Three-dimensional analysis of molar compensation in patients with facial asymmetry and mandibular prognathism

Objective:To evaluate the characteristic transverse dental compensations in patients with facial asymmetry and mandibular prognathism and to compare features of dental compensations between two types of mandibular asymmetry using 3-dimensional (3D) cone-beam computed tomography (CBCT).Materials and Methods:Seventy-eight adult patients with skeletal Class I (control group; n  =  33; 19 men and 14 women) or skeletal Class III with facial asymmetry (experimental group; n  =  45; 23 men and 22 women) were included. The experimental group was subdivided into two groups according to the type of mandibular asymmetry: translation type (T-type; n  =  20) and roll type (R-type; n  =  19). CBCT images were acquired before orthodontic treatment and 3D analyses were performed.Results:The transverse dental distance was significantly different between the two groups only at the palatal root apex of the maxillary first molar (P < .05). In the experimental group, the first molar axes were compensated significantly on both arches except the maxillary nondeviated side. The vertical molar heights were different between the two groups only on the maxillary arch (P < .001). The R-type showed greater mandibular ramal length difference and menton deviation than the T-type (P < .001). In the R-type, transverse compensation of the maxillary first molars was more obvious than with the T-type, which resulted in canting in the maxillary occlusal plane.Conclusions:Mandibular asymmetry with prognathism showed a characteristic transverse dental compensation pattern. The mandibular asymmetry type influenced the amount and direction of molar compensation on the maxillary arch.     

Woman with intertrochanteric femur fracture diagnosed by MR

We present the case of an elderly woman who sustained an intertrochanteric hip fracture from a fall, with negative findings on plain film. The fracture was subsequently diagnosed using MRI and surgically fixed. MRI continues to be the gold standard for diagnosing occult hip fractures in the acute setting. Any elderly patient presenting with hip pain following a fall or other trauma must be regarded as having a fracture until proven otherwise, even if plain films are normal.     

A case of hemorrhagic gallbladder paraganglioma causing acute cholecystitis.

Gallbladder paraganglioma is a very rare tumor and so far only a few cases have been reported. Most of these were asymptomatic and were found incidentally during operation. Recently, we experienced a gallbladder paraganglioma that gave rise to hemorrhage, which in turn caused acute cholecystitis. Our case involved a 45 year-old female patient complaining of an intermittent right upper abdominal pain. After a preoperative evaluation, cholecystectomy and lymphadenectomy were performed under the impression of gallbladder cancer with acute cholecystitis. Postoperative pathologic examination revealed a hemorrhagic gallbladder paraganglioma accompanied by acute cholecystitis. Immunohistochemical staining of the chief cells for neuron specific enolase, chromogranin and synaptophysin were positive. Sustentacular cells also stained positively for S100 protein.     

Toll‐like receptor 5 activation promotes migration and invasion of salivary gland adenocarcinoma

J Oral Pathol Med (2011) 40 : 187–193 Background: Toll‐like receptor (TLR) signaling has been found to be closely associated with tumor development. The aim of this study was to examine whether activation of TLRs promote migration and invasion of salivary gland adenocarcinoma. Materials and Methods: TLR expression in SGT and HSG cells was examined by RT‐PCR. Wound scratch and chemotaxis cell migration assay were performed. Invasiveness was determined by Matrigel invasion assay. Results: All the tested TLRs including TLR1, TLR2, TLR4, and TLR5 and myeloid differentiation factor‐2 (MD‐2) were expressed on SGT and HSG cells. Treatment of flagellin, but not Pam₃CSK₄ and LPS, led to the production of IL‐6 and IL‐8, suggesting TLR5 is functional in both cells. Stimulation by flagellin also accelerated wound closure of SGT and HSG cells in a dose‐dependent manner. In addition, flagellin promoted migration and invasion ability of SGT cells. Blocking of TLR5 using antibody restored the promoting effect of flagellin on migration and invasion of SGT cells. Conclusion: These findings suggest that TLR5 activation by flagellin can promote migration and invasion of salivary gland adenocarcinoma.     

Motor Unit Number Estimation in Evaluating Disease Progression in Patients with Amyotrophic Lateral Sclerosis

We investigated the availability of motor unit number estimation (MUNE) as a quantitative method to assess the severity and clinical progression of amyotrophic lateral sclerosis (ALS). The 143 ALS patients were evaluated by statistical MUNE and the revised amyotrophic lateral sclerosis functional rating scale (ALSFRS-R). By using mean values of MUNE according to disease duration, regression equation between mean MUNE and disease duration was presented as a formula. The individual MUNE ratio was calculated by dividing individual MUNE value by mean MUNE value. All patients were classified into 2 groups (MUNE ratio <1 vs. MUNE ratio ≥1) according to the MUNE ratio. Comparison between the 2 groups revealed that the patients in MUNE ratio <1 group or MUNE ratio ≥1 group were respectively assigned to rapid progression or slow progression. We recommended informative mean values of MUNE and best regression equation in ALS patients according to disease duration. These values allow us to evaluate the severity and rapidity of progression in ALS.