Complete Removal Research Articles

The Fate of the Cyanotoxin Dihydroanatoxin-a in Drinking Water Treatment Processes

Only recently has the cyanotoxin dihydroanatoxin-a (dhATX-a) been detected more frequently in different surface waters, some of which are used for supplying drinking water. As data about the fate of dhATX-a in drinking water treatment processes are still scarce, the present study investigated the behavior of dhATX-a in different water treatment steps: slow sand filtration, flocculation, adsorption onto activated carbon, ozonation and chlorination. The almost complete removal (>95%) of dhATX-a was observed in sand columns simulating slow sand filtration without showing a long adaptation phase. The results further indicate that dhATX-a can be removed using powdered activated carbon at dosages of 50 mg/L with removal rates between 75 and 93% and also by using ozonation with dosages above 1 mg/L at a concentration of ca. 4.5 mg/L background organic carbon. In contrast, no elimination of dhATX-a was observed in flocculation and chlorination experiments.

Intraductal laser ablation during ductoscopy in patients with pathological nipple discharge.

Ductoscopy is a minimally invasive micro-endoscopic approach for direct visualization and removal of intraductal lesions of the breast. A challenge of ductoscopy is an adequate treatment of intraductal lesions by complete removal to prevent exploratory duct excision surgery. This study aimed to determine the in vivo feasibility of intraductal laser ablation during ductoscopy to remove intraductal lesions in patients suffering from pathological nipple discharge (PND). A prospective, single-center diagnostic feasibility trial was conducted between October 2022 and November 2023, enrolling adult women with unilateral PND and no radiological suspicion of malignancy. Intraductal laser ablation was performed after incomplete intraductal biopsy using a Thulium laser. Duct cannulation and subsequent ductoscopic exploration were successful in 21 patients revealing an intraductal lesion in 13 patients (61.9%). From these 13 patients, 9 patients (69.2%) underwent intraductal laser ablation due to a residual lesion after biopsy. Pathology of the removed intraductal lesions showed a papilloma in eight (88.9%) patients and a papilloma/DCIS combination in one patient (11.1%). Post-procedure, PND stopped in 77.8% of the patients (7/9). Two patients had recurrent PND complaints caused by a residual lesion. Intraductal laser ablation during ductoscopy in patients with papillary lesions seems to be feasible and safe. The Thulium laser enables ablation of residual lesions and is therefore suitable for an immediate second intervention after ductoscopic removal of intraductal lesions. Further refinement and validation in a follow-up clinical trial are necessary to further assess its therapeutic efficacy.

Innovative asymmetric CoSA‐N‐Ti3C2Tx catalysis: unleashing superoxide radicals for rapid self‐coupling removal of phenolic pollutant

The polymerization pathway of contaminants rivals the traditional mineralization pathway in water purification technologies. However, designing suitable oxidative environments to steer contaminants toward polymerization remains challenging. This study introduces a nitrogen‐oxygen double coordination strategy to create an asymmetrical microenvironment for Co atoms on Ti3C2Tx MXenes, resulting in a novel Co‐N2O3 microcellular structure that efficiently activates peroxymonosulfate. This unique activation capability led to the complete removal of various phenolic pollutants within 3 min, outperforming the representative Co single‐atom catalysts reported in the past three years. Identifying and recognizing reactive oxygen species highlight the crucial role of ·O2−. The efficient pollutant removal occurs through a ·O2−‐mediated radical pathway, functioning as a self‐coupling reaction rather than deep oxidation. Theoretical calculations demonstrate that the electron‐rich pollutants transfer more electrons to the catalyst surface, inducing the reduction of dissolved oxygen to ·O2− in the Co‐N2O3 microregion. In a practical continuous flow‐through application, the system achieved 100% acetaminophen removal efficiency in 6.5 h, with a hydraulic retention time of just 0.98 s. This study provides new insights into the previously underappreciated role of ·O2− in pollutant purification, offering a simple strategy for advancing aggregation removal technology in the field of wastewater treatment.

Innovative asymmetric CoSA-N-Ti3C2Tx catalysis: unleashing superoxide radicals for rapid self-coupling removal of phenolic pollutant.

The polymerization pathway of contaminants rivals the traditional mineralization pathway in water purification technologies. However, designing suitable oxidative environments to steer contaminants toward polymerization remains challenging. This study introduces a nitrogen-oxygen double coordination strategy to create an asymmetrical microenvironment for Co atoms on Ti3C2Tx MXenes, resulting in a novel Co-N2O3 microcellular structure that efficiently activates peroxymonosulfate. This unique activation capability led to the complete removal of various phenolic pollutants within 3 min, outperforming the representative Co single-atom catalysts reported in the past three years. Identifying and recognizing reactive oxygen species highlight the crucial role of ·O2-. The efficient pollutant removal occurs through a ·O2--mediated radical pathway, functioning as a self-coupling reaction rather than deep oxidation. Theoretical calculations demonstrate that the electron-rich pollutants transfer more electrons to the catalyst surface, inducing the reduction of dissolved oxygen to ·O2- in the Co-N2O3 microregion. In a practical continuous flow-through application, the system achieved 100% acetaminophen removal efficiency in 6.5 h, with a hydraulic retention time of just 0.98 s. This study provides new insights into the previously underappreciated role of ·O2- in pollutant purification, offering a simple strategy for advancing aggregation removal technology in the field of wastewater treatment.

Clinical Efficacy and Outcomes of Electro-Pneumatic Intracorporeal Lithotripsy in the Management of Sialolithiasis.

This study aims to evaluate the clinical efficacy of electro-pneumatic intracorporeal lithotripsy for the treatment of salivary gland stones. A prospective cohort study of patients diagnosed with obstructive salivary gland syndrome, where basket-assisted sialendoscopy alone failed to remove the calculi. This study was conducted at the "Queen Maria" Military Hospital in Brașov, Romania, and a private practice, between February 2023 and May 2024. A total of 29 patients with salivary calculi were treated using the SialoLither device (Hidromed), which operates on the electro-pneumatic principle. The number of sessions required for complete stone removal, the duration of each session, and the number of ballistic impulses applied were recorded. Statistical analyses, including the Mann-Whitney U test and multiple linear regression, were conducted to assess the relationship between stone size, location, and treatment outcomes. Complete removal was achieved in 72.4% of patients after a single session, with 100% success after 3 sessions. The average number of impulses was 13.9 (±4.25), with no significant difference in outcomes between the parotid and submandibular glands (P > .05). The total duration varied, with a mean time of 89.97 (±54.89) minutes. Complications were minimal, with only 2 cases of minor epithelial damage. Electro-pneumatic intracorporeal lithotripsy is a highly effective, minimally invasive technique for managing salivary calculi, offering a safe and efficient alternative to traditional surgical methods.

Continuous electrophoretic separation of submicron-microplastics from freshwater

Anthropogenic and natural weathering processes have produced submicron microplastics (MPs), an emerging contaminant. Due to small size, the treatment of submicron plastics particles by membrane processes requires small cutoff membranes, which necessitates great pressure gradient and suffers from clogging. The present study aims to develop an electrophoretic separation system for the separation of negatively charged submicron plastics particles from water. An electric field was supplied to produce an electrostatic force to counter the drag force in the permeation stream, thereby, preventing submicron plastics particles from entering the permeate. The critical electric field (Ec) for complete particles removal was estimated based on the dilute-to-influent flow rate ratio (qd), zeta potential, and size of submicron plastics particles. The result showed that at steady-state, particle removal could reach 99% at E > Ec at qd = 0.5. The distribution of plastics particles during electrophoretic separation was analyzed considering electrophoresis and particle deposition. The particle removal efficiency can be modelled by hydraulic condition and critical electric field. Finally, the engineering aspects such as long-term operation, electrode degradation and influence of coexisted constituents were evaluated. The operation cost of electrophoretic separation was calculated to be USD 0.48/m3, which is cost-effective at small scales compared to conventional membrane processes.

Different combinations of operating temperature and solids retention time during two-phase anaerobic digestion impacts removal of antibiotic resistance genes

Two-phase anaerobic digestion (AD) performance is significantly influenced by operating parameters such as temperature and solids retention time (SRT), while their impact on antibiotic resistance genes (ARGs) during the acidogenic (AP) and methanogenic (MP) phases remains unclear. This study assessed the abundance of eight ARGs in full-scale two-phase AD, then operated lab-scale two-phase AD systems to evaluate temperature combinations (thermophilic-thermophilic, thermophilic-mesophilic, mesophilic-thermophilic, and mesophilic-mesophilic) at a constant SRT (AP = 2/MP = 13d) and to further assess different SRTs (AP = 2/MP = 13d and AP = 4/MP = 11d). qPCR results revealed that full-scale two-phase AD reduced total ARGs abundance by 87.70 ± 0.50 %. In lab-scale tests, the thermophilic-thermophilic configuration achieved nearly complete ARGs removal (97.61 ± 0.21 %), while the combination of AP = 4/MP = 11d had the highest removal efficiency (83.39 ± 1.17 %). Network analysis indicated that Firmicutes, Bacteroidota, and Proteobacteria were the primary ARG hosts, with Firmicutes dominant. These findings highlight the optimal operating parameters in two-phase AD for maximizing ARGs removal.

Combining nanofiltration and electrooxidation for complete removal of nanoplastics from water.

Nanoplastics (NPs) have emerged as significant water contaminants, attracting increasing attention due to their potential impacts on aquatic ecosystems and human health. In addressing the environmental and health hazards posed by NPs in water, this new study explores a combined nanofiltration (NF) and electrooxidation (EO) approach. The proposed process begins with NF to concentrate the NPs in the water, followed by EO to degrade the NPs in the NF rejection. The results indicated that the employed NF system could completely eliminate NPs at different transmembrane pressures and times. The study also highlighted the influence of NP concentrations on recovery rates, showing a reduction in recovery at higher concentrations. Moreover, following the NF process, the EO process was examined for its efficiency in removing NPs over time and at various initial NP concentrations. The results revealed that the most effective durations were 20, 30, and 40min for NP concentrations of 10, 22.5, and 35mg/L, respectively. As a kinetic study, the rate of NPs degradation by the EO process was modeled using Langmuir-Hinshelwood (L-H) as well as power law models. The comparison between the models' predictions and the experimental data demonstrated that the power law and L-H models had good predictability for NP concentrations exceeding 10mg/L and 2mg/L, respectively. At concentrations below the 2mg/L, deviations from the model were observed, likely due to changes in the reaction mechanism. It can be concluded from these results that, at low concentrations, the surface reactions were no longer the rate-determining step.

Description and Durability of the Various Direct Restoration Techniques in Molar-Incisor Hypomineralization: A Systematic Review.

Molar-incisor hypomineralization (MIH) is a qualitative defect of the enamel structure affecting at least one of the first permanent molars. Treatment will depend on its severity, the stage of dental development and the cooperation of the young patient. The aim of this study is to compare the different materials used for direct restorations on teeth with MIH. A systematic review was conducted on May 2024 and is described according to the PRISMA criteria. It was performed on three databases (PubMed, Science Direct, and Google Scholar). Twenty-nine articles were included. 14 studies (48.3%) described the use of glass-ionomer cement (GIC), among which 12 concluded that its use could be recommended as a temporary material in the presence of MIH, protecting the tooth while awaiting a definitive restoration. Composite resins were described in 21 studies (72.4%), in association with both etch-and-rinse and selfetch adhesive systems. For direct tooth restoration in case of MIH, GIC seem to meet the objective of preserving the child's quality of life by protecting teeth during their eruption with an acceptable survival rate. The use of dental composite resins is more restrictive and will be optimal with complete removal of hypomineralized tissue.

Facial darier-ferrand dermatofibrosarcoma: A case report with review of the literature

Darier-Ferrand Dermatofibrosarcoma (DFS) is a rare mesenchymal tumor of intermediate malignancy, characterized by the proliferation of spindle cells within the deep dermis and subcutaneous tissues. This neoplasm is defined by slow growth but is notable for its marked local aggressiveness and high potential for recurrence without appropriate treatment. Diagnosis is based on histopathological examination, and surgical excision with margins of at least 5 cm remains the standard treatment to ensure complete tumor removal and minimize the risk of local recurrence. The aim of this study is to describe the management of a patient with Darier and Ferrand dermatofibrosarcoma of the face and to review the literature

Tumor-Homing Biomimetic Near-Infrared II SERS Probes for Targeted Intraoperative Resection Guidance of Orthotopic Glioblastoma.

In vivo optical imaging holds great potential for surgical guidance with the ability to intraoperatively identify tumor lesions in a surgical bed and navigate their surgical excision in real time. Nevertheless, its full potential remains underexploited, mainly due to the dearth of high-performance optical probes. Herein, hybrid cell membrane-biomimetic near-infrared II surface-enhanced Raman spectroscopy (NIR-II SERS) probes are reported for intraoperative resection guidance of orthotopic glioblastoma. A novel class of plasmonic Au nanorod (AuNR)@Au-Ag frames is developed with remarkable plasmonic properties tunable beyond 1700 nm. We demonstrate the exceptional NIR-II SERS performance both in vitro and in vivo of the biomimetic NIR-II SERS probes created with AuNR@Au-Ag frames and hybrid cell membranes. The biomimetic NIR-II SERS probes are successfully applied in an orthotopic glioblastoma mouse model for intraoperative resection guidance with complete tumor removal and improved surgical outcomes. This study presents a promising strategy for precise NIR-II SERS surgical navigation.

Automatic Quality Control System and Adenoma Detection Rates During Routine Colonoscopy

High-quality colonoscopy reduces the risks of colorectal cancer by increasing the adenoma detection rate. Routine use of an automatic quality control system (AQCS) to assist in colorectal adenoma detection should be considered. To evaluate the effect of an AQCS on the adenoma detection rate among colonoscopists who were moderate- and low-level detectors during routine colonoscopy. This multicenter, single-blind, randomized clinical trial was conducted at 6 centers in China from August 1, 2021, to September 30, 2022. Data were analyzed from March 1 to June 30, 2023. Individuals aged 18 to 80 years were enrolled. Exclusion criteria were a history of inflammatory bowel disease, advanced colorectal cancer, and polyposis syndromes; known colorectal polyps without complete removal previously; a history of colorectal surgery; known stenosis or obstruction with contraindication for biopsy or prior failed colonoscopy; pregnancy or lactation; and refusal to participate. Intention-to-treat and per-protocol analysis was used. Standard colonoscopy or AQCS-assisted colonoscopy. Adenoma detection rate. A total of 1254 participants (mean [SD] age, 51.21 [12.10] years; 674 [53.7%] male) were randomized (627 standard colonoscopy, 627 AQCS-assisted colonoscopy). Intention-to-treat analysis showed a significantly higher adenoma detection rate in the AQCS-assisted group vs standard colonoscopy group (32.7% vs 22.6%; relative risk [RR], 1.60; 95% CI, 1.23-2.09; P < .001). The adenoma detection rates were significantly higher in the AQCS group when considering pathology (nonadvanced adenomas, 30.1% vs 21.2%; RR, 1.52; 95% CI, 1.16-1.99; P = .002), and morphology (flat or sessile, 29.3% vs 20.4%, RR, 1.52; 95% CI, 1.16-2.00; P = .003). Use of AQCS significantly increased the adenoma detection rate of both the lower-level detectors (30.0% vs 20.0%; RR, 1.71; 95% CI, 1.24-2.35; P = .001) and the medium-level detectors (38.1% vs 27.7%; RR, 1.61; 95% CI, 1.07-2.43; P = .02). Similar increases were found for adenoma detection rates in the academic and nonacademic centers (academic: 29.3% vs 20.8%; RR, 1.58; 95% CI, 1.10-2.29; P = .01; nonacademic: 36.1% vs 24.5%; RR, 1.74; 95% CI, 1.23-2.46; P = .002). The number of adenomas per colonoscopy was significantly higher in the AQCS-assisted group (0.86 vs 0.48; RR, 1.50; 95% CI, 1.17-1.91; P = .001). The mean withdrawal time without intervention was slightly increased with AQCS assistance (6.78 vs 6.46 minutes; RR, 1.38; 95% CI, 1.26-1.52; P < .001). No serious adverse events were reported. In this randomized clinical trial, AQCS assistance during routine colonoscopy increased adenoma detection rates and several related polyp parameters compared with standard colonoscopy in the lower- and medium-level detectors in academic and nonacademic settings. Routine use of AQCS to assist in colorectal adenoma detection and quality improvement should be considered. ClinicalTrials.gov Identifier: NCT04901130.

P-375. Long-Term Suppressive Antimicrobial Therapy in Prosthetic Vascular Graft Infection: a Five-Year Retrospective Evaluation

Abstract Background Prosthetic vascular graft infection (PVGI) is a rare but life-threatening complication of surgery. Complete removal and replacement of the endograft is the only curative strategy but is frequently impracticable for the high mortality risk, therefore, suppressive antimicrobial therapy (SAT) is the best treatment option. This retrospective study aimed to describe the indication and outcome of SAT in patients with a PVGI evaluated since 2019 at Tor Vergata Hospital in Rome. Methods Patients with a PVGI (no cardiac valve replacement infections) were enrolled. The outcome was defined based on the latest available outpatient evaluation. PVGI was stratified as early/late and suspected/diagnosed according to guidelines. Results Twenty-one patients were enrolled (Tab. 1-3). At least one causative organism was identified in 41% of cases, mainly through blood samples (57%): 38% were Gram positive (GPB) and 29% were Gram negative (GNB) bacteria. Unexpectedly, early PVGI were more frequently caused by GNB than GPB (p-value 0.006). All patients were SAT treated; only 3 patients underwent surgery without reaching source-control. Several options, including long-acting antibiotics (LAA), were available for GPB, while cotrimoxazole, ciprofloxacin and ertapenem were the principal long-term SAT for GNB. The CT-PET scan monitoring was done after a median follow-up (FU) time of 90 [IQR 90-180] days; a positive early CT-PET FU (≤3 months from the first test) was associated with treatment failure needing a modification of SAT (p-value 0.003). Drug adverse effects occurred in 38% of cases and were followed by a change in SAT. Subsequently to clinical/radiological improvement (71%) or patient decision (29%), SAT was discontinued in 7 patients after a median time of 336 [292-404] days. Patients who experienced SAT discontinuation were younger, with fewer comorbidities, early infections, known pathogen and LAA therapy, although no statistically significant association was observed. Two patients showed a radiological failure needing to resume treatment; 3 patients (14%) successfully suspended SAT currently without relapse. Conclusion Our results support SAT as a suitable option for patients with PVGI at high surgical risk. Larger prospective studies are needed to guide empirical practice. Disclosures All Authors: No reported disclosures

Two Demosponges as Promising Bioremediators of a Potential Pathogenic Vibrio

Marine sponges play a fundamental role in the proper functioning of the ecosystem by filtering organic matter and contributing to nutrient fluxes. These animals have been proposed as efficient bioremediators of microbiological contamination in various environmental conditions subjected by anthropogenic pressure. In the present study, the bioremediation potential of the demosponges Aplysina aerophoba and Geodia cydonium was analyzed ex situ. For this purpose, the viable count of an antibiotic-resistant bacterial strain belonging to the species Vibrio parahaemolyticus was assessed in presence of the selected sponge species. Although some sponge individuals showed closed oscula during the first hours of the experiment, A. aerophoba and G. cydonium reduced the bacterial load in the seawater up to five orders of magnitude in 72 h. In addition, they had high clearance rates and retention efficiencies, with almost complete removal of the tested bacteria. Low Vibrio concentrations were observed in all tanks after six days, suggesting no excretion of viable Vibrio from sponges. These results corroborate the usefulness of A. aerophoba and G. cydonium as bioremediators of bacteria and therefore appear to be ideal candidates for bioremediation purposes in anthropogenic environments, such as aquaculture facilities, where multidrug-resistant bacteria may play a role in the spread of antimicrobial resistance.

Does cytoreductive surgery and hyperthermic intraperitoneal chemotherapy improve survival in children with desmoplastic small round cell tumors? First experiences from Turkey

Objective: Desmoplastic small round cell tumor (DSRCT) is a rare form of highly aggressive sarcoma and despite multimodal therapy, mortality still remains high. The aim of the study is to review our experience in cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) in children with DSRCT. Patients and Methods: A retrospective review of patients with DSRCT followed in our institution between January 2020-January 2024 was performed. Demographics, radiological imaging, histopathology results, cytogenetic analyses, chemotherapy/radiotherapy protocols, operative data and outcomes were analyzed. Results: Three patients with DSRCT were identified. The median age was 13.3 years (12-16 years). HIPEC was performed after CRS in two patients, while HIPEC procedure could not be applied in one patient with unresectable tumor. One patient underwent reoperation/re-HIPEC for recurrence after seven months. One patient had the diagnosis after complete removal of the tumor. Patient required peritonectomy and HIPEC as a second operation due to peritoneal recurrence. The patients who underwent CRS and HIPEC are still alive for 33 and 34 months since initial diagnosis, nevertheless the patient who had an unresectable tumor died after 8 months. Conclusion: Cytoreductive surgery and HIPEC may be considered as a safe and feasible treatment option in children with DSRCT in experienced centers.

Drilling and Groove-cutting Technique for Safe and Complete Removal of Forehead Osteomas on the Anterior Table of the Frontal Sinus.

Forehead osteomas are benign tumors commonly excised for cosmetic and functional reasons. However, removing osteomas from the anterior table of the frontal sinus presents specific challenges, particularly in determining the appropriate removal thickness. Inaccurate resection depth may result in fracture or perforation of the anterior table of the frontal sinus, or incomplete resection. The authors propose a novel drilling and groove-cutting technique to ensure safe and complete excision while minimizing risks of fracture or perforation of the anterior table. In this study, the authors present a 51-year-old female patient with a recurrent osteoma. Preoperative computed tomography (CT) imaging-guided depth-limiting drilling at the osteoma's center, followed by groove-cutting to establish excision boundaries. Then divided osteoma blocks were excised completely. Postoperatively, the patient showed no sensory deficits or forehead asymmetry and achieved pleasing frontal contour with minimal scarring. This technique effectively safeguards the anterior table and ensures complete removal, demonstrating its utility in craniofacial surgery.

Endoscopic Papillary Balloon Dilation Versus Small Endoscopic Sphincterotomy for Endoscopic Retrograde Cholangiopancreatography-Related Adverse Events in Patients With Non-Dilated Distal Bile Duct.

Endoscopic papillary balloon dilation (EPBD), small endoscopic sphincterotomy (EST), and small EST plus EPBD are commonly used as rescue techniques to remove bile duct stones. However, we often encountered challenging cases with non-dilated distal bile ducts, especially in those undergoing EPBD. We aimed to explore the reasons by assessing whether patients without the dilated bile duct had a higher risk of early complications and whether it was impacted by the rescue techniques. We performed a retrospective cohort study by frequency matching design in patients diagnosed with stones in non-dilated distal bile duct who received rescue techniques from July 2016 to June 2022. Besides, patients with stones and without dilatation of the distal bile duct (DDBD) were divided into 3 subgroups according to the rescue technique received. Outcomes were compared between the subgroups. The non-DDBD group was more likely to develop post-endoscopic retrograde cholangiopancreatography pancreatitis (PEP) and hyperamylasemia (HP) than the DDBD group (P < 0.05). Some cases had mild or moderate pancreatitis, but no one in either group developed severe pancreatitis. For subgroup analysis, each technique resulted in complete stone removal; the EPBD group had a higher HP rate than the other subgroups and reached statistical significance: the EPBD group versus the small EST group (P = 0.013) and the EPBD group versus the EPBD plus small EST group (P = 0.008). Although there was no statistical significance, PEP incidence in the EPBD group was 13.7% higher than in other subgroups (P > 0.05/3). Non-DDBD patients have a higher risk for endoscopic retrograde cholangiopancreatography-related pancreatic inflammation. EPBD should be used cautiously due to the significant association with increased rates of PEP and HP. Conversely, small EST and combination therapy are suitable for non-dilated bile duct stones because of their high safety profile and efficacy.

Enhanced metals precipitation in acid mine drainage by thermal activation magnesite-pine shavings dispersed alkaline substrate

ABSTRACT The acid mine drainage (AMD) is characterized by its highly acidic nature and elevated concentrations of metal ions, thereby exerting significant impacts on both human health and the environment. This study employed a dispersed alkaline substrate (DAS) consisting of thermal activation magnesite and pine shavings for the treatment of AMD. The investigation focused on determining the optimal thermal activation conditions of magnesite, evaluating the effectiveness of the DAS in regulating acidity and removing metal ions from AMD, identifying critical factors influencing treatment efficiency, and conducting toxicity assessment on the effluent. Results indicated that calcination at 700 °C for 60 min was determined to be the optimal thermal activation condition for magnesite. Under the optimal operating conditions of the DAS (flow rate: 0.4 mL/min, filling mass ratio: thermal activation magnesite to pine shavings = 1:1), the system achieved complete removal (100%) of metal ions within 396 h while maintaining a pH above 7.0. Moreover, it significantly minimized operating costs and sludge generation. Toxicity assessment experiments conducted using Chlorella proteolytica demonstrated a significant reduction in biotoxicity after treatment with this system. These findings suggest that a DAS based on thermal activation magnesite holds promise as an effective solution for treating AMD.

Coronectomy of mandibular third molars with dental pathology: a prospective cohort study of 121 molars

PurposeCoronectomy is a valuable treatment proven safe for non-pathological mandibular third molars with an increased risk of inferior alveolar nerve injury. Coronectomy may also be useful for mandibular third molars with dentigerous cysts and caries, but this is not commonly performed due to the lack of well-designed, evidence-based studies. Here, we aim to investigate the safety of coronectomy for mandibular third molars with caries and dentigerous cysts.MethodsOne hundred fifteen patients with an impacted mandibular third molar with a dentigerous cyst or caries underwent coronectomy or complete removal and received follow-up with clinical and radiographical examinations. We statistically compared the presence of postoperative complications after coronectomy versus complete removal.ResultsData from 121 molars were available for analysis. The results revealed no significant difference in the occurrence of postoperative complications (including persistent pain, inferior alveolar nerve injury, infection, alveolar osteitis, excessive bleeding, and the need for retreatment) between coronectomy and complete removal. Additionally, the incidence of postoperative complications was not related to any analyzed patient- or molar-related factors, including age, gender, health status, smoking, caries, dentigerous cyst extent, and impaction degree.ConclusionFor pathological impacted mandibular third molars with dentigerous cysts and caries, coronectomy exhibited both short-term and long-term safety, showing no significant difference in postoperative complications compared to total removal. Our results suggest that coronectomy can be indicated for pathological mandibular third molars with proximity to the inferior alveolar nerve.Trial registration numberNot applicable.

Primary adenocarcinoma of the lacrimal sac with 5-year recurrence-free survival after radiation therapy alone: a case report

Abstract Lacrimal sac tumors are rare, with approximately 800 cases reported worldwide; primary adenocarcinoma of the lacrimal sac is particularly rare. Although there is no established treatment strategy, surgical removal is generally performed. However, complete removal often requires extensive resection, including orbital exenteration and lateral rhinoplasty, which is highly invasive and creates significant cosmetic issues. Here, we report our experience with a 72-year-old woman with primary adenocarcinoma of the lacrimal sac with ethmoid bone invasion. She refused surgery and was treated with radiation therapy alone, totaling 70 Gy in 35 fractions. This is the first report of a patient with primary adenocarcinoma of the lacrimal sac who survived for 5 years without recurrence after radiation therapy alone. She experienced late radiation-related complications: the affected eye developed grade-3 retinopathy according to the common terminology criteria for adverse events, version 5.0, and secondary neovascular glaucoma. Cataract and vitreous surgery with retinal photocoagulation were performed. Her cosmetic appearance was maintained after all treatments were completed. Radiation therapy may be an effective treatment for primary adenocarcinoma of the lacrimal sac for patients who either refuse surgery or in whom surgery is not feasible.