PURPOSE: To evaluate the clinical outcomes of small incision lenticule extraction (SMILE) for the treatment of myopia with corneal opacity. METHODS: Thirteen eyes of 13 patients with corneal opacities who underwent SMILE were retrospectively studied. Uncorrected distance visual acuity, spherical equivalence, efficacy index, and safety index were noted at 3 months after the procedure. The density and area of the corneal opacities were measured and compared preoperatively and 3 months postoperatively. RESULTS: All eyes had preoperative corneal opacities within the lenticule formation areas. The mean area and density of corneal opacities were 0.72 ± 0.33 mm2 and 52.46 ± 15.74, respectively. All procedures were uneventful and no intraoperative complications were observed. At 3 months after the procedure, the efficacy and safety indices were 1.01 ± 0.15, and 1.05 ± 0.10, respectively, and the mean densities and areas of corneal opacities were 46.85 ± 14.56 (p = 0.038) and 0.70 ± 0.36 mm2 (p = 0.776), respectively. CONCLUSIONS: The SMILE procedure was effective and safe for the correction of myopic patients with corneal opacities.
Corneal Opacity ; Humans ; Intraoperative Complications ; Myopia ; Retrospective Studies ; Visual Acuity

Flow-diverting stents (FDSs) have proven advantageous for the treatment of large, fusiform, and dissecting aneurysms that are otherwise difficult to treat. Retreatment strategies for recurrent large or giant aneurysms after FDSs are limited to overlapping implantation of an additional FDS or definitive occlusion of the parent vessel. We report a recurrent giant aneurysm that was initially treated with an FDS with coils and was successfully treated with an additional FDS. Visual symptoms due to the mass effect of the recurrent aneurysm were completely resolved, and follow-up digital subtraction angiography revealed complete obliteration of the aneurysm. Additional FDS implantation for the retreatment of incompletely occluded aneurysms after the initial FDS treatment may be feasible and safe. Further studies are required to validate these results.

Bortezomib (BTZ) is a proteasome inhibitor used to treat multiple myeloma (MM). However, the induction of peripheral neuropathy is one of the major concerns in using BTZ to treat MM. In the current study, we have explored the effects of BTZ (0.01-5 nM) on rat neural stem cells (NSCs). BTZ (5 nM) induced cell death; however, the percentage of neurons was increased in the presence of mitogens. BTZ reduced the B-cell lymphoma 2 (Bcl-2)/Bcl-2 associated X protein ratio in proliferating NSCs and differentiated cells. Inhibition of βIII-tubulin (TUBB3) degradation was observed, but not inhibition of glial fibrillary acidic protein degradation, and a potential PEST sequence was solely found in TUBB3. In the presence of growth factors, BTZ increased cAMP response element-binding protein (CREB) phosphorylation, brain-derived neurotrophic factor (Bdnf) transcription, BDNF expression, and Tubb3 transcription in NSCs. However, in the neuroblastoma cell line, SH-SY5Y, BTZ (1-20 nM) only increased cell death without increasing CREB phosphorylation, Bdnf transcription, or TUBB3 induction. These results suggest that although BTZ induces cell death, it activates neurogenic signals and induces neurogenesis in NSCs.

Bortezomib (BTZ) is a proteasome inhibitor used to treat multiple myeloma (MM). However, the induction of peripheral neuropathy is one of the major concerns in using BTZ to treat MM. In the current study, we have explored the effects of BTZ (0.01-5 nM) on rat neural stem cells (NSCs). BTZ (5 nM) induced cell death; however, the percentage of neurons was increased in the presence of mitogens. BTZ reduced the B-cell lymphoma 2 (Bcl-2)/Bcl-2 associated X protein ratio in proliferating NSCs and differentiated cells. Inhibition of βIII-tubulin (TUBB3) degradation was observed, but not inhibition of glial fibrillary acidic protein degradation, and a potential PEST sequence was solely found in TUBB3. In the presence of growth factors, BTZ increased cAMP response element-binding protein (CREB) phosphorylation, brain-derived neurotrophic factor (Bdnf) transcription, BDNF expression, and Tubb3 transcription in NSCs. However, in the neuroblastoma cell line, SH-SY5Y, BTZ (1-20 nM) only increased cell death without increasing CREB phosphorylation, Bdnf transcription, or TUBB3 induction. These results suggest that although BTZ induces cell death, it activates neurogenic signals and induces neurogenesis in NSCs.

Bortezomib (BTZ) is a proteasome inhibitor used to treat multiple myeloma (MM). However, the induction of peripheral neuropathy is one of the major concerns in using BTZ to treat MM. In the current study, we have explored the effects of BTZ (0.01-5 nM) on rat neural stem cells (NSCs). BTZ (5 nM) induced cell death; however, the percentage of neurons was increased in the presence of mitogens. BTZ reduced the B-cell lymphoma 2 (Bcl-2)/Bcl-2 associated X protein ratio in proliferating NSCs and differentiated cells. Inhibition of βIII-tubulin (TUBB3) degradation was observed, but not inhibition of glial fibrillary acidic protein degradation, and a potential PEST sequence was solely found in TUBB3. In the presence of growth factors, BTZ increased cAMP response element-binding protein (CREB) phosphorylation, brain-derived neurotrophic factor (Bdnf) transcription, BDNF expression, and Tubb3 transcription in NSCs. However, in the neuroblastoma cell line, SH-SY5Y, BTZ (1-20 nM) only increased cell death without increasing CREB phosphorylation, Bdnf transcription, or TUBB3 induction. These results suggest that although BTZ induces cell death, it activates neurogenic signals and induces neurogenesis in NSCs.

BACKGROUND: Maintaining stability and restoring the aesthetic appearance are the fundamental goals when managing zygomatic fractures. We aimed to evaluate the stability and anthropometric outcomes of zygomatic fracture patients who underwent two-point fixation involving the infraorbital rim and zygomaticomaxillary buttress via the transconjunctival and gingivobuccal approaches without any skin incisions. METHODS: We examined 15 zygomatic fracture patients who underwent two-point fixation during a 3-year period. Stability was evaluated using three-dimensional facial bone computed tomography. Superoinferior and anteroposterior displacement of the zygoma was quantified. The aesthetic appearance of the periorbital region was evaluated using indirect anthropometry with standardized clinical photographs. The ratios between the eye fissure height and width, and lower iris coverage ratio were used to evaluate aesthetical changes. The bony displacement and aesthetic ratios were analyzed using Wilcoxon or Friedman tests. The correlation between the preoperative zygoma position and anthropometric values was analyzed. RESULTS: The positions of the zygoma were similar to those on the contralateral side at the long-term follow-up. The preoperative anthropometric measurements on the fractured side differed from those on the contralateral side, although these values were close to the normal values at the long-term follow-up. Furthermore, we noted that the anteroposterior displacement strongly positively correlated with the lower iris coverage rate (Spearman's coefficient= 0.678, P=0.005). CONCLUSIONS: Two-point fixation of zygomatic fractures achieved stable outcomes on long-term follow-up, and also appeared to be reliable in restoring the aesthetic appearance of the periorbital region.
Anthropometry ; Facial Bones ; Follow-Up Studies ; Fracture Fixation ; Humans ; Iris ; Reference Values ; Skin ; Zygoma ; Zygomatic Fractures

PURPOSE: Skin graft is the gold standard surgical treatment in burn wound management. Until now, wet to dry dressing is regarded as the traditionally standard dressing for skin graft. But it needs to be changed daily, burdens the patients and medical caring team and is time consuming. The authors apply VAC to skin graft to secure the skin and compared the outcomes with previous standard dressing technique. METHODS: 38 burn patients who underwent skin graft were included in this study. Patients were selected with their consent for inclusion in an experimental group and a control group. Patients in the experimental group received a VAC appliance after split-thickness skin graft, while those in the control group received wet to dry dressing after the procedure. Time to complete epithelization, rates of skin graft taken areas, satisfaction of patients and medical caring team was evaluated. RESULTS: A shorter time to complete epithelization (12.5 days) was observed in the experimental group than in the control group (14.6 days), and a higher rates of skin graft taken areas (89%) was observed in the experimental group when compared with the control group (84.5%), A higher satisfaction of both the patients and doctors was observed in the experimental group, compared to the control group, with all statistical significance (P<0.05). CONCLUSION: VAC shortens epithelization period and elevate skin graft taken rates. It also makes the patients and doctors the comfortable in burn patients. The VAC is an excellent alternative for securing skin graft.
Bandages ; Burns ; Humans ; Negative-Pressure Wound Therapy ; Skin ; Transplants

PURPOSE: Skin graft is the gold standard surgical treatment in burn wound management. But it has functional and aesthetic limitations, such as burn scar contracture, low quality of the grafted skin, unnatural looking skin, loss of skin elasticity, especially in extensive deep burn wound which has tendon or bone exposed. The authors used Matriderm(R), a dermal analogue, with split-thickness skin graft simultaneously in burn wound and evaluate the effectiveness of Matriderm(R) for treatment of burn wounds, in comparison with the skin graft only. METHODS: 40 burn patients with skin graft were included in this study. Patients were selected with their consent for inclusion in an experimental group and a control group. Patients in the experimental group received a meshed Matriderm(R) appliance and a split-thickness skin graft, while those in the control group received only a split-thickness skin graft. Time to complete epithelization, rates of skin graft taken areas, Vancouver scar scale assessment, skin elasticity was evaluated. RESULTS: A better scores of Vancouver scar scale assessment (3 points) were observed in the experimental group with the control group (6 points) with statistical significance (P<0.05). A higher elasticity ratio of the affected side to the non-affected side was observed in the experimental group, compared with the control group (P<0.05), and a similar time to complete epithelization and rates of skin graft taken areas were observed in the experimental group when compared with the control group. CONCLUSION: Meshed Matriderm(R) enables effective healing and improves functional and aesthetic results in split thickness skin graft treatment of burn wounds.
Burns ; Cicatrix ; Contracture ; Elasticity ; Humans ; Skin ; Skin Transplantation ; Tendons ; Transplants

Life-threatening hemorrhage following maxillofacial injury (MFI) is rare but can be fatal. Conventional measures for hemostasis including nasal packing, balloon tamponade, and surgical ligation of bleeding points may not be effective or efficient in patients at risk of hypovolemic shock. Advantages of transarterial embolization (TAE) include rapid identification of the bleeding focus and its access, direct obstruction of the culprit vessels, ability to control multiple bleeding sites, and no requirement of general anesthesia. The internal maxillary artery is the most frequently targeted vessel for embolization. Several studies have demonstrated that TAE was technically successful at rates between 79.4% and 100% and was associated with good clinical outcomes. However, major complications such as tongue necrosis or facial nerve palsy have rarely been reported (0%–7%), probably because of rich collaterals in the maxillofacial region, and failure to diagnose complications in patients who are severely disabled or died. Traditionally, Gelfoam and coils have been widely used as embolic materials. Polyvinyl alcohol particles and n-butyl-cyanoacrylate are also favored, and newer embolic materials, such as Onyx or precipitating hydrophobic injectable liquid, are available for use. Operators should be familiar with the distinctive characteristics of each embolic material. Early treatment with TAE for intractable hemorrhage may improve outcomes in patients with MFI, and further studies are necessary to develop a treatment algorithm to define when to initiate TAE in cases of severe oronasal hemorrhage following MFI.

Alveolar cleft belongs to the spectrum of cleft lip and/or palate, affecting 75% of cleft lip/palate patients. The goals of alveolar cleft treatment are stabilizing the maxillary arch, separating the nasal and oral cavities, and providing bony support for both erupting teeth and the nasal base via the piriform aperture. Secondary alveolar bone grafting is a well-established treatment option for alveolar cleft. Secondary alveolar bone grafting is performed during the period of mixed dentition using autologous bone from various donor sites. There are several issues relevant to maximizing the success of secondary alveolar bone grafting, including the surgical timing, graft material, and surgical technique. In this study, we reviewed issues related to surgical timing, graft materials, and evaluation methods in secondary alveolar bone grafting.Abbreviations: ABG, alveolar bone grafting; CBCT, cone-beam computed tomography; DBM, demineralized bone matrix; GPP, gingivoperiosteoplasty; rhBMP, recombinant human bone morphogenetic protein; 2D, two dimensional; 3D, three dimensional