Purpose: In chronic inflammatory diseases, neutrophils release NETs (neutrophil extracellular traps), web-like structures composedof DNA and citrullinated histones, to eliminate bacteria and regulate the inflammatory response. In periodontitis, NETosis acts asa crucial defense mechanism, characterized by the expression of citrullinated histones. This study aims to evaluate the impact ofage and smoking on the expression of citrullinated histones in patients with periodontitis and the feasibility of using saliva for their detection. Materials and Methods: A total of 19 patients participated in the experiment. Among them, 15 were grouped accord-ing to smoking status and age, with 5 patients assigned to each group. After clinical and radiographic examinations, blood sampleswere collected from the subjects, and serum was separated. For 4 subjects, both blood and saliva samples were collected. Thelevels of citrullinated histones in the samples were quantified using an ELISA kit, and the results were compared and statisticallyanalyzed. Results: The concentration of citrullinated histones was significantly higher in younger individuals (P < 0.05). Although the expression of citrullinated histones was higher in the smoking group compared to the non-smoking group, the difference was not statistically significant. In patients with periodontitis, the levels of citrullinated histones detected in saliva were comparable to those found in serum. Conclusion Age may be potential risk factors influencing the expression of citrullinated histones in patients with periodontitis. Additionally, saliva, which is easier to collect, could be used as a viable sample for detecting citrullinated histones in periodontitis patients.

Purpose: In chronic inflammatory diseases, neutrophils release NETs (neutrophil extracellular traps), web-like structures composedof DNA and citrullinated histones, to eliminate bacteria and regulate the inflammatory response. In periodontitis, NETosis acts asa crucial defense mechanism, characterized by the expression of citrullinated histones. This study aims to evaluate the impact ofage and smoking on the expression of citrullinated histones in patients with periodontitis and the feasibility of using saliva for their detection. Materials and Methods: A total of 19 patients participated in the experiment. Among them, 15 were grouped accord-ing to smoking status and age, with 5 patients assigned to each group. After clinical and radiographic examinations, blood sampleswere collected from the subjects, and serum was separated. For 4 subjects, both blood and saliva samples were collected. Thelevels of citrullinated histones in the samples were quantified using an ELISA kit, and the results were compared and statisticallyanalyzed. Results: The concentration of citrullinated histones was significantly higher in younger individuals (P < 0.05). Although the expression of citrullinated histones was higher in the smoking group compared to the non-smoking group, the difference was not statistically significant. In patients with periodontitis, the levels of citrullinated histones detected in saliva were comparable to those found in serum. Conclusion Age may be potential risk factors influencing the expression of citrullinated histones in patients with periodontitis. Additionally, saliva, which is easier to collect, could be used as a viable sample for detecting citrullinated histones in periodontitis patients.

Purpose: In chronic inflammatory diseases, neutrophils release NETs (neutrophil extracellular traps), web-like structures composedof DNA and citrullinated histones, to eliminate bacteria and regulate the inflammatory response. In periodontitis, NETosis acts asa crucial defense mechanism, characterized by the expression of citrullinated histones. This study aims to evaluate the impact ofage and smoking on the expression of citrullinated histones in patients with periodontitis and the feasibility of using saliva for their detection. Materials and Methods: A total of 19 patients participated in the experiment. Among them, 15 were grouped accord-ing to smoking status and age, with 5 patients assigned to each group. After clinical and radiographic examinations, blood sampleswere collected from the subjects, and serum was separated. For 4 subjects, both blood and saliva samples were collected. Thelevels of citrullinated histones in the samples were quantified using an ELISA kit, and the results were compared and statisticallyanalyzed. Results: The concentration of citrullinated histones was significantly higher in younger individuals (P < 0.05). Although the expression of citrullinated histones was higher in the smoking group compared to the non-smoking group, the difference was not statistically significant. In patients with periodontitis, the levels of citrullinated histones detected in saliva were comparable to those found in serum. Conclusion Age may be potential risk factors influencing the expression of citrullinated histones in patients with periodontitis. Additionally, saliva, which is easier to collect, could be used as a viable sample for detecting citrullinated histones in periodontitis patients.

Background: and Purpose Patients with cluster headache (CH) exhibit impaired health-related quality of life (HRQoL). However, there have been few studies related to the HRQoL of patients with CH from Asian backgrounds. This study aimed to determine the impact of CH on HRQoL and to identify the factors affecting HRQoL in patients with CH during cluster periods. Methods: This prospective study enrolled patients with CH from 17 headache clinics in South Korea between September 2016 and February 2021. The study aimed to determine HRQoL in patients with CH using the EuroQol 5 Dimensions (EQ-5D) index and the time trade-off (TTO) method. Age- and sex-matched headache-free participants were recruited as a control group. Results: The study included 423 patients with CH who experienced a cluster period at the time. EQ-5D scores were lower in patients with CH (0.88±0.43, mean±standard deviation) than in the controls (0.99±0.33, p<0.001). The TTO method indicated that 58 (13.6%) patients with CH exhibited moderate-to-severe HRQoL deterioration. The HRQoL states in patients with CH were associated with current smoking patterns, headache severity, frequency, and duration, and scores on the Generalized Anxiety Disorder 7-item scale (GAD-7), Patient Health Questionnaire 9-item scale (PHQ-9), 6-item Headache Impact Test, and 12-item Allodynia Symptom Checklist. Multivariable logistic regression analyses demonstrated that the HRQoL states in patients with CH were negatively correlated with the daily frequency of headaches, cluster period duration, and GAD-7 and PHQ-9 scores. Conclusions Patients with CH experienced a worse quality of life during cluster periods compared with the headache-free controls, but the degree of HRQoL deterioration varied among them. The daily frequency of headaches, cluster period duration, anxiety, and depression were factors associated with HRQoL deterioration severity in patients with CH.

Background: Epinephrine (EPI) or norepinephrine (NOR) is widely used to treat cardiovascular collapse during lipid emulsion (LE) resuscitation for drug toxicity. However, the effect of LE on the vasoconstriction caused by EPI or NOR remains unknown. The purpose of this study was to examine the effect of an LE (Intralipid) on the vasoconstriction caused by EPI and NOR in isolated rat aorta. Methods: The effect of LE on the vasoconstriction caused by EPI or NOR in isolated rat aorta was examined. Additionally, the effect of LE on the calcium increase caused by EPI or NOR was investigated. The distribution constant (KD: lipid to aqueous phase) of EPI or NOR between a LE (1%) and an aqueous phase was determined. Results: LE (1 and 2%) did not significantly alter vasoconstriction caused by EPI or NOR in isolated endothelium-intact aorta. Moreover, the LE did not significantly alter the increased calcium level caused by EPI or NOR. The log KD of EPI in the LE (1%) was −0.71, −0.99, and −1.00 at 20, 50, and 100 mM ionic strength, respectively. The log KD of NOR in the LE (1%) was −1.22, −1.25, and −0.96 at 20, 50, and 100 mM ionic strength, respectively. Conclusions Taken together, the Intralipid emulsion did not alter vasoconstriction induced by EPI or NOR that seems to be due to the hydrophilicity of EPI or NOR, leading to sustained hemodynamic support produced by EPI or NOR used during LE resuscitation.

Currently, lipid emulsion (LE) is widely used to treat local anesthetic systemic toxicity (LAST). LE also ameliorates intractable cardiovascular collapse caused by lipid-soluble non-local anesthetic drug toxicity. This review aims to provide the underlying mechanism of LE resuscitation in drug toxicity (including LAST) and a detailed description of LE treatment and to discuss further research directions. We searched for relevant articles using the following keywords: “local anesthetic systemic toxicity or LAST or toxicity or intoxication or poisoning” and “Intralipid or lipid emulsion”. The underlying mechanisms of LE treatment can be classified into indirect and direct effects. One indirect effect known as the lipid shuttle is a commonly accepted mechanism of LE treatment. The lipid shuttle involves the absorption of highly lipid-soluble drugs (e.g., bupivacaine) from the heart and brain through the lipid phase, which are then delivered to the muscle, adipose tissue, and liver for storage and detoxification. The direct effects include inotropic effects, fatty acid supply, attenuation of mitochondrial dysfunction, glycogen synthase kinase-3β phosphorylation, and inhibition of nitric oxide. These mechanisms appear to act synergistically to treat drug toxicity. The recommended protocol for LE treatment of LAST is as follows: a bolus administration of 20% LE at 1.5 ml/kg over 2–3 min followed by 20% LE at 0.25 ml/kg/min. LAST most commonly occurs after intravenous administration of local anesthetics. However, non-local anesthetic drugs that cause drug toxicity are orally administered. Further studies are needed to determine the optimal dosing schedule of LE treatment for non-local anesthetic drug toxicity.