Objectives : To study autonomic nervous system dysfunction of Low Back Pain(LBP) patients, using spectral analysis of Heart Rate Variability(HRV). Methods : HRV of 190 patients was measured and seperated into two groups, those with LBP(n=95) and healthy controls(n=95). HRV was measured by SA-6000(Medicore, Korea) for 5 minutes after 5 minutes' resting. Results : 1. Mean heart rate(MHRT) of the experimental group was slightly higher than that of the control group, but did not show significant difference(P=0.428). The square root of the mean squared differences of successive normal-to-normal intervals(RMSSD), logarithmic very low frequency power(Ln VLF) and low frequency power/high frequency power ratio(LH/HF ratio) were not significantly low between experimental group and control group(P=0.16, 0.130, 0.537). 2. The standard deviation of all the normal-to-normal intervals(SDNN), logarithmic total power(Ln TP), logarithmic low frequency power(Ln LF) and logarithmic high frequency power(Ln HF) were significantly low between experimental group and control group(P=0.03, 0.005, 0.001, 0.007). 3. Ln LF of acute group was significantly low compared with those of chronic group(P= 0.039). Conclusions : This study suggests the activity and imbalance of autonomic nervous system in LBP is low. Also sympathetic nervous system of acute LBP is lower than that of chronic LBP. Further study of HRV related to LBP is needed in the clinical medicine.
Aplastic anemia is a disease characterized by general lack of bone marrow activity; It may affect not only the red blood cells but also the white blood cells and platelets, resulting in pancytopenia. Spontaneous gingival hemorrhage is present in some cases and it is related to the blood platelet deficiency. This case report presents the periodontal treatment of a patient with aplastic anemia. A 43-year-old female was referred for continuous gingival bleeding after periodontal treatment. Periodontal findings revealed generalized gingival imflammation, oozing of blood from gingival crevice, and it was diagnosed as adult periodontitis. Root planing and extraction of the upper left third molar with poor prognosis were put into operation after elevation of the platelet count with platelet transfusion. The extraction socket was sutured with 3-0 silk. Bleeding continued even after digital compression at the upper right second premolar, second molar, and left canine areas, which presented severe inflammation. Although platelets were transfused repeatedly, platelet count did not stay elevated since survival rate of the transfused platelets were low due to alloimmunization. Thrombin gauze packing was not effective. Bleeding ceased 3 days after treatment with transfusion of donor platelets. 20 days after the treatment, the gingiva was generally healthy except upper right second premolar and lateral incisor areas. The result of periodontal treatment was good, but bleeding control after treatment was troublesome. In the periodontal treatment of patient with aplastic anemia, elevation of the platelet count with platelet transfusion seems to be the best method for hemorrhage control.
Human periodontal ligament fibroblasts (hPDLF) are very important for curing the periodontal tissue because they can be differentiated into various cells. A tissue engineering approach using a cell-scaffold is essential for comprehending today's periodontal tissue regeneration procedure. This study examined the possibility of using an acellular dermal matrix as a scaffold for human periodontalligament fibroblast (hPDLF). The hPDLF was isolated from the middle third of the root of periodontally healthy teeth extracted for orthodontic reasons. The cells were cultured in a medium containing Dulbecco's modified Eagle medium supplemented with 10% fetal bovine serum at $37^{\circ}C$ in humidified air with 5% $CO_2$. The acellular dermal matrix(ADM) was provided by the US tissue banks(USA). Second passage cells were used in this study. The hPDLF cells were cultured with the acellular dermal matrix for 2 days, and the dermal matrix cultured by the hPDLF was transferred to a new petri dish and used as the experimental group. The control group was cultured without the acellular dermal matrix, The control and experimental cells were cultured for six weeks. The hPDLF cultured on the acellular dermal matrix was observed by Transmission Electron microscopy (TEM). Electron micrography shows that the hPDLF was proliferated on the acellular dermal matrix. This study suggests that the acellular dermal matrix can be used as a scaffold for hPDLF.
Objective: The purpose of this study was to evaluate differences in three-dimensional (3D) morphology of the hard palate between Korean adults with and without mild-to-moderate obstructive sleep apnea (OSA) using cone-beam computed tomographic (CBCT) data. Methods: The protocol for the two-dimensional (2D) and 3D mathematical modeling was established by analyzing CBCT images of 30 adults with OSA and 30 matched controls without OSA, using MIMICS software. The linear and angular measurements were also determined using this software. The measurements were repeated for 30 palates, by the same operator, to assess reliability. Results: The palates of OSA patients were higher in the posterior part and narrower in the anterior-superior part than those of the control group (p < 0.05). The nasal cavities of patients with OSA were narrower (p < 0.05) than those of controls. The increasing angle of the first molar palatal root is a compensation of the upper dental arch to improve occlusion. However, for most palatal measurements, there were no significant differences between the OSA and control groups (p > 0.05). The results of 2D and 3D mathematical models were consistent for linear and angular measurements, indicating that 2D and 3D mathematical modeling of the palate is a reliable methodology. Conclusions: OSA is a multifactorial disease; the palates of adults with mild-to-moderate OSA do not have specific morphological features distinct from those of healthy controls.
The aim of the present study was to determine the effect of proprioceptive neuromuscular facilitation (PNF) leg patterns on the muscle activation of neck flexors. Twenty healthy subjects participated in this study. Each subject performed bilateral asymmetrical PNF leg patterns against manual resistance under four conditions: through the full range of motion toward the right side, left side, and the end range in the right side, left side. Electromyographic (EMG) data was collected from the sternocleidomastoid (SCM) muscles as neck flexors. The root mean square (RMS) value of the SCM was measured and normalized from maximal EMG activity of the SCM. The data were analyzed using the paired t-test and repeated analysis of variance (ANOV A) was used to compare the statistical significance. The results of this study are summarized as follows: Firstly, the RMS values of SCM were significantly higher in all four PNF leg patterns than in the resting condition (p<.05). Secondly, there was no significant difference in muscle activation according to the direction of PNF leg patterns (p>.05). Thirdly, there was no significant difference in muscle activation according to the point of range of the motion of leg patterns (p>.05). It is suggested that PNF bilateral asymmetrical leg patterns have a considerable effect on muscle activation of the SCM, regardless of the range of motion and direction of PNF bilateral asymmetrical leg patterns.
The purpose of this study was to investigate the effect of gait speed and walkway slope on the body acceleration, for the future validation of using an accelerometer in the estimation of energy consumption. Ten young healthy subjects with accelerometers on the upper thigh and ankle walked on a treadmill at 9 conditions(three speeds ${\times}$ three slopes) for 5 minutes. Acceleration signals of four directions, i.e. anterior-posterior(AP), medio-lateral(ML), superior-inferior(SI) and vector sum(VS) directions, of each sensor were measured, and root means squared(RMS) values of them were used as analysis variables. As statistical analysis, repeated measure two-way ANOVA was performed for RMS accelerations at each attachment sites, with slope and velocity as independent factors. At both the upper thigh and ankle, RMS acceleration of all directions were affected by gait velocities(p<.001) showing greater accelerations for higher velocities. Contrary to expectations, no slope effect existed in RMS accelerations at hip. Moreover, RMS acceleraion at ankle decreased with slope in SI and VS directions(p<.01). These results suggests that RMS acceleration cannot reflect the change in physical activity due to the change in walkway slope.
Purpose: This study was conducted to develop easy-made ssamjang products with differentiated materials and methods to meet the needs for a healthy and easy- lifestyle trend with lowered manufacturing expenses. Methods: Ssamjang was made with cheonggukjang and different kinds of jocheong as glutinous (GRSS), sweet potato (SPTSS), sweet pumpkin (SPKSS), bellflower root (BRSS) and ginger (GSS) and stored at $4^{\circ}C$ for 16 weeks. Quality characteristics and consumer acceptability were measured. Results: Titratable acidity was higher in SPTSS and rapidly increased (p<0.05) after 9 weeks in all groups during storage. Amino-type nitrogen contents of SPTSS and SPKSS were the highest and rapidly increased (p<0.05) after 5 weeks. Total free sugar content was higher in GRSS and did not change during storage. Glutamic acid and total free amino acid contents were higher in SPTSS, SPKSS and continuously increased up to 9 weeks. Yeast counts rapidly increased (p<0.05) after 9 weeks reaching 4.0 Log CFU/g in all groups except for SPTSS. Consumer acceptability did not change during storage in all groups and GSS was least preferable. Conclusion: The optimal quality maintenance period of ssamjang with cheonggukjang and jocheong was determined to 7-9 weeks of storage at $4^{\circ}C$ and ginger jocheong was the least preferable materials. We conclude that it is possible to develop easy-made ssamjang products with cheonggukjang and non-fermented materials also skipping aging period.
The purpose of this study was to investigate intra-rater reliability and determine the validity of electromyography (EMG) measurements to represent muscle activity and ultrasonography (US) to represent muscle thickness during manual muscle testing (MMT) to external abdominal oblique (EO) and lumbar multifidus (MF). Twenty healthy subjects were recruited for this study and asked to perform MMT at differing levels. The subjects' muscle activity using EMG was measured by a ratio to maximum voluntary contraction (MVC) and root mean square (RMS) methods. The subjects' muscle thickness using US was measured by raw muscle thickness and change ratio of thickness to maximum (MVC) or resting condition. In three trials, measurements were performed on each subject by one examiner. The intra-rater reliability of measurements of EMG and US to EO and MF was calculated using intra-class coefficients. The intra-rater reliability of all measurements was excellent (ICC=.75~.98) in EMG and US. The conduct validity was calculated by one-way ANOVA with repeated measurements to compare whether the EMG and US measurements were different between MMT at different levels. There was only a significant difference between all grades at %MVC thickness measurement of US. These results suggest that a %MVC thickness measurement of US was a more sensitive and discriminate in all manual muscle testing grades. This information will be useful for the selection of US measurement and analysis methods in clinics.
Reports on the comparison of clinical effect between non-surgical and surgical therapy, and the change of the clinical parameters during maintenance phase have been rarely presented in Korea. This study was to observe the clinical changes during maintenance phase of 6 months in patients with chronic periodontitis treated by non-surgical or surgical therapy in Department of Periodontics, Chonnam National University Hospital. Among the systemically healthy and non-smoking patients with moderate to severe chronic periodontitis, twenty eight patients (mean age: 47.5 years) treated by non-surgical therapy (scaling and root planning) and nineteen patients (mean age: 47.3 years) treated by surgical therapy (flap surgery) were included in this study. The periodontal supportive therapy including recall check and oral hygiene reinforcement was started as maintenance phase since 1 month of healing after treatment. Probing depth, gingival recession. clinical attachment level and tooth mobility were recorded at initial, baseline and 1, 2, 3 and 6 month of maintenance phase. The clinical parameters were compared between the non-surgical and surgical therapies using Student t-test and repeated measure ANOVA by initial probing depth and surfaces. Surgical therapy resulted in greater change in clinical parameters than non-surgical therapy. During the maintenance phase of 6 months, the clinical effects after treatment had been changed in different pattern according to initial probing depth and tooth surface. During maintenance phase, probing depth increased more and gingival recession increased less after surgical therapy, compared to non-surgical therapy. The sites of initial probing depth less than 3 mm lost more clinical attachment level, and the sites of initial probing depth more than 7 mm gained clinical attachment level during maintenance phase after non-surgical therapy, compared to surgical therapy. Non-surgical therapy resulted in greater reduction of tooth mobility than surgical therapy during maintenance phase. These results indicate that the clinical effects of non-surgical or surgical therapy may be different and may change during the maintenance phase.
Purpose: To evaluate the clinical and microbiological effects of the local use of egg yolk immunoglobulin against Porphyromonas gingivalis (anti-P.g. IgY) as an adjunct to scaling and root planing (SRP) in the treatment of moderate to severe chronic periodontitis. Methods: This was a randomized, placebo-controlled, double-blind trial involving 60 systematically healthy patients with moderate to severe chronic periodontitis. Subjects (n=20/group) were randomly assigned to receive SRP combined with subgingival irrigation of anti-P.g. IgY and anti-P.g. IgY mouthwash, subgingival irrigation of 0.2% chlorhexidine and 0.2% chlorhexidine mouthwash, or subgingival irrigation of placebo and placebo mouthwash for 4 weeks. Probing pocket depth, clinical attachment level, bleeding on probing, and the plaque index were evaluated at baseline and at 4 weeks. Subgingival plaque, gingival crevicular fluid, and saliva were simultaneously collected for microbiological analysis. Results: Our results showed that anti-P.g. IgY mouthwash was as effective as chlorhexidine at improving clinical parameters over a 4-week period. All the groups showed a significant reduction in levels of P.g. at 4 weeks. No significant difference was observed in the test group when compared to placebo regarding the reduction in the levels of P.g. Anti-P.g. IgY significantly suppressed the numbers of red complex bacteria (RCB) in subgingival plaque and saliva in comparison with placebo. No adverse effects were reported in any of the subjects. Conclusions: Within the limitations of the study, the present investigation showed that passive immunization with anti-P.g. IgY may prove to be effective in the treatment of chronic periodontitis due to its ability to improve clinical parameters and to reduce RCB. No significant differences were found between the anti-P.g. IgY and placebo groups in the reduction of P.g.
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