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Purpose@#To investigate the association of the preoperative fat-to-orbit ratio on the outcome of endoscopic orbital decompression in patients with thyroid-associated orbitopathy (TAO). @*Methods@#Between January 2021 and December 2022, 36 patients with TAO, 72 eyes in total, underwent endoscopic orbital decompression at our hospital’s ophthalmology department. We calculated fat-to-orbit ratios using two-dimensional facial computed tomography scans, and conducted both preoperative and postoperative measurements of proptosis and the prism cover test. We used binominal logistic regression analysis to examine the correlation between the ratios and postoperative complications (diplopia, strabismus, lid retraction) following the surgery. Furthermore, simple linear regression analysis was used to assess the relationship between the ratios and change in exophthalmos. @*Results@#The regression indicated significant associations between the ratio and the onset of postoperative complications such as new-onset postoperative diplopia (NOPD) (β = -0.098, p = 0.029), postoperative strabismus (β = -0.123, p = 0.009), and eyelid retraction (β = -0.188, p = 0.002), particularly in cases requiring subsequent strabismus or eyelid retraction surgery after the initial procedure. @*Conclusions@#The preoperative fat-to-orbit ratio is a significant predictor of postoperative complications such as NOPD, strabismus surgery and eyelid retraction surgery in patients undergoing endoscopic orbital decompression for thyroid eye disease. Therefore, it should be considered a valuable indicator of surgical outcomes and complications in such patients.
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Purpose@#Cention N (Ivoclar Vivadent) was a recently introduced alkasite-based restorative material that was expected to replace amalgam and glass ionomer cement. This material was an esthetic restoration with adequate mechanical strength and release of fluoride and calcium. The purpose of this study was to measure the water sorption and water solubility of Cention N and evaluate its long-term durability compared to other esthetic restorations (Resin-Modified Glass Ionomer cement [RMGIC], Giomer, Composite Resin). @*Materials and Methods@#Twenty specimens each of Cention N (CN), Resin Modified-Glass Ionomer Cement (FJ), Giomer (BF), and Composite Resin (FZ) were made. After each specimen was completely dried in a desiccator for 24 hours using a vacuum pressure pump, the specimen was weighed (m1). After that, the specimen was immersed in distilled water at 37°C for 7 days, stored in a drying oven, and weighed (m2). After drying completely for 24 hours in a desiccator, the specimen was weighed (m3) to calculate the water absorption and water solubility using Formulas 1 and 2. The measured values were statistically processed and analyzed using SPSS, and the significance level was set at 0.05.Result: When measuring water sorption, FJ (122.61 μg/mm3 ) showed significantly higher water sorption than CN (35.42 μg/mm3 ) (P<0.05). There was no significant difference between FZ (18.03 μg/mm3 ) and BF (14.76 μg/mm3 ) (P=0.930). When measuring water solubility, CN (6.65 μg/mm3 ) showed significantly higher water solubility than FJ (1.47 μg/mm3 ) (P<0.05). @*Conclusion@#Cention N had lower water sorption than RMGIC, but higher water solubility, indicating that it is more vulnerable to moisture and has lessened long-term durability.
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Persistent trigeminal artery (PTA) represent an unusual remnant of the fetal carotid-basilar anastomosis. Persistent trigeminal artery variant (PTAV) is a rare anastomosis between the internal carotid artery and cerebellar artery, without an interposing basilar artery segment. We report the case of 49-year-old female with an incidentally discovered, rare variation of PTA that directly terminated in the ipsilateral superior cerebellar artery. The variation was observed on CT angiography, digital subtraction angiography, and MR angiography. Additionally, we reviewed the embryogenesis of PTA and PTAV and discussed the clinical implications of this variation.
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Background/Aims@#Different modalities have been employed to reduce the risk and severity of post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis (PEP). However, there has been a paucity of studies comparing the efficacy of various prophylactic modalities for preventing PEP. This network meta-analysis (NMA) aimed to determine the relative efficacy of pancreatic duct stents and pharmacological modalities for preventing PEP. @*Methods@#We performed a systematic and comprehensive search to identify and analyze all randomized controlled studies published until June 2020 that examined the effectiveness of pancreatic duct stents, rectal non-steroidal anti-inflammatory drugs (NSAIDs) based regimens, hydration, and their combinations for the prevention of PEP. The primary outcome was the frequency of PEP. An NMA was performed to combine direct and indirect comparisons of different prophylactic modalities. @*Results@#The NMA included 46 studies evaluating 18 regimens in 16,241 patients. Based on integral analysis of predictive interval plots, and expected mean ranking and surface under the cumulative ranking curve values, combination prophylaxis with indomethacin + lactated Ringer’s solution (LR), followed by diclofenac + nitrate and indomethacin + normal saline, was found to be the most efficacious modality for the overall prevention of PEP. Indomethacin + LR, followed by diclofenac and pancreatic duct stents, was the most efficacious modality for high-risk groups. @*Conclusions@#Rectal NSAIDs-based combination regimens with aggressive hydration or nitrate are superior to single modalities for the prevention of PEP.
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The pegylated interferon plus ribavirin combination therapy has been used as the primary treatment for chronic hepatitis C (CHC) but fails to produce a sustained viral response (SVR) in many patients. In recent years, the treatment of CHC has been rapidly changing because of the introduction of direct-acting antivirals (DAAs), which have a high cure rate. However, retreatment of patients after failure of the first DAA therapy is difficult. We report two rare cases of CHC that showed acquired SVR with other DAA combinations after failure to daclatasvir and asunaprevir.
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The rupture of a pyogenic liver abscess (PLA) with peritonitis is a rare occurrence but a surgical emergency with a high mortality rate in the case of gas-forming PLA. Rare cases of ruptured PLA that recovered completely with only medical treatment have been reported.This paper reports a case of a large PLA rupture with peritonitis. In this case, surgical intervention was too risky because of the patient’s age and poor general condition. The patient recovered fully with appropriate antibiotic therapy and sufficient percutaneous drainage. Therefore, medical treatment may be considered an alternative option in cases of a ruptured large PLA with peritonitis if surgical intervention is too risky.
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The rupture of a pyogenic liver abscess (PLA) with peritonitis is a rare occurrence but a surgical emergency with a high mortality rate in the case of gas-forming PLA. Rare cases of ruptured PLA that recovered completely with only medical treatment have been reported.This paper reports a case of a large PLA rupture with peritonitis. In this case, surgical intervention was too risky because of the patient’s age and poor general condition. The patient recovered fully with appropriate antibiotic therapy and sufficient percutaneous drainage. Therefore, medical treatment may be considered an alternative option in cases of a ruptured large PLA with peritonitis if surgical intervention is too risky.
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This study evaluated the antimicrobial activity of Endoseal TCS, an mineral trioxide aggregate-based root canal sealer, mixed with water-soluble mangostin derivatives (WsMD) of Garcinia mangostana L. (mangosteen) ethanol extract against Enterococcus faecalis and Staphylococcus aureus. The antibacterial activity of Endoseal TCS mixed with WsMD against three strains of E. faecalis and three strains of S. aureus was performed using agar diffusion test. The data showed that Endoseal TCS mixed with 0.115% WsMD had a zone of inhibition of 0.7 ± 0.2–2.4 ± 0.1 mm. The results suggest that Endoseal TCS mixed with WsMD of Garcinia mangostana L. ethanol extract is useful as a root canal sealer with antibacterial activity against E. faecalis and S. aureus.
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This study evaluated the antimicrobial activity of Endoseal TCS, an mineral trioxide aggregate-based root canal sealer, mixed with water-soluble mangostin derivatives (WsMD) of Garcinia mangostana L. (mangosteen) ethanol extract against Enterococcus faecalis and Staphylococcus aureus. The antibacterial activity of Endoseal TCS mixed with WsMD against three strains of E. faecalis and three strains of S. aureus was performed using agar diffusion test. The data showed that Endoseal TCS mixed with 0.115% WsMD had a zone of inhibition of 0.7 ± 0.2–2.4 ± 0.1 mm. The results suggest that Endoseal TCS mixed with WsMD of Garcinia mangostana L. ethanol extract is useful as a root canal sealer with antibacterial activity against E. faecalis and S. aureus.
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Cholangiocarcinoma is a biliary carcinoma with a wide spectrum of imaging, histological, and clinical features. In immunocompromised patients, pyogenic abscesses are relatively common and an echinococcal hepatic cysts are very rare. The authors experienced a very rare case of cholangiocarcinoma showing multiple hypodense masses with wall enhancement mimicking pyogenic liver abscess, echinococcal hepatic cyst, and cystic metastases. An 83-year-old man, complaining of fatigue and poor oral intake, presented to our outpatient clinic. Abdominal computed tomography (CT) revealed multiple, variable-sized hypodense masses with peripheral rim enhancement throughout the liver. Dynamic liver magnetic resonance images also showed findings similar to those of a CT scan. We performed ultrasound-guided biopsy of the mass which revealed cholangiocarcinoma.
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A visceral artery pseudoaneurysm after ERCP is a rare adverse event that is potentially life-threatening. Most cases reported previously originated from the peripancreatic arteries, including the splenic artery, gastroduodenal artery, or pancreaticoduodenal artery. The mechanism of the occurrence of visceral artery pseudoaneurysms after ERCP has not been elucidated until now. Recently, a pseudoaneurysm rupture originating from the superior mesenteric artery after ERCP was observed in a patient without a history of pancreatitis. This paper reports this case with a review of the relevant literature.
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Acute pancreatitis is the most common and feared adverse event associated with performance of endoscopic retrograde cholangiopancreatography (ERCP). Unremitting effort has been made for over 40 years to minimize the frequency and severity of this complication. Recently, the use of rectal non-steroidal anti-inflammatory drugs (NSAIDs) have opened a new era for its prevention. This review focuses on the role of NSAIDs in pancreatitis, the pharmacokinetics of these agents, and summarizes the results of clinical trials with rectal NSAIDs alone and combination regimens in the prevention of post-ERCP pancreatitis.
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Advanced hepatocellular carcinoma (HCC) with tumor thrombus extending through the hepatic veins, inferior vena cava, and right atrium (RA) is very rare. However, whether active treatments such as radiation, transcatheter arterial chemoembolization, and sorafenib in advanced HCC with RA involvement prolong survival is uncertain. We present a rare case of advanced HCC with tumor thrombus nearly occupying the entire RA that was treated with sorafenib. The patient received 400 mg sorafenib twice daily. However, her liver enzyme levels continued to increase and abdominal computed tomography showed an increase in the tumor size in the liver and RA. In the present case, active treatment with sorafenib was ineffective; thus, palliative care may be more beneficial in advanced HCC with extensive RA involvement.
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Humanos , Carcinoma Hepatocelular , Átrios do Coração , Veias Hepáticas , Fígado , Cuidados Paliativos , Trombose , Veia Cava InferiorRESUMO
Enterococcus faecalis is a major causative agent of endodontic treatment failure. The purpose of this study was to investigate bactericidal effects of ethanol extract of Garcinia mangostana L. (mangosteen extract) on five strains of E. faecalis that were isolated from human oral cavities. The bactericidal effects of mangosteen extract were assessed by measurement of minimum bactericidal concentration (MBC) value. The cytotoxicity of mangosteen extract on immortalized human gingival fibroblasts, hTERT-hNOF, was determined based on cell counting method. The data revealed the MBC value of mangosteen extract against the E. faecalis strains was 4 µg/ml. Additionally, the cell viability of mangosteen extract on hTERT-hNOF was 83.7–89.1% at the 1 to 16 µg/ml. These findings indicated that mangosteen extract could be used as a root canal cleaner during management of endodontic treatment failure caused by E. faecalis.
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Humanos , Contagem de Células , Sobrevivência Celular , Cavidade Pulpar , Enterococcus faecalis , Enterococcus , Etanol , Fibroblastos , Garcinia mangostana , Garcinia , Métodos , Boca , Falha de TratamentoRESUMO
Polyphenon 60 refers to the mixture of catechins present in green tea. The aim of this study was to investigate the antimicrobial activities of polyphenon 60 against 4 strains of Streptococcus mutans and 2 strains of Streptococcus sorbrinus, which are the major causative bacteria of dental caries. The minimum bactericidal concentration (MBC) values of polyphenon 60 for S. mutans and S. sobrinus were determined and the effect of biofilm formation inhibition of that was evaluated. The MBC value of polyphenon 60 against the bacterial strains was 2.5 mg/ml except for one particular strain, S. mutans KCOM 1128 for which the value was 1.25 mg/ml. The results of biofilm formation inhibition assay revealed that polyphenon 60 inhibited biofilm formation more than 90% at a concentration of 2.5 mg/ml. It was apparent that polyphenon exhibited biofilm formation inhibition activity along with bactericidal effect against S. mutans and S. sobrinus. Therefore, it is proposed that polyphenon 60 as one of the components of bactericidal agents could be useful in developing oral hygiene products, toothpaste or gargling solution.
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Bactérias , Biofilmes , Catequina , Cárie Dentária , Higiene Bucal , Streptococcus mutans , Streptococcus sobrinus , Streptococcus , Chá , Cremes DentaisRESUMO
Angiomyolipoma (AML) is a rare benign mesenchymal tumor in the liver, which is composed of blood vessels, smooth muscle, and adipose cells. The proportion of each component varies, making a diagnosis difficult. This paper reports a case of AML in the liver without adipose tissue, mimicking a hepatocellular carcinoma (HCC), which was diagnosed by a surgical tissue biopsy. A 65-year-old woman was admitted for an evaluation of a hepatic mass that had been detected by ultrasonography. The serologic markers of viral hepatitis B and C were negative. The liver function tests and alpha fetoprotein level were within the normal limits. Magnetic resonance imaging revealed a 1.9 cm sized mass in segment 6 of the liver with early arterial enhancement and washout on the delayed phase accompanied by a rim-like enhancement, which is similar to the imaging findings of HCC. A frozen section examination during surgery indicated a hepatocellular neoplasm and suggested the possibility of HCC. On the other hand, the final pathologic diagnosis was epithelioid myoid type of AML with no adipose tissue component. The tumor cells were positive for human melanocyte B-45 and negative for cytokeratin and hepatocyte paraffin 1. This paper reports a very rare case of AML without adipose tissue in the liver mimicking HCC that was diagnosed by a surgical tissue biopsy.
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Idoso , Feminino , Humanos , Tecido Adiposo , alfa-Fetoproteínas , Angiomiolipoma , Biópsia , Vasos Sanguíneos , Carcinoma Hepatocelular , Diagnóstico , Secções Congeladas , Mãos , Hepatite B , Hepatócitos , Queratinas , Testes de Função Hepática , Fígado , Imageamento por Ressonância Magnética , Melanócitos , Músculo Liso , Parafina , UltrassonografiaRESUMO
PURPOSE: The most common single nucleotide polymorphism in the IGFBP3 promoter region occurs at position -202. This polymorphic variation occurs frequently and may influence growth hormone responsiveness and somatic growth. However, the effects of IGFBP3 promoter polymorphism on growth in children are unknown. METHODS: Restriction fragment length polymorphism-based genotyping of the -202 single nucleotide polymorphism was performed in 146 Korean girls aged between 15 and 16 years, who were selected randomly from the Seoul School Health Promotion Center. The participants were divided into 3 groups (tall, medium, and short) according to the height percentile established from normal reference values for Korean children. The serum levels of insulin-like growth factor I (IGF-I) and IGF-binding protein-3 (IGFBP-3) were then compared according to genotype. RESULTS: The genotype distribution in the participants was 79 AA (54.1%), 60 AC (41.1%), and 7 CC (4.8%). The C allele frequency at the -202 IGFBP3 position was 25.4% in this group. The mean serum IGFBP-3 concentration in girls with the AA genotype was higher than that in girls with the AC genotype in the medium (P=0.047) and short (P=0.035) groups, respectively. There was no difference in the IGF-I to IGFBP-3 molar ratio between the AA and AC genotype groups (P=0.161). CONCLUSION: In conclusion, the -202 polymorphism in the IGFBP3 promoter region is assumed to affect the serum concentration of IGFBP-3 in children as well as in adults. However, it is unclear whether this affects physical development according to the concentration of IGFBP-3.
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Adulto , Criança , Feminino , Humanos , Estatura , Frequência do Gene , Genótipo , Hormônio do Crescimento , Proteína 3 de Ligação a Fator de Crescimento Semelhante à Insulina , Fator de Crescimento Insulin-Like I , Dente Molar , Polimorfismo de Nucleotídeo Único , Regiões Promotoras Genéticas , Valores de Referência , Serviços de Saúde Escolar , SeulRESUMO
PURPOSE: Both atopy and bronchial hyperresponsiveness (BHR) are characteristic features of asthma. Several BHR studies comparing groups of atopic and nonatopic asthmatics have reported conflicting results. The aim of this study was to compare BHR to indirect stimuli, such as mannitol or exercise, between atopic and nonatopic asthmatics in children. METHODS: We performed a retrospective analysis of data from 110 children with asthma, aged 6–18 years using skin prick tests, and serum total and specific IgE levels. Atopy degree was measured using the sum of graded wheal size or the sum of the allergen-specific IgE. Bronchial provocation tests (BPTs) using methacholine were performed on all subjects. BPTs using indirect simuli, including exercise and mannitol, were also performed. RESULTS: Asthma cases were classified as atopic asthma (n=83) or nonatopic asthma (n=27) from skin prick or allergen-specific IgE test results. There was no significant difference in the prevalence of BHR to mannitol or exercise between atopic and nonatopic asthmatics. Atopic asthma had a significantly lower postexercise maximum decrease in % forced expiratory volume in 1 second (FEV1) (geometric mean [95% confidence interval]: 31.9 [22.9–40.9] vs. 14.0 [9.4–18.6], P=0.015) and a methacholine PC20 (provocative concentration of methacholine inducing a 20% fall in FEV1) than nonatopic asthmatics (geometric mean [95% confidence interval]: 1.24 [0.60–1.87] ng/mL vs. 4.97 [3.47–6.47]) ng/mL, P=0.001), whereas mannitol PD15 (cumulative provocative dose causing a 15% fall in FEV1) was not significantly different between the 2 groups. CONCLUSION: There was no significant difference in the prevalence of BHR to mannitol or exercise between atopic and nonatopic asthmatics in children.
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Criança , Humanos , Asma , Testes de Provocação Brônquica , Volume Expiratório Forçado , Imunoglobulina E , Manitol , Cloreto de Metacolina , Prevalência , Estudos Retrospectivos , PeleRESUMO
PURPOSE: It was found that periostin and squamous cell carcinoma-related antigens (SCCAs) were strongly interleukin-13-inducible gene products. This study measures the serum periostin and SCCA levels in children suffering from atopic dermatitis (AD) and to evaluate the association between the severity of AD and their values. METHODS: Seventy AD children aged 1 month to 10 years were included in our study. Subjects were characterized as having atopic eczema (AE; n=55) or non-AE (NAE; n=15) by atopic sensitization. Serum SCCA and periostin levels were measured. RESULTS: The serum periostin levels were significantly higher in children with AE than in those with NAE (geometric mean [95% confidence interval]: 80.47 ng/mL [75.06–85.93 ng/mL] vs. 67.45 ng/mL [59.99–75.64] ng/mL, P=0.020). The serum concentrations of both SCCA1 and SCCA2 were significantly higher in children with AE than in those with NAE (geometric mean [95% confidence interval]: 1.401 [1.198–1.643] ng/mL vs. 0.969 [0.723–1.268] ng/mL, P=0.039 for SCCA1) (1.178 [0.974–1.455] ng/mL vs. 0.711 [0.540–0.994] ng/mL, P=0.025 for SCCA2). The serum periostin levels were significantly correlated with disease severity and with peripheral blood eosinophil counts. The SCCA levels were not significantly correlated with disease severity. Both SCCA1 and SCCA2 were significantly correlated with serum periostin levels and blood eosinophil counts. CONCLUSION: Serum periostin levels may be significantly correlated with disease severity and blood eosinophil counts in children with AD. Serum SCCA levels can be significantly correlated with serum periostin levels and blood eosinophil counts in children with AD.
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Criança , Humanos , Dermatite Atópica , Eosinófilos , Células EpiteliaisRESUMO
BACKGROUND/AIMS: Adequate bowel preparation is an essential factor affecting the visibility of colonic mucosa and safety of related therapeutic interventions. The aim of this study was to assess the efficacy, tolerability, and safety of three bowel preparation agents –2 L polyethylene glycol with ascorbic acid (PEGA), sodium picosulfate magnesium citrate (SPMC), and oral sodium phosphate tablet (NaP)– for morning colonoscopy. METHODS: Here, we analyzed the medical records of patients who had taken bowel preparation agents using the split-dose method and undergone colonoscopy in a single hospital. The efficacy of bowel preparation agents was evaluated using the Ottawa bowel preparation assessment tool. The safety and tolerability of the agents were assessed by measuring the renal function and electrolytes prior to and after the procedure as well as by assessing the self-reported questionnaire. RESULTS: Of the 365 patients (PEGA:163, SPMC: 93, NaP: 109), 98.6% ingested more than 90% of the agents. NaP showed an inferior cleansing efficacy, and serum phosphate elevation was significantly higher in the NaP group. However, the satisfaction score was lowest in the PEGA group. Age (odds ratio [OR] 0.96, 95% confidence interval [CI] 0.92–0.99, p=0.04) and preparation agents (OR of PEGA versus NaP 5.0, 95% CI 2.28–10.97, p<0.001) (OR of SPMC versus NaP 2.73, 95% CI 1.22–6.08, p=0.01) were independently associated with bowel preparation success. CONCLUSIONS: According to our analysis, NaP showed an inferior cleansing efficacy compared with PEGA and SPMC, which may be attributed to the complex administration method and lower water intake. However, large-volume ingestion remains unsatisfactory for patients. Detailed bowel preparation instructions could enhance bowel cleansing efficacy.