Background: The coronavirus disease (COVID-19) can manifest in a range of symptoms, including both asymptomatic systems which appear nearly non-existent to the patient, all the way to the development of acute respiratory distress syndrome (ARDS). Specifically, COVID-19–associated pneumonia develops into ARDS due to the rapid progression of hypoxia, and although arterial blood gas analysis can assist in halting this deterioration, the current environment provided by the COVID-19 pandemic, which has led to an overall lack of medical resources or equipment, has made it difficult to administer such tests in a widespread manner. As a result, this study was conducted in order to determine whether the levels of oxygen saturation (SpO2) and the fraction of inhaled oxygen (FiO2) (SF ratio) can also serve as predictors of ARDS and the patient’s risk of mortality. Methods: This was a retrospective cohort study conducted from February 2020 to Mary 2020, with the study’s subjects consisting of COVID-19 pneumonia patients who had reached a state of deterioration that required the use of oxygen therapy. Of the 100 COVID-19 pneumonia cases, we compared 59 pneumonia patients who required oxygen therapy, divided into ARDS and non-ARDS pneumonia patients who required oxygen, and then investigated the different factors which affected their mortality. Results: At the time of admission, the ratios of SpO2, FiO2, and SF for the ARDS group differed significantly from those of the non-ARDS pneumonia support group who required oxygen (p<0.001). With respect to the predicting of the occurrence of ARDS, the SF ratio on admission and the SF ratio at exacerbation had an area under the curve which measured to be around 85.7% and 88.8% (p<0.001). Multivariate Cox regression analysis identified that the SF ratio at exacerbation (hazard ratio [HR], 0.916; 95% confidence interval [CI], 0.846–0.991; p=0.029) and National Early Warning Score (NEWS) (HR, 1.277; 95% CI, 1.010–1.615; p=0.041) were significant predictors of mortality. Conclusion The SF ratio on admission and the SF ratio at exacerbation were strong predictors of the occurrence of ARDS, and the SF ratio at exacerbation and NEWS held a significant effect on mortality.

Malignant intracranial meningioma is a rare pathologic entity. Although the topic is widely discussed, there is little agreement in the literatures as to the histological and radiological features that warrant the diagnosis of malignant meningioma. An osteolytic lesion of the skull may have been suggested in several cases. But in adults, the most commonly suspected lesion is metastatic lesion;while meningioma is rarely suspected. Meningiomas are occasionally associated even with extracranial masses. However, most of these masses are firm, and are caused by hyperostosis. Extracranial soft-tissue masses rarely arise in meningiomas, thus, the presence of both osteolytic skull lesion and soft-tissue mass is exceedingly rare in meningiomas. The authors report a case of osteolytic malignant meningioma located at the frontal fossa extending to the subgaleal space appearing as an extracranial soft-tissue mass in a 19-year-old female. The clinical, radiological, neurosurgical, and histopathological features of these lesions are discussed together with a review of the literatures.
Adult ; Diagnosis ; Female ; Humans ; Hyperostosis ; Meningioma* ; Osteolysis ; Skull ; Young Adult

Endometrial carcinoma has been the most common female pelvic malignancy in the U.S.A. Approximately one-fourth of patient treated for early endometrial cancer will develop reccure-nt disease. Kelly and Baker first descibed that the use of progestational agents for treatment of met- astatic endometrial cancer in 1961. Response of progesterone therapy in metastatic endometrial cancer is related to several factors. Higher response rates are observed in well differentiated tumors, longer disease free interval and tumors that positive for estrogen and progesterone re- ceptors. We experienced a case of complete response in recurrent endometrial cancer to metastasis to lung treated by tamoxifen and progesterone, we present this case with a brief review of lite- rature.
Endometrial Neoplasms* ; Estrogens ; Female ; Humans ; Lung* ; Neoplasm Metastasis* ; Progesterone* ; Progestins ; Tamoxifen*

Brain abscess is a rare, extremely aggressive, life-threatening infection. It may occur following : infection of contiguous structure, hematogenous spread, or cranial trauma/ surgery. Dental pathology and/or treatment have been linked to a small number of brain abscesses as possible source of infection. 50-year-old male patient was presented with a brain abscess caused by Streptococcus viridans. In the case presented, the significant oral findings were chronic periapical and periodontal infection due to root remnant of lower right 3rd molar. A case history and brief literature review of brain abscess related odontogenic infection was presented after successful treatment with antibiotics and craniotomy.
Anti-Bacterial Agents ; Brain Abscess* ; Brain* ; Craniotomy ; Humans ; Male ; Middle Aged ; Molar ; Pathology ; Viridans Streptococci

Brain abscess is a rare, extremely aggressive, life-threatening infection. It may occur following : infection of contiguous structure, hematogenous spread, or cranial trauma/ surgery. Dental pathology and/or treatment have been linked to a small number of brain abscesses as possible source of infection. 50-year-old male patient was presented with a brain abscess caused by Streptococcus viridans. In the case presented, the significant oral findings were chronic periapical and periodontal infection due to root remnant of lower right 3rd molar. A case history and brief literature review of brain abscess related odontogenic infection was presented after successful treatment with antibiotics and craniotomy.
Anti-Bacterial Agents ; Brain Abscess* ; Brain* ; Craniotomy ; Humans ; Male ; Middle Aged ; Molar ; Pathology ; Viridans Streptococci

OBJECTIVES: Corticotropin releasing factor (CRF) plays a primary role in coordinating the neuroendocrine, autonomic, immune and behavioral responses to stress. CRF exerts its action through two major receptors, corticotropin-releasing factor 1 Receptor (CRF-R1) and corticotropin-releasing factor 2 receptor (CRF-R2). Using two types of chronic stress models, we investigated the changes of CRF-R1 mRNA and CRF-R2A mRNA expressions and CRF mRNA in the stress related brain circuit areas. METHODS: Male Sprague-Dawley rats were exposed to either immobilization stress or variable intermittent unpredictable stress for 10 days and then in situ hybridization histochemistry was used to quantify CRF expression in the brain. RESULTS: 1) CRF1 receptor mRNA expressions were decreased in bed nucleus stria terminalis (BNST) following stressors. 2) CRF2A receptor mRNA expressions were increased in lateral septum following stressors. 3) CRF mRNA expressions were increased in central nucleus of amygdala (CeA) and BNST. CONCLUSION: The increased CRF mRNA of CeA and BNST may be related with anxiety response in the repeated stress. Down-regulation of CRF-R1 mRNA expression in BNST may represent a compensatory adaptation to chronic stress and may be involved in the anxiety response, whereas up-regulation of CRF-R2A mRNA expression in lateral septum may represent an anxiety response or impaired learning but the functional meaning is uncertain.
Adrenocorticotropic Hormone* ; Amygdala ; Anxiety ; Brain ; Corticotropin-Releasing Hormone* ; Down-Regulation ; Humans ; Immobilization ; In Situ Hybridization ; Learning ; Male ; Rats, Sprague-Dawley ; Receptors, Corticotropin-Releasing Hormone ; RNA, Messenger ; Up-Regulation

OBJECTIVE: To evaluate the differences in maxillomandibular transverse measurements at either the crown or the estimated center of resistance (CR), and to compare values between normal occlusion and Class III malocclusion groups. METHODS: Dental casts and computed tomography (CT) data from 30 individuals with normal occlusion and 30 with skeletal Class III malocclusions were evaluated. Using the casts, dental arch widths (DAWs) were measured from the cusp tips, and basal arch widths (BAWs-cast) were measured as the distance between the points at the mucogingival junction adjacent to the respective cusp tips. The BAWs determined from CT (BAWs-CT) images were measured from the estimated CRs of the teeth. RESULTS: None of the DAW measurements or maxillomandibular DAW differences showed statistically significant intergroup differences. In contrast, the maxillary BAWs-CT and BAWs-cast were lesser in the Class III malocclusion group than in the normal occlusion group. The mandibular BAWs-CT were significantly greater in the Class III malocclusion group than in the normal occlusion group. Moreover, the maxillomandibular BAW differences on both CT and cast showed significant intergroup differences in all transverse measurements. CONCLUSIONS: The maxillomandibular DAW differences showed no significant intergroup differences. In contrast, the maxillomandibular BAW differences on both CT and cast showed significant intergroup differences in all transverse measurements. The maxillomandibular BAW differences at the estimated CRs, measured using CT or casts, can reveal underlying transverse maxillary basal arch deficiencies in patients with skeletal Class III malocclusions.
Crowns ; Dental Arch ; Humans ; Malocclusion* ; Tooth

Objective: To analyze costs and cost-effectiveness of transforaminal endoscopic thoracic discectomy (TETD) for the treatment of symptomatic thoracic disc herniation (TDH) and compare it with open microdiscectomy (MD). Methods: This retrospective cohort study included patients who underwent TETD or MD for symptomatic TDH and had a minimum follow-up of 1 year. Cost analysis included direct costs (primary and secondary hospital costs), indirect costs (lost wages due to work absence), total costs (direct + indirect), and cost-effectiveness (cost per quality-adjusted life year [QALY] and incremental cost-effectiveness ratio [ICER]). Clinical outcomes included patient-reported outcome measures (Oswestry Disability Index [ODI], 36-item Short Form health survey [SF-36]), QALY gained, and reoperation and readmission rates at 1 year. TETD and MD groups were compared for outcome measures. Results: A total of 111 patients (57 TETD, 54 MD) were included. The direct ($6,270 TETD vs. $7,410 MD, p < 0.01), indirect costs ($1,250 TETD vs. $1,450 MD, p < 0.01), total costs ($7,520 TETD vs. $8,860 MD, p < 0.01), and cost per QALY ($31,333 TETD vs. $44,300 MD, p < 0.01) were significantly lower for TETD compared to MD. ICER of TETD was found to be -$33,500. At 1 year, TETD group showed significantly greater improvement in ODI (46% vs. 36%, p < 0.01) and SF-36 (64% vs. 53%, p < 0.01) and significantly greater QALY gained (0.24 vs. 0.2, p < 0.01) compared to MD group. No significant difference was found in reoperation and readmission rates. Conclusion TETD demonstrated significantly better clinical outcomes, lower overall costs, and better cost-effectiveness than MD in appropriately selected patients of symptomatic TDH.

Objective: To analyze costs and cost-effectiveness of transforaminal endoscopic thoracic discectomy (TETD) for the treatment of symptomatic thoracic disc herniation (TDH) and compare it with open microdiscectomy (MD). Methods: This retrospective cohort study included patients who underwent TETD or MD for symptomatic TDH and had a minimum follow-up of 1 year. Cost analysis included direct costs (primary and secondary hospital costs), indirect costs (lost wages due to work absence), total costs (direct + indirect), and cost-effectiveness (cost per quality-adjusted life year [QALY] and incremental cost-effectiveness ratio [ICER]). Clinical outcomes included patient-reported outcome measures (Oswestry Disability Index [ODI], 36-item Short Form health survey [SF-36]), QALY gained, and reoperation and readmission rates at 1 year. TETD and MD groups were compared for outcome measures. Results: A total of 111 patients (57 TETD, 54 MD) were included. The direct ($6,270 TETD vs. $7,410 MD, p < 0.01), indirect costs ($1,250 TETD vs. $1,450 MD, p < 0.01), total costs ($7,520 TETD vs. $8,860 MD, p < 0.01), and cost per QALY ($31,333 TETD vs. $44,300 MD, p < 0.01) were significantly lower for TETD compared to MD. ICER of TETD was found to be -$33,500. At 1 year, TETD group showed significantly greater improvement in ODI (46% vs. 36%, p < 0.01) and SF-36 (64% vs. 53%, p < 0.01) and significantly greater QALY gained (0.24 vs. 0.2, p < 0.01) compared to MD group. No significant difference was found in reoperation and readmission rates. Conclusion TETD demonstrated significantly better clinical outcomes, lower overall costs, and better cost-effectiveness than MD in appropriately selected patients of symptomatic TDH.

Objective: To analyze costs and cost-effectiveness of transforaminal endoscopic thoracic discectomy (TETD) for the treatment of symptomatic thoracic disc herniation (TDH) and compare it with open microdiscectomy (MD). Methods: This retrospective cohort study included patients who underwent TETD or MD for symptomatic TDH and had a minimum follow-up of 1 year. Cost analysis included direct costs (primary and secondary hospital costs), indirect costs (lost wages due to work absence), total costs (direct + indirect), and cost-effectiveness (cost per quality-adjusted life year [QALY] and incremental cost-effectiveness ratio [ICER]). Clinical outcomes included patient-reported outcome measures (Oswestry Disability Index [ODI], 36-item Short Form health survey [SF-36]), QALY gained, and reoperation and readmission rates at 1 year. TETD and MD groups were compared for outcome measures. Results: A total of 111 patients (57 TETD, 54 MD) were included. The direct ($6,270 TETD vs. $7,410 MD, p < 0.01), indirect costs ($1,250 TETD vs. $1,450 MD, p < 0.01), total costs ($7,520 TETD vs. $8,860 MD, p < 0.01), and cost per QALY ($31,333 TETD vs. $44,300 MD, p < 0.01) were significantly lower for TETD compared to MD. ICER of TETD was found to be -$33,500. At 1 year, TETD group showed significantly greater improvement in ODI (46% vs. 36%, p < 0.01) and SF-36 (64% vs. 53%, p < 0.01) and significantly greater QALY gained (0.24 vs. 0.2, p < 0.01) compared to MD group. No significant difference was found in reoperation and readmission rates. Conclusion TETD demonstrated significantly better clinical outcomes, lower overall costs, and better cost-effectiveness than MD in appropriately selected patients of symptomatic TDH.