Factors Influencing Non-Surgical Root Canal Treatment Outcomes in Mandibular Second Molars: A Retrospective Cone-Beam Computed Tomography Analysis.

Background/Objectives: This study aimed to investigate the influence of the root canal morphology and various treatment variables on the outcomes of root canal treatments (RCTs) in mandibular second molars, assessed through cone-beam computed tomography (CBCT) imaging. Methods: A total of 150 CBCT images were examined, comprising 100 cases of persistent endodontic infections and 50 of previously treated root canals with normal apices in the mandibular second molars. CBCT was utilized to evaluate the root canal configuration, the radiographic quality of coronal restorations and treated canal systems, and the presence of periapical lesions. Statistical analyses were performed to explore the correlations between these factors. Results: The presence of a C-shaped root canal configuration did not demonstrate a significant correlation with periapical lesions (p = 0.05). Factors influencing endodontic treatment outcomes included missing canals (p = 0.018), underfilling or overfilling (p = 0.045), and inadequate coronal restoration (p = 0.006). Missing a canal was identified as the variable most significantly associated with periapical lesions (OR = 3.103). Inhomogeneous root canal obturation was more commonly observed in C-shaped root canals (p < 0.001). Conclusions: Regardless of the root canal morphology of mandibular second molars, successful RCT depends on thorough disinfection to eliminate any untreated canals, precise three-dimensional filling of the canals at the correct working length, and a securely sealed coronal restoration to prevent leakage.

Tilted implants for implant-supported fixed hybrid prostheses: retrospective review.

Objectives: This review assessed the performance of implant-supported fixed hybrid prostheses in 21 patients who received a total of 137 implants between 2003 and 2010. The implants were evaluated for marginal bone resorption, complications, success rate, and survival rate based on their vertical angularity, type of bone graft, and measured implant stability. Materials and Methods: One-way ANOVA and chi-square tests were used to analyze the relationships among long-term evaluation factors and these variables. The mean initial bone resorption in the implant group with a vertical angle of more than 20° was 0.33 mm and mean final bone resorption was 0.76 mm. In contrast, the mean initial bone resorption in the implant group with a vertical angle of less than 10° was 1.19 mm and mean final bone resorption was 2.17 mm. Results: The results showed that mean bone resorption decreased with an increase in the vertical placement angle of the implants used in fixed hybrid prostheses, as well as in the group without additional bone grafts and those with high implant stability. The success rate of implants placed after bone grafting was found to be higher than those placed simultaneously. Conclusion: These results suggest that implant-supported fixed hybrid prostheses may be an effective treatment option for edentulous patients, and intentionally placing implants with high angularity may improve outcomes.

Duodenal Ulcer Hemorrhage and Perforation in a Child

Owing to the low incidence of peptic ulcers in children, the early symptoms of the disease are sometimes overlooked, which result in grave complications such as a perforation or hemorrhagic shock. Recently, as a result of the increasing use of endoscopy, the incidence of peptic ulcers in children has increased. This means that the disease might have been underdiagnosed in the past. Although some cases of peptic ulcer perforation or bleeding in children were reported, a case of a peptic ulcer combined with a perforation and hemorrhage has not been reported. We experienced a 19 months old patient in shock with a perforated duodenal ulcer and hemorrhage.

A Case Report of Surgical Treatment of Anal Condyloma Acuminata in HIV-Infected Patient

Acquired immunodeficiency syndrome (AIDS) was reported for the first time in the U.S, 1981 and eversince, the number of patients have increased substantially. Similar situation is encountered in Korea, with concordant increase in number of HIV-infected patients requiring surgical management, a high proportion being anal condyloma acuminata, which needs proper evaluation and management due to its malignant potential. Since, we have had a recent case with surgical intervention, we review the pathogenesis and treatment modality of the disease in this paper.

Pyloric Exclusion in the Pancreaticoduodenal Injury / 한국간담췌외과학회지

BACKGROUND/AIMS: Pyloric exclusion has been recommended in patients with severe injury to the pancreas and duodenum. METHODS: A retrospective case review of 8 patients treated with pyloric exclusion following pancreaticoduodenal injury from March 1994 to May 2002 in Department of Surgery, the Catholic University of Korea, Daejeon St. Mary's Hospital. RESULTS: The age range of the patients was from 8 to 31 years. Most of the etiolgy (n=7) was the blunt abdominal trauma and one case due to the iatrogenic injury from the therapeutic endoscopic retrograde cholangiopancretography. The time interval between the injury and the operation varied from 3 to 48 hours. The most common postoperative complication was wound infection (n=8). We found the other complications such as intraabdominal abscess (n=3), pneumonia (n=3), but the complications were treated successfully with conservative measures. There was no mortality cases in these patients. The duration of admission was delayed in the cases of concomitant injury (64 vs 46 days). All patients above 16 years old (n=7) were supported with parenteral nutritional fluid via central intravenous route (mean 32 days). We could not find the spontaneous opening of the pyloric closure at least 4 patients in postoperative 3 months but there was no major complication according to the sustained gastrojejunostomy. CONCLUSION: Pyloric exclusion appears to offer a satisfactory option for the treatment of the severe pancreaticoduodenal injury with minor complication. Do you have any comments about the spontaneous opening of the pyloric closure?

Case of a Spindle Cell Metaplastic Carcinoma of the Breast

A metaplastic carcinoma of the breast is a histologically diverse type of malignancy in which an adenocarcinoma is found to co-exist with an admixture of spindle cell, squamous, chondroid, or bone-forming neoplastic cells. Metaplastic breast cancer is rare and accounts for less than 1% of all mammary tumors. An adenocarcinoma with spindle cell metaplasia is one of the least often recognized variants of a metaplastic carcinoma. The clinical behavior of this variant of metaplastic carcinoma has not yet been clearly defined. Herein, we report a case of spindle cell metaplastic carcinoma of the breast. We also present a review of the literature.