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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.
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BACKGROUND/AIMS: As the prevalence of diabetes mellitus and its complications increase rapidly, diabetic foot ulcers (DFUs), which are a major diabetic complication, are expected to increase. For prevention and effective treatment, it is important to understand the clinical course of DFUs. The aim of this study was to investigate the natural course and predictors of amputation in patients with DFUs who required hospitalization. METHODS: A total of 209 patients with type 2 diabetes, aged 30 to 85 years, who visited emergency department or needed hospitalization due to DFUs were consecutively enrolled from May 2012 to January 2016, by retrospective medical record review. The main outcome was lower extremity amputation (LEA). RESULTS: Among 192 patients who completed follow-up, 113 patients (58.9%) required LEAs. Compared to patients without amputation, baseline levels of white blood cell counts and C-reactive protein were higher in patients with amputation. In addition, bone and joint involvement was more frequently observed in patients with amputation. Multivariable regression analysis revealed that combined infection (odds ratio [OR], 11.39; 95% confidence interval [CI], 2.55 to 50.93; p = 0.001) and bone or joint involvement (OR, 3.74; 95% CI, 1.10 to 12.70; p = 0.035) were significantly associated with an increased risk of LEA. CONCLUSIONS: The depth of the wound and combined infection of DFU, rather than the extent of the wound, were significant prognostic factors of LEAs in patients with type 2 diabetes.
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Humanos , Amputação Cirúrgica , Proteína C-Reativa , Complicações do Diabetes , Diabetes Mellitus , Pé Diabético , Serviço Hospitalar de Emergência , Seguimentos , Hospitalização , Articulações , Contagem de Leucócitos , Extremidade Inferior , Prontuários Médicos , Prevalência , Prognóstico , Estudos Retrospectivos , Úlcera , Ferimentos e LesõesRESUMO
Emphysematous osteomyelitis, especially that involving the extra-axial skeleton, is an extremely rare presentation but associated with significant morbidity and mortality. Here, we report a case in which a 58-year-old female patient with diabetes mellitus presented with emphysematous osteomyelitis that involved the sternum, clavicle, and pelvic bone and was caused by Escherichia coli via hematogenous spread of urinary tract infection. We successfully treated her with urgent and aggressive surgical drainage with prolonged antibiotics therapy. Early diagnosis and immediate surgical intervention are required for better outcomes in cases of emphysematous osteomyelitis.
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Feminino , Humanos , Pessoa de Meia-Idade , Antibacterianos , Clavícula , Diabetes Mellitus , Drenagem , Diagnóstico Precoce , Escherichia coli , Escherichia , Mortalidade , Osteomielite , Ossos Pélvicos , Esqueleto , Esterno , Infecções UrináriasRESUMO
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.
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Adulto , Humanos , Masculino , Determinação da Idade pelos Dentes , Odontologia Legal , Ciências Forenses , Coreia (Geográfico) , Análise por Pareamento , Dente , Atrito DentárioRESUMO
No abstract available.