Relationship between nasal septum morphology and nasal obstruction symptom severity: computed tomography study

IntroductionThe impact of the nasal septum morphology on the severity of obstruction symptoms has not been fully explored.ObjectiveThis study aimed to investigate whether the morphology of the deviated nasal septum assessed by computed tomography may explain nasal obstruction severity.MethodsThe study included 386 patients who were referred to the computed tomography examination of the paranasal sinuses. Patient selection criteria were the absence of facial anomalies, facial trauma, nasal surgery, and sinonasal tumors. Computed tomography images were used to estimate deviated nasal septum prevalence, the prevalence of Mladina's seven types of deviated nasal septum, and to measure the deviated nasal septum angle. Nasal obstruction severity was assessed by the nasal obstruction symptom evaluation, NOSE scale. The relationship between NOSE score, deviated nasal septum morphology, and deviated nasal septum angle was performed by a statistical regression model on the reduced sample of 225 patients.ResultsThe prevalence of deviated nasal septum was 92.7%. Type 7 deviated nasal septum was the most frequent (34.2%) followed by type 5 (26.2%) and type 3 (23.6%). The worst NOSE scores were recorded in the type 2 deviated nasal septum (45.00 ± 28.28). The mean deviated nasal septum angle in patients with nasal obstruction was 8.5° ± 3.24. NOSE scores were not significantly associated with deviated nasal septum types and angles.ConclusionPatients with different types of deviated nasal septum have different NOSE scores. Computed tomography morphology of the deviated nasal septum could not fully explain the severity of nasal obstruction.     

Preoperative morphologic changes of the medial meniscus correlate with suture translations during knee flexion in pullout repair of medial meniscus posterior root tear

BackgroundMedial meniscus (MM) translates and extrudes posteriorly during knee flexion in MM posterior root tear (MMPRT) knees, and transtibial pullout repair of MMPRT has been performed to regulate the MM extrusion. This study aimed to calculate each suture translation during knee flexion in transtibial pullout repair of MMPRT, and to investigate the morphologic features of the MM that lead to longer suture translations during knee flexion.MethodsThirty patients with MMPRT who met the operative indication of pullout repair were enrolled and investigated prospectively. Pullout repair was performed by using two simple stitches (outer and inner sutures) and an all-inside suture in the posteromedial part of the MM. Each suture’s translation from 0° to 90° of knee flexion was measured intraoperatively. The MM morphologic features, including MM medial extrusion (MMME) and MM posterior height (MMPH), were measured using preoperative magnetic resonance imaging, and the correlation between these values and each suture translation was evaluated.ResultsThe average outer, inner, and all-inside suture translations were 4.8 mm, 3.9 mm, and 1.3 mm, respectively. Significant correlations were observed between the outer suture translation and MMME, and MMPH (p < 0.001 and <0.01, respectively). The thresholds for preoperative MMME and MMPH for longer outer suture translations (≥6 mm) were 2.1 mm and 5.4 mm, respectively.ConclusionsPreoperative longer MMME and higher MMPH were associated with longer meniscus translations during knee flexion during MMPRT repair.     

Do the distal femur and the proximal tibia have narrower aspect ratios in smaller knees? : A morphological analysis of osteoarthritic knees in the Japanese population using computed tomography

BackgroundWhether the distal femur and the proximal tibia have narrower aspect ratios in smaller knees has not been clarified. The purpose of this study was to confirm the dimensional characteristics of the distal femur and the proximal tibia using a novel method for consistently determining knee size.MethodsA total of 220 Japanese osteoarthritic knees (160 female and 60 male knees) were analyzed using computed tomography. The mediolateral (ML) and the anteroposterior (AP) dimensions of the distal femur (fML, fAP) and the proximal tibia (tML, tAP) were measured. The aspect ratios (ML/AP) of the distal femur (fML/fAP) and the proximal tibia (tML/tAP) were assessed against the product of AP × ML as a consistent determination of knee size.ResultsThe fML/fAP ratios positively correlated with knee size (fAP × fML) (r = 0.420, p < 0.001), only in the combined cohort, attributable to the narrower aspect ratios of female knees. No correlations were found between the tML/tAP ratios and knee size (tAP × tML) among females, males, nor all subjects (p = 0.299, 0.994, and 0.996, respectively). Aspect ratio correlations to knee size diverged between the three knee size indices, AP, ML, and AP × ML.ConclusionsAP × ML was the meaningful option for knee size indexing in our morphological analyses. The distal femur, but not the proximal tibia, was found to have a narrower aspect ratio in female knees in the Japanese population.     

Penta-block copolymer microspheres: Impact of polymer characteristics and process parameters on protein release

Here, we aimed to develop protein loaded microspheres (MSs) using penta-block PLGA-based copolymers to obtain sustained and complete protein release. We varied MS morphology and studied the control of protein release. Lysozyme was used as a model protein and MSs were prepared using the solid-in-oil-in-water emulsion solvent extraction method. We synthesized and studied various penta-block PLGA-based copolymers. Copolymer characteristics (LA/GA ratio and molecular weight of PLGA blocks) influenced MS morphology. MS porosity was influenced by process parameters (such as solvent type, polymer concentration, emulsifying speed), whereas the aqueous volume for extraction and stabilizer did not have a significant effect. MSs of the same size, but different morphologies, exhibited different protein release behavior, with porous structures being essential for the continuous and complete release of encapsulated protein. These findings suggest strategies to engineer the morphology of MSs produced from PLGA-based multi-block copolymers to achieve appropriate release rates for a protein delivery system.     

激光照射对牙髓细胞形态的影响

不同的激光能量可以产生不同的生物效应．本文应用扫描电镜、倒置显微镜观察不同能量、不同频率的激光能量设置对牙髓细胞形态的影响，结果表明：１００ｍｊ２０Ｈｚ、６０ｍｊ４０Ｈｚ、４０ｍｊ５０Ｈｚ以上的能量设置可使牙髓细胞产生裂纹、结构模糊．结论：Ｎｄ：ＹＡＧ激光的能量、频率均可影响牙髓细胞形态     

熔附条件对牙科复合树脂中SP1 SiO_2表面结构及形态的影响

目的:研究熔附温度和熔附时间对多微孔纳米二氧化硅粒子(SP1 SiO2)表面结构及形态的影响。方法:将SP1SiO2以250℃/h的升温速度分别升至500、650、800、950、1100℃,并分别保持10、30min和3h制作试样,进行表面结构及形态测试。结果:随烧结温度的增高和时间的延长,SP1 SiO2颗粒表面的Si-OH键特征峰值逐渐减弱,条件为950℃、10min和30min,650℃、3h时完全消失;随着熔附温度的升高和熔附时间的延长颗粒增大、粒度分布变窄。结论:熔附温度和熔附时间影响SP1 SiO2颗粒表面的Si-OH含量和颗粒大小、粒度分布。     

先天缺牙与牙形态、大小异常相互关系的研究

目的 探讨先天缺牙与牙形态异常及牙大小异常的相互关系。方法 对79例先天缺牙患者的缺牙部位、缺牙数目，余留牙异常的牙体形态进行分析。并按缺牙程度及部位分成4组，测量其牙冠宽度。结果 （1）上颌侧切牙、下颌中切牙为临床最常见牙先天缺失部位，上颌中切牙，上下颌第一磨牙为牙列中最不易先天缺失的牙齿，但上颌中切牙在先天缺牙患者中常呈轻度的锥形牙冠。（2）先天缺牙常伴牙齿形态异常，以上颌侧切牙，下颌尖牙、上颌第二前磨牙，上下颌第二磨牙多见。（3）轻度先天缺牙患者余留牙大小无异常，随着先天缺牙严重程度增加，前牙有逐渐减小趋势而后牙大小较稳定。结论 （1）上颌侧切牙为牙列中最不稳定的牙齿：（2）牙齿形态、大小、数目异常可能是一个连续的变异过程，可能为同一机制的不同表现。     

Relationship between mentalis muscle hyperactivity and mandibular symphysis morphology in skeletal Class I and II patients

PurposeTo investigate the relationship between mentalis muscle activity and mandibular symphysis morphology in patients with Class I or II skeletal patterns.Materials and methods123 female Thai patients (17 years old+) participated in the present study. Subject pretreatment lateral cephalometric radiographs were examined. All subjects were diagnosed as having a skeletal normal bite. Subjects were grouped according to their sagittal skeletal pattern (ANB angle) into Class I (ANB 2–6) or Class II (ANB > 6). For each skeletal type, the subjects were divided into 2 groups, normal mentalis muscle activity (control group) and hyperactivity (experimental group). The skeletal Class I group comprised 37 subjects with mentalis muscle hyperactivity and 31 subjects with normal activity, while the skeletal Class II group comprised 30 hyperactive and 25 normal activity subjects. Eight cephalometric variables (angular, linear, and proportional measurements) were measured to evaluate mandibular symphysis morphology. The data were statistically analyzed using the Mann–Whitney U test or Independent-Sample t-test based on the normality of the data.ResultsIn the skeletal Class I type, the experimental group revealed a trend of narrower alveolar symphysis width and greater symphysis height compared to the control group, but this was not significant. However, in the skeletal Class II type, the experimental group demonstrated significantly narrower alveolar symphysis width and significantly greater symphysis height compared to the control group (p < 0.05).ConclusionAn increase in mandibular symphysis height and decrease in alveolar symphysis width may relate to mentalis muscle hyperactivity, and such relationship is more obvious in patients with Class II skeletal pattern.     

术中导航校准技术辅助下青少年特发性脊柱侧凸顶椎区置钉精确性研究

【摘要】 目的：比较青少年特发性脊柱侧凸（adolescent idiopathic scoliosis,AIS）顶椎区相同椎弓根类型在导航及导航校准技术辅助下置钉的精确性及偏出方向,并分析影响导航置钉偏移的相关因素及导航校准技术的临床意义。方法：回顾性分析自2017年10月～2020年10月,在我院明确诊断为AIS并在导航辅助下行经后路脊柱侧凸矫形内固定术治疗的41例患者,依据术中是否使用导航校准技术,将41例患者分为两组：导航组（n=22）和校准组（n=19）。收集两组患者基本信息,记录两组患者Risser征,术前、术后Cobb角,术后1年时矫形率,根据付长峰椎弓根分型系统对两组患者顶椎区椎弓根分型（A、B、C、D、E型）,依据Rao分型评估两组相同椎弓根类型的置钉精确性。结果：校准组A、B、C型椎弓根优良置钉率（96.4%、87.8%、84.0%）显著高于导航组（79.2%、70.5%、56.7%）,且凹凸双侧0级钉率显著高于导航组,同时校准组B型椎弓根及其凹凸双侧3级钉率（4.1%、2.0%、6.3%）及C型椎弓根凸侧2级钉置钉率（11.1%）显著低于导航组（12.4%、11.1%、13.7%、50.0%）,两组间差异均具有统计学意义（P＜0.05）。此外,校准组A、B、C型椎弓根外侧皮质破壁率（33.3%、33.3%、60.0%）显著低于导航组（64.0%、38.6%、73.1%）,同时校准组A型椎弓根椎体前壁穿破率（0.0%）及C型椎弓根凹侧外侧皮质破壁率（66.7%）显著低于导航组（24.0%、77.8%）,而B型椎弓根内侧皮质穿破率（41.7%）高于导航组（40.9%）,但其凹侧内侧皮质穿破率（36.4%）显著低于导航组（33.3%）,两组间差异均具有统计学意义（P＜0.05）。两组间均未发生脊髓、神经血管损伤等严重并发症。结论：与传统导航相比,导航校准技术在术中能够有效地预防导航偏移,显著提高AIS顶椎区A、B、C型椎弓根置钉精确性,降低误置螺钉外侧壁穿孔率及B型椎弓根凹侧内侧壁穿孔率,提高手术的安全性。