The use of three-dimensional strut plates for the management of mandibular angle fractures: a retrospective analysis of 222 patients.

This study was performed to evaluate the use of three-dimensional (3D) strut plates for the surgical management of mandibular angle fractures and to determine the subsequent postoperative complication rate. Two hundred and twenty-two patients met the inclusion criteria for mandible angle fracture at the university hospital in Miami between 2009 and 2013 and were included in this study. The treatment protocol for mandibular angle fractures included open reduction and internal fixation with the utilization of a 3D strut plate. Patients were not placed in postoperative intermaxillary fixation. An evaluation of the cases revealed a complication rate of 15.3%, of which 6.8% were considered major complications requiring a surgical intervention. The 3D strut plate has been found to have many advantages over single miniplate techniques with respect to the stability of the fracture and the rate of complications. Based on the current data, 3D strut plates provide a predictable result in the treatment of mandibular angle fractures.

Laparoscopic evaluation of the onset and progression of endometriosis.

OBJECTIVE: To clarify the pathogenesis of endometriosis on the basis of analysis of primary lesion sites, age at onset, rate of progression, and response to drug treatment. STUDY DESIGN: The clinical records of 690 women with laparoscopically confirmed endometriosis were retrospectively analyzed based on the revised American Fertility Society point system. RESULTS: The primary site of endometriosis was the uterosacral ligament and pelvic peritoneum/pouch of Douglas in 73% of patients with stage I disease, whereas only 16% had ovarian lesions. However, disease progression was associated with an increasing frequency of ovarian lesions. In terms of the revised American Fertility Society score, endometriosis progressed at a mean rate of 0.3 point per month. Thus the earliest onset of endometriosis was estimated at 3 to 4 years after menarche. Drug therapy improved the revised American Fertility Society score by about 50%. Patients with a low response to an initial cycle of therapy generally showed further improvement after an additional treatment cycle. CONCLUSIONS: Because endometriosis may occur as early as 3 to 4 years after menarche and gradually progresses, drug therapy, including long-term treatment, should be carried out in women with definitive evidence of endometriosis who must maintain their reproductive potential.

Oily contrast medium as a therapeutic agent for infertility because of mild endometriosis.

OBJECTIVE: To investigate the utility of using oily contrast medium (Lipiodol; Kodama, Tokyo, Japan) to treat infertility because of mild endometriosis. DESIGN: Macrophages in the peritoneal cavity of ICR mice (Japan SLC, Shizuoka, Japan) were induced by administering OK-432 to simulate the condition of the peritoneal cavity of patients with mild endometriosis, and the pregnancy rate was examined after administration of Lipiodol and/or danazol (Bonzol; Tokyo Tanabe, Tokyo, Japan). Interleukin-1 beta (IL-1 beta), prostaglandin (PG)F2 alpha (PGF2 alpha), and PGE2 levels in the supernatant were measured after incubating macrophages of mice with Lipiodol and/or danazol. MAIN OUTCOME MEASURES: Pregnancy rate (PR) and IL-1 beta, PGF2 alpha, and PGE2 levels. RESULTS: The PR of the Lipiodol group was significantly increased compared with that in control mice. Prostaglandin F2 alpha level in the supernatant was significantly increased, whereas that of IL-1 beta was reduced after incubation with Lipiodol. CONCLUSIONS: Lipiodol may elevate PGF2 alpha level and reduce IL-1 beta level in the peritoneal cavity, and this drug may increase the PR of ICR mice.

[Ovarian metastasis in patients with cervical cancer].

The study included a total of 634 patients with cervical cancer; 311 were in stage I b and 323 were in stage II. All patients received radical hysterectomy at the Department of Obstetrics and Gynecology, Kinki University, between May 1975 and December 1986. One out of 311 patients in stage I b (0.3%) and eight out of 323 patients in stage II (2.5%) had ovarian metastases confirmed histologically. Nine patients who had ovarian metastases were investigated about stages, histological types of the cervical cancer (WHO and CPL classification), incidence of metastases in pelvic lymph nodes, corpus infiltration, parametrial infiltration, and peritoneal cytology. Results obtained were as follows: 1. As to histological types, patients with adenocarcinoma and/or PL type in CPL classification had high incidence of ovarian metastases. 2. Patients with corpus infiltration had high incidence of ovarian metastases. 3. Metastases to both ovary and pelvic lymph nodes tended to occur on the same side, but ovarian metastases and parametrial infiltration did not necessarily occur on the same side. We suggest removal of ovaries, even before menopause, in patients with cervical cancer who have cervical adenocarcinoma, or corpus infiltration, or are suspicious for metastases in more than two pelvic lymph nodes.