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Background: Recent evidence suggests that a lower extent of the retronasal aroma release correspond to a higher amount of ad libitum food intake. This has been regarded as one of the bases of behavioral choices towards food consumption in obese people. In this pilot study we investigated the hypothesis that saliva from obese individuals could be responsible for an alteration of the retro-nasal aroma release. We tested this hypothesis in vitro, by comparing the release of volatiles from a liquid food matrix (wine) after its interaction with saliva from 28 obese (O) and 28 normal-weight (N) individuals., Methods and Findings: Amplicon sequencing of the 16S rRNA V4 region indicated that Firmicutes and Actinobacteria were more abundant in O, while Proteobacteria and Fusobacteria dominated in N. Streptococcaceae were significantly more abundant in the O subjects and constituted 34% and 19% on average of the saliva microbiota of O and N subjects, respectively. The Total Antioxidant Capacity was higher in O vs N saliva samples. A model mouth system was used to test whether the in-mouth wine aroma release differs after the interaction with O or N saliva. In O samples, a 18% to 60% significant decrease in the mean concentration of wine volatiles was detected as a result of interaction with saliva, compared with N. This suppression was linked to biochemical differences in O and N saliva composition, which include protein content., Conclusion: Microbiological and biochemical differences were found in O vs N saliva samples. An impaired retronasal aroma release from white wine was detected in vitro and linked to compositional differences between saliva from obese and normal-weight subjects. Additional in vivo investigations on diverse food matrices could contribute to understanding whether a lower olfactory stimulation due to saliva composition can be a co-factor in the development/maintenance of obesity.

Castleman's disease (giant lymph node hyperplasia, angiofollicular hyperplasia, lymphoid hamartoma, benign giant lymphoma), is a quite rare and complex disease of lymphoid tissue that causes progressive lymph node enlargement, typically presenting as a solitary mediastinal mass. It was first described by Castleman et al in 1956. The head and neck regions are the second, less common site for this lesion. The preoperative diagnosis is very often extremely difficult and the routine investigations are often inconclusive. A multicentric extension of this disease shows poorer prognosis compared to the unifocal Histologically, three types do exist: the hyaline-vascular type, the plasma cell type and the mixed type. The etiology and pathogenesis is still unclear. In the literature, to our knowledge, only 112 cases have been reported involving head and neck, and only 22, including our own, interesting the parotid gland. In this report we describe a rare singular of Castleman's disease presenting as a tumor of the inferior pole of the parotid gland extending in the submandibular region, in a 35-year-old woman. The patient undergone a surgical treatment and, therefore, the mass was successfully totally removed.

Operative removal of impacted mandibular third molars is a common and not riskless surgical procedure. We present an emblematic case of an osteoma closely associated with an impacted third left mandibular molar treated by Mectron Piezosurgery medical ultrasonic device.

Introduction: The two-stage surgical approach for implant placement first documented in 1977 by Brånemark, represents today the most used protocol for placing implants., Aim: Aim of this prospective case series study was to compare the clinical and radiological performance of 12 edentulous jaws treated with of a modified prosthetic and surgical protocol for 3D software planning, guided surgery, immediate loading of implants inserted in edentulous jaws and extraction sockets and restored with Cad-Cam Zirconia and titanium full arch frameworks., Patients and Methods: This work was designed as a prospective case series study. Twelve patients have been consecutively rehabilitated with an immediately loaded implant supported fixed full prosthesis. A total of 72 implants, Nobel Replace Tapered Groovy; Nobel Biocare AB, Goteborg, Sweden) 26 of which were inserted in fresh extraction sockets, were inserted. Outcome measures were implants survival, radiographic marginal bone-levels and bone remodeling, soft tissue parameters and complications., Results: All patients reached 24 months follow-up, and no patients dropped out from the study. The cumulative survival rate was 100%; after 24 months mean marginal bone remodelling value was: 1.35 ± 0.25, mean PPD value was 2.75 ± 0.40 mm and mean BOP value was 3.8% ± 1.8%. Only minor prosthetic complications were recorded., Conclusions: These data seem to validate this surgical and prosthetic protocol with valid results when applied in selected cases.

Myositis Ossificans (MO) is an unusual pathological entity still largely unknown, characterized by dystrophic calcification leading to heterotopic ossification of intramuscular connective tissue. The masticatory muscles are exceptionally involved. Four distinct types of myositis ossificans have been described: MO Progressiva, which is a genetic disorder involving several muscular groups; MO Circumscripta, limited to a single muscle and generally due to calcification of an intramuscular haematoma following severe trauma and progressive ossification; MO Pseudo-malignant limited to soft tissue and not associated to any trauma; MO associated to paraplegia. A case of circumscribed myositis ossificans of the masseter muscle in a 62 years-old woman is reported.

Orbital floor fractures are the most common facial fractures. The goals of orbital floor fracture repair are to free incarcerated or prolapsed orbital tissue from the fracture defect and to span the defect with an implant to restore the correct anatomy of the orbital floor and the pretrauma orbital volume. No consensus exists on the choice of implants to be used for orbital floor reconstruction, and several implant materials are available.Our study intended to evaluate, for the first time, the effectiveness and complications related to the use of a resorbable collagen membrane in the reconstruction of small pure blow-out fractures. From October 2008 to November 2010, 23 patients who underwent reconstruction of the orbital floor using a resorbable collagen membrane following fracture were included in this study. At the 6-month follow-up, only 2 patients (9%) reported postoperative complications secondary to the operative procedure (surgical approach, orbital floor dissection), but these were not directly related to the use of the membrane. In 12 cases, a computed tomography scan revealed new bone formation beneath the membrane.On the basis of this data, we believe that the use of a resorbable collagen membrane is a safe and effective alternative for reconstruction of small (<3 cm(2)) pure orbital floor fractures.

Background: The nasal dorsum is a good skin flap donor site for alar reconstructions because of its qualities: appropriate color, texture, and thickness., Objective: An anatomic vascular study on cadaver and the clinical use of the dorsal nasal skin flap, inferiorly based on the nasal septal branches, is reported., Materials and Methods: Vascular anatomy of the nasal dorsum was demonstrated in five fresh-frozen latex-injected heads. Fourteen patients were operated of reconstruction of the nasal ala using an inferiorly based dorsal nasal flap., Results: Nasal septal branches, from the superior labial arteries, give vascular supply to the nasal tip. Connections of these arteries with lateral nasal branches (facial system) and dorsal nasal arteries (ophthalmic system) form a consistent vascular network in the dorsal nasal superficial muscular aponeurotic system and allow to safely raise cutaneous flaps distally based. No total or partial loss of the flaps was observed in clinical use. The donor site was sutured directly in 13 patients and with a skin graft in one., Conclusion: The inferiorly based dorsal nasal flap provides very good cosmetic and functional results and could be considered an additional adequate surgical option for nasal ala reconstruction, especially when skin from the nasolabial fold, upper lip, and cheek is not available. The authors have indicated no significant interest with commercial supporters., (© 2011 by the American Society for Dermatologic Surgery, Inc.)

We report our experience with the repair of the orbital floor fractures and present new technical findings. We evaluated 30 subjects with pure blowout fractures treated at the Department of Maxillofacial Surgery of the Federico II University of Naples, Italy, between 2005 and 2007. A preoperative examination by computed tomography scans provided classification of the orbital floor fractures into small and large fractures by measurement of the bone defect to choose the appropriate reconstructive implant materials, resorbable or nonresorbable. The clinical follow-up has been performed at 1 week, 1 month, 3 months, and 6 months. We observed a resolution of preoperative symptoms. The scar was not evident, and there was an absence of postoperative complications. We concluded that the use of resorbable materials for small orbital floor fractures and nonresorbable materials for large orbital floor fractures offers satisfactory results in both functional and aesthetic considerations. Furthermore, the new technical findings allow standardization of the surgical technique to be more accurate, also reducing the economic costs.

Mandibular condylar fractures have a high incidence but there is no consensus regarding the best choice of osteosynthesis. From a review of the literature, it is evident that the technique used most frequently for fixation is the positioning of a single plate despite complications concerning plate fracture or screw loosening have been reported by various authors. Different studies have highlighted that the stability of osteosynthesis is correlated with the mechanical strains occurring in the condylar region, generated by the muscles of mastication. The aim of our study was, through a mandibular finite element model (FEM), to confirm this correlation and to analyse the behaviour of single and double elements of union in the fixation of mandibular subcondylar fractures. We concluded that the use of two plates provides greater stability compared with the single plate, reducing the possibility of displacement of the condylar fragment. Therefore we recommend that this technique should be adopted whenever possible., (Copyright 2009 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.)

Background: This report describes preoperative digital planning for rhinoplasty using a new three-dimensional (3D) radiologic viewer that allows both patients and surgeons to visualize on a common monitor the 3D real aspect of the nose in its inner and outer sides., Methods: In the period 2002 to 2008, 210 patients underwent rhinoplasty procedures in the authors' clinic. The patients were randomly divided into three groups according to the type of preoperative planning used: photos only, a simulated result by Adobe Photoshop, or the 3D radiologic viewer. The parameters evaluated included the number of patients that underwent surgery after the first consultation, the number of patients who asked for a reintervention, patient satisfaction (according to a test given to the patients 12 months postoperatively), the surgical time required for a functional intervention, and the improvement in nasal function by postoperative rhinomanometry and subjective evaluation., Results: Computer-aided technologies led to a higher number of patients deciding to undergo a rhinoplasty. Simulation of the postoperative results was not as useful in the postoperative period due to the higher number of reintervention requests., Conclusion: The patients undergoing rhinoplasties preferred new technologies in the preoperative period. The advantages of using the 3D radiologic viewer included improved preoperative planning, reduction in intraoperative stress, a higher number of patients undergoing surgery, reduction in postoperative surgical corrections, reduction in surgical time for the functional intervention, a higher rate of improvement in nasal function, a higher percentage of postoperative satisfaction, and reduced costs.

The aim of the present retrospective chart review was to determine the relationship between nonvascularized osseous graft remodeling and the three-dimensional (3D) features of grafts and recipient sites, the anatomical recipient regions and different graft sources. 32 iliac crest or chin grafts were onlay-positioned in the mandible or maxilla of 14 patients. CT scans, taken before implant positioning and after 1 year, revealed a mean volume resorption of 35-51%. For iliac crest grafts, the average resorption was 42% when the onlay was positioned in the anterior maxilla and 59% when it was positioned in the posterior mandible. Spearman correlation and 3D interpolation analysis revealed, for both iliac crest groups, a moderate or advanced remodeling pattern depending on 3D features, namely graft thickness and shape, basal bone volume of recipient site, and the basal bone/graft volume ratio of the recipient site. No statistically significant differences were found between the recipient and donor site groups. Retrospective analysis of the data indicates that iliac crest grafts, onlay-positioned on adequate basal bone volume, may register a reduced volume remodeling when shaped thick in the anterior maxilla or rounded and convex, on the external surface, in the posterior mandible.

Various skin incision for access to the parotid region are described by different authors, which differ in extension and localization of the scar. Therefore after parotidectomy, patients are often left with a retromandibular and cervical depression. Maintaining normal facial contour may be difficult in parotidectomy defects, but a good symmetry can and should be achieved when reconstructing the parotid region with a specific approach. The authors show their experience in parotid gland surgery using a new skin incision to improve the aesthetic and functional results and three different techniques the reconstruction of the parotid region.

Gas Chromatography-Mass Spectrometry (GC-MS) analysis by Selective Ion Monitoring (SIM) was applied to quantify 4-Hydroxy-2,5-dimethyl-3(2H)-furanone (HDMF) in both red and white wines obtained from some Italian cultivar of Vitis vinifera. Wines were extracted by liquid-liquid extraction performed with 1,1,2-trichlorotrifluoroethane (Freon 113). The ion m/z 128 was used for quantification while the ion m/z 129 as qualifier. Precision, linearity and accuracy of the method resulted satisfactory. Results showed a significant variation in the concentration of furaneol in wine with grape variety. Generally, HDMF concentrations in white wines were lower than in red wines. Among white wines, Chardonnay resulted characterized by the highest concentration of HDMF. Among red wines the highest concentrations of HDMF were detected in Primitivo and Refosco varieties.

One hundred and one volatile compounds, reported in literature as powerful odorants of wine, were quantified by Gas Chromatography-Selective Ion Monitoring/Mass Spectrometry (GC-SIM/MS) in Primitivo, Aglianico, Merlot and Cabernet Sauvignon red wines. Wine samples were extracted by 3 different extraction methods: 1) separation of the alcoholic fraction from the aqueous phase by salting-out and subsequent extraction by liquid-liquid micro-extraction with 1,1,2-trichlorotrifluoroethane (Freon 113); 2) extraction by liquid-liquid micro-extraction with dichloromethane; 3) solid phase extraction (SPE cartridge: 800 mg of LiChrolut EN resin) with pentane-dichloromethane (20:1) and dichloromethane. The selection of the ion fragments used for quantification was directly performed on a red wine sample. For each compound the area of the corresponding peak was normalized respect to the peak of the internal standard and then interpolated in a calibration curve obtained analysing a model wine solution (water, ethanol, tartaric acid and known amounts of analytes and of internal standard). The methods showed a good linearity: r2>0.990, except for farnesol (isomer a and c), octanal, decanal, furaneol and phenylacetic acid with 0.966 < or = r2 < or = 0.990. The 7 most powerful odorants were: beta-damascenone, acetaldehyde, maltol, ethyl 2-methylbutanoate, ethyl 3-methylbutanoate, 3-methylbutanoic acid and acetal; 7 other slightly less important were: ethyl hexanoate, ethyl acetate, 1-octen-3-ol, butanoic acid, rose oxide, furaneol and sotolon. The Aglianico wines were characterised by the major fermentation compounds (esters, fatty acids and 2-phenylethanol), beta-damascenone, beta-ionone and linalool. The Primitivo wines were characterized by furaneol, methoxypyrazine, gamma-nonalactone and acetaldehyde, while Cabernet Sauvignon and Merlot wines principally by cask derivates (vanillin, (Z) 3-methyl-gamma-octalactone [(Z) wiskylactone], maltol and eugenol), some aldehydes and 3-isopropyl-2-methoxypyrazine.

Two vinification methods involving different degrees of antioxidant protection of Falanghina must during prefermentative steps, and referred as HAMP (high antioxidant must protection) and LAMP (low antioxidant must protection), were compared in terms of fermentation performances of four different yeast strains, composition of the volatile fraction of wines at the end of alcoholic fermentation, and shelf life of wines during storage. The use of HAMP technology resulted in wines with lower volatile acidity and higher concentrations of medium-chain fatty acid ethyl esters, acetates, and volatile fatty acids. For two of the four strains a lower concentration of isoamyl alcohol was also observed. HAMP wines also revealed increased shelf life because of the higher concentration of odor active esters at the end of storage and better preservation of varietal aromas.

Aims: Seventy-eight strains of lactic acid bacteria belonging to five genera and showing six different phenotype combinations of Lac (lactose fermentation), Prt (proteolytic activity) and Cit (citrate degradation) characters were investigated for their main flavouring properties with the aim to detect variability among and within the groups., Methods and Results: High resolution gas chromatography-mass spectrometry analysis of neutral volatile compounds produced in whey showed that, considering both neo-formation compounds and substances quantified in the whey cultures at different concentrations in comparison to the extract from sterile whey, the groups of lactococci, enterococci, thermophilic streptococci and mesophilic lactobacilli produced a higher number of volatiles than thermophilic lactobacilli and leuconostocs. Applying principal component analysis (PCA) to the results, enterococci, mesophilic lactobacilli and thermophilic streptococci showed a broad diversity, while lactococci included rather similar strains as well as strains with special flavouring properties. Applying PCA to thermophilic streptococci and enterococci, to lactococci and enterococci, to lactococci and thermophilic streptococci, or to mesophilic and thermophilic lactobacilli, the strains gathered consistently with their systematic position., Conclusion: The study evidenced strains producing some volatile compounds responsible for food flavouring. Flavouring properties were variable among the systematic groups and in some cases different within the same bacterial group., Significance and Impact of the Study: The potential of the findings is discussed with reference to the development of flavouring adjuncts for the dairy industry.

Volatile concentrates were obtained by vacuum distillation from both natural and creamy Gorgonzola cheese and isolated by continuous liquid-liquid extraction. Both were analysed by high resolution gas chromatography (HRGC), HRGC-mass spectrometry and HRGC-olfactometry. A total of 63 components were identified in the neutral extract of the natural type (21 esters, 13 ketones, 14 alcohols, 5 aldehydes, 1 sulphur compound, 7 aromatic compounds and 2 terpenes) and 52 in the creamy type (17 esters, 12 ketones, 10 alcohols, 5 aldehydes, 1 sulphur compound, 5 aromatic compounds and 2 terpenes). Ketones, whose major components were 2-nonanone and 2-heptanone, were the predominant constituents of the neutral fraction. By olfactometric analysis of the neutral extracts, 23 odour-impact compounds were found in the natural and 21 in the creamy Gorgonzola cheese. 1-Octen-3-ol, ethyl hexanoate, 2-nonanone, 2-heptanone, 2-heptanol, ethyl butanoate, 2-nonanol and 4-methylanisole were the key odorants of the natural cheese, whereas 2-heptanone, 2-heptanol, ethyl butanoate, 3-methyl thiopropanal and an unidentified constituent with a fruity odour were characteristic of the creamy Gorgonzola cheese. On the basis of high odour unity values, 2-nonanone, 1-octen-3-ol, 2-heptanol, ethyl hexanoate, methylanisole and 2-heptanone were the most important odorants of natural and creamy Gorgonzola cheese aroma.

If the nodes are involved, survival of patients with squamous cell carcinoma of the tongue is considerably reduced. Surgery remains the treatment of choice and, to define its role, we have reviewed 82 consecutive cases. Sixty-two cases (76%) were T1-2, and 46 patients (56%) had involved nodes. The cervical region II was the most often involved (n=26). Occult nodal metastases were present in 12 cases. The extent of nodal spread and prognosis varies according to whether the body or the base of the tongue is involved. Lesions of the base with involved node should be treated by a selective posterolateral neck dissection, whilst in the case of a lesion of the body of the tongue, the dissection should be selective anterolateral. In lesions of the base, when there are no nodes involved, a prophylactic selective posterolateral neck dissection is recommended, whilst in the case of the lesions of the body, selective supraomohyoid neck dissection in T2-4 lesions is recommended.

Nodal involvement in squamous cell carcinoma considerably lowers survival rate. Despite its importance, neck management has still not been adequately explored. The Authors have retrospectively reviewed the records of 112 cases. Unilateral N+ were treated with a homolateral therapeutic and a controlateral prophylactic neck dissection; bilateral N+ were treated with a bilateral therapeutic neck dissection. On first observation the majority of cases (66.1%) were T1-2, N+ patients accounted for 45.5%. Among N- patients, 21.3% of occult nodal metastases were observed. The 5-year survival rate was 52.7%. With N+ lesions, a radical neck dissection should be performed; the dissection should be performed bilaterally. With N- lesions a prophylactic modified radical neck dissection is recommended in T2-4 lesions.

Twelve previously untreated cases of oral cancer with perineural infiltration were studied retrospectively. Age, sex, site, clinical stage and outcome were evaluated. Management of the neoplasm in each case involved surgical removal and six patients required adjuvant radiotherapy. The most frequent site was the lip. At the time of diagnosis, five patients had sensory complaints and palpable lymphadenopathy was observed in three patients. The 5-year crude survival rate was 16.7%. In the cases with postoperative assessment of perineural infiltration, a median survival time of 30.8 months was observed; while in the case of preoperative assessment of nerve infiltration, extensive surgery was performed with a consequent median survival time of 44.5 months. The perineural infiltration of the lower alveolar nerve is more common (6.3%) than is generally thought. This frequency is due to the relationship with the lower lip and the mandibular region. In carcinoma of the lip, spread is generally limited to 10-15 mm along the lower alveolar nerve. In carcinoma of the mandibular region, spread is entirely dependent on the location of the tumour; the absence of clinical fixation to the bone and the small size of the carcinoma does not preclude the possibility of bone involvement. Neurological symptoms should be evaluated carefully, and a radiographic investigation of the nerve canal is mandatory.