RbAp48 expression and neuronal damage in the gerbil hippocampus following 5 min of transient ischemia / 한국실험동물학회지

Histone-binding protein RbAp48 has been known to be involved in histone acetylation, and epigenetic alterations of histone modifications are closely associated with the pathogenesis of ischemic reperfusion injury. In the current study, we investigated chronological change of RbAp48 expression in the hippocampus following 5 min of transient ischemia in gerbils. RbAp48 expression was examined 1, 2, 5, and 10 days after transient ischemia using immunohistochemistry. In sham operated gerbils, RbAp48 immunoreactivity was strong in pyramidal and non-pyramidal cells in the hippocampus. After transient ischemia, RbAp48 immunoreactivity was changed in the cornu ammonis 1 subfield (CA1), not in CA2/3. RbAp48 immunoreactivity in CA1 pyramidal neurons was gradually decreased and not detected at 5 and 10 days after ischemia. RbAp48 immunoreactivity in non-pyramidal cells was maintained until 2 days post-ischemia and significantly increased from 5 days post-ischemia. Double immunohistofluorescence staining revealed that RbAp48 immunoreactive non-pyramidal cells were astrocytes. At 5 days post-ischemia, death of pyramidal neurons occurred only in the CA1. These results showed that RbAp48 immunoreactivity was distinctively altered in pyramidal neurons and astrocytes in the hippocampal CA1 following 5 mins of transient ischemia. Ischemia-induced change in RbAp48 expression may be closely associated with neuronal death and astrocyte activation following 5 min of transient ischemia.

Age-dependent changes of p53 and p63 immunoreactivities in the mouse hippocampus / 한국실험동물학회지

P53 and its family member p63 play important roles in cellular senescence and organismal aging. In this study, p53 and p63 immunoreactivity were examined in the hippocampus of young, adult and aged mice by using immunohistochemistry. In addition, neuronal distribution and degeneration was examined by NeuN immunohistochemistry and fluoro-Jade B fluorescence staining. Strong p53 immunoreactivity was mainly expressed in pyramidal and granule cells of the hippocampus in young mice. p53 immunoreactivity in the pyramidal and granule cells was significantly reduced in the adult mice. In the aged mice, p53 immunoreactivity in the pyramidal and granule cells was more significantly decreased. p63 immunoreactivity was strong in the pyramidal and granule cells in the young mice. p63 immunoreactivity in these cells was apparently and gradually decreased with age, showing that p63 immunoreactivity in the aged granule cells was hardly shown. However, numbers of pyramidal neurons and granule cells were not significantly decreased in the aged mice with normal aging. Taken together, this study indicates that there are no degenerative neurons in the hippocampus during normal aging, showing that p53 and p63 immunoreactivity in hippocampal neurons was progressively reduced during normal aging, which might be closely related to the normal aging processes.

Photogrammetric Facial Analysis of Attractive Celebrities Using the Glabella for Planning Rhinoplasty and Analyzing Surgical Outcomes

BACKGROUND: Identifying problems and making a surgical plan through a preoperative analysis is important in facial aesthetic surgery. Thus, popular conceptions of an attractive face must be analyzed beforehand. The landmarks used as reference points may change after rhinoplasty, resulting in errors in the prediction and assessment of outcomes. To reduce such errors, it is advantageous to use reference points and landmarks that are subject to minimal variation. This study measured and analyzed landmarks with little preoperative and postoperative variation in rhinoplasty, and established appropriate standards for landmarks indicative of ideal profiles. METHODS: A photogrammetric analysis was performed of 80 famous and attractive celebrities from Korea, Southeast Asia, Japan, China, and America. The nasofrontal angle, nasal angle, nasolabial angle, angle of facial convexity, and angle of total facial convexity were measured. RESULTS: The angle of total facial convexity differed significantly among countries (P=0.013). No significant difference in nasal angle, facial convexity, or total facial convexity was observed between Western and Eastern countries. A significant difference in the nasofrontal angle (Asian: 138.66°, Western: 134.35°; P=0.006) was observed. The nasolabial angle (Asian: 97.09°, Western: 104.59° degrees; P=0.007) was significantly more acute in Asian than in Western subjects. CONCLUSIONS: In this study, we performed a more accurate analysis using the glabella instead of the nasion to measure the facial profiles of patients planning to undergo rhinoplasty and proposed standard values through an analysis of ideal and attractive facial profiles.

Three-dimensional finite element analysis according to the insertion depth of an immediately loaded implant in the anterior maxilla / 대한치과보철학회지

PURPOSE: The purpose of this study was to investigate the effects of the insertion depth of an immediately loaded implant on the stress distribution of the surrounding bone and the micromovement of the implant using the three-dimensional finite element analysis. MATERIALS AND METHODS: A total of five bone models were constructed such that the implant platform was positioned at the levels of 0.00 mm, 0.25 mm, 0.50 mm, 0.75 mm, and 1.00 mm depth from the crest of the cortical bone. A frictional coefficient of 0.3 and the insertion torque of 35 Ncm were simulated on the interface between the implant and surrounding bone. A static load of 178 N was applied to the provisional prosthesis with a vertical load in the axial direction and an oblique load at 30°with respect to the central axis of the implant, then a finite element analysis was performed. RESULTS: The implant insertion depth significantly affected the stress distribution on the surrounding bone. The largest micromovement value of the implant was 39.34 µm. The oblique load contributed significantly to the stress distribution and micromovement in comparison to the vertical load. CONCLUSION: Increasing the implant insertion depth was advantageous in dispersing the concentrated stress in the cortical bone and did not significantly affect the micromovement associated with early osseointegration failure.

Volumetric accuracy of cone-beam computed tomography

PURPOSE: This study was performed to investigate the influence of object shape and distance from the center of the image on the volumetric accuracy of cone-beam computed tomography (CBCT) scans, according to different parameters of tube voltage and current. MATERIALS AND METHODS: Four geometric objects (cylinder, cube, pyramid, and hexagon) with predefined dimensions were fabricated. The objects consisted of Teflon-perfluoroalkoxy embedded in a hydrocolloid matrix (Dupli-Coe-Loid TM; GC America Inc., Alsip, IL, USA), encased in an acrylic resin cylinder assembly. An Alphard Vega Dental CT system (Asahi Roentgen Ind. Co., Ltd, Kyoto, Japan) was used to acquire CBCT images. OnDemand 3D (CyberMed Inc., Seoul, Korea) software was used for object segmentation and image analysis. The accuracy was expressed by the volume error (VE). The VE was calculated under 3 different exposure settings. The measured volumes of the objects were compared to the true volumes for statistical analysis. RESULTS: The mean VE ranged from −4.47% to 2.35%. There was no significant relationship between an object's shape and the VE. A significant correlation was found between the distance of the object to the center of the image and the VE. Tube voltage affected the volume measurements and the VE, but tube current did not. CONCLUSION: The evaluated CBCT device provided satisfactory volume measurements. To assess volume measurements, it might be sufficient to use serial scans with a high resolution, but a low dose. This information may provide useful guidance for assessing volume measurements.

Extrahepatic Portal Vein Aneurysm in a Non-cirrhotic Patient / 대한내과학회지

Portal venous aneurysm (PVA) is an unusual venous malformation and its etiology is not fully understood. Most PVAs are diagnosed incidentally by non-invasive abdominal imaging techniques; indeed, recently, PVAs have frequently been discovered in this way. Most PVAs remain stable, without complications, in patients with no clinical symptoms of portal hypertension or intrinsic liver disease. However, if PVA is discovered in these patients by chance, close imaging follow-up of portal vein aneurysms is recommended. In the case of aneurysm growth or the development of complications related to the aneurysm, medical or surgical approaches are advised but there is no consensus on the use of prophylactic antiplatelet or anticoagulation medications. We report a case of incidental PVA identification in a patient without underlying liver disease by routine investigation. A review of the literature is also provided.

A Case Report of Bilateral Retrobulbar Hemorrhage after Lower Blepharoplasty

Retrobulbar hemorrhage is a rare but serious complication after blepharoplasty, mid-face injury, and treatment of facial bone fractures. The incidence of postoperative retrobulbar hemorrhage is 0.055% with an incidence of associated permanent blindness of 0.005%. A 69-year-old male came to the emergency room with pain on both orbital areas and uncontrolled bleeding after cosmetic lower blepharoplasty performed at a private clinic. He had not been evaluated preoperatively by the private clinic, but we found that he had undergone percutaneous transluminal coronary angioplasty and taken anticoagulants for 10 years. We performed an emergency operation to evacuate the hematoma. However, after surgery, he persistently complained of orbital pain, pressure and diminished visual acuity. Intraocular pressure was increased, and computed tomography demonstrated a retrobulbar hemorrhage with globe displacement. Emergent lateral canthotomy and cantholysis were performed. Intraocular pressure was decreased to 48/30 mm Hg immediately after the operation, falling within the normal range the next day. We recommend three points to minimize loss of vision by retrobulbar hematoma. Firstly, careful preoperative evaluation must be conducted including current medications, underlying diseases and previous history of surgeries. Secondly, cautious postoperative observation is important for the early diagnosis of retrobulbar hematoma. Lastly, immediate treatment is crucial to prevent permanent blindness.

The Development of a Critical Pathway for Facial Bone Fractures and the Effect of its Clinical Implementation

BACKGROUND: If patients have a better understanding about their problem and treatment, compliance and satisfaction with treatment will increase. For this purpose, simple repeated explanations regarding a patients' problem and treatment are essential. Critical pathway (CP) has a very wide range in medicine with the exception of the plastic surgery field. The authors developed a CP for facial bone fractures and implemented it clinically. The aim of this study was to evaluate the effectiveness of the CP on the degree of recognition of the problem along with patient satisfaction with the treatment process. METHODS: From May 2011 to October 2011, a total of 82 patients suffering from facial bone fractures were studied. The CP for facial bone fractures was developed by plastic surgeons, residents and nurses. Subsequently, the authors investigated the degree of recognition of the disease and patient satisfaction with the treatment through the use of a questionnaire. The authors compared the score of the questionnaires before and after implementation of the clinical pathway. RESULTS: The degree of the recognition of the problem changed from 3.1 to 4.2 (p<0.001). Further, the degree of satisfaction with the treatment process changed from 3.6 to 4.3 (p<0.05). Overall, there was a two point increase in improvement. CONCLUSION: Implementation of the CP for facial bone fractures was effective in improving the degree of recognition and satisfaction. The authors expect that hereafter, the CP for facial bone fractures will be implemented actively in the plastic surgery field.

Shear bond strength of the three different kinds of resin cement on CAD/CAM ceramic inlay / 대한치과보철학회지

PURPOSE: The purpose of this study was to evaluate the bond strengths between the latest CAD/CAM ceramic inlay and various resin cements which are used primarily for esthetic restoration. MATERIALS AND METHODS: Cylindrical ceramic blocks(Height: 5 mm, diameter: 3 mm) were fabricated by using Cerec3 and bonded on the dentin of the ninety extracted caries-free molars using three different kinds of resin cement(Unicem(R), Biscem(R), and Variolink II(R)) according to the manufacturer's instructions. Ninety specimens were divided into 3 groups according to three different kinds of resin cement. Half of each group were conducted thermocycling under the conditions of the 5 - 55degrees C, 5,000 cycle but the other half of them weren't. All specimens were kept in normal saline 37degrees C, for 24 hours before measuring the bond strength. The shear bond strength was measured by Universal testing machine with a cross head speed of 0.5 mm/min. The results were analyzed statistically by t-test and one-way ANOVA. RESULTS: Unicem(R) group showed the highest shear bond strength despite a slight decline by thermocycling. The shear bond strength of Unicem(R) group and ValiolinkII(R) group were significantly influenced by thermocycling, whereas Biscem(R) group was not influenced (P<.05). There were no significant differences in the bond strength between the three groups without thermocycling, but there was significant differences between Unicem(R) group and Valiolink II(R) group with thermocycling(P<.05). CONCLUSION: It has been shown to be clinically effective when the self-adhesive resin cements Unicem(R) and Biscem(R) were used instead of the etch-and-rinse resin cement Valiolink II(R) during the bonding of CAD/CAM ceramic inlay restorations with teeth.

Shear bond strength of a self-adhesive resin cement to resin-coated dentin / 대한치과보철학회지

PURPOSE: The aims of this study were to evaluate the effect of a resin coating on the shear bond strength of indirect composite restoration bonded to dentin with a self adhesive resin cement and to compare the shear bond strength with that of a conventional resin cement. MATERIALS AND METHODS: The occlusal enamels of thirty six extracted non-carious human molars were removed until the dentin flat surfaces of the teeth were exposed. Then, they were divided into 3 groups. The dentin surfaces of group 1 and 3 were left without any conditioning, while the dentin surfaces of group 2 were resin-coated with Clearfil SE bond and a flowable resin composite, Metafil Flo. After all specimens were temporized for 24 hours, indirect composite resin blocks fabricated by Tescera were bonded to dentins by Unicem for group 1 and 2, and by Panavia F for group 3. After 48 hours of water storage, shear bond strengths were measured. The data was analyzed with one-way analysis of variance and multiple comparison test (Tukey method). RESULTS: The shear bond strengths of Unicem applied to resin coated dentin surfaces were significantly higher than those of Unicem and Panavia F used to uncoated dentin surfaces (P<.0001). CONCLUSION: Application of a resin coating to the dentin surface significantly improved the shear bonding strength of a self adhesive resin cement in indirect restoration.

Staphylococcus aureus Pericardial Abscess Presenting as Severe Sepsis and Septic Shock After Acupuncture Therapy

Pericardial abscess is an extremely rare complication of Staphylococcus aureus bacteremia. We report a case of a 72-year-old woman with multiple acupuncture scars on both knees who presented with shortness of breath and general weakness. Transthoracic echocardiography and pericardiocentesis confirmed the presence of pericardial fluid collection. Staphylococcus aureus grew in both pericardial fluid and blood. Although an aggressive medical treatment including intravenous antibiotics and percutaneous drainage, the patient died 2 days after admission.

A Case of Acute Cerebral Infarction in Adult Cor Triatriatum Sinistrum / 대한내과학회지

Cor triatriatum is a rare congenital malformation of the heart characterized by a fibromuscular membrane dividing the atrium into two distinct chambers. In the majority of cases, it is diagnosed in early childhood, whereas adult cases are extremely rare [1,2]. The hemodynamics of cor triatriatum are similar to those of mitral stenosis, which sometimes cause embolic infarction. We describe an unusual case of cor triatriatum sinistrum in a 48-year-old man who presented with relapsed embolic infarction.

A Case of Pseudomembranous Colitis in Old Age which was Misdiagnosed as Acute Appendicitis with Perforation

Pseudomembranous colitis is mostly related to antibiotics and it presents symptoms of diarrhea, abdominal pain, fever, hypoalbuminemia and hypovolemia. Diarrhea is the most common manifestation, but in geriatric patients, symptoms of pseudomembranous colitis can be different from those of usual cases and the course of disease can be more aggressive. For these reasons, it can be misdiagnosed. So physicians must take pseudomembranous colitis into consideration in older patients with acute abdominal pain, who have been treated with antibiotics. We reported a case of an older patient with pseudomembranous colitis which was misdiagnosed as acute appendicitis with perforation.

Comparison of cone-beam computed tomography and ultrasonography on experimental bone lesion / 대한구강악안면방사선학회지

PURPOSE: This study was performed to evaluate the diagnostic ability of ultrasonography in detection of bone defects and new bone formation. MATERIALS AND METHODS: Experimental bony defects were prepared on the parietal bone samples acquired from 3.5 kg New Zealand male rabbits. The defects were evaluated using ultrasonography and CBCT, and examined histologically at interval of 1, 3, 6, and 8 weeks. RESULTS: Ultrasonograph demonstrated hyperechogenicity in the defect area at 3 weeks and broadened hyperechogenicity from the margin of bone defect at 6 and 8 weeks due to new bone formation. On the CBCT images, new bone formation was first observed at 3 weeks around the margin of the defect, and showed gradually increase at 6 and 8 weeks. Histologic findings revealed existence of the fibroblasts and fibrous connective tissue with abundant capillary vessels only at 1 week, but osteoid tissue and newly formed trabecular bone at 3 weeks. Bone remodeling in the defect area was observed at 6 weeks and increased calcification and dense trabecular bone formation was observed at 8 weeks. CONCLUSION: Ultrasonograph proved to be a very useful diagnostic tool in detecting the bony defect and new bone formation. Additionally, ultrasonography provided valuable information regarding the blood supply around the defect area.

Photoelastic stress analysis of the mandibular unilateral free-end removable partial dentures according to the design / 대한치과보철학회지

STATEMENT OF PROBLEM: There are common clinical cases in which the mandibular first and second molars are missing unilaterally. PURPOSE: This study was designed to compare and evaluate the magnitude and distribution of stress produced by four kinds of mandibular unilateral free-end removable partial dentures that could be applied clinically in Kennedy class II cases. MATERIAL AND METHODS: Four unilateral free-end removable partial dentures using clasp, Konus crown, resilient attachment, and flexible resin were fabricated on the photoelastic models of the Kennedy class II cases. The vertical load of 6kg was applied on the central fossa of the first molar of every removable partial denture in the stress freezing furnace and the photoelastic models were frozen according to the stress freezing cycle. After these models were sliced mesio-distally to a thickness of 6mm, the photoelastic isochromatic white and black lines of the sliced specimens were examined with the transparent photoelastic experiment device and photographs were taken with a digital camera. The fringe order numbers at eight measuring points in the photograph were measured with the naked eye. RESULTS: The maximum fringe order number of each sliced specimen and the fringe order number at the residual ridge just below the loading point were in the decreasing order of the unilateral removable partial dentures using flexible resin followed by clasp, resilient attachment, and Konus crown. The fringe order number at the root apex of the second premolar was in the decreasing order of the unilateral removable partial dentures using clasp followed by flexible resin, Konus crown, and resilient attachment. CONCLUSION: The removable partial denture using Konus crown showed the most equalized stress distribution to the supporting alveolar bone of abutment teeth and residual ridge under the vertical loads. The removable partial denture using flexible resin can be applied to the case that has a better state of residual ridge than abutment teeth.

The Effect of Sodium Bicarbonate or Lidocaine Mixed with Rocuronium on Withdrawal Movement in Pediatric Patients / 대한마취과학회지

BACKGROUND: Rocuronium administration after the induction of general anesthesia is associated with localized withdrawal of limbs or generalized movements in children and adolescents. The purpose of this study was to evaluate the effect of normal saline, lidocaine, sodium bicarbonate (NaHCO3), and lidocaine-NaHCO3 mixed with rocuronium reduces withdrawal response. METHODS: Eighty-five pediatric patients (aged 5-15 years) were randomly assigned to one of four groups in a double blinded, prospective study; Group S (0.9% normal saline 5 ml mixed with rocuronium 50 mg/5 ml, n = 21), Group L (2% lidocaine 5 ml mixed with rocuronium 50 mg/5 ml, n = 22), group B (8.4% NaHCO3 5 ml mixed with rocuronium 50 mg/5 ml, n = 22) and Group LB (4% lidocaine 2.5 ml and 8.4% NaHCO3 2.5 ml mixed with rocuronium 50 mg/5 ml, n = 20). After loss of consciousness by sevoflurane inhalation, all patients received 0.6 mg/kg premixed rocuronium over 5 seconds. We investigated the incidence and severity of withdrawal movement using 4-point scales. We also measured pH values and the osmolalities of each mixture. RESULTS: The incidence and degree of withdrawal reaction in response to rocuronium injection were significantly reduced in Groups B (18.1%) and LB (15.0%) versus Group S (57.1%). The addition of lidocaine failed to reduce withdrawal response compared with saline. CONCLUSIONS: NaHCO3 mixed with rocuronium is more effective than lidocaine addition with suspect to preventing withdrawal movement in pediatric patients.

A comparative Ki-67 expression of odontogenic keratocysts(OKCs) with or without impacted tooth

Evaluation of bone and disc configuration in TMJ internal derangement / 대한구강악안면방사선학회지

PURPOSE: To investigate bone and disc configuration on MR images in internal derangement related to age. MATERIALS AND METHODS: MR images of 150 TMJs in 107 patients were analyzed to determine the morphologic changes. Two groups were distinguished to be correlated with age. Group 1 consisted of TMJs that were diagnosed as having anterior disc displacement with reduction (ADDwR), and Group 2 consisted of TMJs that were diagnosed as having anterior disc displacement without reduction (ADDwoR). We assessed the configuration of the articular disc, degree of anterior disc displacement, and osseous changes of TMJs. RESULTS: The third decade (83 of 150 joints) was most frequent in this study. In the ADDwR group biconcave discs was most frequent at all ages except fifth decade, but in the ADDwoR group deformed discs was most frequent at third and forth decades. In the ADDwR group slightly displaced discs was most frequent at all ages, but in the ADDwoR group severely displaced discs was most frequent at second decade, and the degree of disc displacement was increased with aging over 30 years of age. TM joints showed osseous changes in 17% of the ADDwR group, and in 30% of the ADDwoR group. MR findings of osseous changes of the TMJ were not found to be significantly correlated with age. CONCLUSION: The prevalence of deformation of disc, displacement of disc, and osseous changes of TMJ was higher in the ADDwoR group than in the ADDwR group. MR findings of disc configuration and degree of disc displacement were found to be correlated with age.

Dento-maxillofacial abnormalities caused by radiotherapy and chemotherapy / 대한구강악안면방사선학회지

A case of dento-maxillofacial abnormality involving a 10-year-old male patient with a history of esthesioneuroblastoma is presented. This patient had been treated with 54 Gy (60)Co-gamma-radiation to the nasal cavity for 6 weeks and 6 cycles of combination chemotherapy of Cyclophosphamide, Cisplatin, Adriamycin, VM-26 (Teniposide), and DTIC (Dacarbazine) when he was 16 months of age. Five years after cessation of cancer therapy, he was disease free and transferred for extensive dental care to Kyung Hee University Dental Hospital. A clinical and radiologic follow-up over last 4 years showed root stunting, premature closure of the root apices, microdontia, developmental arrest, small crowns, and partial anodontia. Maxillofacial morphology evaluated by cephalometric analysis showed deficiency of maxillary development.

Factors influencing quality of life of asthmatic patients in Korea / 천식및알레르기

BACKGROUND: The effectiveness of treatment of asthma has been assessed by lung function test, airway responsiveness and symptoms. But, they rarely capture the emotional and social impairment. Recently, questionnaires that reflect the quality of life (QOL) in asthma patients were developed. In this study, we evaluated the impairment on quality of life in Korean adult asthmatic patients cross-sectionally by using the QOL questionnaires of Juniper EF. METHODS: One hundred eighty nine adult patients with over 1 year history of asthma were enrolled. The patients were asked to choose the five most important daily activities among 40 daily activities which were important in Korea. The QOL questionnaire was composed of 32 items in 4 domains (activity, symptom, emotion and exposure to environmental stimuli) and the response option was scored on a 7-point scale. RESULTS: 45.5% of patients who participated in this study were men, and 48.3% had atopy. The disease severities of asthma evaluated by physician were mild intermittent (31%), mild persistent (35%), moderate persistent (21%) and severe persistent (12%). Among 40 items of general daily activities, 19 items were chosen by more than 20 patients. Among them, running, walking uphills, hurried movement were most impaired daily activities. The QOL of our asthma patients showed statistical difference on disease severity, control state and symptom status during the last 3 months. The QOL was not influenced by sex, age or atopy score. Occupational asthma showed the lowest score on QOL in all 4 domains. On grouping with medications, the group with oral steroid noted statistically lower scores of QOL in all domains. The QOL score of asthma was well correlated with average symptom attacks during the last 3 months. CONCLUSION: According to our study, rapid control of asthma and lowering of the diseaseseverity are essential for improvement of QOL. A QOL questionnaire in Korea should be ... (continue)