Multiple Buttresses Reconstruction of Maxilla with Fibular Flap Using Computer-aided Design/Computer-aided Manufacturing after Maxillectomy.

Background: The maxilla comprises horizontal and vertical buttresses, each with specific functions, supporting various organs, such as the eyes, nose, and oral cavity. Notably, they combine to form a three-dimensional structure, which enables the buttresses to provide their inherent support strength. However, reconstructing the maxilla after maxillectomy by assembling new buttresses is challenging. We successfully reconstructed all the buttresses crucial for facial appearance and dental rehabilitation using a vascularized fibular flap. Methods: Four patients underwent maxillary buttress reconstruction with a fibular flap after total or subtotal maxillectomy. We used computer-aided design/computer-aided manufacturing digital technology to osteotomize the fibula into multiple segments and assemble them to reconstruct the maxillary buttresses. Each buttress was assembled based on a preoperative simulation. Results: All patients underwent immediate one-stage maxillary reconstruction. They had good maxillary buttress alignment and acquired good facial appearance, eye position, nasal airway, and prosthetically suitable maxillary alveolus ridge. Conclusions: The combination of computer-aided design/computer-aided manufacturing digital technology and surgical techniques has enabled novel maxillary reconstruction, providing great hope to patients experiencing facial disfigurement and loss of function after maxillectomy.

Cutaneous wound healing promoted by topical administration of heat-killed Lactobacillus plantarum KB131 and possible contribution of CARD9-mediated signaling.

Optimal conditions for wound healing require a smooth transition from the early stage of inflammation to proliferation, and during this time alternatively activated (M2) macrophages play a central role. Recently, heat-killed lactic acid bacteria (LAB), such as Lactobacillus plantarum (L. plantarum) have been reported as possible modulators affecting the immune responses in wound healing. However, how signaling molecules regulate this process after the administration of heat-killed LAB remains unclear. In this study, we examined the effect of heat-killed L. plantarum KB131 (KB131) administration on wound healing and the contribution of CARD9, which is an essential signaling adaptor molecule for NF-kB activation upon triggering through C-type lectin receptors, in the effects of this bacterium. We analyzed wound closure, histological findings, and inflammatory responses. We found that administration of KB131 accelerated wound closure, re-epithelialization, granulation area, CD31-positive vessels, and α-SMA-positive myofibroblast accumulated area, as well as the local infiltration of leukocytes. In particular, M2 macrophages were increased, in parallel with CCL5 synthesis. The acceleration of wound healing responses by KB131 was canceled in CARD9-knockout mice. These results indicate that the topical administration of KB131 accelerates wound healing, accompanying increased M2 macrophages, which suggests that CARD9 may be involved in these responses.

Biosynthesis of hydrazine from ammonium and hydroxylamine using an anaerobic ammonium oxidizing bacterium.

OBJECTIVES: To synthesize hydrazine (N2H4) from ammonium and hydroxylamine (NH2OH) using an anaerobic ammonium oxidation (anammox) bacterium, Candidatus Kuenenia stuttgartiensis. RESULTS: K. stuttgartiensis cells were anoxically cultivated with the addition of ammonium (2 mM) and NH2OH (1-100 mM) at pH 6-10.5, and 4-65 °C to examine the favorable cultivation conditions for N2H4 production. The influence of NH2OH concentration was more prominent than that of pH and temperature, and NH2OH concentration higher than 1 mM deteriorated N2H4 yields significantly. The following conditions were found to be favorable for N2H4 production using K. stuttgartiensis cells: pH 9, 38 °C, and < 1 mM NH2OH. In a continuous-feed system operated at these conditions, K. stuttgartiensis cells produced N2H4 with a maximum concentration of 0.65 mM, which is the highest N2H4 concentration previously reported in biological processes. CONCLUSIONS: Optimal cultivation conditions for K. stuttgartiensis for N2H4 production were successfully determined, and the present study is the first to document potential biological N2H4 production using anammox bacteria.