Patients with disabilities have difficulties tolerating in-office dental treatment due to limitations relating to cooperation and/or physical problems. Therefore, they often require general anesthesia or sedation to facilitate safe treatment. When deciding on dental treatment under general anesthesia, the plan should be carefully determined because compared to general patients, patients with disabilities are more likely to experience anesthetic complications because of their underlying medical conditions and potential drug interactions. Clinicians prefer simpler and more aggressive dental treatment procedures, such as extraction, since patients with impairment have difficulty maintaining oral hygiene, resulting in a high incidence of recurrent caries or restorative failures. This study aimed to review the available literature and discuss what dentists and anesthesiologists should consider when providing dental treatment to patients with severe disability under general anesthesia.

Background: Patients with disabilities often require general anesthesia for dental treatment because of their cooperative or physical problems. Since most patients with disabilities take central nervous system drugs, the management of recovery status is important because of drug interactions with anesthetics. Methods: The anesthesia records of patients under general anesthesia for dental treatment were reviewed, and data were collected. Healthy patients under general anesthesia for dental phobia or severe gagging reflex were designated as the control group. Patients with disabilities were divided into two groups: those not taking any medication and those taking antiepileptic medications. The awakening time was evaluated in 354 patients who underwent dental treatment under general anesthesia (92 healthy patients, 183 patients with disabilities, and 79 patients with disabilities taking an antiepileptic drug). Based on the data recorded in anesthesia records, the awakening time was calculated, and statistical processes were used to determine the factors affecting awakening time. Results: Significant differences in awakening time were found among the three groups. The awakening time from anesthesia in patients with disabilities (13.09 ± 5.83 min) (P < 0.0001) and patients taking antiepileptic drugs (18.18 ± 7.81 min) (P < 0.0001) were significantly longer than in healthy patients (10.29 ± 4.87 min). Conclusion The awakening time from general anesthesia is affected by the disability status and use of antiepileptic drugs.

Background: Patients with disabilities often require general anesthesia for dental treatment because of their cooperative or physical problems. Since most patients with disabilities take central nervous system drugs, the management of recovery status is important because of drug interactions with anesthetics. Methods: The anesthesia records of patients under general anesthesia for dental treatment were reviewed, and data were collected. Healthy patients under general anesthesia for dental phobia or severe gagging reflex were designated as the control group. Patients with disabilities were divided into two groups: those not taking any medication and those taking antiepileptic medications. The awakening time was evaluated in 354 patients who underwent dental treatment under general anesthesia (92 healthy patients, 183 patients with disabilities, and 79 patients with disabilities taking an antiepileptic drug). Based on the data recorded in anesthesia records, the awakening time was calculated, and statistical processes were used to determine the factors affecting awakening time. Results: Significant differences in awakening time were found among the three groups. The awakening time from anesthesia in patients with disabilities (13.09 ± 5.83 min) (P < 0.0001) and patients taking antiepileptic drugs (18.18 ± 7.81 min) (P < 0.0001) were significantly longer than in healthy patients (10.29 ± 4.87 min). Conclusion The awakening time from general anesthesia is affected by the disability status and use of antiepileptic drugs.

BACKGROUND: Mycobacterial antigens released as PIM, LM, LAM, lipoproteins and other cellular factors may contribute to macrophage and dendritic cell activation through pattern recognition receptors such as TLRs. In this study, we assessed cytokine production and ERK activation with stimulation of several major mycobacterial antigens. METHODS: Purified mycobacterial antigens (10, 22, 30, 38kappaDa) and recombinant antigens (6, 16, 19, 38kappaDa, Ag85A antigen) were studied. The production of cytokines (TNF-alpha, IL-12, IL-6) was measured by ELISA. The ERK activation was detected by western blotting. The expression of TLR2 or TLR4 was measured by flow cytometry. RESULTS: Among purified antigens only 30kappaDa antigen induced production of IL-6 or TNF-alpha in THP-1 macrophage cells. When THP-1 macrophage cells were treated with 30kappaDa antigen, phosphorylation of ERK was detected. ERK activation also occurred in TLR2 transfectant HEK293 cells with 30kappaDa antigen stimulation. CONCLUSION: 30kappaDa antigen is one of the major mycobacterial antigens inducing cytokine production and MAP kinases phosphorylation in macrophages.
Blotting, Western ; Cytokines ; Dendritic Cells ; Enzyme-Linked Immunosorbent Assay ; Flow Cytometry ; HEK293 Cells ; Interleukin-12 ; Interleukin-6* ; Lipoproteins ; Macrophages* ; Phosphorylation ; Phosphotransferases ; Receptors, Pattern Recognition ; Tumor Necrosis Factor-alpha*

This case report discusses the approach and considerations involved in retrieving a fractured implant abutment screw. A 69-year-old male patient presented with a dislodged implant prosthesis caused by a fractured abutment screw. The fracture occurred at the most apical portion of the screw, specifically in the threaded region, making its retrieval particularly challenging. The screw was successfully removed using a commercially available retrieval kit. The effectiveness of the kit was attributed to a guide that allowed the retrieval instrument to align precisely with the long axis of the implant. Without such a guide, a risk of damaging the internal threads of the implant fixture exists, potentially leading to the need for implant removal. Therefore, using a retrieval kit with a guide or fabricating a custom-made guide is crucial for preventing implant damage and ensuring proper alignment during the procedure.

This case report discusses the approach and considerations involved in retrieving a fractured implant abutment screw. A 69-year-old male patient presented with a dislodged implant prosthesis caused by a fractured abutment screw. The fracture occurred at the most apical portion of the screw, specifically in the threaded region, making its retrieval particularly challenging. The screw was successfully removed using a commercially available retrieval kit. The effectiveness of the kit was attributed to a guide that allowed the retrieval instrument to align precisely with the long axis of the implant. Without such a guide, a risk of damaging the internal threads of the implant fixture exists, potentially leading to the need for implant removal. Therefore, using a retrieval kit with a guide or fabricating a custom-made guide is crucial for preventing implant damage and ensuring proper alignment during the procedure.

This case report discusses the approach and considerations involved in retrieving a fractured implant abutment screw. A 69-year-old male patient presented with a dislodged implant prosthesis caused by a fractured abutment screw. The fracture occurred at the most apical portion of the screw, specifically in the threaded region, making its retrieval particularly challenging. The screw was successfully removed using a commercially available retrieval kit. The effectiveness of the kit was attributed to a guide that allowed the retrieval instrument to align precisely with the long axis of the implant. Without such a guide, a risk of damaging the internal threads of the implant fixture exists, potentially leading to the need for implant removal. Therefore, using a retrieval kit with a guide or fabricating a custom-made guide is crucial for preventing implant damage and ensuring proper alignment during the procedure.

Ginsenosides are the major components of ginseng, which is known to modulate blood pressure, metabolism, and immune function, and has been used to treat various diseases. It has been reported that ginseng and several ginsenosides have immunoregulatory effects on the innate and T cell-mediated immune response. However, their effects on the humoral immune response have not been fully explored. The present study examined the direct effects of red ginseng extract (RGE) and ginsenosides on mouse B cell proliferation and on antibody production and the expression of germline transcripts (GLT) by mouse B cells in vitro. RGE slightly reduced B cell proliferation, but increased IgA production by LPS-stimulated B cells. Furthermore, ginsenoside Rg1 and 20(S)-Rg3 selectively induced IgA production and expression of GLTalpha transcripts by LPS-stimulated B cells. Collectively, these results suggest that ginsenoside Rg1 and 20(S)-Rg3 can drive the differentiation of B cells into IgA-producing cells through the selective induction of GLTalpha expression.
Animals ; Antibody Formation ; B-Lymphocytes* ; Blood Pressure ; Cell Proliferation ; Ginsenosides ; Immunity, Humoral ; Immunoglobulin A* ; Metabolism ; Mice* ; Panax

BACKGROUND: In an effort to find alternative therapeutic agents to prevent excessive fibrosis as a sequela to complicated parapneumonic effusion or empyema, we examined the effect of tissue plasminogen activator (tPA) as a fibrinolytic agent combined with talc or transforming growth factor (TGF)-beta1 in a human pleural mesothelial cell line, MeT-5A. METHODS: MeT-5A cells were stimulated with various doses of talc, doxycycline or TGF-beta1 for 24 h and then were treated with tPA for an additional 24 h. Cell viability was measured by MTT assay. The production of interleukin (IL)-8 and vascular endothelial growth factor (VEGF) in the culture supernatants was measured by ELISA. Real-time PCR was carried out for measurement of type I collagen mRNA. RESULTS: MeT-5A cells treated with talc showed a dose-dependent increase in production of IL-8. Talc also increased production of type I collagen mRNA at low doses, but talc did not influence the induction of VEGF. Addition of tPA to talc-stimulated cells showed further increases in the production of IL-8, but tPA did not influence the production of VEGF or type I collagen mRNA. TGF-beta1 increased the production of both VEGF and collagen type I mRNA, both of which were effectively inhibited by additional tPA treatment in MeT-5A cells. CONCLUSION: TGF-beta1 is a potent inducer of collagen synthesis without induction of IL-8 in MeT-5A cells. Addition of tPA after TGF-beta1 stimulation inhibited further fibrosis by direct inhibition of collagen mRNA synthesis as well as by inhibition of VEGF production.
Cell Line ; Cell Survival ; Collagen ; Collagen Type I ; Doxycycline ; Empyema ; Enzyme-Linked Immunosorbent Assay ; Epithelium ; Fibrosis ; Humans ; Interleukin-8 ; Interleukins ; Real-Time Polymerase Chain Reaction ; RNA, Messenger ; Talc ; Tissue Plasminogen Activator ; Transforming Growth Factor beta1 ; Transforming Growth Factors ; Vascular Endothelial Growth Factor A