the higher complication rates both in short and long term with ligation or resection of the carotid artery, resection and revascularization of the carotid artery is advocated for patients with carotid artery involvement when possible.

Alteration of cell-cycle regulatory proteins in human oral epithelial cells immortalized by HPV16 E6 and E7

E6 and E7 oncoproteins from high-risk human papillomavirus (HPV) can transform cells in tissue culture and induce tumors in vivo by abrogating the cell-cycle checkpoint. To investigate the impact of HPV16 E6 and E7 on the cell-cycle regulatory machinery in oral epithelial cells, normal human oral epithelial cells were transfected with HPV16 E6 and E7 open reading frames, and alterations in cell-cycle regulatory proteins in cells expressing HPV16 E6 and E7 were analyzed. E6 and E7 expression results in immortalization of oral epithelial cells. E7 inactivates retinoblastoma protein (Rb) by forming complexes with hypophosphorylated Rb in immortalized oral epithelial cells. P53 and P21 protein levels were increased in immortalized cells compared to normal primary oral epithelial cells. Cyclin D1-cell-cycle-dependent kinase 4 binary association is disrupted in immortalized oral epithelial cells. These results indicate that E7 plays an important role in abrogation of cell-cycle regulation in oral epithelial cells, with E6 having a smaller impact. This suggests that the pathogenesis of HPV in oral epithelial cells differs from that in cervical epithelial cells.

GABA(B) receptor agonist baclofen attenuates the development and expression of d-methamphetamine-induced place preference in rats

The present study investigated the effect of systemic administration of the GABA(B) receptor agonist, baclofen, on the development and expression of d-methamphetamine (d-MA)-induced place preference in male Wistar rats. Using a biased and 8-day schedule of conditioning, it was found that administration of d-MA (0.5 mg/kg, i.p.) produced significant place preference. The administration of baclofen (2.5 and 5.0 mg/kg, i.p.) 30 min prior to the exposure to d-MA attenuated the development of d-MA-induced place preference (p<0.05). In addition, when it was acutely administered 30 min prior to the testing session of an already established d-MA place preference, baclofen (1.25-5.0 mg/kg, i.p.) attenuated the expression of this conditioned response in a dose-dependent manner. These results showed that baclofen suppressed the rewarding effect produced by d-MA and may be potentially effective in the treatment of methamphetamine dependence and craving.

[Reconstruction of the common carotid artery with freeze dried arterial allografts in goats]

OBJECTIVE

To observe the patency rate and histopathologic changes at different times after implantation of freeze dried arterial allografts.

METHODS

4 healthy adult goats were used as the experimental models. A segment of the common carotid artery 2 cm in length was surgically removed and bridged with freeze-dried graft of common carotid artery from another goat. The eight necks of 4 animals were divided into A and B group randomly, each containing 4 arteries. In group A, both cut ends of the carotid artery were anastomosed end to end with the arterial allograft. In group B, the proximal end of the carotid artery was anastomosed end to side with the allograft. The patency of the graft was monitored with Laser Doppler Flowmeter within one week and carotid angiography was performed in selected animal. The allografts with anastomoses were harvested at 1 week, 2 weeks, 3 months and 6 months after implantation, respectively. The surgical fresh specimens were prepared and subject to histopathologic evaluation under light microscope, scanning electron microscope and transmission electron microscope.

RESULTS

In Group A, 2 grafts were patent at 1 week and 2 weeks, respectively. One graft was not patent at 3 months, one was largely occluded at 6 months, only 1/4 part of the graft was patent. In Group B, 3 grafts were patent at 1 week, 2 weeks, 3 months, respectively. One graft was occluded at 6 months. There was no significant difference in patency rate between the two groups. Histopathologic examinations showed that in freezed dried arterial homograft, the endothelial cells were lost but the matrix was complete. One week after implantation, mononuclear macrophages were infiltrated into the wall in large amount and adventitia of loose connective tissues was formed. After 2 weeks of implantation, intimia was noted, intimal hyperplasia was also noted at the anastomotic sites and migrated toward the central portions of the graft. At 3 months, the homograft displayed a complete endothelial cell coverage with only small areas of fresh fibrin and endothelial disruption. The rejection reaction was diminished prominently. The medial matrix was largely substituted by proliferation of smooth muscle cells, the homograft was near normal in structure.

CONCLUSION

Reconstruction of carotid artery defect with freeze dried arterial homografts was feasible. The rejection reaction was not significant. If the endothelial lining does not regenerate within 3 months, long term graft patency is hardly achieved.

Effects of cocaine and cocaine metabolites on cardiovascular function in squirrel monkeys

The effects of cocaine and the cocaine metabolites norcocaine, ecgonine methyl ester, benzoylecgonine and cocaethylene were evaluated in conscious squirrel monkeys for their effects on blood pressure and heart rate. Norcocaine, ecgonine methyl ester and benzoylecgonine are produced in vivo following cocaine use. Cocaethylene is produced in vivo following concurrent cocaine and alcohol use. Increases in both blood pressure and heart rate were observed following cocaine doses of 0.3-3.0 mg/kg. Ecgonine methyl ester and benzoylecgonine had no effect on either parameter up to doses of 10.0 mg/kg. Norcocaine increased blood pressure, but was less potent than cocaine. Norcocaine did not affect heart rate at doses up to 3.0 mg/kg. In contrast to the other metabolites, cocaethylene increased blood pressure and heart rate similarly to cocaine. These results suggest that ecgonine methyl ester and benzoylecgonine are devoid of cardiovascular effects at doses comparable to cocaine and would not be expected to contribute to cocaine's overall cardiovascular effects. Norcocaine's effect on blood pressure might contribute to the cardiovascular effects of cocaine, but this metabolite is produced only at low levels in vivo. The one metabolite that might be expected to contribute to cocaine's overall cardiovascular effect is cocaethylene, although the degree of this contribution is not clear.

[Reconstruction of the common carotid artery with autogenous external jugular vein graft in goats]

OBJECTIVE

To establish a method for reconstruction of carotid artery defect with autogenous graft of external jugular vein, to investigate the patency rate and histopathologic changes at different times after implantation.

METHODS

3 healthy adult goats were used as the experimental models. A segment of 2 cm autogenous external jugular vein was used to bridge a surgical defect of the common carotid artery (2 cm long). The six necks of the three animals were divided into A and B group randomly. In Group A, both cut ends of the artery were anastomosed end to end with the venous graft. In Group B, the proximal end of the artery was anastomosed end to side with the venous graft. The patency rate was recorded at different times. The venous grafts with anastomotic sites were harvested at 2 weeks, 3 months and 6 months after implantation, respectively, for histopathologic examinations.

RESULTS

The grafts in Group A were patent at 2 weeks and 3 months, but occluded at 6 months. The grafts in Group B were patent at 2 weeks and 6 months, but not patent at 3 months. Chi-square test demonstrated insignificant difference in patency rate between Group A and Group B. Histopathologic examinations showed intimal hyperplasia and venous arterialization in venous autografts. The venous wall was loose and edematous, intimal and subintimal hyperplasia was prominent at 2 weeks. Proliferation and migration of smooth muscle cell was found at 3 months after implantation. At 6 months, the venous media was predominantly composed of smooth muscle. Intimal hyperplasia was most prominent adjacent to the anastomosis.

CONCLUSION

Reconstruction of the common carotid artery with autogenous graft of external jugular vein had a higher patency rate. The main histopathologic changes after implantation is intimal hyperplasia and venous arterialization. Intimal hyperplasia is the result of proliferation and migration of host arterial smooth muscle cell, which passes through the anastomosis to the intima of the vein graft.

Influence of tramadol on morphine discriminative behavior in rats

AIM

To study the potential of the psychological dependence of tramadol.

METHODS

Rats were trained to discriminate 4.0 mg/kg morphine, and to discriminate 0.5 mg/kg methamphetamine (MA) from saline under a fixed-ratio (FR10) schedule of reinforcement. After they acquired the discrimination, different doses of tramadol were used to substitute for training dose of morphine and MA. Naltrexone was injected concomitantly with tramadol.

RESULTS

Tramadol fully substituted morphine at a dose of 32 mg/kg or higher. The ED50 value of the discriminative effects of tramadol was 20.94 mg/kg, higher than that of morphine (2.04 mg/kg, P < 0.01). MA failed to generalize to tramadol at the doses tested. Naltrexone antagonized the discriminative response of tramadol.

CONCLUSION

Tramadol can substitute for morphine in morphine discriminative rats. The discriminative stimulus effects of tramadol are mediated by a mu opioid mechanism.

Observations on a Xiphinema insigne Population with Several Males from Hangzhou, China

A population of Xiphinema insigne with several males was found on the campus of Zhejiang University, Hangzhou, China, in November 1998 in the rhizosphere of Yulan Magnolia. Morphometrics of nine males and 25 females of this population are given herein. No sperm were found in the genital tracts of 118 females that were examined. This agrees with all other observations reported for this species except for the synonym of X. insigne, X. neodimorphicaudatum, in which males are as common as females and the females genital tracts contain numerous sperm. In the males of this study population, sperm were observed only in the seminal vesicles at the distal end of the testes before their juncture with the vas deferens. The population did not fit within either of the two forms of the species. This and other populations have filled in the gaps between the two forms, making the morphometrics for all reported populations a continuum.

[Anatomical and histologic study of the cervical vessels in goats]

OBJECTIVE:To investigate the normal anatomic relations and histologic features of the cervical arteries and veins of goat, with the aim of providing a basis for resection and reconstruction of the common carotid artery.MATERIALS AND METHODS: Surgical dissection was performed on 15 healthy adult goats under general anaesthesia. The external diameters of the common carotid artery (CCA) and external jugular vein(EJV) were measured at their midpoints. 1 cm of the CCA and EJV was subject to light microscopic examination. Direct carotid angiography was performed on 2 selected goats to observe the course and branches of the carotid artery and normal blood flow mapping of the CCA was recorded using Laser Doppler Flowmeter. RESULTS:The average external diameter of the EJV was 5.4 mm for the left side and 5.3 mm for the right side. The average external diameter of the CCA was 3.8 mm for the left side and 3.6 mm for the right side. Histologic examinations found that the media of the carotid artery had 10-15 layers of smooth muscles. The EJV had valvulae, its wall was thin, only 1-2 layers of smooth muscle were contained in its medium. CONCLUSION:The CCA and EJV of the goat had a longer course in the neck, and a larger diameter (3-5 mm). Their histologic structures were similar to that of the human being, which makes it advantageous to be more often used as an animal model in experimental surgery.

Immunosuppressive effects of dihydroetorphine, a potent narcotic analgesic, in dihydroetorphine-dependent mice

The immunomodulatory effects of dihydroetorphine were systematically investigated in subchronically treated mice. In a dose-dependent fashion, dihydroetorphine (total doses at 444.5, 889 and 1778 microg/kg) lowered the increase of body weight, decreased the weight of the spleen and thymus, weakened the delayed-type hypersensitivity, reduced the generation of antibody-forming cells, inhibited splenic lymphocyte proliferation induced by concanavalin A and lipopolysaccharide, suppressed the production of interleukin-2 in the supernatant of splenocytes induced by concanavalin A, and depleted the ratio of CD4+ and CD8+ subpopulations. Moreover, the physical dependence on dihydroetorphine was also evaluated to confirm that the immunosuppression was concomitant with the addiction to the drug. These results demonstrate that subchronic treatment with dihydroetorphine dose dependently suppresses both humoral and cell-mediated immune function, and that the immunosuppressive effects of dihydroetorphine are much more potent than those of morphine.

Involvement of mu-opioid receptors and alpha-adrenoceptors in the immunomodulatory effects of dihydroetorphine

The present study investigated the effects of acutely administered dihydroetorphine on mitogen-stimulated lymphocyte proliferation and lymphokine production in mice. These immune functions were significantly suppressed by dihydroetorphine at 24 microg/kg and 128 microg/kg in a dose-dependent fashion. This study further examined the involvement of micro-opioid receptors and alpha-adrenoceptors in the immunomodulatory effects of dihydroetorphine. The micro-opioid receptor antagonist, naloxone (4 mg/kg), and alpha-adrenoceptor antagonist, phentolamine (10 mg/kg), but not the beta-adrenoceptor antagonist, propranolol (10 mg/kg), effectively blocked dihydroetorphine-induced suppression of splenic lymphocyte proliferation and lymphokine production. These results demonstrate that dihydroetorphine has significant immunosuppressive effects in mice and the mechanisms of these effects may lie in its interactions with opioid receptors and adrenergic pathways.

Immunosuppressive effects of intravenous self administration of dihydroetorphine on lymphocyte functions in rats

AIM

To study the effects of dihydroetorphine (DHE) on lymphocyte functions in rats and to further assess the abuse potential of DHE.

METHODS

An intravenous self administration (SA) procedure in rats was used to determine the SA liability of DHE. Concanavalin A (Con A)-stimulated lymphocyte proliferation and lymphokine production of rat splenocytes were measured.

RESULTS

DHE 178 +/- 13 micrograms established a stable and typical rat model of psychological dependence, suppressed lymphocyte proliferation (129 +/- 11 Bq) compared with control group (620 +/- 36 Bq), and inhibited the activity of interleukin-2 (IL-2) (A570 = 0.28 +/- 0.06) compared with control group (A570 = 0.51 +/- 0.03).

CONCLUSION

DHE had a high abuse potential and inhibited the Con A-induced lymphocyte proliferation and interleukin-2 production in rats.

[Using the lower leg lateral skin flap to reconstruct oral and maxillofacial soft tissue defects (9 cases report)]

OBJECTIVE:In order to investigate the clinical value of lower leg lateral skin flap for the reconstructin of soft tissue defects at oral-maxillofacial regions. METHODS: 9 cases of different soft tissue defects of oral and maxillofacial regions were under went surgery with leg lateral skin flap transplantion in out patients department. RESULTS: All the 9 flaps were got success of one stage repair. This paper describes in detail the anatomy of the flap,technique of make up the flap, clinical application,advantages and disadvantages. CONCLUSION: The lower leg lateral skin flap is versatile flap,but is not the one for first choice.