A rare cause of abdominal pain in pregnancy - mesenteric artery thrombosis and miscarriage in a 34-year-old patient.

BACKGROUND: Mesenteric arterial thrombosis is an extremely rare thrombotic event, especially during pregnancy, that can cause rapid fatal consequences unless the patient receives early definitive treatment. CASE PRESENTATION: We report the case of a 34-year-old female presenting in her seventh week of gestation with severe abdominal pain who was promptly diagnosed with mesenteric artery occlusion amidst incipient miscarriage. The patient underwent a successful mesentery artery embolectomy, recovered and was later diagnosed with elevated factor VIII activity. CONCLUSION: The diagnosis of mesenteric ischemia should be considered in pregnant women presenting with severe abdominal pain and any prior predisposing factors. Our case highlights the pivotal role of the emergency physician in maintaining a high index of suspicion coupled with timely and determined action. The prognosis of this high mortality condition depends on prompt diagnosis, early definite management and successful multidisciplinary cooperation.

Management of Odontogenic Sinusitis: Results with Single-Step FESS and Dentoalveolar Surgery.

OBJECTIVE: Odontogenic sinusitis (OS) is a well-known and important border of specialties in otorhinolaryngology and dentoalveolar surgery. Odontogenic sinusitis can develop due to iatrogenic harm or odontogenic infection. The gold standard diagnostic method is clinical and radiological-CBCT (cone beam computed tomography)-examination. The treatment of this condition requires collaboration between ENT and dentoalveolar surgery specialists and can be non-surgical or surgical based on staging. This paper aims to share the results of our clinical study whereby complex therapy was administered by a dentoalveolar surgeon and an otorhinolaryngologist in cooperation. PATIENTS AND METHODS: We conducted a retrospective study comprising 111 OS patients who underwent complex therapy between 2016 and 2023 at Semmelweis University, Budapest, Hungary. All patients were treated with concurrent FESS (functional endoscopic sinus surgery) and dentoalveolar surgery. Follow-up was based on symptoms, clinical examination and CBCT imaging. RESULTS: Of the 111 patients, 107 were successfully treated with concurrent FESS and dentoalveolar surgery, and only 4 had further symptoms following the complex therapy and needed retreatment. CONCLUSIONS: The complex, single-session therapy involving FESS and oral surgery is an effective treatment method, which is less invasive and associated with fewer complications compared to previous interventions, such as the Luc-Caldwell procedure.

Acute hydrocephalus caused by a colloid cyst - a case report.

BACKGROUND: Colloid cysts are rare benign, slowly growing intracranial tumors of endodermal origin. Most colloid cysts are found incidentally and are asymptomatic, but rarely, they can lead to sudden death. CASE PRESENTATION: A 73-year-old female patient was admitted to our emergency department with complaints of dizziness, nausea, vomiting, fatigue, walking difficulties, and behavioral changes. CT imaging revealed acute obstructive hydrocephalus attributable to a third ventricular colloid cyst. The patient was immediately transferred to a tertiary center where she underwent successful neurosurgical resection of the mass. Pathology results of the lesion confirmed the diagnosis of colloid cyst. CONCLUSION: The case we present emphasizes the critical importance of prompt identification of warning signs, complex thinking, and evaluation. Establishing the right diagnostic approach early on can facilitate accurate diagnosis.

Shaker-IR K+ channel gating in heavy water: Role of structural water molecules in inactivation.

It has been reported earlier that the slow (C-type) inactivated conformation in Kv channels is stabilized by a multipoint hydrogen-bond network behind the selectivity filter. Furthermore, MD simulations revealed that structural water molecules are also involved in the formation of this network locking the selectivity filter in its inactive conformation. We found that the application of an extracellular, but not intracellular, solution based on heavy water (D2O) dramatically slowed entry into the slow inactivated state in Shaker-IR mutants (T449A, T449A/I470A, and T449K/I470C, displaying a wide range of inactivation kinetics), consistent with the proposed effect of the dynamics of structural water molecules on the conformational stability of the selectivity filter. Alternative hypotheses capable of explaining the observed effects of D2O were examined. Increased viscosity of the external solution mimicked by the addition of glycerol had a negligible effect on the rate of inactivation. In addition, the inactivation time constants of K+ currents in the outward and the inward directions in asymmetric solutions were not affected by a H2O/D2O exchange, negating an indirect effect of D2O on the rate of K+ rehydration. The elimination of the nonspecific effects of D2O on our macroscopic current measurements supports the hypothesis that the rate of structural water exchange at the region behind the selectivity filter determines the rate of slow inactivation, as proposed by molecular modeling.

Evaluation of the Histomorphometric and Micromorphometric Performance of a Serum Albumin-Coated Bone Allograft Combined with A-PRF for Early and Conventional Healing Protocols after Maxillary Sinus Augmentation: A Randomized Clinical Trial.

The aim of this study was to compare the microarchitecture of augmented bone following maxillary sinus augmentation (MSA) after healing periods of 3 (test) and 6 (control) months using the combination of advanced platelet-rich fibrin (A-PRF) and a serum albumin-coated bone allograft (SACBA). Twenty-six patients with 30 surgical sites who required two-stage MSA were enrolled and grafted with the combination of A-PRF and SACBAs. The surgical sites were randomly allocated to the test or control group. During implant site preparation, 17 bone core biopsy samples were collected from each study group for histological, histomorphometric and micromorphometric analysis. Resonance frequency analysis was performed at the time of implant placement and 6, 8, 10, and 12 weeks postoperatively. The percentage of newly formed bone was 44.89 ± 9.49% in the test group and 39.75 ± 8.15% in the control group (p = 0.100). The results of the µCT analysis showed no significant differences in morphometric parameters between the study groups. The implant stability quotient was not significantly different between the two groups at 10 and 12 weeks postoperatively. Based on these findings, the total treatment time may be reduced by 3 months with the use of A-PRF and SACBAs for two-stage MSA.

Bioenergetic Impairment of Triethylene Glycol Dimethacrylate- (TEGDMA-) Treated Dental Pulp Stem Cells (DPSCs) and Isolated Brain Mitochondria are Amended by Redox Compound Methylene Blue †.

BACKGROUND: Triethylene glycol dimethacrylate (TEGDMA) monomers released from resin matrix are toxic to dental pulp cells, induce apoptosis, oxidative stress and decrease viability. Recently, mitochondrial complex I (CI) was identified as a potential target of TEGDMA. In isolated mitochondria supported by CI, substrates oxidation and ATP synthesis were inhibited, reactive oxygen species production was stimulated. Contrary to that, respiratory Complex II was not impaired by TEGDMA. The beneficial effects of electron carrier compound methylene blue (MB) are proven in many disease models where mitochondrial involvement has been detected. In the present study, the bioenergetic effects of MB on TEGDMA-treated isolated mitochondria and on human dental pulp stem cells (DPSC) were analyzed. METHODS: Isolated mitochondria and DPSC were acutely exposed to low millimolar concentrations of TEGDMA and 2 µM concentration of MB. Mitochondrial and cellular respiration and glycolytic flux were measured by high resolution respirometry and by Seahorse XF extracellular analyzer. Mitochondrial membrane potential was measured fluorimetrically. RESULTS: MB partially restored the mitochondrial oxidation, rescued membrane potential in isolated mitochondria and significantly increased the impaired cellular O2 consumption in the presence of TEGDMA. CONCLUSION: MB is able to protect against TEGDMA-induced CI damage, and might provide protective effects in resin monomer exposed cells.

A novel hydrogel scaffold for periodontal ligament stem cells.

Periodontal ligament stem cells (PDLSCs) possess extensive regeneration potential. However, their therapeutic application demands a scaffold with appropriate properties. HydroMatrix (HydM) is a novel injectable peptide nanofiber hydrogel developed recently for cell culture. Our aim was to test whether HydM would be a suitable scaffold for proliferation and osteogenic differentiation of PDLSCs. PDLSCs were seeded on non-coated or HydM-coated surfaces. Both real-time impedance analysis and cell viability assay documented cell growth on HydM. PDLSCs showed healthy, fibroblast-like morphology on the hydrogel. After a 3-week-long culture in osteogenic medium, mineralization was much more intense in HydM cultures compared to control. Alkaline phosphatase activity of the cells grown on the gels reached the non-coated control levels. Our data provided evidence that PDLSCs can adhere, survive, migrate, and proliferate on HydM and this gel also supports their osteogenic differentiation. We first applied impedimetry for dental stem cells cultured on a scaffold. HydM is ideal for in vitro studies of PDLSCs. It may also serve not only as a reference material but also in the future as a promising biocompatible scaffold for preclinical studies.

[Removable dentures with implants for edentulous lower jaw]. / Implantaciós fogpótlások protetikai aspektusai kiveheto teljes alsó fogpótlások esetén.

Fabrication of a complete mandibular denture that offers patient comfort, function, and aesthetics along with stability and acceptable retention remains one of the most challenging procedures in dental practice. Based on a thorough treatment planning and a successful surgical procedure implants have been shown to be reliable abutment for both retention and support of overdentures. During planning important relevant factors must be considered such as old age, systemic diseases, increased financial capability, etc. Implants retained overdentures can be divided into three groups according to the type of support: mucosal, muco-implantal and implantal. Key factors concerning the planning of prosthetic rehabilitation are the number and length of the implants, together with the quality and quantity of the anchoring bone tissue.

[Histological investigations in ambulatory oral surgery practice]. / Szövettani vizsgálatok az ambuláns szájsebészeti gyakorlatban.

In the practice of oral surgery correspondence with the pathologist is required in order to identify the lesions in question by histologic examination. By current legal regulations the histological evaluation of removed tissues is mandatory. In the presentation the authors process the data obtained in their Department since 2008. Coincidence of the clinical and histological diagnosis is analysed statistically such is the occurrence of various types of oral mucosa lesions and cysts. In cases of presumed malignancy the biopsies were carried out in a department with adequate oncological background. In indications of autoimmun deseases mainly in cases of Sjögren's syndrome the Department has been requested to carry out minor salivary gland biopsies. Statistical analysis of the findings of the minor salivary gland biopsies will also be discussed. The histological diagnoses have been provided by Prof. Zsuzsanna Suba MD, DMD, PhD of the Semmelweis University, Department of Oral and Maxillofacial Surgery, Oral Pathology Unit. In order of prevalence the most common histologically verified lesions were: radicular cyst, fibromas and granulation tissue. In 84.5% of the cases the histological findings confirmed the clinical diagnoses. In 44,5% of the cases Sjögren's syndrome was verified by the minor salivary gland biopsy. Although in most cases the histological examination supported the clinical diagnoses, close cooperation of the oral surgeon and pathologist is essential.

[Etiology and diagnostics of upper canine tooth retention]. / A felsô szemfog retenció etiológiája és diagnosztikája.

Upper canines have significant esthetical and functional roles in the dental arch. Upper canine retention is a frequent anomaly as the germ develops rather far from its final place. Moreover, the neighboring teeth may narrow the place of the canine because of its late eruption. Impacted canines without treatment may cause severe complications. Impaction of canines can be diagnosed early by clinical and radiological findings, which enables the clinician to perform a complete rehabilitation by successful surgical and orthodontic treatment.

[Surgical-orthodontic treatment of the upper canine retention]. / Az attörésben visszamaradt felso szemfogak szájsebészeti-orthodonciai ellátása.

Combined surgical and orthodontic treatment of upper canine retention showed thorough development during the past decade. Depending on the axial position of the unerupted canine there are three methods for their alignment. When the axis of the unerupted canine is near vertical making a mucosal window is enough for deliberation of the crown. When the unerupted canine is covered by bone a palatinal or buccal corticotomy is necessary for the accessibility of the crown. When the unerupted tooth is positioned near horizontally redressment force or removal is advisable. Combined surgical and orthodontic method for alignment of unerupted canine may achieve excellent cosmetical and functional results.

[Oral cancer: morbus Hungaricus in the 21st century]. / Szájüregi rák: Morbus Hungaricus a 21. században.

Hungary is the leader both in oral cancer morbidity and mortality among the European countries. Oral cancer mortality had increased dramatically in Hungary to near fourfold between 1975 and 2002 both among the male and female populations. The increased oral cancer morbidity among the non-smoker, non-drinker elderly women and young adults, suggest that factors other than tobacco and alcohol consumption may also have important role in the pathogenesis of oral cancer. To reveal the epidemiological changes oral cancer cases and tumor-free controls were studied in the Department of Oral and Maxillofacial Surgery of the Semmelweis University in two phases between 1985-1986 and 2004-2005. In the 1st phase of the study, 460 cases with histologically confirmed oral squamous cell cancer and 350 tumor-free control cases were included. In the 2nd phase data of 550 oral cancer cases and 450 tumor-free controls were examined. Location of the tumors, alcohol consumption, and smoking habits of the male and female patients were separately evaluated. Among the oral cancer cases and their controls the ratio of smokers showed a significantly decreasing tendency in the examined period. Both the male oral cancer patients and their controls showed a significant decrease in the ratio of regular drinkers, whereas among the female tumor cases and controls the ratio of alcohol consumers were similarly low in both phases. The high male to female ratio of oral cancer cases significantly decreased over the examined period. Among elderly women (>60 yrs) oral cancer morbidity conspicuously increased. Among male cases the primacy of lower lip cancer had been taken over by sublingual cancer during the examined period. Among female patients, gingival tumor location was the most frequent in both phases. Our data suggest that the extraordinarily rapid increase in oral cancer morbidity and mortality in Hungary is not reasonable simply on the basis of excessive tobacco and alcohol consumption habits. Changes in the male to female ratio of oral cancer after 20 years, the older age of female patients as compared with males and the gender related difference of the prevalent tumor sites suggest some role of gender specific, systemic risk factors for oral cancer.

Mixed odontogenic tumors in children and adolescents.

The typical forms of mixed odontogenic tumors in the jaws of children and adolescents are ameloblastic fibroma, ameloblastic fibroodontoma, complex odontoma, and compound odontoma. Ameloblastic fibromas (AFs) are true, mixed, soft tissue neoplasms, deriving from the proliferation of both odontogenic epithelium and mesenchyma. They have a potential for both recurrence and malignant transformation. Ameloblastic fibroodontomas (AFOs) may be regarded as hamartomas, which exhibit epithelial, mesenchymal, and abundant hard tissue components of the developing teeth. Odontomas are calcifying benign hamartomas and represent the most common type of odontogenic jaw tumors among patients less than 20 years old. Complex odontomas (CXOs) are built up from amorphous hard tissue elements, and generally occur in the premolar or molar regions of the maxilla. Compound odontomas (CDOs) usually appear in the maxilla, in the region of the incisors and canines and contain small, radio-opaque structures reminiscent of rudimentary teeth. In the present study, mixed odontogenic tumor cases are presented in patients under 20 years old. All of them were associated with tooth eruption disturbances. Further aim of this study was to discuss the nature and interrelationships of this group of lesions.

[Mixed odontogenic tumors in children and adolescents]. / Fogelotörési zavarokkal járó vegyes odontogén daganatok.

Mixed odontogenic tumors in the jaws of children and adolescents usually cause dentition anomalies. The typical forms of these are ameloblastic fibroma, ameloblastic fibroodontoma, complex odontoma and compound odontoma. In the present study mixed odontogenic tumor cases are presented in patients under 20 years of age. All of them were associated with tooth eruption disturbances. Further aim of this study was to discuss the nature and interrelationships of this group of lesions. Ameloblastic fibromas (AFs) are true, mixed, soft tissue neoplasms, deriving from the proliferation of both odontogenic epithelium and mesenchyma. They have a potential to both recurrence and malignant transformation. Ameloblastic fibroodontomas (AFOs) may be regarded as hamartomas, which exhibit epithelial, mesenchymal and abundant hard tissue components of the developing teeth. Odontomas are calcifying benign hamartomas, and represent the most common type of odontogenic jaw tumors among patients less than 20y, having complex and compound variants. Complex odontomas (CXOs) are built up from amorphous hard tissue elements, and generally occur in the premolar or molar regions of the maxilla. Compound odontomas (CDOs) usually appear in the maxilla, in the region of the incisors and canines, and contain small, radio-opaque structures reminiscent of rudimentary teeth. Early diagnosis and treatment of mixed odontogenic jaw tumors in children may prevent the serious orthodontic complications and jaw deformations.

Cleidocranial dysplasia: diagnostic criteria and combined treatment.

Cleidocranial dysplasia (CCD) is an uncommon, generalized skeletal disorder characterized by delayed ossification of the skull, aplastic or hypoplastic clavicles, and serious, complex dental abnormalities. There are many difficulties in the early diagnosis of CCD because a majority of the craniofacial abnormalities becomes obvious only during adolescence. In the present case, a hypoplastic midface, a relative prognathia of the mandible, and close approximation of the shoulders in the anterior plane were the conspicuous extraoral findings. Prolonged exfoliation of the primary dentition, unerupted supernumerary teeth, and the irregularly and partially erupted secondary dentition produced occlusional anomalies. The presence of the second permanent molars together with the primary dentition and wide spacing in the lower incisor area were typical dental signs. Gradual extraction of the supernumerary teeth and over-retained primary teeth was the first step of oral surgery. This was followed by a surgical exposure of the unerupted teeth by thinning of the cortical bone. Orthodontic treatment was aimed at parallel growth of the jaws. Removable appliances were used to expand the narrow maxillary and mandibular arches, and a Delaire mask compensated for the lack of sagittal growth of the upper jaw. Temporary functional rehabilitation was solved by partial denture. When the jaws have been fully developed, implant insertions and bridges are the therapeutic measures. The reported case and the literature data support the importance of the early diagnosis and interdisciplinary treatment of CCD.

Facilitation of beta-tricalcium phosphate-induced alveolar bone regeneration by platelet-rich plasma in beagle dogs: a histologic and histomorphometric study.

PURPOSE: The effects of 2 graft materials, beta-tricalcium phosphate (Cerasorb) alone and a combination of Cerasorb and platelet-rich plasma (PRP), on the bone regeneration process were evaluated in the canine mandible. MATERIALS AND METHODS: The mandibular premolars of 12 beagle dogs were surgically removed. The extraction sockets were filled with Cerasorb on the control side and a mixture of Cerasorb and PRP on the test side. Bilateral biopsy samples were taken from the graft insertion sites at 6, 12, and 24 weeks after surgery. Sections were prepared from the undecalcified resin-embedded samples. RESULTS: Six weeks after grafting, the proliferation of cellular osteogenic mesenchyma was more abundant in the test group. The histomorphometric data revealed a significantly higher percentage of bone area in the test group (45.9%) than in the control group (30.8%) (P < .05). Twelve weeks after grafting, the test group still had some advantage over the control group in terms of bone regeneration (52.5% bone in the test group versus 49.4% in the control group, P < .05). Twenty-four weeks after grafting, bone-forming activity was nearly equal in the 2 groups, and the bone area in the 2 groups did not differ significantly (62.9% and 61.9%, respectively) (P < .05). DISCUSSION: The histomorphometric results suggested more intensive bone regeneration in the early healing phase following the topical application of PRP. CONCLUSION: The increase in bone density facilitated by grafting with a combination of Cerasorb and PRP requires thorough study in humans.

[Alveolar bone regeneration stimulated by a combination of platelet-rich plasma and Cerasorb graft in Beagle dogs. Histological and histomorphometric studies]. / Alveolaris csontregeneráció serkentése thrombocyta-dús plasma és Cerasorb-graft kombinációjával Beagle kutyákban (Szövettani és hisztomorfometriai vizsgálatok).

Healing of extraction wounds was examined in an animal experiment model on Beagle dogs. After bilateral extraction of the premolars of 12 dogs the alveoli were filled up with a combination of beta-tricalcium phosphate (Cerasorb) graft and platelet rich plasma (PRP) on the experimental side, and with Cerasorb alone on the control side. Biopsy specimens were taken from the regenerating bone at 6, 12 and 24 weeks after surgery for histological study. Results of the histologic and histomorphometric examinations revealed that after 6 weeks the newly formed bone was significantly denser on the experimental side. After 12 weeks this difference became moderate, and after 24 weeks the bone forming activity was nearly equal on the two sides. These results suggest that local administration of Cerasorb and PRP results in more intense bone regeneration, especially in the early phase.

[Factors impeding obstructed teeth in their eruption. Case report]. / Az áttörésükben visszamaradt fogak elótörését akadályozó tényezók (Esetismertetés).

With preparation of six study cases the objective of the authors was to abrow colleagues' attention to the fact that teeth remained in impactio and retention might cause complaints not only due to normal anatomical reasons but some complications might occur resulting from anomaly of development. The authors consider the topic extremely important by reason of the case's varieties and the clinical observations made recently and frequently. An increased attention to this case is reasonable since eruption of teeth might happen in case of removal of obstructic fact in time, permanent row of teeth returns to normal, and adequate dental arch might develop. It is also obvious that medical treatment of impact abnormalities derived from anomaly has lack of exact therapy theories, only general protocol can be provided.