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Background Although three-dimensional (3D)-printed digital ostectomy templates (DOTs) can help surgeons perform mandibular angle ostectomy (MAO) more precisely and safely, the clinical application of such templates is problematic. Objectives The aim of this study was to evaluate the accuracy of a novel DOT and improve the precision of MAO. Methods A total of 20 patients with a prominent mandibular angle (PMA) were allocated into 2 groups (10 patients per group). A conventional DOT and a novel DOT were applied to guide MAO in Groups A and B, respectively. The mean time taken for curved osteotomy and the volume of postoperative drainage on 1 side within 24 hours were recorded. The deviations between the simulated and postoperative lower border of the mandible were measured on both sides. Results All the patients were satisfied with the cosmetic outcomes. Statistical results showed that the mean time taken for curved osteotomy was shorter in Group B than in Group A, and that the volume of postoperative drainage on 1 side within 24 hours was similar between the 2 groups. The deviations at the anterior and posterior parts of the inferior border showed that the accuracy of osteotomy was higher in Group B than in Group A, and that there was no significant difference between the 2 groups in the middle part. Conclusions The novel DOT is easy to locate and fix tightly, which reduced the operating time and increased the safety and precision of the procedures. Level of Evidence: 4

Objective: To evaluate the mean values of Genial angle measured by Lateral cephalogram and Orthopantomogram. Study Design: comparative cross sectional study. Place and Duration of Study: Armed Forces Institute of Dentistry, Rawalpindi, from Aug 2018 to Feb 2019. Methodology: Patients irrespective of gender between the ages of 13-20 who reported for the treatment of class I malocclusion with complete anterior dentition were included. Orthopantomogram and lateral cephalogram were drawn by the same person. Gonial angle on orthopantomogram was measured by drawing tangents on posterior border of ramus and lower border of mandible on both halves of orthopantomogram. On lateral cephalogram the angle was measured between ramus and mandible. Gonial angle measured from lateral cephalogram and orthopantomogram were compared. T-test was applied. Results: Mean age of the individuals was 18.33 ± 3.97 years. The mean gonial angle measured on lateral cephalogram was 122.66 ± 1.64 degrees while the mean gonial angle measured on right and left side of orthopantomogram was 122.41 ± 1.56 degrees and 122.33 ± 1.55 degrees respectively. Conclusion: Orthopantomogram can also be used to measure gonial angle as accurately as a lateral cephalogram with the advantage that there are no superimpositions and both the gonial angles can be measured simultaneously on orthopantomogram.

This is a case report of a 19 year old adult female with facial asymmetry secondary to right Temporomandibular Joint (TMJ) ankylosis with a history of previous surgery at the age of 10 years with gap arthroplasty for tmj ankylosis which was unsuccessful and lead to relapse .Because of decreased mouth opening and facial disfigurement patient was not able to have a quality life. She reported to our department where she got operated simultaneously for tmj ankylosis with interpositional arthroplasty using temporalis myofascial flap and novel osteotomy technique for correction of chin asymmetry. After surgery there is a significant improvement in patient both functionally and aesthetically.

Introduction: Breast reduction is one of the most prevalent plastic surgery procedures in Syria and the world, bottoming out on the other hand is one of the most happened disadvantages after breast reduction with inferior pedicle technique. Different techniques were used to prevent this deformity after inferior pedicle. In this study we tried to prevent bottoming out by using two crossed dermal flaps suspending the inferior pedicle to the periosteum of the 2nd rib. Methods and materials: 32 patients had breast reduction surgery using inferior pedicle technique at Almowassat University Hospital in Damascus. We divide them into 2 groups, 16 patients each. First group we used crossed dermal flaps with the inferior pedicle and the second group was without these flaps, the dermal flaps had a base on the side of the inferior pedicle base, crossed anterior to it in the middle point between the lower edge of the areola and the IMF and then sutured to the periosteum of the 2nd rib on each side. Results: Preoperatively, the average distance between the inframammary fold and areola was 14.5 cm (range, 11 - 18 cm) in the first group without dermal flaps and 14 cm in the second group with dermal flaps. The average amount of breast parenchymal resection was 790 g (range, 140 - 1600 g). The average distance between the inframammary fold and the lower border of the areola was 8.5 cm (range, 7.5 - 9 cm) on the postoperative first-year measurements in the group with flaps and 10.2 cm (8.6 - 11.4 cm) in the other group. Conclusion: Inferior pedicle suspension using crossed dermal flaps has a real role in preventing bottoming out, without using any allogenic or alloplastic materials, making it one of the considered ways in preventing bottoming after breast reduction.

The work was carried out in the Amur region at the Belogorsk poultry farm. In the period from 2015 to 2019, five experiments were carried out taking into account the seasonality. The aim of the study was to identify the influence of the spectral composition of light sources on the pubertation of replacement young egg chickens at the age of 15 weeks: the development of the pineal gland, pituitary gland and genital organs of the youngs. The study on replacement young egg crosses of Hisex White and Decalb White chickens was carried out. In the breeding workshop, four groups of day-old chickens were formed, 200 heads each. From one day of age to 15 weeks, young birds were kept under light of different colors in conditions of gradually decreasing daylight hours from 24 to 12 hours a day and an illumination level from 50-30 to 7-6 lux. White, yellow, green and blue compact fluorescent lamps were used as light sources. In young birds at the age of 30, 60 and 90 days, the live weight was determined by weighing 100 heads from each group. A 15-week-old bird was bled for β-estradiol content at a random selection of 30 birds from each group. For anatomical examination, 5 pullets from each group were sacrificed at the age of 15 weeks, taking into account the body weight required by the norm. The absolute mass of the pineal gland, pituitary gland, ovary, oviduct was determined in the bird, the length of the oviduct was measured. Regardless of the season of the year, the live weight of 90-day-old young in groups under white and yellow illumination had the upper values of the norm, with green and blue it could be at its lower border. Under white and yellow illumination, pullets at 15 weeks of age have higher serum β-estradiol levels. At anatomical examination in 15-week-old chickens under white and yellow lamps, the absolute mass of the pineal gland is less by 10.5 - 41.7% than under green and blue ones, and the mass of the pituitary gland, on the contrary, is more by 4.8 - 8.3%. Pullets with different color illumination did not have significant differences in the mass of the ovary and oviduct, as well as the length of the oviduct, the level of development of which corresponded to a given age. Under white and yellow lighting, the first signs of the onset of puberty at 15 weeks of age are slightly more pronounced than under green and blue light sources.

OBJECTIVE: To find the mean curve spee depth and association in three different skeletal vertical patterns (Hypodivergent, Normodivergent and Hyperdivergent). METHODOLOGY: Orthodontic models of mandibular arch and Lateral cephalogram of 110 patients with the mean age of 17.16±4 years, 26.4% (N=29) males and 73.6% (N=81) females were taken from the patients who visited for the orthodontic treatment, to the Department of Orthodontics of Karachi Medical and Dental College. Skeletal divergence defined by the mandibular plane (Lower border of mandible) to sella-nasion line angle (SN-MP). It was measured on lateral cephalogram and Curve of spee depth measured on mandibular cast. RESULTS:Out of 110 patients 20.9% (N= 23) were hypodivergent, 29.1% (N=32) were normodivergent and 50% (N=55) were hyperdivergent. The curve of spee among these three groups were 3.39±0.30mm, 2.62±0.23mm and 2.02±0.45mm. One-way ANOVA has been applied and it showed highly significant differences in the value of curve of spee depth among three vertical skeletal patterns with the p-value of 0.000. Moving from Hypodivergent to Hyperdivergent cases, the curve of Spee depth reduces. CONCLUSION: It has been found that there is a significant difference in curve of spee among hypodivergent, normodivergent and hyperdivergent patients. KEYWORDS: Dentistry, Curve of Spee, Vertical Skeletal Patterns, Orthodontic Diagnosis. HOW TO CITE: Rehman SA, Rizwan S, Faisal SS, Hussain SS. Association of curve of spee with vertical skeletal patterns. J Pak Dent Assoc 2020;29(4):254-258.

Objective To determine the horizontal and vertical locations and dimensions of the mental foramen (MF) in digital panoramic images (DPI), and to evaluate the effect of impacted mandibular cuspids (IMC) on the position of the MF. Materials and Methods 715 Digital panoramic images were obtained from the archives of oral radiology clinics of the College of Dentistry, Jouf University. Altogether 236 DPI that met inclusion and exclusion criteria were investigated. One specialist principal investigator examined and analyzed the DPI on a computer screen for horizontal location, average position, and vertical location of the MF. Results The most common horizontal location of MF with the apices of the teeth in the non-impacted group (NIG) was found to be c = 64.70%, and in the impacted group (IG) d = 47.10%. The average magnitude of MF relative to the apex of second bicuspid in the NIG was found to be 47.10% on the mesial side, and in IG 44.10% on the distal side. The average vertical distance of MF from the lower border of the mandible to the lower border of MF (DLM) in NIG was 14.13 mm (SD ± 1.75 mm), and in IG was 16.85 mm (SD ± 3.06 mm). The average vertical distance of MF from the alveolar crest to the superior border of MF (DAC) in NIG was 6.56 mm (SD ± 2.02 mm), and in IG was 6.67 mm (SD ± 2.28 mm). Conclusion The impacted mandibular cuspid has a definite influence on the location and position of the MF.

In this work we address the Final Open Pit problem in a continuous framework, that is, the problem of finding the optimal profile for an open pit that satisfies an additional slope and maximum capacity conditions on extraction. Using optimal control theory and calculus of variations tools, we provide optimality conditions for that problem. In particular, we prove that the distribution of gain along the lower border of the optimal pit must be zero, when the slope and capacity constraints are not active.

Background and Objectives The mental foramen which is located on the anterior surface of the mandible is a bilateral opening transmitting mental nerves and vessels that supply important structures around. However, it is reported that the location of mental foramen varies across different races and genders, the awareness of which is vital in surgical interventions, anesthetic applications, and various other invasive procedures. Hence, the objectives of the present study were to study the location, size, and shape of mental foramina in dry human mandibles and to study the incidence of accessory mental foramina in human mandibles. Materials and Methods One hundred eighty dried mandibles were observed for the location, size, and shape of mental foramen. Digital Vernier calipers were used to measure the distance of right and left mental foramen from various locations like alveolar crest, symphysis menti, lower border of mandible, and posterior border of the ramus of mandible. The data were analyzed using SPSS 20 software. The position and number of accessory mental foramen were determined. Results The various positions of mental foramina studied revealed the most common type to be type IV as per the Tebo and Telford classification. The average horizontal diameter was slightly higher than the average vertical diameter in majority of the bones. Accessory mental foramina were observed in 3 mandibles. Conclusion The mental foramen was most commonly situated along the longitudinal axis of second premolar tooth and the shape of the mental foramen was found to be oval in 95% of the bones studied.

The speed of knockdown state occurrence, the height of ixodid mites climb on the fabric processed with ProfiLine antiparasitic drops and ProfiLine antiparasitic collar are determined. The composition of ProfiLine antiparasitic drops contains fipronil in combination with S-methoprene, in ProfiLine antiparasitic collar – propoxur. ProfiLine antiparasitic drops medicine is an insectoacaricide solution, which used in practical conditions one time by dot application on the animal skin. ProfiLine antiparasitic collar intends to permanent wearing by animal with the aim of prevention against ectoparasites. The effect of knockdown in all parasites was starting from disorientation, which means the mite started to move aside, then down and around. Time from the moment of crossing by parasites the lower border of site, processed by medicines, into their fall off, was amounted to: in test of ProfiLine antiparasitic drops - 0,50-3,54 minutes, in test of ProfiLine antiparasitic collar - 0,54-5,10 minutes, and in average - correspondently 1,46 and 2,23 minutes. Meanwhile the maximal height of mite climb in test with active ingredient fipronil+S-methoprene was from 8,1-13,5 cm, an average value of AH 10,6 сm, for propoxur - 7,1-26 cm and 15,64 cm. Besides it should be noted that average T10 value for ProfiLine antiparasitic drops was 47,4 sec, and ProfiLine antiparasitic collar - 40,03 sec, in control group - up to 36,6 sec. The time of parasites fall off from controll test was over 10 minutes, meanwhile the height of mite climb by test been maximal - up to the end of tape. The fall down mites were forwarded in clean utensils and observed during one hour. It was determined after the lapse of time, that all parasites from experimental group died, meanwhile the mites from controll group staying alive. The mites vitality was checking by their mobility and reaction to breath. Thus, ProfiLine antiparasitic drops has an expressed knockdown effect. The time of knockdown state occurrence is 1,46 minutes, when the average height of climb - 10,6 cm. ProfiLine antiparasitic collar has also an expressed knockdown effect, which is 2,23 minutes with the average height of climb 15,64 cm.

Objectives: To avoid anatomical and functional damage to mandibular interforaminal region during surgeries, it is necessary to detect the existence of mandibular incisive canal (MIC) and its proximity to adjacent structures. This study was aimed to evaluate the prevalence of MIC and its proximity to adjacent structures among Indian population. Materials and Methods: The images of 80 subjects with the age range of 20–60 years who had undergone cone beam computed tomography examination of the mandible were retrieved from the archival records. There was equal distribution of males and females. Results: The prevalence of MIC in the current study sample was found to be 43.89% with a slightly higher prevalence on left side as compared to right side, and higher prevalence among females as compared to males. Among different age groups, there was an increased incidence in the age group of >50 years. The distance of MIC from labial and lingual cortical plates and lower border of mandible were 4.338 ± 1.478 mm, 4.34 ± 1.53 mm and 9.417 ± 1.832 mm respectively. Conclusions: To conclude, the prevalence of MIC among Indian population was lower as compared to the prevalence among other populations. There were variations in prevalence in terms of age, gender and laterality, which could be used as a reference for further studies conducted on larger sample size. Mapping the incisive nerve canal will enable oral radiologists, to plan safely and negotiate the interforaminal region.

BackgroundEndotracheal tube (ETT) tip position is determined on chest X-ray (CXR) and should lie between the upper border of the first thoracic vertebra (T1) and the lower border of second thoracic vertebra (T2). Infant weight is commonly used to estimate how far the ETT should be inserted but frequently results in malpositioned ETT tips. Palpation of the ETT tip at the suprasternal notch has been recommended as an alternative.ObjectiveTo determine whether estimating ETT insertion depth using suprasternal palpation of the ETT tip rather than weight results in more correctly positioned ETT tips.DesignSingle-centre randomised controlled trial.SettingLevel III neonatal intensive care unit (NICU) at a university maternity hospital.PatientsNewborn infants without congenital anomalies intubated in the NICU.InterventionsParticipants were randomised to have ETT insertion depth estimated using palpation of the ETT tip at the suprasternal notch or weight [insertion depth (cm)=6 + wt (kg)].Main outcome measureCorrect ETT position, that is, between the upper border of T1 and lower border of T2 on CXR, determined by one consultant paediatric radiologist masked to group assignment.ResultsThere was no difference in the proportion of correctly placed ETT tips between the groups (suprasternal palpation 27/58 (47%) vs weight 23/60 (38%), p=0.456). Most incorrectly positioned ETTs were too low (56/68 (82%)).ConclusionEstimating ETT insertion depth using suprasternal palpation did not result in more correctly positioned ETTs.Trial registration numberISRCTN13570106.

Aim This study was undertaken to evaluate the relationships among dental arch widths, mandibular bone widths, and masseter muscle dimensions in growing children with different underlying vertical facial patterns using three-dimensional computed tomography (3D-CT). Method Fifty-eight young subjects (32 male and 26 female) with a mean age of 13.27 (±1.59) years had undergone cranial CT examinations as part of medical diagnosis. 3D-CT images were reconstructed for the assessment of various mandibular dental and bone widths in relation to the vertical facial pattern and masseter muscle dimensions. Results The cross-sectional area and volume of the masseter muscle, mandibular plane angle, total posterior face height and lower posterior face height were significantly different among the vertical pattern groups. There were a number of significant positive and negative correlations among the muscular dimensions and the dental and bone widths with the different vertical patterns. Conclusions Dolichofacials are likely to have relatively smaller masseter cross-sectional areas and volumes than brachyfacials, and vice versa. There is likely to be a close association between mandibular intermolar width and the corresponding widths at the apical and lower border levels. There is not likely to be the same association between the intercanine width and the corresponding lower border width. Brachyfacials are likely to have a greater width of buccal cancellous bone through which the canines can potentially be expanded laterally.

The kidneys are located in the retroperitoneum. They measure approximately 10–12 cm (longitudinal) and weigh approximately 125–170 g. The kidneys are relatively larger in infants and children, and temporary prominent lobations can be present. The lateral border can have a focal parenchymal bulge, a dromedary hump, which can be a normal variant. Because of displacement by the liver, the right kidney lies 1–2 cm lower than the left kidney. The upper limit of the right kidney reaches the upper border of the 12th rib and lies between the first to third lumbar vertebrae. The left kidney reaches the lower border of the 11th rib and lies between the 12th thoracic to 3rd lumbar vertebrae. Inspiration can cause the kidney to descend about 3–5 cm.

The forehead is a region with boundaries of the hairline as the upper border and the eyebrow as the lower border. In this region, the frontalis m. is broadly placed. The function of this muscle is related to facial expressions, and as people age, they develop facial wrinkles.

Background The frequency of appearance of anatomical variability in the terminal division of the popliteal artery (PA) is different according to the type of sample used, and ranges from 2% to 21%. The PA locates 1,01 cm behind to the lateral meniscus, which makes it vulnerable during surgical procedures. Iatrogenic injury of the PA or its terminal branches increases if anatomical variables are present. Our aim was to describe and review the branching pattern of the PA in a body-donors to science sample to determine the influence of the sample used (body-donors vs imaging test). Methods A sample consisting of 260 popliteal regions, corresponding to 130 corpses (66 women, 64 men), have been dissected. Multivariate analysis was carried out. Results The terminal division of the PA was classified as follows: Pattern 1: the PA divided into the anterior tibial (ATA) and the posterior tibial arteries (PTA) at the level or distal to the lower border of the popliteal muscle (PM) (94.7%). Pattern 2: the PA bifurcated into the ATA and PTA, proximal to the lower border of the PM (3.3%). Pattern 3: the PA divided at the same level into the ATA, PTA and PEA. (2%). No significant differences between gender and side of the limb could be find. Conclusions We propose a classification that encloses three identifiable groups only. This will allow clinicians to bear in mind these variables easily, at the same time avoiding injuries during surgical procedures such as lateral meniscus repair.

Background Umbilical hernia (UH) is one of the most common problems seen by paediatric surgeons. The recurrence rate after surgical repair is 1–2%. In this study, we examined the ring of umbilical hernia histologically to detect differences between the two types of umbilical hernia and the relation between this histologic difference and the technique of surgical repair. Results Fifty paediatric patients of both sexes with clinically diagnosed direct and indirect (oblique) umbilical hernia were collected from the paediatric surgery department in the period between March 2016 and February 2018. Age ranged between 2 and 5 years. Biopsies (5 mm) were taken from the upper, lower, right and left borders of the ring in both types and processed for histological examination. Classification of umbilical hernia was based on Chang-Seok et al.’s classification, which classified the umbilical hernia into three types (direct, oblique and hernia into umbilical cord) which depend on the presence of a hole in the ring and whether the ring is covered by ligamentum teres or not. Histological sections were examined by light microscopy, and data was analysed using chi-square test to detect predominance of one type of collagen fibre over the other in each sample. Transverse collagen fibres were predominant in the upper border of the ring in 15 patients (75%) and the lower border in 14 patients (70%) of direct umbilical hernia. Transverse collagen fibres were also predominant in the right border of the ring in 21 patients (70%) and the left border in 21 patients (70%) of indirect umbilical hernia. This predominance in both cases was found to be statistically significant. Conclusions Predominance of transverse collagen fibres in the upper and lower borders of the ring in direct umbilical hernia and predominance in the right and left borders of the ring in oblique umbilical hernia encouraged us to suggest that wound will be more stable if closed in a transverse manner in direct umbilical hernia and a longitudinal manner in oblique umbilical hernia especially in recurrent cases.

Bilateral sagittal split osteotomy (BSSO) is the most common orthognathic surgical procedure for the correction of facial deformities. Like any other surgical procedure, it is also associated with a risk of complications. One of these is described in the literature as notching at the lower inferior border of the mandible. Such discontinuity in the contour of the lower border is often a concern for patients. To overcome this complication, we recommend a modified vertical osteotomy cut while performing BSSO.

Upper lip Curvature is a location of the oral commissure relative to the center of upper lip lower border. The aim of this study was to find the relation between gender and lip curvature. A special tool had been made to help in measurement of lip curvature. There was no significant relation between gender and curvature, however upward group was the highest one followed by straight then downward group.

Aim: To determine the position of mental foramen based on the height from alveolar crest and lower border of the mandible from CBCT scans. Objective: The purpose of the study is to determine the position of mental foramen based on the height from alveolar crest and lower border of the mandible from CBCT scans. Materials and Method: A total of 50 CBCT scans will be evaluated. The number, size and form of the mental foramen will be recorded and their three dimensional relationship with the mandibular premolars will be observed and noted. The position of each mental foramen relative to bony reference points will be measured and distances from mental foramen to the cement enamel junctions of the mandibular premolars will be measured. Data will be analyzed and results will be determined. Results: The average values were obtained for the distance between the mental foramen and the alveolar crest, mental foramen to the lower border of the mandible the horizontal and vertical dimensions of the mental foramen. All of the individuals has a single mental foramen which was ovoid in shape. The mean horizontal dimensions were (2.70±0.73)mm and (2.73±0.72)mm on the right and left sides respectively. Vertical dimensions were (2.20±0.65)mm and (1.86±0.16)mm respectively on the right and left sides. Mean distances from the mental foramen to alveolar crest and the lower border of the mandible were (11.35±3.92,10.48±2.84) and (9.47±1.48, 9.72±1.38) respectively. Conclusion: The average values obtained from the study help in understanding the anatomy and position of the mental foramen better on CBCT. The detailed information about the relationship between mental foramen and its surrounding structures will facilitate diagnostic and surgical procedures done in the oral and maxillofacial region.

INTRODUCTION To measure the height, length, and area of the upper tarsal plate in Korean children between 6 months and 13 years of age and analyze growth of the tarsal plate. METHODS Children who underwent lower epiblepharon correction surgery and congenital nasolacrimal duct obstruction were included. Under general anesthesia, the upper eyelid was everted and a photograph was taken with a reference ruler using a digital camera. Tarsal plate central height, upper border length, lower border length, and area were measured using Image J software. Objectives were classified into 4 groups according to age. Mean analysis and comparison between groups were performed using the SPSS program. RESULTS One hundred two tarsal plates in 51 patients were measured. Mean central tarsal height was 6.92 ± 1.09 in the 0 to 3 years old group, 7.25 ± 0.81 in the 4 to 6 years old group, 7.64 ± 0.71 in the 7 to 9 years old group, and 8.11 ± 0.46 in the 10 to 13 years old group. The height and area of the tarsal plate gradually increased with age (P = 0.001), but the lower length of the 0 to 3 years old group differed from the other groups and showed abrupt increase between the 0 to 3 years and 4 to 6 years old groups (P

This study aimed to compare the effectiveness of different graft materials using induced membrane technique for reconstruction of mandibular segmental bone defects. New Zealand rabbits were used as the experimental animal. As first-stage surgical procedure, segmental bone defects were created at the lower border of the mandibula in all groups. Polymethylmethacrylate (PMMA) cement was inserted into the defects. After 6 weeks, PMMA cement was removed in all groups. In the Control group, defect areas were left empty. Defects were filled with autogenous graft in the Autograft group, xenograft in the Xenograft group, and a mixture of autogenous graft and xenograft in the Autograft + Xenograft group. Histopathological, stereological, and immunohistochemical analyses were performed. A total of 40 New Zealand rabbits were used. Rabbits were randomly divided into four subgroups as Control, Autograft, Xenograft and Autograft + Xenograft groups (n = 10). When the groups were compared in terms of newly formed bone tissue volumes, significant difference was found between the Control group and Autograft group, Xenograft group and Autograft + Xenograft group (p < 0.001, p < 0.001, p = 0.003). The results of immunohistochemical examination were consistent with this finding. Stereological and immunohistochemical results can be used as a justification to adopt the induced membrane technique on an experimental basis in humans when it comes to the reconstruction of small segmental mandibular defects. (c) 2021 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

This technique aims to evaluate fixation of the sleeved distal part of the stomach to the root of the transverse mesocolon and greater omentum after its shortening in a T-shaped design. Sleeve gastrectomy is done in a standard five-port technique. Then, we fix the distal end of the staple line using an inverting interrupted 2/0 Ticron suture. We plicate the anterior and posterior walls to invert the staple line and then fix it to the mesocolic fat below the pancreas and to the edge of the disconnected distal omentum close to the antrum. Proceeding caudally, we shorten the greater omentum in the form of a T-shaped suture that forms an omental window between the two edges of the omentum. Plication and fixation are continued upwards until the lower border of the pancreas. Then, we plicate the sleeved stomach using a 2/0 Ticron suture starting cranially near the angle of His. All patients are discharged from the hospital the next day and followed-up at the clinic after the end of first and second weeks, then after 3, 6, and 12 months postoperatively. Plicated sleeve gastrectomy combined with mesocolon and greater omentum fixation after T-Shaped omentoplasty is safe and feasible. Long-term follow-up study is required to validate our results.

Objective. To establish the impact of combined application of sorbilact and L-аrginin on renal detoxicating function and the indices of the endogenous intoxication syndrome (EIS) in a period of unstable compensation of toxicosis (on the seventh day of observation). Маterials and methods. There was investigated the impact of administration of sorbilact and L-аrginin on a separate indices of the EIS of a purulent-septic genesis in patients of four Groups: Group I (control) - 31 patients with systemic inflammatory response syndrome (SIRS), Group II - 16 patients with EIS, to whom a standard therapy was conducted, Group III - 13 patients with EIS, to whom sorbilact was administered on a standard therapy base, Group IV - 10 patients with EIS, in whom a standard treatment was added by sorbilact with L-аrginin. Results. On the seventh day of the investigation the middle mass molecules (MMM) excretion in patients with EIS have constituted (7,5 ± 0,28) conventional units/min, what was by 77% higher, than in the patients of the control Group, but concentration of MMM in the blood serum have persisted in 2,1 times higher and their clearance hardly achieved a lower border of a corresponding index in patients of the control Group, thus the EIS compensation have appeared unstable. Conclusion. Application of complex, consisting of sorbilact and L-аrginin, activates a detoxication function of kidneys and reduces the endogenous intoxication severity of a purulent-septic genesis.

Introduction: Temporal recession in male-pattern baldness is common. The method of marking of temporal point practiced worldwide, described by Walter P. Unger, does not help in marking temporal triangle border in Indian population. We have found aesthetically superior way of marking temporal point and easy method of construction of lower border of temporal triangle. Case Series: The new marking was applied over 126 young male patients from March 2014 to December 2017; they were regularly followed up and results were observed. Conclusion: With the new method of marking, we found that the lower border of temporal triangle can be easily constructed and temporal point can be more aesthetically placed in Indian population.

Purpose. To compare rigid rectoscopy with three different MRI measurement techniques for rectal cancer height determination, all starting at the anal verge, in order to evaluate whether MRI measurements starting from the anal verge could be an alternative to rigid rectoscopy. Moreover, potential cut-off values for MRI in categorizing tumor height measurements were evaluated. Methods. In this retrospective study, 106 patients (75 men, 31 female, mean age 64±11.59 years) with primary rectal cancer underwent rigid rectoscopy as well as MR imaging. Three different measurements (MRI1–3) in T2w sagittal scans were used to evaluate the exact distance from the anal verge (AV) to the distal ending of the tumor (MRI1: two unbowed lines, AV to the upper ending of the anal canal and upper ending of the anal canal to the lower border of the tumor; MRI2: one straight line from the AV to the lower boarder of the tumor; MRI3: a curved line beginning at the AV and following the course of the rectum wall ending at the lower border of the tumor). Furthermore, agreement between the gold standard rigid rectoscopy (UICC classification: low part, 0-6 cm; mid part, 6-12 cm; and high part, >12 cm) and each MRI measuring technique was analyzed. Results. Only a fair correlation in terms of individual measures between rectoscopy and all 3 MRI measurement techniques was shown. The proposed new cut-off values utilizing ROC analysis for the three different MRI beginning at the anal verge were low 0-7.7 cm, mid 7.7-13.3 cm, and high>13.3 cm (MRI1); low 0-7.4 cm, mid 7.4-11.2 cm, and high>11.2 cm (MRI2); and low 0-7.1 cm, mid 7.1-13.7 cm, and high>13.7 cm (MRI3). For MRI1 and MRI3, the agreement to the gold standard was substantial (r=0.66, r=0.67, respectively). Conclusion. This study illustrates that MRI1 and MRI3 measures can be interchangeably used as a valid method to determine tumor height compared to the gold standard rigid rectoscopy.

Autologous fat grafting is an important tool for plastic surgeons treating the aging face. Malar augmentation with fat is often targeted to restore the youthful facial contour and provides support to the lower eyelid. The existence of distinct facial fat compartments suggests that a stepwise approach may be appropriate in this regard. The authors describe a three-step approach to malar augmentation using targeted deep malar fat compartmental augmentation, termed the "boomerang lift." Clinical patients undergoing autologous fat grafting for malar augmentation were injected in three distinct deep malar fat compartments: the lateral sub-orbicularis oculi fat, the medial sub-orbicularis oculi fat, and the deep medial cheek (n = 9). Intraoperative three-dimensional images were taken at baseline and following compartmental injections (Canfield VECTRA H1). Images were overlaid between the augmented and baseline captures, and the three-dimensional surface changes were analyzed, which represented the resulting "augmentation zone." Three-dimensional analysis demonstrated a unique pattern for the augmentation zone consistent across patients. The augmentation zone resembled a boomerang, with the short tail supporting the medial lower lid and the long tail extending laterally along the zygomatic arch. The upper border was restricted by the level of the nasojugal interface, and the lower border was defined medially by the nasolabial fold and laterally by the level of the zygomaticocutaneous ligament. Lateral and medial sub-orbicularis oculi fat injections defined the boundaries of the boomerang shape, and injection to the deep medial cheek provided maximum projection. This is the first description of deep malar augmentation zones in clinical patients. Three-dimensional surface imaging was ideal for analyzing the surface change in response to targeted facial fat grafting. The authors' technique resulted in a reproducible surface shape, which they term the boomerang lift.

Little is known about the effect of border costs on FDI location. This paper explores this for the fifth European Union (EU) enlargement that integrated the ten Central and Eastern European countries (CEECs). It regresses count data for 35,105 FDI projects locating in 25 European countries over the period 1997–2010. Four EU accession events are examined for the more- and less-liberalized CEECs. It finds that the lower border costs doubled FDI in the CEECs at EU membership, of which 60% is diverted from the ‘old’ Europe. This membership effect is three-times greater for the more-liberalized countries, for which earlier accession events are unimportant.

OBJECTIVE Cervical esophageal stenosis is often diagnosed with a qualitative evaluation of a barium esophagram. Although the esophagram is frequently the initial screening exam for dysphagia, a clear objective standard for stenosis has not been defined. In this study, we measured esophagram diameters in order to establish a quantitative standard for defining cervical esophageal stenosis that requires surgical intervention. STUDY DESIGN Single institution case-control study. METHODS Patients with clinically significant cervical esophageal stenosis defined by moderate symptoms of dysphagia (Functional Outcome Swallowing Scale > 2 and Functional Oral Intake Scale

Context: Anatomical literature has described the anterior loop being an extension of the mental nerve which is present anterior to the mental foramen while the caudal loop has been described as the distance between the lower border of the mental foramen and the lowest point of the mandibular canal. The knowledge and identification of the anterior and caudal loop of the mental nerve are important in surgical procedures performed around the mental foramen to avoid inadvertent damage to these vital structures resulting in postoperative complications. Aim: The present study was conducted to determine the incidence and measurement of mental nerve loop in the mandibular arches using cone beam computed tomography (CBCT). Settings and Design: A total of 200 CBCT images were retrieved and inspected for the presence of the mental nerve loop. The length of the anterior loop was measured by counting the number of consecutive contiguous vertical cross sections displaying two round hypodense images. This number was multiplied by the thickness of the slices. The caudal loop was measured as the distance between the lower border of the mental foramen and the lowest point of mandibular canal. Statistical Analysis Used: Shapiro–Wilk test and Mann–Whitney U-test were used. P < 0.05 was considered statistically significant. Results: 57.5% (n = 200 scans) presented with the anterior loop of the mental nerve with a mean length of 0.50 mm and 0.37 mm on the right side and left side, respectively. All the samples of CBCT scans taken were having caudal loop extension with a mean length of 3.53 mm. Conclusion: A considerable number of individuals (57.5%) in the present study presented with the anterior loop of the mental nerve. CBCT was found to be an effective imaging modality for the detection of anterior loop of the mental nerve.

Background The present study was performed with the following aims: (1) to assess the relationship between skeletal age, measured using the cervical vertebral maturity (CVM) method, and chronological age; (2) to determine the correlation of skeletal and chronological age to the cortical thickness of the lower border of the mandible using the linear radiomorphometric; and (3) to explore the relationship between these indices and skeletal malocclusion type. Material and methods The data were collected from the records of 180 patients, including 57 males (31.7%) and 123 females (68.3%). The data were based on the panoramic and lateral cephalograms of each patient. The CVM stages were determined on the basis of the patients' lateral cephalograms. Three radiomorphometric indices were measured: AI, MI and GI. The patients were divided up into three groups of skeletal malocclusion: Class I, II, and III. For all the tests, statistical significance was set at P Results The relationship between chronological age and skeletal age was 0.496. Furthermore, with an increase in chronological and skeletal age, the cortical thickness of the lower border of the mandible and consequently the radiomorphometric indices increase, except for the GI (P > 0.05). Lastly, the relationship between GI and skeletal malocclusion type proved significant. Conclusions AI and MI were found to increase significantly with increasing age, so the assessment of mandibular radiomorphometric indices could be clinically useful in estimating of the growth and maturation of the mandible. Key words:Orthodontics, Radiomorphometric indices, Skeletal age, Skeletal malocclusion.

Objective. The aim of the study was to determine and compare the position of the mental foramen MF in the north and south Indian populations using Panoramic radiographs. Materials and methods. A total of 100 Panoramic radiographs were selected from the archives of PMNM Dental College and the Department of Oral Medicine and Radiology, of which 50 radiographs belonged to a north Indian population and 50 radiographs belonged to a local population of Bagalkot Karnataka. The position of the MF was classified into 6 positions depending on the relationship to the mandibular teeth. The distance from the superior border of the MF to the lower border of the mandible was also measured. Results. The most common position of the MF was along the long axis of the second premolar in the north Indian population and in south Indian populations it was found to be between the first and second premolar. Descriptive analysis was used to compare the distance between the superior border of the mental foramen and the lower border of the mandible bilaterally. Conclusion. There was a significant difference in the position of the MF between the north and south Indian populations.