Acute limbic encephalitis with focal hyperperfusion on single photon emission computed tomography

Here we report an 11-year-old boy with acute encephalopathy with neuropsychiatric symptoms. The patient had mildly decreased consciousness, delirious behavior, and affective changes next day of fever onset. Hematologic, biochemical, and metabolic examinations were unremarkable. CSF analysis revealed cell counts of 278 cells/mm³ and a protein level of 87 mg/dL. Although MRI revealed no abnormal findings, an increase in regional cerebral blood flow was present in the bilateral frontal lobes, mesial temporal lobes, and basal ganglia on single photon emission computed tomography. The measurement of the concentrations of biomarkers such as cytokines in the patient’s serum and cerebrospinal fluid revealed elevated levels of IL-4 and TNF-α in the cerebrospinal fluid. Immunohistochemical studies applying control human brain sections did not demonstrate the presence of autoantibodies. We considered that innate immunity rather than autoantibody response may have contributed to the neuropsychiatric symptoms of our patient. These results suggest heterogeneity of patients with acute encephalopathy with neuropsychiatric symptoms.     

Association between food mixing ability and mandibular movements during chewing of a wax cube

The purpose of this study was to clarify whether masticatory movements during chewing of a wax cube associate with food mixing ability. Twenty-six dentate subjects (mean age 25.3 years) were directed to chew a two-coloured paraffin wax cube for 10 strokes on preferred chewing side. Mixing Ability Index (MAI) was determined from the colour mixture and shape of the chewed wax cube. MAI was employed as an estimate of food mixing ability. Mandibular movements during chewing of the wax cube were recorded using a six-degrees-of freedom jaw movements recording system, and motion of a lower incisal point of the mandible was computed. Twelve parameters of masticatory movements in relation to mandibular excursion, angle, velocity, cycle duration, duration of each phase were measured for each masticatory cycle. In addition, unilateral maximum biting was performed, and the maximum force during biting was measured using a force-transducer. A multiple regression analysis identified vertical amplitude, closing duration, closing angle and maximum bite force as significant predictors accounting for 63% of inter-subject variation (adjusted R(2)) in the MAI (P < 0.05). Only some parameters of masticatory movements seem to have an influence on the MAI in dentate subjects.     

Influence of altered occlusal guidance on masticatory muscle activity during clenching

This study investigated the influence of experimentally altered occlusal guidance on masticatory muscle activity. Twenty healthy human subjects (15 males and five females with an average age of 26.5 years) volunteered to participate in this study. Metallic occlusal overlays were fabricated for the lower working side canine and overlaid on the second molar and the non-working side second molar to simulate a canine-protected occlusion, group function occlusion and bilateral balanced occlusion. Electromyography (EMG) activities in the bilateral masseter, anterior and posterior temporalis were recorded during maximal clenching. The experimental occlusal pattern revealed to have statistically significant effects on EMG activity. As the most characteristic change, EMG activity in the anterior temporalis significantly increased in the simulated group function occlusion and the simulated bilateral balanced occlusion compared with the simulated cuspid protected occlusion. The increased teeth contacts to the posterior region altered the unilateral pattern of the anterior temporalis activity to the bilateral pattern, while that of masseter activity remained unchanged.     

The relationship between missing occlusal units and oral health-related quality of life in SDA patients

The aim of this multi-center study was to explore the relationship between missing occlusal units and oral health-related quality of life (OHRQoL) in subjects with the shortened dental arches (SDAs). Subjects with SDAs were recruited consecutively for one month from six university-based prosthodontic clinics. In total, 115 SDA subjects participated (mean age, 58.5 +/- 10.0 yrs; 71% female). The location and number of missing teeth were examined and the number of missing occlusal units was calculated. To evaluate OHRQoL, the Japanese version of the Oral Health Impact Profile (OHIP-J) was administered and the summary score of OHIP-J was calculated. The SDA subjects were categorized depending upon the anterior-posterior lengths of the missing or remaining occlusal units. Regression analyses were performed to investigate 1) the association between missing OU and OHIP-J summary scores and 2) the OHIP-J differences between groups of subjects with various anterior-posterior SDA lengths. The first analyses revealed that one missing OU was significantly related to an increase of 2.1 OHIP-J units (95% CI: 0.6-3.5, P=0.016). The second analysis revealed that subjects who only lost the second molar contact exhibited significantly better OHRQoL than those who lost more teeth (Coefficient: 11.1, 95% CI: 2.8-19.2, P=0.02). Furthermore a statistically significant group difference was observed between the groups with and without the first molar occlusal contact (Coefficient: 12.8, 95% CI: 1.4 to 24.1, P=0.03). These results suggest that missing occlusal units are related to the OHRQoL impairment in subjects with SDAs. They also suggest that the patterns of missing occlusal units are likely to be related to the OHRQoL impairment in SDA subjects with the presence of first molar contact having an important role.     

Intraoperative thrombectomy for occluded carotid arteries in patients with acute aortic dissection: report of two cases

The present study describes two cases in which intraoperative thrombectomy was performed for occluded or severely stenosed carotid arteries in patients with acute aortic dissection complicated by cerebral malperfusion. A Fogarty catheter was inserted into the true lumen of the occluded branch under hypothermic circulatory arrest, and thrombi within the false lumen were removed. The arch vessels were patent on subsequent computed tomographic imaging, and no neurological complications were found postoperatively. In these cases, the choice of appropriate management strategies took into consideration the brain ischemic time and the presence or absence of cerebral infarction. This technique represents a useful option for the management of this clinical scenario.     

Comparing the Efficacy of a Microperforated Titanium Membrane for Guided Bone Regeneration with an Existing Mesh Retainer in Dog Mandibles

Acute-type lateral ridge defects (25 mm × 6 mm × 5 mm) were bilaterally created in the mandibles of four dogs (two defects per animal). The defects were reconstructed with particulate autologous bone and covered with a microperforated titanium membrane (Ti-honeycomb membrane, TiHM) or an existing conventional titanium mesh as control. The samples were dissected after 16 weeks postoperatively and processed for radiographic, histologic, and histomorphometric analyses. Regenerated tissue and bone volume were significantly larger in the TiHM group than in the control group (p = 0.05; p = 0.049). In contrast, bone mineral density was similar between the two groups. Histomorphometric analysis revealed that the regenerated bone area and calcific osseous area were larger in the TiHM group than in the control group; however, the differences were not significant. The efficacy of TiHM was generally satisfactory with the potential to become a standard tool for the GBR procedure; however, early membrane exposure will be a major problem to overcome.