Long-term observation of the mineral trioxide aggregate extrusion into the periapical lesion: a case series / 国际口腔科学杂志·英文版

One-step apexification using mineral trioxide aggregate (MTA) has been reported as an alternative treatment modality with more benefits than the use of long-term calcium hydroxide for teeth with open apex. However, orthograde placement of MTA is a challenging procedure in terms of length control. This case series describes the sequence of events following apical extrusion of MTA into the periapical area during a one-step apexification procedure for maxillary central incisor with an infected immature apex. Detailed long-term observation revealed complete resolution of the periapical radiolucent lesion around the extruded MTA. These cases revealed that direct contact with MTA had no negative effects on healing of the periapical tissues. However, intentional MTA overfilling into the periapical lesion is not to be recommended.

Prognostic Significance of Thyroid Autoantibodies in Urticaria / 대한피부과학회지

BACKGROUND: The association between chronic urticaria and thyroid autoantibodies is now generally accepted, and some authors recommend screening for thyroid autoimmunity and function in all patients with chronic urticaria for early identification of patients who might require treatment of underlying thyroid dysfunction or follow-up. However, the prognostic significance of thyroid autoantibodies in urticaria patients is still unclear. OBJECTIVE: To evaluate antibody reactivity as a prognostic factor, the association between antibody positivity and disease duration were analyzed. METHODS: Medical records from March 2002 to October 2010 of urticaria patients (M: 41, F: 125), who were tested for thyroid auto-antibodies at their first visit, were collected and reviewed for the duration of urticaria. Patients with a 6-week or longer history of urticaria were categorized into the chronic urticaria group; patients whose urticaria resolved within 6 weeks were categorized into the acute urticaria group. RESULTS: A positive result to the thyroid autoantibody was shown by 28.9% of chronic urticaria patients and 10.7% of acute urticaria patients. Average duration of urticaria in patients who were thyroid autoantibody positive was 33.9 weeks, while patients with thyroid autoantibody negative tests had urticaria for 6.9 weeks on average. The frequency of a positive result to only the thyroid peroxidase antibody was different between the chronic urticaria group (15.6%) and the acute urticaria group (2.5%). CONCLUSION: According to our results, the average duration of urticaria in patients with thyroid autoantibodies was significantly longer than in urticaria patients without thyroid autoantibodies. Thyroid autoantibodies were statistically meaningful prognostic factors predicting the duration of urticaria.

Vitamin K1 Dermatitis / 대한피부과학회지

Vitamin K1 dermatitis is a cutaneous adverse reaction to vitamin K1, and this malady presents as an erythematous eczematoid patch or pseudoscleroderma. At first, liver disease was thought to be related to vitamin K1 dermatitis. However, it is no longer considered as being related to liver disease due to the increasing case reports of patients with vitamin K1 dermatitis and who are without liver disease. Type IV hypersensitivity reaction was suspected to be the cause of this reaction. This disease can be easily ignored because of its low incidence. We hereby report on a case of vitamin K1 dermatitis that was confirmed by a skin test.

Pedunculated Sclerotic Fibroma Resembling Soft Fibroma / 대한피부과학회지

Sclerotic fibroma is a rare skin neoplasm that can occur seen sporadically or in association with Cowden's disease. Clinically, it presents as asymptomatic flesh-colored or pinkish slow-growing papules or nodules with a wide anatomical distribution. We report a rare case of pedunculated type of sclerotic fibroma resembling soft fibroma, which has not been reported in Korea.

Acral Lentiginous Melanoma Developing during Long-standing Atypical Melanosis: Usefulness of Dermoscopy for Detection of Early Acral Melanoma

Clinical guidelines suggest that suspicious pigmented lesions of the plantar or palmar area require biopsy for early detection of acral melanoma. We present here a case of acral lentiginous melanoma in which various melanocytic atypia was observed at each biopsy site, including focal melanocytic proliferation. We suggest that this atypical melanosis is part of a contiguous phase of invasive tumor growth, which is known as the very early stage of melanoma in situ. In addition, noninvasive dermoscopy has been effective for the early discovery of hidden lesions of acral melanoma.

Kaposi's Sarcoma in a Patient with Iatrogenic Cushing's Syndrome / 대한피부과학회지

Kaposi's sarcoma (KS) is a multifocal proliferative vascular tumor involving cutaneous and extra-cutaneous tissues. KS has been reported in patients treated with immunosuppressive agents for autoimmune diseases. However, KS has rarely been reported in patients with iatrogenic Cushing's syndrome. A 77-year-old woman was evaluated with multiple asymptomatic violaceous nodules and plaques on both lower legs. She had been diagnosed with iatrogenic Cushing's syndrome and had been treated with low-dose corticosteroid replacement therapy for >10 years. A histopathologic study showed extensive vascular proliferation in the dermis with spindle-shaped cells. Immunohistochemical staining for CD31, CD34, human herpesvirus (HHV)-8, and D2-40 was positive. We hereby report a case of KS in a patient with iatrogenic Cushing's syndrome.

Birt-Hogg-Dube Syndrome, a Rare Case in Korea Confirmed by Genetic Analysis

Simple benign tumors can present as part of a syndrome with substantial mortality. Fibrofolliculomas are benign skin tumors most often associated with the Birt-Hogg-Dube syndrome (BHDS). The most life-threatening complication of this syndrome is renal cancer and other major features include multiple lung cysts and spontaneous pneumothorax. We present the case of a 54 year-old man with multiple flesh-colored papules on his face confirmed histologically as fibrofolliculomas. He had a history of recurrent pneumothorax and chest computed tomography showed multiple lung cysts. To confirm the diagnosis of BHDS, we conducted gene analysis that revealed a single nucleotide duplication in the folliculin (FLCN) gene (Exon 11, C.1285dupC). BHDS confirmed by the FLCN gene mutation is rarely reported in Korea. Appropriate investigation is recommended whenever a patient with benign skin tumors is encountered.

Poststeroid Panniculitis in an Adult / 대한피부과학회지

Poststeroid panniculitis is a very rare complication of corticosteroid therapy, and this is characterized by firm subcutaneous nodules on the cheek, neck or upper trunk within days or weeks following rapid systemic steroid tapering or cessation in childhood. It can be identified by the clinical features and a history of using steroid, and if necessary, with a biopsy. There have been just 2 reported cases in adulthood, one was an autopsy case of a 28-year woman and another was a 60-year-old man after massive administration of corticosteroids for congestive heart failure. Herein, we report a case of panniculitis accompanied by Cushing's syndrome in an adult after long-term misuse of systemic steroid for rosacea.

A Case of Axillar Syringomas

Syringoma is common benign neoplasm that is mostly seen around the eyes. However these tumors can occur in atypical locations such as the axilla. Although the axilla is possible site for syringoma, no previous case of syringoma limited to the axilla has been reported in Korea. We report here on a case of syringoma that appeared as grouped yellow-brownish papules limited to the axillae of a 24-year-old woman.

A Case of Cutaneous Inflammatory Myofibroblastic Tumor

Pseudo-inflammatory tumors are also known as plasma cell granuloma, inflammatory pseudo-tumor and inflammatory myofibroblastic tumor, and these tumors are a group of highly variable proliferations of myofibroblastic cells that are associated with a prominent inflammatory infiltrate. This tumor is known to most commonly occur in the lungs, bladder and gastrointestinal system with only a few cases having been reported in the skin. A previously healthy 26-year-old man presented with a 6-year history of an intermittently pruritic lesion on his back. On the histologic examination, there were spindle cells in fascicles and a mixed inflammatory cellular infiltrate of plasma cells and lymphocytes. A diagnosis of inflammatory fibroblastic tumor was made and the nodule was surgically removed. We report here on an additional case of this rare cutaneous entity, and it is probably the first such report from Korea.

Fracture resistance of crown-root fractured teeth repaired with dual-cured composite resin and horizontal posts / 대한치과보존학회지

The purpose of this study was to investigate the fracture resistance of crown-root fractured teeth repaired with dual-cured composite resin and horizontal posts. 48 extracted human premolars were assigned to control group and three experimental groups. Complete crown-root fractures were experimentally induced in all control and experimental teeth. In the control group, the teeth (n=12) were bonded with resin cement and endodontically treated. Thereafter, the access cavities were sealed with dual-cured composite resin. In composite resin core - post group (n=12), the teeth were endodontically treated and access cavities were sealed with dual-cured composite resin. In addition, the fractured segments in this group were fixed using horizontal posts. In composite resin core group (n=12), the teeth were endodontically treated and the access cavities were filled with dual-cured composite resin without horizontal posts. In bonded amalgam group (n=12), the teeth were endodontically treated and the access cavities were sealed with bonded amalgam. Experimental complete crown-root fractures were induced again on repaired control and experimental teeth. The ratio of fracture resistance to original fracture resistance was analyzed with Kruskal-Wallis test. The results showed that teeth in control and composite resin core - post group showed significantly higher resistance to re-fracture than those in amalgam core group (p < 0.05). The resistance to refracture was high in the order of composite resin - post group, control group, composite resin group and bonded amalgam group. Within the scope of this study, the use of horizontal post could be beneficial in increasing the fracture resistance of previously fractured teeth.

Ingredients and cytotoxicity of MTA and 3 kinds of Portland cements / 대한치과보존학회지

The aim of this study was to compare the compositions and cytotoxicity of white ProRoot MTA (white mineral trioxide aggregate) and 3 kinds of Portland cements. The elements, simple oxides and phase compositions of white MTA (WMTA), gray Portland cement (GPC), white Portland cement (WPC) and fast setting cement (FSC) were measured by inductively coupled plasma atomic emission spectrometry (ICP-AES), X-ray fluorescence spectrometry (XRF) and X-ray diffractometry (XRD). Agar diffusion test was carried out to evaluate the cytotoxicity of WMTA and 3 kinds of Portland cements. The results showed that WMTA and WPC contained far less magnesium (Mg), iron (Fe), manganese (Mn), and zinc (Zn) than GPC and FSC. FSC contained far more aluminum oxide (Al2O3) than WMTA, GPC, and WPC. WMTA, GPC, WPC and FSC were composed of main phases, such as tricalcicium silicate (3CaO.SiO2), dicalcium silicate (2CaO.SiO2), tricalcium aluminate (3CaO.Al2O3), and tetracalcium aluminoferrite (4CaO.Al2O3.Fe2O3). The significance of the differences in cellular response between WMTA, GPC, WPC and FSC was statistically analyzed by Kruskal-Wallis Exact test with Bonferroni's correction. The result showed no statistically significant difference (p > 0.05). WMTA, GPC, WPC and FSC showed similar compositions. However there were notable differences in the content of minor elements, such as aluminum (Al), magnesium, iron, manganese, and zinc. These differences might influence the physical properties of cements.

An electrochemical study of the sealing ability of three retrofilling materials / 대한치과보존학회지

The purpose of this study was to evaluate the apical sealing ability of Super-EBA, MTA and Dyract-flow as retrofilling materials. Forty-eight extracted human teeth with straight and single root canal were used in this study. The root canals were prepared to a #40 apical canal size and obturated with gutter-percha. Apicoectomies were performed and root end cavities were prepared to a depth of 3mm using an ultrasonic device. The root end cavities were filled with Super-EBA, MTA or Dyract-flow. Leakage was measured using an electrochemical technique for 4 weeks. According to this study, the results were as follows. 1. Increasing leakage with time was observed in all groups. 2. No significant difference was noted among the 3 groups with time (p = 0.216). 3. No significant difference was noted among the 3 groups when measured within the same time interval (p = 0.814). The results of this study suggest that the sealing ability of Dyract-flow is equal to that of Super-EBA and MTA, and Dyract-flow may be an alternative to other materials for root-end filling.

IL-1 and TNF-alpha release in human polymorphonuclear leukocytes after exposure to calcium hydroxide treated Porphyromonas endodontalis lipopolysaccharide / 대한치과보존학회지

Bacterial lipopolysaccharide (LPS) plays a major role in stimulating the synthesis and release of the principal osteoclast-activating cytokines, namely, interleukin 1 and tumor necrosis factor-alpha from immune cells. Although monocytes/macrophages are the main producers of these cytokines, recent evidence has indicated that polymorphonuclear leukocytes (PMN) have the ability to release IL-1 and TNF-alpha. Calcium hydroxide has been shown to be an effective medicament in root canal infections, reducing the microbial titre within the canal. It has been proposed that the therapeutic effect of Ca(OH)2 may also be the result of direct inactivation of LPS. The purpose of this study was to investigate whether treatment of Porphyromonas endodontalis LPS with calcium hydroxide alters its biological action as measured by human PMN secretion of IL-1 and TNF-alpha, and it was compared with Escherichia coli LPS. P. endodontalis ATCC 35406 was cultured in anaerobic condition, and LPS was extracted using the hot-phenol water extraction method and purified. Purchased E. coli LPS was also purified. 100 microg/ml of each LPS in pyrogen free water were incubated with 25mg/ml Ca(OH)2 at 37degrees C for 7 days. The supernatants were subjected to ultrafiltration, and the isolates were lyophilized and weighed. PMNs were obtained from peripheral blood by centrifugation layered over Lymphoprep. The cells were resuspended (4x106 cells/ml) in RPMI 1640 followed by treatment with various concentrations of LPS (0, 0.1, 1, 10microg/ml) for 24 hours at 37degrees C in 5% CO2 incubator. The supernatants of cells were collected and the levels of IL-1alpha, IL-1beta and TNF-alpha were measured by enzyme-linked immunosorbent assay. The results were as follows; 1. The levels of IL-1alpha, IL-1beta, TNF-alpha from PMN treated with each LPS were significantly higher than those released from unstimulated PMN of the control group (p0.05). 3. The levels of secretion for all three cytokines were affected in a dose-dependent manner in PMN stimulated with each LPS (p0.05). 4. The levels of all three cytokines released from PMN stimulated with P. endodontalis LPS were significantly lower than those released from PMN stimulated with E. coli LPS (p<0.05).

Comparison of ultrasonic and sonic root end preparations using anaerobic bacterial leakage model / 대한치과보존학회지

No abstract available.