Journal of The Korean Dental Society of Anesthesiology
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v.13
no.4
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pp.203-207
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2013
Aplastic anemia (AA) is a serious hematologic disease characterized by hypocellular bone marrow and deficient production of erythrocytes, granulocytes and platelets. Serious complications such as uncontrolled bleeding and bacteremia can occur. A case of severe AA are presented with dental considerations. A 4-year-old boy had been referred from Seoul National University Hospital for dental examination before the hematopoietic stem cell transplantation (HSCT). Treatments were planned under general anesthesia, due to the poor compliance. Following medical consult, dental treatments were performed after platelet transfusion and antibiotic prophylaxis. Postoperatively, neither significant bleeding nor complictation was observed. On the time of the treatment planning. the anesthesiologist and dentist should perform a complete hematological assessment. It is imperative not only platelet counts but also other leukocyte counts are under safe boundaries. It is mandatory to follow strict aseptic precautios for all anesthetic and surgical maneuvers. In severe thrombocytopenic patients, platelet transfusion should be considered. Also, it is recommended to establish a good oral hygiene.
Sun Murray Han;Hye Young Na;Onju Ham;Wanho Choi;Moah Sohn;Seul Hye Ryu;Hyunju In;Ki-Chul Hwang;Chae Gyu Park
IMMUNE NETWORK
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v.16
no.1
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pp.61-74
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2016
Dendritic cells (DCs) are professional antigen-presenting cells that sample their environment and present antigens to naïve T lymphocytes for the subsequent antigen-specific immune responses. DCs exist in a range of distinct subpopulations including plasmacytoid DCs (pDCs) and classical DCs (cDCs), with the latter consisting of the cDC1 and cDC2 lineages. Although the roles of DC-specific transcription factors across the DC subsets have become understood, the posttranscriptional mechanisms that regulate DC development are yet to be elucidated. MicroRNAs (miRNAs) are pivotal posttranscriptional regulators of gene expression in a myriad of biological processes, but their contribution to the immune system is just beginning to surface. In this study, our in-house probe collection was screened to identify miRNAs possibly involved in DC development and function by targeting the transcripts of relevant mouse transcription factors. Examination of DC subsets from the culture of mouse bone marrow with Flt3 ligand identified high expression of miR-124 which was able to target the transcript of TCF4, a transcription factor critical for the development and homeostasis of pDCs. Further expression profiling of mouse DC subsets isolated from in vitro culture as well as via ex vivo purification demonstrated that miR-124 was outstandingly expressed in CD24+ cDC1 cells compared to in pDCs and CD172α+ cDC2 cells. These results imply that miR-124 is likely involved in the processes of DC subset development by posttranscriptional regulation of a transcription factor(s).
The purpose of this study was to investigate whether the ashed tooth powder is utilized as an alternative material of the implant to recovery the bony defect. For this purpose its biocompatibility was evaluated comparing to the synthetic calcium phosphate compounds, such as Syntograft and Calcitite, as well as the vacuum firing porcelain (Ceramco Inc.) which is anticipated to use as a matrix to aid sintering. Bony defects to exposure the bone marrow, $3{\times}5$ mm in size, were created in the right and left tibias of fifteen rabbits, and then the ashed tooth powder at $950^{\circ}C$, the porcelain powder, Syhtograft and Calcitite were inserted in the defects of twelve rabbits of the experimental group and the blood clot only was filled in the defects of three rabbits of the control group. The experimental and control rabbits were sacrificed at 1st, 2nd 3rd week after implantation and the histologic examination was performed. The ashed tooth powder in order to make the needed form of the implant was molded using the cylindrical mold 1 cm high, 1 cm in diameter under the pressure of $1000kg/cm^2$ and the ashed tooth powder was sintered at $1100^{\circ}C$ for 1 hour and the mixture of the porcelain powder and the ashed tooth powder at the weight ratio of 7:3, 6:4, 5:5, 4:6 were molded in the same manner and were sintered at $925^{\circ}C$. From this sintered material, square shaped implants were prepared in the dimension of $2{\times}4{\times}6mm$. The prepared implants were surgically placed in the subperiosteum of lateral surfaces of the right and left mandibular bodies. The dogs were sacrificed at 4 weeks, and then the specimens were examined using the light and scanning electron microscopes. The results of this study were obtained as follows: 1. Any inflammatory response was not noted after implanting of the ashed tooth powder, Syntograft, Calcitite and the porcelain powder during the whole experimental period after implantation. 2. Induction of the new bone formation was significantly shown in the ashed tooth powder, Syntograft and Calcitite. 3. The more the porcelain powder was contained in the implants, the more the porosity was and the bigger the pore size was under the scanning electron microscope. And there was ingrowing of the fibrous connective and the osteoid tissue. 4. The osteoid tissues were found to be directly fused to the implant of the ashed tooth powder, and the mixture implant of the porcelain powder and the ashed tooth powder at the weight ratio of 4:6 under the light and scanning electron microscopes.
The silkworm extract powder contain 1-deoxynojirimycin (DNJ), a potent ${\alpha}$-glycosidase inhibitor, has therapeutic potency against diabetes mellitus. Therefore, natural products containing DNJ from mulberry leaves and silkworm are consumed as health functional food. The present study was performed to evaluate the safety of the silkworm extract powder, a health food which containing the DNJ. The repeated toxicity studies and gentic toxicity studies of the silkworm extract powder were performed to obtain the data for new functional food approval in MFDS. The safety was evaluated by a single-dose oral toxicity study and a 90 day repeated-dose oral toxicity study in Sprague-Dawley rats. The silkworm extract powder was also evaluated for its mutagenic potential in a battery of genetic toxicity test: in vitro bacterial reverse mutation assay, in vitro chromosomal aberration test, and in vivo mouse bone marrow micronucleus assay. The results of the genetic toxicology assays were negative in all of the assays. The approximate lethal dose in single oral dose toxicity study was considered to be higher than 5000 mg/kg in rats. In the 90 day study, the dose levels were wet at 0, 500, 1000, 2000 mg/kg/day, and 10 animals/sex/dose were treated with oral gavage. The parameters that were monitored were clinical signs, body weights, food and water consumptions, ophthalmic examination, urinalysis, hematology, serum biochemistry, necropsy findings, organ weights, and histopathological examination. No adverse effects were observed after the 90 day administration of the silkworm extract powder. The No-Observed-Adverse-Effect-Level (NOAEL) of silkworm extract powder in the 90 day study was 2000 mg/kg/day in both sexes, and no target organ was identified.
Kim, Tae-Yon;Yoon, Hyeong-Kyu;Moon, Hwa-Sik;Park, Sung-Hak;Min, Chang-Ki;Kim, Chun-Choo;Jung, Jung-Im;Song, Jeong-Sup
Tuberculosis and Respiratory Diseases
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v.49
no.2
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pp.198-206
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2000
Background : Pulmonary complications following bonemarrow transplantation (BMT) are common and associated with a high mortality rate. We investigated the yield, safety, and impact of fiberoptic bronchoscopy (FOB) for diagnosis of postBMT pneumoniae. Methods : From May 1997 to April 2000, 56 FOBs were performed in 52 post BMT patients for clinical pneumoniae. BMT patients with respiratory symptoms and/or pulmonary infiltrates had a thoracic HRCT(high resolution computed tomography) and bronchoscopic examination including BAL (bronchoalveolar lavage), TBLB (transbronchial lung biopsy), PSB (protected specimen brush). Results : The characteristics of the subjects were as follows : 37 males, 15 females, mean age of 31.3 years(l7-45), 35 sibling donor allogenic BMTs, 15 nonrelated donor allogenic BMTs, and 2 autologous BMTs. Fiftynine percent of FOBs (33 FOBs, 31 patients) were diagnostic. Isolated pathogens included the following : 12 cytomegalovirus (CMV) (21.4 %), 7 pneumocystis carinii (PC) (12.5 %), 11 CMV with PC (19.6 %), 2 Mycobacaterium tuberculosis (3.6%), and 1 streptococcus (1.8%). Most of the radiographic findings were diffuse interstitial lesions. CMV pneumoniae had mainly diffuse interstitial nodular lesion, and PC pneumoniae had diffuse, interstitial ground glass opacity(GGO). When CMV was accompanied by PC, a combined pattern of nodular and GGO was present. Of the 56 cases (23.2%), 13 died of CMV pneumoniae (n=2), PCP (n=2),mixed infection with CMV and PC (n=3), underlying GVHD (n=1), underlying leukemia progression (n=1), or respiratory failure of unknown origin (n=4). There was no major complication by bronchoscopy. Only 3 cases developed minor bleeding and 1 episode temporary hypoxemia. Conclusion : Based on our findings, CMV and PC are the major causes of postBMT pneumoniae. In addition, BAL can be considered a safe and accurate procedure for the evaluation of pulmonary complications after BMT.
A clinical review of 31 cases of multiple myeloma which were diagnosed by criteria of the SWOG between May 1983 and February 1990 at Yeungnam University Hospital was done. The results were as followings : 1. The peak incidence was in 7th decade and male to female ratio was 1.8 : 1. 2. The most common presenting symptom at first diagnosis was bone pain (58%), but fever, dyspnea, dizziness and palpable mass were also noted. 3. The distribution of laboratory findings as following diagnostic criteria of Southwest oncology group(SWOG) : plasmacytoma on tissue biopsy was noted 6 cases, bone marrow plasmacytosis with more than 10% plasma cells was 22 cases, monoclonal globulin spike on serum electrophoresis was 24 cases, lytic bone lesions was observed 22 cases. 4. Initial clinical stages were classified as 2 cases in stage I, 3 cases in stage II, 26 cases in stage III(84%) 5. Immunoelectrophoresis revealed the distribution of IgG 64%, light chain 22%, IgA 10%. Kappa to Lambda ratio of 1.1 : 1. 6. Hematologic & biochemical fingins revealed anemia with <8.5% of hemoglobulin in 42%, hypercalcemia with < 10.6mg% of serum calcium in 22%, azotemia >2.0mg% of serum creatinine in 19%. 7. The multiple punched out lesion of bone x-ray examination were noticed skull(65%), rib(42%), L-spine(35%), pelvis(23%), T-spine(19%). The initial skeletal roentgenographic findings showed osteoporosis, osteolytic lesion and fracture in 55%, only osteolytic lesion in 23%, only osteoporosis in 10%. 8. Complications of multiple myeoloma, such as 10 cases of renal impairment, 8 cases of infection, 16 cases of compression fracture of spine were observed.
Journal of the korean academy of Pediatric Dentistry
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v.34
no.3
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pp.468-472
/
2007
The Wiskott-Aldrich Syndrome (WAS) is an inherited immunodeficiency caused by a variety of mutations in the gene encoding the WAS protein (WASp). First described in 1937 by Wiskott, the incidence of WAS has so far been estimated at 4 in 106 live births. The Wiskott-Aldrich Syndrome is an X-linked condition characterized by 1) an increased tendency to bleed caused by a reduced number of platelets, 2) recurrent bacterial, viral and fungal infections, and 3) eczema of the skin. The purpose of this report is to present cases highlighting the clinical features of the syndrome and the required considerations in the treatment of patients. The report consists of two particular cases: a 2-year-11-month-old boy seen for a routine oral examination prior to his bone marrow transplantation and a 2-year-6-month-old boy with herpes gingivostomatitis and teeth discoloration.
Ye, Yuan-Xin;Zhou, Juan;Zhou, Yan-Hong;Zhou, Yi;Song, Xing-Bo;Wang, Jun;Lin, Li;Ying, Bin-Wu;Lu, Xiao-Jun
Asian Pacific Journal of Cancer Prevention
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v.15
no.22
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pp.9961-9966
/
2014
Background: Some reports have suggested that chronic myeloid leukemia (CML) patients have a higher prevalence of M-bcr than acute lymphoblastic leukemia (ALL) patients, which show a higher prevalence of m-bcr. However, the relationship between BCR-ABL subtypes and progression of CML and ALL remains unclear. Materials and Methods: 354 CML chronic phase (CML-CP) patients, 26 CML blastic phase (CML-BP) patients and 72 ALL patients before treatment with BCR-ABL positive were recruited for blood routine examination and bone marrow smear cytology. Some 80 CML-CP and 32 ALL patients after imatinib (IM) treatment were followed-up for BCR-ABL relative concentrations detected after treatment for 3, 6 and 9 months and 1 year. Results: Before treatment, CML-CP patients showed lower BCR-ABL relative concentrations with a higher proportion of M-bcr (42.7%) compared to CML-BP and ALL patients while ALL patients had a higher BCR-ABL relative concentration with high expression of m-bcr (51.4%). Patients with M-bcr demonstrated higher WBC counts than those with m-bcr and the mixed group and higher PLT counts were noted in the CML-CP and ALL groups. After imatinib (IM) treatment, patients with m-bcr showed higher BCR-ABL relative concentrations in both CML-CP and ALL groups. Conclusions: This study identified the BCR-ABL gene as an important factor in CML and ALL cases. The M-bcr subtype was associated more with CML while the m-bcr subtype was associated more with ALL. Patients with m-bcr seem to have a poorer response to IM in either CML or ALL patients compared to M-bcr patients.
Acute respiratory distress syndrome (ARDS) has been reported to be associated with a variety of medical and surgical conditions, including All-trans-retinoic acid (ATTA). ATRA is very efficaceous drug to acute promyelocytic leukemia (APL). This drug can induce complete remission at APL without fatal risk of disseminated intravascular coagulation. But ATRA treatment, sometimes, produces the symptoms of fever, weight gain and acute respiratory distress, renal function impairment. The causes of these symptoms are not fully proved, but supposed as the result of leukostasis and capillary leak syndrome from excessive leukocyte differentiation and cytokines release. Recently, we experienced a 24-year-old woman who complained gum bleeding for 6 days. At bone marrow biopsy, she was diagnosed as APL. 2 days after ATRA treatment, she was suffered from the symptoms of dyspnea and general ache. At laboratory examination, total leukocyte count was 50,400/$mm^3$, $PaO_2$ was 42.5 mm Hg and chest PA revealed the findings compatible with ARDS. Treatment with low dose ara-C, corticosteroid and general supportive cares were tried. Within 3 days after treatment, the patient recovered from ARDS by evidence of arterial blood gas study and chest radiographs. She has acquired complete remission of APL with maintenance of A TRA. And so, we present this case with a review of related literatures.
Recently, the interest in the orthodontic treatment for children is increased by a rise in national income level. The number of cephalometric radiography that could diagnose a malocclusion and malposition between teeth and jawbone increased. It required attention to radiation exposure, because the subject of dental examination is children which are more sensitive to radiation and the head and neck, the object of that include radiation sensitive organ such as the thyroid, bone marrow, eyes, salivary gland, and so on. In this study, we measured two-dimensional dose distribution in cephalometric radiography system (VATEC Pax-400C) using Agfa CP-G Plus film and MagicMax Dosimeter, and calculated radiation organ dose of head and neck through MCNPX simulation. And then we designed a radiation protective device to decrease radiation dose. The dose distribution of the cephalometric radiography system irradiated the head and neck overall as well as the oral and maxillofacial parts. The radiation organ dose calculated that thyroid, oesophagus and eyes are irradiated high, and the radiation organ dose decreased about 70 ~ 80% by the application of the radiation protective device. The results of this study will be used construction of database for dental radiation exposure and research of reducing radiation dose.
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