Meningioma arises from arachnoid cap cells and is a common intracranial neoplasm; however, primary extracranial meningioma is rare, accounting for only 1%–2% of cases and is therefore frequently misdiagnosed. We report a case of primary extracranial meningioma arising in the temporal region without intracranial or dural involvement. A 66-year-old woman presented with a slowly enlarging mass in the left temporal region for approximately 10 years, without pain or limitation of mouth opening. Computed tomography revealed a 2.1× 2.7× 4.6 cm mass between the temporalis muscle and the skull, with no intracranial extension. Fine-needle aspiration suggested a spindle-cell neoplasm, and complete excision was performed via a coronal scalp incision for diagnosis and treatment. Histopathologic and immunohistochemical examination confirmed a World Health Organization grade II extracranial meningioma. The patient recovered without complications. Postoperative magnetic resonance imaging showed no residual tumor, and adjuvant radiotherapy was not administered. Surveillance imaging every 6 months demonstrated no recurrence over 3.5 years. This case highlights the importance of including extracranial meningioma in the differential diagnosis of temporal masses and supports complete excision as effective management. A brief literature review is included.

Pressure sores are frequently observed in chronically bedridden patients. When body position is not changed regularly, a single ulcer may develop in the area subjected to constant pressure, such as the sacral or trochanteric region; one habitual position usually results in one sore. The simultaneous presence of pressure sores on the sacrum and both trochanteric regions in a single patient is uncommon, and their reconstruction is challenging. A 48-year-old male paraplegic patient with three pressure sores on the pelvis was referred. The sores involved the sacral and bilateral trochanteric regions and were complicated by infection, including osteomyelitis. Serial flap coverage was staged according to wound readiness and the resolution of infection. First, the right trochanteric sore was reconstructed using a perforator-based island flap (PBIF). After 9 days, the sacral sore was reconstructed with another PBIF. After an additional 20 days, the left trochanteric sore was covered using a pedicled anterolateral thigh musculocutaneous flap. All flaps were selected based on lesion size and condition and survived without major complications. When reconstructing multiple sores in one patient, establishing a clear strategy is essential. The order of reconstruction, appropriate intervals between procedures, and optimal flap selection are key considerations.

Reconstructing Fournier’s gangrene is particularly challenging because it rapidly leads to soft tissue necrosis that requires extensive debridement. This often results in a large soft tissue defect with dead space due to structural irregularity. We report two cases of Fournier’s gangrene successfully reconstructed using a pedicled anterolateral thigh (ALT) flap with a chimeric pattern. A 61-year-old man with Fournier’s gangrene presented with extensive necrosis in the penoscrotal area. After radical debridement and infection control, the wound was reconstructed using a chimeric pattern pedicled ALT flap. The flap was composed of fasciocutaneous and muscle components supplied by branch vessels from the main pedicle. The fasciocutaneous component adequately resurfaced the defect, and the muscle component filled in the dead space between the two testes. A 58-year-old man with Fournier’s gangrene on the penoscrotal area also underwent reconstruction using the same method. In both cases, the flaps survived without any major complications and the reconstructions were successful with no recurrence of infection. When reconstructing Fournier’s gangrene, a trapezoidal-shaped dead space between the two testes is inevitable. Inadequate obliteration of this space may result in recurrent infection. An ALT flap with a chimeric pattern offers an adequate option for resurfacing and dead space obliteration.

Purpose: We examined the progression of experimental peri-implantitis in sites that underwent either alveolar ridge preservation (ARP) or spontaneous healing (SH), comparing infected teeth (IT) and non-infected teeth (NIT). This investigation is a secondary analysis of a preclinical study aimed at exploring the correlation between newly formed bone and implant stability quotient (ISQ), as well as the association between newly formed bone and the progression of experimental peri-implantitis. Methods: The bilateral mandibular third or fourth premolars of 6 beagle dogs were randomly assigned to 4 groups: IT/SH, IT/ARP, NIT/SH, and NIT/ARP. Following implant placement, core biopsies were retrieved from each site, and the ISQ value was measured. A 3-month period was allowed for peri-implantitis induction, followed by an additional 3 months for the spontaneous progression of peri-implantitis, with radiographs taken at each time point. Results: During the spontaneous progression of peri-implantitis, no statistically significant differences were observed among the groups in terms of mean ISQ values and radiographic marginal bone loss. Similarly, the percentages of bone substitute, newly formed bone, and fibrovascular connective tissue in core biopsies did not differ significantly among the groups.Linear regression analysis revealed no significant linear correlation between newly formed bone and ISQ in any group (P>0.05). However, a weak linear correlation between newly formed bone and marginal bone loss during the spontaneous progression of peri-implantitis was noted in the IT/SH group alone (P=0.036). Conclusions Within the limitations of this study, we were unable to demonstrate that ARP could improve newly formed bone or primary implant stability. Furthermore, neither ARP nor SH significantly influenced the spontaneous progression of experimental peri-implantitis.

Purpose: This study aimed to analyze the bone regeneration and biosorption patterns of different bone substitutes in a rabbit skull defect model. Methods: Four circular 8 mm-defects were created in the cranium of 12 New Zealand white rabbits, each weighing approximately 3 kg. Each defect was randomly assigned to one of 4 treatment groups: cortical deproteinized porcine bone mineral (DPBM), cancellous DPBM, biphasic calcium phosphate (BCP) with a 6:4 ratio of hydroxyapatite (HA) to β-tricalcium phosphate (β-TCP) (TCP4), and BCP with a 2:8 ratio of HA to β-TCP (TCP8). The rabbits were euthanized at either 6 weeks (n=6) or 12 weeks (n=6) post-surgery. The harvested specimens were then analyzed both radiographically and histomorphometrically. Results: In the micro-computed tomography analysis, no statistically significant differences were observed among the 4 groups, except in the bone graft volume/tissue volume (GV/TV) at 12 weeks. Cortical DBPM exhibited a higher GV/TV ratio than cancellous DBPM at the same time point. The histomorphometric analysis revealed increased biosorption in cancellous DBPM compared to cortical DBPM at 12 weeks. However, the percentage of newly formed bone did not significantly differ among the 4 groups. Conclusions All types of bone substitutes demonstrated similar patterns of bone regeneration at both 6 and 12 weeks of observation. However, cancellous DPBM exhibited a higher rate of bioabsorption compared to other bone substitutes, suggesting that it may have different indications or applications in guided bone regeneration protocols.

A 12-year-old, spayed female Pekingese dog was presented with frequent syncope and exercise intolerance. Thoracic auscultation revealed a grade 4 heart murmur bilaterally and respiratory sinus arrhythmia. Electrocardiography indicated right axis deviation, suggesting right ventricular hypertrophy. Thoracic radiographs showed normal vertebral heart score of 9, vertebral left atrial size of 2.1, and intercostal space of 3.2, with an increased contact area between the sternum and right heart. Echocardiography revealed moderate tricuspid regurgitation and severe pulmonary hypertension (velocity 4.48 m/s; pressure gradient 80.4 mmHg). Based on diagnostic findings, congenital shunts, left-sided heart disease, tracheobronchial disease, pulmonary embolism, and heartworm disease were excluded, leading to a diagnosis of right-sided heart failure secondary to brachycephalic obstructive airway syndrome, with the characteristic narrow nostrils observed in the pekingese breed. The initial treatment with sildenafil citrate, along with pimobendan, enalapril maleate, and furosemide for right-sided heart failure, failed to improve syncope or pulmonary hypertension after three months. Beraprost sodium, a prostacyclin analog, was added, resulting in significant improvement in syncope despite unchanged echocardiographic findings (velocity 4.42 m/s; pressure gradient 78.2 mmHg). Clinical improvements persisted for 12 months with a regimen of sildenafil citrate (3 mg/kg PO bid) and beraprost sodium (20 µg/kg PO bid).

A 10-year-old spayed female Toy Poodle dog presented with nasal edema, erythema, pain, pruritus, and discharge. The size of the lesion had gradually increased, measuring 29 × 22.8 × 17.8 mm at the first visit. No infection was detected on microscopic cytologic evaluation of the nasal discharge. On radiography and computed tomography (CT), the nasal septum structure was normal, and bony invasion was not identified. On rhinoscopy, the soft tissues were thickened and erythematous. Decreased lumen diameter and severe congestion were found in the right nasal cavity. On histopathological examination of the right dorsal nasal skin lesion, there was multifocal-to-coalescing moderate-to-severe inflammation and fibrosis in the deep dermis and skeletal muscle layer. The inflammatory cells were primarily lymphocytes and plasma cells. Based on the patient history and test results, the patient was diagnosed with canine dermatomyositis. Treatment included immunosuppressive agents (prednisolone and cyclosporine) and antibiotics (amoxicillin/clavulanate). This treatment reduced the nasal edema, erythema, and lesion size. The diameter of the edematous area decreased by approximately 40%, with an 80% reduction in nasal discharge, and the dog demonstrated clinical benefits at a follow-up visit at 17 weeks. Although canine dermatomyositis usually develops before six months of age, this report demonstrates that this disease can also occur in adult dogs. Additionally, this is the first reported case of a dermatomyositis-like disease in a small breed dog which was histologically diagnosed and further characterized using immunohistochemistry, including VEGF and T-cell markers such as CD4 and CD8. The patient showed a favorable response to immunosuppressive therapy.

The use of thermogenic dietary supplements has led to growing concerns about potential adverse health effects. A 19-year-old female patient experienced recurrent blurred vision after consuming thermogenic dietary supplements for 5 weeks and eating only one meal per day. Initial brain imaging showed a lesion at the corpus callosum, which disappeared after a month, and her symptoms resolved within 2 days. The potential risks associated with using thermogenic dietary supplements in combination with intermittent fasting need to be carefully considered.

As the number of coronavirus disease 2019 (COVID-19) patients increased rapidly, the Korean government decided to pay most of the related medical expenses with finances from the National Health Insurance (NHI). We aimed to document changes in NHI medical expenses during the COVID-19 pandemic period. We also sought to compare how Japan and Taiwan, neighboring countries with NHI systems, responded to COVID-19 and to discuss policy implications.

Purpose: Microbiota manipulation through selected probiotics may be a promising tool to prevent cancer development as well as onset, to improve clinical efficacy for cancer treatments. The purpose of this study was to evaluate change in microbiota composition after-probiotics supplementation and assessed the efficacy of probiotics in improving quality of life (QOL) in postoperative cancer patients. Methods: Stool samples were collected from 30 cancer patients from February to October 2020 before (group I) and after (group II) 8 weeks of probiotics supplementation. We performed 16S ribosomal RNA gene sequencing to evaluate differences in gut microbiota between groups by comparing gut microbiota diversity, overall composition, and taxonomic signature abundance. The health-related QOL was evaluated through the EORTC Quality of life Questionnaire Core 30 questionnaire. Results: Statistically significant differences were noted in group II; increase of Shannon and Simpson index (P = 0.004 and P = 0.001), decrease of Bacteroidetes and Fusobacteria at the phylum level (P = 0.032 and P = 0.014, retrospectively), increased of beneficial bacteria such as Weissella (0.096% vs. 0.361%, P < 0.004), Lactococcus (0.023% vs. 0.16%, P < 0.001), and Catenibacterium (0.0% vs. 0.005%, P < 0.042) at the genus level. There was a significant improvement in sleep disturbance (P = 0.039) in group II. Conclusion Gut microbiota in cancer patients can be manipulated by specific probiotic strains, result in an altered microbiota. Microbiota modulation by probiotics can be considered as part of a supplement that helps to increase gut microbiota diversity and improve QOL in cancer patients after surgery.