[Object Detection Model Utilizing Deep Learning to Identify Retained Surgical Gauze in the Body on Postoperative Radiography: Phantom Study].

PURPOSE: Foreign bodies such as a surgical gauze can be retained in the body after surgery and in some cases cannot be detected by postoperative radiography. The aim of this study was to develop an object detection model capable of postsurgical detection of retained gauze in the body. The object detection model used deep learning using abdominal radiographs, and a phantom study was performed to evaluate the ability of the model to automatically detect retained surgical gauze. MATERIALS AND METHODS: The object detection model was constructed using a Single Shot MultiBox Detector (SSD) 300. In total, 268 abdominal phantom images were used: 180 gauze images were used as training data, 20 gauze images were used as validation data, and an additional 34 gauze images and 34 nongauze images were used as test data. To evaluate the performance of the object detection model, a confusion matrix was created and the accuracy and sensitivity were calculated. RESULT: True-positive (TP) rate, true-negative (TN) rate, false-positive (FP) rate, and false-negative (FN) rate were 0.92, 1.00, 0.00, and 0.08, respectively. Accuracy was 0.96, and sensitivity was 0.92. CONCLUSION: The object detection model could detect surgical gauze on abdominal phantom images with a high accuracy and sensitivity.

Effect of local bone marrow stromal cell administration on ligature-induced periodontitis in mice.

Bone marrow-derived multipotent stromal cells (BMSCs) have potent antiinflammatory effects. This study aimed to investigate the antiinflammatory potential of BMSCs using a mouse model of ligature-induced periodontitis. BMSCs were isolated from the femurs and tibiae of mice. Periodontitis was induced by placing a ligature around the right maxillary second molar. After 3 days, the mice were administered BMSC in the gingiva of the mesial interdental papilla around the ligatured molar. The ligatured and non-ligatured mice that were not administered BMSC served as controls. Differences in inflammatory infiltration and bone resorption around the roots of the second molar were assessed and were subsequently quantified using microcomputed tomography (micro-CT), histological analysis, and tartrate-resistant acid phosphatase (TRAP) staining. Micro-CT revealed that alveolar bone loss around the ligatured molars increased in a time-dependent manner; however, the effect was significantly less in BMSC-treated mice compared with ligatured control mice. Tissue histopathology revealed that BMSC administration mitigated inflammatory infiltration in ligatured BMSC mice. In addition, the number of TRAP-positive osteoclasts was markedly elevated in ligatured control mice compared with those in BMSC-treated mice. These findings indicate that local BMSC administration can mitigate inflammation and alveolar bone resorption, suggesting that administering BMSC leads to new therapeutics for periodontitis.

Transplantation of mature adipocyte-derived dedifferentiated fat cells into three-wall defects in the rat periodontium induces tissue regeneration.

The transplantation of dedifferentiated fat (DFAT) cells in combination with poly(d,l-lactic-co-glycolic acid) (PLGA) scaffolds has previously been proven as an effective approach in promoting periodontal tissue regeneration in a rat fenestration defect model. The aim of this study was to assess the regenerative potential of DFAT cells in a rat model of three-wall periodontal bone defect. Three-wall bone defects were created bilaterally on the mesial side of rat maxillary first molars and were either left untreated or treated by implantation of PLGA scaffolds with DFAT cells or PLGA alone. Four weeks after surgery, the tissues were processed for micro-computed tomography (micro-CT) and histomorphometric examination. Micro-CT revealed that the PLGA/DFAT group had significantly higher rates of bone regeneration than the other groups, while histomorphometric analysis showed that the PLGA/DFAT group had significantly higher densities of collagen fiber bundles in acellular and cellular cementum than the PLGA group. Moreover, the results indicate that the placement of the PLGA scaffold prevented the downgrowth of the junctional epithelium. These findings suggest that DFAT cells contribute to tissue regeneration in three-wall periodontal defects, while PLGA provides space necessary for periodontal tissue restoration.

Induction of neural crest cells from human dental pulp-derived induced pluripotent stem cells.

We previously generated induced pluripotent stem (iPS) cells from human dental pulp cells of deciduous teeth. Neural crest cells (NCCs) play a vital role in the development of the oral and maxillofacial region. Therefore, NCCs represent a cell source for bone, cartilage, and tooth-related tissue engineering. In this study, we examined whether iPS cells are capable of differentiating into NCCs through modification of the human embryonic stem cell protocol. First, iPS cells were dissociated into single cells and then reaggregated in low-cell-adhesion plates with neural induction medium for 8 days in suspension culture to form neurospheres. The neurospheres were transferred to fibronectin-coated dishes and formed rosette structures. The migrated cells from the rosettes abundantly expressed NCC markers, as evidenced by real-time polymerase chain reaction, immunofluorescence, and flow cytometric analysis. Furthermore, the migrated cells exhibited the ability to differentiate into neural crest lineage cells in vitro. They also exhibited tissue-forming potential in vivo, differentiating into bone and cartilage. Collectively, the migrated cells had similar characteristics to those of NCCs. These results suggest that human dental pulp cell-derived iPS cells are capable of differentiating into NCCs. Therefore, iPS cell-derived NCCs represent cell sources for bone and cartilage tissue engineering.

Systematic review and assessment of systematic reviews examining the effect of periodontal treatment on glycemic control in patients with diabetes

OBJECTIVES: There have been several systematic reviews(SRs) on whether periodontal treatment for an individual with both periodontal disease and diabetes can improve diabetes outcomes. The purpose of this investigation was to conduct a systematic review (SR) of previous meta-analyses, and to assess the methodological quality of the SRs examining the effects of periodontal treatment and diabetes. (PROSPERO Registration # CRD 42015023470). Study DESIGN: We searched five electronic databases and identified previous meta-analyses of randomized controlled trials published through July 2015. In cases where the meta-analysis did not meet our criteria, the meta-analyses were recalculated. General characteristics of each included trial were abstracted, analyzed, and compared. The mean difference, 95% confidence intervals (CIs) and the I2 statistic were abstracted or recalculated. The Assessment of Multiple Systematic Reviews Instrument (AMSTAR) was used to assess methodological quality. RESULTS: Of the 475 citations screened, nine systematic reviews were included. In total, 13 meta-analyses included in nine SRs were examined. In comparability analyses, meta-analyses in four SRs did not meet our criteria, and were recalculated. Of these 13 meta-analyses, 10 suggested significant effects of periodontal treatment on HbA1c improvement. Mean differences found in the 13 meta-analyses ranged from -0.93 to 0.13. AMSTAR assessment revealed six SRs with moderate and three with high overall quality. CONCLUSIONS: We can conclude that there is a significant effect of periodontal treatment on improvement of HbA1c in diabetes patients, although the effect size is extremely small. In addition to the small effect size, not all SRs could be considered of high quality

Effect of basic fibroblast growth factor on angiogenesis and bone regeneration in non-critical-size bone defects in rat calvaria.

We used microcomputed tomography (micro-CT) to evaluate the effects of basic fibroblast growth factor (FGF-2) contained in absorbable collagen sponges on angiogenesis and bone regeneration in rat calvarial non-critical-size bone defects. Two symmetrical non-critical-size calvarial bone defects (diameter, 2.7 mm) were created in male Fisher rats. An absorbable collagen sponge with or without FGF-2 (0.1% or 0.3%) was implanted into each defect. Blood vessel volume and bone volume were calculated using software. On day 28, blood vessel volume and bone volume were significantly greater in the 0.3% and 0.1% FGF-2 groups than in the control group. FGF-2 concentration-dependently increased blood vessels and bone formation in non-critical-size bone defects in rat calvaria.

[Left apical tumor extirpation via left ventriculotomy with the aid of epicardial echocardiography].

We reported a rare case of cardiac lipoma in the left ventricular apex. A 67-year-old woman who was diagnosed with cardiac tumor in the left ventricular apex was underwent the extirpation of the tumor via left ventriculotomy with the aid of intraoperative epicardiac ultra-sound. An intraoperative epicardiac ultra-sound is a very useful tool to document a location of the tumor, and a left ventriculotomy approach for the extirpation of the tumor provides a good operative field.

Marked improvement of extensive atelectasis by unilateral application of the RTX respirator in elderly patients.

The RTX respirator is a biphasic external cuirass-style ventilator that supports both inspiration and expiration at various cycle rates and pressures, as well as allowing application of the vibration and cough modes. With this respirator, the duration and pressure can be altered in both the inspiratory and expiratory phases, and it can promote the removal of secretions by switching between the vibration mode (which involves external high-frequency oscillation: EHFO) and the cough mode. We used this respirator to remove secretions in two elderly patients with extensive atelectasis. They were nursed in the lateral decubitus position with the cuirass attached to one side of the chest only. The vibration mode removed secretion to reduce the viscosity of secretions and loosen impacted bronchial secretions. The cough mode interrupts the vibration mode and forces secretions towards the pharynx. The lateral decubitus position was useful for postural drainage. The extensive atelectasis of both patients was improved by this procedure. The RTX respirator may be a useful tool for the management of elderly patients with sputum retention.