The effect of autogenous tooth bone graft material without organic matter and type I collagen treatment on bone regeneration / 대한악안면성형재건외과학회지

Objectives@#The aim of this study is to examine the effect of particulate autogenous tooth graft removed with organic matter and type I collagen addition on bone regeneration and to validate the possibility of useful allograft material for jaw defects.Material and methods: Autogenous tooth bone maker (Korean Dental Solution® KOREA) made particulate autogenous tooth not including organic matter. We used to the developed tooth grafts for experiment. Cell adhesion test with hemacytometer and energy dispersive X-ray spectroscopy (Supra40 VP®, Carl Zeiss, Germany) analysis about the particulate autogenous tooth and type I collagen were performed. Rabbits were divided into three groups: bone graft with organic matter (OM) removing particulate autogenous tooth group, bone graft with OM removing particulate autogenous tooth and type I collagen group, and a control group. Bone grafting was performed in rabbit’s calvaria. The rabbits were sacrificed at different interval at 1, 2, 4, and 6 weeks after bone grafting for the histopathologic observation and observed the effect of bone regeneration by SEM, H-E & Masson stains, osteocalcin IHC staining.Result: In vitro cytopathological study showed affinity for cells, cell attachment pattern, and cell proliferation in the order of control group, OM-removed and collagen-treated group, OM-removed particulate autogenous tooth group. The results of the degree of mineralization were opposite to those of the previous cell experimental results, and the OM-removed group, OM-removed group and collagen-treated group were relatively higher than the control group. Histopathologic analysis showed that vascularization and neonatal bone formation were higher in particulate autogenous tooth group with removing OM and with addition of collagen than control group and group of OM removed only. Immunohistochemical analysis showed that osteocalcin (OSC) expression was not observed in the control group, but at 4 weeks groups, OSC expression was observed the OM removed and OMremoved-collagen-treated particulate autogenous tooth, and the degree of expression was somewhat stronger in group of the OM removed and collagen additionally treated particulate autogenous tooth. @*Conclusion@#Particles that do not contain organic matter, the saint tooth, was responsible for sufficient bone graft material through the role of space maintenance and bone conduction, and further improved bone formation ability through additional collagen treatment. Therefore, research on various extracellular substrates and autologous bone grafting materials is necessary, and through this, it is possible to lay the foundation for a new type of autologous bone grafting material with excellent academic and technical utility.

The Effect of Autogenous Demineralized Dentin Matrix and Interleukin-6 on bone Regeneration

The aim of this study was to evaluate the role of demineralized and particulate autogenous tooth, and interleukin-6 in bone regeneration. A demineralized and particulate autogenous tooth was prepared and human osteoblast-like cells (MG63) and human osteosarcoma cells were inoculated into the culture. The rate of cell adhesion, proliferation and mineralization were examined, and the appearance of cellular attachment was observed. An 8 mm critical size defect was created in the cranium of rabbits. Nine rabbits were divided into three groups including: An experimental group A (3 rabbits), in which a demineralised and particulate autogenous tooth was grafted; an experimental group B (3 rabbits), in which a demineralized, particulate autogenous tooth was grafted in addition to interleukin-6 (20 ng/mL); and a control group. The rabbits were sacrificed at 1, 2, 4 and 6 weeks for histopathological examination with H-E and Masson's Trichrome, and immunohistochemistry with osteocalcin. The cell-based assay showed a higher rate of cell adhesion, mineralization and cellular attachment in the experimental group A compared with the control group. The animal study revealed an increased number of osteoclasts, newly formed and mature bones in the experimental group A compared with the control group. Eventually, a higher number of osteoclasts were observed in the experimental group B. However, the emergence of newly formed and mature bone was lower than in the experimental group A. The current results suggest that treatment with demineralized and particulate autogenous tooth and interleukin-6 is not effective in stimulating bone regeneration during the bone grafting procedure.

Severe Fever with Thrombocytopenia Syndrome Presenting with Rhabdomyolysis

Severe fever with thrombocytopenia syndrome (SFTS) is an emerging febrile illness. While many kinds of severe complications including acute renal failure have been reported, rhabdomyolysis is rarely reported in association with SFTS. A 54-year-old female farmer was admitted with fever and diffuse myalgia. Laboratory finding showed thrombocytopenia, leukopenia, azotemia, extremely elevated muscle enzyme levels and myoglobinuria. We describe a fatal case of rhabdomyolysis with acute renal failure complicated by SFTS.

The effect of biomechanical stimulation on osteoblast differentiation of human jaw periosteum-derived stem cells / 대한악안면성형재건외과학회지

BACKGROUND: This study was to investigate the effect of biomechanical stimulation on osteoblast differentiation of human periosteal-derived stem cell using the newly developed bioreactor. METHODS: Human periosteal-derived stem cells were harvested from the mandible during the extraction of an impacted third molar. Using the new bioreactor, 4% cyclic equibiaxial tension force (0.5 Hz) was applied for 2 and 8 h on the stem cells and cultured for 3, 7, and 14 days on the osteogenic medium. Biochemical changes of the osteoblasts after the biomechanical stimulation were investigated. No treatment group was referred to as control group. RESULTS: Alkaline phosphatase (ALP) activity and ALP messenger RNA (mRNA) expression level were higher in the strain group than those in the control group. The osteocalcin and osteonectin mRNA expressions were higher in the strain group compared to those in the control group on days 7 and 14. The vascular endothelial growth factor (VEGF) mRNA expression was higher in the strain group in comparison to that in the control group. Concentration of alizarin red S corresponding to calcium content was higher in the strain group than in the control group. CONCLUSIONS: The study suggests that cyclic tension force could influence the osteoblast differentiation of periosteal-derived stem cells under optimal stimulation condition and the force could be applicable for tissue engineering.

Hypertensive Brainstem Encephalopathy in a Patient with Acute Lacunar Infarction

No abstract available.

A Critical Case of Wernicke's Encephalopathy Induced by Hyperemesis Gravidarum / 대한구급학회지

Wernicke's encephalopathy is a reversible but potentially critical disease caused by thiamine deficiency. Most patients complain of symptoms such as ophthalmoplegia, ataxia and confusion. Heavy alcohol drinking is commonly associated with the disease, but other clinical conditions also can provoke it. In pregnant women, hyperemesis gravidarum can lead to the depletion of body thiamine due to poor oral intake and a high metabolic demand. We report a case of Wernicke's encephalopathy following hyperemesis gravidarum in a 36-year-old female at 20 weeks of pregnancy, who visited our hospital because of shock with vaginal bleeding. This case suggests that although the initial presentation may include atypical symptoms (e.g., shock or bleeding), Wernicke's encephalopathy should be considered, and thiamine replacement should be performed in pregnant women with neurologic symptoms and poor oral intake.

A Critical Case of Wernicke's Encephalopathy Induced by Hyperemesis Gravidarum / 대한중환자의학회지

Wernicke's encephalopathy is a reversible but potentially critical disease caused by thiamine deficiency. Most patients complain of symptoms such as ophthalmoplegia, ataxia and confusion. Heavy alcohol drinking is commonly associated with the disease, but other clinical conditions also can provoke it. In pregnant women, hyperemesis gravidarum can lead to the depletion of body thiamine due to poor oral intake and a high metabolic demand. We report a case of Wernicke's encephalopathy following hyperemesis gravidarum in a 36-year-old female at 20 weeks of pregnancy, who visited our hospital because of shock with vaginal bleeding. This case suggests that although the initial presentation may include atypical symptoms (e.g., shock or bleeding), Wernicke's encephalopathy should be considered, and thiamine replacement should be performed in pregnant women with neurologic symptoms and poor oral intake.

Non-Infective Endocarditis in a Patient with Rheumatoid Arthritis / 대한내과학회지

Pericarditis and atherosclerotic events are generally regarded as relatively common cardiac manifestations of rheumatoid arthritis (RA). However, RA-associated endocarditis is rarely reported, and can be confused (by clinicians) with an infective vegetation. Herein, we report a case of sterile endocarditis involving the mitral valve in a 36 year-old patient with longstanding RA; the problem was accidentally detected during performance of a valve operation.

Lipoma on superficial lobe of the parotid gland: case report

A lipoma is a benign tumor of matured adipose tissue that usually occurs at the shoulder, back, and abdomen. 13% of lipomas occur in the head and neck area. However, the incidence of lipoma in the parotid gland is very low, approximately 2.5%. A conservational surgical excision is recommended in cases of lipoma of the parotid gland, with only 1-2% of lipomas recurring. We report a case of a lipoma in the parotid gland that was removed by conservational surgical excision. The lesion was exposed by the pre-auricular approach and the tissue was detached. After the parotid gland envelop was exposed, a yellowish mass is observed that was easy to remove due to capsulation. Most authors recommend a surgical excision of the superficial lobe of the parotid gland as the treatment for a lipoma in the parotid gland. However, enucleation only may be a sufficient treatment when a lipoma occurs in the superficial lobe or around the parotid gland. A patidectomy is not needed when a lipoma is located at the superficial lobe of the parotid gland, and a conservational surgical excision is suitable. Therefore, a clinical diagnosis is important for reducing the damage to the facial nerve.

Amniotic fluid embolism that took place during an emergent Cesarean section: A case report / 대한마취과학회지

Amniotic fluid embolism (AFE) is a rare but fatal obstetric emergency, characterized by sudden cardiovascular collapse, dyspnea or respiratory arrest and altered mentality, disseminated intravascular coagulation (DIC). It can lead to severe maternal morbidity and mortality, but the prediction of its occurrence and treatment are very difficult. We experienced a case of AFE during emergent Cesarean section in a 40(+6) weeks healthy pregnant woman, age 33. Sudden dyspnea, hypotension, signs of pulmonary edema and DIC were developed during Cesarean section, and cardiac arrest followed after these events. The course of these events was so rapid and catastrophic, which was consistent with AFE. Thus, we report this case precisely and review pathophysiology, diagnosis, treatment of AFE by referring to up-to-date literatures.

Study about the relationship between the amount of posterior impaction and the change of occlusal plane angle and incisor inclination in Le Fort I osteotomy

INTRODUCTION: In the management of dentofacial deformities, variable movement of the maxilla can be made possible by a Le Fort I osteotomy. Posterior impaction of the maxilla necessary for rotation of the maxillomandibular complex enhances the functions and esthetic results. In cases of posterior impaction of the maxilla, an increase in the figure of the occlusal plane angle and incisor inclination can occur. This study reports the relationship between the amount of posterior impaction and the change in the occlusal plane angle and incisor inclination in a Le Fort I osteotomy by preoperative and postoperative lateral cephalograms. MATERIALS AND METHODS: Twenty patients who had undergone orthognathic surgery in Dong-A University Medical Center participated in this study. Lateral cephalometrics, within 3 weeks prior to surgery and 3 days after surgery, were used for analysis. Pre and postoperative measurements of the occlusal plane angle and incisal inclination based on the Frankfort horizontal (FH) plane were performed. X and Y were defined as the amount of vertical change in the upper incisor tip and the amount of vertical change in the upper first molar mesial cup tip through the operation. The amount of final posterior maxillary impaction was determined by subtracting Y from X, which is the difference in vertical height. According to the amount of posterior maxillary impaction, the change in the occlusal plane angle and incisal inclination was measured. RESULTS: The average posterior maxillary impaction was 2.91 mm and the average change in the occlusal plane angle and incisal inclination was 6.54degrees after surgery. As a result, each mm of posterior maxillary impaction changed the occlusal plane angle and incisal inclination by 2.25degrees. Statistically, there was high significance. Two cases were observed: one with the same amount of posterior maxillary impaction performed on both the right and left showing 2.20degrees, and the other with a different amount of posterior maxillary impaction performed showing 2.35degrees. In this case, there was no significance difference between the two cases. CONCLUSION: Each mm of posterior maxillary impaction changes the occlusal plane angle and incisal inclination by an average of 2.25degrees. In posterior maxillary impaction, there was no significant difference in the amount of change in the occlusal plane angle and incisal inclination regardless of whether there was an equal amount of posterior maxillary impaction on both sides. This study is expected to help in the presurgical orthodontic preparation and presurgical treatment planning.

Effect of adipose-derived stem cells on bone healing on titanium implant in tibia of diabetes mellitus induced rats

INTRODUCTION: Diabetes mellitus, as a major health problem for the elderly has been shown to alter the properties of the bone and impair bone healing around a titanium implant in both humans and animals. The aim of this study was to examine the effect of adipose-derived stem cells on the healing process around a titanium implant in streptozotocin-induced diabetic rats. MATERIALS AND METHODS: Thirteen rats were divided into two groups: adipose-derived stem cells injected group and a control group. A titanium screw implant (diameter: 2.0 mm, length: 3.5 mm) was placed into both tibia of 13 rats: 13 right tibia as the control group and 13 left tibia as the experimental group. The rats were sacrificed at different intervals (1, 2, and 4 weeks) after implantation for histopathology observations and immunohistochemistric analysis. RESULTS: The histopathological findings revealed earlier new formed bone in the experimental group than the control group. In particular, at 1 week after implantation, the experimental group showed more newly formed bone and collagen around the implant than the control group. In immunohistochemistric analysis, osteoprotegerin (OPG) expression in the experimental group increased early compared to that of the control group until 2 weeks after implantation. However, after 2 weeks, OPG expression in the experimental group was similar to OPG expression in the control group. The receptor activator of nuclear factor kappaB ligand (RANKL) expression in the experimental group increased early compared to that of the control group, and then decreased at 2 weeks. After 2 weeks, the level of RANKL expression was similar in both groups. CONCLUSION: These results suggest that adipose-derived stem cells in implantation can promote bone healing around titanium, particularly in diabetes mellitus induced animals.

Comparision of remifentanil and remifentanil/midazolam for outpatient anesthesia in prolotherapy / 대한마취과학회지

BACKGROUND: Prolotherapy is a therapeutic procedure used for chronic musculoskeletal and arthritic pain. It involves injecting an irritant solution to pain sites and causes patient discomfort, which can lead to treatment discontinuation. Remifentanil is an ultra short-acting micro-opiate receptor agonist that permits a rapid transition from intense analgesia to a minimal residual effect. Here, we evaluated the effect of remifentanil as a preparative medication for ambulatory prolotherapy. METHODS: Eighty patients taking prolotherapy were assigned into three groups for pre-therapeutic injections: remifentanil 0.1 microgram/kg/min alone (Group R), remifentanil 0.05 microgram/kg/min with midazolam 2 mg (Group M), and normal saline (Group C). Pain and sedation scores, blood pressure, pulse oxygen saturation, heart rate, satisfaction score, and time to discharge were measured. RESULTS: Pain scores in groups M and R were lower than group C during and after prolotherapy. The sedation score of group M was higher than groups R and C. Nine patients in group R experienced dizziness during prolotherapy. In group M, 8 patients experienced dizziness and 2 patients experienced nausea. There was no difference in time to discharge among all groups. Satisfaction scores in group M (7.3 +/- 0.8) and group R (7.0 +/- 0.8) were higher than that of group C (5.3 +/- 0.6). CONCLUSIONS: Remifentanil and remifentanil/midazolam effectively reduce the pain produced by prolotherapy.

Continuous Femoral Nerve Block Guided by Ultrasound Sonography in Metastatic Cancer Patient: A case report / 대한마취과학회지

Terminal cancer pain is always a challenge to pain doctors.If the focus of the cancer pain is located in the restricted area, it is easy to control the pain. However, if the focus of cancer pain is widespread, it is very difficult to control the pain and it makes pain doctors embarrassed.Nowadays, the ultrasound-guided nerve block become a popular method. It is easy to find the nerve and helps to insert the catheter around the nerve for the continuous nerve block. We encountered a patient who was 59 years old with a stomach cancer and vertebral metastasis. He complained about the pain in his abdomen, back and left thigh. His abdominal and back pain vanished with the use of continuous lumbar epidural injection. However, the patient still complained about the pain and numbness on the left thigh, because of this, he couldn't get any sleep.We tried a continuous femoral nerve block under the ultrasound guidance, after that his pain was gone.The ultrasound-guided nerve block will be very helpful to control the pain.

The Influence of Nitrous Oxide on Postoperative Bowel Function Recovery for Gynecologic Patients

BACKGROUND: Nitrous oxide may cause distension of the intestine. We studied the influence of nitrous oxide on the recovery of bowel function and the incidence of complications of bowel distension. METHODS: Fifty patients scheduled for abdominal hysterectomy were anesthetized with sevoflurane and oxygen and were randomly assigned to be given 50% nitrous oxide (n = 25) or 50% air (n = 25) in two groups. A surgeon assessed the closing condition. Patients reported pain, nausea and vomiting after surgery. The lapse of time before the passing of flatus was recorded. RESULTS: There was no difference between the two groups with respect to body weight, duration of surgery, alfentanil and atracurium requirements, pain score, nausea and vomiting, and closing condition. The time elapsing before the passing of flatus was significantly greater for the patients that received nitrous oxide. CONCLUSIONS: Our results suggest that avoiding nitrous oxide administration during prolonged intraabdominal surgery shortens the time for recovery of bowel function.

A Clinical Analysis of 29 Cases of Centipede Bite / 대한피부과학회지

BACKGROUND: The relative lack of knowledge and interest in arthropod bites has made it difficult to investigate centipede envenomation in Korea. OBJECTIVE: To describe the epidemiology and clinical characteristics of centipede bites in Korea. METHODS: A prospective study of clinical manifestations in patients with centipede bites was performed during the period of May 2004 to April 2005. Factors investigated included sex, age, location and time of assaults, affected parts of the body, signs and symptoms, treatment modalities, and complications. All centipedes that were involved were brought to the clinic, examined, and species-identified. RESULTS: A total of 29 cases of centipede bite were identified. Scolopendra subspinipes was the causative centipede in all cases. Centipede bites occurred exclusively in summer (June, July, and August). Most of the bites which occurred during the daytime happened outdoors, whereas most nocturnal assaults happened indoors. All patients were bitten on an exposed area and the fingers (37.9%) were the most frequent sites of involvement. Local reactions developed at the bitten sites and usually remained localized. Erythema (100%) and local swelling (79.3%) were the most prominent features. The majority of patients did not show severe systemic symptoms. Most lesions healed completely within a week, without complications. CONCLUSION: Centipede bites are a common occurrance in rural and island areas during the summer season. Dermatologists need to be aware of the clinical manifestations in order to make an appropriate diagnosis and proper treatment decision.

A Clinical Analysis of 133 Cases of Pitted Keratolysis / 대한피부과학회지

BACKGROUND: Pitted keratolysis (PK) is an acquired, chronic, usually asymptomatic, non-inflammatory, superficial bacterial infection of the stratum corneum of the soles. Corynebacterium species are thought to be the causative organisms of PK. This condition is common in feet of active people wearing sweaty shoes, namely, athletes and soldiers. OBJECTIVE: To analyze the clinical manifestations of pitted keratolysis. METHODS: A total of 133 Korean male soldiers diagnosed with PK (aged between 19 and 33, mean 21.9 years) were included in this study. All patients were investigated between April 2004 and May 2005. Factors investigated included age, location, duration, date of visit, physical examination, subjective symptoms, associated medical conditions, and treatment modalities. All patients were examined carefully to verify accompanying erythrasma or trichomycosis axillaris (TMA). RESULTS: About half of the patients visited our department in spring (March, April, and May). However, PK was found in all the seasons. The ball of the foot was the most frequently involved site (92.5%). The big toe (72.2%) was also a frequent site of involvement. Forty-five patients (41.7%) had coexistent erythrasma, 22 (20.4%) had TMA, and 14 (13.0%) had a simultaneous presence of both erythrasma and TMA. Hyperhidrosis (98.5%) and foul odor (95.5%) were the main complaints in most of the patients. Other symptoms associated with PK were sliminess (38.3%), burning (23.3%), itching (18.8%), and prickling (13.5%) sensations. Various treatment modalities such as topical antibiotics, topical antifungal agents, and oral erythromycin have been used. All lesions subsided within 1 month after treatment. Although recurrence rate was high (64.3%), parameters such as period of prevalence, size and shape of the lesion, and treatment modality were not associated with the recurrence rate. CONCLUSION: The present study provides basic clinical information on PK, which is a common condition of the feet of Korean male soldiers.

Gram-negative Folliculitis following Prolonged Use of Broad-spectrum Antibiotics / 대한피부과학회지

Gram-negative folliculitis is an infection with Gram-negative bacteria that most often occurs as a complication of prolonged broad-spectrum antibiotic therapy in patients suffering from acne or rosacea. A 21-year-old male soldier with acne vulvaris had been treated with broad-spectrum antibiotics for two months because of severe pyoderma on the soles. While the plantar lesions improved significantly, prolonged use of the systemic antibiotics resulted in widespread follicular pustules on his face, scalp, and back of the neck. A skin biopsy showed features of superficial pustular folliculitis. Klebsiella species were identified from the pus culture. A diagnosis of gram-negative folliculitis was made. The lesions almost disappeared after 4 weeks of treatment with oral isotretinoin (0.5 mg/kg/day).

Gram-negative Folliculitis following Prolonged Use of Broad-spectrum Antibiotics / 대한피부과학회지

Gram-negative folliculitis is an infection with Gram-negative bacteria that most often occurs as a complication of prolonged broad-spectrum antibiotic therapy in patients suffering from acne or rosacea. A 21-year-old male soldier with acne vulvaris had been treated with broad-spectrum antibiotics for two months because of severe pyoderma on the soles. While the plantar lesions improved significantly, prolonged use of the systemic antibiotics resulted in widespread follicular pustules on his face, scalp, and back of the neck. A skin biopsy showed features of superficial pustular folliculitis. Klebsiella species were identified from the pus culture. A diagnosis of gram-negative folliculitis was made. The lesions almost disappeared after 4 weeks of treatment with oral isotretinoin (0.5 mg/kg/day).

Caterpillar Dermatitis Caused by Euproctis similis / 대한피부과학회지

The yellow-tail moth Euproctis similis, belongs to the genus Euproctis (Lymantriidae) and has a wide distribution within Korea, Japan, China and Europe. Contact with the 'urticating hairs' of the Euproctis similis caterpillar induces dermatitis due to the combination of mechanical and chemical mechanisms. Clinically, patients with caterpillar dermatitis show wheals in the early stage and/or erythematous papules in the late stage after contact with the spicules. We report 5 young soldiers who developed pruritic wheals and erythematous papules on their upper back after contact with the hairs of the Euproctis similis caterpillar.