The stimulatory effect of Angelica tenuissima Nakai in osteoblastic/odontoblastic differentiation of human periodontal ligament stem cells / 대한치과재료학회지

Angelica tenuissima Nakai (ATN) is an herbal medicine used to treat toothache, headaches, and cold symptoms. However, the therapeutic effects of ATN have not been thoroughly identified. The purpose of this research was to explore the effect of ATN in osteo/odontoblastic differentiation of human periodontal ligament stem cells (hPDLSCs). The influences of ATN on the differentiation and proliferation of hPDLSCs were evaluated using alizarin red S staining, real-time PCR, western blot and MTT assay. ATN promoted osteo/odontoblastic differentiation of hPDLSCs, accelerated mineral nodule formation in vitro, and displayed no toxicity at higher concentrations. The mRNA expression levels of alkaline phosphatase (ALP), type I collagen (COL1), osteopontin (OPN), dentin matrix acidic phosphoprotein 1 (DMP-1), and dentin sialophosphoprotein (DSPP) in hPDLSCs and the protein levels of osteocalcin (OCN), DSPP, DMP-1, and Runx2 were significantly higher after ATN treatment. HEK293 cells overexpressing the osterix (OSX) gene and treated with ATN (100 µg/mL) showed an increase in BSP promoter activity.Those results suggest that ATN enhances the osteo/odontoblastic differentiation of hPDLSCs. These therapeutic properties of ATN can serve as a theoretical basis for further research on the applicability of ATN in periodontal tissue regeneration.

Sinus lifts in the presence of pseudoantral and mucous retention cysts

Objectives@#Mucous retention cysts and pseudoantral cysts are mainly located within the floor of the maxillary sinus. Most of these maxillary cysts are asymptomatic and often only require observation. However, the presence of these benign maxillary cysts may create problems when maxillary sinus all types of implants are needed. Various treatment methods have been introduced. The selected treatment option depends on the type, size, and location of the cyst and its symptoms. @*Patients and Methods@#The case reports of four patients with maxillary cysts were reviewed retrospectively. These patients received a sinus lift between January 2016 and October 2021 at the Wonkwang University Dental Hospital. @*Results@#To reduce unnecessary operations and the duration of treatment, a conservative treatment method is required. A sinus lift in the presence of maxillary cyst will not typically cause sinus problems if the lifted sinus membrane does not interfere with ventilation of the maxillary sinus. @*Conclusion@#When proper treatment is provided, sinus perforation during a sinus lift performed in the presence of maxillary cyst and contamination of bone graft materials by cystic fluid does not necessarily result in adverse outcomes.

Quantification of three-dimensional facial asymmetry for diagnosis and postoperative evaluation of orthognathic surgery / 대한악안면성형재건외과학회지

Background@#To evaluate the facial asymmetry, three-dimensional computed tomography (3D-CT) has been used widely. This study proposed a method to quantify facial asymmetry based on 3D-CT. @*Methods@#The normal standard group consisted of twenty-five male subjects who had a balanced face and normal occlusion. Five anatomical landmarks were selected as reference points and ten anatomical landmarks were selected as measurement points to evaluate facial asymmetry. The formula of facial asymmetry index was designed by using the distances between the landmarks. The index value on a specific landmark indicated zero when the landmarks were located on the three-dimensional symmetric position. As the asymmetry of landmarks increased, the value of facial asymmetry index increased. For ten anatomical landmarks, the mean value of facial asymmetry index on each landmark was obtained in the normal standard group. Facial asymmetry index was applied to the patients who had undergone orthognathic surgery. Preoperative facial asymmetry and postoperative improvement were evaluated. @*Results@#The reference facial asymmetry index on each landmark in the normal standard group was from 1.77 to 3.38. A polygonal chart was drawn to visualize the degree of asymmetry. In three patients who had undergone orthognathic surgery, it was checked that the method of facial asymmetry index showed the preoperative facial asymmetry and the postoperative improvement well. @*Conclusions@#The current new facial asymmetry index could efficiently quantify the degree of facial asymmetry from 3D-CT. This method could be used as an evaluation standard for facial asymmetry analysis.

Case series of cleidocranial dysplasia: Radiographic follow-up study of delayed eruption of impacted permanent teeth

This report describes 3 cases of cleidocranial dysplasia (CCD) and presents relevant findings on long-term follow-up radiographic images of impacted permanent teeth with delayed eruption. Radiographic images of 3 CCD patients were reviewed retrospectively. These images were mainly composed of panoramic and skull radiographs, and the follow-up periods were 3, 13, and 13 years, respectively. The distinct features revealed by the images were described, and the eruption state of impacted permanent teeth was evaluated. The features common to the 3 cases were multiple supernumerary teeth, the presence of Wormian bone, underdevelopment of the maxilla and the maxillary sinus, and clavicular hypoplasia. The eruption of impacted permanent teeth was not observed without proper dental treatment in adult CCD cases, even after long time periods had elapsed. When proper orthodontic force was applied, tooth movement was observed in a manner not significantly different from the general population.

Discovery and characterization of berberine derivatives as stimulators of osteoblast differentiation

Berberine has been used clinically for more than a decade to treat various diseases, has been shown to be effective in osteoblast differentiation, and is a potential treatment option for osteoporosis. However, compared with existing osteoporosis drugs, berberine is somewhat less effective. This study aimed to identify a new compound with efficacy superior to that of berberine. The osteogenic activities of various berberine derivatives were evaluated via cell differentiation in C2C12 preosteoblast cell lines. Alkaline phosphatase (ALP) staining assay and structure–activity relationship demonstrated that compound 2b had a potent osteogenic effect. Furthermore, compound 2b dose dependently increased ALP activity and showed no toxicity at the effective concentration, indicating its efficacy. Additionally, compound 2b upregulated BMP2-induced transcriptional activity in a promoter activity assay using ALP, BSP, and OC promoters.

Late complication of the Nuss procedure: recurrent cardiac tamponade / 영남의대학술지

Pectus excavatum (PE) is known as one of the most common congenital deformities of the anterior chest wall. The Nuss procedure is an effective surgical therapy to correct PE. Here, we report a case of recurrent cardiac tamponade due to hemopericardium that occurred after 16 months following the Nuss procedure. The cause of recurrent hemopericardium was thought to be local, repetitive irritation of the pericardium by the Nuss steel bar. We should keep in mind that this serious complication can occur after the Nuss procedure, even in the late phase.

Post-extraction pain in the adjacent tooth after surgical extraction of the mandibular third molar

BACKGROUND: After tooth extraction, pain due to dry socket and pain in the adjacent tooth are common. The aim of this study was to retrospectively analyze pain in the adjacent tooth after surgical extraction of the mandibular third molar. METHODS: Postoperative pain due to dry socket, pain in the adjacent tooth, and pain from other causes were present. Group A included patents with dry socket alone; group B included patients with pain in the adjacent tooth alone; and group C included patients with both. The duration of symptoms was recorded. In addition, the prognosis of pain was divided into the complete improvement, improvement, maintenance, deterioration, and complete deterioration groups. RESULTS: A total of 312 mandibular third molars were extracted from 13, 60, and 10 patients in groups A, B, and C, respectively. The mean duration of symptoms was 5 days in group A and B and 15.2 days in group C. There were statistically significant differences in the duration of symptoms between groups A and C and groups B and C. CONCLUSION: Pain in the adjacent tooth after third molar extraction can be caused by inflammatory reactions and pressure on this tooth. The pain caused by pressure on the periodontal ligament and alveolar bone results from the cytokines released by osteoclasts, which are responsible for bone destruction. However, pain from periodontal ligament damage caused by excessive pressure may be misunderstood as pulpal pain. Unconscious parafunctional habits, such as clenching and bruxism, could also be associated with post-extraction pain.

Late complication of the Nuss procedure: recurrent cardiac tamponade / 영남의대학술지

Pectus excavatum (PE) is known as one of the most common congenital deformities of the anterior chest wall. The Nuss procedure is an effective surgical therapy to correct PE. Here, we report a case of recurrent cardiac tamponade due to hemopericardium that occurred after 16 months following the Nuss procedure. The cause of recurrent hemopericardium was thought to be local, repetitive irritation of the pericardium by the Nuss steel bar. We should keep in mind that this serious complication can occur after the Nuss procedure, even in the late phase.

Protrusive maxillomandibular fixation for intracapsular condylar fracture: a report of two cases

Clinical limitations following closed reduction of an intracapsular condylar fracture include a decrease in maximum mouth opening, reduced range of mandibular movements such as protrusion/lateral excursion, and reduced occlusal stability. Anteromedial and inferior displacement of the medial condyle fragment by traction of the lateral pterygoid muscle can induce bone overgrowth due to distraction osteogenesis between the medial and lateral condylar fragments, causing structural changes in the condyle. In addition, when conventional maxillomandibular fixation (MMF) is performed, persistent interdental contact sustains masticatory muscle hyperactivity, leading to a decreased vertical dimension and premature contact of the posterior teeth. To resolve the functional problems of conventional closed reduction, we designed a novel method for closed reduction through protrusive MMF for two weeks. Two patients diagnosed with intracapsular condylar fracture had favorable occlusion after protrusive MMF without premature contact of the posterior teeth. This particular method has two main advantages. First, in the protrusive position, the lateral condylar fragment is moved in the anterior-inferior direction closer to the medial fragment, minimizing bone formation between the two fragments and preventing structural changes. Second, in the protrusive position, posterior disclusion occurs, preventing masticatory muscle hyperactivity and the subsequent gradual decrease in ramus height.

Protrusive maxillomandibular fixation for intracapsular condylar fracture: a report of two cases

Clinical limitations following closed reduction of an intracapsular condylar fracture include a decrease in maximum mouth opening, reduced range of mandibular movements such as protrusion/lateral excursion, and reduced occlusal stability. Anteromedial and inferior displacement of the medial condyle fragment by traction of the lateral pterygoid muscle can induce bone overgrowth due to distraction osteogenesis between the medial and lateral condylar fragments, causing structural changes in the condyle. In addition, when conventional maxillomandibular fixation (MMF) is performed, persistent interdental contact sustains masticatory muscle hyperactivity, leading to a decreased vertical dimension and premature contact of the posterior teeth. To resolve the functional problems of conventional closed reduction, we designed a novel method for closed reduction through protrusive MMF for two weeks. Two patients diagnosed with intracapsular condylar fracture had favorable occlusion after protrusive MMF without premature contact of the posterior teeth. This particular method has two main advantages. First, in the protrusive position, the lateral condylar fragment is moved in the anterior-inferior direction closer to the medial fragment, minimizing bone formation between the two fragments and preventing structural changes. Second, in the protrusive position, posterior disclusion occurs, preventing masticatory muscle hyperactivity and the subsequent gradual decrease in ramus height.

Correlations between anatomic variations of maxillary sinus ostium and postoperative complication after sinus lifting

OBJECTIVES: The maxillary sinus mucosa is reported to recover to preoperative sterility after sinus floor elevation. However, when drainage of maxillary sinus is impaired, recovery can be delayed and maxillary sinusitis can occur. Therefore, in this study, we investigated the correlations between anatomic variants that can interrupt the ostium of the maxillary sinus and incidence of complication after sinus lifting. MATERIALS AND METHODS: The subjects are 81 patients who underwent sinus lifting in Wonkwang University Dental Hospital (Iksan, Korea). Computed tomography (CT) images of the subjects were reviewed for presence of nasal septum deviation, anatomic variants of the middle turbinate, and Haller cells. Correlations between anatomic variations and occurrence of maxillary sinusitis were statistically analyzed. RESULTS: Patients with anatomic variants of ostio-meatal units, such as deviated nasal septum, concha bullosa or paradoxical curvature of the middle turbinate, or Haller cells, showed a higher rate of complication. However, only presence of Haller cell showed statistically significant. CONCLUSION: Before sinus lifting, CT images are recommended to detect anatomic variants of the ostio-meatal complex. If disadvantageous anatomic variants are detected, the use of nasal decongestants should be considered to reduce the risk of postoperative sinusitis.

Diseases having an influence on inhibition of angiogenesis as risk factors of osteonecrosis of the jaw

OBJECTIVES: The objective of this study was to retrospectively investigate the association of diseases having an influence on inhibition of angiogenesis such as hypertension, diabetes mellitus type II, hypercholesterolemia, and rheumatoid arthritis (RA) with the development of osteonecrosis of the jaws. MATERIALS AND METHODS: The 135 patients were allocated into 4 groups of bisphosphonate-related osteonecrosis of the jaw (BRONJ) group (1A); non-BRONJ group (1B); osteonecrosis of the jaw (ONJ) group (2A); and control group (2B), according to histologic results and use of bisphosphonate. This retrospective study was conducted with patients who were treated in one institute from 2012 to 2013. Fisher's exact test and logistic regression analysis were used to analyze the odds ratios of diseases having an influence on inhibition of angiogenesis for development of ONJ. RESULTS: The effects of diabetes and hypertension were not statistically significant on development of ONJ. When not considering bisphosphonate use, RA exhibited a high odds ratio of 3.23 (P=0.094), while hyperlipidemia showed an odds ratio of 2.10 (P=0.144) for development of ONJ. More than one disease that had an influence on inhibition of angiogenesis showed a statistically significant odds ratio of 2.54 (P=0.012) for development of ONJ. CONCLUSION: Patients without diseases having an influence on inhibition of angiogenesis were at less risk for developing ONJ.

Changes of lip morphology following mandibular setback surgery using 3D cone-beam computed tomography images / 대한악안면성형재건외과학회지

BACKGROUND: The aims of this study are to evaluate the lip morphology and change of lip commissure after mandibular setback surgery (MSS) for class III patients and analyze association between the amount of mandibular setback and change of lip morphology. METHODS: The samples consisted of 14 class III patients treated with MSS using bilateral sagittal split ramus osteotomy. Lateral cephalogram and cone-beam CT were taken before and about 6 months after MSS. Changes in landmarks and variables were measured with 3D software program Ondemand™. Paired and independent t tests were performed for statistical analysis. RESULTS: Landmarks in the mouth corner (cheilion, Ch) moved backward and downward (p .05, p < .005). On lateral view, upper lip prominent point (UP) moved downward and stomion moved backward and upward and the angle of Ls-UP-Stm (°) was decreased. Lower lip prominent point (LP) moved backward and downward, and the angle of Stm-LP-Li (°) was increased. Li moved backward. Finally, landmarks in the lower incisor tip (L1) moved backward and upward, but stomion moved downward. After surgery, lower incisor tip (L1) was positioned more superiorly than stomion (p < .05). There were significant associations between horizontal soft tissue and corresponding hard tissue. The posterior movement of L1 was related to statistically significantly about backward and downward movement of cheilion. CONCLUSIONS: The lip morphology of patients with dento-skeletal class III malocclusion shows a significant improvement after orthognathic surgery. Three-dimensional lip morphology changes in class III patients after MSS exhibited that cheilion moved backward and downward, upper lip projection angle became acute, lower lip projection angle became obtuse, change of upper lip area on lateral view was increased, change of lower lip area decreased, and morphology of lower lip was protruding. L1 was concerned with the lip tissue change in statistically significant way.

Advantages of intraoral and transconjunctival approaches for posterior displacement of a fractured zygomaticomaxillary complex / 대한악안면성형재건외과학회지

BACKGROUND: Fracture of the zygomaticomaxillary complex (ZMC) is one of the most common facial injuries. A previous study has performed 3D analyses of the parallel and rotational displacements that occur in a fractured ZMC. However, few studies have investigated adequate fixation methods according to these displacements. Here, we assessed whether specific approaches and fixation methods for displacement of ZMC fractures produce esthetic results. METHODS: Hospital records and pre- and post-surgical computed tomographic scans of patients treated for ZMC fractures at the Department of Oral and Maxillofacial Surgery, College of Dentistry, Wonkwang University, between January 2010 and December 2015, were selected. Data were analyzed according to the direction of displacement and post-reduction prognosis using a 3D software. RESULTS: With ZMC fractures, displacement in the posterior direction occurred most frequently, while displacement in the superior-inferior direction was rare. A reduction using a transconjunctival approach and an intraoral approach was statistically better than that using an intraoral approach, Gillies approach, and lateral canthotomy approach for a posterior displacement (P<0.05). CONCLUSIONS: When posterior displacement of a fractured ZMC occurs, use of an intraoral approach and transconjunctival approach simultaneously is recommended for reducing and fixing the displaced fragment accurately.

A Case of Extrinsic Compression of the Left Main Coronary Artery Secondary to Pulmonary Artery Dilatation

Extrinsic compression of the left main coronary artery (LMCA) secondary to pulmonary artery dilatation is a rare syndrome. Most cases of pulmonary artery hypertension but no atherosclerotic risk factors rarely undergo coronary angiography, and hence, diagnoses are seldom made and proper management is often delayed in these patients. We describe a patient that presented with pulmonary hypertension, clinical angina, and extrinsic compression of the LMCA by the pulmonary artery, who was treated successfully by percutaneous coronary intervention. Follow-up coronary angiography showed patent stent in the LMCA in the proximity of the dilated main pulmonary artery. This case reminds us that coronary angiography and percutaneous coronary intervention should be considered in pulmonary hypertension patients presenting with angina or left ventricular dysfunction.

Treatment of a Huge Odontogenic Myxoma in the Mandible with Surgical Resection and Reconstruction Using a Vascularized Fibular Free Flap: Case Report

Early Stage Loeffler's Endocarditis Detected by Transthoracic Echocardiography / 영남의대학술지

Loeffler's endocarditis involves progressive eosinophilic infiltration of the endocardium, which leads to apical thrombotic obliteration of the ventricle and endomyocardial fibrosis, that may finally represent a characteristic feature of restrictive cardiomyopathy. This paper presents a case of a 44-year-old male with symptoms of dyspnea and peripheral hypereosinophilia, who was diagnosed with early stage Loeffler's endocarditis via multicardiac imaging modalities.

Malignant Tumors of the Hand

PURPOSE: Malignant tumors of the hand occurred very rarely and optical surgical treatment and prognosis are not clearly established. We report the clinical characteristics and treatment outcomes of primary and metastatic bone and soft tissue tumors during last twenty years with a review of literatures. MATERIALS AND METHODS: We reviewed 20 cases of malignant tumors in the hand (7 cases of acrometastasis, 9 cases of malignant melanoma, 2 cases of chondrosarcoma and 2 cases of squamous cell carcinoma) retrospectively. RESULTS: Patients of early Clark stage (I to III) of malignant melanoma survived after wide resection or ray amputation. But patients with late Clark stage (IV to V) expired associated with distant metastasis. All seven patients with acrometastasis expired in 6.3 months after diagnosis of metastasis. Two patients with chondrosarcoma survived without recurrence. Among patients with squamous cell carcinoma, one patient is free of disease after wide resection, but the other was dead due to metastasis. CONCLUSION: Good results might be attained after surgical treatment of malignant tumors of the hand by proper surgical technique to minimize loss of hand function and systemic evaluation of metastasis.

Production of Antihypertensive Angiotensin I-Converting Enzyme Inhibitor-Enriched Edible Yeast Using Gugija (Lycium chinesis Mill)

To produce bioactive compound enriched yeast using medicinal Gugiga (Lycium chinensis Mill), several edible Saccharomyces species were cultured in Gugija extracts added yeast extract, peptone and dextrose medium (GE - YEPD medium) at 30degrees C for 24 hr, and their growth were determined. Growth of Saccharomyces cerevisiae K-7 and Sacchromyces cerevisiae ACTC 7904 were better than those of the other yeasts. Two yeasts were selected and then determined their some physiological functionalities after cultivated the yeasts in the GE - YEPD medium and compared those grown on YEPD medium. Antihypertensive angiotensin I-converting enzyme (ACE) inhibitory activity of S. cerevisiae K-7 grown on GE - YEPD medium was about 20% higher than that grown on YEPD medium. Superoxide dismutase-like activity of S. cerevisiae ACTC 7904 was also about 12% more high. However, the other physiological functionalities were almost same or lower. Optimal addition concentration of Gugija extract was 10%, and maximally growth and ACE inhibitory activity of S. cerevisiae K-7 were shown when the strain was cultured in 10% Gugija extracts containing YEPD medium at 30degrees C for 12 hr.

The Role of Dynamic CT for the Differential Diagnosis of Solitary Pulmonary Nodule / 영남의대학술지

BACKGROUND: Malignant pulmonary nodules account for 30 to 40 percent of all solitary pulmonary nodules (SPNs). Therefore, characterization of SPNs is very important for treatment. Recently, dynamic CT has been widely used for tissue characterization and formation of differential diagnoses. The purpose of this study was to evaluate the ability of dynamic CT to formulate the differential diagnosis of SPNs. MATERIALS AND METHODS: Nineteen patients with SPNs underwent dynamic CT (unenhanced scans, followed by a series of images at 20, 40, 60, 80, 100, 120, 140, 160, and 180 sec after intravenous injection of contrast medium). Diagnosis of SPN was performed based on pathologic findings in needle biopsy samples. Peak enhancement, net enhancement, slope of enhancement, and maximum relative enhancement ratio of the SPN were measured on dynamic CT, and Levene's test was performed to assess benignancy and malignancy. RESULTS: Twelve SPNs were confirmed to have malignant pathology. There were no significant differences between benign and malignant nodules with respect to peak enhancement (p=0.787), net enhancement (p=0.135), or slope of enhancement (p=0.698). The maximal enhancement ratio was increased in malignancy compared to benignancy, but the difference was not statistically significant (p=0.094). CONCLUSION: In our study, the hemodynamic characteristics of dynamic CT were not significantly different between benign and malignant nodules. Therefore, long-term studies of larger patient samples are required to confirm our findings.