• Title/Summary/Keyword: Bone destruction

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Suppressive Effects of Haedongpi-san, a Traditional Herbal Medicine, on Collagen-induced Arthritis in Mice (해동피산(海桐皮散)의 콜라젠으로 유발된 류마티스관절염 억제 효과)

  • Kang, Sung-Youp;Jin, Mi-Rim;Choi, Jeong-June;Koo, Young-Sun;Roh, Seong-Soo;Kim, Dong-Hee
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.21 no.4
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    • pp.982-991
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    • 2007
  • The present study was done to assess the suppressive effects of Haedongpi-san(HDPS), a traditional herbal medicine, on collagen induced arthritis (CIA) in mice and to examined it's effects on immune system. Oral administration of HDPS (200 or 400 mg/Kg) significantly suppressed the progression of CIA, which extend is comparable to that of methotrexate (MTX, 30 mg/Kg), a positive control. Histological examinations reveled that HDPS inhibited infiltration of inflammatory cells into affected paw joint, and bone erosion and cartilage destruction were greatly reduced compared with control. In paw joint, the number of CD3+ cells and CD11b+/Gr-1+ cells were greatly reduced by HDPS. The levels of pathologic cytokines including TNF-a and IL-6 were significantly decreased in the serum by oral treatment with HDPS. The levels of $IFN-{\gamma}$ in the culture supernatant of splenocyte stimulated with CD3/CD28 or collagen were dramatically decreased, while those of IL-4 was increased. Rheumatoid factors including IgG, IgM and collagen specific antibody were present much lower in the serum of HDPS treated mice than control. In peripheral blood mononuclear cells of HDPS treated mice, the percentage of CD3+, CD3+/CD69+, CD4+, CD4+/CD25+ cells were significantly decreased, while CD19+ cells were slightly increased compared with control. The absolute number of CD19+, CD3+, CD3+/CD69+, CD4+/CD25+, CD49b+ cell in spleen from HDPS treated mice were significantly decreased. The absolute number of CD3+, CD3+/CD69+, CD4+, CD4+/CD25+ CD8+, CD49b+, CD3+/CD49b+ cells in draining lymph node were significantly increased compared with control. Taken together, HDPS has suppressive effects on rheumatoid arthritis by modulating immune system, and has potential to use as an therapeutic for rheumatoid arthritis.

Effect of 840 nm Light-Emitting Diode(LED) Irradiation on Monosodium Iodoacetate-Induced Osteoarthritis in Rats (흰쥐의 MIA 유발 무릎 뼈관절염에 대한 840 nm LED의 효과)

  • Jekal, Seung-Joo;Kwon, Pil-Seung;Kim, Jin-Kyung;Lee, Jae-Hyoung
    • Journal of the Korean Society of Physical Medicine
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    • v.9 no.2
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    • pp.151-159
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    • 2014
  • PURPOSE: The purpose of this study was to evaluate whether light-emitting diodes (LED) irradiation could be effective in a noninvasive, therapeutic device for the treatment of osteoarthritis(OA). METHODS: Twenty-four male Sprague-Dawley rats were divided into four groups: Vehicle control (saline); monosodium iodoacetate-injection (MIA); LED irradiation after MIA injection (MIA-LED); indomethacin-treatment after MIA injection (MIA-IMT). OA was induced by intra-articular injection of 3 mg MIA through the patellar ligament of the right knee. Vehicle control rats were injected with an equivalent volume of saline. The LED was irradiated for 15 min/day for a week after 7 days of MIA treatment. To compare with the effect of LED irradiation, the indomethacin was administrated 20 mg/kg twice a week orally after 7 days of MIA treatment. Knee joints were removed and fixed overnight in 10% neutral buffered formalin and decalcified by EDTA for 2 week before being embedded in paraffin. The assessment of OA induction were monitored by knee movement and radiographic finding. Histologic analysis were performed following staining with hematoxylin and eosin, safranin O-fast green, or toluidine blue, picrosirius red, and histologic changes were scored according to a modified Mankin system. Apoptotic cell in tissue sections was detected using TUNEL method. RESULTS: Radiographic examination could not show the differences between the MIA-treated and the MIA-LED-treated rats. In the histologic analysis, however, LED irradiation prevented cartilage damage and subchondral bone destruction, and significantly reduced mononuclear inflammatory cell infiltration and pannus formation. LED irradiation also reduced apoptosis of cartilage cells, but it prevented apoptosis of infiltrated inflammatory cells in synovium. In addition, LED irradiation showed an increase of collagen production in the meniscus. CONCLUSION: These results suggest that the 840 nm LED irradiation would be a suitable non-thermal phototherapy for the treatment of OA, as a cartilage protection and anti-inflammatory modality.

Study of 4 Cases with Changes of Unified Parkinson's Disease Rating Scale, Heart Rate Variability and Quality of Life in Parkinson's Disease Patients through Whole Body Gi-Hyeol Therapy (전신기혈요법 치료를 통해 Unified Parkinson's Disease Rating Scale, Heart Rate Variability 및 삶의 질이 변화된 파킨슨 환자 4례에 대한 증례보고)

  • Mok, Seo-Hee;Lee, Ji-Won;Lee, Tae-Jong;Seo, Jung-Bok;Kim, Kyoung-Ah;Kim, Joe-Young;Park, Byung-Jun;Kim, Dong-Hee
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.35 no.2
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    • pp.71-80
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    • 2021
  • Parkinson's disease is one of the typical neurodegenerative disease and it is caused by the destruction of substantia nigra in brain leading to lack of dopamine secretion, and it presents 4 major motor symptoms such as tremor, bradykinesia, stiffness, postural instability. Furthermore, it causes many non-motor symptoms such as anosmia, REM sleep conduct disorder, orthostatic hypotension, dementia and autonomic ataxia such as lack of adjusting blood pressure, hyperhydrosis, constipation. Dopaminergic therapy is the most commonly used strategy, but long term treatment of levodopa induce various adverse effects. Thus, many people are focusing on new therapies other than established therapies, and there are many tries and approaches with paradigm shift. Our medical team was able to get 4 cases of PD patients who are hospitalized in our hospital, treated by Whole Body Gi-Hyeol Therapy consisting of acupuncture therapy, herbal therapy, and mental therapy, and their conditions improved in perspective of Unified Parkinson's Disease Rating Scale(UPDRS), Heart Rate Variability(HRV), and Quality of life. Among all 4 cases, UPDRS score and quality of life score is gotton better, and among 2 cases SDNN, RMS-SD, TP, LF, HF scores are finely increased. And PDQ-39 score which shows quality of life is also improved. However, in spite of these improvements and positive results, there were no meaningful improvement in a hurt from a fall which is important to the aged, muscular atrophy which causes bone fracture and SMI(Skeletal Muscle Mass Index) which is indicator of osteoporosis. Thus, supplementary treatment about Whole Body Gi-Hyeol Therapy such as more active nutrition intervention, safe and effective kinesitherapy is needed, and from now on continuous case reports and systematic clinical research which has control group must be carried out.

Pathophysiology and MRI Findings of Infectious Spondylitis and the Differential Diagnosis (감염성 척추염과 감별질환의 병태생리와 MRI 소견)

  • Sunjin Ryu;Yeo Ju Kim;Seunghun Lee;Jeongah Ryu;Sunghoon Park;Jung Ui Hong
    • Journal of the Korean Society of Radiology
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    • v.82 no.6
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    • pp.1413-1440
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    • 2021
  • On MRI, abnormal signals of the intervertebral disc, destruction of the upper and lower vertebral body endplate around the disc, and bone marrow edema around the endplate are considered typical findings of infectious spondylitis. These findings can also appear in various non-infectious spinal diseases, such as degenerative changes, acute Schmorl's node, spondyloarthropathy, synovitis, acne, pustulosis, hyperostosis, and osteitis (SAPHO), chronic recurrent multifocal osteomyelitis, and calcium pyrophosphate dihydrate crystal deposition disease. The imaging findings of infectious spondylitis that can be differentiated from these non-infectious spinal diseases on MRI are high signal intensity and abscess of the disc space, an abscess in the paraspinal soft tissue, and the loss of the linear low signal intensity on T1-weighted images of the bony endplate. However, these differentiation points do not always apply since there are many similarities in the imaging findings of infectious and non-infectious diseases. Therefore, for an accurate diagnosis, it is important to know the imaging characteristics related to the pathophysiology of not only infectious spondylitis but also non-infectious spinal diseases, which requires differentiation from infection.

Effect of Mouthguard on Tooth Distortion During Clenching (이악물기 시 발생되는 치아변형에 대한 구강보호장치의 역할)

  • Lee, Yun;Choi, Dae-Gyun;Kwon, Kung-Rock;Lee, Richard Sung-Bok;Noh, Kwan-Tae
    • Journal of Dental Rehabilitation and Applied Science
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    • v.26 no.4
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    • pp.405-417
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    • 2010
  • Previous studies have already shown that mouthguard is effective in protecting jaw bone, teeth and oral tissue against sports trauma. However, other than severe trauma, repetitive force, such as disorders like clenching, cause teeth or oral tissue damage. These kinds of disorders usually present pathologic attrition in the posterior teeth, resorption in alveolar bone, loss of teeth and destruction of occlusion. Wearing a mouthguard is believed to be effective in preventing these disorders. But its effect is not examined thoroughly enough. The purpose of this study is to identify whether mouthguard is effective in reducing strain caused by clenching. Mandibular first molars in the normal occlusal relationship without any history of dental treatment were chosen. Biaxial type strain gauge was placed on the buccal surface of the tooth. Having maximum occlusal force, measured by load cell, as a standard, clenching intensity were divided into three stages; moment of slightly tooth contact, medium bite force (50% of maximum bite force), maximum bite force. Strain occurring in dentition in each stage with and without mouthguard was measured. Changes in strain (on dentition) between each stage and difference in strain, between with or without mouthguard were recorded by PCD-300 analyzer and PCD-30 soft ware. The data was statistically analyzed by Wilcoxon signed rank test. The following results were drawn; Without mouthguard, strain given on dentition increased as the clenching force increased. With mouthguard, strain given on dentition also increased as the clenching force increased. With mouthguard, strain decreased, in all cases of clenching force stages. Data on the moment of slightly tooth contact stage, had no statistical significance. However, with mouthguard, 50-90% of decrease in strain could be obtained in maximum occlusal force, compared to the group without mouthguard. Mouthguard decreased the strain on the dentition, caused by clenching. Therefore, mouthguard seems to be effective in preventing damage on dentition, by acting against clenching, which occurs both consciously and unconsciously during sports activities.

Expressions of transforming growth factor β in patients with rheumatioid arthritis and osteoarthritis (류머티스 관절염과 골관절염 환자에서 Transforming growth factor β의 발현 양상)

  • Kim, Chae-Gi;Yoon, Wern Chan;Song, Yong-Ho;Kim, Sang-Gyung;Choe, Jung-Yoon
    • IMMUNE NETWORK
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    • v.1 no.3
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    • pp.244-249
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    • 2001
  • The transforming growth $factor-{\beta}$ ($TGF-{\beta}$) is a multifunctional cytokine modulating the onset and course of autoimmune disease as shown in experimental models. In synovial inflammation, there is a potential role for $TGF-{\beta}$ in repairment, the inhibition of cartilage and bone destruction, and the down-regulation of immune response. The biologic effects of $TGF-{\beta}$ depend on the cell type, the isoform and the availability of active $TGF-{\beta}$. We investigated $TGF-{\beta}$ expression in patients with rheumatoid arthritis (RA) and compared to those of osteoarthritis (OA). And we determined a correlation between $TGF-{\beta}1$ and $TGF-{\beta}2$, and also the relationships between each $TGF-{\beta}$ isoform and the parameters for disease activity of RA. Methods: The study population consisted of 20 patients with RA and 20 patients with OA. The commercial ELISA kit was used to study $TGF-{\beta}1$ and $TGF-{\beta}2$ levels in peripheral blood (PB) and synovial fluids (SF). Results: 1) While PB $TGF-{\beta}1$ level was of no difference between RA and OA patient groups, SF $TGF-{\beta}1$ level was higher in RA group than OA group. Similarly, PB $TGF-{\beta}2$ levels of RA and OA groups was not different, but SF $TGF-{\beta}2$ levels was higher in RA group than OA group. 2) In patients with RA, the $TGF-{\beta}1$ levels were higher than $TGF-{\beta}2$ in both the PB and SF, while in patients with OA, there showed higher readings for $TGF-{\beta}1$ than $TGF-{\beta}2$ in SF but no difference between $TGF-{\beta}1$ and $TGF-{\beta}2$ levels in PB. 3) In patients with RA, there were no correlations between PB $TGF-{\beta}1$ and PB $TGF-{\beta}2$ levels, nor between SF $TGF-{\beta}1$ and SF $TGF-{\beta}2$ levels. At the same way, there was no correlation between PB $TGF-{\beta}1$ and SF $TGF-{\beta}1$ levels, nor between each levels of $TGF-{\beta}2$ in patients with RA. 4) There was also no correlation between each $TGF-{\beta}$ isoform and the parameters for disease activity such as ESR, CRP, tender joint count, swollen joint count, rheumatoid factor, and the duration of morning stiffness except between in PB $TGF-{\beta}1$ and disease duration of RA (r=0.637, p<0.01). Conclusion: Each $TGF-{\beta}$ isoforms were higher in synovial fluid of patients with RA than that of patients with OA. The data from the RA patients demonstrated different patterns of expressions of the isoforms depending on which compartment (PB or SF) was investigated. The quantification of different $TGF-{\beta}$ isoform is thought to be important when $TGF-{\beta}$ is measured under disease conditions of RA.

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A Literature Study of the Teeth (치(齒)에 대(對)한 문헌적(文獻的) 고찰(考察))

  • Gwak, Ik-Hun;Yun, Cheol-Ho;Jeong, Ji-Cheon
    • The Journal of Internal Korean Medicine
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    • v.16 no.2
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    • pp.146-177
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    • 1995
  • The purpose of this study was to investigate the relationship between the teeth and Zhang-Fu(臟腑), dental diseases, and the hygiene of the mouth through the literature of oriental medicine. First, the relatonship between the teeth and Zhang-Fu is reviewed as follows: The teeth are influenced by Shen(腎) because they are the end of bone and Biao(標) of Shen. Gingiva is related to Wei(胃) and Da-Chang(大腸) because it is passed by Yangming-Channel(陽明經). The growth and nutrition of teeth depends on Shen. The pathological condition of Shen causes the gingival atrophy, the loose of teeth, dedentition due to aging, withering of teeth, and tartar: whereas the pathological condition of Wei and Da-Chang causes toothache, gingivitis, inflamed gums, bad breath, and gingival hemorrhage. Second, the causes and therapies of dental diseases through the literature can be summarized as follows: The major causes of toothache are the pathogenic condition of wind-heat and wind-cold, the heat syndrome of Wei, the damp-heat of intestine, flaring-up of fire of deficiency type, rotten tooth, etc... The principal causes of dedentition and the shaking and loose of teeth are the deficiency of Shen, and the rest of causes are the damp-heat of Yangming. Gingival atrophy is caused by the deficiency of Shen, whereas the gingival hemorrhage comes from the factors in the pathogenic factor of wind-heat of Yangming-Channel, the heat syndrome of stomach, and the deficiency of Shen. The causes of grinding of teeth during sleeping are stomach-heat, and the delayed dentition and the withering result from the deficiency of Shen-Jing.(腎精) The principal therapies of toothache are removing wind and heat, clearing away heat and prompting diuresis, clearing away the stomach-heat, replenishing vital essence to tonify the Shen, relieving superficial syndrome by wind-cold, and alleviating pain by destroying parasites. For the prescription of the principal therapies, there are Xijio Dihuang Tang, Jiajian Ganlu Yin, Qufeng Wan, Qingwei San, Tiaowei Chenggi Tang Shengong Wan, Liangge San Qingwei Tang Yunu Jian, Liuwei Dihuang Wan Zuogui Yin Bawei Wan Wanshao Dan, Xixin San Badou Wan Gianghuo Fuzi Tang, Jiuzi Tang Badou Wan, etc... The therapies of dedentition and the shaking and loose of teeth are replenishing vital essence to tonify the Shen, and warming and recuperating the Shen-Yang: as the prescription, there are Liuwei Dihuang Wana Zuogui Yin, and Bawei Wan Anshen Wan Wanshao Dan Yougui Wan etc... The therapies of gingival hemorrhage are clearing away the stomach-heat, replenishing vital essence to tonify the Shen, warming and recuperating the Shen-Yang(腎陽), and moisturing and purging intence heat with the prescription of Tiaowei Chenggi Tang Xijiao Dihuang Tang, Liuwei Dihuang Wan Zuogui Yin, Bawei Wan Anshen Wan, and Yunu Jian. The therapy of gingival atrophy is replenishing vital essence to tonify the Shen in the prescription of Liuwei Wan Bawei Wan Ziyin Dabu Wan. The therapies of grinding of teeth during sleeping are clearing away the stomach-heat and purging intense heat, and invigorating the spleen through eliminating dampness in the prescription of Qingwei San, Wumei Wan, etc... The therapy of delaed dentition is replenishing vital essence to tonify the Shen with the prescription of Liuwei Wan Buyin Jian, etc... Third, clinical treatment reports of dental diseases are reviewed as follows: The toothache due to stomach-heat was treated by medical herbs like Gypsum, Natrir Sulfas, Rehmanniae, Schizonepetal Herba, Menthae Folium, Cimicifugae Rhizoma, and Scrophulariae Radix. The therapies of toothache due to flaring-up of fire in deficiency type from deficiency of Shen provided with replenishment of vital essence to tonify the Shen and clean ministerial fire, and the prescription was the kind of Liuwei Wan, which worked very well. The therapy of dedentition and loose of teeth due to deficiency of Shen was done to stablize the teeth as tonifing the Shen with the prescription of Guchi Wan. The rate of imrovement was over 90%. The destruction of periodontal tissue due to periodonititis was cured of dispelling wind, reducing heat, and alleviating pain, It was improved by taking Zizhi Xingiong Tang, Guchi Xiaotong San, Yunii Jian, and Qingwei San about 3-7 days, and the rate of improvement was over 80%. Fourth, the prevention and regimens are reviewed as follows: As a physical and breathing exercise of the teeth, tapping teeth which stimulates the circulation of Qi(氣) and Xue(血) had been used. The tapping time of 14, 17, 36, etc... has been reported, and it should be applied based on the body condition. The medical herbs for gargling and brushing teeth have been used. Specifically, Cimicifugae Rhizoma, Gypsum, Gypsum Fibrosum, and Indigo pulrelrata Lereis have been used to reduce heat, Coptidis Rhizama and Yang Jinggu to eliminate damp-heat, Amomi Semen, Cyperi Rhizoma, Flos Caryophylli, Asari Radix, Piperis Longi Fructus, Santali Albae Lignum, Meliae Fructus, Moschus, Aquillaiae Lignum, and Borneol to promote the circulation of Qi and to relieve pain, Ligustici Radix, Angelice Radix, Rhizoma Nardostachydis, Tribuli Semen to relieve superficial syndrome by means of diaphiresis, and Cnidii Rhizoma, Angelicae sinensis Radix, and Olibanum to promote blood circulation to stop pain.

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Anti-diabetic effects of aqueous and ethanol extract of Dendropanax morbifera Leveille in streptozotocin-induced diabetes model (Streptozotocin에 의해 유도된 당뇨모델동물에서 황칠나무 (Dendropanax morbifera Leveille)의 열수추출물과 에탄올추출물의 당뇨 질환 개선 효능)

  • An, Na Young;Kim, Ji-Eun;Hwang, DaeYoun;Ryu, Ho Kyung
    • Journal of Nutrition and Health
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    • v.47 no.6
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    • pp.394-402
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    • 2014
  • Purpose: Dendropanax morifera Leveille (DML) exhibits diverse biological and pharmacological activities, including anti-oxidative effect, anti-cancer activity, hepatoprotection, immunological stimulation, and bone regeneration. As part of the identification for novel functions of DML, we investigated the therapeutic effects of DML on diabetes induced by streptozotocine (STZ) treatment. Methods: First, the four extracts including the water extract of leaf (DLW), the ethanol extract of leaf (DLE), the water extract of stem (DSW), and the ethanol extract of stem (DSE) were collected from the leaf and stem of DML using a hot water and ethanol solvent. Alterations in body weight, glucose concentration, insulin level, and pancreatic islet structure were investigated in diabetic mice after treatment with extracts of DML for 2 weeks. Results: Among four extracts, the highest level of total polyphenols and total flavonoids was detected in DLW, while the lowest level of these was measured in DSE. The radical scavenging activity was also higher in DLW than in the other three extracts at the concentration of $25-100{\mu}g/mL$, although this activity was maintained at a constant level in all groups at the concentration of $500{\mu}g/mL$. Based on the results of anti-oxidant activity, DLW and DLE were selected for examination of anti-diabetic effects in a diabetes model. Body weight was gradually decreased in all STZ treated groups compared with the No treated group. However, four STZ/DML treated groups maintained a high level of body weight during 7-14 days, while the STZ/vehicle treated group showed a gradual decrease of body weight during the same period. Also, a significant decrease or increase in the concentration of glucose and insulin in the blood of the diabetes model was detected in a subset of groups, although the highest increase was detected in the STZ/DLE-200 treated group. In addition, the histological structure of pancreatic islet was significantly recovered after treatment with DLW and DLE. Conclusion: These results suggest that DLW and DLE may contribute to attenuation of clinical symptoms of diabetes as well as prevent the destruction of pancreatic ${\beta}$-cells in STZ-induced diabetes mice.

Therapeutic Effects of Curdrania tricuspidata Leaf Extract on Osteoarthritis (골관절염 실험모델에서 꾸지뽕나무 추출물의 골관절염 억제효과 연구)

  • Nam, Da-Eun;Kim, Ok Kyung;Lee, Jeongmin
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.42 no.5
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    • pp.697-704
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    • 2013
  • The inhibitory effect of ethanol extracts from Curdrania tricuspidata leaves (CTL) on osteoarthritis was investigated in primary cultured rat cartilage cells and a monosodium-iodoacetate (MIA)-induced arthritis rat model. To identify the effects of CTL 80% ethanol extracts (CTL80) and CTL 10% ethanol extracts (CTL10) against $H_2O_2$ treatment in vitro, cell survival was measured by the MTT assay. Cell survival after $H_2O_2$ treatment increased with CTL80 and CTL10 close to normal up to $300{\mu}g/mL\;H_2O_2$. The mRNA expression of matrix metalloproteinases (MMPs) was determined MMP-7 and MMP-13 (known catabolic factors), were significantly inhibited by CTL 80 and CTL10; a $200{\mu}g/mL$ dose of CTL80 especially decreased MMP-13 expression. In vivo, osteoarthritis was induced by an intra-articular injection of MIA into the knee joints of rats, then CTL80 and CTL10 orally administered daily for 35 days. After the animals were sacrificed, histological evaluations of their knee joints revealed a reduction in polymorphonuclear cell infiltration and smooth synovial lining in the CTL80-500 group. Micro-CT analysis of hind paws from CTL80-500 and CTL10 showed a protection against osteophyte formation, soft tissue swelling, and bone resorption. In conclusion, CTL ethanol extracts are effective in ameliorating joint destruction and cartilage erosion in MIA-induced rats. CTL decreases and normalizes articular cartilage through preventing extracellular matrix degradation and chondrocyte injury, and could potentially serve as a therapeutic treatment for humans.

THE ROLE OF TYPE 2 DIABETES AS A PREDISPOSING RISK FACTOR ON THE PULPO-PERIAPICAL PATHOGENESIS: REVIEW ARTICLE (치수 치근단 병소의 전구 위험요인으로서의 제 2 형 당뇨의 역할에 관한 소고)

  • Kim, Jin-Hee;Bae, Kwang-Shik;Seo, Deog-Gyu;Hong, Sung-Tae;Lee, Yoon;Hong, Sam-Pyo;Kum, Kee-Yeon
    • Restorative Dentistry and Endodontics
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    • v.34 no.3
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    • pp.169-176
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    • 2009
  • Diabetes Mellitus (DM) is a syndrome accompanied with the abnormal secretion or function of insulin, a hormone that plays a vital role in controlling the blood glucose level (BGL). Type land 2 DM are most common form and the prevalence of the latter is recently increasing, The aim of this article was to assess whet her Type 2 DM could act as a predisposing risk factor on the pulpo-periapical pathogenesis. Previous literature on the pathologic changes of blood vessels in DM was thoroughly reviewed. Furthermore, a histopathologic analysis of artificially-induced periapical specimens obtained from Type 2 diabetic and DM-resistant rats was compared. Histopathologic results demonstrate that the size of periapical bone destruction w as larger and the degree of pulpal inflammation was more severe in diabetic rats, indicating that Type 2 D M itself can be a predisposing risk factor that makes the host more susceptible to pulpal infection. The possible reasons may be that in diabetic state the lumen of pulpal blood vessels are thickened by atheromatous deposits, and microcirculation is hindered, The function of polymorphonuclear leukocyte is also impair ed and the migration of immune cells is blocked, leading to increased chance of pulpal infection. Also, lack of collateral circulation of pulpal blood vessels makes the pulp more susceptible to infection. These decrease the regeneration capacity of pulpal cells or tissues, delaying the healing process, Therefore, when restorative treatment is needed in Type 2 DM patients, dentists should minimize irritation to the pulpal tissue un der control of BGL.