Background: The management of dental plaque and the appropriate use of oral hygiene tools are crucial for oral health. Withincreasing interest in oral health care, various oral hygiene products are available on the market. As the most basic oral hygiene tool, the large-head toothbrush has gained significant consumer interest. This study evaluates the suitability of large-head toothbrushes as oral hygiene tools by comparing their efficacy with that of regular-sized toothbrushes. Methods: We evaluated the efficacy of large-head and regular-sized toothbrushes. The amount of dental plaque before and afterbrushing was measured using quantitative light-induced fluorescence digital (QLF-D) images and the plaque index (PI) in adult participants with more than 28 teeth (n=15/group). After brushing, the collected toothbrushes were rinsed 10 times in clean water, thoroughly dried, and weighed on an electronic scale. Data were analyzed using the Wilcoxon signed-rank test with SPSS Statistics Version 29.0. Results: QLF-D analysis showed a significant decrease in fluorescence intensity scores after use of a regular-sized toothbrush,whereas the scores after use of a large-head toothbrush were not significantly reduced. PI measurements indicated significant reductions in dental plaque for both head types. However, detailed analysis by tooth surface revealed that the regular-sized toothbrush significantly reduced plaque on the proximal, palatal/lingual, and labial/buccal surfaces. In contrast, the large-head toothbrush only showed significant reductions in place on the proximal and palatal/lingual surfaces, not on the labial/buccal surface. Additionally, compared to the regular-sized toothbrush, the large-head toothbrush retained more toothpaste residue despite similar cleaning efforts after brushing. Conclusion Compared to the regular-sized toothbrush, the large-head toothbrush showed lower overall efficacy in dentalplaque removal. The results of this study provide significant information regarding the use of large-head toothbrushes.

Purpose: To evaluate the effectiveness of an instrument devised for slit-lamp examination of donor corneas suspended in preservation medium. Methods: The study examined two donor corneas received at Yeouido St. Mary's Hospital in February 2023 and March 2023. The instrument has three main components: a plastic holder to hold the preservation medium bottle, a cube with a mirror for reflecting the slit beam, and a stand to attach the device to the slit-lamp. Using the instrument, the donor corneas were examined via slit-lamp: microscopy with the endothelium facing upward and downward. Specular microscopy and anterior segment optical coherence tomography (OCT) were also performed on the preserved donor corneas. Results: Slit-lamp examination of donor corneas in preservation medium using the instrument showed overall corneal buttoning and optical sections of the donor cornea. Using specular reflection and retroillumination, the endothelial layer was partially visible. However, specular microscopy and anterior segment OCT could not examine the donor cornea in preservation medium using the instrument. Conclusions The devised instrument facilitates slit-lamp examination of donor corneas in preservation medium, enabling a qualitative assessment of donor corneas before corneal transplantation surgery.

Purpose: In the present study, we introduce human lacrimal gland imaging using an ultrasound biomicroscopy (UBM) with a soft cover and show their findings Methods: The representative UBM findings of palpebral lobes in seven subjects (four with non-Sjögren dry eye syndrome, one with Sjögren syndrome, and two healthy subjects) were described in this study. To prolapse the palpebral lobe, the examiner pulled the temporal part of the upper eyelid in the superotemporal direction and directed the subject to look in the inferonasal direction. We scanned the palpebral lobes longitudinally and transversely using UBM. We used an Aviso UBM with a 50 MHz linear probe and ClearScan. Results: In UBM of two healthy subjects, the echogenicity of the lacrimal gland was lower than that of the sclera and homogeneous. But the parenchyma of a patient with Sjögren dry eye syndrome was quite inhomogeneous compared to the healthy subjects. In two patients with dry eye syndrome, we were able to observe some lobules in the parenchyma. We could find excretory ducts running parallel at the surface of the longitudinal section in some subjects. In the longitudinal UBM scan of a subject, we observed a tubular structure at a depth of 1,500 μm that was considered a blood vessel. It ran from the superonasal to the inferotemporal direction. In a subject, we observed a large cyst beneath the conjunctiva. Conclusions Lacrimal gland imaging using UBM has both advantages of optical coherence tomography and sonography, and could be useful for evaluating dry eye syndrome.

Purpose: To introduce an intuitive method for measuring conjunctival microvascular blood flow velocity by imaging bulbar conjunctival microvessels using a slit-lamp biomicroscope equipped with a zoom lens and an ultra-high-speed camera. Methods: After obtaining consent from 10 patients (1 male, 9 females) who visited Yeouido St. Mary’s Hospital from August 21, 2020, to June 12, 2021, the patients were examined under a slit lamp microscope equipped with an ultra-high-speed camera and zoom lens. The blood flow in the conjunctival microvessels was photographed. The captured images were analyzed with ImageJ software to measure the blood flow velocity in the conjunctival microvessels, and we investigated whether the blood flow velocity correlated with the vessel diameter and age. Results: The median age of the subjects was 49.0 years. The mean conjunctival blood flow velocity in 53 microvessels was 0.786 ± 0.468 mm/s. The median conjunctival microvascular diameter was 7.06 μm (interquartile range 5.84 to 9.23 μm). The conjunctival microvascular diameter and blood flow velocity were not significantly correlated (Spearman’s p = 0.177), and the subjects’ age and conjunctival microvascular blood flow velocity were also not correlated (Spearman’s p = 0.669). Conclusions In this study, the blood flow velocity in the bulbar conjunctival microvessels could be measured easily by means of image analysis using a slit-lamp microscope equipped with an ultra-high-speed camera with a zoom lens.

Carcinosarcoma is a highly malignant tumor characterized by dual malignant histologic differentiation of epithelial and mesenchymal components, which rarely occurs in the maxillary sinus. We experienced a case of carcinosarcoma mixed with a keratinizing squamous cell carcinoma and an osteosarcoma arising from the right maxillary sinus recently. A 55-year-old male patient presented with right nasal obstruction and epistaxis. The initial punch biopsy revealed a high-grade sarcoma, favoring an osteosarcoma. After general evaluation, the patient was staged as cT4aN0M0. The patient was treated by right total maxillectomy, radiotherapy, and chemotherapy. We present with a review of the literature a case of a carcinosarcoma originating from the right maxillary sinus that had invaded into the orbital cavity and protruded into the nasal cavity.

Purpose: Cluster analysis on pediatric asthma identifying a cluster characterized by obesity, females, and puberty showed that obesity is an independent risk factor for severe asthma in this cluster. In the present study, we aimed to investigate the effect of overweight/obesity on lung function and asthma severity in prepubertal asthmatic children. Methods: One hundred fifty-five prepubertal children (aged 6–10) with asthma were enrolled and divided into 2 groups: the overweight/obese group (body mass index [BMI] ≥ 85th percentile, n = 44) and the normal BMI group ( < 85th percentile, n = 111). We reviewed their medical records and analyzed whether there were any differences in clinical features, lung function and degree of bronchial hyperresponsiveness (BHR) between the 2 groups. The clinical factors associated with asthma severity were also investigated. Results: There was no difference in clinical features between the 2 groups. Pulmonary function tests showed that only forced vital capacity in 1 second/forced vital capacity (FEV1/FVC) was significantly lower in the overweight/obese group than in the normal BMI group (P = 0.032). There was no difference in dysanapsis and BHR between the 2 groups. There were significantly more children with moderate-to-severe asthma in the overweight/obese group compared to the normal BMI group (P = 0.018). In multivariate logistic regression analysis, overweight/obesity has been identified as an independent risk factor of affecting asthma severity (odds ratio, 2.44; P = 0.018), in addition to the already known risk factor, FEV1. Conclusion Our study showed that overweight/obese prepubertal asthmatic children had lower FEV1/FVC than those with normal BMI. It also suggests that overweight/obesity may be an independent risk factor for severe asthma before puberty.

Objectives: . Facial nerve monitoring (FNM) can be used to identify the facial nerve, to obtain information regarding its course, and to evaluate its status during parotidectomy. However, there has been disagreement regarding the efficacy of FNM in reducing the incidence of facial nerve palsy during parotid surgery. Therefore, instead of using electromyography (EMG) to identify the location and state of the facial nerve, we applied an intraoperative neuromonitoring (IONM) system using a surface pressure sensor to detect facial muscle twitching. The objective of this study was to investigate the feasibility of using the IONM system with a surface pressure sensor to detect facial muscle twitching during parotidectomy. Methods: . We evaluated the stimulus thresholds for the detection of muscle twitching in the orbicularis oris and orbicularis oculi, as well as the amplitude and latency of EMG and the surface pressure sensor in 13 facial nerves of seven rabbits, using the same stimulus intensity. Results: . The surface pressure sensor detected muscle twitching in the orbicularis oris and orbicularis oculi in response to a stimulation of 0.1 mA in all 13 facial nerves. The stimulus threshold did not differ between the surface pressure sensor and EMG. Conclusion . The application of IONM using a surface pressure sensor during parotidectomy is noninvasive, reliable, and feasible. Therefore, the IONM system with a surface pressure sensor to measure facial muscle twitching may be an alternative to EMG for verifying the status of the facial nerve.

Objective: Adults with autism spectrum disorders (ASD) experience significant difficulties with executive functioning (EF) and related adaptive skills, yet the lack of interventions in South Korea targeting these areas has resulted in a heightened need to develop an evidence- based program. Therefore, we developed a novel intervention aiming to enhance everyday EF and daily adaptive skills in adults with high-functioning ASD and conducted a pilot study to evaluate the validity and feasibility of the program. Methods: A behavioral intervention of 10-weekly sessions was developed based on literature searches and focus group interviews. Seven adults with high-functioning ASD (mean age=20.29) participated in a single-group pilot trial. We used self and parent-report questionnaires as well as skills measured by assessment instruments to analyze differences before and after the intervention. Results: Significant improvements were shown in everyday EF, including time management, organization, self-restraint, and regulation of emotions. Additionally, results demonstrated an enhancement in adaptive functioning, especially in the subdomains of daily living skills. Analyses of parental outcomes only revealed a significant decrease in the scores of emotion regulation. Conclusion The current study provides good evidence for the validity and feasibility of an intervention to improve everyday EF and adaptive skills in adults with ASD.

Objective: Adults with autism spectrum disorders (ASD) experience significant difficulties with executive functioning (EF) and related adaptive skills, yet the lack of interventions in South Korea targeting these areas has resulted in a heightened need to develop an evidence- based program. Therefore, we developed a novel intervention aiming to enhance everyday EF and daily adaptive skills in adults with high-functioning ASD and conducted a pilot study to evaluate the validity and feasibility of the program. Methods: A behavioral intervention of 10-weekly sessions was developed based on literature searches and focus group interviews. Seven adults with high-functioning ASD (mean age=20.29) participated in a single-group pilot trial. We used self and parent-report questionnaires as well as skills measured by assessment instruments to analyze differences before and after the intervention. Results: Significant improvements were shown in everyday EF, including time management, organization, self-restraint, and regulation of emotions. Additionally, results demonstrated an enhancement in adaptive functioning, especially in the subdomains of daily living skills. Analyses of parental outcomes only revealed a significant decrease in the scores of emotion regulation. Conclusion The current study provides good evidence for the validity and feasibility of an intervention to improve everyday EF and adaptive skills in adults with ASD.

Paramolar tubercle is a rare developmental dental anomaly defined as an additional cusp occurring on the buccal or lingual sur-faces of the molar. Permanent molar fused with paramolar tubercles can be a cause of difficulty in root canal treatment. Therefore, proper understanding of these variations is important in order to ensure successful endodontic treatment. Cone beam computed tomography (CBCT) can be helpful to understand anatomy of complicated cases. This case report describes nonsurgical endodontictreatment of maxillary second premolar fused with paramolar tubercle.