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Mandibular reconstruction using customized three-dimensional titanium implant Mandibular defects lead to severe deformation and functional deficiency. Vascularized osteocutaneous tissue has been widely used to reconstruct the mandible. However, it is technically challenging to shape this type of grafts in such a manner that they resemble the configuration of the mandible. A 48-year-old female patient who underwent anterolateral thigh (ALT) flap coverage after a tonguecancer excision (...) was diagnosed with a tumor recurrence during the follow-up. A wide excision mandibulectomy and mandibular reconstruction with an ALT flap and a titanium implant were performed. The prefabricated titanium implant was fixed to the condyle. Then, an ALT flap was harvested from the ipsilateral thigh and anastomosed. After confirming that the circulation of the flap was intact, the implant was fixed to the parasymphysis. On the radiograph taken after the surgery, the prosthesis was well positioned and overall
Earable RCC: Development of an Earphone-Type Reliable Chewing-Count Measurement Device Gastric cancer patients having undergone gastrectomy are at a high risk of becoming malnourished owing to decreased gastric function. To prevent malnutrition, patients need to thoroughly chew a mouthful of food at least 30 times. For these gastrectomy patients requiring dietary support, we developed a chewing-count measurement device named earable RCC using an earphone-type sensor. Experiments to evaluate (...) at the timing of chewing. The experimental results also imply that earphone-type sensors may be used to measure swallowing, occlusal force, and tongue motion. Our future plans include clinical testing of the earphone-type chewing-count measurement device to determine its utility in patients who have undergone gastrectomy. We also intend to expand the application of this device for use in other patients to aid in dementia prevention and dietary support.
sclerosis, schizophrenia, depression, etc.; The ASA class I or II; The people signed informed consent. Exclusion Criteria: Had severe head and face disease, trauma history or history of surgery; Had a history of influenza in 3 weeks; The serious body disease and tobacco, wine and other substance abuse history; The presence of malignanttumor with shorter survival disease. Contacts and Locations Go to Information from the National Library of Medicine To learn more about this study, you or your doctor may (...) or equal to 65 years old; Han Nationality, mother tongue is chinese; The MMSE score: Illiteracy is greater than or equal to 17 points, primary school is greater than or equal to 20 points, higher secondary school is more than 24 points; Being able to complete the assessments without serious visual or hearing difficulty; Without serious heart, brain, liver, kidney, lung and other organs; Without serious neurological and psychiatric disorders, such as Alzheimer's disease, Parkinson's syndrome, multiple
, or xerostomia. Presence of tongue piercings or other foreign objects likely to interfere with dissolution procedure of IMP in the opinion of the investigator. Use of St. John's Wort or kava-kava within 3 months prior to screening. History of malignancy including leukemia and lymphoma (except basal cell skin cancer) within the past 5 years prior to screening. Vegetarian or any abnormal diet (for whatever reason). Any condition not identified in the protocol that in the opinion of the investigator (...) Details Study Description Go to Brief Summary: The purpose of the study is to compare the pharmacokinetic (PK) profiles and assess bioequivalence between a new nicotine lozenge and a reference nicotine lozenge in healthy smokers Condition or disease Intervention/treatment Phase Smoking Cessation Drug: Nicotine lozenge Phase 1 Study Design Go to Layout table for study information Study Type : Interventional (Clinical Trial) Actual Enrollment : 42 participants Allocation: Randomized Intervention Model
: No Criteria Inclusion Criteria: non-smoker diabetic patients type II Patients with unstimulated resting saliva ≤ 0.16 ml/min considered to be abnormally low flow rate and included in the study (Navazesh et al., 1992) Exclusion Criteria: Cancer patients (patients on chemotherapy/immunotherapy and history of head and neck radiotherapy). Cardiac patients (cardiac pacemakers and defibrillators). Patients wearing hearing aids. Chronic inflammatory autoimmune diseases Acute oral inflammatory disorders Patients (...) on bilateral parotid glands. Condition or disease Intervention/treatment Phase Diabetes type2 Hyposalivation Device: TENS Not Applicable Detailed Description: Diabetes mellitus is the most significant disorder associated with varied oral manifestation ranging from xerostomia (subjective sensation od dry mouth) to serious bacterial and fungal infections due to alterations in flow rate of saliva. Systemic agents increase rate of stimulated salivary flow but often have unfavourable side effects
of glucocorticoid treatment in the subset of LV-GCA patients and the diagnostic accuracy of 18F-FDG PET/CT in cranial artery inflammation in new-onset, treatment naïve c-GCA patients as compared to a control group of patients with a previous diagnosis of malignant melanoma was also evaluated and is registered elsewhere (ClinicalTrials.gov Identifier: NCT03285945 and NCT03409913, respectively) Condition or disease Intervention/treatment Giant Cell Arteritis Vasculitis Diagnostic Test: Ultrasound Detailed (...) it is increasingly used in the diagnosis of c-GCA, is readily available and cheap. 18F-FDG PET/CT is an appealing diagnostic tool in LV-GCA suspected patients, since it also evaluates malignancy and infection, differential diagnoses often considered in this disease subset. However, 18F-FDG PET/CT is often not readily available, is expensive and exposes patients to radiation. Moreover, its sensitivity seems to decrease with glucocorticoid (GC) treatment and the window of opportunity in which sensitivity
Le lymphangiome circonscrit superficiel de la langue Superficial circumscribed lymphangiomas are predominantly benign lesions occuring in the cervicofacial area. These malformations of the lymphatic vessels are frequently diagnosed in children. We report the clinical case of lymphangioma of the tongue that occurred in an old man. The differential diagnosis was made primarily with Kaposi's disease, circumscribed angiokeratoma and metastases of a solid tumor. The patient had a biopsy
. The imaging features are generally diagnostic for characterization. However, these masses can exhibit indeterminate appearance at imaging. We present a series of five cases which includes two rare presentations: a case of low-grade cribriform adenocarcinoma of the base of tongue and a vallecular lipoma. The other three cases presented for differential diagnosis including benign vallecular cysts and two cases to show that malignant masses arising from neighboring anatomical sites such as tongue base (...) Large Vallecular Masses; Differential Diagnosis and Imaging Features Large vallecular masses are an uncommon disease entity which includes a wide spectrum of rare pathologies. These masses may present as purely vallecular in location or appear as an extension from adjacent anatomical sites like tongue base including lingual tonsils, epiglottis, palatine tonsils, epiglottis, and the remainder of supraglottis. Literature review reveals very rare conditions presenting as vallecular mass lesions
with oral carcinogenesis still remains unclear and its underlying mechanism needs to be addressed. Here, we established a combined experimental system of 4NQO-induced oral carcinoma model and chronic periodontitis model and investigated the effects of P. gingivalis infection on oral carcinogenesis and fatty acid metabolism during oral carcinogenesis. The data showed that in this animal model, P. gingivalis infection induced mice periodontitis, increased the tongue lesion size and multiplicity of each (...) mouse and promoted oral cancer development. P. gingivalis treatment significantly increased the level of free fatty acids and altered the fatty acid profile in tongue tissues and the serum of mice. And P. gingivalis induced the formation of fatty liver of the mice. Besides, immunohistochemical analysis and qRT-PCR showed that the expression of fatty-acid synthase and acetyl-CoA carboxylase 1 were increased in the tongue and liver tissues of 4NQO-treated mice infected with P. gingivalis
the presented case series, we hope to emphasize the versatile nature of the free ulnar forearm flap in addressing various craniofacial soft-tissue defects. Following institutional review board approval, a retrospective review of the senior authors' clinical experience performing microvascular free ulnar forearm flap reconstruction of craniofacial soft-tissue defects was performed. A total of 10 patients were identified through our review. Soft-tissue defect locations included lower eyelid (n = 2), tongue (...) and floor of mouth (n = 2), lower lip (n = 2), palatopharyngeal area (n = 1), nose (n = 1), and palate (n = 1). Trauma was the most common defect etiology (n = 5), followed by malignancy (n = 4), and iatrogenic injury in 1 case. All patients demonstrated good aesthetic and functional outcomes related to vision, speech, and oral intake at follow-up when applicable. The free ulnar forearm flap is a versatile reconstructive option that can be used to address a wide spectrum of craniofacial soft-tissue
induced in the rat small intestine after external irradiation of the tongue, and to explore the potential radio-protective effects of melatonin gel. Male Wistar rats were subjected to irradiation of their tongues with an X-Ray YXLON Y.Tu 320-D03 irradiator, receiving a dose of 7.5 Gy/day for 5 days. For 21 days post-irradiation, rats were treated with 45 mg/day melatonin gel or vehicle, by local application into their mouths. Our results showed that mitochondrial oxidative stress, bioenergetic (...) intestinal mucosa recovery. Our findings suggest that oral treatment with melatonin gel may be a potential preventive therapy for radiotherapy-induced gut toxicity in cancer patients.
. . . go home, get your NHS number, and ring it through to the surgery straight away, and we will start the referral process. Following several bounces around the system I was diagnosed with a rare, but lucky for me slow growing, cancer in my mouth. I also had an anomaly on my tongue that needed exploring. What did I learn? The experience taught me that I didn’t act on my instincts and wasn’t assertive. Yes folks, the system still makes it hard for patients to be assertive about seemingly “trivial (...) in this article where I reflect on three aspects of my experience with cancer, from a personal and professional perspective. Instinct and being heard I had been bothering about a lump in my mouth for well over a year, and I had mentioned it to others. However, it was my dental hygienist who really listened to me during the summer of 2018. In short it went like this: Me: I’m really worried about this lump. I have had it for ages and no one seems to be taking me seriously. Her: Then we should get it checked out
be indicated in pediatric patients for the eval- uation of upper GI tract tumors and pancreatic disorders, characterization of esophageal strictures, and for evalua- tion of enteric duplications. 31-34 Use of a miniprobe that can be passed through conventional endoscopes has increased the potential utility of EUS in infants and chil- dren. 35 EUS may be particularly important in the assess- ment of submucosal lesions, and its indications include cancer staging and pancreatic and biliary disease. Rectal EUS (...) of pedi- atric colonoscopies at the population level is far lower than that of adults. More uncommon, but nevertheless critically important, indications for colonoscopy in children include surveillance for neoplasia in children with long-standing in?ammatory bowel disease 5 and hereditary polyposis syn- dromes 12 as well as for graft-versus-host disease. 13,14 There are few contraindications to performing endo- scopic procedures in children. The size of the patient is rarely a contraindication
, cricopharyngeal bar) ? Eosinophilic esophagitis ? Head and neck malignancies and the consequences (e.g., hard fibrotic strictures) of surgical and/or radiotherapeutic interventions on these tumors ? Cervical osteophytes ? Oropharyngeal malignancies and neoplasms (rare) Neuromuscular disturbances: ? Central nervous system diseases such as stroke, Parkinson disease, cranial nerve palsy, or bulbar palsy (e.g., multiple sclerosis, motor neuron disease), amyotrophic lateral sclerosis ? Contractile disturbances (...) dysphagia) Mediastinal diseases —obstruct the esophagus by direct invasion, compression, or through lymph- node enlargement ? Tumors (e.g., lung cancer, lymphoma) ? Infections (e.g., tuberculosis, histoplasmosis) ? Cardiovascular (dilated auricles, vascular compression) Mucosal diseases —narrow the lumen through inflammation, fibrosis, or neoplasia ? Peptic stricture secondary to gastroesophageal reflux disease ? Esophageal rings and webs (sideropenic dysphagia or Plummer –Vinson syndrome) [8
). The threshold for these indications is 95%. Wheno 90% of procedures are for these indications, the department will review the process of patient selection. Gastric Feeding Many studies have shown that children with chronic diseases have decreased caloric intake or increased nutritional requirements (9,10). Althoughtemporaryaccesstothegastrointestinaltractcanbeobtained via a natural ori?ce such as with a nasogastric or nasojejunal feeding tube, such tubes are notoriously prone to occlusion and dislodgment (...) in children can lead to cholestatic liver disease and liver failure requiring liver transplantation (9,14,15). For all these reasons, placement of a percutaneousGtubehasbecomeacommonlyperformedprocedure.In adults, the most commonly used arti?cial feeding route is via a gastrostomy with feeds delivered directly into the stomach (8). To receive a G tube, a child must have normal or near-normal gastric and small bowel motility, and gastric anatomy must be adequate (8). At least in the newborn, transpyloric
; ; for the American College of Physicians High Value Care Task Force 1 Division of Adult Palliative Care, Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, Massachusetts 2 Ariadne Labs, Brigham and Women's Hospital & Harvard School of Public Health, Boston, Massachusetts 3 Division of Aging, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts 4 Center for Palliative Care, Harvard Medical School, Boston, Massachusetts 5 Departments of Psychiatry (...) of care. References1.Bernacki, RE, Block, SD. Communication About Serious Illness Care Goals : A Review and Synthesis of Best Practices . JAMA Intern.Med. 2014: 174(12):1-112. Blackhall, LJ, Frank, G et al. Bioethics in a different tongue : The case of truth-telling. J Urban Health.2001:78(1):59-713. Kagawa-Singer M, Blackhall LJ. Negotiating cross-cultural issues at the end of life: \"You got to go where he lives\". JAMA. 2001: 286(23):2993–3001.4. Blackhall, LJ, Murphy, ST et al .Ethnicity
hypertension, diabetes mellitus, cardiovascular disease, osteoarthritis, and sleep apnea. (2|⊕⊕○○) 2.2 We also recommend that such comorbidities be longitudinally monitored and rigorously managed. (Ungraded recommendation) 2.3 We suggest screening for colon neoplasia with colonoscopy at diagnosis. (2|⊕⊕○○) 2.4 We suggest a thyroid ultrasound if there is palpable thyroid nodularity. (2|⊕⊕○○) Evidence Morbidity and mortality from acromegaly are consequences of tumor compression, GH/IGF-1 excess (...) in those found to have a polyp or with persistently elevated IGF-1 and every 10 years in those without a polyp and with normal IGF-1 ( ). Acromegaly is associated with an increase in thyroid volume and nodularity. Disease duration correlates with the number of nodules on palpation ( ). In multicenter studies, 54% of subjects had thyroid nodules (approximately 25% with toxic nodules), 18–20% with diffuse goiter, and 1.2–7.2% with thyroid cancer (> 1-cm papillary thyroid carcinomas) ( – ). Thyroid cancer
2006;cD004175. 20. Zhu Bh, lv hT, Sun l, et al. A meta-analysis on the effect of corticosteroid therapy in Kawasaki disease. eur j Pediatr 2012;171:571–8. 21. Maury cP , Salo e, Pelkonen P . elevated circulat- ing tumor necrosis factor-alpha in patients with Kawasaki disease. j lab clin Med 1989;113:651–4. 22. crystal MA, Syan SK, y eung RS, Dipchand AI, Mccrindle BW. echocardiographic and electrocar- diographic trends in children with acute Kawasaki disease. can j cardiol 2008;24:776–80. 23 (...) Kawasaki disease. The importance of prompt recognition and early referral clinical individuals. 3 Timely treatment reduces coronary artery damage by up to 75%. 4 The aetiology of Kawasaki disease is unknown. It is believed that ubiquitous infection(s) trigger an abnormal host inflammatory response, leading to Kawasaki disease in genetically predisposed children. The diagnostic criteria include fever of at least 5 days duration, together with four of five cardinal clinical criteria, 5 which