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Sphenoid sinus malignancies are rare diseases. Secondary hypopituitarism associated with sphenoid sinus malignancy is not well known. A 41-year-old male complained of right ptosis. Neurological findings revealed right oculomotor, trochlear and glossopharyngeal nerve palsy. Imaging diagnosis suggested a tumor that had spread bilaterally from the sphenoid sinus to the ethmoid sinus, nasopharynx and posterior pharyngeal space. Biopsy revealed squamous cell carcinoma (SCC). Based on these findings, a clinical diagnosis of SCC of the sphenoid sinus was made. Removal of the tumor without damaging nearby organs would have been difficult because the tumor extended to the bilateral optic nerves, optic chiasma and internal carotid artery, and surgeons, therefore, recommended proton beam therapy (PBT). Before PBT, the hypopituitarism occurred in the patient and we administered hydrocortisone and levothyroxine. During treating for hypopituitarism, we performed PBT with nedaplatin and 5-fluorouracil. The daily PBT fractions were 2.2 relative biological effectiveness (RBE) for the tumor received total dose of 81.4 Gy RBE. The acute side effect of grade 2 dermatitis according to the National Cancer Institute Common Terminology Criteria for Adverse Events version 4.0. Occurred after PBT. The patient needs to take hydrocortisone and levothyroxine, but he remains in complete remission 8 years after treatment without surgery or chemotherapy. Visual function is gradually declining, but there is no evidence of severe radiation-induced optic neuropathy.

Background and purpose Boron neutron capture therapy (BNCT) can be performed without reactors due to development of cyclotron-based epithermal neutron source (C-BENS), which is optimized for treatment for deeper-seated tumors. The purpose of this study was to evaluate efficacy and safety of cyclotron-based BNCT with borofalan (10B) for recurrent or locally advanced head and neck cancer. Materials and methods In this open-label, phase II JHN002 trial of BNCT using C-BENS with borofalan (10B), patients with recurrent squamous cell carcinoma (R-SCC) or with recurrent/locally advanced non-squamous cell carcinoma (R/LA-nSCC) of the head and neck were intravenously administered 400 mg/kg borofalan (10B), followed by neutron irradiation. The tumor dose was determined passively as the mucosal maximum dose of 12 Gy-Eq. The primary endpoint was the objective response rate (ORR). Post-trial observational JHN002 Look Up study was planned for evaluating locoregional progression-free survival (LRPFS). Results Eight R-SCC and 13 R/LA-nSCC patients were enrolled. All R-SCC patients had prior radiotherapy with a median dose of 65.5 Gy (range, 59.4–76.0 Gy). The ORR for all patients was 71%, and complete response/partial response were 50%/25% in R-SCC and 8%/62% in R/LA-nSCC. The 2-year overall survival for R-SCC and R/LA-nSCC were 58% and 100%, respectively. The median LRPFS was 11.5 months for R-SCC. Frequently observed adverse events included alopecia (95%), hyperamylasemia (86%), and nausea (81%). Conclusion These data suggest that BNCT using C-BENS with borofalan (10B) is a promising treatment option for patients with R-SCC or R/LA-nSCC of the head and neck.

Adenoid cystic carcinoma (ACC) is a very rare epithelial tumor of the salivary glands. Surgical resection is considered to be a standard therapy. However, the optimal treatment strategy for managing advanced cases has not yet been established. This study evaluated the efficacy and toxicity of proton beam therapy (PBT) combined with selective intra-arterial infusion chemotherapy (IAIC) using weekly cisplatin for locally advanced ACC of the base of the tongue. Between March 2009 and February 2018, 15 patients were treated. The median follow-up duration was 56 (range: 15–116) months. The 5-year local control and overall survival rates were 89% and 76%, respectively. With regard to late toxicities, grade 2 osteoradionecrosis was found in one patient and grade 5 pharyngeal necrosis was observed in one patient. Considering most cases were significantly advanced and inoperable, this therapy was effective in controlling the primary tumor, preserving function and maintaining the quality of life. Although improvements are needed to reduce adverse events, PBT in combination with IAIC can be a treatment option for locally advanced ACC of the base of the tongue.

Proton therapy for paediatric cancer patients is an effective treatment; however, young children have may have difficulties staying still during irradiation. This study investigated the indication of general anaesthesia in paediatric proton therapy. Background information and anaesthesia/treatment protocols were retrospectively extracted from the medical records of cancer patients under 15 years who underwent proton therapy at Southern TOHOKU General Hospital, Fukushima, Japan between April 2016 and December 2018. The anaesthesia and non-anaesthesia groups were compared to evaluate factors determining the need for general anaesthesia. Thirty-two patients who received 285 irradiations were analysed. The median age was 5 years old (range: 1–15), and 13 patients (40.6%) were female. Twelve (37.5%) patients received general anaesthesia. In the general anaesthesia group, airway management using a laryngeal mask was performed in 11 patients (91.6%). Patient age was significantly lower in the general anaesthesia group than in the non-anaesthetised group (p P

Objectives Oral function management has been recognized as important strategy for preventing postoperative complications. In this historical cohort study, we focused on the patients who planed gastrectomy, and investigated the appropriate duration and frequency of preoperative oral care to prevent complications after surgery. Methods Patients who planed surgery for gastric cancer between 2012 to 2018 were enrolled. We defined intensive oral care as initial intervention at least three weeks before surgery and follow-up intervention within a week before surgery. As the primary outcome, the incidence of postoperative infectious complications was compared between the intensive oral care and non- intensive oral care groups. Results A total of 576 patients were enrolled, including 66 with intensive oral care. The incidence of infectious complications was 2/66 (3.0%) in the intensive oral care group and 64/510 (12.5%) in the non-intensive oral care group. After adjusting for confounding factors, patients with intensive oral care exposure had a lower chance of developing postoperative infectious complications (Odds ratio; 0.217, 0.051-0.927). Conclusions Intensive oral care can help prevent postoperative infectious complications after gastrectomy. These findings suggest that appropriate preoperative oral care include at least two interventions: three weeks or more before and within one week before surgery.

ObjectiveThe purpose of this cross-sectional study was to evaluate the efficacy and safety of proton beam therapy for liver metastatic recurrence in gastric cancer patients.MethodsConsecutive patients who underwent proton beam therapy from 2010 to 2015 were isolated from our institutional database. Patients with extrahepatic metastatic lesions were excluded. Seven patients were enrolled. The median diameter of target lesions was 31 mm (13–68 mm). The most frequent dosage was 72.6 Gy equivalent in 22 fractions. The effectiveness was assessed based on the local control, overall survival and progression-free survival rates. The local control, overall survival and progression-free survival rates were calculated using the Kaplan–Meier method. Adverse events were described according to the patients’ medical records.ResultsThe median follow-up period was 41.7 months (20.7–66.3 months). The 3-year local control, overall survival and progression-free survival rates were 85.7, 68.6 and 43%, respectively. All patients completed proton beam therapy without interruption. No grade ≥3 adverse events were observed.ConclusionsProton beam therapy might be a treatment option for patients with liver metastasis of gastric cancer.

Background Perioperative oral management has been reported to be effective for preventing postoperative infectious complications. In addition, severe periodontal disease was identified as the significant risk factor for complications after gastrointestinal surgery. We investigated the bacteriological association between the periodontal pocket, stomach mucosa and drainage fluid to determine whether oral bacteria directly cause intra-abdominal infection after gastrectomy. Methods Patients who were scheduled to undergo surgery for gastric cancer were prospectively enrolled. We evaluated the similarity of bacterial strains in periodontal pocket, stomach mucosa and fluid from drainage tube. Gingival crevicular fluid and dental plaque were collected from the periodontal pocket and cultured to detect bacteria. Specimens from the resected stomach were collected and used for bacterial culturing. Drainage fluid from the abdominal cavity was also cultured. Results All of 52 patients were enrolled. In the periodontal pocket, α-Streptococcus spp., Neisseria sp., and Prevotella sp. were mainly detected. Bacterial cultures in the stomach mucosa were positive in 26 cases. In 20 cases (76.9%), the detected strains were the same as those in the periodontal pocket. Six patients had the postoperative intra-abdominal infection after gastrectomy, and the same bacterial strains was detected in both of drainage fluid and periodontal pocket in two patients with severe periodontal disease. Conclusions We found the bacteriological association that same strain detected in periodontal pocket, stomach and in intra-abdominal drainage fluid after gastrectomy in patients with periodontal disease.

Adenoid cystic carcinoma (ACC) is a very rare epithelial tumor of the salivary glands. Surgical resection is considered to be a standard therapy. However, the optimal treatment strategy for managing advanced cases has not yet been established. This study evaluated the efficacy and toxicity of proton beam therapy (PBT) combined with selective intra-arterial infusion chemotherapy (IAIC) using weekly cisplatin for locally advanced ACC of the base of the tongue. Between March 2009 and February 2018, 15 patients were treated. The median follow-up duration was 56 (range: 15–116) months. The 5-year local control and overall survival rates were 89% and 76%, respectively. With regard to late toxicities, grade 2 osteoradionecrosis was found in one patient and grade 5 pharyngeal necrosis was observed in one patient. Considering most cases were significantly advanced and inoperable, this therapy was effective in controlling the primary tumor, preserving function and maintaining the quality of life. Although improvements are needed to reduce adverse events, PBT in combination with IAIC can be a treatment option for locally advanced ACC of the base of the tongue.

The effectiveness of perioperative oral management in gastrointestinal surgery remains unclear. To elucidate the clinical significance of oral care, we investigated the relationship between the oral environment and postoperative infectious complications (POICs) in patients undergoing gastrointestinal surgery. This was a single-institute and historical cohort study of 341 patients. The participants were isolated from consecutive patients undergoing planned radical resection for gastrointestinal carcinoma from January 2016 to June 2017. Dentists assessed the oral environment for periodontal disease, hygiene status, dry mouth, fur on tongue, and tooth stumps. All patients received scaling and tooth brushing instructions. A stepwise logistic regression analysis was conducted to identify risk factors for POICs among the different oral statuses. The surgical procedures performed were gastrectomy in 123 (36.1%), colorectal resection in 185 (54.2%), and pancreatoduodenectomy or others in 38 (11.1%). POICs occurred in 48 patients (14.1%), including deep organ space infection in 20, surgical site infection in 11, anastomotic leakage in 5, urinary tract infection in 4, pneumonia in 2, and others in 6. After adjusting for confounding factors, periodontal disease was isolated as an independent risk factor for POICs (odds ratio 2.091, p = 0.037, 95% confidence interval 1.045–4.183). Other variables of oral environment such as hygiene status, dry mouth, fur on tongue, and tooth stumps did not have a significant impact on POICs. Periodontal disease is a risk factor for infectious complications after gastrointestinal surgery.

This study aimed to evaluate the therapeutic effect and toxicity of proton beam therapy in combination with intra-arterial infusion chemotherapy in patients with squamous cell carcinoma of the maxillary gingiva. Between December 2010 and March 2016, 30 patients with T4 squamous cell carcinoma of the maxillary gingiva were treated with radiotherapy and retrograde intra-arterial infusion chemotherapy using cisplatin (20&ndash, 40 mg/m2, 4&ndash, 6 times). Radiotherapy was basically administered using boost proton beam therapy for primary tumor and neck lymph node tumors, following 36&ndash, 40 Gy photon radiation therapy delivered to the prophylactic area, to a total dose of 70.4&ndash, 74.8 Gy. The median follow-up was 33 months. The 3-year local control and overall survival rates were 69% and 59%, respectively. Major grade 3 or higher acute toxicities included mucositis, neutropenia, and dermatitis in 12 (40%), 5 (17%), and 3 (10%) patients, respectively. No grade 3 or higher late toxicities were observed. These results suggested that proton beam therapy in combination with intra-arterial infusion chemotherapy was not inferior to other treatment protocols and should be considered as a safe and effective option in patients with T4 squamous cell carcinoma of the maxillary gingiva.

Radiotherapy has been found to be valuable for the control and eradication of local foci in various malignant tumors. The abscopal effect is determined as a systemic antitumor response at a distance from the irradiation site invoked by local irradiation. We herein present an extremely rare case of breast cancer in a 64-year-old woman, in whom the abscopal effect was observed after radiotherapy induced an antitumor response in all metastatic lesions, without any combination therapy. The patient was admitted to our hospital complaining of a breast mass and pain at the left hip, and was diagnosed with breast cancer with multiple bone, lung and lymph node metastases. She received treatment with local radiotherapy delivered to the breast tumor and some of the bone metastases but did not receive chemotherapy due to her poor performance status. However, 10 months after radiotherapy, spontaneous regression was observed, not only within the irradiated field, but also in the non-irradiated areas. All signs of cancer throughout the body disappeared, and the patient's performance status drastically improved. To the best of our knowledge, there have been no reports of advanced breast cancer cases in which the abscopal effect was observed after radiation monotherapy; therefore, this case report is extremely rare and highly valuable.

We report herein on use of a percutaneous zygomatic arch osteotomy that is simple, safe, and less invasive than conventional methods on patients in whom protrusion deformity of the zygoma following facial fracture surgery. Even though osteotomy is performed percutaneously, this technique entails a lower risk of facial nerve damage compared with other extraoral approaches, and the method is both minimally invasive and simple. No serious postoperative side effects were observed and the facial symmetry was achieved.

Several studies have reported certain bone morphogenic proteins (BMPs) to have positive effects on bone generation. Although some investigators have studied the effects of human recombinant BMP (rhBMP-2) in sinus augmentation in sheep, none of these studies looked at the placement of implants at the time of sinus augmentation. Furthermore, no literature could be found to report on the impact that different implant systems, as well as the positioning of the implants had on bone formation if rhBMP-2 was utilized in sinus-lift procedures.The aim of this study was to compare sinus augmentation with rhBMP-2 on a poly-d, l-lactic-co-glycolic acid gelatine (PLPG) sponge with sinus augmentation with autologous pelvic cancellous bone in the maxillary sinus during the placement of different dental implants.Nine adult female sheep were submitted to bilateral sinus-floor elevation. In one side (test group) the sinus lift was performed with rhBMP-2 on a PLPG-sponge, while the contralateral side served as the control by using cancellous bone from the iliac crest. Three different implants (Bränemark(®), 3i(®) and Straumann(®)) were inserted either simultaneously with the sinus augmentation or as a two staged procedure 6 weeks later. The animals were sacrificed at 6 and 12 weeks for histological and histomorphometrical evaluations during which bone-to-implant contact (BIC) and bone density (BD) were evaluated.BD and BIC were significantly higher at 12 weeks in the test group if the implants were placed at the time of the sinus lift (p0.05). No difference was observed between the different implant systems or positions.The use of rhBMP-2 with PLPG-sponge increased BIC as well as BD in the augmented sinuses if compared to autologous bone. Different implant systems and positions of the implants had no effect on BIC or BD.

The first 77 GHz frequency modulated continuous wave (FMCW) radar transceiver IC with an accurate FMCW chirp signal generator using a 90 nm CMOS process is presented. To realize accurate FMCW radar system in CMOS, a PLL synthesizer based FMCW generator with chirp smoothing technique that is able to output linear FMCW frequency chirp using a nonlinear reference chirp signal supplied from a low spec/cost digital-oriented frequency reference is applied. The fabricated IC consists of an LNA, a down-conversion mixer with an output buffer, a driver amplifier, a power amplifier with power combiner, an LO distributer and an FMCW synthesizer. The measured FMCW signal from the proposed FMCW generator achieves 93 kHz frequency error (nonlinearity) at the 77 GHz chip signal. Radar performance of the IC has less than 1% ranging error from 1 m to 8 m distance from the measurement in a laboratory. These results show the transceiver achieves a fundamental function for radar applications with 520 mW power consumptions.

Necrotising ulcerative stomatitis is a very rapid, destructive disease of the alveolar bone and gingiva. The rapid destruction leads to devastating facial defects and death, if it is not treated promptly. Candida albicans and Pseudomonas aeruginosa are frequent causes of disseminated infections among patients who are immunocompromised. This report is of a 72-year-old woman with dose large B-cell lymphoma, who developed acute necrotising ulcerative stomatitis and septic shock together with histopathological and microbiological evidence of C. albicans and P aeruginosa infections. Gingival necrosis was managed by debridement to remove slough and irrigation with povidone iodine. All oral symptoms subsided following the initiation of antimicrobial therapy and debridement. The patient completed chemotherapy and achieved prompt remission. This report highlights the importance of prompt recognition, debridement, teeth extraction, scrupulous oral hygiene, appropriate antibiotic therapy, and nutritional support for immunocompromised patients with necrotising ulcerative stomatitis.

A 60-GHz receiver (RX) front-end chip fabricated in 90 nm CMOS process is presented. The RX chip consists of an LNA, a downconversion mixer, and a phase-locked loop synthesizer. The RX chip is capable of generating LO signal from phase-locked synthesizer. The components of the RX chip employ fully differential architecture to avoid influences of parasitic components and operate with low LO signal amplitude. Measured power gain and NF of 22 dB and 8.4 dB were obtained at 61.5 GHz, respectively, and the RX chip receives a radio signal with an on-chip dipole antenna. These results indicate the possibility of realization of a CMOS single-chip 60-GHz transceiver.

TransferJet™ is an emerging high-speed close-proximity wireless communication standard, which enables a data transfer of up to 522 Mbps within a few centimeters transmission range. We have designed a fully integrated TransferJetTM SoC with a 4.48-GHz operating frequency and a 560-MHz signal bandwidth using a 65 nm CMOS technology. A module has also been developed employing 3D integration technology. The SoC with RF and digital baseband circuits is embedded in an organic resin substrate of the module to achieve a module size of 4.8 mm × 4.8 mm × 1.0 mm. Since RF signals are sensitive to the low height and small footprint of the module, we propose a waveform pre-emphasis scheme to handle the ultra-wide bandwidth and a programmable power attenuator for precise output power in the transmitter of the SoC to meet the TransferJetTM standard.

BACKGROUND: The aim of this study was to evaluate the efficacy of a combination graft, using recombinant human bone morphogenetic protein-2 (rhBMP-2) and culture-expanded cells derived from bone marrow, for bone regeneration in a nonhuman primate mandible. METHODS: Five Japanese monkeys were used. Three milliliters of bone marrow was obtained from the tibia and plated into culture flasks. Adherent cells were cultured until near confluence; then, the proliferated cells were transferred to a three-dimensional culture system using collagen beads as the cell carrier. The medium was supplemented with ascorbic acid, beta-glycerophosphate, and dexamethasone to promote osteoblastic differentiation. After further proliferation on beads, the cells were mixed with a collagen sponge that was impregnated with rhBMP-2 and grafted into surgically created segmental bone defects of the mandibles. Three animals received this treatment, and either culture-expanded cells alone or collagen beads without cells were implanted into the remaining two monkeys as controls. The animals were killed 24 weeks after surgery, and the results were assessed by radiographic and histologic evaluation. RESULTS: The combination graft of culture-expanded bone marrow cells with rhBMP-2 in a collagen sponge regenerated the mandibular bone completely. By contrast, the graft of culture-expanded cells alone resulted in only a small amount of bone formation, and the implantation of collagen beads alone led to no bone formation. CONCLUSION: The combination graft of rhBMP-2 and culture-expanded cells, which requires only a small amount of bone marrow, is a reliable method for the reconstruction of segmental bone defects of the mandible.

Objectives: In alveolar distraction, the bone segment tends to incline palatally or lingually, making rigid control of the segments difficult. The aim of this study was to evaluate the usefulness of a newly developed bi-directional extraosseous alveolar distractor (Medartis V2-Alveolar distractor) for pre- and perioperative vector management. Material and methods: Seven patients with segmental alveolar atrophy following traumatic tooth loss were treated using the distraction device. The patients were followed up clinically and radiologically. Preoperatively, the initial vector for distraction was determined using CT by measuring the cross-section of the bone. The morphology of the alveolar bone was also analyzed in relation to the planned implant position. Postoperatively, the rate of osteogenesis was monitored with plane radiographs and CT scan. Results: All cases had bone deficit at the anterior surface of the alveolar ridge, showing a typical inclination of the long axis of the bone. Using the distractor, vertical distraction and positioning of the segments with labial orientation was possible. After a consolidation period of 12 weeks on average, sufficient bone formation for implant installation was radiologically observable. Histologic and histomorphometric analysis of one bone biopsy showed very dense mineralized bone (area fraction=78%) with a multidirectional, complex architecture. Implant-supported prosthetic oral rehabilitation was successfully performed in all cases. Conclusion: All complications observed in this study were related to the bone deficiency at the anterior surface of the alveolar process. If the technique can be improved, this type of bi-directional distraction is a promising method for alveolar bone repair.

Purpose We sought to evaluate the effectiveness and the complications related to the use of Ethisorb (resorbable alloplastic material) in the reconstruction of orbital floor fractures. Patients and methods We retrospectively reviewed the charts of all patients who underwent orbital floor fracture reconstruction with Ethisorb since 2001. We only included patients with a minimum follow-up of 3 months. The following data were recorded for every patient: age, gender, cause of trauma, time from trauma to surgery, signs and symptoms, concomitant ocular injuries, radiographic analysis, pertinent intraoperative findings (including the type of approach), follow-up time, and postoperative complications. Results Eighty-seven patients were included in the study. Twenty-one patients (24.1%) experienced postoperative complications. Of these, only 3 patients (3.4%) had permanent complications directly related to the Ethisorb membrane (diplopia, enophthalmos). Two of these patients required revision surgery and are discussed in the article. Conclusions The results of our study demonstrate the effectiveness of Ethisorb in the repair of small-to-moderate orbital floor fracture defects (up to a maximum size of 2 × 2 cm).

Polymorphous low-grade adenocarcinoma (PLGA) is a neoplasm arising most commonly in the palatal minor salivary glands. Not established as a distinct entity until 1983, PLGA was often misdiagnosed as adenoid cystic carcinoma or pleomorphic adenoma. This tumor was first reported by Evans and Batsakis (1984) and was adopted as a new entity in the subclassification of adenocarcinoma in the histological classification of salivary gland tumors of the World Health Organization (1991). In this report, we describe a case of PLGA of the palate in a 74-year-old woman. She became aware of palatal swelling, 3 months previously and came to our hospital.A soft, elastic, well-demarcated tumor arising in the left side of the palate, measuring 1.4×1.3cm, and a mucosal ulcer (0.6cm in diameter) were recognized. She underwent partial maxillectomy. There has been no recurrence or metastasis of the tumor as of 1 year after operation.

Bone morphogenetic proteins have been found to be one of the most promising osteoinductive substances and they are expected to be utilized clinically for the reconstruction of defective mandibles. However, newly formed bone induced by recombinant human bone morphogenetic protein-2 (rhBMP-2) has not yet been proven able to withstand the masticatory force applied by oral implants. In this study, we examined the qualitative changes in an rhBMP-2-induced mandible from the functional force of osseointegrated oral implants. Segmental (30 mm) bone defects were created in the mandibles of beagles. A poly D,L-lactic coglycolic acid-coated gelatin sponge impregnated with rhBMP-2 was grafted to the resected canine mandible. The new bone was formed 8 weeks after surgery and the Branemark system fixtures were implanted into the reconstructed mandible. After another 8 weeks, the prosthesis was placed over the oral implants. The prosthesis was maintained in occlusion with the opposing natural dentition for 0, 4, 12, 24, or 48 weeks before the animal was euthanized. The quality of regenerated bone was then evaluated histologically and the osseointegration ratio between oral implants and the bonemeasured. During the first 4 weeks, the ratio remarkably increased from 48.9% to 64.5%. After 48 weeks, the ratio approached about 74.5%. The bone loaded for 48 weeks had undergone extensive remodeling and consolidation; its quality was better and maturer than that of bone that was not loaded. These results indicated that the newly formed bone induced by rhBMP-2 was able to withstand the masticatory force applied by oral implants and had become as functionally mature as a natural bone.

A low-height, small module for 4.48GHz carrier frequency, 560MHz bandwidth transceiver has been designed employing 3D integration technology. An LSI integrated with RF and digital baseband circuits is embedded in an organic resin substrate of the module to achieve a small module size of 4.8mm × 4.8mm × 1.0mm. Since RF signals are degraded by parasitic capacitance associated with the low height and small footprint of the module, three design techniques are proposed in the paper. The module realizes the world's smallest size, and achieves sufficient transmitter modulation accuracy and receiver sensitivity, which meet TransferJet™ standards.

We propose utilizing a radio-over-fiber technique of optical subcarrier-multiplexing transmission for radio base stations (BSs) with adaptive array antennas. The proposed system can be constructed at low cost since only one optical transmitter and receiver is required for a center station and a BS. Moreover, relative phases among antenna branches are insensitive to equivalent length fluctuation of an optical fiber.

Arch bars still play an important role in the treatment of severely dislocated and comminuted fractures as well as in injuries where functional treatment is required. In an effort to optimise stability and reduce operation time, we developed a new titanium arch bar for use in maxillomandibular fixation. This report is an update on old and current methods of maxillomandibular fixation and the application of this new arch bar.

TransferJet™ is an emerging high-speed close-proximity wireless communication standard, which enables a data transfer of up to 522Mbps within a few centimeters range. We have developed a fully integrated TransferJet SoC with a 4.48-GHz operating frequency and a 560-MHz bandwidth (BW) using 65nm CMOS technology. Baseband filtering techniques for both a transmitter (TX) and a receiver (RX) are proposed to obtain a sensitivity of −70dBm with low power consumption. The SoC achieves an energy per bit of 0.19nJ/bit and 0.43nJ/bit for the TX and the RX, respectively, We have also built the world's smallest module prototype using the SoC, which is suitable for small mobile devices.

We propose a Polarization Shift Keying (POLSK) phase diversity homo-dyne system with multiplying detection in coherent optical communications. The proposed system uses only one of three Stokes parameters, which is the phase difference between two orthogonal polarizations. Although such systems using only one Stokes parameter are very sensitive to polarization fluctuation, the proposed system becomes insensitive to the linear polarization fluctuation by using the multiplying detection with a combination of in-phase and quadrature optical signal components on two orthogonal polarizations. Furthermore, insensitivity to phase noise and offset frequency and attractiveness due to homodyne type in high-speed transmissions are maintained. The most attractive feature of the proposed system is that neither a polarization controller nor electronic feedback loop for matching the state of polarization (SOP) between transmitted and local oscillator (LO) optical signals is needed. We theoretically analyze the r...

Congenital insensitivity to pain with anhydrosis is very rare. We describe a case of congenital insensitivity to pain with anhydrosis, associated with unusual healing of a buccal ulcer, which occurred in a patient with no teeth. The patient presented with swelling of the left cheek. An ulcer with induration was found on the left buccal mucosa. The pathological diagnosis was fibromatosis. Because of recurrent swelling, we extirpated the buccal ulcer and the mass behind it. Only 3 days after operation, we found a pedicle mass at, the same location. The secondary lesion was extirpated, and pathological examination showd fibrous tissue overgrowth. Altough the wound opened after operation, it healed completely 15 months later.

This study reports on 15 mandibular reconstructions using the Dumbach Titan Mesh-System and particulate cancellous bone and marrow harvested from bilateral posterior ilia. All cases showed segmental defects. Eleven cases involved patients with malignant tumor. Six patients had received irradiation of 40-50 Gy. Reconstructions were performed immediately in 1 patient and secondarily in the remaining 14 patients. In 13 cases, mandibles were successfully reconstructed. Of these 13 patients, 9 reconstructions were completed without complications, whereas the other 4 cases showed complications. In 2 cases, reconstruction failed completely. Overall success rate was 87%. Statistical analysis revealed the extent of mandibular defect, but not malignancy of the original disease or radiotherapy of

In recent mobile communication systems, impairments in analog circuits cannot be disregarded owing to the need to achieve high performance. Errors in analog circuits consist of a distortion of a power amplifier(PA), gain and phase imbalance in a quadrature modulator(QMOD) and a quadrature demodulator(QDEMOD), dc offset, frequency offset, and so on. Because of high accuracy of compensation, many techniques of error compensation by using digital signal processing have been studied recently. Digital predistorter(DPD), which can eliminate odd-order distortion caused by PA nonlinearity, is one of the compensation techniques. However, in the case that direct conversion architecture is used in a loop-back path, errors in a QMOD and a QDEMOD affect the performance of DPD. Previously, we proposed an error estimation technique for a QMOD and a QDEMDO by using a variable phase shifter and evaluated the performance through computer simulation. In this paper, we evaluate the performance through an experiment by image rejection ratio(IRR) and error vector magnitude(EVM) in the case that the output of a QMOD is directly connected to the input of a QDEMOD. The results show that IRR improvement after compensation is 10 dB at the output of the QMOD and EVM improvement after compensation is 10 dB at the output of the QMOD and 20 dB at the output of the QDEMOD.

A 60-GHz receiver (RX) chip fabricated in 90 nm CMOS process is reported. The RX chip consists of an LNA, a downconversion mixer and a phase-locked loop synthesizer. The RX chip is capable of generating LO signal from phase-locked synthesizer. Measured power gain and NF of 22 dB and 8.4 dB were obtained at 61.5 GHz. These results indicate the possibility of realization of CMOS single-chip 60-GHz transceiver.

A 5 GHz MIMO direct-conversion transceiver composed of 2 transmitters (TXs) and 3 receivers (RXs) is fabricated with 0.13 mum CMOS technology. Die size is 4.56 mm times 7.7 mm. For driving 10 GHz LO signal lines of 5 mm length for both TXs and RXs, inductor-less low-power LO repeaters are equipped in individual LO paths. A linearized RF variable gain amplifier is proposed for low power operation. Isolation of over 40 dB is obtained by equipping separate GNDs on both the MIMO IC and the circuit board. This results in negligible degradation of EVM. TX EVM of over -31 dB is obtained at -8.6 dBm for 2 TX mode when external LO of 10 GHz is applied. The 3 RXs and 2 TXs with LO paths dissipate 703 mW and 412 mW from 1.5 V, respectively.

Objective The objective of this study was to determine alternative ratios of soft-to-hard tissue movement after mandibular setback, taking skeletal relapse and differing patterns of facial divergence into account. Study design Thirty patients were analyzed cephalometrically over a mean follow-up period of 14 months. Results The relationship between skeletal and soft tissue movements in the mentolabial folds and at the pogonion was 1:1. Final skeletal relapse was 0.8 mm at the B-point and 0.5 mm at the pogonion. Hence, the alternative ratios were 81% and 68%, respectively. The alternative ratio for the mentolabial sulcus was considerably lower in the low- than in the high- and medium-angle groups of patients. However, there was no statistically significant difference between the patient groups with different facial patterns. Conclusion When the smallness of the measured relapse and the tracing error are taken into account, the difference between the alternative and the conventional ratios was insignificant.

An antenna-selective transmit diversity (ASTD) technique, applied to a PC card for an orthogonal frequency division multiplexing (OFDM)-based wireless local area network (WLAN) system, is presented. The PC card, which is based on IEEE 802.11 a/g, is equipped with dual-band printed antennas. The ASTD processing is implemented in the developed WLAN system, which has two antennas for transmit and receive modes. The effects of the ASTD technique on the TCP (transmission control protocol) throughput performance are experimentally evaluated. Measurement results with the PC card in an imitated office show that the TCP throughput is improved on both the 2.4 and 5.2 GHz bands under the conditions of an indoor radio propagation channel due to the ASTD technique. In particular, application of the ASTD technique to an access point (AP) achieves four times the average TCP throughput on the 5.2 GHz band.

We have developed a wireless LAN PC card for 2.4 GHz and 5 GHz dual-band operation using printed planar antennas, and evaluated its throughput performance. The planar antennas, which combine an inverted-F antenna with an inverted-L antenna, can realize a dual-band at low cost in a limited integrated area on the PC card. The radio propagation performance was evaluated in a shielded room which is modeled after an office. In the 2.4 GHz band, operation is stable and independent of the deployed position and the direction of a laptop PC with the PC card. On the other hand, in the 5 GHz band, although the performance is affected by surrounding objects and antenna directivity, the PC card with the printed antennas can realize as high a throughput as one with external omnidirectional antennas.

Background: The development of endosseous implants and free vascularized bone grafting has permitted increased possibilities of oromandibular reconstruction in patients with oral cancer. In this study, a concept combining surgical and prosthodontic treatments for mandibular fibula free flap reconstruction after tumor surgery was made based on a classification of bone defects. A follow-up study was performed to evaluate the treatment concept for oral rehabilitation in order to identify possible factors which may influence the functional result. Material and methods: A follow-up examination included 28 patients who underwent the ablative tumor surgery and mandibular reconstruction during a 4-year period. The follow-up protocol included clinical examination, radiological evaluation, and an interview using a standardized questionnaire. The timing of the study was set to allow for a minimum 2-year follow-up (mean 45 months). Results and conclusion: At the time of examination, prosthesis-based oral rehabilitation was completed in six patients (21%), and the prosthodontic work was still unfinished in four other patients. The other 18 had no dental prosthetic rehabilitation. Thirteen patients received a total of 37 oral implants, and 23 implants were functionally loaded. No implant loss was recorded. Oral functions such as speech, diet tolerance and oral competence were not directly affected by the presence of dentures. A decisive factor affecting the oral function was the extent of soft-tissue loss. According to the classification described here, the extent of the mandibular defect did not correlate with oral functions. The application of oral implants seemed to be advantageous for the oral rehabilitation of patients who had undergone intraoral resections.

A fully differential direct conversion receiver IC for W-CDMA is presented. The receiver IC consists of a complete active portion of a W-CDMA receiving system, such as an LNA, quadrature demodulator, low-pass filter (LPF), and variable gain amplifier (VGA). In order to suppress the DC offset, which is the most important issue in a direct conversion system, an active harmonic mixer is applied to the quadrature demodulator. Furthermore, the receiving system, including an LNA and RF filter, adopts a differential architecture to reduce local signal leakage, which generates DC offset. The performance of the entire receiving system was evaluated and the DC offset in steady state was measured at only 40 mV. Moreover, the DC offset variation in the LNA gain change, which has the largest affect on the receiving performance, was limited to 60 mV, which is less than -10 dB compared to the desired signal strength. It was confirmed by computer simulation that the DC offset variation in the LNA gain change did not degrade the bit error rate (BER) performance at all.

The purpose of this study was to evaluate the long-term functional properties of regenerated bone induced by recombinant human bone morphogenetic protein -2 (rhBMP-2) in segmental bone defects of primate mandibles. The 30-mm defects were created in the mandibles of six young monkeys and the mandibles were fixed with titanium plates. Then 9 mg of rhBMP-2 permeating a poly-D, L-lactic-co-glycolic acid-coated gelatin sponge (PGS) was implanted into the bone defect. Dental implants were placed into the regenerated mandible 20 weeks after surgery, then suprastructures were placed and masticatory force loading was begun 8 weeks after the insertion of the dental implants. Bone formation and the quality of new bone were evaluated radiologically and histologically at 15 and 30 weeks after surgery, and 4 and 24 weeks after masticatory force loading. The resected mandibles were completely regenerated with the rhBMP-2-induced bone. Excellent remodelling and consolidation of new bone were observed after loading. This study demonstrated that the new bone induced by rhBMP-2 in large segmental defects was maintained and functional for at least 1 year. Bone regeneration induced by rhBMP-2 holds promise as a future therapy and may be an effective alternative to autogenous bone grafts for implant dentistry and reconstructive surgery.

The efficacy of bone morphogenetic protein (BMP) for bone reconstruction has been widely studied in numerous animal experiments, but insufficient information exists about its ability to regenerate bone in primates. The purpose of this study was to evaluate the effects of recombinant human BMP-2 (rhBMP-2) on bone formation in alveolar bone defects in the mandibles of young primates. Marginal bone defects were created in the mandibles of nine 5-year-old rhesus monkeys and rhBMP-2 permeated in a polylactic-co-glycolic acid-coated gelatin sponge (PGS) was implanted into the bone defects. The resected bone treated with rhBMP-2 regenerated completely at 12 weeks postoperatively, and remodelling and consolidation of new bone were seen histologically. This study provides evidence of considerable bone regeneration in alveolar defects after surgical implantation of rhBMP-2 in non-human primates. This technique may be an effective alternative to autogenous bone grafts for reconstructive surgery in clinical practice.

In this study, an attempt was made to transform a muscle vascularized pedicle raised on host vessels into a vascularized bone flap, using recombinant human bone morphogenetic protein 2 (rhBMP-2). The purpose of this study was to produce new bone vascularized in nature to increase the survival rate of the subsequently grafted bone and to fabricate the newly formed bone into the desired shape. Silicone molds in the shape of a rat mandible were used to deliver rat bone matrix impregnated with or without rhBMP-2. A muscle pedicle the same size as the mold was raised on the saphenous vessels in the rat thigh and then sandwiched in the center of the silicone molds. The molds were sliced in half and each section was filled with rat bone matrix that was impregnated either with 25 microg of rhBMP-2 for the experimental group or with diluting material alone for the control group. The sandwiched flaps were then secured by tying them to the adjacent muscles and were harvested at 2 and 4 weeks after surgery. Three and six rats were used in the control and experimental groups at each time point, respectively. Bone formation was assessed in the ex vivo specimens by macroscopic, radiologic, and histologic evaluation. Macroscopically, the continuation of the vascular pedicle was clearly visible for both the control and experimental muscle flaps. However, no evidence of muscle-tissue transformation was observed in the control flaps, whereas all the flaps treated with rhBMP-2 produced new bone that replicated the shape of the mold exactly and had saphenous vessels supplying the newly formed bone. This study demonstrates that this experimental model has the potential to be therapeutically applied for effective bone reconstruction.

Purpose: This study evaluated whether recombinant human bone morphogenetic protein-2 (rhBMP-2) can be used to regenerate a resected part of the mandible in a primate model. Materials and Methods: Segmental bone defects were created surgically in the mandible of Japanese monkeys. rhBMP-2 was suspended in a solution of polyglycolic co-lactic acid (PGLA) and lyophilized to make a BMP/PGLA complex. The rhBMP-2/PGLA complex and autogenous bone marrow in ratios of 3:0, 2.5:0.5, or 2:1 (vol:vol) were each implanted into the bone defects in 3 monkeys. Bone marrow or PGLA alone were each implanted in 1 monkey as a control. The animals were killed 16 weeks after surgery, followed by radiologic and histologic evaluation. Results: The implantation of bone marrow alone succeeded in reconstruction of the mandible, but the implantation of the rhBMP-2/PGLA complex showed only a small amount of bone formation. The combination graft of rhBMP-2/PGLA and bone marrow resulted in a greater degree of bone formation; especially the 2:1 combination showed the same result as only bone marrow implantation. Conclusion: The combination graft of rhBMP-2 and bone marrow, which requires only a small amount of bone marrow, was a reliable method for reconstruction of mandibular segmental defects in this animal model. © 2001 American Association of Oral and Maxillofacial Surgeons

Objectives To clarify the patterns of frontobasal and frontosinal fractures in children and teenagers and to analyze whether the patterns relate to developmental stage of the facial skeleton. Design Retrospective study. Setting Level I trauma center in Bern, Switzerland. Patients Forty-three consecutive patients aged 18 years or younger with fracture of the frontal skull base. Main Outcome Measures Age at the time of injury and site, type, and degree of displacement among frontobasal and frontosinal fractures. Results The orbital roof was the most common frontobasal fracture site (86.0% [37 of 43]), and a combined lateral and central frontobasal fracture was the most common fracture type (55.8% [24 of 43]). Frontosinal fractures were observed in 46.5% of patients (20 of 43). Displacement or communitation of frontobasal fractures occurred in 46.5% of patients (20 of 43) and of frontosinal fractures in 70.0% (14 of 20). Isolated central frontobasal fractures were significantly more frequent in teenagers than in children aged 6 years or younger, but isolated lateral frontobasal fractures were significantly more frequent in children aged 6 years or younger than in teenagers ( P = .02 for both). Dislocation or communition of frontosinal fractures was significantly more frequent in teenagers than in children aged 6 years or younger ( P = .04). Conclusion Frontobasal fracture patterns are related to age, reflecting their correlation with the developmental phase of the facial skeleton, particularly size and degree of pneumatization of the paranasal sinuses.