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Condylar position changes and prognosis in patients with unilateral mandibular condylar fracture treated non-surgically
No full textBackground: Non-surgical method is a treatment option for mandibular condylar fracture; however, it is questionable whether bone fragments are adequately reduced and remodeled. The purpose of this study was to identify three-dimensional positional changes in the mandibular condyles in patients treated non-surgically, analyze factors influencing the extent of positional changes, and evaluate clinical prognosis. Methods: This retrospective study included 31 patients with unilateral mandibular condylar fractures treated non-surgically at the Ajou University Dental Hospital between 2005 and 2023. Computed tomography was performed at the time of the fracture (T0) and > 6 months after non-surgical treatment (T1). The extent of recovery of the highest point of the condyle head was measured in three-dimensional x-, y-, and z-axes. At the last follow-up > 6 months after remodeling (T1), the prognosis was evaluated by clinical examination of mouth opening limitation, malocclusion, deviation on opening, temporomandibular joint disorder (TMD), and facial asymmetry. Results: Position differences were statistically significant between T0 and T1 (paired Student’s t-test, P < 0.05), and between the x-, y-, and z-axes (Welch’s ANOVA, P < 0.05). The degree of positional recovery in the superior and lateral directions showed a statistically significant negative correlation with age (Pearson’s correlation analysis, P < 0.05). The average amount of recovery between two age groups of over and under 19 years old was statistically significant (independent t-test, P < 0.05). Complications included TMD (6.4%), malocclusion (3.2%) and facial asymmetry (3.2%). Conclusion: After non-surgical treatment, the condyle head of the fractured mandible recovered significantly laterally and superiorly in under 19-year-olds. The functional prognosis was favorable in all age groups. Non-surgical treatment can be an applicable treatment option for patients with mandibular condylar fractures
Assessing the Viability of Polycaprolactone Mesh in Bilateral Orbital Floor Reconstruction: Insights From Le Fort II Fracture Cases
No full textObjective: This study aims to evaluate the effectiveness of pure polycaprolactone (PCL) mesh in reconstructing complex bilateral orbital floor fractures associated with Le Fort II fractures. PCL mesh is traditionally viewed as less suitable for severe fractures due to its perceived weakness. This study challenges that perception by demonstrating the utility of PCL mesh in high-severity cases. Materials and Methods: Two patients with Le Fort II fractures and bilateral orbital floor fractures underwent orbital reconstruction using a 3D-printed PCL mesh. The mesh was molded and inserted through subciliary or transconjunctival incisions. Orbital volumes were analyzed preoperatively and postoperatively using CT scans and a 3D Analysis program. Results: Both cases demonstrated significant correction of orbital volume differences postoperatively, leading to improved symmetry and successful reconstruction. For case 1, the preoperative orbital volume difference of 3.2 cc was reduced to 1.1 cc postoperatively. For case 2, the preoperative orbital volume difference of 1.18 cc was reduced to 0.4 cc postoperatively. The PCL mesh provided adequate structural support and facilitated effective tissue integration. Despite the radiolucency of the PCL mesh on CT scans, volumetric analysis confirmed stable and balanced orbital volumes. Conclusions: Pure PCL mesh is a viable alternative for orbital floor reconstruction in severe craniofacial fractures, offering a balance of structural support and biocompatibility. To validate these findings, further research with larger samples and long-term follow-up is recommended
Spatial associations of daily PM2.5 concentration with cardiovascular and pulmonary morbidity in Korea
No full textAir pollution, particularly fine particulate matter less than 2.5 μm in diameter (PM2.5), contributes to respiratory and cardiovascular diseases and poses significant public health risks worldwide. This study evaluated the short-term effects of PM2.5 on hospital admissions for cardiovascular and respiratory diseases, with additional analyses to identify vulnerable populations based on regional characteristics. The present study analyzed data from 249 Korean communities between 2006 and 2021. Data on daily hospital admissions for cardiovascular and respiratory diseases were obtained from the National Health Insurance Service. Data on PM2.5 concentrations were sourced from air quality modeling. Additional data on regional characteristics, including the regional deprivation index, proportion of elderly residents, education levels, and greenness levels, were also collected. We used case time series analysis to assess the associations between PM2.5 concentrations and hospital admissions for cardiovascular and respiratory diseases and explored effect modification by regional characteristics with stratified analyses. The mean numbers of daily cardiovascular admissions and respiratory admissions were 5.68 ± 5.46 and 6.46 ± 8.03, respectively. The mean PM2.5 concentrations were 23.58 ± 13.66 μg/m3. A10 μg/m³ increment in daily PM2.5 concentration was associated with increase of cardiovascular and respiratory hospitalization by 0.94% (95% CI: 0.84%, 1.04%) and 1.43% (95% CI: 1.34%, 1.52%), respectively. Regional characteristics analysis showed significant disparities, with higher risks for hospital admissions in areas with lower deprivation and low greenness. This study highlights the significant short-term health impacts of PM2.5 on respiratory and cardiovascular hospital admissions in Korean communities. The findings underscore the critical role of regional and demographic factors in modulating these effects, identifying socio-economic areas, age structure of the population, lower education levels, and low greenness as key vulnerability factors
Protocol for the acquisition and maturation of oligodendrocytes from neonatal rodent brains
Get PDFThe generation of an oligodendrocyte primary culture model encompassing the diverse stages of the lineage is essential for the in vitro research of oligodendrocyte physiology and pathophysiology. Here, we provide a protocol for generating oligodendrocytes from the neonatal rodent brain. We describe steps for isolating oligodendrocyte progenitor cells (OPCs) through differential centrifugation, their subsequent expansion, passaging, and differentiation. For complete details on the use and execution of this protocol, please refer to Kim et al.1
Targeting the Hippo pathway in Schwann cells ameliorates peripheral nerve degeneration via a polypharmacological mechanism
Get PDFPeripheral neuropathies (PNs) are common diseases in elderly individuals characterized by Schwann cell (SC) dysfunction and irreversible Wallerian degeneration (WD). Although the molecular mechanisms of PN onset and progression have been widely studied, therapeutic opportunities remain limited. In this study, we investigated the pharmacological inhibition of Mammalian Ste20-like kinase 1/2 (MST1/2) by using its chemical inhibitor, XMU-MP-1 (XMU), against WD. XMU treatment suppressed the proliferation, dedifferentiation, and demyelination of SCs in models of WD in vitro, in vivo, and ex vivo. As a downstream mediator of canonical and noncanonical Hippo/MST1 pathway activation, the mature microRNA (miRNA) let-7b and its binding partners quaking homolog (QKI)/nucleolin (NCL) modulated miRNA-mediated silencing of genes involved in protein transport. Hence, direct phosphorylation of QKI and NCL by MST1 might be critical for WD onset and pathogenesis. Moreover, p38α/mitogen-activated protein kinase 14 (p38α) showed a strong affinity for XMU, and therefore, it may be an alternative XMU target for controlling WD in SCs. Taken together, our findings provide new insights into the Hippo/MST pathway function in PNs and suggest that XMU is a novel multitargeted therapeutic for elderly individuals with PNs
Early pulmonary fibrosis-like changes between delta and pre-delta periods in patients with severe COVID-19 pneumonia on mechanical ventilation
Get PDFIt remains unclear whether pulmonary fibrosis-like changes differ in patients with different SARS-CoV-2 variants. This study aimed to compare pulmonary fibrotic changes between two SARS-CoV-2 variant periods (delta vs. pre-delta) in critically ill patients with SARS-CoV-2 pneumonia. Clinical data and chest CT images of patients with SARS-CoV-2 pneumonia receiving mechanical ventilation were collected from 10 hospitals in South Korea over two periods: delta (July-December, 2021; n = 64) and pre-delta (February, 2020-June, 2021; n = 120). Fibrotic changes on chest CT were evaluated through visual assessment. Of 184 patients, the mean age was 64.6 years, and 60.5% were ale. Fibrosis-like changes on chest CT (median 51 days from enrollment to follow up CT scan, interquartile range 27–76 days) were identified in 75.3%. Delta group showed more fibrosis-like changes (≥ 2) (69.8% vs. 43.1%, P = 0.001) and more frequent reticulation and architectural distortion+/-parenchymal band than pre-delta group. Even after propensity score matching with clinical variables, delta group had more severe (≥ 2) fibrosis-like changes (71.4% vs. 38.8%, P = 0.001), and more frequent reticulation and architectural distortion+/-parenchymal band than pre-delta group. Our data suggest that critically ill patients with SARS-CoV-2 in delta period had more severe pulmonary fibrosis-like changes than those in pre-delta period
The last chain of trauma survival: development of a scale for trauma-rehabilitation linkage in South Korea using a systematic review and expert consensus
Get PDFPurpose: There is a high possibility of trauma patients being referred to an unsuitable medical institution for their rehabilitation treatment since the decision is made by them. This study sought to develop a standardized scale to evaluate the need for specialized rehabilitation in patients with multiple traumas and evaluate the effectiveness of the developed scale. Methods: This study employed a systematic review of existing literature to inform the development of a specialized rehabilitation evaluation scale. An expert panel consisting of trauma surgeons, orthopedic surgeons, and rehabilitation medicine physicians collaborated to create a discharge-planning checklist by assessing the need for specialized rehabilitation. The checklist was validated using retrospective data from trauma patients treated at Seoul National University Hospital. Results: We identified 12 studies, providing factors influencing the discharge location and rehabilitation needs of trauma patients. The checklist was developed through expert consensus and comprised 3 criteria: discharge feasibility to specialized rehabilitation facilities, diagnostic eligibility for specialized rehabilitation, and functional assessment. Validation of the checklist demonstrated that the percentage agreement, likelihood ratio of a positive test, and Cohen's kappa value were 82.1%, 5.21, and 0.375, respectively when comparing whether the checklist was met and the actual discharge location, indicating its effectiveness. Conclusion: This study established standardized criteria for assessing the need for specialized rehabilitation in trauma patients, offering a practical tool for clinical use. Implementation of this assessment scale has the potential to improve the trajectory of trauma survivors by facilitating access to appropriate rehabilitation services
Sun Exposure Behaviors and Knowledge Among the At-Risk Population: Results From an International Survey, the HELIOS Project
Get PDFCB1R activates the epilepsy-associated protein Go to regulate neurotransmitter release and synaptic plasticity in the cerebellum
No full textGNAO1 encodes the alpha subunit of the heterotrimeric Go protein. Despite being the most abundant G protein at synapses, the role of Go in the brain remains unclear, primarily because of the high mortality associated with developmental and epileptic encephalopathy (DEE) 17 in Gnao1 mutated animals. Here, we conducted proteomic analyses with a brain synaptosomal fraction to investigate the Go-interactome and then generated a non-DEE model using Gli1CreERT2 mice to selectively knockout (KO) the presynaptic Gαo within cerebellum. Our findings revealed that Gαo interacts with multiple proteins involved in neurotransmitter release, as well as cannabinoid receptor type 1 (CB1R), a key Gi/o-coupled receptor in presynaptic terminals. In Gnao1 KO mice, synapse formation was reduced in the cerebellum with a concomitant reduction in depolarization-induced suppression of excitation, a manifestation of CB1R-mediated synaptic plasticity found in the cerebellum. These mice displayed motor deficits in rotarod, grip strength, gait, and beam balance tests. Our results suggest that Go plays a critical role in regulating neurotransmitter releases at the presynaptic terminals and its absence in the entire brain may contribute to DEE pathogenesis. This study also provides valuable insights into the signaling pathways in the brain from a Go-dependent perspective
Characteristics of Pediatric Ulcerative Colitis at Diagnosis in Korea: Results From a Multicenter, Registry-Based, Inception Cohort Study
No full textBackground: We aimed to investigate the characteristics of pediatric ulcerative colitis (UC) at diagnosis in Korea. Methods: This was a multicenter, registry-based, inception cohort study conducted in Korea between 2021 and 2023. Children and adolescents newly diagnosed with UC < 18 years were included. Baseline clinicodemographics, results from laboratory, endoscopic exams, and Paris classification factors were collected, and associations between factors at diagnosis were investigated. Results: A total 205 patients with UC were included. Male-to-female ratio was 1.59:1, and the median age at diagnosis was 14.7 years (interquartile range 11.9–16.2). Disease extent of E1 comprised 12.2% (25/205), E2 24.9% (51/205), E3 11.2% (23/205), and E4 51.7% (106/205) of the patients. S1 comprised 13.7% (28/205) of the patients. The proportion of patients with a disease severity of S1 was significantly higher in patients with E4 compared to the other groups (E1: 0% vs. E2: 2% vs. E3: 0% vs. E4: 24.5%, P < 0.001). Significant differences between disease extent groups were also observed in Pediatric Ulcerative Colitis Activity Index (median 25 vs. 35 vs. 40 vs. 45, respectively, P < 0.001), hemoglobin (median 13.5 vs. 13.2 vs. 11.6 vs. 11.4 g/dL, respectively, P < 0.001), platelet count (median 301 vs. 324 vs. 372 vs. 377 × 103/μL, respectively, P = 0.001), C-reactive protein (median 0.05 vs. 0.10 vs. 0.17 vs. 0.38 mg/dL, respectively, P < 0.001), and Ulcerative Colitis Endoscopic Index of Severity (median 4 vs. 4 vs. 4 vs. 5, respectively, P = 0.006). No significant differences were observed in factors between groups divided according to sex and diagnosis age. Conclusion: This study represents the largest multicenter pediatric inflammatory bowel disease cohort in Korea. Disease severity was associated with disease extent in pediatric patients with UC at diagnosis