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Factors affecting the reduction rate of odontogenic cysts after decompression based on 3-dimensional volumetric analysis

  • Sarawut Wongrattanakarn;Vorapat Trachoo;Boosana Kaboosaya;Pornkawee Charoenlarp;Net-nada Chongruangsri;Patcharapit Promoppatum
    • Imaging Science in Dentistry
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    • v.53 no.4
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    • pp.313-323
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    • 2023
  • Purpose: This study aimed to investigate the potential factors that could affect the reduction rate of odontogenic cysts following decompression using cone-beam computed tomography (CBCT) for 3-dimensional volumetric analysis. Materials and Methods: The study sample consisted of CBCT images of 41 individuals who underwent decompression of odontogenic cysts at the Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Chulalongkorn University, between 2010 and 2022. Preoperative and postoperative CBCT results were collected, and a volumetric analysis was conducted to evaluate the differences in the reduction rate and the percentage of volume reduction of cystic lesions based on different parameters. Correlations between these parameters were analyzed to determine associations. Results: In this study, the average time of decompression for odontogenic cysts was 316 days. Males demonstrated a higher reduction rate than females (P<0.05). The reduction rate was directly proportional to initial cyst volume, with higher reduction rates for cysts with large initial volume than those with small initial volume (P<0.05). Spearman's rank correlation coefficient indicated a weak positive correlation between the initial cyst volume and the duration of decompression. Additionally, a strong positive correlation was observed between the initial volume and the reduction rate. Conclusion: Knowledge of the reduction rate of odontogenic cysts is vital for surgeons to evaluate the duration of decompression before enucleation and to determine a definitive treatment plan. Sex and initial lesion volume had significant effects on the reduction rate.

The branching patterns and termination points of the facial artery: a cadaveric anatomical study

  • Vu Hoang Nguyen;Lin Cheng-Kuan;Tuan Anh Nguyen;Trang Huu Ngoc Thao Cai
    • Archives of Craniofacial Surgery
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    • v.25 no.2
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    • pp.77-84
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    • 2024
  • Background: The facial artery is an important blood vessel responsible for supplying the anterior face. Understanding the branching patterns of the facial artery plays a crucial role in various medical specialties such as plastic surgery, dermatology, and oncology. This knowledge contributes to improving the success rate of facial reconstruction and aesthetic procedures. However, debate continues regarding the classification of facial artery branching patterns in the existing literature. Methods: We conducted a comprehensive anatomical study, in which we dissected 102 facial arteries from 52 embalmed and formaldehyde-fixed Vietnamese cadavers at the Anatomy Department, University of Medicine and Pharmacy, Ho Chi Minh City, Vietnam. Results: Our investigation revealed eight distinct termination points and identified 35 combinations of branching patterns, including seven arterial branching patterns. These termination points included the inferior labial artery, superior labial artery, inferior alar artery, lateral nasal artery, angular artery typical, angular artery running along the lower border of the orbicularis oculi muscle, forehead branch, duplex, and short course (hypoplastic). Notably, the branching patterns of the facial artery displayed marked asymmetry between the left and right sides within the same cadaver. Conclusion: The considerable variation observed in the branching pattern and termination points of the facial artery makes it challenging to establish a definitive classification system for this vessel. Therefore, it is imperative to develop an anatomical map summarizing the major measurements and geometric features of the facial artery. Surgeons and medical professionals involved in facial surgery and procedures must consider the detailed anatomy and relative positioning of the facial artery to minimize the risk of unexpected complications.

Ehlers-Danlos Syndrome with Classical Subtype in a Cat

  • Jihyun Kim;Yunji Sul;Jaewon Lee;Sooa Yoon;Seungjin Lee;Woojin Song;Youngmin Yun
    • Journal of Veterinary Clinics
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    • v.41 no.2
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    • pp.101-105
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    • 2024
  • Ehlers-Danlos syndrome (EDS) is a rare genetic disorder in dogs and cats and has been mostly reported in purebred cats. In this study, we report a case of a 1-year-old castrated male Korean shorthair cat, who presented with multiple small skin tears and bruises distributed over the entire trunk area. The cat's skin was hyperextensible and easily torn with gentle touch. The skin extensibility index of the cat was 25%, indicating the possibility of EDS. The cat exhibited no signs of pruritus or inflammation, and no underlying disease was found. However, radiography revealed hip joint subluxation and arthritis. Following this, biopsy of the lacerated skin was performed. Histopathological examination of the skin revealed that in the dermis adjacent to the lesions, the collagen fibers were irregular in size and width, with a slightly thinner epidermis, and increased interfibrillar spaces containing low numbers of scattered well-differentiated fibroblasts and mast cells. Histopathological examination of the skin confirmed EDS. The symptoms observed in the cat, including skin hyperextensibility, multiple bruising, hip joint subluxation, and arthritis, corresponded to the classical subtype of EDS in humans. Thus, this study is a rare report of a classical EDS case in a Korean shorthair cat. This study suggests that skin extensibility index and biopsy are useful diagnostic procedures for confirming EDS in animals until a more definitive genetic test is established.

Abnormal State Detection using Memory-augmented Autoencoder technique in Frequency-Time Domain

  • Haoyi Zhong;Yongjiang Zhao;Chang Gyoon Lim
    • KSII Transactions on Internet and Information Systems (TIIS)
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    • v.18 no.2
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    • pp.348-369
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    • 2024
  • With the advancement of Industry 4.0 and Industrial Internet of Things (IIoT), manufacturing increasingly seeks automation and intelligence. Temperature and vibration monitoring are essential for machinery health. Traditional abnormal state detection methodologies often overlook the intricate frequency characteristics inherent in vibration time series and are susceptible to erroneously reconstructing temperature abnormalities due to the highly similar waveforms. To address these limitations, we introduce synergistic, end-to-end, unsupervised Frequency-Time Domain Memory-Enhanced Autoencoders (FTD-MAE) capable of identifying abnormalities in both temperature and vibration datasets. This model is adept at accommodating time series with variable frequency complexities and mitigates the risk of overgeneralization. Initially, the frequency domain encoder processes the spectrogram generated through Short-Time Fourier Transform (STFT), while the time domain encoder interprets the raw time series. This results in two disparate sets of latent representations. Subsequently, these are subjected to a memory mechanism and a limiting function, which numerically constrain each memory term. These processed terms are then amalgamated to create two unified, novel representations that the decoder leverages to produce reconstructed samples. Furthermore, the model employs Spectral Entropy to dynamically assess the frequency complexity of the time series, which, in turn, calibrates the weightage attributed to the loss functions of the individual branches, thereby generating definitive abnormal scores. Through extensive experiments, FTD-MAE achieved an average ACC and F1 of 0.9826 and 0.9808 on the CMHS and CWRU datasets, respectively. Compared to the best representative model, the ACC increased by 0.2114 and the F1 by 0.1876.

The characteristics and clinical outcomes of trauma patients transferred by a physician-staffed helicopter emergency medical service in Korea: a retrospective study

  • Myung Jin Jang;Woo Sung Choi;Jung Nam Lee;Won Bin Park
    • Journal of Trauma and Injury
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    • v.37 no.2
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    • pp.106-113
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    • 2024
  • Purpose: Helicopter transport with medical teams has been proven to be effective, with improvements in patient survival rates. This study compared and analyzed the clinical characteristics and treatment outcomes of trauma patients transported by doctor helicopters according to whether patients were transferred after a clinical evaluation or without a clinical evaluation. Methods: This study retrospectively reviewed data from the Korean Trauma Data Bank of trauma patients who arrived at a regional trauma center through doctor helicopters from January 1, 2014, to December 31, 2022. The patients were divided into two groups: doctor helicopter transport before evaluation (DHTBE) and doctor helicopter transport after evaluation (DHTAE). These groups were compared. Results: The study population included 351 cases. At the time of arrival at the trauma center, the systolic blood pressure was significantly lower in the DHTAE group than in the DHTBE group (P=0.018). The Injury Severity Score was significantly higher in the DHTAE group (P<0.001), and the accident to trauma center arrival time was significantly shorter in the DHTBE group (P<0.001). Mortality did not show a statistically significant between-group difference (P=0.094). Surgical cases in the DHTAE group had a longer time from the accident scene to trauma center arrival (P=0.002). The time from the accident to the operation room or from the accident to angioembolization showed no statistically significant differences. Conclusions: DHTAE was associated with significantly longer transport times to the trauma center, as well as nonstatistically significant trends for delays in receiving surgery and procedures, as well as higher mortality. If severe trauma is suspected, air transport to a trauma center should be requested immediately after a simple screening test (e.g., mechanism of injury, Glasgow Coma Scale, or Focused Assessment with Sonography in Trauma), which may help reduce the time to definitive treatment.

Full mouth rehabilitation of a patient with tooth wear and insufficient restorative space due to loss of posterior teeth support: a case report (구치부 지지 상실로 인해 치아 마모와 부족한 수복 공간을 보이는 환자에서의 완전구강회복 증례)

  • Hyunsub Kim;Young-Jun Lim;Ho-Beom Kwon;Myung-Joo Kim
    • The Journal of Korean Academy of Prosthodontics
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    • v.62 no.1
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    • pp.72-81
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    • 2024
  • To rehabilitate a patient with inappropriate occlusion due to posterior support loss, it is necessary to achieve an appropriate occlusal vertical dimension and create prostheses that demonstrate stable occlusion at the centric relation for full mouth restoration. This case shows full mouth rehabilitation in a patient with missing posterior teeth and tooth wear, achieved through implant-supported prostheses and zirconia full-veneer crowns. To assess adaptation to the increased occlusal vertical dimension, an occlusal splint and temporary restorations were secured. By fabricating the definitive restorations based on the anterior guidance of the temporary restorations, stable occlusal rehabilitation was successfully achieved.

Fixed implant rehabilitation of maxillary edentulous patient using intraoral scanning digital workflow: a case report (상악 완전 무치악 환자에서 구강 스캐닝 디지털 워크플로우를 활용한 완전 고정성 임플란트 수복 증례)

  • Seung Min Park;YoungBum Park
    • The Journal of Korean Academy of Prosthodontics
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    • v.62 no.1
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    • pp.38-46
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    • 2024
  • In order to treat edentulous patients with fixed implant prosthesis, the final prosthesis form should be predetermined based on the anatomic structures of the arch, the opposing dentition, and the occlusal plane. The design and occlusion of the interim prosthesis can provide useful information when fabricating the definitive prosthesis. In this case report, scan data of the edentulous region and the interim prosthesis were superimposed through an intraoral scanning digital workflow. In this way, the interim prosthesis information was incorporated into the design of the final prosthesis. Furthermore, the interim prosthesis data acquired through intraoral scanning was utilized to plan the positions and angles of the implants based on the final prosthesis design. Surgical guides were used to accurately place the implants in the planned three-dimensional positions. In this case report, satisfactory esthetic and functional clinical outcomes were achieved through application of digital techniques.

Management of gunshot wounds near the elbow: experiences at a high-volume level I trauma center

  • Umar Ghilzai;Abdullah Ghali;Aaron Singh;Thomas Wesley Mitchell;Scott A. Mitchell
    • Clinics in Shoulder and Elbow
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    • v.27 no.1
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    • pp.3-10
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    • 2024
  • Background: Gunshot-related fractures near the elbow are challenging, and available data to guide the practitioner are lacking. This report analyzes injury patterns and treatment strategies in a case series from a high-volume urban trauma center. Methods: All periarticular gunshot fractures near the elbow treated at a level 1 trauma center from 2014 to 2018 were retrospectively reviewed. Fracture location, patient demographics, concomitant injuries, treatment modalities, and complications were analyzed. Results: Twenty-four patients were identified. All patients received prophylactic antibiotics upon admission and underwent urgent surgical debridement. Open reduction and internal fixation (ORIF) was performed with initial debridement in 22 of 24 patients. Seven patients sustained distal humerus fractures, 10 patients sustained isolated proximal ulna or proximal radius fractures, and seven had combined fracture patterns. Eleven patients presented with nerve palsy, and two had transected nerves. Two patients had vascular injury requiring repair. One patient required a temporary elbow-spanning external fixator and underwent staged debridement followed by ORIF. One patient with a grade IIIC fracture developed a deep infection that precluded ORIF. One patient required revision ORIF due to fracture displacement. Conclusions: This investigation reports on management of ballistic fractures near the elbow at a busy urban level I trauma center. Our management centered on rapid debridement, early definitive fixation, and intravenous antibiotic administration. We report on associated neurovascular injury, bone loss, and other challenges in this patient population. Level of evidence: IV.

Feasibility of laparoscopic cholecystectomy for symptomatic gallstone disease with portal cavernoma: Can prior portal vein decompression be avoided?

  • Bappaditya Har;Siddharth Mishra;Ayyar Srinivas Mahesh;Ankur Shrimal;Rajesh Bhojwani
    • Annals of Hepato-Biliary-Pancreatic Surgery
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    • v.27 no.4
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    • pp.366-371
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    • 2023
  • Backgrounds/Aims: Biliary surgery in patients with extrahepatic portal vein obstruction with portal cavernoma (PC) is technically challenging, and associated with the risk of bleeding. Therefore, prior portal vein decompression is usually recommended before definitive biliary surgery. Only a few studies have so far reported the safety of isolated laparoscopic cholecystectomy. We aimed to evaluate our experience of laparoscopic cholecystectomy in patients with PC without prior portal decompression. Methods: Prospectively maintained data for patients with PC who underwent laparoscopic cholecystectomy for symptomatic gallstone disease without portal decompression were analyzed. Clinical features, imaging, intraoperative factors, conversion rate, complications of surgery, and long-term outcomes were assessed. Results: Sixteen patients underwent cholecystectomy without portal decompression from 2012 to 2021, of which interventions 14 were laparoscopic cholecystectomies. One patient required conversion (7.1%) to open surgery. Jaundice was present in 5 patients (35.7%), and underwent endoscopic stone clearance before surgery. Median intraoperative blood loss, operative time, and hospital stay were 100 mL (20-400 mL), 105 min (60-220 min), and 2 days (1-7 days), respectively. Blood transfusion was required in two patients (14.2%). Prior endoscopic or percutaneous intervention was associated with significant blood loss and prolonged intraoperative time. Conclusions: In centers with experience, prior portal decompression can be avoided in patients with PC requiring isolated cholecystectomy to treat gallstones or their complications. Laparoscopic surgery is safe and feasible for these patients, and gives excellent outcomes in the selected group.

Functional Outcome after Reimplantation in Patients Treated with and without an Antibiotic-Loaded Cement Spacers for Hip Prosthetic Joint Infections

  • Michele Fiore;Claudia Rondinella;Azzurra Paolucci;Lorenzo Morante;Massimiliano De Paolis;Andrea Sambri
    • Hip & pelvis
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    • v.35 no.1
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    • pp.32-39
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    • 2023
  • Purpose: A staged revision with placement of a temporary antibiotic-loaded cement spacer after removal of the implant is the "gold standard" for treatment of chronic prosthetic joint infection (PJI). It enables local delivery of antibiotics, maintenance of limb-length and mobility, easier reimplantation. However, bacterial colonization of spacers and mechanical complications can also occur. The aim of this study is to evaluate functional results and infection control in two-stage treatment of total hip arthroplasty (THA) PJI with and without a spacer. Materials and Methods: A retrospective review of 64 consecutive patients was conducted: 34 underwent two-stage revision using a cement spacer (group A), 30 underwent two-stage revision without a spacer (group B). At the final follow-up, functional evaluation of patients with a THA in site, without PJI recurrence, was performed using the Harris hip score (HHS). Measurement of limb-length and off-set discrepancies was performed using anteroposterior pelvic X-rays. Results: Most patients in group B were older with more comorbidities preoperatively. Thirty-three patients (97.1%) in group A underwent THA reimplantation versus 22 patients (73.3%) in group B (P<0.001). No significant differences in limb-length and off-set were observed. The results of functional evaluation performed during the final follow-up (mean, 41 months) showed better function in patients in group A (mean HHS, 76.3 vs. 55.9; P<0.001). Conclusion: The use of antibiotic-loaded cement spacer seems superior in terms of functional outcomes and reimplantation rate. Resection arthroplasty might be reserved as a first-stage procedure in patients who are unfit, who might benefit from a definitive procedure.