Sapporo Medical Journal

Abstract : Lymphocytic hypophysitis, a rare autoimmune disorder causing inflammation of the pituitary gland, often presents diagnostic challenges due to its varied manifestations and rarity. This report discusses a unique case of a 20-year-old female patient presented with polyuria, polydipsia, and fatigue. The initial laboratory evaluation suggested diabetes insipidus (DI), and magnetic resonance imaging (MRI) revealed an enlarged pituitary gland with mild, uniform thickening of the pituitary stalk. The patient was diagnosed with lymphocytic hypophysitis and managed with desmopressin and hydrocortisone. This case report highlights the challenges in diagnosing and treating lymphocytic hypophysitis presenting with central DI. The report emphasizes the importance of considering lymphocytic hypophysitis as a potential differential diagnosis in cases of unexplained DI, particularly in young women. Additionally, it underlines the significance of a comprehensive diagnostic approach, including laboratory tests and imaging studies, to reach a conclusive diagnosis in such rare and complex cases. The management of lymphocytic hypophysitis involves addressing the underlying autoimmune inflammation and associated hormonal imbalances. In this case, the use of desmopressin and hydrocortisone proved successful in managing the patient's symptoms and improving her overall clinical condition.

Abstract : One of the HR problems that occur in hospitals is a high turnover rate which can have a negative impact on hospitals, that are the emergence of instability and uncertainty in the workforce, besides it can also increase financial investment in HR financing. Problems at Universitas Indonesia Hospital related to the high turnover rate can be seen from the increase in the turnover rate for General Practitioners, in 2020 42%, in 2021 55%, and in 2022 101%. This research was conducted with the aim of knowing HR problems related to the high rate of resignation of General Practitioners at Universitas Indonesia Hospital and factors that cause it. This research is a cross-sectional study using a descriptive analysis approach by looking at data on the number of General Practitioners who have resigned in 2020-2022. Reasons of resignation at RSUI are divided into 3 main reasons based on the majority of results found in the exit interview form for resigning employees, the reasons for resignation cumulatively during 2020-2022 are due to accepting other jobs by 58%, continuing education by 36%, and moving residence by 6%. Several strategies in dealing with the turnover rates in order to not have negative impact on hospital services as follows: Setting the time period for resignation; Carry out further analysis and evaluation regarding the benefits of the compensation; Build and increase the loyalty of General Practitioners to hospital; Create plans for general practitioner workload analysis

Abstract : Aim: to evaluate patient`s satisfaction and peri-implant parameters around dental implants restored with customized PEEK abutments compared to Zirconium abutments and loaded with PEEK superstructure. Methodology: 30 implants in the esthetic were restored with custom made hybrid abutments made from PEEK (n=15) and zirconium (n=15), both groups were loaded with PEEK crowns veneered with Visiolign., outcomes were assessed at time of superstructure insertion (T0), 3 months (T1), 6months (T2) and 12 months (T3) after loading. Patient`s satisfaction was measured using the visual analogue scale (VAS), Peri-implant parameters included bleeding on probing (BOP), plaque index (PI) and probing depth (PD) were measured using a graduated periodontal probe. Results: There was no statistically significant difference between PEEK and zirconium abutments regarding patient`s satisfaction, Plaque index, Probing depth, however PEEK abutments group showed statistically significant lower BOP results at T1. Conclusions: Within the limitation of the current study it was concluded that PEEK is a viable substitute to zirconium abutments when restoring dental implants, with the advantage of decreasing plaque accumulation.

Abstract : Background: Studies suggest Positive End Expiratory Pressure (PEEP) could affect clinical outcomes and pulmonary vascular resistance. Objective: To explore the influence of high PEEP versus low PEEP on pulmonary function and clinical outcomes in critically ill COVID-19 patients. Methods: This single-centred retrospective observational study included 107 patients admitted to a tertiary care centre in Saudi Arabia. Demographic data included age, gender, comorbidities, oxygen saturation, length of intensive care unit (ICU) stay, mechanical ventilation requirement, supplemental oxygen requirement, PEEP, peak pressure, driving pressure, and tidal volume (TV). PEEP ≥10cm H2O was considered high and <10cm H2O was considered low. Results: High PEEP was associated with higher mortality than low PEEP (82% versus 50%, p<0.05). The regression model also showed that high PEEP increases the risk of mortality (B= 0.51, R2=57%, p<0.04). PEEP was higher in patients with severe consolidation/progressive lung lesions (r=0.48). Lower PEEP related to improved outcomes (r=-0.21). Hypercapnia (r=-0.28) or higher respiratory rate (r=-0.61) and FiO2 (r- -0.24), were associated with poorer outcomes. The intercept was highly significant (p<0.05), indicating there could be other independent variables influencing discharge outcomes. Conclusion: Higher PEEP was associated with higher mortality. Driving pressure, peak pressure, and TV should be considered alongside PEEP to evaluate mortality risk in COVID-

Abstract : Purpose: The objective of this study was to.evaluate the effect of different angulations of impacted maxillary canine on root resorption of lateral incisor using cone-beam computed tomography(CBCT). Methods and material : The sample included 30 CBCTs presenting with unilateral or bilateral impacted maxillary canines were evaluated ranging in age from 15 to 30 years that were selected and collected.from the Department of Radiology Faculty of Dentistry (Suez Canal University). Canine angulation relative to the maxillary occlusal plane and adjacent lateral incisor was measured, as well as the locations of the impacted canines. Results : The results of the current study showed (58.8 %) with slight resorption, and (26.5%) with moderate resorption of lateral incisor root. Lateral incisor root resorption was more common in the apical third and palatal surface. There was a statistically significant relationship between root resorption severity and angulation of impacted maxillary canine relative to the lateral incisor. Angle.of impacted maxillary canine with occlusal plane can`t be solely relied on determining the severity of root resorption (RR). Conclusion : RR occure due to.proximity.of impacted.maxillary canine to adjacent lateral incisor .Slight RR occur most commonly at apical and palatal surface.