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Vascular Pythiosis caused by Pythium insiodiosum rarely involves carotid artery. A case of concealed ruptured pseudoaneurysm of the carotid artery with neck abscesses, and cerebral septic emboli is described. Patient presented with large pulsatile neck mass that failed to response to surgery, antifungals and immunotherapeutic vaccine. Residual unresectable disease leads to death in the patient. Pythiosis should be considered as a differential diagnosis of head and neck infection. Keywords: Pythiosis, Pythium insidiosum, Carotid artery, Meningitis, Brain

Introduction: Dens evaginatus (DE) is a dental anomaly with a supernumerary tubercle projection that typically contains dentin and pulp tissue. However, the tubercle projection can fracture, exposing the dentin and potentially the dental pulp, which induces pulpal diseases. Managing DE should be primarily based on the clinical diagnosis of the pulp. Methods: The literature search in prevalence, prophylaxis, and management of dens evaginatus was performed in PubMed database as well as by manual search, in which the related contents were collected and descriptively analyzed. Results: Of the 264 searched literatures, 62 articles were included for this scoping review. The prophylactic management of the tubercle of DE teeth with a normal pulp should be performed as early as possible by the prep-and-fill technique or the reinforcement technique to preserve tooth vitality and continued root development, with the former reported to be superior compared with the latter. Furthermore, DE teeth with reversible pulpitis should be managed with the prep-and-fill technique. For DE teeth with irreversible pulpitis, vital pulp therapy, ie, partial or full/coronal pulpotomy, should be considered when the pulpal inflammation is limited to the coronal pulp to preserve the vitality of the radicular pulp that induces apexogenesis. A pulpectomy should be performed if the pulpal inflammation has progressed into the radicular pulp. For DE teeth with pulpal necrosis (or after pulpectomy) and immature roots, mineral trioxide aggregate apexification or regenerative endodontic procedures are the treatment options. For DE teeth with pulpal necrosis and complete root formation, nonsurgical root canal treatment is the treatment of choice. A flow chart of the decision-making for managing DE teeth based on pulpal diagnosis is proposed. Conclusion: DE teeth should be properly managed, by prophylaxis or treatment, depending on pulpal diagnosis and related factors. [ABSTRACT FROM AUTHOR]

BACKGROUND: Declining immune function poses an important clinical challenge worldwide and supplementation with natural products that possessing immune enhancing properties is a promising approach for preventing or delaying immune function decline. Cocoons from yellow silkworms are a significant source of lutein, and this unexplored silk extract could be a viable alternative source for dietary lutein. This study assessed immunomodulatory activities of the silk lutein extract. Female BALB/c mice orally received lutein, either as silk or marigold extracts (10 or 20 mg/kg daily), or vehicle only (1% tween 80 in PBS pH 7.4) for 4 weeks. Natural killer (NK) cell activity, specific antibody production, lymphocyte subpopulations, mitogen-induced lymphocyte proliferation, and cytokine production were examined. RESULTS: Silk lutein extract increased NK cell activity, and the effect was dose-related whereas marigold lutein extract was ineffective. Silk lutein extract dose-dependently enhanced antibody production in pre-immunized mice but marigold lutein extract had no effect. Feeding with silk lutein extract increased the populations of CD3+ and CD4 + CD3 + cells. Silk lutein extract also stimulated concanavalin A- and lipopolysaccharide-induced proliferations of T and B lymphocytes, respectively. Moreover, silk lutein extract increased IL-2 and IFN-γ production while the effect of marigold lutein extract was undetectable. CONCLUSIONS: Together, silk lutein extract enhanced both innate and adaptive immune functions. This preparation may prove to be an effective supplement for strengthened immunity.

Vascular Pythiosis caused by Pythium insiodiosum rarely involves carotid artery. A case of concealed ruptured pseudoaneurysm of the carotid artery with neck abscesses, and cerebral septic emboli is described. Patient presented with large pulsatile neck mass that failed to response to surgery, antifungals and immunotherapeutic vaccine. Residual unresectable disease leads to death in the patient. Pythiosis should be considered as a differential diagnosis of head and neck infection. [ABSTRACT FROM AUTHOR]

SQL is one of the major languages to manipulate and retrieve data in the databases. It was standardized by the corporation among researchers and commercial database industries into many versions. SQL provides NULL values for attributes which are unknown to the user. There are three meanings of NULL but they are not classified by database engines. Results of SQL queries show different meaning when they are produced by subqueries or atomic predicates. This paper explains the meaning of them with suggestions proposing to database community. [ABSTRACT FROM AUTHOR]

This study aimed to compare the incidence of root fractures that led to extraction in immature teeth endodontically treated by mineral trioxide aggregate (MTA) apexification and were restored with either reinforced (resin composite or fiber post) or nonreinforced (gutta percha or MTA) intraradicular materials. Necrotic immature teeth treated with MTA apexification from 1996 to 2017 were selected according to the inclusion and exclusion criteria. Intraradicular materials and preoperative and treatment factors were obtained from dental charts and radiographs. The incidence of fatal root facture was identified. Kaplan-Meier survival analysis and the Cox proportional hazard model were used to show the survival rate and predisposing factors at a significance level of.05. The average recall period was 30 months. The incidence of root fracture in the teeth restored with the reinforced materials was 5.5%, which was not significantly different from the nonreinforced materials (8.3%). Furthermore, the fracture rates between the fiber post and resin composite groups were not significantly different. Two significant predisposing factors influencing the incidence of root fracture were detected: preoperative external inflammatory root resorption (hazard ratio = 26.86; P <.05) and patient age > 15 years (hazard ratio = 8.60, P <.05). Immature teeth treated with MTA apexification and restored with the reinforced or nonreinforced intraradicular materials exhibited a similar rate of root fracture. Preoperative external inflammatory root resorption and patient age > 15 years were found to be the predisposing factors that significantly increased the incidence of root fracture. [ABSTRACT FROM AUTHOR]

Seventy-six extracted human permanent canines and premolars with single canals were used in this study. The crowns were removed, the canals were instrumented, and the roots were randomly divided into four groups of 18 each. Three groups were medicated with Ca(OH)2 USP, Calasept, and Vitapex, respectively, while the control group was not medicated. The roots were incubated in 100% relative humidity at 37 degrees C for 1 wk, after which the medicaments were removed and the canals were enlarged to the next file size. One tooth in each group was examined in the scanning electron microscope while the remaining roots were filled with gutta-percha using a lateral condensation technique. The roots were placed in 2% methylene blue solution for 2 wk and both linear and volumetric dye penetration evaluated. A highly significant correlation between linear and volumetric leakage was observed. The leakage among the experimental groups was not significantly different, but was significantly less than in the control group.