Abstract This study describes the management of 216 patients with post-traumatic iatrogenic lingual nerve injuries (LNIs; n = 93) and inferior alveolar nerve injuries (IANI; n = 123). At initial ...consultation, 6% IANI and 2% LNI patients had undergone significant resolution requiring no further reviews. Reassurance and counselling was adequate management for 51% IANI and 55% LNI patients. Systemic or topical medication was offered as pain relief to 5% of patients. Additional cognitive behaviour therapy (CBT) was offered to 8% of patients. Topical 5% lidocaine patches reduced pain and allodynia in 7% of IANI patients, most often used without any other form of management. A small percentage of IANI patients (4%) received a combination of therapies involving CBT, surgery, medication and 5% lidocaine patches. Exploratory surgery improved symptoms and reduced neuropathic area in 18 LNI and 15 IANI patients resulting in improved quality of life. In conclusion, the authors suggest a more diverse and perhaps holistic strategy for management of patients with iatrogenic trigeminal nerve injuries and recommend pragmatic assessment criteria for measurement of treatment success in these patients.
Since the Kyoto protocol signed in December 1997 the majority of governments around the world have committed themselves to reducing the emission of the greenhouse gases. Thus, efficient use of energy ...and sustainability has become a key issue for the most energy policies. Sustainability and energy saving terms take place in building construction industry too since buildings are one of the most significant energy consumers. It is known that heating energy demand of a building has a great rate in building total energy consumption. In addition to that, the most of the heating energy has been lost from building envelope. TS 825, Heating Energy Conservation Standard for Buildings in Turkey, aims the reducing of heat loss in buildings through the envelope. But within buildings, one of the fastest growing sources of new energy demand is cooling and especially in hot-humid and hot-dry climatic parts of Turkey cooling season is much longer than the heating season. Moreover in hot-dry climate heat storage capacity of the envelope becomes more important issue than heat insulation for energy efficiency of the building. Since the Turkish standard is considering only heating energy conservation by using degree-day concept, Istanbul and Mardin are considered in the same zone, however those are in temperate-humid and hot-dry climatic zones, respectively. In this study energy efficient design strategies for these climatic zones have been explained and thermal performance of two buildings, which are constructed according to the TS 825 in Mardin and Istanbul cities were evaluated to show the importance of thermal mass in hot-dry climates.
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infects human cells by binding its spike (S) glycoproteins to angiotensin-converting enzyme 2 (ACE2) receptors and causes the coronavirus ...disease 2019 (COVID-19). Therapeutic approaches to prevent SARS-CoV-2 infection are mostly focused on blocking S-ACE2 binding, but critical residues that stabilize this interaction are not well understood. By performing all-atom molecular dynamics (MD) simulations, we identified an extended network of salt bridges, hydrophobic and electrostatic interactions, and hydrogen bonds between the receptor-binding domain (RBD) of the S protein and ACE2. Mutagenesis of these residues on the RBD was not sufficient to destabilize binding but reduced the average work to unbind the S protein from ACE2. In particular, the hydrophobic end of RBD serves as the main anchor site and is the last to unbind from ACE2 under force. We propose that blocking the hydrophobic surface of RBD via neutralizing antibodies could prove to be an effective strategy to inhibit S-ACE2 interactions.
A 10‐year‐old golden retriever was presented for the evaluation of exercise intolerance. Physical examination and laboratory tests showed no abnormalities except for mild anaemia. Standard ...transthoracic echocardiography revealed dilated coronary sinus, raising suspicion of a persistent left cranial vena cava, and the persistency of this anomaly was confirmed by agitated‐saline study. Right ventricular echocardiographic parameters did not change significantly, while conventional parameters and global longitudinal strain analysis revealed left ventricular systolic dysfunction. Moreover, post‐systolic shortening and early systolic lengthening were detected by two‐dimensional speckle tracking echocardiography. This report shows that post‐systolic shortening and early systolic lengthening may be useful diagnostic markers indicating regional left ventricular systolic dysfunction. Further studies are needed to elucidate whether persistent left cranial vena cava contributes to left ventricular systolic dysfunction or is an accidental benign finding in dogs.
Purpose
Bony changes after orthognathic surgery are always followed by changes of the overlying soft tissues. Therefore, morphologic changes of the nose may be expected after procedures involving the ...maxilla. The purpose of this study was to evaluate the changes in the nasal region due to orthognathic surgery using computed tomography (CT) images of virtually planned patients.
Methods
35 patients who underwent Le Fort I osteotomy, with or without bilateral sagittal split osteotomy, were included. 3D measurements on preoperative and postoperative images were performed and analyzed.
Results
The results revealed that aesthetically acceptable results can be achieved by orthognathic surgery alone.
Conclusions
According to the results of this study, it can be concluded that it is best to reserve decisions on rhinoplasty to the post-orthognathic period.
Abstract Trigeminal nerve injury is the most problematic consequence of dental surgical procedures with major medico-legal implications. This study reports the signs and symptoms that are the ...features of trigeminal nerve injuries caused by mandibular third molar (M3M) surgery. 120 patients with nerve injury following M3M surgery were assessed. All data were analysed using the SPSS statistical programme and Microsoft Excel. 53 (44.2%) inferior alveolar nerve (IAN) injury cases and 67 (55.8%) lingual nerve injury (LNI) cases were caused by third molar surgery (TMS). Neuropathy was demonstrable in all patients with varying degrees of paraesthesia, dysaesthesia (in the form of burning pain), allodynia and hyperalgesia. Pain was one of the presenting signs and symptoms in 70% of all cases. Significantly more females had IAN injuries and LNIs ( p < 0.05). The mean ages of the two groups of patients were similar. Speech and eating were significantly more problematic for patients with LNIs. In conclusion, chronic pain is often a symptom after TMS-related nerve injury, resulting in significant functional problems. Better dissemination of good practice in TMS will significantly minimize these complex nerve injuries and prevent unnecessary suffering.
Neurofibrillary tangles (NFT), a neuronal lesion found in Alzheimer's disease (AD), are composed of fibrillary aggregates of modified forms of tau proteins. The propagation of NFT follows ...neuroanatomical pathways suggesting that synaptically connected neurons could transmit tau pathology by the recruitment of normal tau in a prion-like manner. Moreover, the intracerebral injection of pathological tau from AD brains induces the seeding of normal tau in mouse brain. Creutzfeldt-Jacob disease has been transmitted after ocular transplants of cornea or sclera and the scrapie agent can spread across the retino-tectal pathway after intraocular injection of scrapie mouse brain homogenates. In AD, a tau pathology has been detected in the retina. To investigate the potential risk of tau pathology transmission during eye surgery using AD tissue material, we have analysed the development of tau pathology in the visual pathway of mice models expressing murine tau, wild-type or mutant human tau after intraocular injection of pathological tau proteins from AD brains. Although these pathological tau proteins were internalized in retinal ganglion cells, they did not induce aggregation of endogenous tau nor propagation of a tau pathology in the retino-tectal pathway after a 6-month incubation period. These results suggest that retinal ganglion cells exhibit a resistance to develop a tau pathology, and that eye surgery is not a major iatrogenic risk of transmission of tau pathology, contrary to what has been observed for transmission of infectious prions in prion diseases.
•PHF-tau proteins can be internalized by the retinal ganglion cells.•Tau pathology was never observed in the geniculate nucleus after intraocular injection of PHF-tau proteins.•Tau pathology in the superior colliculus in AD or CTL injected Tg22 mice did not show any differences.
Targeted disruption of the Rel/NF‐κB family members NF‐κB2, encoding p100/p52, and RelB in mice results in anatomical defects of secondary lymphoid tissues. Here, we report that development of ...Peyer's patch (PP)‐organizing centers is impaired in both NF‐κB2‐ and RelB‐deficient animals. IL‐7‐induced expression of lymphotoxin (LT) in intestinal cells, a crucial step in PP development, is not impaired in RelB‐deficient embryos. LTβ receptor (LTβR)‐deficient mice also lack PPs, and we demonstrate that LTβR signaling induces p52–RelB and classical p50–RelA heterodimers, while tumor necrosis factor (TNF) activates only RelA. LTβR‐induced binding of p52–RelB requires the degradation of the inhibitory p52 precursor, p100, which is mediated by the NF‐κB‐inducing kinase (NIK) and the IκB kinase (IKK) complex subunit IKKα, but not IKKβ or IKKγ. Activation of RelA requires all three IKK subunits, but is independent of NIK. Finally, we show that TNF increases p100 levels, resulting in the specific inhibition of RelB DNA binding via the C‐terminus of p100. Our data indicate an important role of p52–RelB heterodimers in lymphoid organ development downstream of LTβR, NIK and IKKα.
The ‘beauty arch’, an aesthetic feature of the midface, is a double-S-shaped curve that extends downward from the lateral canthus. This retrospective study evaluated whether modified high Le Fort I ...advancement (combined with impaction or down-grafting) without malar augmentation can approximate a patient’s ‘ideal’ beauty arch (IBA). Pre- and postoperative profile (natural head position) photographs for 36 patients with midfacial hypoplasia were aligned digitally. For each individual, standardized methods were used to identify landmarks and draw the preoperative real beauty arch (RBA), postoperative RBA, and IBA. Distances from a defined landmark to each arch were measured and means were compared. The mean advancement range was 4.2 ± 2.2 mm, and the mean pre- and postoperative RBA distances were significantly different (138.7 ± 24.1 vs 145.0 ± 25.8 pixels, respectively; P = 0.0001). In the impaction and down-grafting subgroups, there was no significant correlation between amount of maxillary movement and the difference between pre- and postoperative RBA distances (P > 0.05 for both). The postoperative RBA was satisfactorily close to the IBA in 35 cases (97.2%); one patient required later augmentation. The findings suggest that modified high Le Fort I advancement surgery without malar augmentation provides satisfactory malar projection for most patients with maxillary hypoplasia.
Measuring key components of resilience is vital for understanding cross‐cultural dynamics among youth and the environment. The Child and Youth Resilience Measure (CYRM‐28) was developed as a ...cross‐cultural measure of resilience and has been used globally. To examine the cross‐cultural utility of the CYRM‐28, we conducted a systematic review of the literature reporting on the psychometric properties of the measure. Using data representing six countries (N = 6,232) that were supplied from authors of the studies reviewed, a multilevel confirmatory factor analysis was also conducted to estimate the variability of the measurement properties among communities, ages, and sex. Results indicate that the literature generally did not include reliability and validity information for the instrument. From the multilevel confirmatory factor analysis, the measure was invariant between adolescent age‐groups and sexes but not across communities.
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