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To investigate the highest opportunity skin puncture point and needle orientation according to facial asymmetry and classification.Computed tomography of 136 patients was analyzed. Horizontal and vertical angles and distances from the canthal-tragal line were investigated to determine the puncture point and needle's angle.All patients' average points were 7.39 (±2.85) mm anterior to the tragus and 3.44 (±4.18) mm below the canthal-tragal line with an angle of 8.53 (±6.90)° anteriorly and 32.26 (±7.23)° superiorly. Regarding asymmetry, there was a statistical difference in horizontal angle, depth, and canthal-tragal distance between the deviated and non-deviated sides. Especially, vertical distances were 4.44 (±4.66) mm and 2.59 (±4.11) mm in the deviated and non-deviated sides, respectively (In closed-mouth, the puncture point was closer to the tragus and lower than the conventional point. The point in the deviated side should be considered lower than the non-deviated side.

This retrospective study aimed to analyze data on nerve damage in patients who complained of sensory changes after dental implant surgery, the clinical results according to proximity of the implant fixture to the inferior alveolar nerve (IAN) canal, and the factors affecting recovery of sensation.The electronic medical records of 64 patients who had experienced sensory change after implant surgery were reviewed. Patients were classified by sex, age, implant installation sites, recovery rate and the distance between the implant fixture and IAN canal on computed tomography (CT). The distance was classified into Group I (D2 mm), Group II (2 mm≥D0 mm), and Group III (D≤0 mm).The 64 patients were included and the mean age was 57.3±7.3 years. Among the 36 patients who visited our clinic more than two times, 21 patients (58.3%) reported improvement in sensation, 13 patients (36.1%) had no change in sensation, and 2 patients (5.6%) reported worsening sensation. In Group II, symptom improvement was achieved in all patients regardless of the removal of the implant fixture. In Group III, 8 patients (40.0%) had reported symptom improvement with removal of the implant fixture, and 2 patients (33.3%) of recovered patients showed improvement without removal. Removal of the implant fixture in Group III did not result in any significant difference in recovery (Clinicians first should consider removing the fixture when it directly invades the IAN canal. However, in cases of sensory change after dental implant surgery where the drill or implant fixture did not invade the IAN canal, other indirect factors such as flap elevation and damage due to anesthesia should be considered as causes of sensory change. Removal of the implant should be considered with caution in these situations.

The benefits of dissecting inferior pulmonary ligament (IPL) during upper lobectomy using video-assisted thoracoscopic surgery (VATS) for early-stage lung cancer remains controversial. This study evaluates the effect of IPL dissection by comparing the lung volume, bronchial angle, and bronchial tortuosity of the left lower lobe (LLL) during VATS upper lobectomy. Medical records of all patients who underwent VATS left upper lobectomy for early-stage lung cancer were evaluated. Patients were divided into group P (preservation) and group D (dissection). Pre- and post-surgery lung volumes, bronchial angles (angle 1: axial angulation, angle 2: vertical angulation), and bronchial tortuosity (curvature index of the left main bronchus) were measured using computed tomography images for comparison. Forty patients were included in each group. Patient characteristics such as age, gender, body mass index, and smoking status, and preoperative lung volume, bronchial angles, and tortuosity were not significantly different between the two groups, and there was no statistically significant difference in the axial and vertical angulations, however, the change in pre- and postoperative bronchial tortuosity (0.03 ± 0.03 vs. 0.06 ± 0.03) and lung volume (−558.1 ± 410.0 mL vs. −736.3 ± 382.7 mL) showed a significant difference (p &lt, 0.001 and p = 0.04, respectively). Preservation of IPLs during left upper lobectomy may be beneficial for LLL expansion and induces less movement and positional change in the left main bronchus.

Repetitive transcranial magnetic stimulation (rTMS) is a non-invasive therapy that has been implicated in treatment of serious neurological disorders. However, the neurobiological mechanisms underlying the effects of rTMS remain unclear. Therefore, this study examined the differential effects of repetitive magnetic stimulation (rMS) in an in vitro neuronal model of ischemia/reperfusion (I/R) injury, depending on low and high frequency. Neuro-2a cells were differentiated with retinoic acid and established for in vitro neuronal model of I/R injury under a subsequent 3 h of oxygen and glucose deprivation/reoxygenation (OGD/R) condition. After the I/R injury, the differentiated neuronal cells were stimulated with rMS on day 1 and randomly divided into three groups: OGD/R+sham, OGD/R+low-frequency, and OGD/R+high-frequency groups. High-frequency rMS increases cell proliferation through activation of extracellular signal-regulated kinases and AKT-signaling pathway and inhibits apoptosis in OGD/R-injured cells. Furthermore, high-frequency rMS increases Ca2+–calmodulin-dependent protein kinase II (CaMKII)-cAMP-response element binding protein (CREB) signaling pathway, further leading to alternation of brain-derived neurotrophic factor expression and synaptic plasticity in OGD/R injured cells. These results verified the neurobiological mechanisms of frequency-dependent rMS in I/R injury-treated neuronal cells. These mechanisms will help develop more powerful and credible rTMS stimulation treatment protocols.

Infected aortic aneurysms are rare, but the mortality of patients with infected aortic aneurysms remains high. Open surgical procedures are the standard of care for infected aneurysms of aorta, but the surgical results are often disappointing. The risk factors related to the high mortality include aneurysm rupture and a suprarenal aneurysm location. The classic method for treating infected aneurysms has been aneurysm resection, soft tissue debridement, remote arterial reconstruction out of the field of infection and antibiotics. Infected anuerysms located in the suprarenal aorta are highly lethal because of the need to reimplant the visceral or renal arteries and the graft related complications. We reported here on a case of suprarenal infected aortic aneurysm in a 55-years-old man. We also include a review of the relevant medical literature.

Recent studies of the distribution of PKC isoenzymes in the mouse kidney demonstrated that PKC-α, -βI, and -δ are expressed in intercalated cells. The purpose of this study was to identify the intercalated cell subtypes that express the different PKC isoenzymes and determine the location of the PKC isoenzymes within these cells. Adult C57BL/6 mice kidney tissues were processed for multiple-labeling immunohistochemistry. Antibodies against the vacuolar H+-ATPase and pendrin were used to identify intercalated cell subtypes, whereas antibodies against calbindin D28Kand aquaporin-2 (AQP2) were used to identify connecting tubule cells and principal cells of the collecting duct, respectively. Within type A intercalated cells, PKC-δ was highly expressed in the apical part of the cells, whereas immunoreactivity for both PKC-α and PKC-βIwas weak. Type B intercalated cells exhibited strong expression of PKC-α, -βI, and -δ. PKC-α and -βIwere localized throughout the cytoplasm, whereas PKC-δ was restricted to the basal domain. Within non-A-non-B cells, immunoreactivity for both PKC-α and PKC-βIwas high in intensity and localized diffusely in the cytoplasm, whereas PKC-δ was localized in the apical part of the cells. None of the PKC isoenzymes (PKC-α, -βI, or -δ) were expressed in the calbindin D28K-positive connecting tubule cells. Within AQP2-positive principal cells of the collecting duct, PKC-α was expressed on the basolateral plasma membrane, but no significant staining was detected for PKC-βIand -δ. In summary, this study demonstrates distinct and differential expression patterns of PKC-α, -βI, and -δ in the three subtypes of intercalated cells in the mouse kidney.

Axanthogranuloma (XG) is a rare benign histiocytic disorder that occurs mostly in infants and young children.' Approximately 15% of XGs occur in adults and usually appear as solitary lesions in the head and the neck region. In most cases, an XG appears as a solitary yellow-red cutaneous nodule in the head and the neck region that regresses spontaneously over a course of months to years. 1,2 An extracutaneous XG is uncommon, and it can occur with or without a cutaneous XG. An extracutaneous XG most commonly occurs in the eye, but findings at other sites such as the central nervous system, lungs, liver, spleen, kidneys, and bone have also been reported. 2-5 The pathogenesis of XGs is unknown. Although physical and infectious factors have been considered, most investigators postulate that they are caused by a reactive response to an unknown stimulus. 3,4 Xanthogranulomas can be divided into juvenile and adult forms. Distinctive from the juvenile form, the adult XG rarely undergoes a spontaneous regression, and concomitant extracutaneous examples are very uncommon. 2-5 Patients with adult XGs are mostly in their late teens to late 30s, although approximately 5% of the patients are in their 60s to 70s. 2-5 We report an exceptional case of an adult breast XG in a 60-year-old woman.