Changes in lip forms on three-dimensional images with alteration of lip support and/or occlusal vertical dimension in complete denture wearers

PurposeThis study aimed to examine changes in the lip form, oral fissure form and vermilion height of complete denture wearers resulting from altered occlusal vertical dimension (OVD) and/or lip support.MethodsThree-dimensional facial images of 10 edentulous patients (four males and six females) when wearing six experimental record blocks (ExpRBs) with varying OVD and/or lip support were analyzed. Analysis was performed using three landmarks on the mid-line (labrale superius (ls), stomion (sto), and labrale inferius (li)) and two landmarks on the oral fissure (at points 20 mm right and left of the midline (r-OFP and l-OFP, respectively)). Curvature of the oral fissure (COF) in the frontal view was evaluated by calculating the difference between sto and the average of r-OFP and l-OFP (avrl-OFP). The vermilion height in the frontal view was calculated as the distance from sto to ls and li. In 10 subjects, comparison between standard ExpRB and test ExpRBs with altered OVD and/or lip support was performed by calculating differences between these data.ResultsThe ls, sto, and li landmarks changed with alteration of OVD and/or lip support, whereas avrl-OFP changed vertically with alteration of lip support and anteroposteriorly with alteration of OVD and/or lip support. COF and vermilion height were affected by alterations in OVD and/or lip support.ConclusionDeficient OVD with extensive lip support can curve the oral fissure form upward, and deficient OVD with deficient lip support can reduce the vermilion height.     

Recovery from insulin dependence in immune checkpoint inhibitor-associated diabetes mellitus: A case report

Immune checkpoint inhibitor-associated diabetes mellitus (ICI-DM) is a rare immune-related adverse event and is usually considered permanent. Here, we report the first case of a 54-year-old man with ICI-DM who recovered from insulin dependence. He was diagnosed with lung cancer and started pembrolizumab therapy. After seven cycles, he developed ICI-associated secondary adrenal insufficiency and started hydrocortisone supplementation. Subsequently, he complained of fatigue, and blood examinations showed hyperglycemia with ketosis. A glucagon challenge test indicated insulin dependence. He was diagnosed with ICI-DM and insulin therapy was initiated. Pembrolizumab therapy was discontinued due to concomitant ICI-associated hepatitis. Six months later, a glucagon challenge test result showed an improvement in insulin secretion, and insulin therapy was discontinued. The lung cancer lesions continued to shrink. Even if ICI-DM develops, it might be possible to control the underlying cancer while avoiding lifelong insulin therapy through early discontinuation of ICI.     

Anti-SARS-CoV-2 IgG antibody titer after BNT162b2 mRNA COVID-19 vaccination in Japanese patients who underwent renal replacement therapy,hemodialysis, peritoneal dialysis,and kidney transplantation

Clinical and Experimental Nephrology - Coronavirus disease (COVID-19) vaccination is recommended for patients undergoing renal replacement therapy (RRT), including hemodialysis (HD), peritoneal...     

Relationship between serum sodium level at dialysis initiation and all-cause mortality

Clinical and Experimental Nephrology - Hyponatremia is a common electrolyte disorder in patients with chronic kidney disease. In addition, hyponatremia is associated with mortality in patients with...     

Transmesenteric approach for laparoscopic endoscopic cooperative surgery for a duodenal adenoma located in the third portion of the duodenum

We report our experience in a patient with adenoma located in the horizontal part of the duodenum, which was effectively treated with the transmesenteric laparoscopic endoscopic cooperative surgery (LECS) approach. This approach, which entails incising the mesentery of the colon, simplified laparoscopic access to the horizontal part of the duodenum, which was minimally mobilized. Thus, the bulb and descending part of the duodenum were fixed to the retroperitoneum, facilitating stable handling of the endoscope and enabled safe and effective excision of an adenoma located in the horizontal part of the duodenum. This approach enabled safe and effective excision of an adenoma located in the horizontal part of the duodenum. The advantages of this method include a secure field of view, lower probability of damage to large vessels, and minimizing the defect to the intestine caused by the incision.