Eruption disturbances of the mandibular first molars can cause multiple problems in occlusal development although they are extremely rare. Early diagnosis and treatment are very important to prevent complications associated with eruption disturbances. The present case report describes the treatment of two cases of eruption disturbances of the mandibular first permanent molar. A fixed appliance composed of a cantilever spring with mandibular second deciduous molar as an anchor tooth was used to tract the impacted mandibular first permanent molar. The success of both cases shows that this novel traction appliance can be used to induce the eruption of an impacted mandibular first permanent molar within a short time in patients with intact mandibular second deciduous molar as an anchor tooth.

This study aimed to analyze the preoperative factors of immature first molars treated with vital pulp therapy and to find out their correlation in pediatric patients. From May 2014 to January 2020, 523 patients and 1,242 immature first molars were investigated. Factors including age, sex, tooth location, Molar-incisor hypomineralization (MIH), caries cavity location, and history of previous restoration were evaluated. As a result of the study, the vital pulp therapy group had 5.56 times more MIH, 3.39 times more mesial cavities, and 8.73 times more distal cavities. In order to avoid vital pulp therapy in immature first molar, early diagnosis and active management of MIH and preventive treatment of mesial and distal caries are necessary after its immediate eruption.

Cerebrospinal fluid (CSF) rhinorrhea can be caused by head trauma, brain or sinus surgery, or neoplastic sinonasal disease. There are many diverse techniques for repairing skull base defects, and recently there has been a shift from using external approaches to endoscopic approaches. The reported success rate after endoscopic repair is 97%, but CSF rhinorrhea may recur in some cases. Recently, we witnessed one case of recurrent CSF rhinorrhea from the posterior wall of the frontal sinus after a traffic accident. The patient was a 48-year-old male and had recurrent CSF rhinorrhea, severe pneumocephalus and mental change even after a CSF leakage repair operation was performed by the neurosurgeon using the periosteal flap. We successfully treated recurrent frontal CSF rhinorrhea with fat graft and mucosal graft, using the above and below approach with the guidance of a navigation system.
Accidents, Traffic ; Brain ; Cerebrospinal Fluid Leak* ; Cerebrospinal Fluid Rhinorrhea ; Cerebrospinal Fluid* ; Craniocerebral Trauma ; Frontal Sinus* ; Humans ; Male ; Middle Aged ; Neurosurgeons ; Pneumocephalus ; Skull Base ; Transplants

Eosinophilic gastroenteritis is a member of eosinophilic gastrointestinal (GI) diseases and is characterized by the accumulation of eosinophils within the GI tract. Common symptoms of eosinophilic gastroenteritis are vomiting, abdominal pain, dysphagia, and weight loss, but rare fever in neonate. This report describes a 10-day-old boy who developed fever, bloody mucoid stool, and bilious vomiting resulting from eosinophilic gastroenteritis, mimicking sepsis. Sigmoidoscopy and pathologic findings revealed mucosal edema, small hemorrhagic spot, and segmental erythemoid edema in the colon and increased number of eosinophils in the lamina propria with intraepithelial eosinophils. After breast milk feeding with restriction of milk from the mother for 6 months, specific immunoglobulin to milk was class 0 (class 3, previous). The boy restarted formula feeding, and he had no fever and GI symptoms.
Abdominal Pain ; Colon ; Deglutition Disorders ; Edema ; Eosinophils ; Fever ; Gastroenteritis ; Gastrointestinal Tract ; Humans ; Immunoglobulins ; Infant, Newborn ; Male ; Milk ; Milk, Human ; Mothers ; Mucous Membrane ; Sepsis ; Sigmoidoscopy ; Vomiting ; Weight Loss

BACKGROUND AND OBJECTIVES: The main treatment of laryngopharyngeal reflux disease (LPRD) includes life style modification and proton pump inhibitor (PPI) medication. However, LPRD is sometimes refractory to PPI medication. The Reza band has been developed to exert external pressure on the upper esophageal sphincter thus preventing gastric acid reflux to the larynx and pharynx. The aim of this study was to evaluate safety and efficacy of using the Reza band in patients with LPRD. SUBJECTS AND METHOD: We prospectively enrolled 16 LPRD patients who were refractory to PPI medication and who had agreed to wear the Reza band. Patients were treated with the Reza band and PPI medication simultaneously or only the Reza band. We studied complications related to the Reza band, analyzed Reflux Symptom Index (RSI) and Reflux Finding Score (RFS) before and after the application of the band up to 12 weeks. RESULTS: The Reza band was endured by 15 patients except one patient. One patient (6.25%) ceased wearing the band due to pain and discomfort in the neck. No major complications occurred, except one patient who reported mild neck discomfort when the band was applied. The mean value of RSI before the application of the Reza band was 12.31±6.43, which significantly improved at 8 weeks and 12 weeks (9.17±5.08, p=0.005 and 8.20±5.59, p=0.007, respectively) post-treatment. The mean value of RFS before the application of the Reza band was 13.50±2.97, which significantly improved at 2, 4, 8, and 12 weeks (p < 0.05) post-treatment. CONCLUSION: We conclude that the Reza band is safe and effective for the treatment of LPRD in properly selected patients.
Esophageal Sphincter, Upper ; Gastroesophageal Reflux ; Humans ; Laryngopharyngeal Reflux* ; Larynx ; Life Style ; Methods ; Neck ; Pharynx ; Prospective Studies ; Proton Pumps

Background: Current international guidelines recommend against deep sedation as it is associated with worse outcomes in the intensive care unit (ICU). However, in Korea the prevalence of deep sedation and its impact on patients in the ICU are not well known. Methods: From April 2020 to July 2021, a multicenter, prospective, longitudinal, noninterventional cohort study was performed in 20 Korean ICUs. Sedation depth extent was divided into light and deep using a mean Richmond Agitation–Sedation Scale value within the first 48 hours. Propensity score matching was used to balance covariables; the outcomes were compared between the two groups. Results: Overall, 631 patients (418 [66.2%] and 213 [33.8%] in the deep and light sedation groups, respectively) were included. Mortality rates were 14.1% and 8.4% in the deep and light sedation groups (P = 0.039), respectively. Kaplan-Meier estimates showed that time to extubation (P < 0.001), ICU length of stay (P = 0.005), and death P = 0.041) differed between the groups. After adjusting for confounders, early deep sedation was only associated with delayed time to extubation (hazard ratio [HR], 0.66; 95% confidence inter val [CI], 0.55– 0.80; P < 0.001). In the matched cohort, deep sedation remained significantly associated with delayed time to extubation (HR, 0.68; 95% 0.56–0.83; P < 0.001) but was not associated with ICU length of stay (HR, 0.94; 95% CI, 0.79–1.13; P = 0.500) and in-hospital mortality (HR, 1.19; 95% CI, 0.65–2.17; P = 0.582). Conclusion In many Korean ICUs, early deep sedation was highly prevalent in mechanically ventilated patients and was associated with delayed extubation, but not prolonged ICU stay or in-hospital death.