Purpose: This study aimed to evaluate the clinical usefulness of magnetic resonance (MR) neurography using the 3-dimensional double-echo steady-state with water excitation (3D-DESS-WE) sequence for the preoperative delineation of the facial and lingual nerves. Materials and Methods: Patients underwent MR neurography for a tumor in the parotid gland area or lingual neuropathy from January 2020 to December 2021 were reviewed. Preoperative MR neurography using the 3D-DESS-WE sequence was evaluated. The visibility of the facial nerve and lingual nerve was scored on a 5-point scale, with poor visibility as 1 point and excellent as 5 points. The facial nerve course relative to the tumor wasidentified as superficial, deep, or encased. This was compared to the actual nerve course identified during surgery. The operative findings in lingual nerve surgery were also described. Results: Ten patients with parotid tumors and 3 patients with lingual neuropathy were included. Among 10 parotid tumor patients, 8 were diagnosed with benign tumors and 2 with malignant tumors. The median facial nerve visibility score was 4.5 points. The distribution of scores was as follows: 5 points in 5 cases, 4 points in 1 case, 3 points in 2 cases, and 2 points in 2 cases. The lingual nerve continuity score in the affected area was lower than in the unaffected area in all 3 patients. The average visibility score of the lingual nerve was 2.67 on the affected side and 4 on the unaffected side. Conclusion This study confirmed that the preoperative localization of the facial and lingual nerves using MR neurography with the 3D-DESS-WE sequence was feasible and contributed to surgical planning for the parotid area and lingual nerve.

The difficult oral healthcare in intellectually disabled patients with poor behavioral control has led to debate over the cost-effectiveness and validity of implant treatment in these patients. The patient in the present report had schizophrenia that had led to poor oral care and severe dental caries in the full mouth. Tooth extraction and a removable prosthesis were planned, but the guardian wanted an implant procedure. Since the guardian showed strong will and cooperation with regard to the patient's oral healthcare, extraction followed by immediate implant placement was performed across two rounds of general anesthesia. Since the outcome appears successful, we present this case report. Immediate implant placement after tooth extraction requires fewer surgeries and rounds of general anesthesia, reduces horizontal bone resorption, and can achieve better esthetic results. Therefore, as long as a certain degree of oral care is possible, this can be a positive option for restoration of a partially edentulous mouth, even in intellectually disabled patients.
Anesthesia, General* ; Bone Resorption ; Delivery of Health Care ; Dental Caries ; Humans ; Mouth ; Mouth, Edentulous ; Outpatients* ; Prostheses and Implants ; Schizophrenia ; Tooth Extraction

The difficult oral healthcare in intellectually disabled patients with poor behavioral control has led to debate over the cost-effectiveness and validity of implant treatment in these patients. The patient in the present report had schizophrenia that had led to poor oral care and severe dental caries in the full mouth. Tooth extraction and a removable prosthesis were planned, but the guardian wanted an implant procedure. Since the guardian showed strong will and cooperation with regard to the patient's oral healthcare, extraction followed by immediate implant placement was performed across two rounds of general anesthesia. Since the outcome appears successful, we present this case report. Immediate implant placement after tooth extraction requires fewer surgeries and rounds of general anesthesia, reduces horizontal bone resorption, and can achieve better esthetic results. Therefore, as long as a certain degree of oral care is possible, this can be a positive option for restoration of a partially edentulous mouth, even in intellectually disabled patients.
Anesthesia, General* ; Bone Resorption ; Delivery of Health Care ; Dental Caries ; Humans ; Mouth ; Mouth, Edentulous ; Outpatients* ; Prostheses and Implants ; Schizophrenia ; Tooth Extraction

A nucleoside diphosphate-linked moiety X (Nudix) hydrolase-like gene, YSA1, has been identified as one of the gromwell plant extract-responsive genes in Cryptococcus neoformans. Ysa1 is known to control intracellular concentrations of ADP-ribose or O-acetyl-ADP-ribose, and has diverse biological functions, including the response to oxidative stress in the ascomycete yeast, Saccharomyces cerevisiae. In this study, we characterized the role of YSA1 in the stress response and adaptation of the basidiomycete yeast, C. neoformans. We constructed three independent deletion mutants for YSA1, and analyzed their mutant phenotypes. We found that ysa1 mutants did not show increased sensitivity to reactive oxygen species-producing oxidative damage agents, such as hydrogen peroxide and menadione, but exhibited increased sensitivity to diamide, which is a thiol-specific oxidant. Ysa1 was dispensable for the response to most environmental stresses, such as genotoxic, osmotic, and endoplasmic reticulum stress. In conclusion, modulation of YSA1 may regulate the cellular response and adaptation of C. neoformans to certain oxidative stresses and contribute to the evolution of antifungal drug resistance.
Adenosine Diphosphate Ribose ; Ascomycota ; Basidiomycota ; Cryptococcus neoformans* ; Cryptococcus* ; Diamide ; Drug Resistance, Fungal ; Endoplasmic Reticulum Stress ; Hydrogen Peroxide ; Lithospermum ; O-Acetyl-ADP-Ribose ; Oxidative Stress* ; Oxygen ; Phenotype ; Plants ; Saccharomyces cerevisiae ; Vitamin K 3 ; Yeasts

Hemophilia A is a hemorrhagic disease caused by coagulation factor VIII deficiency. In head and neck cancer surgery, especially during a reconstructive one, complications can occur. These include hematomas due to bleeding which can then lead to flap ischemia, necrosis, and impaired wound healing. There are fewer cases of reconstructive surgery in patients with hemophilia A. Here in we report, a reconstructive surgery that involved mass resection, partial glossectomy (right), selective neck dissection (right, Levels I, II, III, IV), and reconstruction at the lateral arm free flap (left) in a 25-year-old man with hemophilia A. The surgery was successfully performed without any complications after pretreatment with Factor VIII concentrate, which has not been reported earlier.

Hemophilia A is a hemorrhagic disease caused by coagulation factor VIII deficiency. In head and neck cancer surgery, especially during a reconstructive one, complications can occur. These include hematomas due to bleeding which can then lead to flap ischemia, necrosis, and impaired wound healing. There are fewer cases of reconstructive surgery in patients with hemophilia A. Here in we report, a reconstructive surgery that involved mass resection, partial glossectomy (right), selective neck dissection (right, Levels I, II, III, IV), and reconstruction at the lateral arm free flap (left) in a 25-year-old man with hemophilia A. The surgery was successfully performed without any complications after pretreatment with Factor VIII concentrate, which has not been reported earlier.

A 7-year-old girl visited the Samsung Medical Center emergency room for primary tooth aspiration during primary tooth extraction under conscious sedation with N2O. The patient showed no signs of respiratory complications.Chest radiography and CT revealed a tooth in the right bronchi. Foreign body removal using rigid bronchoscopy was performed on the day of aspiration. With close monitoring of the airway in the pediatric ICU, extubation was performed the next day, and the patient was discharged the same day. The primary objective of this case report was to highlight the potential risk of aspiration associated with the use of N2O gas for conscious sedation.

BACKGROUND: Over the last decade, the incidence of ultraviolet B (UVB)-related skin problems has increased. Oxidative stress caused by UVB induces the secretion of melanocyte growth and activating factors from keratinocytes, which results in the formation of cutaneous hyperpigmentation. Therefore, increasing the antioxidant abilities of skin cells is thought to be a beneficial strategy for the development of sunscreen agents. Superoxide dismutase 1 (SOD1) is an antioxidant enzyme that is known to exhibit antioxidant properties. OBJECTIVE: The purpose of this study was to investigate the effect of SOD1 on alpha-melanocyte stimulating hormone (alpha-MSH) and UVB-induced melanogenesis in B16F10 melanoma cells and HRM-2 melanin-possessing hairless mice. METHODS: The inhibitory effect of SOD1 on tyrosinase activity was evaluated in a cell-free system. Additional experiments were performed using B16F10 melanoma cells to demonstrate the effects of SOD1 in vitro, and HRM-2 melanin-possessing hairless mice were used to evaluate the antimelanogenic effects of SOD1 in vivo. RESULTS: We found that SOD1 inhibited melanin production in a dose-dependent manner without causing cytotoxicity in B16F10 melanoma cells. SOD1 did not inhibit tyrosinase activity under cell-free conditions. The results indicate that SOD1 may reduce pigmentation by an indirect, nonenzymatic mechanism. We also found that SOD1 decreased UVB-induced melanogenesis in HRM-2 melanin-possessing hairless mice, as visualized through hematoxylin and eosin staining and Fontana-Masson staining. CONCLUSION: Our results indicate that SOD1 has an inhibitory effect on alpha-MSH and UVB-induced melanogenesis, indicating that SOD1 may be a promising sunscreen agent.
alpha-MSH ; Animals ; Cell-Free System ; Eosine Yellowish-(YS) ; Hematoxylin ; Hyperpigmentation ; Incidence ; Keratinocytes ; Melanins ; Melanocytes ; Melanoma ; Mice ; Mice, Hairless ; Monophenol Monooxygenase ; Oxidative Stress ; Pigmentation ; Skin Pigmentation ; Skin* ; Superoxide Dismutase*

Objective: Bisphenol A (BPA) is a widely produced synthetic chemical used to manufacture polycarbonate plastics and epoxy resins. We aimed to investigate the association between exposure to BPA and behavioral and cognitive function in children with attention-deficit/hyperactivity disorder (ADHD) and healthy controls. Methods: The study included 444 children aged from 6 to 10 years. The ADHD and control groups included 195 and 249 children, respectively. BPA levels were assessed via urinalysis, while behavior was assessed using the Korean version of the ADHD Rating Scale (K-ARS) and the Behavior Assessment System for Children (BASC-2). Cognitive function was assessed using the Continuous Performance Test (i.e., ADHD Diagnostic System [ADS]). Participants were categorized into tertile groups based on urinary BPA concentration. Results: Scores on the K-ARS and the hyperactivity, aggression, anxiety, and depression subscales of the BASC-2 were significantly different among tertile groups for urinary BPA levels. Scores on visual omission error, commission error, response time variability, and auditory commission error of the ADS were significantly different among three BPA groups. Subgroup analysis revealed that these differences of behavior and cognition among three BPA groups were observed in only boys and normal controls. Conclusion Exposure to BPA was associated with unfavorable behavioral and cognitive outcomes. Our study extends the findings of previous studies regarding the association between BPA exposure and behavior/cognitive function by including children with ADHD. Further studies are required to determine the mechanisms underlying sex- and group-based differences in these associations.

Background: Complications from osteoradionecrosis (ORN) and medication-related osteonecrosis of the jaw (MRONJ) include oro-cutaneous fistulas, necrotic bone exposure, soft-tissue defects, and pathologic fractures. The fibula free flap (FFF) is a common free flap method used to reconstruct the mandible in severe cases. Recently, we have used the FFF successfully for the reconstruction of ORN and MRONJ mandibular defects. We report this method as a recommended technique for the treatment of ORN and MRONJ and the management method of postoperative infections. Methods: Four patients who were diagnosed with ORN of the mandible and 3 patients who were diagnosed with MRONJ of the mandible were included in the study. Among the 7 patients, 3 patients also had pathologic fractures. Partial mandibulectomy and FFF reconstruction were performed at the Department of Oral and Maxillofacial Surgery, Samsung Medical Center from April 2019 to March 2021. Results: All 7 patients recovered following the reconstruction of the defect by FFF. Four patients experienced infections after surgery and pus cultures were performed. All were well healed without flap damage after changing the antibiotics by consultation with infectious medicine experts. Conclusion FFF is a widely used method and can provide an extensive flap to reconstruct the mandible, especially those affected by ORN or MRONJ. If an infection occurs after surgery, appropriate antibiotic changes should be made through cooperation with the infectious medicine department. Therefore, FFF is a well-established and recommended method even in cases of challenging reconstruction.