Background Acute pulmonary embolism (APE) is a major cause of death from cardiovascular disease. Right ventricular systolic dysfunction (RVD) caused by APE is closely related to a poor outcome. Early risk stratification of APE is a vital step in prognostic assessment. The objective of this study was to investigate the usefulness of computed tomographic pulmonary angiography (CTPA) measured right ventricular (RV)/ left ventricular (LV) diameter ratio by the emergency department (ED) specialists for early risk stratification of APE patients in ED. Methods The retrospective data of 229 APE patients were reviewed. Two ED specialists measured both RV and LV diameters on a single transverse scan perpendicular to the long axis of the heart. The patients were divided into two groups, RV/LV diameter ratio <1 and ratio >1. CTPA measured RV/LV diameter ratio were analyzed and compared with sPESI score, cardiac biomarkers such as N-Terminal Pro-B-Type Natriuretic Peptide (NT-pro-BNP), high sensitivity cardiac troponin T (hs-cTnT), and RVD measured by echocardiography (Echo). Results The mean age in RV/LV > 1 group was significantly higher than that of the other group (67.81±2.7 years vs. 60.68±3.2 years). Also, there were more hypertension patients (44.4% vs. 33.3%), and mean arterial pressure (MAP) was lower. A significantly higher ICU admission rate (28.05% vs. 11.61%) was shown in RV/LV >1 group, and five patients expired only in RV/LV > 1 group. RVD by Echo demonstrated the highest sensitivity, specificity, and negative predictive value (NPV) (values of 94.3%, 81.1%, 95.5%). RV/LV >1 diameter ratio by CTPA showed usefulness equivalent to cardiac biomarkers. RV/LV >1 patients’ cardiac enzymes were higher, and there were more RVD in RV/LV >1 group. Conclusion Simple measurement of RV/LV diameter ratio by ED specialist would be a help to the clinicians in identifying and stratifying the risk of the APE patients presenting in the ED.

To survey the advantages, future prospects, and cases using robotic systems in oromaxillofacial surgery.Background: With the accumulation of advances in minimally invasive surgery in the entire body area, robot-assisted surgeries have become very common in operating rooms, despite of their short history. Thus, advances in robotic surgery are accelerating rapidly, particularly with respect to the maxillofacial region. In this regard, researchers reviewed the literatures using the keywords given below, including systematic metaanalysis.Methods: The report follows the format of the "narrative review" and reviewed literatures extracted from the PubMed database since 1980 when 'Robotic surgical procedures', 'neck dissection' and 'oral surgery' were searched.Conclusions: Robotic surgery in the oral and maxillofacial region allows the incision to hide the scar by making the incision line far from the surgical field, resulting in fewer intra-operative and post-operative complications, such as amount of drainage or hospital days. Furthermore, recent studies show similar or superior results in terms of oncologic safety of robot assisted surgeries compared to conventional surgeries.Robotic surgery is likely to extend throughout the oral and maxillofacial region once it becomes capable of manipulating bone such as in osteotomies, particularly as robotic systems become smaller. When combined with artificial intelligence technology, the surgical robot will become more useful and powerful in relieving human suffering.

Restoring midfacial defects following the resection of head and neck tumors is difficult in terms of achieving oral and facial reconstruction and rehabilitation. As surgical techniques for free tissue transfer develop, reconstruction of maxillary palatal defect becomes easier and more practical, and dental implant placement can be achieved using bone flaps. Scapular flaps have several advantages in the reconstruction of maxillary bone defects, including anatomical similarity and suitability for dental implants. Herein, we report the case of a 56-year-old patient who underwent partial maxillectomy for squamous cell carcinoma of the right maxillary gingiva; the surgical defects were reconstructed using a scapular free flap. Dental implant surgery with three implants was performed two years after an oral cancer surgery. Masticatory function gradually improved over approximately four months of provisional prosthesis use. After confirming that the patient adapted well to the provisional prosthesis, the final prosthesis was installed after adapting to the provisional prosthesis.