Development and application of a rapid rehabilitation system for reconstruction of maxillofacial soft-tissue defects related to war and traumatic injuries.

BACKGROUND: The application of a maxillofacial prosthesis is an alternative to surgery in functional-aesthetic facial reconstruction. Computer aided design/computer aided manufacturing has opened up a new approach to the fabrication of maxillofacial prostheses. An intelligentized rapid simulative design and manufacturing system for prostheses was developed to facilitate the prosthesis fabrication procedure. METHODS: The rapid simulation design and rapid fabrication system for maxillofacial prostheses consists of three components: digital impression, intelligentized prosthesis design, and rapid manufacturing. The patients' maxillofacial digital impressions were taken with a structured-light 3D scanner; then, the 3D model of the prostheses and their negative molds could be designed with specific software; lastly, with resin molds fabricated by the rapid prototyping machine, the prostheses could be produced directly and quickly. RESULTS: Fifteen patients with maxillofacial defects received prosthesis rehabilitation provided by the established system. The total clinical time used for each patient was only 4 hours over 2 appointments on average. The contours of the prostheses coordinated properly with the appearance of the patients, and the uniform-thickness border sealed well to adjacent tissues. All of the patients were satisfied with their prostheses. CONCLUSIONS: The rapid simulative rehabilitation system of maxillofacial defects is approaching completion. It could provide an advanced technological solution for the Army in cases of maxillofacial defect rehabilitation.

Virtual transplantation in designing a facial prosthesis for extensive maxillofacial defects that cross the facial midline using computer-assisted technology.

PURPOSE: The aim of this article was to demonstrate a novel approach to designing facial prostheses using the transplantation concept and computer-assisted technology for extensive, large, maxillofacial defects that cross the facial midline. MATERIALS AND METHODS: The three-dimensional (3D) facial surface images of a patient and his relative were reconstructed using data obtained through optical scanning. Based on these images, the corresponding portion of the relative's face was transplanted to the patient's where the defect was located, which could not be rehabilitated using mirror projection, to design the virtual facial prosthesis without the eye. A 3D model of an artificial eye that mimicked the patient's remaining one was developed, transplanted, and fit onto the virtual prosthesis. A personalized retention structure for the artificial eye was designed on the virtual facial prosthesis. The wax prosthesis was manufactured through rapid prototyping, and the definitive silicone prosthesis was completed. RESULTS: The size, shape, and cosmetic appearance of the prosthesis were satisfactory and matched the defect area well. The patient's facial appearance was recovered perfectly with the prosthesis, as determined through clinical evaluation. CONCLUSION: The optical 3D imaging and computer-aided design/computer-assisted manufacturing system used in this study can design and fabricate facial prostheses more precisely than conventional manual sculpturing techniques. The discomfort generally associated with such conventional methods was decreased greatly. The virtual transplantation used to design the facial prosthesis for the maxillofacial defect, which crossed the facial midline, and the development of the retention structure for the eye were both feasible.

Relationship of alloreactive NK cells to prognosis of HLA-identical sibling allogeneic hematopoietic stem cell transplantation / 中国实验血液学杂志

In recent years, the interaction between HLA class I alleles and receptors of NK cells have been paid more attention in HLA-identical sibling hematopoietic stem cell transplantation (HLA-identical sibling HSCT). NK cells mediate alloreactions when the allogeneic targets do not express HLA class I alleles that block inhibitory receptors of NK cells. Alloreactive donor-derived NK cells reduce GVHD by eliminating host-type antigen-presenting cells, but favor engraftment by killing host lymphocyte cells and reduce the risk of relapse by eradicating leukemia cells. Moreover, activating receptors also influence the outcome of HLA-identical sibling HSCT. In this review, the advance of the impact of both inhibitory and activating KIR (killer cell immunoglobulin-like receptor, KIR) on the outcome of HLA-identical sibling HSCT is briefly summarized.