Correlation between Metal Ions and Cytokines in the Saliva of Patients with Oral Lichenoid Lesions

Purpose@#We aimed to investigate the effect of metal ions from oral prostheses (OPs) released into the saliva of patients with oral lichenoid lesions (OLLs). @*Materials and Methods@#Subjects (n=183) were divided into four groups according to the presence or absence of OLL and OP.Concentrations of the metal ions titanium, chromium (Cr), cobalt (Co), nickel (Ni), palladium (Pd), silver (Ag), platinum (Pt), gold (Au), and zirconium (Zr) were measured using a laser-ablation microprobe inductively coupled to a plasma mass spectrometer. Saliva levels of interleukin (IL)-6, IL-1β, IL-8, and tumor necrosis factor-α were detected using an enzyme-linked immunosorbent assay. The reticulation/keratosis, erythema, and ulceration (REU) scoring system was used to assess the severity of OLL. @*Results@#Mean concentrations of IL-6 and IL-8 were statistically higher in OLL patients with OPs. The concentration of Ni was high in OLL groups. The concentrations of Cr, Ni, and Au ions in the saliva were positively correlated with IL-8. REU scores were positively correlated with salivary concentrations of IL-6 and IL-8, as well as with concentrations of Cr, Ni, and Au. @*Conclusion@#Increased concentrations of metal ions, especially Ni, in saliva were positively correlated with IL-8 and showed positive correlations with the severity of OLL.

Correlation between Metal Ions and Cytokines in the Saliva of Patients with Oral Lichenoid Lesions

Purpose@#We aimed to investigate the effect of metal ions from oral prostheses (OPs) released into the saliva of patients with oral lichenoid lesions (OLLs). @*Materials and Methods@#Subjects (n=183) were divided into four groups according to the presence or absence of OLL and OP.Concentrations of the metal ions titanium, chromium (Cr), cobalt (Co), nickel (Ni), palladium (Pd), silver (Ag), platinum (Pt), gold (Au), and zirconium (Zr) were measured using a laser-ablation microprobe inductively coupled to a plasma mass spectrometer. Saliva levels of interleukin (IL)-6, IL-1β, IL-8, and tumor necrosis factor-α were detected using an enzyme-linked immunosorbent assay. The reticulation/keratosis, erythema, and ulceration (REU) scoring system was used to assess the severity of OLL. @*Results@#Mean concentrations of IL-6 and IL-8 were statistically higher in OLL patients with OPs. The concentration of Ni was high in OLL groups. The concentrations of Cr, Ni, and Au ions in the saliva were positively correlated with IL-8. REU scores were positively correlated with salivary concentrations of IL-6 and IL-8, as well as with concentrations of Cr, Ni, and Au. @*Conclusion@#Increased concentrations of metal ions, especially Ni, in saliva were positively correlated with IL-8 and showed positive correlations with the severity of OLL.

Evaluation of Patients with Sensory Disturbance after Dental Treatment / 대한법의학회지

The Korean Dental Association recommends a disability rate (DR) of 1%-3% in the judgment of physical disability owing to sensory disturbance (SD) after dental treatment; however, criteria for deciding the exact percentage have not been suggested. Therefore, this study aims to provide practical criteria in the application of forensic physical disability evaluation by comparing the results of SD using the current perception threshold (CPT) test. A total of 324 patients with SD who visited the Department of Oral Medicine at Pusan National University Dental Hospital between January 2013 and August 2020, underwent the test. The eight stages, as a result of the CPT value, were reorganized as follows: profound sensory loss, very severe and severe as “severe group”, advanced and moderate as “moderate group”, mild and very mild as “mild group”, and normal as “normal group” The analysis of variance (ANOVA) test was used to calculate the statistical difference in the CPT values at 2000 Hz, 250 Hz, and 5 Hz among the four groups. There were significant statistical differences in the average values of CPT among the four groups (P<0.001). Additionally, a significant statistical difference in the CPT value between the affected and nonaffected sides of the patients was observed among the four groups (P<0.001).Therefore, based on the results of this study, the rationale for applying DR from 1%-3% was in accordance with the severity of the mandibular nerve injury.

Local Injection of Growth Hormone for Temporomandibular Joint Osteoarthritis

PURPOSE: Osteoarthritis (OA) of the temporomandibular joint (TMJ) elicits cartilage and subchondral bone defects. Growth hormone (GH) promotes chondrocyte growth. The aim of this study was to evaluate the efficacy of intra-articular injections of GH to treat TMJ-OA.MATERIALS AND METHODS: Monosodium iodoacetate (MIA) was used to induce OA in the TMJs of rats. After confirming the induction of OA, recombinant human GH was injected into the articular cavities of rats. Concentrations of GH and IGF-1 were measured in the blood and synovial fluid, and OA grades of cartilage and subchondral bone degradation were recorded by histological examination and micro-computed tomography.RESULTS: MIA-induced OA in the rat TMJ upregulated insulin-like growth factor-1 (IGF-1) rather than GH levels. GH and IGF-1 concentrations were increased after local injection of GH, compared with controls. Locally injected GH lowered osteoarthritic scores in the cartilage and subchondral bone of the TMJ.CONCLUSION: Intra-articular injection of GH improved OA scores in rat TMJs in both cartilage and subchondral bone of the condyles without affecting condylar bone growth. These results suggest that intra-articular injection of human GH could be a suitable treatment option for TMJ-OA patients in the future.

Age Estimation Based on Pulp Chamber Size of Mandibular First Molars from Intraoral Periapical Radiographs in Korean / 대한법의학회지

The teeth are the hardest structures in the body and can be a biomarker of aging. The aging process and degenerative changes in the teeth are helpful for estimation of age in adults. One of the best-known features of dental aging is a reduction in the size of the pulp chamber as a result of secondary deposition of dentin. In this study, we developed new regression models to estimate chronological age in Korean adults using the mandibular first molars to examine the relationship between age and pulp cavity size on intraoral radiographs. Intraoral periapical digital radiographs of the mandibular first molars were collected from 243 patients (147 male, 96 female) of known age. The radiographic images were analyzed by using the Adobe Photoshop CS5 image editing program. The pulp chamber height ratio (PCHR), pulp chamber width ratio (PCWR) were calculated and found to have a significant negative correlation with age. The correlation was consistently higher for PCHR than for PCWR. The strongest correlation was found for PCHR in female patients (r=−0.824). Multiple regression models were derived using the PCHR and PCWR. The determination coefficients (R²) of the models ranged from 0.660 to 0.730. Our results indicate that the measurement of pulp chamber height and width in the mandibular first molar is a practical, simple and reliable method for estimation of age in Korean adults.

Age Estimation Based on Pulp Chamber Size of Mandibular First Molars from Intraoral Periapical Radiographs in Korean / 대한법의학회지

The teeth are the hardest structures in the body and can be a biomarker of aging. The aging process and degenerative changes in the teeth are helpful for estimation of age in adults. One of the best-known features of dental aging is a reduction in the size of the pulp chamber as a result of secondary deposition of dentin. In this study, we developed new regression models to estimate chronological age in Korean adults using the mandibular first molars to examine the relationship between age and pulp cavity size on intraoral radiographs. Intraoral periapical digital radiographs of the mandibular first molars were collected from 243 patients (147 male, 96 female) of known age. The radiographic images were analyzed by using the Adobe Photoshop CS5 image editing program. The pulp chamber height ratio (PCHR), pulp chamber width ratio (PCWR) were calculated and found to have a significant negative correlation with age. The correlation was consistently higher for PCHR than for PCWR. The strongest correlation was found for PCHR in female patients (r=−0.824). Multiple regression models were derived using the PCHR and PCWR. The determination coefficients (R²) of the models ranged from 0.660 to 0.730. Our results indicate that the measurement of pulp chamber height and width in the mandibular first molar is a practical, simple and reliable method for estimation of age in Korean adults.

An Assessment of Radiological Age Estimation Method Using Mandibular First Molars in Korean Adults / 대한법의학회지

Age estimation is important in the practice of forensic science to establish the identity of human remains, as well as with living persons. Particularly in Korea, age estimation in adults has been increase in the demand for incorrect birth records in order to be entitled to civil liability, social benefits, employment. The reduction of pulp cavity size as a result of secondary dentin deposit with increasing age could be used to estimate age. This regressive change can be analyzed using radiological techniques; thus, a variety of methods for dental age estimation based on this approach have been proposed. The purpose of this study is to evaluate the concurrence between the Drusini's method and the Jeon's method using the mandibular first molar on orthopantomographs (OPGs) in Korean adults. A total of 232 OPGs (91 females and 141 males) of Korean individuals with ages ranging from 20 to 69 years were analyzed using Drusini's method and Jeon's method. Our results revealed that the correlation of the two methods with age was statistically significant (r=0.501). Both Drusini's method and Jeon's method showed significant correlation with chronological age, and Jeon's method showed a greater correlation with chronological age (r=0.738) than Drusini's method (r=0.586). The mean absolute error was 7.99 years for Jeon's method and 9.79 years for Drusini's method. Our results demonstrate that Jeon's method using the mandibular first molar on OPGs is a practical and suitable method for age estimation in Korean adults.

Pattern analysis of patients with temporomandibular disorders resulting from unilateral mastication due to chronic periodontitis

PURPOSE: The purpose of the present study was to perform a pattern analysis in patients with temporomandibular disorder (TMD) resulting from unilateral mastication due to chronic periodontitis. METHODS: Thirty participants with signs or symptoms of TMD who engaged in unilateral mastication due to periodontitis-related discomfort (test group) were selected. Another 30 subjects exhibiting signs or symptoms of TMD resulting from unilateral mastication not due to chronic periodontitis (control group) were also recruited. An interview-based questionnaire was administered, and an examination of the temporomandibular joint (TMJ) with determination of periodontal status was performed. RESULTS: The duration of unilateral mastication was significantly longer in the control group than in the test group. There was a significant negative correlation between the duration of unilateral mastication and the Community Periodontal Index score. Using the Research Diagnostic Criteria for TMD (RDC/TMD) axis I algorithms, all the subjects were assigned to 3 main groups. The test group exhibited significantly a higher diagnostic distribution of group III (arthralgia, osteoarthritis, or osteoarthrosis), and in both the test and control groups, the number of diagnoses was larger for the non-chewing side. The control group showed a significantly higher diagnostic distribution of group I (myofacial pain), and in both the test and control groups, the number of diagnoses was larger for the chewing side. CONCLUSIONS: The results of the present study indicate that unilateral mastication due to chronic periodontitis could induce not only pain but also structural TMJ changes if adequate treatment is not administered and supported within a short time from the onset of the condition. Therefore, immediate treatment of chronic periodontitis is recommended to prevent not only the primary progress of periodontal disease, but also secondary TMJ-related problems. Furthermore, subjects who have suffered chronic long-term periodontitis without treatment should be urged to undergo a TMJ examination.

Management for traumatic neuropathy after dental treatment

Whereas a somatic pain notifies tissue damage, a neuropathic pain presents disorder of the nerve itself. The causes of neuropathic pains are trauma, infection, chronic irritation by adjacent tissue and so on. The iatrogenic trauma or infection also causes traumatic neuropathy, which may exert a bad influence on doctor-patient relationship. Some of related dental treatments are implantation (directly or indirectly through heating), root canal treatment, teeth extraction, block anesthesia, mandibular surgery. If inappropriate management is performed after nerve trauma, there will be many chances to develop chronic neuropathy for the patient. It is important that the sign of nerve trauma have to be caught by the practitioner as soon as possible and treated properly.

Drusini's and Takei's Methods for Age Estimation in Korean Adults / 대한법의학회지

Estimation of an individual's age has received considerable attention in forensic science. Several methods have been described, and abundant results have been obtained and evaluated. Among the numerous methods for dental age prediction in adults, the progressive diminution of the coronal pulp cavity and dental attrition have been primarily used. Although the reliability of age estimation methods using teeth has been demonstrated, correlation between methods has not been reported. Therefore, the aim of this study was to evaluate concurrence between Drusini's methods. We reanalyzed the age of 107 patients (64 male, 43 female) using Drusini's method. The ages had been previously estimated as ranging from 24 to 69 years using Takei's method. Our results revealed a strong correlation between the two methods (r=0.762) and suggest both methods to be suitable for application in Korean individuals younger than 50 years old. A previous study has shown Takei's and Drusini's methods to be reliable for forensic purposes. The strong correlation between the two methods in the present study suggests that it would be reasonable to use the most appropriate method for age estimation dependent on oral state.

A Rare Cause of Acute Upper Abdominal Pain: Diverticulitis of the 3rd Portion of the Duodenum

Duodenal diverticulitis is a rare cause of upper abdominal pain and is usually not considered when evaluating patients with acute upper abdominal pain. Furthermore, the duodenum is located near the pancreas and bile duct, and duodenal diverticulitis can be misdiagnosed as acute pancreatitis, cholangitis, cholecystitis, or other pancreatobiliary disorders such as pancreatic cystic neoplasms. Recently, we experienced a rare case of duodenal diverticulitis in the 3rd portion of the duodenum. The patient presented with deep seated upper abdominal pain aggravated by supine posture and relieved by sitting up. The patient was initially diagnosed with acute pancreatitis. However, serum levels of pancreatic enzymes were normal and abdominal CT scan revealed diverticulitis in the 3rd portion of the duodenum. The patient was successfully managed conservatively. Delayed diagnosis of duodenal diverticulitis can result in substantial morbidity and mortality if duodenal perforation occurs and should be considered as a possible cause of upper abdominal pain.

Prevalence of Gastric Subepithelial Tumors in Korea: A Single Center Experience / 대한소화기학회지

BACKGROUND/AIMS: The incidental finding of gastrointestinal subepithelial tumors (SETs) is increasing with national cancer screening endoscopy. In a Swedish population, screening endoscopy found a prevalence of SETs of 0.36%. However, the prevalence of gastric SETs in Korean patients has not been described. Therefore, this study evaluated the prevalence of SETs of the stomach in a Korean patient population. METHODS: We reviewed endoscopic reports of 11,712 subjects who underwent screening esophagogastroduodenoscopy (EGD) at Hanyang University Hospital between July 2012 and June 2013. RESULTS: Among 11,712 patients, 194 (1.7%) had SET of the stomach. Of these, 71 (prevalence, 0.6%) were male and 123 (prevalence, 1.1%) were female. When grouped by age, the prevalence of SET was as follows: 1.0% for patients in their twenties, 6.2% for those in their thirties, 19.1% for those in their forties, 33.0% for those in their fifties, 30.4% for those in their sixties, and 10.3% for those over 70 years of age. CONCLUSIONS: The overall prevalence of gastric SET among healthy examinees was 1.7%. The prevalence of gastric SET increased with age and was higher in female.

Fulminant Hepatic Failure with Hepatitis B Virus Reactivation after Rituximab Treatment in a Patient with Resolved Hepatitis B / 대한소화기학회지

It is well known that the reactivation of hepatitis B virus (HBV) may occur as an acute hepatitis after chemotherapy or immunosuppressive therapy. Although most of these cases have been reported in HBsAg-positive patients, there have been a few reports of HBV reactivation in HBsAg-negative patients. There have been concerns for the need to screen the reactivation as well as anti-viral prophylaxis in HBsAg-negative patients with possible HBV occult infection who are planning to undergo chemotherapy or immunosuppressive therapy. Rituximab, an anti-CD20 monoclonal antibody, is effective in the treatment of non-Hodgkin's lymphoma. However, rituximab can affect the immunity against HBV, consequently increasing viral replication. In fact, there have been reports of HBV reactivation after treatment with rituximab. Here, we report a case of HBV reactivation following rituximab plus systemic chemotherapy in diffuse large B cell lymphoma patient who was HBsAg negative, anti-HBs positive, and anti-HBc positive, ultimately leading to treatment-unresponsive fulminant hepatic failure.

Asphyxial Death Using Plastic Bag / 대한법의학회지

Asphyxia due to plastic bag is not common. The manner of death may be accidental, suicidal or homicidal. We report an asphyxial death using plastic bag, giving us difficulty in determining the manner of death, suicidal or homicidal. A 32-year-old female was found dead in bathroom and her head was wrapped in a supermarket shopping bag sealed with adhesive tape around the neck. Strangely she was handcuffed behind the back of the victim. Because of no evidence of violence on the body and the presence of a suicide note at the scene, the manner of death was concluded as suicide. This case emphasizes that the interpretation of postmortem examination should be incorporated with the proper investigation of circumstances at the scene of death to determine the manner of death.

Mutation of the N-ras Gene in a Patient Suffering from the Blast Phase of Chronic Myelogenous Leukemia / 대한혈액학회지

The blast phase in chronic myelogenous leukemia (CML) is associated with mutation of several genes. It is well known that p53 gene mutation plays a key role in the myeloid or lymphoid blast phase of CML. But for the case of the N-ras gene, the association between N-ras mutations and the blast phase of CML is not yet known. We report here on a case of detecting N-ras point mutation without p53 mutation in a 64 year-old man who suffered from the lymphoblastic blast phase of CML.

T-cell Large Granular Lymphocytic Leukemia: A Case Report / 대한혈액학회지

T cell large granular lymphocytic leukemia (T-LGL leukemia) is defined as a clonal proliferative disorder of CD3+ cytotoxic T cells. T-LGL leukemia usually expresses CD3+, CD4-, CD8+, CD16+, CD56- and CD57+ cell markers, and this represents a rearrangement of the T cell receptor (TCR) gene. The clinical course is indolent in most cases, but on rare occasions, when CD3+ and CD56+ are expressed on the leukemic cells, it can be more aggressive. We experienced a patient with T-LGL leukemia and the disease was indolent at the time of diagnosis, and so any specific treatment was not required. Two years after the initial diagnosis, her clinical course became quite aggressive as the CD 56+ cell surface antigen was expressed. We report here on the first case of T-LGL leukemia in Korea and we review the relevant literature.

A Case of Resistant Polymyositis That Was Successfully Treated with Tacrolimus / 대한류마티스학회지

Polymyositis is one form of inflammatory myopathy. In some patients, this disease does not entirely respond to conventional initial therapy with glucocorticoid, methotrexate and azathioprine. Multiple options exist for treating these patients, but only intravenous immune globulin has been subjected to a randomized clinical trial. We report here on a case of polymyositis that did not respond to multiple drug therapy, but it did respond to tacrolimus. After treatment with tacrolimus, the patient's disease has been well controlled for many years.

Pathogenesis of Sudden Manhood Death Syndrome / 대한법의학회지

Sudden manhood death syndrome (SMDS) is a disorder found in southeast Asia, particularly Thailand, Philippines and Japan, which causes sudden cardiac death during sleep. In Korea, SMDS cases have been occasionally encountered in forensic autopsy practice. However, the incidence and pathogenesis has been rarely studied. This study to review chronologically the proposed pathogenesis of SMDS; pathology of cardiac conduction system, sleeping and breathing disorder, K+ and thiamine deficiency, mental stress, testosterone, hyperlipidemia, and narrow circumference of coronary artery. Brugada syndrome and SMDS are phenotypically, genetically and functionally the same disorder and Brugada syndrome has been a subject of intensive study since its early description in 1992. While Brugada syndrome is an inherited cardiac disorder caused by mutations in the SCN5A gene encoding the cardiac sodium channel alpha-subunit. less than 20% of its patients are known to be associated with SCN5A mutations. Moreover, the postmortem molecular screening of SCN5A mutations on formalin fixed paraffin embbeded cardiac tissues from SMDS cases has not been rewarding due to technical problems. The role of structural heart disease and sodium channel dysfunction in the induction of electrical instability in SMDS and Brugada syndrome is still debatable.

Colorectal Trauma by Compressed Air / 대한법의학회지

A seaman died after a jet of compressed air directed to his anus while working with his colleagues in deck of the ship. He suffered from abdominal pain and distension, and died 5 hours later in the ship. Autopsy was performed and revealed rupture of the splenic flexure of the colon and partial seromuscular tearing in the rectosigmoidal region. We concluded that the cause of death was tension pneumoperitoneum by the pneumatic colonic rupture. The need for education of the workers handling compressed air appliances is emphasized.

Sudden Death Due to a Ganglioglioma / 대한법의학회지

The incidence of sudden death due to undiagnosed primary intracranial tumor is very low in forensic autopsy practice. The ganglioglioma is a well differentiated, slow growing primary brain tumor that is encountered predominantly in childhood. We report a sudden, unexpected death in a 6-year-old girl from a ganglioglioma. On autopsy, there was an intraventricular tumor with recent hemorrhage, occupying the anterior aspect of the lateral ventricle and resulting in hydrocephalus. Acute intratumoral hemorrhage appears to be the mechanism of sudden death.