[A case of pleural metastasis of malignant peripheral nerve sheath tumor].

Malignant peripheral nerve sheath tumor (MPNST) frequently metastasizes to the lungs, although pleural metastasis is rare. This article reported a case of pleural metastasis of MPNST. The patient was a young man who presented with 1 week of shortness of breath with dry cough. He had a history of malignant peripheral nerve sheath tumor. The patient was diagnosed with MPNST pleural metastasis after a thoracoscopic pleural biopsy, which revealed short spindle cell hyperplasia, immunohistochemical staining for S-100(+), SOX-10(+), Ki-67(+) with a positive index of 20%, and H3K27Me3(-) in the pleural pathology.

[Clinical features and short-term prognosis of Holmes' tremor].

Objective: To explore the clinical characteristics and short-term prognosis of Holmes' tremor (HT) patients. Methods: The clinical and imaging data of HT patients in 5 teaching hospitals between January 2014 and January 2018 were retrospectively analyzed, and Fahn-Tolosa-Marin Tremor Rating Scale (TRS) was used to compare the clinical severity and short-term prognosis between the different subtypes. Results: (1) The time from primary disease to tremor onset was 2 days to 20 months (median time 29 d) in 23 patients with HT enrolled, and the most common cause of HT was cerebrovascular disease (78.3%). (2) The most common involved locations were midbrain (65.2%), thalamus (47.8%) and cerebellum (30.4%). No significant difference in total TRS scores between the isolated lesion group (12 cases) and multiple lesions group (11 cases) (P=0.57), while the scores of the mesencephalic group (15 cases) was significantly higher than the non-mesencephalic group (8 cases) (P=0.00). (3) One case was treated with deep brain stimulation (DBS), while 22 cases were treated with medical therapy. Levodopa combined with clonazepam (7/12) and single levodopa (9/20) were partially effective. (4) At the 3-month follow-up after discharge, patients received DBS had good prognosis. Among the 22 patients treated with medicine, only 8 (36.4%) patients had good outcomes. The short-term prognosis was not significantly different between the isolated and multiple lesion groups (P=0.40), while it was worse in the mesencephalic group than the non-mesencephalic group (P=0.02). Conclusion: The most common cause of HT is cerebrovascular disease, and primary lesions are midbrain, thalamus, and cerebellum. The pharmacologic agents are partially valid for disease control of HT and the short-term prognosis is poor, while the patients with mesencephalic involvement have more severe tremor and worse prognosis.

[Morphometric analysis of the infrazygomatic crest zone in 84 mini-implants using cone-beam CT].

Objective: To investigate the soft and hard tissue morphology in the infrazygomatic crest zone by observing the cone-beam computed tomography (CBCT) scans in patients with mini-implants. Methods: CBCT scans of 43 patients performed from January 2014 to December 2016 in the Department of Stomatology, Beijing Friendship Hospital, Capital Medical University, with 84 existing mini-implants in the infrazygomatic crest region were collected. The bone thickness and cortical bone thickness were measured in the palatal and buccal side of the mini-implant. The maxillary sinus membrane thickness, sinus septa, reverse fold, and the sinus opening angle were also determined and analyzed in the maxillary posterior region. Results: The bone thicknesses in the buccal and palatal side of the existing mini-implant were 2.5 (1.5, 3.2) and 5.2 (4.0, 6.4) mm, respectively. However, the corresponding cortical bone thicknesses were only 2.1 (1.3, 2.8) and 1.5 (1.0, 1.9) mm, respectively. The prevalences of the septa and the reverse fold were 33% (28/84) and 45% (38/84), respectively. The sinus opening angle was the largest in the mid-coronal plane of the maxillary first molar (71.6°±15.6°). In the coronal plane located at 10 mm mesially, the angle was the smallest (46.1°±18.0°), and in this area, 20% (16/82) of the angle was less than 30°. Conclusions: The outer cortical plate of the infrazygomatic crest along with the cortical plate of sinus floor could be related to the initial stability of mini-implant anchorage. The anatomic variation such as the reverse fold indicated thorough consideration of insertion depth and angle to avoid unexpected sinus injury.

[Long-term treatment outcome and influencing factors of teeth receiving modified crown lengthening].

Objective: To observe the long-term clinical treatment outcome and the influencing factors of the outcome for the teeth receiving modified crown lengthening surgery combined with root canal treatment and post-core crown restoration. To summarize the clinical guidelines of modified crown lengthening surgery in selection of indications and for mulation of treatment planning. Methods: Fifty-seven patients with a total of 67 teeth receiving modified crown lengthening surgery combined with root canal treatment and post-core crown restoration for at least a 6 months' follow-up period between July 2004 and July 2013 were recruited in this retrospective study by phone call interviews. The patients' clinical outcomes were evaluated by the combination of clinical examination, radiograph and questionnaire regarding patient-reported outcome of the last follow up (≥9 months post modified crown lengthening surgery and ≥6 months after definite crown restorations). All of the treated teeth were classified into two groups, group A (teeth with good clinical treatment outcome) and group B (teeth with poor clinical treatment outcome), based on the defined criteria including patients' satisfaction with the function and esthetics of the teeth and absence of periodontal, endodontic and prosthodontic complications. The potential influencing factors of clinical treatment outcome were also determined by Logistic regression analysis. Results: Vertical root fracture in 1 tooth was found on its periapical film and the tooth was deemed hopeless. Thus, the survival rate is 99% (66/67) for the multidisciplinary treatment approach. Seventy-two percent (48/67) of the teeth achieved good clinical treatment outcome and 28% (19/67) of the teeth developed one or several complications. In group B (teeth with poor clinical treatment), 16 out of teeth exhibited periodontal complications with bleeding on probing (BOP) positive mostly found. Logistic regression analysis demonstrated that plaque control (OR=21.392, P=0.014), edge form (OR=7.610, P=0.011), and smoking experience (OR=7.315, P=0.018) were the risk factors influencing the clinical treatment outcome of modified crown lengthening surgery combined with root canal treatment and post-core restoration. Conclusions: Modified crown lengthening surgery combined with root canal treatment and post-core restoration has a good and stable clinical effect in the observational time of 6-114 months. Plaque control, smoking status and edge form of the tooth appeared to be the influencing factors of this multidisciplinary treatment approach.