Oral lichen planus (OLP) is a chronic inflammatory disease of unknown etiology affecting the oral mucosa. As it is difficult to cure, long-term management aims to improve the patient’s quality of life by reducing inflammation and alleviating pain. While systemic and topical corticosteroids are commonly used treatments, their efficacy is often limited by side effects or poor compliance. This study investigates the effectiveness of intralesional steroid injections (ILIs) in patients resistant to conventional therapies. Two patients with refractory OLP were treated with intralesional triamcinolone acetonide injections administered directly into affected mucosal sites at minimal intervals. Clinical outcomes were assessed over an extended follow-up period using the Numerical Rating Scale (NRS) for pain and evaluations of lesion severity. Both patients exhibited significant and sustained improvements in pain and lesion severity following ILIs treatment. In one case, the NRS score decreased from 8 to 2 over multiple visits, with no additional injections needed in the last 6 months. In the other case, the NRS score improved from 6 to 1, requiring minimal injections for maintenance. The localized treatment was well-tolerated without significant side effects. ILIs are an effective and safe treatment for refractory OLP, offering durable symptom relief while minimizing systemic exposure and associated side effects.This approach provides a practical option for long-term management of OLP, enhancing patient quality of life when conventional therapies are inadequate. Future research should explore the potential of combining ILI with other immunomodulatory agents to further improve therapeutic outcomes.

Trigeminal neuralgia (TN), primarily affecting the maxillary nerve and mandibular nerve, manifests as sudden and severe facial pain without autonomic symptoms such as tearing and ptosis. However, rare cases present with such symptoms, which necessitate differentiation from short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing (SUNCT)/short-lasting unilateral neuralgiform headache attacks with cranial autonomic symptoms (SUNA), as these disorders share similar pain episodes within the trigeminal sensory territory, often including autonomic manifestations. This study aims to clarify distinguishing features and facilitate accurate diagnosis. We report a 63-year-old female presenting with left upper premolar area pain upon infraorbital, zygoma, and upper lip contact. Her pain history followed re-endodontic and prosthodontic treatment of the left upper second premolar, and examination showed electric-like sensations without spontaneous pain. Treatments included anti-inflammatory medications and occlusal adjustments, which proved ineffective. A tentative diagnosis of TN led to treatment with carbamazepine, oxcarbazepine, and baclofen, noting episodic conjunctival injection and asymmetric tongue sensations during severe attacks. This case, marked by touch-evoked, short-duration pain in the maxillary branch and late-emerging mild autonomic symptoms, responded well to carbamazepine, favoring a TN diagnosis over SUNCT/SUNA. The presence of autonomic symptoms in suspected TN cases necessitates careful reevaluation to distinguish from SUNCT/SUNA, particularly when carbamazepine response is suboptimal. Accurate differentiation is crucial for targeted therapy, as medication efficacy varies significantly between these conditions.

A 74-year-old female presented with a complaint of dry mouth, continuous spontaneous burning sensation in the tongue, and asymptomatic submucosal soft tissue mass on both sides of the lower labial mucosa. She refused to undergo total excision of the mass due to concern about the possibility of complications such as nerve damage because of the large size of the mass. As her clinical features and magnetic resonance imaging indicated the possibility of Sjögren’s syndrome, a biopsy of the minor salivary gland of the right lower lip was performed. Consequently, she was diagnosed with mucosa-associated lymphoid tissue (MALT) lymphoma. Although the patient had typical signs and symptoms of Sjögren’s syndrome, the histopathological result of MALT lymphoma made it impossible to determine whether the patient had a history of Sjögren’s syndrome. For patients with risk factors for MALT lymphoma, such as Sjögren’s syndrome, a biopsy of the labial minor salivary gland with immunohistochemical staining can be helpful in the diagnosis of not only Sjögren’s syndrome but also MALT lymphoma.

Objective: The optimal imaging approach for evaluating pathological nipple discharge remains unclear. We investigated the value of adding ductography to ultrasound (US) for evaluating pathologic nipple discharge in patients with negative mammography findings. Materials and Methods: From July 2003 to December 2018, 101 women (mean age, 46.3 ± 12.2 years; range, 23–75 years) with pathologic nipple discharge were evaluated using pre-ductography (initial) US, ductography, and post-ductography US. The imaging findings were reviewed retrospectively. The standard reference was surgery (70 patients) or > 2 years of followup with US (31 patients). The diagnostic performances of initial US, ductography, and post-ductography US for detecting malignancy were compared using the McNemar’s test or a generalized estimating equation. Results: In total, 47 papillomas, 30 other benign lesions, seven high-risk lesions, and 17 malignant lesions were identified as underlying causes of pathologic nipple discharge. Only eight of the 17 malignancies were detected on the initial US, while the remaining nine malignancies were detected by ductography. Among the nine malignancies detected by ductography, eight were detected on post-ductography US and could be localized for US-guided intervention. The sensitivities of ductography (94.1% [16/17]) and post-ductography US (94.1% [16/17]) were significantly higher than those of initial US (47.1% [8/17]; p = 0.027 and 0.013, respectively). The negative predictive value of post-ductography US (96.9% [31/32]) was significantly higher than that of the initial US (83.3% [45/54]; p = 0.006). Specificity was significantly higher for initial US than for ductography and post-ductography US (p = 0.001 for all). Conclusion The combined use of ductography and US has a high sensitivity for detecting malignancy in patients with pathologic nipple discharge and negative mammography. Ductography findings enable lesion localization on second-look post-ductography US, thus facilitating the selection of optimal treatment plans.

Objective: To investigate perceptions of coronavirus disease-19 (COVID-19) associated with anxiety caused by the COVID-19 epidemic in the elderly who are vulnerable to mental health problems. Methods: This study used data of a survey on perceptions of COVID-19 and changes in mental health of 1,000 out of residents in a province of Korea in April 2020. The survey included questions about psychological perceptions for COVID-19. Subjects were dived into two groups (<60 and ≥60). Binary logistic regression analyses were performed for evaluating the association between anxiety and perceptions about COVID-19 in each group. Results: Results of binary logistic regression analyses revealed that only ‘fear of getting infected myself’among perceptions for COVID-19 was associated with anxiety in the elderly aged more than 60 years. However, in adults aged less than 60 years, all perceptions for COVID-19 except impairment of performance were associated with such anxiety. Conclusion We found that the anxiety for COVID-19 in elderly with age over 60 years was associated with ‘fear of getting infected myself’ rather than ‘fear of family or people around them’, unlike adults aged less than 60 years. These results can be applied in strategies for psychological quarantine against COVID-19 among the elderly.

Objective: To investigate perceptions of coronavirus disease-19 (COVID-19) associated with anxiety caused by the COVID-19 epidemic in the elderly who are vulnerable to mental health problems. Methods: This study used data of a survey on perceptions of COVID-19 and changes in mental health of 1,000 out of residents in a province of Korea in April 2020. The survey included questions about psychological perceptions for COVID-19. Subjects were dived into two groups (<60 and ≥60). Binary logistic regression analyses were performed for evaluating the association between anxiety and perceptions about COVID-19 in each group. Results: Results of binary logistic regression analyses revealed that only ‘fear of getting infected myself’among perceptions for COVID-19 was associated with anxiety in the elderly aged more than 60 years. However, in adults aged less than 60 years, all perceptions for COVID-19 except impairment of performance were associated with such anxiety. Conclusion We found that the anxiety for COVID-19 in elderly with age over 60 years was associated with ‘fear of getting infected myself’ rather than ‘fear of family or people around them’, unlike adults aged less than 60 years. These results can be applied in strategies for psychological quarantine against COVID-19 among the elderly.

The aim of this study was to investigate the change of microbial contamination levels in the different areas and at the different time points after application of a quaternary ammonium compound (QAC) that has mechanical antimicrobial effect. The microbial contamination levels were measured in three different areas; unit chair handle, spit sink area and hand piece holder at different time points using adenosine triphosphate (ATP) monitoring system and ATP surface test kit. Hand piece holder showed the highest level of microbial contamination. In most of the clinics, QAC significantly reduced the levels of microbial contamination, and maintained antimicrobial activity for 4 to 6 months. QAC may be used effectively in dental clinics due to the duration of antimicrobial effect and the minimal exposure of chemicals and further studies are needed with large sample size.

Management of migraine, one of common primary headache disorders, involves the diverse strategies non-pharmacological treatment, such as headache diary, lifestyle modification, regular exercise and relaxation, cognitive behavioral therapy and neurostimulation, and pharmacological treatment. Among the treatments, this review described a pharmacologic treatment of migraine, classified into acute and preventive treatment based on the severity and the frequency of headache. It introduced the way to optimize pharmacological treatment and updated the latest treatment for migraine.

PURPOSE: The congenital H-type rectovestibular fistula, a fistula between the anorectum and genital tract besides a normal anus is a rare variant of anorectal deformities. This disease needs proper treatment but there are no standard of diagnosis and treatment. The purpose of this report is to review a 13-year experience of approach and management for H-type rectovestibular fistula at a single institution. METHODS: From February 2002 to August 2015, we cared for 11 patients who had congenital H-type rectovestibular fistula and reviewed their clinical presentation, accompanied anomalies, diagnostic modalities, operative technique, and postoperative progress. RESULTS: Most patients with H-type rectovestibular fistula presented with symptoms including vestibular defecation and major labial abscess. We could find the fistula tract in most of patients by fistulography using contrast dye. All of the patients had been operated. There were 2 recurrences after surgical treatment who had inflammation and infection associated with the fistula. All other patients recovered without complications. CONCLUSION: We think the operation including fistulectomy and repair of perineal body through a transanal approach can be a feasible option to the congenital H-type rectovestibular fistula. Also, combined inflammation and infection should be treated prior to surgery to reduce postoperative complications.
Abscess ; Anal Canal ; Congenital Abnormalities ; Defecation ; Diagnosis* ; Fistula* ; Humans ; Inflammation ; Postoperative Complications ; Recurrence

No abstract available.
Ascorbic Acid/*chemistry ; Blood Chemical Analysis/instrumentation/*methods ; Blood Glucose/*analysis ; Maltose/*chemistry