• Title/Summary/Keyword: Clinical anatomy

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Success and failure of endodontic microsurgery (미세 치근단 수술의 성공과 실패)

  • Song, Min-Ju;Kim, Eui-Seong
    • Restorative Dentistry and Endodontics
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    • v.36 no.6
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    • pp.465-476
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    • 2011
  • In current endodontic practice, introduction of operating microscope, ultrasonic instruments, and microinstruments has induced a big change in the field of surgical retreatment. In this study, we aimed to offer key steps of endodontic microsurgery procedure compared with traditional root-end surgery, and to evaluate factors influencing success and failure based on published articles. Endodontic microsurgery is a surgical procedure performed with the aid of a microscope, ultrasonic instruments and modern microsurgical instruments. The microscope provides magnification and illumination - essential for identifying minute details of the apical anatomy. Ultrasonic instruments facilitate the precise root-end preparation that is within the anatomical space of the canal. Modern endodontics can therefore be performed with precision and predictability, thus eliminating the disadvantages inherent in traditional periapical surgery such as large osteotomy, beveled apicoectomy, inaccurate root-end preparation and the inability to observe isthmus. Factors influencing the outcomes of endodontic microsurgery may be diverse, but standardization of procedures can minimize its range. Among patient and tooth-related factors, periodontal status and tooth position are known to be prognostic, but there are only few articles concerning this matter. High-evidence randomized clinical trials or prospective cohort studies are needed to confirm these findings.

Protective effects of remifentanil against H2O2-induced oxidative stress in human osteoblasts

  • Yoon, Ji-Young;Kim, Do-Wan;Kim, Eun-Jung;Park, Bong-Soo;Yoon, Ji-Uk;Kim, Hyung-Joon;Park, Jeong-Hoon
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.16 no.4
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    • pp.263-271
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    • 2016
  • Background: Bone injury is common in many clinical situations, such as surgery or trauma. During surgery, excessive reactive oxygen species (ROS) production decreases the quality and quantity of osteoblasts. Remifentanil decreases ROS production, reducing oxidative stress and the inflammatory response. We investigated remifentanil's protective effects against $H_2O_2$-induced oxidative stress in osteoblasts. Methods: To investigate the effect of remifentanil on human fetal osteoblast (hFOB) cells, the cells were incubated with 1 ng/ml of remifentanil for 2 h before exposure to $H_2O_2$. For induction of oxidative stress, hFOB cells were then treated with $200{\mu}M$ $H_2O_2$ for 2 h. To evaluate the effect on autophagy, a separate group of cells were incubated with 1 mM 3-methyladenine (3-MA) before treatment with remifentanil and $H_2O_2$. Cell viability and apoptotic cell death were determined via MTT assay and Hoechst staining, respectively. Mineralized matrix formation was visualized using alizarin red S staining. Western blot analysis was used to determine the expression levels of bone-related genes. Results: Cell viability and mineralized matrix formation increased on remifentanil pretreatment before exposure to $H_2O_2$-induced oxidative stress. As determined via western blot analysis, remifentanil pretreatment increased the expression of bone-related genes (Col I, BMP-2, osterix, and $TGF-{\beta}$). However, pretreatment with 3-MA before exposure to remifentanil and $H_2O_2$ inhibited remifentanil's protective effects on hFOB cells during oxidative stress. Conclusions: We showed that remifentanil prevents oxidative damage in hFOB cells via a mechanism that may be highly related to autophagy. Further clinical studies are required to investigate its potential as a therapeutic agent.

Arthroscopic Anterior Cruciate Ligament Reconstruction using Fresh Frozen Achilles Allograft - Clinical results, 2nd look Arthroscopic and Histologic findings - (신선 동결 아킬레스 동종건을 이용한 전방 십자 인대 재건술 - 임상적 결과, 2차 관절경 및 조직학적 소견 -)

  • Chun Churl Hong;Ha Dae Ho;Choi Min Kyu;You Son Soo
    • Journal of the Korean Arthroscopy Society
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    • v.5 no.1
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    • pp.7-12
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    • 2001
  • Purpose : We observed usability of allograft by evaluating the clinical results, second look arthroscopic and histologic findings at last follow up after anterior cruciate ligament(ACL) reconstruction using by fresh frozen Achilles allograft. Materials and Methods : We analyzed in 58 patients(59 cases) by subjective and objective parameters, Telos stress arthrometer and Modified Feagin Scoring System. The average age and follow up period was 25 years(ranging from 18 to 49 years), and 15 months(ranging from 12 to 19 months). Among them we studied second look arthroscopic and histologic findings in 16 patients. Results : The mean Lysholm Score wits improved from 60 to 88.2 as well the anterior translation was improved from 7.1 min to 2.3mm at last follow up. The second look arthroscopic findings were close to normal in ligament thickness, tension and showed revasculization at the holly attachment site. Light microscope(LM) findings showed dense cellularity like a normal ligament. In electron microscope(EM) collagen fibrils showed parallel arrangement longitudinally and unimodal pattern diameter close to normal tissue in the transverse section. Conclusion : We think that the fresh frozen Achilles allograft is a good substitution of autograft in cruciate ligament reconstruction.

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Agrobacterium sp.-derived β-1,3-glucan enhances natural killer cell activity in healthy adults: a randomized, double-blind, placebo-controlled, parallel-group study

  • Lee, Yeon Joo;Paik, Doo-Jin;Kwon, Dae Young;Yang, Hye Jeong;Park, Yongsoon
    • Nutrition Research and Practice
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    • v.11 no.1
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    • pp.43-50
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    • 2017
  • BACKGROUND/OBJECTIVES: The present study investigated the hypothesis that a highly pure linear ${\beta}$-1,3-glucan produced by Agrobacterium sp. R259 enhances human natural killer (NK) cell activity and suppresses pro-inflammatory cytokines. SUBJECTS/METHODS: In an eight-week, double-blind, randomized, placebo-controlled clinical trial, 83 healthy adults with white blood cell counts of $4,000-8,000cells/{\mu}L$ were participated and randomly assigned to take two capsules per day containing either 350 mg ${\beta}$-1,3-glucan or placebo. Six participants withdrew their study consent or were excluded due to NK cell activity levels outside the normal range. NK cell activity and serum levels of immunoglobulin G (IgG) and cytokines, such as interferon (IFN)-${\gamma}$, interleukin (IL)-2, IL-4, IL-6, IL-10, IL-12 and tumor necrosis factor (TNF)-${\alpha}$ were measured. RESULTS: NK cell activity and the serum levels of IL-10 were significantly higher from baseline to week 8 in the ${\beta}$-glucan group compared with the placebo group (P = 0.048, P = 0.029). Consumption of ${\beta}$-1,3-glucan also significantly increased NK cell activity compared with placebo after adjusting for smoking and stress status (P = 0.009). In particular, the effect of ${\beta}$-1,3-glucan on NK cell activity was greater in participants with severe stress than in those experiencing mild stress. However, the administration ${\beta}$-1,3-glucan did not significantly modulate the levels of IFN-${\gamma}$, IL-2, IL-4, IL-6, IL-12, TNF-${\alpha}$ and IgG compared with the placebo. CONCLUSION: The results showed that supplementation with bacterial ${\beta}$-1,3-glucan significantly increased NK cell activity without causing any adverse effects. Additionally, the beneficial effect of ${\beta}$-1,3-glucan on NK cell activity was greater in participants experiencing severe stress.

Clinical and molecular biological aspect of the hyaluronidases: basis and clinical overview for oriental medical application

  • Kim, Cheorl-Ho;Lee, Dong-Gyu;Jang, Jun-Hyouk;Kim, Jong-De;Nam, Kyung-Soo;Kim, Jeong-Joong;Park, Jong-Kun;Choo, Young-Kug;Kim, Hyung-Min;Lee, Young-Choon
    • Advances in Traditional Medicine
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    • v.1 no.1
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    • pp.8-27
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    • 2000
  • Components of extracellular matrix and the matrix-degrading enzymes are some of the key regulators of tumor metastasis and angiogenesis. Hyaluronic acid (HA), a matrix glycosaminoglycan, is known to promote tumor adhesion and migration, and its small fragments are angiogenic. Until now, we have compared levels of hyaluronidase, an enzyme that degrade HA, in normal adult prostate, benign prostate hyperplasia and prostate cancer tissues and in conditioned media from epithelial explant cultures, using a substrate (HA)-gel assay and ELISA-like assay (Kim et al., unpublished results). The present review described an overall characterization of hyaluronidases and its application to human diseases. The hyaluronidases are a family of enzymes that have, until recently, deed thorough explication. The substrate for these enzymes, hyaluronan, is becoming increasingly important, recognized now as a major participant in basic processes such as cell motility, wound healing, embryogenesis, and implicated in cancer progression. And in those lower life forms that torment human beings, hyaluronidase is associated with mechanisms of entry and spread, e.g. as a virulence factor for bacteria, for tissue dissection in gas gangrene, as a means of treponema spread in syphilis, and for penetration of skin and gut by nematode parasites. Hyaluronidase also comprises a component of the venom of a wide variety of organisms, including bees, wasps, hornets, spiders, scorpions, sh, snakes and lizards. Of particular interest is the homology between some of these venom hyaluronidases and the enzyme found in the plasma membrane of mammalian spermatozoa, attesting to the ancient nature of the conserved sequence, a 36% identity in a 300 amino acid stretch of the enzyme protein. Clearly, hyaluronidase is of biological interest, being involved in the pathophysiology of so many important' human disorders. Greater effort should be made in studying this family of enzymes that have, until recently, been overlooked. Also, oriental medical application of the hyaluronidase will be discussed with respect to inhibition and suppression of inflammation and malignacy.

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Natural Substance MS-10 Improves Women's Health via Regulation of Estrogen Receptor (천연소재 MS-10의 에스트로겐 수용체 조절을 통한 여성건강 증진)

  • Noh, Yoo-Hun;Lee, Ji Won;Park, Jiae;Lee, Sang Hyung;Lee, Jun Young;Kim, Sung-Su;Park, Kwang-Kyun;Kim, Tae Jin;Myung, Soon-Chul;Jeong, Yoonhwa
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.45 no.6
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    • pp.903-910
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    • 2016
  • In this study, the expression level of estrogen receptor in an ovariectomized rat model was effectively enhanced by MS-10, Cirsium japonicum and Thymus vulgaris extract complex, in a reversible manner. MS-10 plays a positive role in enhancing estrogen activity at low concentrations, leading to improved women's health. In order to determine whether or not MS-10 improves menopausal symptoms clinically, a randomized, double-blinded, and placebo-controlled clinical study was carried out on 62 middle-aged women treated with 500 mg of MS-10 or placebo daily for 12 weeks. Clinical menopausal symptoms were evaluated by Kupperman's index (KI) detecting various menopausal symptoms, including hot flushes, parenthesis, insomnia, nervousness, melancholia, dizziness, fatigue, rheumatic pain, palpitations, formication, and headaches. Total KI score decreased significantly by about 18% upon ingestion of MS-10. Colpoxerosis, a main symptom of menopause, was significantly reduced by about 21% upon ingestion of MS-10 in contrast to placebo. In addition, reduction of insulin-like growth factor-1 with age was improved by over 10% upon ingestion of MS-10, whereas there were no significant difference with placebo. No side effects appeared after treatment with MS-10. Thus, MS-10 can be suggested as a plausible natural substance for improving women's health.

Outcomes and Patency of Complex Configurations of Composite Grafts Using Bilateral Internal Thoracic Arteries

  • Shih, Beatrice Chia-Hui;Chung, Suryeun;Kim, Hakju;Chang, Hyoung Woo;Kim, Dong Jung;Lim, Cheong;Park, Kay-Hyun;Kim, Jun Sung
    • Journal of Chest Surgery
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    • v.53 no.2
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    • pp.64-72
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    • 2020
  • Background: It is generally agreed that using a bilateral internal thoracic artery (BITA) composite graft improves long-term survival after coronary artery bypass grafting (CABG). Although the left internal thoracic artery (LITA)-based Y-composite graft is widely adopted, technical or anatomical difficulties necessitate complex configurations. We aimed to investigate whether BITA configuration impacts survival or patency in patients undergoing coronary revascularization. Methods: Between January 2006 and June 2017, 1,161 patients underwent CABG at Seoul National University Bundang Hospital, where the standard technique is a LITA-based Y-composite graft with the right internal thoracic artery (RITA) sequentially anastomosed to non-left anterior descending (LAD) targets. Total of 160 patients underwent CABG using BITA with modifications. Their medical records and imaging data were reviewed retrospectively to investigate technical details, clinical outcomes, and graft patency. Results: Modifications of the typical Y-graft (group 1, n=90), LITA-based I-graft (group 2, n=39), and RITA-based composite graft (group 3, n=31) were used due to insufficient RITA length (47%), problems using LITA (28%), and target vessel anatomy (25%). The overall 30-day mortality rate was 1.9%. Among 116 patients who underwent computed tomography or conventional angiography at a mean interval of 29.9±33.1 months postoperatively, the graft patency rates were 98.7%, 95.3%, and 83.6% for the LAD, left circumflex artery, and right coronary artery territories, respectively. Patency rates for the inflow, secondary, and tertiary grafts were 98.2%, 90.5%, and 80.4%, respectively. The RITA-based graft (group 3) had the lowest patency rate of the various configurations (p<0.011). Conclusion: LITA-based Y composite graft, showed satisfactory clinical outcomes and patency whereas modifications of RITA- based composite graft had the lowest patency and 5-year survival rates. Therefore, when using RITA-based composite graft, other options should be considered before proceeding atypical configurations.

Single and Double-row Repair in Rotator Cuff Tears (회전근 개 파열의 일열 봉합술과 이열 봉합술)

  • Park, Jin-Young;Choi, Jin-Hyung;Park, Hong-Keun;Yu, Je-Wook;Seo, Joong-Bae
    • Clinics in Shoulder and Elbow
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    • v.9 no.1
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    • pp.89-95
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    • 2006
  • Purpose: Arthroscopic repair of rotator cuff tears are many techniques that have been developed to improve the initial postoperative strength of the repair. There was a doubt that current arthroscopic cuff repairs using a single row of suture anchors reproduce insufficient area of the anatomic cuff insertion, and concerns about failure of fixation often lead surgeons to limit early motion. Newer technique of double-row repair in arthroscopic treatment may provide initial stronger fixation and more contact with bone at the repair site than single-row repair did. We studied the comparison between clinical outcomes of arthroscopic single- and double-row repair in cuff tears at 1year postoperatively. Materials and methods: We retrospectively analyzed 40 shoulders with single-row repair and 38 shoulders with double-row repair of full-thickness rotator cuff tears between May 2002 and October 2004. Out of total 78 shoulders, 42 (54%) were male patients and 36 (46%) were female patients and the mean age at surgery was 56 years. All patients were diagnosed by physical examination and MRI. At 1year' follow-up after operation, we evaluated with the ASES and the Constant scoring system, and measured muscle power of abduction, internal and external rotation of the affected shoulder then compared with each other. Results: Mean ASES scores and Constant scores in double-row repair group improved more than single-row repair group significantly at 1year postoperatively. Muscle power of abduction and internal rotation, especially abduction power, improved more significantly in double-row repair group than in single-row repair. Conclusion: Arthroscopic double-row repair for the full thickness rotator cuff tear may be a superior technique, which showed better clinical outcomes and restoration of muscle power compared with single-row repair at relatively short period of postoperative follow-up. Restoration of footprint close to normal anatomy by double-row repair seems to play an important role in the recovery of muscle strength.

Polioencephalomyelitis in Pigs Experimentally Infected with Porcine Enterovirus Isolated in Korea: I. Histopathological Observations (Enterovirus 감염에 의한 자돈의 Polioencephalomyelit: I. 병리조직학적 관찰)

  • Shin, Tae-kyun;Lee, Cha-soo
    • Korean Journal of Veterinary Research
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    • v.25 no.2
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    • pp.103-112
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    • 1985
  • A total of 1-0 colostrum-deprived pigs (1 or 2-day-old) and 6 pigs (35-day-old), which had been raised by natural maternal nursing, were used to study the pathogenicity of the porcine enteroviruses by the intracerebral and intramuscular routes of inoculation, which the enterovirus were isolated from the diseased pigs in Korea. The porcine enteroviruses produced an identical polioencephalomyelitis in colostrum-deprived pigs and 35-day-old pigs, which manifested clinical signs and histopathological changes. Clinically it was characterized by incoordination, rise in rectal temperature, ataxia, flaccid paralysis in all the experimental groups. Histopathologically, the lesions were present in both grey and white matter at all levels of central nervous system, though usually more severe in the grey matter. These changes were characterized by meningeal infiltration, degeneration of nerve cells, neuronophagia, diffuse and focal gliosis, glial nodules and perivascular lymphocytic infiltrations. Ganglionitis of the dorsal root ganglia was frequently observed. On the basis of the clinical and histopathological changes mentioned above, it was concluded that porcine enteroviruses isolated in Korea were pathogenic strains which could produce polioencephalomyelitis in pigs. The most severe Jisease was prcduced by the inoculation of both enterovirus and hog cholera vaccine in the 35-day-old pigs at a time when colostral immunity presumably was low. The porcine enterovirus infections seemed to be associated with certain stress factor such as hog cholera vaccine in or immediately following the weanling period.

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The establishment of Digital Image Capture System(DICS) using conventional simulator (Conventional simulator를 이용한 Digital image capture system(DICS)의 구축)

  • Oh Taesung;Park Jongil;Byun Youngsik;Shin HyunKyoh
    • The Journal of Korean Society for Radiation Therapy
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    • v.16 no.2
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    • pp.25-32
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    • 2004
  • Purpose : The simulator is used to determine patient field and ensure the treatment field, which encompasses the required anatomy during patient normal movement such as during breathing. The latest simulator provide real time display of still, flouroscopic and digitalized image, but conventional simulator is not yet. The purpose of this study is to introduce digital image capture system(DICS) using conventional simulator and clinical case using digital captured still and flouroscopic image. Methods and materials : We connect the video signal cable to the video terminal in the back up of simulator monitor, and connect the video jack to the A/D converter. After connection between the converter jack and computer, We can acquire still image and record flouroscopic image with operating image capture program. The data created with this system can be used in patient treatment, and modified for verification by using image processing software. (j.e. photoshop, paintshop) Result : DICS was able to establish easy and economical procedure. DCIS image was helpful for simulation. DICS imaging was powerful tool in the evaluation of the department specific patient positioning. Conclusion : Because the commercialized simulator based of digital capture is very expensive, it is not easily to establish DICS simulator in the most hospital. DICS using conventional simulator enable to utilize the practical use of image equal to high cost digitalized simulator and to research many clinical cases in case of using other software program.

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