Procedures for treatment of molar furcation invasion defects range from open flap debridement, apically repositioned flap surgery, hemisection, tunneling or extraction, to regenerative therapies using bone grafting or guided tissue regenerative therapy, or a combination of both. Several clinical evaluations using regenerative techniques have reported the potential for osseous repair of treated furcation invasions. Regenerative treatment of maxillary molars are more difficult due to the multiple root anatomy and multiple furcation entrances therefore, purpose of this study was to evaluated histologically compomer and Ketac Silver as a barrier in the treatment of a bi-furcated maxillary premolar. Five adult beagle dogs were used in this experiment. With intrasulcular and crestal incision, mucoperiosteal flap was elevated. Following decortication with 1/2 high speed round bur, furcation defect was made on maxillary premolar. 2 month later one premolar was filled with compomer and the other premolar was filled with Ketac Silver. After 4, 8 weeks, the animals were sacrificed by vascular perfusion. Tissue block was excised including the tooth and prepared for light microscope with H-E staining. Results were as follows. 1. Compomer & Ketac Silver restoration were encapsulated fine connective tissue. 2. In 4 weeks, compomer & Ketac Silver restoration slightly infiltrated inflammatory cells but not disturb the new bone or new cementum formation. 3. In 8 weeks, compomer & Ketac Silver restoration were less infiltrated inflammatory cell and encapsulated fine connective tissue. 4. Therefore, compomer & Ketac Silver filling to the grade III maxillary furcations with multiple root anatomy and multiple furcation entrances is possible clinical method and this technique is useful method for maxillary furcation involvement but it is thought that periodic maintenace should be needed
Adult ; Animals ; Bicuspid ; Bone Transplantation ; Cermet Cements* ; Connective Tissue ; Debridement ; Dental Cementum ; Dogs* ; Furcation Defects ; Humans ; Molar ; Perfusion ; Tooth

Generally, if the size of a lip cancer defect exceeds 30% of the lower lip, a local flap or free flap is recommended. However, defects up to 50% of the lower lip in size have been reconstructed successfully by primary closure without a local flap or free flap. In one case, an 80-year-old male farmer who had smoked for more than 50 years presented with squamous cell carcinoma of the lower lip and underwent mass resection and supraomohyoid neck dissection. The defect accounted for almost 2/3 of the lower lip and was repaired by primary closure with V-shaped resection. Biopsy results confirmed pT2N0cM0 stage II disease with clear margins. In another case, a 68-year-old male also presented with squamous cell carcinoma of the lower lip and underwent mass resection. The defect accounted for about half the size of the lower lip but was repaired by primary closure with V-shaped resection.Both patients experienced no discomfort while eating or speaking and were satisfied with the cosmetic and functional outcomes with no evidence of recurrence. Thus, direct closure can be considered even in large lower lip cancers.

The lung nodule is one of the pleuropulmonary menifestations in rheumatoid arthritis. We report here a case exhibiting hydropneumothorax due to a bronchoplerual fistula resulting from a ruptured rheumatoid lung nodule complicated with a aspergilloma in it. A 39 year-old man with rheumatoid arthritis was admitted because of cough for one month. Multiple subcutaneous nodules were noted and multiple lung nodules were seen on chest X-ray, Peripheral white cells were 9,600/mm3 with 1896 of eosinophils. The percutaneous needle aspiration biopsy of the largest lung nodule of right upper lobe showed massive necrosis without acid fast bacillus, fungus, or malignant cell. Three months after discharge, air-meniscus sign was seen on the biopsied lung nodule on X-ray. Five months later, the patient was readmitted due to dyspnea and chest pain and simple chest X-ray showed hydropneumothorax on the right side. The pneumothorax was not healed after closed thoracotomy and tube drainage, and high fever developed. The pleural fluid culture revealed Pseudomonas aeroginosa and Aspergillus fumigatus. Seventy days after admission, exploratory thoracotomy was done. Aspergilloma was found in the cavitated lung nodule which was ruptured into the pleural cavity through bronchopleural fistula.
Adult ; Arthritis, Rheumatoid* ; Aspergillus fumigatus ; Bacillus ; Biopsy, Needle ; Chest Pain ; Cough ; Drainage ; Dyspnea ; Eosinophilia* ; Eosinophils ; Fever ; Fistula* ; Fungi ; Humans ; Hydropneumothorax ; Lung* ; Necrosis ; Needles ; Pleural Cavity ; Pneumothorax ; Pseudomonas ; Thoracotomy ; Thorax

Patients with severe coronavirus disease 2019 (COVID-19) demonstrate dysregulated immune responses including exacerbated neutrophil functions. Massive neutrophil infiltrations accompanying neutrophil extracellular trap (NET) formations are also observed in patients with severe COVID-19. However, the mechanism underlying severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-induced NET formation has not yet been elucidated.Here we show that 2 viral proteins encoded by SARS-CoV-2, the nucleocapsid protein and the whole spike protein, induce NET formation from neutrophils. NET formation was ROSindependent and was completely inhibited by the spleen tyrosine kinase inhibition. The inhibition of p38 MAPK, protein kinase C, and JNK signaling pathways also inhibited viral protein-induced NET formation. Our findings demonstrate one method by which SARSCoV-2 evades innate immunity and provide a potential target for therapeutics to treat patients with severe COVID-19.

Fibrous dysplasia (FD) accompanying osteomyelitis (OM) has been reported to result in recurrent, refractory pain and swelling. Although radical resection of the lesions has been suggested, effective surgical treatment strategies have not yet been established due to the limited number of studies on this pathological condition. In this report, we present the conservative surgical management of FD accompanying OM in two patients who exhibited recurrent signs and symptoms. The present report suggests that OM occurring in patients with FD can be successfully managed with conservative surgical treatment and following removal of the odontogenic origin although bone defect in which inflammatory fibro-osseous lesions is removed through decompression surgery may exhibit regeneration of dysplastic bone. In addition, for the prevention of OM in patients with FD, careful clinical examination and thorough management of dental-related pathologies are necessary with regular follow-up examinations to screen for the possibility of malignant changes.

Objectives: The objective of this study is to compare a nutritionally balanced soft blend diet (SBD) with a soft fluid diet (SFD) on the health of inpatients who have undergone oral and maxillofacial (OMF) surgery, ultimately aiming to enhance care outcomes, improve healthrelated quality of life (QOL), and increase satisfaction with the hospital. Methods: Thirty-two patients were randomized into two groups: sixteen received SFD and sixteen received SBD. Anthropometric, laboratory evaluations were conducted upon admission and discharge. Patients filled out questionnaires on demographics, diet satisfaction, food intake amount, and health-related QOL on the day of discharge, assessed using the EuroQoL 5 Dimensions 3 Level and EuroQoL Visual Analogue Scale (EQ-VAS) instruments. Data were analyzed with descriptive statistics, χ 2 tests for group differences, and paired nonparametric t-tests for within-group comparisons. The Mann-Whitney U test evaluated inter-group differences in preoperative weight and body mass index (BMI), postoperative changes, meal satisfaction, intake, health-related QOL, and self-assessed health status. P-values were set at a significance level of 0.05. Results: The SBD group had higher dietary intake (63.2% vs. 51.0%) and greater diet satisfaction (80.6 vs. 48.1, P < 0.0001) compared to SFD group. Health-related QOL, measured by EQ-VAS, was better in SBD group (70.3 vs. 58.8, P < 0.05). Postoperative weight and BMI decreased in SFD group but increased in SBD group (P < 0.01). Changes in laboratory results showed more stability in the SBD group. No postoperative infections were reported in SBD group, whereas SFD group had a 31.25% complication rate. Conclusions While SFD is often recommended after OMF surgery to protect oral wound healing process, our study reveals that SBD not only enhances physical and psychological outcomes but also, somewhat unexpectedly, supports wound healing and reduces complications. Essentially, SBD promotes physical recovery and enhances health-related QOL than SFD by supporting both somatic and mental healing aspects.

PURPOSE: According to the 2005 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care, unconscious adult patients with ROSC after out-of-hospital cardiac arrest should be cooled to between 32degrees C and 34degrees C for 12 to 24 hours. Two recent randomized controlled trials that included comatose survivors of cardiac arrest have documented that therapeutic hypothermia improved the neurological recovery. (ED note: Newer cooling devices have recently been introduced, such as endovascular...?)We have introduced newer devices, such as endovascular cooling devices, so we compared endovascular cooling with the previously used surface cooling Methods. METHODS: This is a cohort study of patients with ROSC (>24hours) after cardiac arrest and who were admitted to the intensive care unit in a tertiary hospital over a twentyeight month period from September 2006 to December 2008 and they had received therapeutic hypothermia. The patients'baseline characteristics, the mortality, the neurologic outcomes, the side effects during therapeutic hypothermia and other factors were evaluated according to the cooling methods. RESULTS: Seventy-five patients were included over a 28 month period. Surface cooling methods were used in 37 patients, and endovascular cooling methods were used in 38 patients. There were no significant differences of the mortality and the neurologic outcome according to the cooling methods (p=0.973, 0.937). The time from collapse to reaching therapeutic hypothermia was 587.14+/-384.18 minutes for surface cooling and 496.24+/-213.83 minutes for endovascular cooling (p=0.105). The rewarming time was 451.09+/-229.93 minutes and 802.38+/-209.09 minutes for each cooling method, respectively, and the difference was statistically significant (p=0.002). There were no significant differences of the side effects during therapeutic hypothermia between the surface and endovascular cooling methods. CONCLUSION: Endovascular cooling methods are useful to maintain the target temperature within a narrower range and these methods have the advantage of automatic feedback control of the temperature and controlled rewarming. There were no significant differences in mortality, the neurologic outcome and other side effects between the surface and endovascular cooling methods during therapeutic hypothermia after cardiac arrest.
Adult ; American Heart Association ; Brain ; Cardiopulmonary Resuscitation ; Cohort Studies ; Coma ; Emergencies ; Heart Arrest ; Humans ; Hypothermia ; Imidazoles ; Intensive Care Units ; Nitro Compounds ; Out-of-Hospital Cardiac Arrest ; Rewarming ; Survivors ; Tertiary Care Centers ; Unconscious (Psychology)

According to improved radiation therapy technology such as IMRT and proton therapy, the accuracy of patient alignment system is more emphasized and IGRT is dominated research field in radiation oncology. We proposed to study the feasibility of cone-beam CT system using simple x-ray imaging systems for image guided proton therapy at National Cancer Center. 180 projection views (2,304x3,200, 14 bit with 127 micrometer pixel pitch) for the geometrical calibration phantom and humanoid phantoms (skull, abdomen) were acquired with 2degrees step angle using x-ray imaging system of proton therapy gantry room (360degrees for 1 rotation). The geometrical calibration was performed for misalignments between the x-ray source and the flat-panel detector, such as distances and slanted angle using available algorithm. With the geometrically calibrated projection view, Feldkamp cone-beam algorithm using Ram-Lak filter was implemented for CBCT reconstruction images for skull and abdomen phantom. The distance from x-ray source to the gantry isocenter, the distance from the flat panel to the isocenter were calculated as 1,517.5 mm, 591.12 mm and the rotated angle of flat panel detector around x-ray beam axis was considered as 0.25degrees. It was observed that the blurring artifacts, originated from the rotation of the detector, in the reconstructed toomographs were significantly reduced after the geometrical calibration. The demonstrated CBCT images for the skull and abdomen phantoms are very promising. We performed the geometrical calibration of the large gantry rotation system with simple x-ray imaging devices for CBCT reconstruction. The CBCT system for proton therapy will be used as a main patient alignment system for image guided proton therapy.
Abdomen ; Artifacts ; Axis, Cervical Vertebra ; Calibration ; Cone-Beam Computed Tomography ; Humans ; Isothiocyanates ; Proton Therapy ; Protons ; Radiation Oncology ; Skull

The purpose of this study was to compare physical and biodegradable properties of 3D printed resorbable membranes that are used for guided tissue regenerations in periodontal tissues. Three types of 3D printed membranes (two types of non β-TCP and one type of β-TCP) were considered. The form and element compositions of 3D printed membranes were analyzed by field-emission scanning electron microscopy (FE-SEM) with energy-dispersive X-ray spectroscopy (EDS). Porosity and pore size were measured using Micro-CT. Also, tensile strength, biodegradability tests were performed. Statistical analyses were carried in tensile strength and cell viability test (p<0.05). The result of SEM images with EDS analyses showed linear layers of lattice structure with presence of C and O in all groups. There was a slight difference in Ca and P among some groups. Tensile strength was significantly different among all groups (p<0.05), and biodegradability showed that the group containing β-TCP resulted in the fastest degradation rate. Therefore, the results of this study concluded that the 3D printed resorbable membrane has variable physical and biodegradable properties for clinical use, where such information would be useful to be considered for the future development of related products and clinical application of the products.

The purpose of this study was to compare physical and biodegradable properties of 3D printed resorbable membranes that are used for guided tissue regenerations in periodontal tissues. Three types of 3D printed membranes (two types of non β-TCP and one type of β-TCP) were considered. The form and element compositions of 3D printed membranes were analyzed by field-emission scanning electron microscopy (FE-SEM) with energy-dispersive X-ray spectroscopy (EDS). Porosity and pore size were measured using Micro-CT. Also, tensile strength, biodegradability tests were performed. Statistical analyses were carried in tensile strength and cell viability test (p<0.05). The result of SEM images with EDS analyses showed linear layers of lattice structure with presence of C and O in all groups. There was a slight difference in Ca and P among some groups. Tensile strength was significantly different among all groups (p<0.05), and biodegradability showed that the group containing β-TCP resulted in the fastest degradation rate. Therefore, the results of this study concluded that the 3D printed resorbable membrane has variable physical and biodegradable properties for clinical use, where such information would be useful to be considered for the future development of related products and clinical application of the products.