Evaluation of fracture strength and translucency of 3D printing resin crown for carious primary anterior tooth / 대한구강보건학회지

Objectives@#The purpose of this study was to compare the fracture strength and traslucency of 3D printing resin crowns according to different thicknesses. @*Methods@#Resin crowns were designed with CAD software and a 3D scanner, using scanned data of the #61 tooth model. Resin Crowns with different thicknesses were printed using a 3D printer, and subsequently divided into four groups according to thickness (0.3, 0.5, 0.7, and 1.0 mm). Fracture strength was compared among groups with a resin strip crown of 1.0 mm thickness. Compressive force was applied using a universal testing machine at 30° along the lingual surface at 1 mm/min cross head speed. For translucency evaluation, thin square specimens were printed of thicknesses 0.3, 0.5, 0.7, and 1.0 mm, and translucency was measured using a spectrophotometer. @*Results@#As a result of fracture strength measurement, fracture strength increased as thickness increased, and a significant difference was observed solely between thicknesses of 0.3 and 0.5 mm, and the thicknesses of 0.3 and 0.5 mm (P<0.05). Translucency decreased as thickness increased, and similarly, a significant difference was observed only between thicknesses of 0.3 and 0.5 mm and the thicknesses of 0.7 and 1.0 mm (P<0.05). @*Conclusions@#A 3D printing resin crown can be used as a clinical option for restoring a primary anterior tooth affected by caries.

Reduction in malodor, gingival index and plaque index after 4-week use of new concept oral irrigator / 대한구강보건학회지

Objectives@#This study aimed to evaluate the changes in clinical indexes related to periodontitis, such as malodor, gingival and plaque indexes, during the adjuvant use of a high pressure oral irrigator (COMORAL ® , SMDsolutions, Seoul, Korea) in volunteers. @*Methods@#We recruited 17 volunteers from an advertisement posted on Dankook University’s bulletin board. The oral malodor, gingival index, and plaque index of each volunteer were during the adjuvant use of a high pressure oral irrigator within a 4-week period. @*Results@#Routine tooth brushing was done together with the adjuvant use of a new high pressure oral irrigator in the 4-week period. The oral malodor, gingival index, and plaque index measured after 2 and 4 weeks of use significantly decreased (P＜0.05) compared with the baseline values obtained before the start of the study. @*Conclusions@#The adjuvant use of a new high pressure oral irrigator with routine tooth brushing in volunteers may more effectively manage daily oral hygiene.

Selective inhibition of V600E-mutant BRAF gene induces apoptosis in thyroid carcinoma cell lines

Purpose@#Papillary thyroid cancer (PTC) has a high incidence of BRAF V600E mutation. The purpose of this study was to evaluate the potential relationship between thyroiditis and BRAF V600E mutation status in patients with PTC. We investigated how a selective inhibitor of BRAF V600E PLX4032 affects the proliferation and inflammatory cytokine levels of thyroid cancer. @*Methods@#Two thyroid cancer cell lines TPC1 and 8505C were treated with PLX4032, an analysis was done on cell growth, cell cycle, the degree of apoptosis, and levels of inflammatory cytokines. To identify the functional links of BRAF, we used the STRING database. @*Results@#Docking results illustrated PLX4032 blocked the kinase activity by exclusively binding on the serine/threonine kinase domain. STRING results indicated BRAF is functionally linked to mitogen-activated protein kinase. Both cell lines showed a dose-dependent reduction in growth rate but had a different half maximal inhibitory concentration value for PLX4032. The reaction to PLX4032 was more sensitive in the 8505C cells than in the TPC1 cells. PLX4032 induced a G2/ M phase arrest in the TPC1 cells and G0/G1 in the 8505C cells. PLX4032 induced apoptosis only in the 8505C cells. With PLX4032, the TPC1 cells showed decreased levels of vascular endothelial growth factor, granulocyte-macrophage colonystimulating factor, chemokine (C-C motif) ligand 2/monocyte chemoattractant protein 1, whereas the 8505C cells showed significantly decreased levels of IL-8, serpin E1/plasminogen activator inhibitor-1, and matrix metalloproteinase (MMP)-3. @*Conclusion@#PLX4032 was cytotoxic in both TPC1 and 8505C cells and induced apoptosis. In the 8505C cells, inflammatory cytokines such as IL-8 and MMP-3 were down-regulated. These findings suggest the possibility that the BRAF V600E mutation needs to target inflammatory signaling pathways in the treatment of thyroid cancer.

Radiation hazards to vascular surgeon and scrub nurse in mobile fluoroscopy equipped hybrid vascular room

PURPOSE: The aim of the present study was to identify the radiation hazards to vascular surgeons and scrub nurses working in mobile fluoroscopy equipped hybrid vascular operation rooms; additionally, to estimate cumulative cancer risk due to certain exposure dosages. METHODS: The study was conducted prospectively in 71 patients (53 men and 18 women) who had undergone vascular intervention at our hybrid vascular theater for 6 months. OEC 9900 fluoroscopy was used as mobile C-arm. Exposure dose (ED) was measured by attaching optically stimulated luminescence at in and outside of the radiation protectors. To measure X-ray scatter with the anthropomorphic phantom model, the dose was measured at 3 distances (20, 50, 100 cm) and 3 angles (horizontal, upward 45°, downward 45°) using a personal gamma radiation dosimeter, Ecotest CARD DKG-21, for 1, 3, 5, 10 minutes. RESULTS: Lifetime attributable risk of cancer was estimated using the approach of the Biological Effects of Ionizing Radiation report VII. The 6-month ED of vascular surgeons and scrub nurses were 3.85, 1.31 mSv, respectively. The attenuation rate of lead apron, neck protector and goggle were 74.6%, 60.6%, and 70.1%, respectively. All cancer incidences among surgeons and scrub nurses correspond to 2,355 and 795 per 100,000 persons. The 10-minute dose at 100-cm distance was 0.004 mSv at horizontal, 0.009 mSv at downward 45°, 0.003 mSv at upward 45°. CONCLUSION: Although yearly radiation hazards for vascular surgeons and scrub nurses are still within safety guidelines, protection principles can never be too stringent when aiming to minimize the cumulative harmful effects.

Trichuris trichiura Infection in North Korean Defector Resulted in Chronic Abdominal Pain and Growth Retardation / 대한소화기학회지

Trichuris trichiura infection is a common helminth infection, which is transmitted via soil, with worldwide distribution, especially in rural areas of developing countries. Occasionally, sporadic cases occur in non-endemic, developed areas due to the widespread of immigration. We experienced a case of Trichuris dysentery syndrome in a young North Korean defector, who had been suffering from chronic abdominal pain for 10 years. He is relatively short and thin compared with his older brother. Unexpectedly, the diagnosis, made by a colonoscopy, revealed numerous, small, white, and gently moving worms at the cecum and ascending colon. After 3 days of albendazole (400 mg once daily) administration, clinical symptoms subsided dramatically. On the follow-up colonoscopy, which was performed two months after the completion of his treatment, complete eradication was identified. Soil-transmitted helminths, including Trichuris trichiura, are disappearing becoming less prevalent in South Korea as a result of both national driving force and environmental improvement. However, these diseases should be considered when we meet foreign patients from developing countries, like North Korea, presenting chronic abdominal pain. Moreover, proper treatment of North Korean defectors and performing cohort studies of them would help to prepare for the possible unification era in the field of gastroenterology.

A Case of Intestinal Tuberculosis with Perianal Fistula Diagnosed after 30 Years / 대한소화기학회지

Tuberculosis can occur anywhere in the gastrointestinal tract. However, anorectal tuberculosis has rarely been reported. A 46-years-old male presented with abdominal pain and perianal discharge of 30 years' duration. The patient had received operations for anal fistula and inflammation three times. Although he had been taking mesalazine for the past three years after being diagnosed with Crohn's disease, his symptoms persisted. Colonoscopy performed at our hospital revealed cicatricial change of ileocecal valve and diffuse ulcer scar with mild luminal narrowing of the ascending, transverse, and descending colon without active lesions. Multiple large irregular active ulcers were observed in the distal sigmoid and proximal rectum. An anal fistula opening with much yellowish discharge and background ulcer scar was observed in the anal canal. However, cobble-stone appearance and pseudopolyposis were not present. Therefore, we clinically diagnosed him as having intestinal tuberculosis with anal fistula and prescribed antituberculosis medications. Follow-up colonoscopy performed 3 months later showed much improved multiple large irregular ulcers in the distal sigmoid colon and proximal rectum along with completely resolved anal fistula without evidence of pus discharge.

A Rare Case of Free Bowel Perforation Associated with Infliximab Treatment for Stricturing Crohn's Disease / 대한소화기학회지

Crohn's disease is characterized by chronic transmural inflammation of the bowel and is associated with serious complications, such as bowel strictures, abscesses, fistula formation, and perforation. As neither medical nor surgical therapy provides a cure for Crohn's disease, the primary goals of therapy are to induce and maintain remission and prevent complications. As a biologic agent, infliximab, a monoclonal antibody to tumor necrosis factor, is indicated for refractory luminal and fistulizing Crohn's disease that does not respond to other medical therapies or surgery. Infliximab has proven to be very effective for inducing and maintaining remission in Crohn's disease; however, infliximab treatment has several potential complications. Here, we report a case of free perforation following a therapeutic response after an initial dose of infliximab for Crohn's disease. This is the first case report describing a free perforation in a Crohn's disease patient after an initial dose of infliximab.

How Should Azathioprine Be Dosed in Crohn's Disease? A Novel Strategy of Maximum Dose-titration Based on the Lower Limit of Leukocyte Count and Tolerability / 대한소화기학회지

BACKGROUND/AIMS: Although general guidelines have suggested weight-based dosing of azathioprine (AZA, 2.5 mg/kg/day) for Crohn's disease (CD), a substantial number of patients develop bone marrow suppression. The aim of this study was to evaluate the maximum dose of AZA not based on weight but titrated according to the lower limit of leukocyte count for maintaining remission in patients with CD. METHODS: Among a total of seventy-eight patients with CD, who had been followed-up at Kosin University Gospel Hospital (Busan, Korea) from 2010 to 2011, those treated with the maximum dose of AZA meeting both drug-tolerability and leukocytes count of more than 4,000/mm3 for steroid-free maintaining remission were enrolled. The titrated maximum AZA dose and its relationship with weight were evaluated. RESULTS: A total of 42 patients (male, 32 patients; mean age, 31 years) were enrolled. The maximum dose of AZA was 49.1 mg/day. The dose per weight was 0.87 mg/kg/day and negatively correlated with body weight (gamma=-0.51, p=0.01) and BMI (gamma=-0.33, p=0.034). AZA dose per weight in the below 40 years old group was significantly higher than that in the above 40 years old group (p=0.039). CONCLUSIONS: Dose decision of AZA based only on weight could put the patients to inappropriately low or high dose resulting in need of additional therapy or serious side effect, respectively. Therefore, the maximum dose-titration based on the lower limit of leukocyte count and tolerability is a novel and a valuable strategy in deciding the dose of thiopurines.

Growth Inhibition of Hepatocellular Carcinoma Huh7 Cells by Lactobacillus casei Extract

PURPOSE: Lactobacillus casei (L. casei) is known to exert anti-proliferation effects on many types of cancer cells. However, the effect of L. casei on liver cancer has not been reported. Accordingly, the aim of this study was to determine the anti-cancer effect of L. casei extract on Huh7 cells. MATERIALS AND METHODS: L. casei ATCC393 extract was prepared and purified. After the treatment of L. casei extract on Huh7 cells, cell viability, cell cycle arrest and cell death were analyzed by flow cytometry. The expression levels of tumor necrosis factor-alpha receptor 1 (TNFR1) and death receptor 3 (DR3) mRNA related with extrinsic apoptosis were assessed by reverse transcription polymerase chain reaction. Additionally, P21 and P27 cell cycle proteins as well as Caspase-3, -8, -9, phospho-Bad and Bcl-2 apoptosis proteins were analyzed by western blot analysis. To determine the effect of L. casei extract on cancer stem-like cells, we analyzed changes in side population fraction through flow cytometry. RESULTS: The cell viability of Huh7 cells treated with L. casei extract was decreased by 77%, potentially owing to increases in the rates of Huh7 cells arrested in the G2/M phase (3% increase) and that underwent apoptosis (6% increase). The expression levels of TNFR1 and DR3 mRNA, as well as P21 and P27 cell cycle proteins, were increased. Meanwhile, the expressions of caspase-8, -9, phospho-Bad and Bcl-2 proteins decreased. However, in the case of side population cells, no remarkable changes were observed. CONCLUSION: L. casei extract exerts a potent anti-tumor effect on the viability of liver cancer cells, although not on cancer stem-like cells.

Berberine Inhibited the Growth of Thyroid Cancer Cell Lines 8505C and TPC1

PURPOSE: Thyroid cancer is the most common malignancy in Korean females and can be treated with good prognosis. However, drugs to treat aggressive types of thyroid cancer such as poorly differentiated or anaplastic thyroid cancer have not yet been established. To that end, we analyzed the effects of berberine on human thyroid cancer cell lines to determine whether this compound is useful in the treatment of aggressive thyroid cancer. MATERIALS AND METHODS: The two thyroid cancer cell lines 8505C and TPC1, under adherent culture conditions, were treated with berberine and analyzed for changes in cell growth, cell cycle duration, and degree of apoptosis. RESULTS: Following berberine treatment, both cell lines showed a dose-dependent reduction in growth rate. 8505C cells showed significantly increased levels of apoptosis following berberine treatment, whereas TPC1 cells showed cell cycle arrest at the G0/G1 phase. Immunobloting of p-27 expression following berberine treatment showed that berberine induced a little up-regulation of p-27 in 8505c cells but relatively high up-regulation of p-27 in TPC1 cells. CONCLUSION: These results suggest that berberine treatment of thyroid cancer can inhibit proliferation through apoptosis and/or cell cycle arrest. Thus, berberine may be a novel anticancer drug for the treatment of poorly differentiated or anaplastic thyroid cancer.

Crohn's Disease Presenting with Erythema Nodosum as an Early Sign: A Case Report / 대한소화기학회지

Erythema nodosum is the most common form of septal panniculitis and the most frequent skin manifestation associated with inflammatory bowel disease, affecting up to 15% of Crohn's disease patients. Since the development of erythema nodosum is closely related with a variety of disorders and condition, it can serve as an important early sign of systemic disease. Here, we present the occurrence of erythema nodosum as an early sign of Cronh's disease in a 16-year-old woman.

Clinical Approaches for Understanding the Expression Levels of Pattern Recognition Receptors in Otitis Media with Effusion

OBJECTIVES: Bacterial infections in the normally sterile environment of the middle ear cavity usually trigger host immune response, whereby the innate immune system plays a dominant role as the host's first line of defense. We evaluated the expression levels of Toll-like receptors (TLRs) -2, -4, -5, -9, and nucleotide-binding oligomerization domain-containing proteins (NODs) -1 and -2, all of which are related to bacterial infection in pediatric patients with otitis media with effusion (OME). METHODS: The study sample consisted of 46 pediatric patients with OME, all of whom had ventilation tubes inserted. The expression levels of TLR-2, -4, -5, -9, NOD-1 and -2 mRNA in middle ear effusion were assessed by polymerase chain reaction (PCR). Difference of pattern recognition receptors (PRRs) expression level by presence of bacteria, ventilation tube insertion rate, and effusion fluid character was assessed. RESULTS: All effusion fluid samples collected from patients with OME showed expression of TLR-2, -4, -5, -9, NOD-1, and -2 mRNA by PCR. However, we found no differences among expression levels of PRRs in relation to characteristics of exudates, presence of bacteria, or frequencies of ventilation tube insertion (P>0.05). CONCLUSION: Our findings suggest that exudates of OME patients show PRR expressions that are related to the innate immune response regardless of the characteristics of effusion fluid, presence of bacteria in exudates, or frequency of ventilation tube insertion.

Prognosis of IgA Nephropathy with No Proteinuria on Routine Urinalysis / 대한신장학회지

PURPOSE: In patients with IgA nephropathy, more than 1 g/day of proteinuria is a risk factor to develop end-stage renal failure. Uncommonly, patients with IgA nephropathy exhibit negative proteinuria on routine dipstick test during follow-up examination, spontaneously or after use of ACEI or ARB. We evaluated whether no proteinuric patients have good prognosis or not. METHODS: 41 patients who had no proteinuria on routine urinalysis for more than 6 months, were classified into spontaneous remission group (25 cases, SR) without any treatment and drug-induced remission group (16 cases, DR) with treatment of ACEI/ARB or both, were analyzed for clinical findings and renal function, retrospectively. We examined spot urine protein/creatinine ratio (Up/c) to evaluate exact amount of proteinuria and GFR was estimated by MDRD equation. RESULTS: Twenty eight percent of cases in SR and 50 percent in DR showed spot Up/c 0.3-1 g/g. After follow-up of 58+/-41 (9-192) months in SR and 79+/-56 (35-192) months in DR, the stages of CKD shifted to advanced levels as follows; in SR group, 11, 10, 4 patients in stage 1 (GFR> or =90 ml/min/ 1.73m2), 2 (GFR 60-89 ml/min/1.73m2), 3 (GFR 30-59 ml/min/1.73m2) to 7, 13, 5 patients, respectively; in DR, 7, 8, 1 patients in stage 1, 2, 3 to 3, 8, 5 patients, respectively. There was a tendency of slow decreasing GFR in both groups but no case progressed to CKD stage 4 and 5. CONCLUSION: Of IgA nephropathy patients with no proteinuria on routine urinalysis, 30-50% of patients have proteinuria 0.3-1.0 g/g on spot Up/c and there was also a risk of progression.

Anomalous Origin of the Right Coronary Artery from the Left Anterior Descending Artery: An Extremely Rare Variety of Single Coronary Artery

Single anomalous coronary artery is a rare congenital anomaly of the coronary circulation. Right coronary artery (RCA) arising from the left anterior descending artery is an extermely rare variety of single coronary artery. We report a 68-year-old patient with a single coronary artery system, in whom the right coronary artery originated from the mid left anterior descending artery.

A Case of Liver Abscess Metastasizing to Prostate Resulting in Prostatic Abscess

Klebsiella pneumoniae(K. pneumoniae) infection has a tendency of abscess formation and it is known to be associated with diabetes mellitus. Metastatic infection was an important feature of K. pneumoniae liver abscess and bacteremia, metastatic prostate abscess was rare. We present a case of a 81-year-old man with K. pneumoniae liver abscess and metastatic prostate abscess, This patient was successfully treated with percutaneous abscess drainage of liver abscess and transurethral incisional drainage of prostate abscess.

A Case of Recurrent Paragonimiasis

Pulmonary paragonimiasis is a food-borne zoonosis, which is acquired from eating the raw or undercooked freshwater crabs or crayfish (crustaceans). It was highly endemic in Korea the late 1960's. However, human paragonimiasis is still sporadically occuring because of pupularization of Korean traditional crab dishes and is one of the lung disease which needs differential diagnosis. Recently, we experienced a case of pulmonary paragonimiasis in a 55 years man with dyspnea, dry cough and abdominal pain. The patient had hypereosinophilia and pulmonary infiltrates with pleural effusion, which did not improve on antibiotics. Diagnosis was confirmed by sputum with Paragonimus westermani ova, which was treated with praziquantel for two days at a daily dosage of 75 mg/kg. The patient was readmitted to the hospital 1 month following first treatment with recurrence of symptoms and he was cured by a second course of praziquantel.

Transluminal Removal of a Fractured and Embolized Indwelling Central Venous Catheter in the Pulmonary Artery

Vascular catheters are associated with complications such as infection, thrombosis and stenosis. The embolization of a venous catheter fragment is a rare complication. A 39-year-old woman underwent placement of a totally implantable venous access device for chemotherapy to treat a recurrent liposarcoma of the left thigh. The "pinch-off sign" was noted on a routine chest X-ray but that was ignored. Three-months after implantation of the intravenous access device, the indwelling central catheter was fractured and embolized to the pulmonary trunk. The catheter in the pulmonary trunk was successfully removed through a percutaneous femoral vein approach using a pigtail catheter and goose neck snare.

Two Cases of Ramsay Hunt Syndrome Complicated with Multiple Cranial Nerve Palsy and Aseptic Meningitis / 대한이비인후과학회지

Herpes zoster oticus or Ramsay Hunt syndrome occurs in about one percent of all cases of herpes zoster and represents 12 percent of all facial palsies. The typical clinical presentation includes otalgia, facial palsy, herpetic lesions of the auricle and external auditory canal, but is frequently accompanied with sensorineural hearing loss, vertigo and tinnitus. Rarely, it may be associated with the involvement of V, VI, IX, X, XI and XII cranial nerves, aseptic meningitis, and the syndrome of inappropriate secretion of antidiuretic hormone (SIADH). With a review of literature, we report two cases. The first case is a 64-year-old male with Ramsay Hunt syndrome complicated with cranial nerve VIII palsy and aseptic meningitis. The second case is a 30-year-old female with Ramsay Hunt syndrome complicated with the cranial nerve III, IV, V, VI and VIII palsies and aseptic meningitis.

Characteristic Features of Immune B Cells in Murine Cervical Lymph Node / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: To investigate the characteristic features of B cells in murine cervical lymph node. Animal experiment. SUBJECTS AND METHOD: We obtained cervical lymph node of mice. Isolated B cells were cultured in media after the addition of several stimuli. The expression of various surface molecules to characterize lymphoid B cells were analysed by flow cytometry. Immunoglobulin secreted into the culture supernatants was evaluated by enzyme-linked immunosorbent assay. B220+ cells cultured for 5 days with media alone, or LPS. Entering into S phase in response to stimuli was measured by proliferative assay. RESULTS: Identifying phenotypic characteristics for B cells of lymph node include CD5low, CD23high, CD43low, B220high, Ig (sIg)Mlow, sIgDhigh, CD80 (B7.1)low, CD86 (B7.2)low, and Syndecam-1low. Spontaneous Immunoglobulin production did not occur in lymphoid B cells. When stimulation, IgM secretion was increased more than that of IgA and IgG. Lipopolysaccharide is a most powerful stimulus which secreted immunoglobulin. In thymidine incorporation, B cells were entered actively S phase after 48hours stimulation. CD40 plus anti-CD8 stimulated B cells to produce substantial thymidine incorporation that was much greater than those of other stimuli. CONCLUSION: The B cells in cervical lymph node are conventional B cells (B2). Lymph node B cells secreted mainly IgM at stimuli and cell proliferation was activated at 48 hours of stimulation.

The Effectiveness of Myprodol(R) on the Post-tonsillectomy Pain Control and Time to Return to Normal Daily Activities / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Pain is one of most troublesome discomfort after tonsillectomy. Although various analgesics have been administrated for pain control, it has not been effectively controlled until now. This study was performed to evaluate the effectiveness of Myprodol(R) codein combination analgesics, on the pain control and time to return to normal daily activities. SUBJECTS AND METHOD: Ninety adult patients undergoing tonsillectomy were included in this study. Patients were randomly divided into a Myprodol(R) group (n=30), a NSAID group (n=30) and a codeine group (n=30). They received Myprodol(R) NSAID and codeine, respectively, from the 3rd to 14th postoperative days. On the 1st, 7th and 14th postoperative days, which consisted of rising, breakfast, lunch and supper time, we assessed pain intensity by visual analogue scale. And on the 21st postoperative day, we investigated time to return to normal daily activities and adverse effects of analgesics. RESULTS: When pain intensity on the 1st postoperative day was compared, there was no significant difference among 3 groups. On the 7th postoperative day, the Myprodol(R) group showed significant pain decrease compared with the codeine group but did not with the NSAID group. On the 14th postoperative day, the Myprodol(R) group showed significant pain decrease compared with both NSAID and codeine groups. The Myprodol(R) group also showed shortened recovery time compared with the others and there was no significant adverse effects in any of the groups. CONCLUSION: We find that Myprodol(R) is an effective and safe oral analgesics for pain control and shortens time to return to normal daily activities.