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Laparoscopic gastrectomy (LG) has gradually increased for treating advanced gastric cancer (AGC). However, there is a lack of evidence on oncologic safety for AGC, especially with serosal invasion. This study evaluates the surgical and oncologic outcomes between laparoscopic and open gastrectomy (OG) for gastric cancer with serosal invasion. We retrospectively reviewed 256 patients who underwent OG and 147 patients who underwent LG for gastric cancer with serosal invasion between August 2005 and December 2017. Finally, 124 patients in the LG group and 124 in the OG group were enrolled according to one-to-one propensity score matching (PSM) analysis. We evaluated surgical and oncological outcomes, including overall survival (OS) and recurrence-free survival (RFS). There were no statistical differences in hospital stay and major complications between the two groups. The retrieved lymph nodes of the LG group were similar to those of OG (40 ± 16.23 vs. 38 ± 14.42, p = 0.306), and it showed a similar operation time compared with the other (164 ± 43.86 vs. 156 ± 37.66, p = 0.063). There was no statistical difference in OS (p = 0.761) and RFS (p = 0.121) for survival analysis between the two groups. LG for gastric cancer with serosal invasion is feasible and could be considered as a standard treatment. [ABSTRACT FROM AUTHOR]

Optimal treatment for an adult patient with hyperdivergent facial morphology, Class III malocclusion, bilateral posterior crossbite, and skeletal disharmony usually requires comprehensive orthodontics combined with extractions, orthognathic surgery, or both. However, treatment becomes more challenging when the patient rejects surgery because of fear or cost. This case report presents the orthodontic treatment of a 24-year-old woman with a Class III malocclusion and bilateral posterior crossbite without surgery using orthopedic and comprehensive orthodontic approaches. The extraoral evaluation showed a hyperdivervent pattern, paranasal deficiency, a slightly protrusive lower lip, and an obtuse labiomental angle with a chin deviated to the left. Intraorally, she exhibited a severe Angle Class III malocclusion bilaterally with edge-to-edge to -1 mm overjet, canting of the occlusal plane up to the left with mandibular midline 5.3 mm to the left of the maxillary and facial midlines, and bilateral posterior crossbite with 5.7 mm of arch width discrepancy. Therefore, the patient was diagnosed with skeletal and dental Class III relationship, hyperdivergent pattern, a deviation of the mandible to the left, bilateral posterior crossbite, mild to moderate maxillary and mandibular crowding, slightly proclined maxillary incisors and upright mandibular incisors. After 15 months of treatment, all treatment objectives were achieved, and the appliances were removed. Teeth were well leveled and aligned, ideal overbite and overjet were established with premolars and canines in a Class I relationship, bilateral posterior crossbite was corrected, vertical dimension was controlled, and the smile was improved with a slight improvement in the profile; however, bilaterally, the molar occlusion was not completely settled and remained in a Class III relationship. This case report demonstrates the successful nonsurgical treatment of an adult with Class III malocclusion, hyperdivergent facial morphology, and bilateral posterior crossbite using a midfacial skeletal expander and facemask for orthopedic correction. With reduced costs and fewer risks than surgical treatment options, this treatment protocol offers an alternative to adult patients. [ABSTRACT FROM AUTHOR]

Introduction: This study aimed to investigate the short-term effects on the circummaxillary sutures induced by microimplant-assisted rapid palatal expansion (MARPE) in skeletally mature patients.Methods: Cone-beam computed tomography (CBCT) images of preexpansion (T0) and postexpansion (T1) of 23 patients (mean age, 20.9 ± 3.65 years) treated with MARPE were evaluated. The T0 and T1 CBCT images were reoriented and superimposed on the basis of the anterior cranial base, using OnDemand3D software (Cybermed, Seoul, Korea). Then, width changes of 9 circummaxillary sutures (frontonasal, frontomaxillary, frontozygomatic, nasomaxillary, zygomaticomaxillary, intermaxillary, midpalatal, zygomaticotemporal, and pterygopalatine sutures) were measured on 1 section of each patient's T0 and T1 CBCT images. In addition, correlation coefficients between changes in the midpalatal sutures, the amount of appliance activation, age, and the changes in other circummaxillary sutural widths were also calculated.Results: Statistically significant (P <0.05) width increases were found in all 9 circummaxillary sutures. The changes in midpalatal suture at the maxillary central incisor level positively correlated with the intermaxillary sutures at the anterior nasal spine level, midpalatal sutures at the posterior nasal spine level, and frontomaxillary sutures (P <0.05). In addition, the changes in the midpalatal sutures at the posterior nasal spine level also positively correlated with the changes in the intermaxillary sutures at the anterior nasal spine level, frontomaxillary sutures, and medial pterygopalatine sutures (P <0.05).Conclusions: All 9 circummaxillary sutural widths increased in skeletally mature patients immediately after MARPE. The greatest increases in width were measured in the midpalatal sutures and the intermaxillary sutures, followed by the frontomaxillary sutures. [ABSTRACT FROM AUTHOR]

Search heuristics were evaluated in terms of their ability to solve a flowshop scheduling problem in a printed circuit board assembly process with the main objective of minimizing tardiness. The heuristics included the NEH, the Extensive Neighborhood Search method, the Taboo Search method, the Simulated Annealing method and the Rolling Block Optimization algorithm. The simulated annealing and taboo search algorithms outperformed all other search algorithms, with simulated annealing providing the best results.

Introduction: The objectives of this study were to evaluate the effects of bicortical engagement by microimplants with maxillary skeletal expanders on pterygopalatine sutures opening and to analyze the postexpansion skeletal changes associated with it.Methods: Eighteen subjects treated with maxillary skeletal expanders were examined for pterygopalatine suture openings. Eight subjects who showed no evidence of the suture opening were assigned to the nonsplit group (NG), whereas 10 subjects with opened sutures were assigned to the split group (SG). Preexpansion and postexpansion cone-beam computed tomography images were superimposed for each group, and the changes in the 2 groups were compared. Finally, cone-beam computed tomography volumes were reoriented along the axis of each microimplant to check the bicortical engagement of the 4 microimplants.Results: There was a significant correlation between the bicortical engagement of the orthodontic microimplants and the pterygopalatine suture opening (P = 0.0003). In the NG, the average amount of transverse expansion measured at the center of resistance of the maxillary first molars, anterior nasal spine, and posterior nasal spine (PNS) was 4.33 mm, 2.22 mm, and 1.58 mm, respectively, whereas the transverse expansion in the SG was 5.29 mm, 2.21 mm, and 2.46 mm, respectively. The magnitude of transverse expansion at PNS was significantly higher in the SG than in the NG (P = 0.036). The PNS also showed a significant anterior displacement in the SG (0.89 mm) compared with the NG (0.06 mm) (P = 0.033).Conclusions: Bicortical microimplant anchorage is essential for pterygopalatine suture opening in microimplant-assisted maxillary skeletal expansion, which may result in further skeletal expansion and forward movement in the posterior part of the palatomaxillary complex. [ABSTRACT FROM AUTHOR]

This study compared two transferring methods for virtually planned orthognathic surgery — the CAD/CAM intermediate splint and the customized surgical guide with fixation plates. This was a prospective clinical study in which participants were consecutively recruited and underwent bimaxillary orthognathic surgery. They were divided into two groups based on the transferring method used. The pre- and postoperative CBCTs were aligned using voxel-based landmark-free registration, and the discrepancies for selected points were compared with the planned displacement of the virtually planned surgery. The maxilla and mandible were analyzed separately, and translation and rotation movements were considered. A total of 16 patients, divided into two groups of eight patients each, were included in this study. The splintless group was significantly more accurate for the translation movement along the x -axes for points A (p = 0.008; mean absolute error 0.527 ± 0.387 for the splint group and 0.137 ± 0.067 for the splintless group) and Ans (p = 0.045; mean absolute error 0.535 ± 0.446 for the splint group and 0.156 ± 0.002 for the splintless group). For the mandible there was a significant difference in accuracy along the x -axes for points B (p = 0.049; mean absolute errors 1.728 ± 1.181 and 0.697 ± 0.519 for the splint and splintless groups, respectively), LL3 (p = 0.049; mean absolute error 1.629 ± 0.912 and 0.851 ± 0.797 for the splint and splintless groups, respectively), LR3 (p = 0.049; mean absolute error 1.711 ± 0.906 and 0.844 ± 0.780 for the splint and splintless groups, respectively), with the splintless group being more accurate. For the rotation the splintless group was significantly more accurate along the y -axes (p = 0.04; mean absolute error 1.62 ± 0.78 and 0.49 ± 0.31 for the splint and splintless groups, respectively) and z -axes (p = 0.04; mean absolute error 0.63 ± 0.45 and 0.17 ± 0.05 for the splint and splintless groups, respectively) for the maxilla, while no significant difference was found for the mandible. Overall, the customized fixation plate system is more accurate than the intermediate CAD/CAM splint for transferring the virtual plan into the operation room. [ABSTRACT FROM AUTHOR]

Introduction: The aim of this study was to investigate 3-dimensional changes of the zygomaticomaxillary complex (ZMC) after mini-implant assisted rapid maxillary expansion (MARME).Methods: A total of 15 pairs of cone-beam computed tomography 3-dimensional images taken before expansion (T0) and after expansion (T1) were analyzed by measuring changes in the coordinates of the landmarks of the ZMC.Results: Changes in the x coordinates of the landmarks showed significant expansion (P <0.01) and greater expansion at the lower than upper portion of the ZMC (P <0.05) in the transverse dimension. All y coordinates of the landmarks except the jugal point (J) showed forward displacement (P <0.05), and the z coordinates of ANS, PNS, Alare, A, and ectocanine showed downward displacement (P <0.01) in the sagittal and vertical dimensions. Also, z coordinates of the landmarks that were closer to the midsagittal plane and in a more posterior portion of the ZMC displaced further downward (P <0.05). SNA and ANB angles increased (P <0.05 and P <0.001, respectively) and the SNB angle decreased (P <0.01). There was a significant correlation between changes in the x coordinates of the ectomolare and ectocanine and the amount of expansion measured from the center of resistance of the maxillary first molars (CR6; P <0.05). There was no significant correlation between the amount of CR6 expansion and changes in y and z coordinates of the landmarks.Conclusions: 3-Dimensional changes of the ZMC after MARME showed expansion in a pyramidal shape from the coronal view, downward and forward displacement from the sagittal view, and parallel palatal expansion from the axial view. These findings might be useful for understanding skeletal expansion patterns using MARME. [ABSTRACT FROM AUTHOR]

• Matrix metalloproteinase-1 plays a pivotal role in wound healing and pathologies. • In-house assay system for MMP-1 was developed using β-lactamase zymogen. • Using the system, peptide inhibitors of MMP-1 collagenase activity were identified. • The peptide inhibitor had a sequence of GFTLGRGDACTTHW. Matrix metalloproteinases (MMPs) are zinc-dependent proteases involved in the degradation of extracellular matrix proteins. As one of the isoforms, MMP-1 breaks down collagen, and its activity is known to be important in wound healing. Its timely and adequate level of expression is pivotal because MMP-1 is also involved in the damage or aging of skins as well as in certain types of cancers. Thus, both assaying the MMP-1 activity and developing its inhibitors are of great importance. We here developed an in-house assay system that gave us the high degree of freedom in screening peptide inhibitors of MMP-1. The assay system utilized a circularly permutated fusion of β-lactamase and its inhibitory protein through an MMP-1-sensitive linker so that the activity of MMP-1 could be translated into that of β-lactamase. As a proof of concept, we applied the developed assay system to initial screens of MMP-1 inhibitors and successfully identified one lead peptide that inhibited the collagenase activity of the enzyme. [ABSTRACT FROM AUTHOR]

Abstract The aim of this case report was to demonstrate the effects of the Maxillary Skeletal Expander (MSE) used to orthopedically correct a maxillary constriction, on the respiratory functions and swimming performance of a Para-athlete. Cone-beam computed tomography (CBCT) images taken before and after MSE activation were used to demonstrate the disarticulation of midpalatal suture, and the changes involved in dental and nasomaxillary structures, nasal cavity and pharyngeal airway. Respiratory tests included: maximum inspiratory and expiratory pressure, oral peak expiratory flow and inspiratory nasal flow. The 6-min-walk and heart rate recovery tests were also performed. Patient's swimming performances during national swimming competitions were compared. CBCT images showed that palatal expansion was 5.91 mm at the suture, and that nasal and pharyngeal airways increased in volume by 31%. All respiratory indices improved after MSE activation. The 6-min walk test and heart rate recovery test performance also improved after the maxillary expansion. Patient's swimming performance in all category were anemic prior to the treatment, but performance improved considerably after the expansion, particularly the 100 m-Backstroke modality. MSE treatment had a significant positive impact in respiratory functions and sport performance. [ABSTRACT FROM AUTHOR]

Graphical abstract Highlights • Production yields of erythorbyl laurate were compared among three reaction systems. • Gas-solid-liquid multiphase system (GSL-MPS) was established. • Effects of reaction variables on the production yield in GSL-MPS were evaluated. • Erythorbyl laurate was synthesized in high yield in GSL-MPS. Abstract Erythorbyl laurate is a potential food additive as a multi-functional emulsifier having antioxidant and antimicrobial activities. In this study, a gas-solid-liquid multiphase system (GSL-MPS) was established to enhance the production yield of erythorbyl laurate in a lipase-catalyzed solvent-free synthesis. The significant reaction variables were optimized as follows: substrate molar ratio of 2:1 (lauric acid:erythorbic acid) and enzyme concentration of 120 mg/mL (840 PLU/mL). Under these conditions, the maximum production yield in GSL-MPS was 13.974 mg/mL, which is 8.60- and 4.26-fold higher than the yields obtained in an organic solvent monophase system (OS-MPS) and a solid-liquid biphase system (SL-BPS), respectively. Moreover, the operational stability of the immobilized lipase was significantly improved in GSL-MPS compared with OS-MPS. These results indicate that GSL-MPS can be an enzymatic reaction system facilitating efficient production of ester compounds as a means of increasing production yields and the reusability of the immobilized lipase. [ABSTRACT FROM AUTHOR]

Introduction: Our objectives were to evaluate midfacial skeletal changes in the coronal plane and the implications of circummaxillary sutures and to localize the center of rotation for the zygomaticomaxillary complex after therapy with a bone-anchored maxillary expander, using high-resolution cone-beam computed tomography.Methods: Fifteen subjects with a mean age of 17.2 ± 4.2 years were treated with a bone-anchored maxillary expander. Pretreatment and posttreatment cone-beam computed tomography images were superimposed and examined for comparison.Results: Upper interzygomatic distance increased by 0.5 mm, lower interzygomatic distance increased by 4.6 mm, frontozygomatic angles increased by 2.5° and 2.9° (right and left sides), maxillary inclinations increased by 2.0° and 2.5° (right and left sides), and intermolar distance increased by 8.3 mm (P <0.05). Changes in frontoethmoidal, zygomaticomaxillary, and molar basal bone angles were negligible (P >0.05).Conclusions: A significant lateral displacement of the zygomaticomaxillary complex occurred in late adolescent patients treated with a bone-anchored maxillary expander. The zygomatic bone tended to rotate outward along with the maxilla with a common center of rotation located near the superior aspect of the frontozygomatic suture. Dental tipping of the molars was negligible during treatment. [ABSTRACT FROM AUTHOR]

Introduction: The 2-fold purpose of this study was to evaluate the effects of acid etching and calcium chloride immersion on removal torque and the bone-cutting ability of orthodontic mini-implants (OMIs).Methods: For the removal torque part of the study, 3 types of OMIs (titanium alloy) were evaluated in a rabbit model: OMIs with acid surface etching with and without calcium chloride immersion (ECG and EG, respectively) and a control group (CG), in which the OMIs had an untreated, machined surface. We inserted 126 OMIs (42 OMIs per type) into both tibias of 21 male rabbits (5 months of age) with body weights of 3.0 to 3.5 kg. Removal torque was evaluated after 1, 4, and 7 weeks. To determine the OMIs' bone-cutting ability, total insertion time to place an OMI 6 mm into artificial bone was measured (6 OMIs per group).Results: Removal torque values for the EG (3.97 ± 0.52 Ncm) and ECG (4.21 ± 0.44 Ncm) were statistically and significantly higher than those of the CG (3.02 ± 0.53 Ncm) 1 week after implantation (P <0.05). The ECG (6.54 ± 0.50, 6.61 ± 0.66 Ncm) showed the highest removal torque value followed by the EG (5.68 ± 0.58, 5.89 ± 0.70 Ncm) and CG (3.43 ± 0.62, 3.38 ± 0.54 Ncm) at 4 and 7 weeks after implantation (P <0.05). Removal torque did not change over time with the CG, but with the ECG and EG, it was significantly higher in weeks 4 and 7 than in week 1 (P <0.05). Total insertion time was significantly greater for the EG than for the ECG and CG (P <0.05).Conclusions: Treating OMIs with a calcium chloride solution improved the initial bone reaction by preventing contamination of the implant surface, and increasing the surface roughness of OMIs by acid etching enhanced their stability without decreasing the bone-cutting ability compared with OMIs without surface treatment. [ABSTRACT FROM AUTHOR]

Class III malocclusion can be treated dentally as well as skeletally depending on the nature of the problems and the skeletal maturity of the patients. When young patients present skeletal discrepancy, use of a facemask (FM), with or without palatal expansion, is one of the traditional approaches. This treatment modality involves utilization of maxillary dentition as an anchorage unit, often resulting in excessive flaring of the upper incisors by forward movement of maxillary dentition, and an increase in the vertical dimension of the lower face by buccal tipping and extrusion of maxillary posterior dentition, especially in high-angle cases. In recent years, incorporating micro-implants (MI) with expansion and protraction devices in various ways, in order to avoid the unwanted dental side effects, resulted in significantly better outcomes. One popular application is the use of a micro-implant-assisted rapid palatal expander (MARPE), by incorporating the MI with an expansion device, in order to promote bone anchored expansion, and by applying FM force against MARPE, in order to promote bone anchored protraction. Among countless designs of MARPE, the Maxillary Skeletal Expander (MSE) has unique features that produce unique treatment results. MSE causes expansion of the entire midface, disrupting all perimaxillary structures. When MSE is applied in combination with FM, almost negligible vertical side effects are observed, the existing antero-posterior dental compensation can be reversed, the maxilla advances efficiently in large magnitude, and the skeletal protraction is possible even in older growing patients. Combining FM and MSE has also resulted in some skeletal protraction even in mature patients, simulating distraction-like movement, which gives hope of discovering a novel non-surgical orthopedic treatment modality for Class III adult patients. [ABSTRACT FROM AUTHOR]