Objective: The study explores the long-term impacts of traumatic brain injury (TBI) on neuroinflammation and neuronal apoptosis in pediatric and adult mice, focusing on how age at injury influences these processes. Methods: Controlled cortical impacts were used to induce TBI in pediatric (21–25 days old) and adult (8–12 weeks old) C57BL/6 male mice. Neuroinflammation was evaluated by measuring immunoreactivity for allograft inflammatory factor 1 (AIF-1)/ionized calcium-binding adaptor molecule 1 (Iba-1) and glial fibrillary acidic protein (GFAP), while apoptosis was assessed using markers such as B-cell lymphoma 2 (Bcl-2)-associated X protein (Bax), Bcl-2, and procaspase-3. Additionally, heat shock protein 70 (HSP70) expression was measured to understand the stress response. Results: Following controlled cortical impacts, pediatric mice exhibited a significant reduction in expression of neuronal nuclei (P<0.001), and significant increases in expression of GFAP (P<0.01) and AIF-1/Iba-1 (P<0.05) at 3 days post-injury (DPI) compared with sham controls. In contrast, adult mice exhibited no significant change in AIF-1/Iba-1 expression and a less pronounced increase in GFAP (P<0.05) at 3 DPI compared with sham controls. A more significant increase in Bax/Bcl-2 ratio at 7 DPI (P<0.01) was seen in pediatric mice, while a weak but significant increase in Bax/Bcl-2 ratio at 7 DPI (P<0.05) was evident in adults. Both age groups showed a significant but transient increase in HSP70 levels at 7 DPI, which normalized by 90 DPI. Conclusion Pediatric and adult mice exhibited significant time-dependent differences in neuroinflammation and apoptosis following TBI, with pediatric mice showing more intense early responses indicative of age-specific vulnerabilities in post-injury outcomes. Both age groups showed a significant but transient increase in HSP70 expression, suggesting an acute response to stress post-injury.

An implant-supported hybrid prosthesis is a fixed restoration composed of a metal framework and acrylic resin, offering advantages such as aesthetics, function, phonetics, and lip support, while providing retention and support through the splinting of implants with the metal framework. However, poor oral hygiene can lead to peri-implantitis, and long-term use may result in wear or fracture of the artificial teeth, causing reduced masticatory function and loss of vertical dimension. Traditionally, a new metal framework is cast for remanufacturing, but if the existing framework is intact, it can be reused for a more rapid and simplified protocol. This case involves a 58-year-old male patient with peri-implantitis, where some implants were removed and treated, and the superstructure was remanufactured using the existing metal framework. By preserving the existing metal framework during the remanufacturing of the implant-supported hybrid prosthesis, the treatment time and number of visits were reduced, minimizing patient discomfort.

An implant-supported hybrid prosthesis is a fixed restoration composed of a metal framework and acrylic resin, offering advantages such as aesthetics, function, phonetics, and lip support, while providing retention and support through the splinting of implants with the metal framework. However, poor oral hygiene can lead to peri-implantitis, and long-term use may result in wear or fracture of the artificial teeth, causing reduced masticatory function and loss of vertical dimension. Traditionally, a new metal framework is cast for remanufacturing, but if the existing framework is intact, it can be reused for a more rapid and simplified protocol. This case involves a 58-year-old male patient with peri-implantitis, where some implants were removed and treated, and the superstructure was remanufactured using the existing metal framework. By preserving the existing metal framework during the remanufacturing of the implant-supported hybrid prosthesis, the treatment time and number of visits were reduced, minimizing patient discomfort.

An implant-supported hybrid prosthesis is a fixed restoration composed of a metal framework and acrylic resin, offering advantages such as aesthetics, function, phonetics, and lip support, while providing retention and support through the splinting of implants with the metal framework. However, poor oral hygiene can lead to peri-implantitis, and long-term use may result in wear or fracture of the artificial teeth, causing reduced masticatory function and loss of vertical dimension. Traditionally, a new metal framework is cast for remanufacturing, but if the existing framework is intact, it can be reused for a more rapid and simplified protocol. This case involves a 58-year-old male patient with peri-implantitis, where some implants were removed and treated, and the superstructure was remanufactured using the existing metal framework. By preserving the existing metal framework during the remanufacturing of the implant-supported hybrid prosthesis, the treatment time and number of visits were reduced, minimizing patient discomfort.

An implant-supported hybrid prosthesis is a fixed restoration composed of a metal framework and acrylic resin, offering advantages such as aesthetics, function, phonetics, and lip support, while providing retention and support through the splinting of implants with the metal framework. However, poor oral hygiene can lead to peri-implantitis, and long-term use may result in wear or fracture of the artificial teeth, causing reduced masticatory function and loss of vertical dimension. Traditionally, a new metal framework is cast for remanufacturing, but if the existing framework is intact, it can be reused for a more rapid and simplified protocol. This case involves a 58-year-old male patient with peri-implantitis, where some implants were removed and treated, and the superstructure was remanufactured using the existing metal framework. By preserving the existing metal framework during the remanufacturing of the implant-supported hybrid prosthesis, the treatment time and number of visits were reduced, minimizing patient discomfort.

An implant-supported hybrid prosthesis is a fixed restoration composed of a metal framework and acrylic resin, offering advantages such as aesthetics, function, phonetics, and lip support, while providing retention and support through the splinting of implants with the metal framework. However, poor oral hygiene can lead to peri-implantitis, and long-term use may result in wear or fracture of the artificial teeth, causing reduced masticatory function and loss of vertical dimension. Traditionally, a new metal framework is cast for remanufacturing, but if the existing framework is intact, it can be reused for a more rapid and simplified protocol. This case involves a 58-year-old male patient with peri-implantitis, where some implants were removed and treated, and the superstructure was remanufactured using the existing metal framework. By preserving the existing metal framework during the remanufacturing of the implant-supported hybrid prosthesis, the treatment time and number of visits were reduced, minimizing patient discomfort.

Purpose: We aimed to evaluate whether pediatric emergency practice has improved since the introduction of pediatric specialist care (PSC). Methods: Retrospective observational study was conducted using the data retrieved from the emergency department (ED) of a tertiary university hospital in Cheongju, Korea. Patients younger than 19 years who visited the ED from January 2019 through December 2023 were enrolled in this study. Hospitalization (overall and intensive care unit [ICU]), in-hospital mortality, and return visit within 24 hours were compared between the periods before (January 2019-January 2021) and after (June 2021-December 2023) the introduction of PSC. Adjusted odds ratios with 95% confidence intervals were calculated for the outcomes using multivariable logistic regression. Results: During the study period, a total of 36,162 patients visited the ED. The visits increased from 12,196 before to 22,387 after the introduction of PSC (increase by 83.6%). Annual numbers of the visits have increased since 2020 and reached 10,942 in 2023. After the introduction of PSC, decreases were noted in the hospitalization (adjusted odds ratio, 0.67; 95% confidence interval, 0.62-0.72) and return visit within 24 hours (0.73; 0.61-0.88). Hospitalization to the ICU increased (2.90; 2.29-3.69), while there was no significant difference in the in-hospital mortality (1.31; 0.77-2.25). Conclusion After the introduction of PSC, overall hospitalization and return visit decreased, while hospitalization to the ICU increased without a difference in the in-hospital mortality. Multidisciplinary efforts are needed to continue providing the pediatric specialist-centered emergency practice.

Cochlear implantation is the treatment of choice for patients with profound sensorineural hearing loss. Neurofibromatosis type II is a multiple tumor syndrome caused by gene mutation, and MRI is necessary for follow up. When patients with cochlear implantation undergo MRI, pain, dislocation of the device, and artifacts of the image are common problems. The degree of image artifacts may vary depending on the implant position. We report a case of neurofibromatosis type II diagnosed in a patient, who received cochlear implantation in a position most optimal for observation of vestibular schwannoma via MRI.

Objective: Resuscitation-related gastric inflation is associated with inadequate ventilation and the risk of gastric regurgitation in out-of-hospital cardiac arrest (OHCA) patients. This study aims to estimate resuscitation-related gastric inflation values by using multi-detector computed tomography (MDCT) scanning. Methods: MDCT imaging data were obtained from OHCA patients undergoing resuscitation from January 2014 to December 2020. Thirty age- and sex-matched healthy controls that underwent an MDCT scan were included. Gastric air volume (GAV), total gastric volume (TGV), and GAV/gastric content volume (GCV) ratio values were estimated. Results: In healthy controls (n=30), GAV and TGV values were in the range 5.0-35.0 mL, and 202.0-1,002.0 mL, respectively. The mean GAV and TGV values of OHCA patients (n=97) were 251.0 mL (range, 55.5-896.0) and 878.0 mL (range, 430.5-1,696.0), respectively. Significant between-group differences were determined in the mean GCV, GAV, and GAV/GCV ratio values. In OHCA patients, the cut-off value for abnormal GAV was defined as 56.5 mL (mean value plus two times standard deviation). Patients with abnormal GAV findings on MDCT scans had a longer duration from arrest to the return of spontaneous circulation, low body mass index, and increased rates of lactic acidosis. Conclusion Our results indicate an association between gastric air accumulation after resuscitation with longer recovery from arrest to return of spontaneous circulation, low body mass index, and increased lactic acidosis.

Objectives: Given that cardiopulmonary resuscitation (CPR) is an aerosol-generating procedure, it is necessary to use a mechanical ventilator and reduce the number of providers involved in resuscitation for in-hospital cardiac arrest in coronavirus disease (COVID-19) patients or suspected COVID-19 patients. However, no study assessed the effect of changes in inspiratory time on flowrate and airway pressure during CPR. We herein aimed to determine changes in these parameters during CPR and identify appropriate ventilator management for adults during CPR. Methods: We measured changes in tidal volume (Vt), peak inspiratory flow rate (PIFR), peak airway pressure (Ppeak), mean airway pressure (Pmean) according to changes in inspiratory time (0.75 s, 1.0 s and 1.5 s) with or without CPR. Vt of 500 mL was supplied (flowrate: 10 times/min) using a mechanical ventilator. Chest compressions were maintained at constant compression depth (53 ± 2 mm) and speed (102 ± 2/min) using a mechanical chest compression device. Results: Median levels of respiratory physiological parameters during CPR were significantly different according to the inspiratory time (0.75 s vs. 1.5 s): PIFR (80.8 [73.3 – 87.325] vs. 70.5 [67 – 72.4] L/min, P < 0.001), Ppeak (54 [48 – 59] vs. 47 [45 – 49] cmH2O, P < 0.001), and Pmean (3.9 [3.6 – 4.1] vs. 5.7 [5.6 – 5.8] cmH2O, P < 0.001). Conclusions Changes in PIFR, Ppeak, and Pmean were associated with inspiratory time. PIFR and Ppeak values tended to decrease with increase in inspiratory time, while Pmean showed a contrasting trend. Increased inspiratory time in low-compliance cardiac arrest patients will help in reducing lung injury during adult CPR.