Predicting optimal patient-specific postoperative facial landmarks for patients with craniomaxillofacial deformities

Orthognathic surgery primarily corrects skeletal anomalies and malocclusion to enhance facial aesthetics, aiming for an improved facial appearance. However, this traditional skeletal-driven approach may result in undesirable residual asymmetry. To address this issue, a soft tissue-driven planning methodology has been proposed. This technique estimates bone movements based on the envisioned optimal facial appearance, thereby enhancing surgical accuracy and effectiveness. This study investigates the initial implementation phase of the soft tissue-driven approach, simulating the patient's ideal appearance by realigning distorted facial landmarks to an ideal state. The algorithm employs symmetrization and weighted optimization strategies, aligning projected optimal landmarks with standard cephalometric values for both facial symmetry and form, which are essential in orthognathic surgery for facial aesthetics. It also incorporates regularization to preserve the patient's facial characteristics. Validation through retrospective analysis of preoperative patients and normal subjects demonstrates this method's efficacy in achieving facial symmetry, particularly in the lower face, and promoting a natural, harmonious contour. Adhering to soft tissue-driven principles, this novel approach shows promise in surpassing traditional methods, potentially leading to enhanced facial outcomes and patient satisfaction in orthognathic surgery.

Clinical feasibility of deep learning-based automatic head CBCT image segmentation and landmark detection in computer-aided surgical simulation for orthognathic surgery

The purpose of this ambispective study was to investigate whether deep learning-based automatic segmentation and landmark detection, the SkullEngine, could be used for orthognathic surgical planning. Sixty-one sets of cone beam computed tomography (CBCT) images were automatically inferred for midface, mandible, upper and lower teeth, and 68 landmarks. The experimental group included automatic segmentation and landmarks, while the control group included manual ones that were previously used to plan orthognathic surgery. The qualitative analysis of segmentation showed that all of the automatic results could be used for computer-aided surgical simulation. Among these, 98.4% of midface, 70.5% of mandible, 98.4% of upper teeth, and 93.4% of lower teeth could be directly used without manual revision. The Dice similarity coefficient was 96% and the average symmetric surface distance was 0.1 mm for all four structures. With SkullEngine, it took 4 minutes to complete the automatic segmentation and an additional 10 minutes for a manual touchup. The results also showed the overall mean difference between the two groups was 2.3 mm for the midface and 2.4 mm for the mandible. In summary, the authors believe that automatic segmentation using SkullEngine is ready for daily practice. However, the accuracy of automatic landmark digitization needs to be improved.

Fluctuating asymmetry of the normal facial skeleton

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

Theoretical investigation on peripheral ligands of oxygen-evolving center in photosystem II

The interaction between the Mn-cluster and its peripheral ligands in oxygen-evolving center is still unclear. Theoretical investigation on the coordination of histidine, H(2)O, and CI to Mn2O2 units in OEC is conducted. The following conclusions are obtained: (i) both histidine and H(2)O molecule, bound to the two Mn ions, respectively, are vertical to the Mn2O2 plane, and maintain a large distance; (ii) the two H(2)O molecules cannot bind to the same Mn2O2 unit. Based on Mn-cluster structure in OEC, we theoretically predict that two H(2)O molecules bind to the two Mn ions at the "C"-shaped open end in S(0) state, while two His residues at the closed end. Cl ion can only terminally ligate at the open end. Individual valence for the four Mn ions in S(0) state is assigned.

Therapeutic vaccination against advanced pancreatic cancer by autologous dendritic cells pulsed with a MUC1 peptide: Preclinical results of a clinical phase I trial

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Background: Pancreatic ductal adenocarcinoma has a particularly poor prognosis. Therefore, novel therapeutic strategies such as immunotherapy are required. The aim of the present phase I study was to evaluate the safety, immune responses and clinical activity of a vaccine based on autologous dendritic cells (DC) pulsed with a specific MUC1 peptide in advanced pancreatic cancer patients. Methods: Five patients who had pancreatic cancer ductal adenocarcinoma expressing MUC1 in stage of III/IV were enrolled to the clinical trial. Patients underwent leukapheresis to generate dendritic cells by culture in vitro with granulocyte macrophage colony-stimulating factor and interleukin-4 for 5 days. Dendritic cells were then pulsed overnight with MUC1 peptide (GVTSAPDTRPAPGSTAPPAH) and harvested for vaccination. Dendritic cells (3×106-6×106) were injected intradermally every 2 weeks for 3–4 times. Results: All patients remained with progressive disease. Four patients developed strong T-cell IFN-γ and Granzyme B Elispot responses to the vaccine. Most interestingly, the patient who was treated with the highest number of DC(6×106) had more number of CTL than other patients and showed delayed-type hypersensitivity responses at injection sites and this patient stopped application of the analgetics. Another patient with relapsed pancreatic cancer who had finished the 4 times of vaccination and then followed 6 times of chemotherapy with Gemcitabine had a surprisingly long term of survival of 12 month. No evidence of significant treatment related toxicity or auto-immunity was observed. Conclusions: This study showed the safety and clinical response of MUC1 peptide-pulsed dendritic cell therapy for patients with advanced pancreatic cancer. It confirms the capability of this DC vaccine to stimulate an immune response in patients with pancreatic cancer even in the presence of a large tumor burden. Dendritic cell therapy is recommended for further clinical studies in pancreatic cancer patients.

No significant financial relationships to disclose.

The presence of 9-cis-beta-carotene in cytochrome b(6)f complex from spinach

Cytochrome b(6)f complex with stoichiometrically bound beta-carotene molecule was purified from spinach chloroplasts. The configuration of this beta-carotene was studied by reversed-phase HPLC and resonance Raman spectroscopy. Both the absorption spectrum of this beta-carotene in dissociated state and the Raman spectrum in native state can be unambiguously assigned to a 9-cis configuration. This finding is in contrast to the predominantly all-trans isomers commonly found in membranes and protein-pigment complexes of chloroplasts, suggesting that the 9-cis-beta-carotene is an authentic component and may have a unique structural and functional role in cytochrome b(6)f complex.

Characterization of photosynthetic pigment composition, photosystem II photochemistry and thermal energy dissipation during leaf senescence of wheat plants grown in the field

Photosynthetic pigment composition and photosystem II (PSII) photochemistry were characterized during the flag leaf senescence of wheat plants grown in the field. During leaf senescence, neoxanthin and beta-carotene decreased concomitantly with chlorophyll, whereas lutein and xanthophyll cycle pigments were less affected, leading to increases in lutein/chlorophyll and xanthophyll cycle pigments/chlorophyll ratios. The chlorophyll a/b ratio also increased. With the progression of senescence, the maximal efficiency of PSII photochemistry decreased only slightly in the early morning (low light conditions), but substantially at midday (high light conditions). Actual PSII efficiency, photochemical quenching and the efficiency of excitation capture by open PSII centres decreased significantly both early in the morning and at midday and such decreases were much greater at midday than in the early morning. At the same time, non-photochemical quenching, zeaxanthin and antheraxanthin contents at the expense of violaxanthin increased both early in the morning and at midday, with a greater increase at midday. The results in the present study suggest that a down-regulation of PSII occurred in senescent leaves and that the xanthophyll cycle plays a role in the protection of PSII from photoinhibitory damage in senescent leaves by dissipating excess excitation energy, particularly when exposed to high light.

Changes of absorption spectra during heat-induced denaturation of Photosystem II core antenna complexes CP43 and CP47: revealing the binding states of chlorophyll molecules in these two complexes

The Photosystem II (PSII) core antenna complexes, CP43 and CP47, were prepared from spinach (Spinacia oleracea L.). The absorption spectra in the red region at room temperature were recorded for the PSII core antenna samples after increased temperature treatment (up to 80 degrees C). Derivative and difference spectra revealed the existence of two groups of chlorophyll a (Chl a) molecules in both CP43 and CP47. The one with the absorption peak in the shorter wavelength region was designated as CP43-669 and CP47-669, while the other with the absorption peak in the longer wavelength region was designated as CP43-682 and CP47-680. The results of the thermal treatment experiment demonstrated that CP43-669 and CP47-669 may exist as monomers of Chl a and that their binding sites on the polypeptides are insensitive to thermal treatment, whereas CP43-682 and CP47-680 may exist as dimers or multimers of Chl a and their binding regions in the polypeptide chains are more sensitive to heat treatment. The excitation energy transfer mechanism between these two different groups of Chl a molecules is also analyzed.

Spectroscopic study of trypsin, heat and triton X-100-induced denaturation of the chlorophyll-binding protein CP43

Trypsin-, heat- and Triton X-100-induced denaturation of CP43, the core antenna complex of photosystem II purified from spinach, has been investigated using absorption, fluorescence and circular dichroism spectroscopy. Triton X-100 was found to bring about considerable dissolution of pigments from the protein to the monomeric state in solution and destruction of the interactions among the chlorophyll, carotene and protein. Heat induced significant unfolding of the protein secondary structure and loss of excitonic interactions of the pigments, but no apparent dissolution of the pigments from CP43. Trypsin caused structural changes in the extrinsic part of the protein but no change of the native state of the pigments. Trypsin, heat and Triton X-100 treatments increased the light sensitivity of chlorophyll in CP43 to different extents. The results suggest that the protein and beta-carotene can protect the chlorophyll from light-induced destruction in CP43.

The inhibited xanthophyll cycle is responsible for the increase in sensitivity to low temperature photoinhibition in rice leaves fed with glutathione

Exposure of intact rice leaves to an irradiance of 1000 mumol m(-2) s(-1) at 6 degrees C for 2 h caused severe photoinhibition of Photosystem II. The rate and extent of photoinhbition were greatly exacerbated in leaves fed with 10 mM reduced glutathione (GSH) or 10 mM cysteine. Analyses of antioxidant enzyme activities as well as the application of protein synthesis inhibitors revealed that the increased sensitivity to photoinhibition following GSH feeding was not related to its effect on cellular antioxidant systems. On the other hand, feeding with GSH markedly suppressed the formation of zeaxanthin and antheraxanthin via the xanthophyll cycle and its associated nonradiative energy dissipation in leaves chilled in high light, suggesting that the stimulating effect of exogenous GSH on photoinhibition may be attributable to its action on the xanthophyll cycle. In vitro experiments using isolated thylakoids indicated that GSH is a weak inhibitor of violaxanthin deepoxidation. The possible implications of these results are discussed.

[An investigation on multiple drug resistance of the rifampin resistant strains of Mycobacterium tuberculosis]

The correlation between rifampin resistance and multiple drug resistance in 236 clinical isolates of Mycobacterium tuberculosis was investigated in this thesis. It has found that 99.4% of the strains with rifampin resistance were multidrug-resistant strains and 89% of the multidrug-resistant strains were resistant to rifampin. This result showed that the rifampin resistance of Tuberculosis baccilli could be used as the marker of multidrug resistance of Mycobacterium tuberculosis.

[Microcolony observation for rapid detection and identification of cultures of Mycobacterium tuberculosis]

219 sputa were seeded on Kuang's agar plates. A total of 112 isolates of Mycobacterium tuberculosis were detected in 219 specimens. Of these 112 isolates, 104 (92.8%) were detected in Kuang's agar media and 108 (96.4%) were detected by microcolony observation. The detection time of microcolony observation and culture method needed 11 and 18.6 days respectively. The detection time of microcolony method is much shorter (P < 0.001). The results of conventional tests of different species of Mycobacterium and microcolony differentiation were identical in 99% of isolates of Mycobacterium tuberculosis.

Cardiovascular risk factor prevalence in three Chinese communities in 1989

The cardiovascular risk prevalence of 935 adult Chinese living in Chauzhou, Meizhou, and Xinhui cities of Guangdong Province, China, is reported. The three communities are geographically separated, and represent the three major dialect group in Guangdong Province (Teochew, Hakka and Cantonese respectively) which are also the major donor populations of overseas Chinese to Australia and South East Asia. Taking into account historical data, the conventional cardiovascular risk factor prevalence of these combined communities in China as a whole is on the increase and approaches or even exceeds that in Western Society. However, the three communities are not very alike in their prevalences of individual conventional cardiovascular risk factors, notably for hyperlipidaemia (most prevalent in Chauzhou), hypertension (most prevalent in Chauzhou men at 12.4% and least in Meizhou women 5.0%) and cigarette smoking (most prevalent in Xinhui men at 72.7% and least in Xinhui women, 0%). They are similar in stature, body weight, BMI, and waist-to-hip ratio, with very low prevalences of overweight/obesity, or abdominal obesity. An understanding of the contributors to sub-ethnic difference in cardiovascular risk should emerge with further study of these Chinese populations.

[The study on the simplified agar media for mycobacteria]

Three kinds of simplified agar media were reported in this paper, which are easy to prepare and are simple in constituents. The velocity and the quantity of growth of seven strains tested on simplified agar media 309A and 309C were similar to or prevail over those on Lowenstein-Jensen medium and No. 92 potato-soup agar medium. Simplified agar media 309C and 309A could be applied to isolate mycobacteria from sputum and to test the drug susceptibility of M. tuberculosis.

The embryonically active gene, unkempt, of Drosophila encodes a Cys3His finger protein

The unkempt gene of Drosophila encodes a set of embryonic RNAs, which are abundant during early stages of embryogenesis and are present ubiquitously in most somatic tissues from the syncytial embryo through stage 15 of embryogenesis. Expression of unkempt RNAs becomes restricted predominantly to the central nervous system in stages 16 and early 17. Analysis of cDNAs from this locus reveals the presence of five Cys3His fingers in the protein product. Isolation and analysis of mutations affecting the unkempt gene, including complete deletions of this gene, indicate that there is no zygotic requirement for unkempt during embryogenesis, presumably due to the contribution of maternally supplied RNA, although the gene is essential during post-embryonic development.