A gossypiboma (foreign body granuloma) mimicking a residual odontogenic cyst in the mandible: a case report

<p>Abstract</p> <p>Introduction</p> <p>Gossypiboma (foreign body granuloma) in the tooth socket as a complication of tooth removal is rare. Several cases of gossypiboma have been reported after orthopedic, abdominal, otorhinolaryngology, or plastic surgery, but there has been only one reported case after oral surgery.</p> <p>Case presentation</p> <p>A 42-year-old Caucasian German-speaking Swiss woman applied to our clinic for removal of her right mandibular first molar. Her right mandibular third molar had been removed seven years ago. Post-operatively, she complained of pain and foreign body sensation for six months in the area of the removed tooth. A panoramic radiograph of our patient showed a defined and oval radiolucent area in the socket of the right mandibular third molar evoking a residual cyst. An operation was planned to remove the cyst-like lesion. During surgery, a foreign body composed of gauze was found in the right mandibular third molar region. The histological findings were compatible with a foreign body reaction around gauze.</p> <p>Conclusion</p> <p>Retained gauze must be considered if patients complain of pain and foreign body sensation after tooth removal. The use of gauze with radio-opaque markers and extensive irrigation of the socket with saline to remove gauze fragments can avoid this mishap.</p

Interpretation of Experimental J^PC Exotic Signals

We investigate theoretical interpretations of the 1.4 GeV J^PC exotic resonance reported by the E852 collaboration. It is argued that interpretation in terms of a hybrid meson is untenable. A K-matrix analysis shows that the 1.4 GeV enhancement in the E852 eta pi data can be understood as an interference of a non-resonant Deck-type background and a resonance at 1.6 GeV. A final state rescattering calculation shows that the 1.6 GeV hybrid has a eta pi width which is bounded above by 57 \pm 14 MeV.Comment: 23 pages, LaTeX, 4 encapsulated postscript figures. Accepted for publication by Physical Review

Inter-domain Communication Mechanisms in an ABC Importer: A Molecular Dynamics Study of the MalFGK2E Complex

ATP-Binding Cassette transporters are ubiquitous membrane proteins that convert the energy from ATP-binding and hydrolysis into conformational changes of the transmembrane region to allow the translocation of substrates against their concentration gradient. Despite the large amount of structural and biochemical data available for this family, it is still not clear how the energy obtained from ATP hydrolysis in the ATPase domains is “transmitted” to the transmembrane domains. In this work, we focus our attention on the consequences of hydrolysis and inorganic phosphate exit in the maltose uptake system (MalFGK2E) from Escherichia coli. The prime goal is to identify and map the structural changes occurring during an ATP-hydrolytic cycle. For that, we use extensive molecular dynamics simulations to study three potential intermediate states (with 10 replicates each): an ATP-bound, an ADP plus inorganic phosphate-bound and an ADP-bound state. Our results show that the residues presenting major rearrangements are located in the A-loop, in the helical sub-domain, and in the “EAA motif” (especially in the “coupling helices” region). Additionally, in one of the simulations with ADP we were able to observe the opening of the NBD dimer accompanied by the dissociation of ADP from the ABC signature motif, but not from its corresponding P-loop motif. This work, together with several other MD studies, suggests a common communication mechanism both for importers and exporters, in which ATP-hydrolysis induces conformational changes in the helical sub-domain region, in turn transferred to the transmembrane domains via the “coupling helices”

Dynamics of disease characteristics and clinical management of critically ill COVID-19 patients over the time course of the pandemic: an analysis of the prospective, international, multicentre RISC-19-ICU registry.

BACKGROUND It remains elusive how the characteristics, the course of disease, the clinical management and the outcomes of critically ill COVID-19 patients admitted to intensive care units (ICU) worldwide have changed over the course of the pandemic. METHODS Prospective, observational registry constituted by 90 ICUs across 22 countries worldwide including patients with a laboratory-confirmed, critical presentation of COVID-19 requiring advanced organ support. Hierarchical, generalized linear mixed-effect models accounting for hospital and country variability were employed to analyse the continuous evolution of the studied variables over the pandemic. RESULTS Four thousand forty-one patients were included from March 2020 to September 2021. Over this period, the age of the admitted patients (62 [95% CI 60-63] years vs 64 [62-66] years, p < 0.001) and the severity of organ dysfunction at ICU admission decreased (Sequential Organ Failure Assessment 8.2 [7.6-9.0] vs 5.8 [5.3-6.4], p < 0.001) and increased, while more female patients (26 [23-29]% vs 41 [35-48]%, p < 0.001) were admitted. The time span between symptom onset and hospitalization as well as ICU admission became longer later in the pandemic (6.7 [6.2-7.2| days vs 9.7 [8.9-10.5] days, p < 0.001). The PaO2/FiO2 at admission was lower (132 [123-141] mmHg vs 101 [91-113] mmHg, p < 0.001) but showed faster improvements over the initial 5 days of ICU stay in late 2021 compared to early 2020 (34 [20-48] mmHg vs 70 [41-100] mmHg, p = 0.05). The number of patients treated with steroids and tocilizumab increased, while the use of therapeutic anticoagulation presented an inverse U-shaped behaviour over the course of the pandemic. The proportion of patients treated with high-flow oxygen (5 [4-7]% vs 20 [14-29], p < 0.001) and non-invasive mechanical ventilation (14 [11-18]% vs 24 [17-33]%, p < 0.001) throughout the pandemic increased concomitant to a decrease in invasive mechanical ventilation (82 [76-86]% vs 74 [64-82]%, p < 0.001). The ICU mortality (23 [19-26]% vs 17 [12-25]%, p < 0.001) and length of stay (14 [13-16] days vs 11 [10-13] days, p < 0.001) decreased over 19 months of the pandemic. CONCLUSION Characteristics and disease course of critically ill COVID-19 patients have continuously evolved, concomitant to the clinical management, throughout the pandemic leading to a younger, less severely ill ICU population with distinctly different clinical, pulmonary and inflammatory presentations than at the onset of the pandemic

Tatool: A Java-based open-source programming framework for psychological studies

Tatool (Training and Testing Tool) was developed to assist researchers with programming training software, experiments, and questionnaires. Tatool is Java-based, and thus is a platform-independent and object-oriented framework. The architecture was designed to meet the requirements of experimental designs and provides a large number of predefined functions that are useful in psychological studies. Tatool comprises features crucial for training studies (e.g., configurable training schedules, adaptive training algorithms, and individual training statistics) and allows for running studies online via Java Web Start. The accompanying "Tatool Online” platform provides the possibility to manage studies and participants' data easily with a Web-based interface. Tatool is published open source under the GNU Lesser General Public License, and is available at www.tatool.c

Spätrezidive beim keratozystischen odontogenen Tumor (KZOT) : Ein Bericht über drei Patientenfälle

BACKGROUND: Keratocystic odontogenic tumours (KCOT) are benign neoplasia of dentogenic origin and have a high relapse rate. Various invasive treatment methods (decompression, marsupialisation, enucleation, enucleation with adjunctive therapy such as scraping out of the bone cavity, Carnoy's solution or cryotherapy, mandibular resection) have been described for the treatment of KCOT. There is no common opinion on the best kind of treatment. Most of the articles in the literature report on a follow-up period of 5-7 years, but relapses have been described even after longer periods of time. This article presents 3 cases with late relapses that were treated at the University of Zurich, Center of Dental Medicine, Clinic of Cranio-Maxillofacial Surgery and Clinic for Oral Surgery. At the time of the initial diagnosis, the patients were 19, 24.5 and 36 years old. In all 3 patients the KCOT was localized in the angulus/ramus mandibula and an impacted wisdom tooth was present in the affected area. Case no. 1 was treated solely by marsupialisation of the KCOT. In cases no. 2 and 3, the cystic lesion was first marsupialised and later treated by enucleation and application of Carnoy's solution. In case no. 1, a relapse developed 13.5 years after the first operation. In case no. 2, relapses occurred 9, 28 and 31 years after the first operation. In case no. 3, a first relapse appeared 9 years and a second one 18 years after the first operation. CONCLUSION: Patients with a KCOT require lifelong aftercare because relapses of KCOTs can arise even after 10 or more years. The aftercare concept at the University of Zurich, Center of Dental Medicine, Clinic of Cranio-Maxillofacial Surgery and Clinic for Oral Surgery therefore consists of a clinical and x-ray (orthopantomogram) follow-up examination every year for the first 10 years and every two years thereafter

The most common complications after wisdom-tooth removal: Part 2: A retrospective study of 1,562 cases in the maxilla

The possible complications of wisdom-tooth removal must be considered, because it is the most common surgical intervention in dental practices. This retrospective study assessed the complications occurring during the removal of 1,562 maxillary wisdom teeth in 1,212 patients. A total of 543 cases of surgical removal and 1,019 cases of non-surgical removal were analyzed. In all cases, a pre-operative panoramic radiograph was taken. Anatomical and clinical parameters were included in the evaluation. 106 complications occurred in 92 patients (5.9%) of the total 1,562 operations. Of these complications, 5.1% were intra-operative and 0.8% postoperative. An oroantral fistula (OAF) was found in 38 cases (2.4%), and alveolar osteitis occurred post-operatively in 6 cases (0.4%). The risk of OAF correlated with increasing patient age (p=0.0368). Root fractures also increased the risk of OAF. On the basis of the analysis of pre-operative panoramic radiographs, it was shown that radiological projection of the root tips to the sinus floor is a reliable criterion to assess the risk of OAF