Although immune checkpoint inhibitor-related encephalitis has been reported, its underlying mechanism and treatment strategies remain unclear. Here, we present the case of a 60-yearold male patient with small cell lung cancer who developed autoimmune encephalitis during treatment with atezolizumab. Notably, this case involved the concurrent detection of two paraneoplastic autoantibodies (anti-Hu and anti-SOX1). Encephalitis was treated by discontinuing atezolizumab and administering steroids, despite the persistence of the antibodies. This case provides insights into the interaction between immune checkpoint inhibitors and paraneoplastic autoantibodies.

Purpose: A meta-analysis was conducted to determine the proportion of contrast-enhanced ultrasound (CEUS) Liver Imaging Reporting and Data System category M (LR-M) in hepatocellular carcinomas (HCCs) and non-HCC malignancies and to investigate the frequency of individual CEUS LR-M imaging features. Methods: The MEDLINE and Embase databases were searched from January 1, 2016 to July 23, 2020 for studies reporting the proportion of CEUS LR-M in HCC and non-HCC malignancies. The meta-analytic pooled proportions of HCC and non-HCC malignancies in the CEUS LR-M category were calculated. The meta-analytic frequencies of CEUS LR-M imaging features in nonHCC malignancies were also determined. Risk of bias and applicability were evaluated using the Quality Assessment of Diagnostic Accuracy Studies-2 tool. Results: Twelve studies reporting the diagnostic performance of the CEUS LR-M category were identified, as well as seven studies reporting the frequencies of individual CEUS LR-M imaging features. The pooled proportions of HCC and non-HCC malignancies in the CEUS LR-M category were 54% (95% confidence interval [CI], 44% to 65%) and 40% (95% CI, 28% to 53%), respectively. The pooled frequencies of individual CEUS LR-M imaging features in non-HCC malignancies were 30% (95% CI, 17% to 45%) for rim arterial phase hyperenhancement, 79% (95% CI, 66% to 90%) for early (<60 s) washout, and 42% (95% CI, 21% to 64%) for marked washout. Conclusion In total, 94% of CEUS LR-M lesions were malignancies, with HCCs representing 54% and non-HCC malignancies representing 40%. The frequencies of individual CEUS LR-M imaging features varied; early washout showed the highest frequency for non-HCC malignancies.

Immune checkpoint inhibitors (ICIs) including an anti-cytotoxic T-lymphocyte-associated antigen 4 inhibitor, anti-programmed cell death protein 1 (PD-1) inhibitors, and anti-PD-ligand 1 inhibitors are representative therapeutics for various malignancies. In oncology, the application of ICIs is currently expanding to a wider range of malignancies due to their remarkable clinical outcomes. ICIs target immune checkpoints which suppress the activity of T-cells that are specific for tumor antigens, thereby allowing tumor cells to escape the immune response. However, immune checkpoints also play a crucial role in preventing autoimmune reactions. Therefore, ICIs targeting immune checkpoints can trigger various immune-related adverse events (irAEs), especially in endocrine organs. Considering the endocrine organs that are frequently involved, irAEs associated endocrinopathies are frequently life-threatening and have unfavorable clinical implications for patients. However, there are very limited data from large clinical trials that would inform the development of clinical guidelines for patients with irAEs associated endocrinopathies. Considering the current clinical situation, in which the scope and scale of the application of ICIs are increasing, position statements from clinical specialists play an essential role in providing the appropriate recommendations based on both medical evidence and clinical experience. As endocrinologists, we would like to present precautions and recommendations for the management of immune-related endocrine disorders, especially those involving the adrenal, thyroid, and pituitary glands caused by ICIs.

Since the first outbreak of coronavirus disease 2019 (COVID-19), ongoing efforts have been made to discover an efficacious vaccine against COVID-19 to combat the pandemic. In most countries, both mRNA and DNA vaccines have been administered, and their side effects have also been reported. The clinical course of COVID-19 and the effects of vaccination against COVID-19 are both influenced by patients’ health status and involve a systemic physiological response. In view of the systemic function of endocrine hormones, endocrine disorders themselves and the therapeutics used to treat them can influence the outcomes of vaccination for COVID-19. However, there are very limited data to support the development of clinical guidelines for patients with specific medical backgrounds based on large clinical trials. In the current severe circumstances of the COVID-19 pandemic, position statements made by clinical specialists are essential to provide appropriate recommendations based on both medical evidence and clinical experiences. As endocrinologists, we would like to present the medical background of COVID-19 vaccination, as well as precautions to prevent the side effects of COVID-19 vaccination in patients with specific endocrine disorders, including adrenal insufficiency, diabetes mellitus, osteoporosis, autoimmune thyroid disease, hypogonadism, and pituitary disorders.

Calcium hydroxide has been widely used for root canal dressing material in endodontic treatment. This report describes that when the accurate diagnosis and proper nonsurgical endodontic retreatment is applied to periapical lesion with accidentally extruded calcium hydroxide paste, the lesion can be successfully treated. Overfilled calcium hydroxide can affect the healing process, so the overextension of calcium hydroxide agent should be avoided.

Since the first outbreak of coronavirus disease 2019 (COVID-19), ongoing efforts have been made to discover an efficacious vaccine against COVID-19 to combat the pandemic. In most countries, both mRNA and DNA vaccines have been administered, and their side effects have also been reported. The clinical course of COVID-19 and the effects of vaccination against COVID-19 are both influenced by patients’ health status and involve a systemic physiological response. In view of the systemic function of endocrine hormones, endocrine disorders themselves and the therapeutics used to treat them can influence the outcomes of vaccination for COVID-19. However, there are very limited data to support the development of clinical guidelines for patients with specific medical backgrounds based on large clinical trials. In the current severe circumstances of the COVID-19 pandemic, position statements made by clinical specialists are essential to provide appropriate recommendations based on both medical evidence and clinical experiences. As endocrinologists, we would like to present the medical background of COVID-19 vaccination, as well as precautions to prevent the side effects of COVID-19 vaccination in patients with specific endocrine disorders, including adrenal insufficiency, diabetes mellitus, osteoporosis, autoimmune thyroid disease, hypogonadism, and pituitary disorders.

There are several unfavorable conditions regarding alveolar bone condition that may compromise the denture patient's satisfaction. Chewing efficiency may not be satisfactory when alveolar bone is deficient, and the denture stability could hardly be achieved when alveolar bone shape is irregular. Implant overdenture can be useful to provide satisfactory denture experience compared to conventional denture. The attachment for implant overdenture can be classified into bar attachment and solitary attachment. When the positions of the implants are in the mandibular anterior region, bar attachment may be favorable to obtain a rigid support of the entire denture. When implants are distributed both on anterior and posterior region, a solitary attachment could be considered for ease of removal and maintenance. This report presents implant overdenture cases with the patients that had unilateral mandibular alveolar bone atrophy conditions. Different abutments were chosen based on the individual patient's mandibular alveolar bone condition and the treatments were successful in terms of patient satisfaction.
Alveolar Bone Loss ; Atrophy ; Denture Retention ; Denture, Overlay ; Dentures ; Humans ; Mandible ; Mastication ; Patient Satisfaction

When inflammatory products are found in both periodontal and pulpal tissues simultaneously, a periodontal-endodontic combined lesion is established. The treatment of periodontal-endodontic combined lesions includes root canal therapy and periodontal regenerative procedure for resolution of both the apical and marginal inflammatory lesions. The present study reports the treatment of periodontal-endodontic combined lesions in the mandibular anterior area with root canal therapy, followed by guided tissue regeneration therapy. Teeth with severe bone destruction in each case could be preserved, without extraction, over a 3-year period. Therefore, it appears that treatment of periodontal-endodontic combined lesions in the mandibular anterior area using guided tissue regeneration technique after root canal therapy may provide clinical advantages.
Dental Pulp Cavity ; Guided Tissue Regeneration ; Periodontitis ; Root Canal Therapy ; Tooth

In the case of edentulous patients, the total amount of occlusal force is dispersed by the keratinized gingiva during mastication, in result, causing lower masticatory and chewing efficiency. In particular, the mandibular area has more side effects such as pain than the maxilla has. It gets worse when the patient has more absorption of alveolar bone, but the implant treatment is often interrupted due to the existence of the inferior alveolar nerve. In this case, a patient treated with the all-on-4 method by placing the implant in the anterior part of mandible and with the conventional complete denture for the maxilla has maintained without complications and was satisfied with the restoration both functionally and esthetically.
Absorption ; Bite Force ; Denture, Complete ; Gingiva ; Humans ; Mandible ; Mandibular Nerve ; Mastication ; Maxilla ; Methods

Crown fractures are the most frequent traumatic injuries to permanent teeth and mainly involve the maxillary incisors due to their exposed position in the dental arch. One option for managing crown fractures, when the tooth fragment is present and in good condition, is reattachment of the fragment to its original position. This paper reports on three crown fracture cases in which successful esthetic and functional results were achieved by reattachment of the tooth fragment.
Crowns ; Dental Arch ; Incisor ; Tooth