The challenge in bimaxillary surgery lies in significant intraoperative bleeding, prompting various strategies to minimize blood loss. Among the methods considered for controlling intraoperative bleeding, hypotensive anesthesia and the use of piezosurgical instruments (Osada, Tokyo, Japan) have been explored. However, hypotensive anesthesia may have adverse effects on cardiac function, and surgical time is likely to be prolonged when using piezosurgical instruments. This study retrospectively examined whether the combined use of hypotensive anesthesia and piezosurgical instruments reduces intraoperative bleeding and whether the combination impacts cardiac function. The combination of hypotensive anesthesia and piezosurgical instruments significantly reduced intraoperative bleeding. Furthermore, the combination was associated with a significantly higher incidence of tachycardia, particularly with the use of nicardipine. Additionally, the combination significantly lengthened the duration of the surgery and may have increased the burden on cardiac function. Landiolol was effectively employed to manage tachycardia. When selecting hypotensive anesthesia as a means to limit bleeding, proactive preparation and preventive small-dose administration of landiolol could be beneficial in managing the potential occurrence of tachycardia.

Adenocarcinoma, not otherwise specified (NOS) exhibits ductal differentiation without the diagnostic histomorphological features of other defined salivary carcinomas. Adenocarcinoma, NOS rarely occurs in the lip, and when adenocarcinomas occurs in more than one organ, it is often difficult to identify the primary site. We report a case of adenocarcinoma of the left-upper lip occurring in a 67-year-old woman, which need to clearly identify the type of tumor required collaboration with Department of Respiratory Surgery to identify the primary origin site. The woman was referred to our department because of a painless mass in the upper lip. The clinical diagnosis was a benign tumor or mucous cyst and we performed a biopsy. The histopathological diagnosis was adenocarcinoma, NOS. Chest computed tomography demonstrated a mass in the lower-right-lung lobe. We suspected lung metastases and histopathologically attempted to identify the primary lesion. Immunohistochemical analysis showed positive staining for cytokeratin 7 and negative staining for thyroid transcription factor 1 and napsin A. The analysis identified the primary lesion as a salivary adenocarcinoma, NOS. We performed a full-thickness resection of the left-upper lip and reconstructive surgery of the upper lip. Postoperative computed tomography at the 3-month follow-up showed no mass in the lower-right-lung lobe. Follow-up examinations have shown no evidence of recurrence for 4 years after the surgery.

Air embolism is generally considered the most common cause of death within 1 h of a blast injury. Shock lung, respiratory arrest, and circulatory failure caused by vagal reflexes contribute to fatal injuries that lead to immediate death; however, informative mechanistic data are insufficient. Here we used a laser-induced shock wave (LISW) to determine the mechanism of acute fatalities associated with blast injuries. We applied the LISW to the forehead, upper neck, and thoracic dorsum of mice and examined their vital signs. Moreover, the LISW method is well suited for creating site-specific damage. Here we show that only mice with upper neck exposure, without damage elsewhere, died more frequently compared with the other injured groups. The peripheral oxygen saturation (SpO(2)) of the former mice significantly decreased for < 1 min [p < 0.05] but improved within 3 min. The LISW exposure to the upper neck region was the most lethal factor, affecting the respiratory function. Protecting the upper neck region may reduce fatalities that are related to blast injuries.

The aim of this study was to retrospectively investigate the validity of rigid internal fixation of panfacial fractures (PFFs) without postoperative maxillomandibular fixation (MMF) in patients who underwent open reduction and internal fixation (ORIF). The medical records of patients with PFFs who underwent rigid internal fixation without postoperative MMF from April 2015 to November 2021 were retrospectively reviewed. The locations of PFFs were classified by the location affected. All patients except for 2 head-injured patients had regular follow-up examinations including postoperative imaging for over 6 months. There were 25 patients (15 males, 10 females; median age 51.3 years, range 16–89 years); median body mass index (BMI) 22.4 kg/m2, range 17.3–28.2 kg/m2). The most common location of PFFs was orbital bone (80%), with the exception of the maxilla. Mean operating time was 330 min, and mean blood loss was 120 ml. Postoperatively, one patient (4%) had malocclusion and mouth opening limitation, 5 patients (20%) required elastic traction for postoperative occlusal instability, and 2 patients (8%) had suture dehiscence. Three patients (12%) had postoperative soft tissue problems. Malocclusion or limited mouth opening was seen in one patient each (4%), and no patient exhibited facial asymmetry. The overall complication rate was 16%. The majority of patients (13/25) started oral feeding with a solid diet by postoperative day 3. In conclusion, proactively avoiding postoperative MMF for PFFs in which sufficient occlusal and bone stability can be achieved by rigid internal fixation not only avoids the disadvantages of postoperative MMF, but also provides satisfactory outcomes.

Introduction: The aim of this study was to investigate the validity of the duration for which we provide antibiotic prophylaxis to maxillofacial fracture patients who undergo open reduction and internal fixation (ORIF) in our hospital by retrospectively reviewing the incidence of surgical site infections (SSIs). Methods: The medical records of 83 patients with maxillofacial fractures who underwent ORIF from April 2010 to October 2019 were retrospectively reviewed. The surgeon selected the proper surgical approach to the fracture site depending on the location and type of fractures. ORIF was performed by an intraoral, extraoral, or transconjunctival approach, or a combination of these approaches. No statistical investigation of differences in the method of prophylactic antibiotic administration and the occurrence of SSIs was conducted because of the small sample size. Results: This retrospective study included 81 patients (58 males; median age 41 (range: 13–82) years; median BMI 22.4 (range: 16.5–33.6) kg/m2) with maxillofacial fractures. Two patients with infected fractures before operation withdrew from this study. The most common choice of antibiotic prophylaxis was cefmetazole for 2 days, followed by cefmetazole for 1 day. Two patients were diagnosed with an SSI; one was on cefazolin 2 g for 2 days, and the other was on cefmetazole 2–4 g for 2 days. In both cases the infection was successfully controlled, and implant removal was not required. Conclusions: In principle, antibiotic prophylaxis for 2 days postoperatively is sufficient in ORIF for maxillofacial fracture, but a multicenter, prospective, randomized study may be required to confirm this.

Bioshell calcium oxide (BiSCaO) is derived from scallop shells and after heat treatment exhibits broad microbicidal activity. BiSCaO Water is a disinfectant prepared by collecting the aqueous layer after adding BiSCaO powder to water, is colorless and transparent, and has a pH of 12.8. We compared the utility of commercially available BiSCaO Water, ethanol, sodium hypochlorite, hypochlorous acid and hydrogen peroxide solutions as sterilization agents to enable the reuse of surgical and N95 face masks. The microbicidal efficacy of each disinfectant was evaluated using pieces of surgical and N95 face masks contaminated with normal bacterial flora. The results suggest that BiSCaO Water has excellent disinfection activity toward contaminated polypropylene masks and has minimal adverse effect on the structure of non-woven masks.

The importance of protecting the eyes from infectious agents in patients' blood and saliva during dental surgery has long been known, but the global COVID-19 pandemic has made this even more important. The use of ATP bioluminescence to investigate the contamination of dental goggles during the surgical removal of impacted teeth in the present study indicates their importance for protecting the eyes from aerosols from the front, from above, and from the sides.

Bioshell calcium oxide (BiSCaO) possesses deodorizing properties and broad microbicidal activity. This study aimed to investigate the application of BiSCaO ointment for the prevention and treatment of infection in chronic wounds in healing-impaired patients, without delaying wound healing. The bactericidal activities of 0.04, 0.2, 1, and 5 wt% BiSCaO ointment, 3 wt% povidone iodine ointment, and control (ointment only) were compared to evaluate the in vivo disinfection and healing of Pseudomonas aeruginosa-infected wounds in hairless rats. Treatment of the infected wounds with 0.2 wt% BiSCaO ointment daily for 3 days significantly enhanced wound healing and reduced the in vivo bacterial counts compared with povidone iodine ointment and control (no wound cleaning). Although 5 wt% BiSCaO ointment provided the lowest bacterial counts during 3 days' treatment, it delayed wound healing. Histological examinations showed significantly advanced granulation tissue and capillary formation in wounds treated with 0.2 wt% BiSCaO ointment for 3 days compared to wounds treated with the other ointments. This study suggested that using 0.2 wt% BiSCaO ointment as a disinfectant for infected wounds and limiting disinfection to 3 days may be sufficient to avoid the negative effects of BiSCaO on wound repair.

Weakly acidic hypochlorous acid (HClO; 200 ppm, pH 6.5) is effective against a broad range of microorganisms. We have previously reported a study of developing antimicrobial biomaterials made up of chitin-nanofiber sheet (CNFS) -immobilized silver nanoparticles (CNFS/Ag NPs) and showed that either cleansing with HClO or covering with CNFS/Ag NPs daily for more than 7 days resulted in delayed wound healing. This study aimed to evaluate disinfection and wound healing by a combination of cleansing with HClO and covering with CNFS/Ag NPs daily for 3 days. Applying HClO + CNFS/Ag NPs daily for 3 days and then cleansing with just pure water and covering with CNFS alone daily for 9 days were performed for Pseudomonas aeruginosa-infected wounds in db/db diabetic mice. We found a significant enhancement of wound healing and a reduction of bacteria counts compared to the controls. Histological examination showed significantly advanced granulation tissue and capillary formations in the wounds on Day 12. These results suggest that limited disinfection to 3 days with HClO + CNFS/Ag NPs may be sufficient to avoid negative effects on wound repair.

Bioshell calcium oxide (BiSCaO) exhibits deodorizing properties and broad microbicidal activity. In this study, we examined possible utility of BiSCaO Water for that purpose. BiSCaO Water was prepared by adding 10 wt% BiSCaO to clean water and gently collecting the supernatant in a bottle. The same volume of clean water was gently poured onto the BiSCaO precipitate and the supernatant was gently collected in a bottle; this process was repeated fifty times. The produced BiSCaO Water contained nanoparticles (about 400–800 nm) composed of smaller nanoparticles (100–200 nm), and was colorless and transparent, with a pH > 12.7. In vitro assays demonstrated that BiSCaO Water eliminated more than 99.9% of influenza A (H1N1) and Feline calicivirus, Escherichia coli such as NBRC 3972 and O-157:H7, Pseudomonas aeruginosa, Salmonella, and Staphylococcus aureus within 15 min. We compared BiSCaO Water with the other microbicidal reagents such as ethanol, BiSCaO, BiSCa(OH)2 suspensions, povidone iodine, NaClO, BiSCaO dispersion and colloidal dispersion with respect to deodorization activity and microbicidal efficacy. The results showed that BiSCaO Water was a potent reagent with excellent deodorization and disinfection activities against pathogenic bacteria and viruses (including both enveloped and nonenveloped viruses).

Application of a high-velocity steam-air micromist jet spray (HVS-AMJS) with disinfectants for cleansing the skin is proposed. Low-pressure steam is mixed with compressed air in a nozzle and then sprayed onto a surface of skin or material located approximately 22 cm from the nozzle. The temperature on the sprayed surface was controlled between 40ºC and 45 ºC. The improved HVS-AMJS installed scattering prevention cover with tap water effectively removed normal bacterial flora (total viable count and coliform bacteria) from contaminated skin pieces and pig skin wounds. Furthermore, the cleansing efficacy increased by advanced-treating with bio-shell calcium oxide (BiSCaO), hypochlorous acid (HClO), sodium hypochlorite (NaClO), povidone iodine, or chlorhexidine gluconate. Especially, the improved HVS-AMJS combined with BiSCaO had higher bactericidal activity than when combined with other disinfectants. This study suggests that application of the HVS-AMJS with disinfectants, especially BiSCaO, may be useful for skin cleansing to prevent infection.

Recently, there has been an increase in the number of food poisoning cases associated with histamine in food, mainly in relation to histamine in fish. Here, we investigated methods to decrease histamine levels in Japanese pilchard, Japanese horse mackerel, and chub Mackerel, stored at 10 °C using various concentrations of heated scallop bioshell calcium oxide (BiSCaO) suspension, dispersion (BiSCaO + Na2HPO4), colloidal dispersion (BiSCaO + NapolyPO4), scallop shell powder (SSP) Ca(OH)2 in pure water (PW) or saline, and BiSCaO water. BiSCaO in a high alkaline pH solution chemically decomposes histamine poorly, but the partial flocculation/precipitation of histamine was observed with 1 and 0.2 wt.% BiSCaO dispersion and BiSCaO colloidal dispersion, respectively. Cleaning fish samples with BiSCaO suspension, dispersion, colloidal dispersion, or BiSCaO water remarkably reduced histamine levels and normal bacterial flora (coliform bacteria (CF) and total viable bacterial cells (TC)) after storage for four days at 10 °C, while much higher histamine levels were observed after cleaning with saline. These results suggest that cleaning fish with BiSCaO dispersion, colloidal dispersion, or BiSCaO water can significantly reduce histamine levels through their bactericidal activity against histamine-producing bacteria.

Nivolumab has various immune-related adverse events, including thyroid dysfunction. We describe a case of maxillary gingival malignant melanoma and lung adenocarcinoma with destructive thyroiditis after administration of nivolumab in a 62-year-old man who received multidisciplinary treatment with heavy particle therapy, surgical therapy, and immunotherapy. When destructive thyroiditis appeared, there were no symptoms but TSH decreased and FT3, FT4 increased in the hematology values. Nivolumab treatment was therefore discontinued in cooperation with endocrinologists. Without thyrotoxicosis, thyroid function normalized two months after discontinuing nivolumab. There has been a continuous cytoreductive effect on maxillary gingival malignant melanoma, and 29 months have passed since the start of treatment, but no metastasis has been observed.

Immediately post-production, commercially available bioshell calcium oxide (BiSCaO) water is colorless, transparent, and strongly alkaline (pH 12.8), and is known to possess deodorizing properties and broad microbicidal activity. However, BiSCaO Water may represent a serious safety risk to the living body, given the strong alkalinity. This study aimed to investigate the safety of BiSCaO Water for use as an antiseptic/disinfectant despite concerns regarding its high alkalinity. The change over time in pH of BiSCaO Water was measured during air contact (stirring BiSCaO Water in ambient air). When sprayed on metal, plastic, wood piece, paper, and skin surfaces, the pH of BiSCaO Water decreased rapidly, providing a white powder coating upon drying. Scanning electron microscopy images, energy dispersive X-ray elemental mapping, and X-ray diffractograms showed that the dried powder residues of BiSCaO Water were composed primarily of calcium carbonate. These results suggested that BiSCaO Water is a potent reagent that may overcome the obstacles of being strongly alkaline, making this material appropriate for use in disinfection against pathogenic microbes.

Heparinoid is the generic term that is used for heparin, heparan sulfate (HS), and heparin-like molecules of animal or plant origin and synthetic derivatives of sulfated polysaccharides. Various biological activities of heparin/HS are attributed to their specific interaction and regulation with various heparin-binding cytokines, antithrombin (AT), and extracellular matrix (ECM) biomolecules. Specific domains with distinct saccharide sequences in heparin/HS mediate these interactions are mediated and require different highly sulfated saccharide sequences with different combinations of sulfated groups. Multivalent and cluster effects of the specific sulfated sequences in heparinoids are also important factors that control their interactions and biological activities. This review provides an overview of heparinoid-based biomaterials that offer novel means of engineering of various heparin-binding cytokine-delivery systems for biomedical applications and it focuses on our original studies on non-anticoagulant heparin-carrying polystyrene (NAC-HCPS) and polyelectrolyte complex-nano/microparticles (N/MPs), in addition to heparin-coating devices.

The bactericidal activity of heated bio-shell calcium oxide (BiSCaO) powder suspension (pH 12.4) , hypochlorous acid (HClO; pH 6), sodium hypochlorite (NaClO; pH 8) , povidone-iodine (Isodine solution®) , and chlorhexidine gluconate (Hibiscrub®) under organic matter contaminated environments were compared for tests conducted on wood scraps and pig skin pieces that were incubated with normal bacterial flora (total viable counts and coliform bacteria) . The test results showed that BiSCaO suspension had higher bactericidal activity than HClO and NaClO. Furthermore, more than 10-fold higher concentrations of antiseptics such as povidone-iodine and chlorhexidine gluconate were required to achieve bactericidal activity comparable to that of BiSCaO suspension. Our results demonstrate the possibility of using BiSCaO suspension under organic matter contaminated environments as a disinfectant for environmental and food hygiene applications.

Bioshell calcium oxide (BiSCaO) is a scallop-shell powder heated at a high temperature. BiSCaO is composed mainly of calcium oxide and exhibits broad microbicidal properties. The aim of this study is to evaluate the disinfection and decontamination abilities of BiSCaO colloidal dispersions with that of commercially available bioshell calcium hydroxide (BiSCa(OH)2) following the formation of flocculants/precipitates under strongly alkaline conditions (pH 11.5–12.2). Various concentrations of BiSCaO and BiSCa(OH)2 colloidal dispersions were prepared by mixing with Na-polyPO4 (PP) and Na-triPO4 (TP) as flocculating agents. The microbicidal activities, and the degree of flocculation/precipitation of trypan blue, albumin, chondroitin sulfate, heparin, non-anticoagulant heparin carrying polystyrene (NAC-HCPS), and low-molecular-weight heparin/protamine nanoparticles (LMWH/P NPs) were dependent on the pH, the average particle diameter, and the concentration of BiSCaO or BiSCa(OH)2 and of the phosphate compound. BiSCaO (average particle diameter: 6 μm) colloidal dispersions (0.2 wt.%) containing 0.15 wt.% PP or TP exhibited substantially stronger microbicidal activity and flocculation/precipitation under strongly alkaline conditions. These results suggest that BiSCaO colloidal dispersions together with phosphate compounds have practical applicability for disinfection.

Scallop-shell powder (SSP) heated at high temperature exhibits high pH and broad antimicrobial activity. Bioshell calcium oxide (BiSCaO) is an SSP composed mainly of calcium oxide. It is poorly water-soluble under alkaline conditions and the generated precipitate can plug spray nozzles. The aim of this study was to establish that BiSCaO dispersion caused no significant CaO loss and plugging of spray nozzles, and to evaluate its deodorization and microbicidal abilities and its ability to reduce the concentrations of NO2- and NO3-. BiSCaO dispersions were prepared by mixing various concentrations of BiSCaO suspension, while phosphate compounds such as Na3PO4, Na2HPO4 or NaH2PO4 and the pH, average diameter, zeta potential, and form of the compounds with cryo-SEM were evaluated. We evaluated deodorization using tainted pork meat and microbicidal efficacy using contaminated suspension with normal bacterial flora. The concentration of NO2- and NO3- after mixing BiSCaO dispersion and pure water containing a high proportion of NO2- and NO3- were measured. BiSCaO dispersion formed with Na2HPO4, whose ratio to BiSCaO was 60%, showed a high pH (>12), a small particle diameter (>181 nm) and was stable for seven days. The BiSCaO dispersion showed higher deodorization and microbicidal activities than SSP-Ca(OH)2, which was mainly composed of Ca(OH)2. BiSCaO, but not SSP-Ca(OH)2, could reduce the concentration of NO2- and NO3- by more than 90% within 15 min. We developed a stable BiSCaO dispersion, and it had high deodorization and microbicidal efficacy. These activities of BiSCaO might result from the high pH caused by CaO hydration and a reduction activity causing active radical species.

Acanthomatous ameloblastoma is classified as one type of ameloblastoma. There have been only a few reports on acanthomatous ameloblastoma of the maxilla associated with bone tissue in the tumor stroma. This report describes a case of acanthomatous ameloblastoma of the maxilla with bone tissue that developed in a 25-year-old woman. The preoperative results of biopsy at another hospital showed an acanthomatous ameloblastoma. Partial maxillectomy was performed with the patient under general anesthesia in our department. Acanthomatous ameloblastoma was diagnosed on histopathological examination, and bone tissue associated with bone formation and resorption was observed in the tumor stroma. Follow-up examinations have shown no evidence of recurrence as of 7 years after surgery.