[Show abstract][Hide abstract] ABSTRACT: This study evaluated the use of an augmented reality navigation system that provides a markerless registration system using stereo vision in oral and maxillofacial surgery.
A feasibility study was performed on a subject, wherein a stereo camera was used for tracking and markerless registration. The computed tomography data obtained from the volunteer was used to create an integral videography image and a 3-dimensional rapid prototype model of the jaw. The overlay of the subject’s anatomic site and its 3D-IV image were displayed in real space using a 3D-AR display. Extraction of characteristic points and teeth matching were done using parallax images from two stereo cameras for patient-image registration.
Accurate registration of the volunteer’s anatomy with IV stereoscopic images via image matching was done using the fully automated markerless system, which recognized the incisal edges of the teeth and captured information pertaining to their position with an average target registration error of < 1 mm. These 3D-CT images were then displayed in real space with high accuracy using AR. Even when the viewing position was changed, the 3D images could be observed as if they were floating in real space without using special glasses.
Teeth were successfully used for registration via 3D image (contour) matching. This system, without using references or fiducial markers, displayed 3D-CT images in real space with high accuracy. The system provided real-time markerless registration and 3D image matching via stereo vision, which, combined with AR, could have significant clinical applications.
Full-text · Article · Dec 2015 · BMC Medical Imaging
[Show abstract][Hide abstract] ABSTRACT: Background:
Collagenous connective tissue membranes (biosheets) are useful for engineering cardiovascular tissue in tissue engineering. The aim was to evaluate the use of biosheets as a potential tracheal substitute material in vivo in a rabbit model.
Group 1: Rectangular-shaped Gore-Tex (4×7mm) was implanted into a 3×6mm defect created in the midventral portion of the cervical trachea. Group 2: Rectangular-shaped dermis was implanted into a tracheotomy of similar size. Group 3: Biosheets were prepared by embedding silicone moulds in dorsal subcutaneous pouches in rabbits for 1month. Rectangular-shaped biosheets were implanted into a tracheotomy of similar size in an autologous fashion. All groups (each containing 10 animals) were sacrificed 4weeks after implantation.
All materials maintained airway structure for up to 4weeks after implantation. Regenerative cartilage in implanted Biosheets in group 3 was confirmed by histological analysis. Tracheal epithelial regeneration occurred in the internal lumen of group 3. There were significant differences in the amounts of collagen type II and glycosaminoglycan between group 3 and group 1 or 2.
We confirm that cartilage can self-regenerate onto an airway patch using Biosheets.
No preview · Article · Nov 2015 · Journal of Pediatric Surgery
[Show abstract][Hide abstract] ABSTRACT: Mesenchymal stem cell (MSC) condensation contributes to membrane ossification by enhancing their osteodifferentiation. We investigated bone regeneration in rats using the human bone marrow-derived MSC-spheroids prepared by rotation culture, without synthetic or exogenous biomaterials. Bilateral calvarial defects (8 mm) were created in nude male rats; the left-sided defects were implanted with MSC-spheroids, β-tricalcium phosphate (β-TCP) granules, or β-TCP granules + MSC-spheroids, while the right-sided defects served as internal controls. Micro-computed tomography and immunohistochemical staining for osteocalcin/osteopontin indicated formation of new, full-thickness bones at the implantation sites, but not at the control sites in the MSC-spheroid group. Raman spectroscopy revealed similarity in the spectral properties of the repaired bone and native calvarial bone. Mechanical performance of the bones in the MSC-implanted group was good (50 and 60 % those of native bones, respectively). All tests showed poor bone regeneration in the β-TCP and β-TCP + MSC-spheroid groups. Thus, significant bone regeneration was achieved with MSC-spheroid implantation into bone defects, justifying further investigation.
Full-text · Article · Nov 2015 · Journal of Materials Science Materials in Medicine
[Show abstract][Hide abstract] ABSTRACT: Short lingual osteotomy is a useful method for the performance of sagittal split ramus osteotomy involving interference between the proximal and distal bone fragments when lateral differences exist in the setback distance. However, this procedure occasionally results in abnormal fracture and nerve injury; expert surgical skill is thus required. We herein describe a novel technique involving the use of an ultrasonic bone-cutting device (Piezosurgery; Mectron Medical Technology, Carasco, Italy) for vertical osteotomy posterior to the mandibular foramen. Successful short lingual osteotomy was performed using this technique with avoidance of abnormal fracture and neurovascular bundle damage.
No preview · Article · Oct 2015 · The Journal of craniofacial surgery
[Show abstract][Hide abstract] ABSTRACT: Intraoral vertical ramus osteotomy (IVRO) is used widely to correct mandibular prognathism. However, several disadvantages of this procedure have been reported, such as condylar luxation and bony interference at the osteotomy site. The aim of this study was to survey the incidence of complications (condylar luxation and bony interference) based on the shape of the osteotomy line. One hundred and eighty-five rami in 118 patients with jaw deformities, which were treated with IVRO, were examined retrospectively. The shape of the osteotomy line and the postoperative complications were examined on panoramic radiographs. Osteotomy lines were classified into three types: vertical, C-shaped, and oblique. Of the 185 osteotomy sites, 98 were vertical, 37 C-shaped, and 50 oblique. Condylar luxation was found in six rami (3.2%); four had undergone vertical osteotomy and two had undergone C-shaped osteotomy. Bony interference occurred in seven rami (3.8%), all with vertical type osteotomy lines. Most complications occurred in the vertical type cases and no complications were found in oblique type cases. Condylar luxation was found mainly in unilateral IVRO cases and bony interference was found in bilateral IVRO cases. These results suggest that the oblique type of osteotomy line has the advantage of avoiding complications.
No preview · Article · Sep 2015 · International Journal of Oral and Maxillofacial Surgery
[Show abstract][Hide abstract] ABSTRACT: Introduction:
Odontogenic cutaneous sinus tract is a relatively rare occurrence that can be complicated to diagnose. The presence of a cutaneous lesion is often not even partly associated with a dental etiology because of the less frequency of occurrence in the case of dental symptoms. Consequently, the underlying dental cause is often missed leading to inappropriate diagnosis and treatment.
Here, we report the case of a 45-year-old man who presented with a persistent lesion of the cervical region. At the time of presentation, the lesion had been present for approximately one year with a gradual increase in size but no specific symptoms. The patient had previously undergone punch resection under local anesthesia, which resulted in a histopathological diagnosis of inverted follicular keratosis. A diagnosis was made of an odontogenic cutaneous sinus tract secondary to chronic apical periodontitis of the left mandibular second molar.
Cutaneous sinus tract in the face and neck is most likely to develop intraorally. Root canal treatment or surgical extractions are the common treatment choices. A previously reported review of 137 cases found that 106 (77%) were treated by extraction and 27 (20%) were treated by surgical or conservative nonsurgical endodontic therapy.
Early diagnosis of cutaneous sinus tract using proper aid is responsible for shortening the treatment duration and avoiding unnecessary treatment.
Full-text · Article · Sep 2015 · International Journal of Surgery Case Reports
[Show abstract][Hide abstract] ABSTRACT: Induced pluripotent stem cells (iPSCs) are a promising cell source for cartilage regenerative medicine. Meanwhile, the risk of tumorigenesis should be considered in the clinical application of human iPSCs (hiPSCs). Here, we report in vitro chondrogenic differentiation of hiPSCs and maturation of the differentiated hiPSCs through transplantation into mouse knee joints. Three hiPSC clones showed efficient chondrogenic differentiation using an established protocol for human embryonic stem cells. The differentiated hiPSCs formed hyaline cartilage tissues at 8 weeks after transplantation into the articular cartilage of NOD/SCID mouse knee joints. Although tumors were not observed during the 8 weeks after transplantation, an immature teratoma had developed in one mouse at 16 weeks. In conclusion, hiPSCs are a potent cell source for regeneration of hyaline articular cartilage. However, the risk of tumorigenesis should be managed for clinical application in the future.
Preview · Article · Jul 2015 · Biomedical Research
[Show abstract][Hide abstract] ABSTRACT: Previously, we reported that the transcription factor Nanog, which maintains the self-renewal of embryonic stem cells (ESCs), promotes the osteogenic differentiation of the mouse mesenchymal cell line C3H10T1/2 through a genome reprogramming process. In the present study, to clarify the mechanism underlying the multipotency of mesenchymal stem cells (MSCs) and to develop a novel approach to bone regenerative medicine, we attempted to identify the downstream effectors of Nanog in promoting osteogenic differentiation of mouse mesenchymal cells. We demonstrated that Runx1 and Runx3 are the downstream effectors of Nanog, especially in the early and intermediate osteogenic differentiation of the mouse mesenchymal cell line C3H10T1/2.
[Show abstract][Hide abstract] ABSTRACT: The nasolabial cyst, a rare lesion involving the soft tissues of the maxillofacial region, commonly occurs in middle-aged females. These cysts usually present as soft, fluctuating growths in the sublabial folds, and are seen as swellings between the upper lip and nostril. Modern radiographic methods aid in the diagnosis of these cysts. There is an ongoing debate regarding the origin of nasolabial cysts, as there are two schools of thought: some believe that these cysts originate from fissural cysts, while others are of the opinion that they originate from remnants of the nasolacrimal groove. Herein, we present a rare case of a nasolabial cyst occurring in a 13-year-old girl treated for unilateral cleft lip and alveolus, using bone grafts nearly 5 years after lip and nose revision surgery. This contradicts with the previous theory regarding the origin of nasolabial cysts from fissural cysts. Despite indications that the cyst may have originated from remnants of the nasolacrimal groove, in the present study, trauma, infection or other unknown factors may have contributed to the pathogenesis of the nasolabial cyst.
[Show abstract][Hide abstract] ABSTRACT: Occurrences of aneurysm caused by intraoral inflammation or infection are very rare. Osseous dysplasias (ODs), the most common fibro-osseous lesions (FOLs), occur in the jaw. However, osseous lesion very rarely occurs in association with impacted tooth. We present here the case of a 22-year-old female who developed aneurysm in the cavernous region of the internal carotid artery (ICA) because of the infection of the maxillary OD with impacted and semi-impacted teeth. The aneurysm was later confirmed by contrast enhanced magnetic resonance imaging (MRI). The ICA trapping was performed under general anesthesia, and postoperative magnetic resonance angiography (MRA) confirmed disappearance of aneurysm. Approximately 2 months after the surgery, we performed left maxilla tumor excision under general anesthesia; the patient showed satisfactory progress after the excision. Since inflammation/infection of the maxilla may lead to aneurysm as found in this case, we recommend physicians to pay serious attention in such cases to prevent rupture of aneurysm.
[Show abstract][Hide abstract] ABSTRACT: Background Ossification of the posterior longitudinal ligament (OPLL) of the spine is a common human myelopathy that leads to spinal cord compression. No disease-modifying drug for OPLL has been identified, whereas surgery and conservative management have been established.
Objectives To evaluate the therapeutic potential of the H2 blocker famotidine for ectopic ossification in the cervical spine in an OPLL mouse model.
Methods The H2 blocker famotidine was orally administered to Enpp1ttw/ttw mice, a model of OPLL, at either 4 or 15 weeks of age. Radiological and survival rate analyses were performed to assess the effects of famotidine on OPLL-like lesions and mortality in Enpp1ttw/ttw mice.
Results Oral administration of famotidine suppressed the progression of OPLL-like ectopic ossification and reduced mortality in Enpp1ttw/ttw mice when administration began at 4 weeks of age, early in the development of ossification.
Conclusions This study points to the use of famotidine as a disease-modifying drug for ectopic ossification of spinal soft tissue, including OPLL.
[Show abstract][Hide abstract] ABSTRACT: Human pluripotent cells are promising for treatment for kidney diseases, but the protocols for derivation of kidney cell types are still controversial. Kidney tissue regeneration is well confirmed in several lower vertebrates such as fish, and the repair of nephrons after tubular damages is commonly observed after renal injury. Even in adult mammal kidney, renal progenitor cell or system is reportedly presents suggesting that adult stem-like cells in kidney can be practical clinical targets for kidney diseases. However, it is still unclear if kidney stem cells or stem-like cells exist or not. In general, stemness is defined by several factors such as self-renewal capacity, multi-lineage potency and characteristic gene expression profiles. The definite use of stemness may be obstacle to understand kidney regeneration, and here we describe the recent broad findings of kidney regeneration and the cells that contribute regeneration.
[Show abstract][Hide abstract] ABSTRACT: Introduction:
Mammary analog secretory carcinoma (MASC) is a newly described rare malignancy of the salivary glands characterized by an ETS variant 6 (ETV6)-neurotrophic tyrosine kinase receptor type 3 (NTRK3) fusion gene (EN fusion gene).
Presentation of case:
We present a case of MASC derived from the left upper lip in a 61-year-old woman. ETV6 rearrangement was detected by fluorescence in situ hybridization (FISH). The presence of EN fusion transcripts was verified by reverse-transcriptase polymerase chain reaction (RT-PCR) and sequencing of the PCR products. Accordingly, this tumor was diagnosed as MASC. Moreover, we performed mutation analysis of the 50 known cancer-related genes using next-generation sequencing. No mutation of cancer-related genes was identified here. Subsequently, the methylation status in promoter region of tumor-suppressor genes, RASSF1A and RARB2, was examined. Both genes have been reported to be methylated in malignant salivary gland tumors, but they were found to be unmethylated.
Recent studies have demonstrated that distinct types of malignant salivary gland carcinomas are driven by specific, highly recurrent genetic alterations. Detection of molecular abnormalities could be powerful diagnostic tools in the field of salivary gland tumors in near future.
We experienced a rare malignant salivary gland carcinoma, MASC. We diagnosed this tumor by molecular approach and subsequently tried to identify novel molecular abnormalities. Although no novel molecular alteration except for EN fusion gene was identified, this result might represent the favorable prognosis of patients with MASC.
Full-text · Article · Feb 2015 · International Journal of Surgery Case Reports
[Show abstract][Hide abstract] ABSTRACT: Stevens–Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are rare life threatening severe cutaneous adverse reactions, primarily caused by drugs and infection. Most of the cases of SJS are predominantly drug related. Drugs including antibacterial sulfonamides, non-steroidal anti-inflammatory drugs (NSAIDs) and anti-epileptic drugs have been identified to cause SJS/TEN. We report a case of 35 year old male, road accident victim, who suffered from mandibular fracture and a splenic injury, admitted to our hospital. Following the splenic embolization in Radiology Department he was administered cefazolin sodium and diclofenac sodium. The patient developed skin lesions characteristic of SJS, which was confirmed by skin biopsy. From the course of the skin lesions and its relation to diclofenac sodium administration and discontinuation, the drug was suspected to have caused SJS. The cefazolin sodium and diclofenac sodium were stopped one after another. Patient was successfully treated with prednisolone and was issued with drug card to prevent further attack of SJS by the same drug. We report the present case, in order to raise awareness that frequently prescribed NSAIDs diclofenac sodium has potential to cause rare skin disorder like SJS and prepare physician for the early intervention of any such future incidence.
[Show abstract][Hide abstract] ABSTRACT: In maxillofacial region, reconstruction of defects after inflammation, trauma, tumor resection and congenital anomaly should be functional and aesthetic. Meanwhile, recent approaches using regenerative medicine have shown great potential, enabling functionally and esthetically-satisfying reconstructions with less invasive manner. This review describes such regenerative medicine of bone in maxillofacial region, including transplantation of particulate cancellous bone and marrow (PCBM) in combination with a titanium mesh tray, and custom-made artificial bone (CT-Bone). Our preclinical and clinical study on tissue-engineered cartilage for patients with cleft-lip and nose is also covered.
No preview · Article · Jan 2015 · Nippon Koku Geka Gakkai zasshi
[Show abstract][Hide abstract] ABSTRACT: Odontogenic infection in immunocompromised patients tends to extend systemically beyond the oral cavity. Our case report presents a patient with sepsis due to a Streptococcus constellatus (S. constellatus) odontogenic infection in a 64-year-old-immunocompromised woman with Cogan's syndrome. She had been suffering from chronic mandibular osteomyelitis which was thought to have been caused by dental caries and/or chronic periodontitis with furcation involvement of the left mandibular first molar. We suspect that the acute symptoms of the chronic osteomyelitis due to S. constellatus led to the systemic infection. This infection could be accelerated by the use of a corticosteroid and an alendronate. This is the first report which represents the potential association between odontogenic infection and Cogan's syndrome.
[Show abstract][Hide abstract] ABSTRACT: Severe tracheomalacia is a life-threatening disease, but symptoms usually improve with growth. The aims of this study were to investigate how slow release basic-Fibroblast Growth Factor (b-FGF) acts on tracheal cartilage, and whether growth-promoted trachea is more resistant against an increase in externally-applied pressure.Methods
Biodegradable gelatin hydrogel sheets soaked in 10 μl of distilled water (sham) or 0.5 or 5 μg/10 μl of b-FGF solution were inserted behind the cervical trachea of three-week-old male Wistar rats. The cervical trachea was harvested 4 weeks later. Extratracheal pressure was increased from 0 to 40 cmH2O in a chamber, while video-recording the internal lumen. The luminal area at each pressure was expressed as a proportion to that at 0 cmH2O. The amounts of collagen type II and glycosaminoglycan were measured by ELISA.ResultsThe luminal areas at 40 cmH2O in the control (no intervention), sham, and each of the b-FGF groups were 0.65, 0.62, 0.72, and 0.73, respectively. The amounts of collagen type II and glycosaminoglycan in each group were 127, 136, 193, 249 μg/mg, respectively, and 15, 16, 19, 33 μg/mg, respectively. There were significant differences between the control group and the FGF 5 group (P = 0.02, 0.01, 0.01, for luminal area, collagen, and glycosaminoglycan, respectively).Conclusion5 μg of slow-release b-FGF promotes matrix production (collagen type II and glycosaminoglycan). The growth-enhanced trachea was more resistant to collapse, suggesting that slowly released b-FGF might be useful in patients with severe tracheomalacia.
No preview · Article · Nov 2014 · Journal of Pediatric Surgery
[Show abstract][Hide abstract] ABSTRACT: Hedgehog (Hh) signaling plays important roles in various development processes. This signaling is necessary for osteoblast formation during endochondral ossification. In contrast to the established roles of Hh signaling in embryonic bone formation, evidence of its roles in adult bone homeostasis is not complete. Here we report the involvement of Gli1, a transcriptional activator induced by Hh signaling activation, in postnatal bone homeostasis under physiological and pathological conditions. Skeletal analyses of Gli1+/- adult mice revealed that Gli1 haploinsufficiency caused decreased bone mass with reduced bone formation and accelerated bone resorption, suggesting an uncoupling of bone metabolism. Hh-mediated osteoblast differentiation was largely impaired in cultures of Gli1+/- precursors, and the impairment was rescued by Gli1 expression via adenoviral transduction. In addition, Gli1+/- precursors showed premature differentiation into osteocytes and increased ability to support osteoclastogenesis. When we compared fracture healing between wild-type and Gli1+/- adult mice, we found that the Gli1+/- mice exhibited impaired fracture healing with insufficient soft callus formation. These data suggest that Gli1, acting downstream of Hh signaling, contributes to adult bone metabolism, in which this molecule not only promotes osteoblast differentiation but also represses osteoblast maturation toward osteocytes to maintain normal bone homeostasis.