An alternative treatment option for a bony defect from large odontoma using recycled demineralization at chairside

Odontoma is the most common odontogenic benign tumor, and the treatment of choice is generally surgical removal. After excision, bone grafts may be necessary depending on the need for further treatment, or the size and location of the odontoma. Although the osteogenic capacity of a demineralized tooth was verified as early as 1967 by Urist and many other investigators, the cumbersome procedure, including a long demineralization time, may be less than comfortable for clinicians. A modified ultrasonic technology, with periodic negative pressure and temperature control, facilitated rapid and aseptic preparation of demineralized teeth for bone grafts. This approach reduces the demineralization time dramatically (< or =80 minutes), so that the graft material can be prepared chairside on the same day as the extraction. The purpose of this article is to describe two cases of large compound odonotomas used as graft material prepared chairside for enucleation-induced bony defects. These two clinical cases showed favorable wound healing without complications, and good bony support for future dental implants or orthodontic treatment. Finally, this report will suggest the possibility of recycling the benign pathologic hard tissue as an alternative treatment option for conventional bone grafts in clinics.

Various autogenous fresh demineralized tooth forms for alveolar socket preservation in anterior tooth extraction sites: a series of 4 cases / 대한악안면성형재건외과학회지

The aim of this study was to evaluate the clinical relevance of autogenous fresh demineralized tooth (Auto-FDT) prepared at chairside immediately after extraction for socket preservation. Teeth were processed to graft materials in block, chip, or powder types immediately after extraction. Extraction sockets were filled with these materials and dental implants were installed immediately or after a delay. A panoramic radiograph and a conebeam CT were taken. In two cases, tissue samples were taken for histologic examination. Vertical and horizontal maintenance of alveolar sockets showed some variance depending on the Auto-FDT and barrier membrane types used. Radiographs showed good bony healing. Histologic sections showed that it guided good new bone formation and resorption pattern of the Auto-FDT. This case series shows that Auto-FDT prepared at chairside could be a good material for the preservation of extraction sockets. This study will suggest the possibility of recycling autogenous tooth after immediate extraction.

Evaluation of alveolar bone density by intraoral periapical radiography / 대한치과보철학회지

PURPOSE: A method detecting change of jaw or alveolar bone density may be helpful in periodontal care, implant dentistry and evaluation of bone density of whole body. MATERIALS AND METHODS: In this study, bone density of intraoral periapical radiography using phantom-integrated XCP is compared with that of quantitative computed tomography (QCT). RESULTS: Bone density of intraoral periapical radiography and the one measured by QCT showed high correlation (correlation coefficient = 0.92, P<.001) in alveolar bone, and relatively high correlation (0.73, P<.001) in cancellous bone. CONCLUSION: This study revealed possibility of scoring of bone density by intraoral periapical radiography.

Vertical Augmentation of Maxillary Posterior Alveolar Ridge Using Allogenic Block Bone Graft and Simultaneous Maxillary Sinus Graft / 대한악안면성형재건외과학회지

The maxillary posterior area is the most challenging site for the dental implant. Although the sinus graft is a predictable and successful technique for rehabilitation of atrophic and pneumatized posterior maxilla, when there is severe destruction of alveolar bone, a very long crown length remains challenging after successful dental implants installation with sinus graft. We performed vertical augmentation of the maxillary posterior alveolar ridge using the allogenic block bone graft with a simultaneous sinus graft using allogenic and heterogenic bone chips. After about six months, we installed the dental implant. After this procedure, we achieved a more favorable crown-implant fixture ratio and better results clinically and biomechanically. This is a preliminary report of vertical augmentation of maxillary posterior alveolar ridge using allogenic block bone graft and simultaneous maxillary sinus graft. Further research requires longer observation and more patients.

Scanning Electron Microscopy and Energy Dispersive X-ray Spectroscopy Studies on Processed Tooth Graft Material by Vacuum-ultrasonic Acceleration / 대한악안면성형재건외과학회지

PURPOSE: The current gold standard for clinical jawbone formation involves autogenous bone as a graft material. In addition, demineralized dentin can be an effective graft material. Although demineralized dentin readily induces heterotopic bone formation, conventional decalcification takes three to five days, so, immediate bone grafting after extraction is impossible. This study evaluated the effect of vacuum ultrasonic power on the demineralization and processing of autogenous tooth material and documented the clinical results of rapidly processed autogenous demineralized dentin (ADD) in an alveolar defects patient. METHODS: The method involves the demineralization of extracted teeth with detached soft tissues and pulp in 0.6 N HCl for 90 minutes using a heat controlled vacuum-ultrasonic accelerator. The characteristics of processed teeth were evaluated by scanning electron microscopy (SEM), and energy dispersive X-ray spectroscopy (EDS). Bone grafting using ADD was performed for narrow ridges augmentation in the mandibular area. RESULTS: The new processing method was completed within two hours regardless of form (powder or block). EDS and SEM uniformly demineralized autotooth biomaterial. After six months, bone remodeling was observed in augmented sites and histological examination showed that ADD particles were well united with new bone. No unusual complications were encountered. CONCLUSION: This study demonstrates the possibility of preparing autogenous tooth graft materials within two hours, allowing immediate one-day grafting after extraction.

Dedifferentiated Liposarcoma of the Retroperitoneum / Journal of the Korean Cancer Association, 대한암학회지

A dedifferentiated liposarcoma of the retroperitoneum is an extremely rare tumor. A 51-year old man was admitted to our department because a retroperitoneal mass was seen on abdominal computed tomography at another hospital. Computed tomography of the abdomen and magnetic resonance imaging showed a large pelvic mass located in the right hemipelvis, and it was pushing the right ureter and invading the right kidney, duodenum, colon and inferior vena cava. The patient underwent right radical nephrectomy, pylorus preserving pancreatoduodenectomy, right hemicolectomy and artificial blood vessel replacement for the inferior vena cava. The histopathological diagnosis was dedifferentiated liposarcoma and the patient was free from recurrence on the computed tomography that was done 6 months after the operation.

Proteomic Analysis of Differentially Expressed Proteins in Bovine Endometrium with Endometritis

Endometritis is one of the primary reasons for reproductive failure. In order to investigate endometritis-associated marker proteins, proteomic analysis was performed on bovine endometrium with endometritis. In bovine endometritis, desmin, alpha-actin-2, heat-shock protein (HSP) 27, peroxiredoxin-6, luteinizing hormone receptor isoform 1, collectin-43 precursor, deoxyribonuclease-I (DNase-I), and MHC class I heavy chain (MHC-Ih) were up-regulated. In contrast, transferrin, interleukin-2 precursor, hemoglobin beta subunit, and potassium channel tetramerisation domain-containing 11 (KCTD11) were down-regulated in comparison to normal endometrium. The proteomic results were validated by semiquantitative-PCR and immunoblot analysis. The mRNA levels of desmin, transferrin, alpha-actin-2, HSP27, KCTD11, and MHC-Ih were up-regulated by over 1.5-fold, and showed a pattern similar to their proteomic profiles. Desmin and alpha-actin-2 protein showed positive correlations between proteomic analysis and immunoblot analysis. These results suggest that desmin and alpha-actin-2 may play important roles in endometritis-related function, and could be useful markers for the diagnosis of bovine endometritis.

CTG and restoration in treatment of gingival recession associated with a cervical lesion: report of three cases / 대한치주과학회지

PURPOSE: The purpose of this report is to show three cases treated by an intergrated periodontal and restorative dentistry approach. METHODS: Three patients with Miller Class I gingiva recessions associated with cervical lesions were enrolled for treatment. Two patients received a connective tissue graft and resin modified glass ionomer, and one patient was treated with a connective tissue graft, resin restoration. Keratinized gingiva and relative gingival recession were measured. RESULTS: The mean reduction of relative gingival recession was 3.7 mm, and the mean keratinized gingiva increase was 2.5 mm. The percentage of root coverage was 80% in average. No signs of gingival inflammation or bleeding on probing were seen. The patients were satisfied with the final esthetics and had no more dentin hypersensitivity. CONCLUSIONS: This report indicates that teeth with Miller Class I gingival recession associated with cervical lesions can be successfully treated by a connective tissue graft combined with restorative dentistry. However, longitudinal randomized controlled clinical trials must be performed to support this approach.

Incidental Polyorchidism in Testicular Injury / 대한남성과학회지

Polyorchidism is a very rare congenital anomaly and about 100 cases have been documented in the literature until today. Polyorchidism or supernumenary testis is defined as the presence of more than 2 histologically proven testes. In most case, polyorchidism have characteristics of unilateral involvement and three testis and mainly finding in left-side testis. And although patient age was various, average age was about 18-year-old in previous review of article. We report a rare case of polyorchidism that an old age patient had an incidentally found right accessory testis in operating a testicular injury.

Renal Artery Pseudoaneurysm after Blunt Renal Trauma

Renal artery pseudoaneurysm after blunt renal trauma is an uncommon complication of delayed hemorrhage, and diagnostic difficulties are experienced due to its rarity. Delayed hemorrhage after renal trauma is a lifethreatening complication. Angiography is considered the gold standard to diagnose a traumatic renal artery pseudoaneurysm. We report here a case of delayed bleeding from a renal artery pseudoaneurysm that was diagnosed at 17 days after the injury and that was managed successfully with selective renal artery embolization without medical complication.

Comparison of Treatment Efficacy between Shock Wave Lithotripsy and Ureteroscopic Stone Removal for Lower Ureteral Stones

PURPOSE: We compared the efficacy and patient satisfaction between shock wave lithotripsy (SWL) and ureteroscopic removal of stone (URS) for the treatment of lower ureteral stones. MATERIALS AND METHODS: We reviewed 223 patients who were treated for lower ureteral stones from August 2006 to January 2009. SWL and URS were performed in 47 and 176 patients, respectively. After treatment, the patients' subjective inconvenience/pain and their satisfaction with the treatment process were estimated by questionnaire. We analyzed success rates, complication rates, inconvenience/pain scores, and satisfaction scores for each group of patients. RESULTS: The overall success rates of SWL and URS were 82.9% and 97.7%, respectively (p=0.001). The complication rates of SWL and URS were 8.5% and 10.8%, respectively (p=0.162). The satisfaction scores of SWL and URS were 7.4 and 9.2, respectively (p=0.001). Whereas 87.5% of the URS group preferred the same treatment in case of a recurrence of ureteral stones, only 68% of the SWL group preferred the same treatment in the future (p=0.002). CONCLUSIONS: URS was more successful and satisfactory to the patients with lower ureteral stones. Although both SWL and URS were highly effective for treatment of distal ureteral stones, we believe that URS is the first-line treatment modality for lower ureteral stones.

Effects of Biophysical Index, Knowledge, and Self Management Compliance of Patients with Primary Hypertension by a Self Management Compliance Promotion Program / 간호학회지

PURPOSE: This study was to develop and prove the effects of aself management compliance promotion program for primary hypertension patients who reside in rural communities. METHOD: The content of the self management compliance promotion program developed by this study was as follows: A leader trains patients as a group or individually, in walking, education and green tea therapy from the first to twelfth week. From the thirteenth to twenty fourth week, the patients should perform walking and green tea therapy by themselves. One hundred twenty subjects volunteered to participate in the study, who were among those registered as hypertension patients in the 14 community health clinics located in Chungcheongbuk-do. RESULT: Systolic blood pressure, total cholesterol, low-density lipoprotein cholesterol, triglyceride, step width, and degree of obesity decreased significantly. High-density lipoprotein cholesterol, step length, knowledge of hypertension, and self management compliance significantly increased. CONCLUSION: A self management compliance promotion program for primary hypertensive patients enhances biophysical index and knowledge on hypertension, thus ultimately suggesting a nursing intervention for promoting self management compliance.

The Role of c-Jun N-terminal Kinase in the Radiation-Induced Lung Fibrosis / 결핵

BACKGROUND: The undrlying pathogenesis of radiation-induced lung fibrosis (RTLF) has not been very well defined. However, the role of TGF-β in the generation of RTLE has been a major focus because there is an increase in the expression of both the TGE-β stimulated lung fibrosis includes the activation of many mediators such as Smad and c-Jun N-terminal kinase (JNK) through TAK1. It is we hypothesized that JNK activation may play a pivotal role in RTLF pathogensis through increased transcription of the fibrogenic cytokines. The present study evaluates JNK activity in alveolar macrophages after irradiation and the relationship between JNK activity and the amount of collagen in the lung tissues. METHODS: C57BL/6 mice(20-25 gr. males) received cholorotetracycline(2g/L) in their drinking water 1 week prior to irradiation and continuously there after. The mice were irradiated once with 1400 cGy of 60COγ-ray over the whole chest. The cellular composition of the whole lung bronchoalveolar lavage fluids(BALF), elastin expression in the lung tissues, the level of hydroxyproline in lung tissues, and an in vitro JNK assay was measured before irradiation and one, four, and eight weeks after irradiation (RT). RESULTS: The volumes of BALF retrieved from instilled 4ml of saline with 2% heparin were 3.7-3.8ml for each group. The cell numbers were similar before(4.1×10(4)±0.5±10(4)/ml) and 1 week(3.1×10(4)±0.5±10(4)/ml) after RT. At four and eight weeks after RT, the cell number reached to 14.0×10(4)±1.5±10(4)/ml and 10.0×10(4)±1.3±10(4)/ml, respectively. There we no changes in the lymphocytes and neutrophils population obseved in the BALF after RT. The H-E stain of the lung tissues did not show any structural and fibrotic change in the lung tissues at 4 and 8 weeks after RT. In addition, the amount of elastin and collagen were not different on Verhoeff staining of the lung tissues before RT to eight weeks after RT. The hydroxyproine content was measured with the left lung dissected from the left main bronchus. The lung were homogenized and hydrolyzed with 6 N HCI for 12 hours at 110℃ then measured as previously described. The content of hydroxyproline, standardized with a lung protein concentration, reached a peak 4 weeks after RT. and thereafter showed a plateau. An In vitro JNK assay using c-Jun(1-79)-GST sepharose beads were performed with the alveolar macrophages obtained from the BAL. JNK activity was not detected prior to RT, However, the JNk activity increased from one week after RT and reached a peak four weeks after RT. CONCLUSION: JNK may be involved in the pathogensis because the JNK activity showed similar pattern observed with the hydroxyproine content. However, it is necessary to clarify that the JNK increases the transcription of fibrogenic cytokines through the transcription factor.

Comparison of Modified Broth Microdilution Method, E test, and Disk Diffusion Method for Antimicrobial Susceptibility Testing of Helicobacter pylori / 대한임상병리학회지

BACKGROUND: The emergence of metronidazole (MTZ) resistance among Helicobacter pylori (H. pylori) isolates has compromised the efficacy of the triple therapy. Therefore, special attention should be given toward reliable methods for determining the in vitro susceptibility. But susceptibility testing of H. pylori is not yet either standardized or routinely performed. The purpose of this study was to establish more reliable, but simple to perform and cost-effective antimicrobial susceptibility testing method. METHODS: With 135 clinical isolates of H. pylori, antimicrobial susceptibility tests for MTZ and clarithromycin (CLR) were performed by antibiotic gradient method (E test, AB BIODISK, Sweden) and disk diffusion method (disk method), and the results were compared with the reference modified broth microdilution method (broth method). RESULTS: Resistant rates of Korean isolates of H. pylori for MTZ and CLR were 46.2% and 2.2%, respectively. There was 100% agreements between the E test, disk method and the broth method for CLR. For MTZ, however, agreements between the results obtained by the three methods were variable. Between the E test and broth method, the agreements were 85.1% in terms of susceptibility categories, 80.5% between the disk and broth method, and 93.1% between the E test and disk method. CONCLUSIONS: Routine susceptibility testing of H. pylori to MTZ seems to be required in Korea. The broth method is recommended for MTZ until more accurate, simple and practical alternative method become available. For the CLR, the disk method is recommended, because it is reliable, simple, and economical.

A Clinical Analysis of the Treatment of Primary Varicose Vein of the Lower Limbs

BACKGROUND: Primary varicose veins are caused by a retrograde blood flow and increased hydrostatic pressure as a result of an increase in height or in physical strain associated with work. Treatment for varicose vein involves 1) conservative management - periodic leg elevation, elastic stocking support, and exercise with stocking support, 2) sclerotherapy, and 3) surgery. METHODS: Ninety-two limbs with primary varicose veins of the lower limb were operated on from Jan. 1996 to Dec. 1996. RESULTS: The prevalent age group consisted of those patients between 50 and 60 years old, and the female to male ratio was 2 : 1. Varicose veins developed in the right lower limb in 48 cases, in the left lower limb in 37 cases, and in both lower limbs in 7 cases. Presumed etiological factors included occupations requiring long periods of standing in 13 male cases, and pregnancy in 26 female cases. The average duration of illness was 12.5 8.6 years. Of the 92 cases operated on, a greater saphenous vein (GSV) high ligation (HL) and above knee (AK) stripping with varicosectomy (VS) was done in 38 cases, a GSV HL and total stripping with VS in 4 cases, a short saphenous vein (SSV) HL and VS in 14 cases, an external banding valvuloplasty of GSV and VS in 29 cases, an external banding valvuloplasty only in 2 cases, a Linton's operation in 2 cases, a GSV branch ligation and VS in 1 case, and sclerotherapy in 2 cases. The reduction rates of venous volume (VV) and ambulatory venous pressure (AVP) were 15 19% and 33 33%, respectively, after stripping. The reduction rates of VV and AVP were 19 18% and 33 36%, respectively, after valvuloplasty. Postoperative complications were wound complication in 1 case in the AK stripping group; postoperative numbness in 3 cases and wound complication in 1 case in the total stripping group; and wound complication in 1 case, GSV thrombosis in 2 cases, postoperative bleeding in 1 case, and postoperative reflux in 1 case in the valvuloplasty group. CONCLUSIONS: Generally, postoperative conditions were good and complications were negligible. In the stripping group, postoperative numbness developed only in the total stripping group. Between the valvuloplasty and the stripping groups, there was no significant hemodynamic difference.

Comparison of Detection Methods and Culture Media for Isolation of Helicobacter pylori from Gastric Biopsy Specimens / 대한임상병리학회지

BACKGROUND: Helicobacter pylori(H. pylori) has been implicated in the pathogenesis of chronic active gastritis and peptic ulcer disease. All patients with ulcers who are infected with H. pylori receive antimicrobial therapy. Therefore diagnosis of H. pylori infection is imperative for the treatment gastritis or ulcer patients. We evaluated the four diagnostic methods and three culture media for the isolation of H. pylori. MATERIALS AND METHODS: Rapid urease test(CLO test), modified Gram stain, culture, and nested polymerase chain reaction (PCR) were performed with 108 gastroscopic biopsy specimens from patients with peptic ulcer or chronic gastritis. Among them 40 specimens were inoculated onto each of 5% sheep blood agar, e99 Yolk emulsion (EYE) agar, and 7% horse blood agar containing antibiotics. RESULTS: The positive rates were the highest by the PCR(72%), 67% by modified Gram stain, 64% by CLO test, and 57% by culture. Among the three media the horse blood agar (selective medial) gave the highest isolation rate (48%), followed by sheep blood agar (45%), and EYE agar (38%). CONCLUSION: Though PCR was the most sensitive method for the detection H. pylori modified Gram stain was sensitive enough, simple, rapid, and economical as the routine diagnostic method of H. pylori. For the culture of H. pylori combination of sheep blood agar as nonselective media and horse blood agar as selective media would show the highest isolation rate.

Growth and Neurodevelopmental Outcome on Very Low Birth Weight Infants During 2 Years

PURPOSE: By rapid development of neonatal intensive care from 1960, we are able to expect the long survival of the very low birth weight infants. But, there were high risk of poor growth, neurodevelopmental delay, deafness, and blindness in very low birth weight infants. So, it is important to follow-up after discharge. We try to compare normal term infants with very low birth weight infants by evaluating growth and neurodevelopmental outcome from living very low birth weight infants to corrected 2 years age. METHODS: This study was performed on 55 very low birth weight infants with corrected age 6 months to 24 months who were admitted to the neonatal intensive care unit of Presbyterian Medical Center from August 1991 to December 1993 and 61 normal term infants with age 6 months to 24 months who had been born in Presbyterian Medical Center. We compared very low birth weight infants with normal term infants about growth and neurodevelopmental outcome at corrected age 6, 12, 18, 24 months. Weight, height and head circumference were measured. Developmental testing was performed using the BSID-II(Bayley scales of infant development, II). BSID-II test provide Mental Development Index (MDI) and Psychomotor Development Index(PDI). Motor handicap was graded as mild, moderate, or severe cerebral palsy. Sensorineural impairments were measured. RESULTS: 1) Very low birth weight infants were low in weight, height and head circumference compared with normal term infants to corrected 2 years age. But, most cases were above 10 percentile 2) Very low birth weight infants were in low in BSID-II's MDI(93.5+/-15.8) and PDI(91.3+/-17.9) compared with normal term infants. But, 76% of them were within normal range in MDI, 77% of them in PDI. 3) Seven patients of 55 very low birth weight infants had severe neurodevelopmental handicaps and three patients had severe cerebral palsy. CONCLUSIONS: We concluded that very low birth weight infants had significantly lower growth and BSID-II than normal term infants, but majority of very low birth weight infants belong to normal range.

Determination of human T & B cells and Th/Ts cells tests in variousdisorders / 대한임상병리학회지

No abstract available.

A Clinical and Statistical Observation on the Idiopathic Neonatal Hyperbilirubinemia

Clinical and statistical observations were performed on 97 newborn infants who were admitted to newborn nursery of St. Paul's Hospital from September, 1978 to August, 1979 with the diagnosis of idiopathic neontal hyperbilirubinemia and the following results were obtained. 1. The highest monthly incidence was seen in March with 19 cases(19.2%). 2. The peak gestational age and birth weight were 40 weeks(33.0%) and 3,001-3,500 gm(38.2%), respectively. 3. In majority of cases appearence of jaundice was seen between 2 and 4 days. The peak value was reached between 3 and 8 days in premature infants and between 3 and 5 days in term infants. 4. The peak serum bilirubin levels in most of premature infants were 12.1-16.0mg% and term infants were 14.1-18.0mg%. 5. Apgar score at 1 minute and 5 minutes in majority of newborn infants were 7-10. 6. Total number o cases who were received exchange transfusion were 5 (5.2%).