A CLINICAL STUDY ON THE EMERGENCY PATIENTS WITH ACTIVE ORAL BLEEDING

This is a retrospective study on emergency patients with active oral bleeding. The study was based on a series of 135 patients treated as emergency patients at Wonju Christian Hospital, from Jan. 1, 1997, to Dec. 31, 2001. The postoperative bleeding was the most frequent cause of active oral bleeding in emergency room and bleeding from trauma and medically compromised (bleeding disorders) patients were next in order of frequency. In the injury of maxillofacial vessels, peak incidence was occurred in the inferior alveolar vessel (42.9%), followed by the submucosal vessel of lip & cheek, the superior alveolar vessel, and sublingual vessels. The most common disease of bleeding disorders was vascular wall alteration (infection, etc), followed by liver disease, thrombocytopenic purpura, anti-coagulation drugs in order. In the characteristics of dental diseases on bleeding disorders, periodontal disease and alveolar osteitis (osteomyelitis) were more common. The hemostasis was most obtained by use of wound suture, simple pressure dressing, drainage for infection control and primary interdental wiring of fracture. In the complication group, the infrequent incidence was showed in vomiting, hypovolemic shock, syncope, recurred bleeding & aspiration pneumonia. In the uncontrolled oral bleeding, the injured vessels were suspected as skull base & ethmoidal vessels. In this study, authors found that the close cooperation between the dentistry (Oral and maxillofacial surgery) and the medicine (emergency & internal medicine) was the most important for early proper control of active oral bleeding. And then post-operative wound closure, drainage for infection control and previous systemic evaluation of bleeding disorders were critical for the prevention of postoperative bleeding in the local dental clinic.ope

Prediction of African Swine Fever Virus Inhibitors by Molecular Docking-Driven Machine Learning Models

African swine fever virus (ASFV) causes a highly contagious and severe hemorrhagic viral disease with high mortality in domestic pigs of all ages. Although the virus is harmless to humans, the ongoing ASFV epidemic could have severe economic consequences for global food security. Recent studies have found a few antiviral agents that can inhibit ASFV infections. However, currently, there are no vaccines or antiviral drugs. Hence, there is an urgent need to identify new drugs to treat ASFV. Based on the structural information data on the targets of ASFV, we used molecular docking and machine learning models to identify novel antiviral agents. We confirmed that compounds with high affinity present in the region of interest belonged to subsets in the chemical space using principal component analysis and k-means clustering in molecular docking studies of FDA-approved drugs. These methods predicted pentagastrin as a potential antiviral drug against ASFVs. Finally, it was also observed that the compound had an inhibitory effect on AsfvPolX activity. Results from the present study suggest that molecular docking and machine learning models can play an important role in identifying potential antiviral drugs against ASFVs.ope

Exploring the chemical space of protein-protein interaction inhibitors through machine learning

Although protein-protein interactions (PPIs) have emerged as the basis of potential new therapeutic approaches, targeting intracellular PPIs with small molecule inhibitors is conventionally considered highly challenging. Driven by increasing research efforts, success rates have increased significantly in recent years. In this study, we analyze the physicochemical properties of 9351 non-redundant inhibitors present in the iPPI-DB and TIMBAL databases to define a computational model for active compounds acting against PPI targets. Principle component analysis (PCA) and k-means clustering were used to identify plausible PPI targets in regions of interest in the active group in the chemical space between active and inactive iPPI compounds. Notably, the uniquely defined active group exhibited distinct differences in activity compared with other active compounds. These results demonstrate that active compounds with regions of interest in the chemical space may be expected to provide insights into potential PPI inhibitors for particular protein targets.ope

Management of oral mucositis owing to chemical burn by intoxication of agricultural chemicals(gramoxon) : report of cases

Chemical burns onto oral mucosa which are infrequent, may result from contact with a wide variety of chemical agents. The degree of injury depends on the chemical, its concentration, duration of contact, and the natural penetrability and resistance of the tissues involved. Chemicals do not usually “burn”in that they do not cause destruction by hyperthermic activity. Rather, they damage tissue by causing coagulation of protein by one of several processes, reduction, oxidation, desiccation, corrosion, or vesication. Paraquat(Gramoxon) is the most frequently agricultural chemicals that induce the severe toxic reactions onto the organs of human body in Korea. The toxic reaction are composed of pulmonary edema and fibrosis, formation of hyaline membrane, inflammatory reaction and bleeding tendency, owing to the cell damage by the production of superoxide radicals. The contents of essential treatment in paraquat intoxication are commonly airway and breathing maintenance, gastric lavage, much hydration and diuresis, hemoperfusion and medications for the removal of the chemicals and the prevention of various complications. The sedative oral dressings, such as, orabase ointment application, warm saline gargling, lidocaine viscous gargling and oral gargling by the mixed solutions(tetracycline, prednisolone and 10% dextrose water) are important for the improvement of chemical oral mucositis and the comfortable feeding of diet. The authors managed properly two cases of oral chemical mucositis that were occurred by the incorrect use of agricultural chemicals(paraquat) and report the cases with the review of literatures about care of the chemical intoxication and oral mucositis.ope

Niclosamide and Pyrvinium Are Both Potential Therapeutics for Osteosarcoma, Inhibiting Wnt–Axin2–Snail Cascade

Osteosarcoma, the most common primary bone malignancy, is typically related to growth spurts during adolescence. Prognosis is very poor for patients with metastatic or recurrent osteosarcoma, with survival rates of only 20–30%. Epithelial–mesenchymal transition (EMT) is a cellular mechanism that contributes to the invasion and metastasis of cancer cells, and Wnt signaling activates the EMT program by stabilizing Snail and β-catenin in tandem. Although the Wnt/Snail axis is known to play significant roles in the progression of osteosarcoma, and the anthelmintic agents, niclosamide and pyrvinium, have been studied as inhibitors of the Wnt pathway, their therapeutic effects and regulatory mechanisms in osteosarcoma remain unidentified. In this study, we show that both niclosamide and pyrvinium target Axin2, resulting in the suppression of EMT by the inhibition of the Wnt/Snail axis in osteosarcoma cells. Axin2 and Snail are abundant in patient samples and cell lines of osteosarcoma. The treatment of niclosamide and pyrvinium inhibits the migration of osteosarcoma cells at nanomolar concentrations. These results suggest that Axin2 and Snail are candidate therapeutic targets in osteosarcoma, and that anthelminthic agents, niclosamide and pyrvinium, may be effective for osteosarcoma patients.Furthermore, we showed that both niclosamide and pyrvinium target Axin2, and effectively induce EMT reversion in osteosarcoma cell lines. Our findings suggest an effective biomarker and potential EMT therapeutics for osteosarcoma patients.ope

Tongue Mass Arising after Hematopoietic Cell Transplantation and Leukemia Relapse

Oral examination in a patient with a history of acute lymphoblastic leukemia (ALL) and allogeneic hematopoietic cell transplantation (HCT) needs considerations of leukemia relapse and graft-versus-host disease (GVHD). Oral manifestations may contribute to early detection of relapse or systemic complications making accurate oral examination and diagnosis significant. We report a case of a large tumor like mass arising in a patient with a history of ALL and HCT. The patient had been diagnosed with ALL relapse and was being treated with chemotherapy, and furthermore was suspected of GVHD development.ope

Localized Jaw Enlargement as Oral Manifestation in Renal Osteodystrophy - Report of a case and review of the literature -

Renal osteodystrophy is the complex disease of the skeleton that occurs in patients with chronic renal failure. A 29-year-old female with chronic renal failure and a h istory of hemodialysis during 10 years showed localized jaw enlargement in the anterior mandible. She also revealed increased serum PTH level, osteosclerosis in her skull base and facial bone, chronic pain in the both knee joint, and gastrointestinal disorder which are symptoms of renal osteodystrophy. The patient was diagnosed hyperparathyroidism associated with chronic renal failure. Parathyroidectomy was performed, however, serum PTH level increased again after the parathyroidectomy, the affected area of the mandible was enlarged as the serum PTH level increased. The enlarged area seemed like as peripheral lesion clinically. We reported a case of localized jaw enlargement as oral manifestation in renal osteodystrophy.ope

Metastatic Undifferentiated Pleomorphic Sarcoma on Tongue: Case Report

Sarcoma is rare malignant tumors that develop from mesenchymal cells. Metastasis to the oral cavity is a rare occurrence. Undifferentiated Pleomorphic sarcoma(UPS), formerly known as Malignant fibrous histiocytoma(MFH), is rare spindle cell neoplasm that can have poorly prognosis with metastasis and local recurrence. This report describes a case of a 77-year-old man who was diagnosed with Undifferentiated Pleomorphic Sarcoma of the chest wall and underwent adjuvant radiation therapy after surgical resection. Although there was success of wide excision, two years later, he presented with metastasis to the several organs including tongue. We retrospectively analyzed results of Next Generation Sequencing(NGS), and we figured out RB1 gene mutation. Until now targeted therapy of RB1 gene mutation is not established. Surgeon needs to consider metastatic tumors through identifying patients’ chief complaints and past medical & dental history. We need to research through NGS, and take a step closer to find targeted therapy for tumors.ope

Non-invasive Mucormycosis Associated with Ameloblastoma of the Mandible in Liver Transplant Patients

Mucormycosis is an aggressive opportunistic fungal infection that can be found in the oral cavity. The fungus usually affects the immunocompromised patients and tends to invade and block blood vessels, resulting in significant tissue necrosis and invasive mucormycosis. However, a non-invasive form of mucormycosis is mostly asymptomatic and found accidentally in the immunocompetent normal hosts, manifested by localized overgrowth of the fungus. Here, we report a rare case of asymptomatic non-invasive mucormycosis of the mandible that was incidentally diagnosed in wide resection specimen of liver transplant patient who had previously underwent surgery of excision and simultaneous alloplastic bone graft due to mandibular ameloblastoma. Histopathological examination of the specimen revealed that there was neither vasculitis nor tissue necrosis, but numerous fungal hyphae were located only within the alloplastic graft materials in decalcified tissue sections. Awareness of the possibility of life-threatening mucormycosis in immunocompromised patients should be emphasized because it can be inactive or reactivated depending on the immune state of patients.ope

An Angiosarcoma in the Maxillary Gingiva Accompanying with Severe Bleeding ：A Case Report

Angiosarcoma is an extremely rare sarcoma arising from oral mucosa. We report a case of angiosarcoma in the right maxillary gingiva causing excessive bleeding. The lesion exhibited typical histologic features of angiosarcoma, showing infiltrative proliferation of polygonal endothelial cells and arborizing blood vessels. Tumor cells showed expression of CD 31 and factor VIII, but no expression of CD 34 antigen. The patient expired due to severe bleeding in the oral cavity.ope