• Clinical Pain
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• v.19 no.2
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• pp.111-115
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• 2020

We report a case of a healthy 38-year-old man presenting with insufficiency fracture of proximal tibia associated with unrecognized osteoporosis. Radiologic bone DEXA (Dual Energy X-ray Absorptiometry) assessment revealed osteoporosis, but the patient displayed no apparent risk factors for insufficiency fractures and osteoporosis except for a history of smoking. Following right proximal tibial open reduction and internal fixation, the patient commenced smoking cessation and began taking alendronate. The patient was treated for gait rehabilitation, which included quadriceps strengthening exercises and his condition improved with independent walking. This report highlights an unusual site of proximal tibial insufficiency fractures and the potential effect of smoking on low bone mineral density in a young male patient.

• The Korean Journal of Physiology
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• v.27 no.1
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• pp.27-35
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• 1993

Effects of the endothelium on the contractile responses to norepinephrine (NE) were investigated in isolated helical strips of the proximal and distal coronaries artery of pigs. The helical strips were immersed in Tris-buffered Tyrode's solution equilibrated with 100% $O_2$ at $35^{\circ}C$ and its isometric tension was measured. NE relaxed the strips precontracted with acetylcholine from both the proximal and distal coronary artery. NE-induced relaxation, which might be induced mainly by $\beta$-adrenoceptor function was dominant in the distal coronary arteries. NE-induced relaxation was converted to a contraction after $\beta$-adrenoceptor blockade with propranolol $(3{\times}10^{-6}M)$. ${\alpha}$-adrenoceptor-mediated contraction by NE was greater in the proximal coronary artery than the distal coronary artery. Quantitatively, ${\alpha}_1$-adrenoceptor mediated contraction by NE was greater than ${\alpha}_2$-adrenoceptor mediated contraction by NE in both arteries. NE-induced relaxation was decreased by rubbing of endothelium in both arteries. ${\alpha}_1-and\;{\alpha}_2$-adrenoceptor mediated contraction by NE were potentiated by rubbing of endothelium in both arteries. Pretreatment with methylene blue, an inhibitor of soluble guanylate cyclase, increased ${\alpha}_1-\;and\;{\alpha}_2$-adrenoceptor mediated contraction by NE in both arteries with endothelium. From the above results, we suggest that the effect of activation of $\alpha$-adrenoceptors by NE may be modulated by endothelium in the proximal and distal coronary arteries of pigs. This effect may be mediated via endothelium derived relaxing factor.

• Restorative Dentistry and Endodontics
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• v.47 no.2
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• pp.15.1-15.18
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• 2022

This review aimed to characterize the effect of direct restorative material types and adhesive protocols on marginal adaptation and the bond strength of the interface between the material and the proximal dentin/cementum. An electronic search of 3 databases (the National Library of Medicine [MEDLINE/PubMed], Scopus, and ScienceDirect) was conducted. Studies were included if they evaluated marginal adaptation or bond strength tests for proximal restorations under the cementoenamel junction. Only 16 studies met the inclusion criteria and were included in this review. These studies presented a high degree of heterogeneity in terms of the materials used and the methodologies and evaluation criteria of each test; therefore, only a descriptive analysis could be conducted. The included studies were individually evaluated for the risk of bias following predetermined criteria. To summarize the results of the included studies, the type of restorative material affected the test results, whereas the use of different adhesive protocols had an insignificant effect on the results. It could be concluded that various categories of resin-based composites could be a suitable choice for clinicians to elevate proximal dentin/cementum margins, rather than the open sandwich technique with resin-modified glass ionomers. Despite challenges in bonding to proximal dentin/cementum margins, different adhesive protocols provided comparable outcomes.

• Imaging Science in Dentistry
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• v.44 no.3
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• pp.199-205
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• 2014

Purpose: This study aimed to investigate the effect of changing the kilovoltage peak (kVp) on the radiographic assessment of dental caries. Materials and Methods: Seventy-five extracted posterior teeth with proximal caries or apparently sound proximal surfaces were radiographed with conventional E-speed films and a photostimulable phosphor system using 60 kVp and 70 kVp for the caries assessment. The images were evaluated by three oral radiologists and compared with the results of the stereomicroscope analysis. Results: No statistically significant difference was found between 60 kVp and 70 kVp for the caries detection, determination of caries extension into dentin, and caries severity in either the conventional or the digital images. Good to very good inter-observer and intra-observer agreements were found for both kilovoltage values on the conventional and digital images. Conclusion: Changing the kilovoltage between 60 kVp and 70 kVp had no obvious effect on the detection of proximal caries or determination of its extension or severity.

• Journal of Physiology & Pathology in Korean Medicine
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• v.26 no.4
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• pp.441-445
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• 2012

Cadmium is an important occupational and environmental pollutant that damages various organs, especially renal proximal tubular cells. We examined the effect of aqueous extract of Buddleja officinalis (ABO) on cadmium chloride ($CdCl_2$)-induced cytotoxicity in HK-2 human renal proximal tubular cells. HK-2 cells were preincubated with ABO (50, 100, 200 and 400 ${\mu}g/ml$) for 3 hr and then treated with 10 ${\mu}M$ $CdCl_2$ for 24 hr. The effect of ABO on $CdCl_2$-induced cytotoxicity in HK-2 cells was investigated by using MTT assay, morphological observation, flow cytometric analysis and Western blot. The results of the MTT assay and morphological observation indicated that $CdCl_2$-induced cytotoxicity was prevented by pretreatment with ABO. In flow cytometric analysis, ABO reduced sub-G1 peak (apoptotic peak) in $CdCl_2$-treated cells. $CdCl_2$-induced procaspase-3 proteolysis and PARP cleavage reduced by pretreatment with ABO. These results suggest that ABO effectively inhibited $CdCl_2$-induced cytotoxicity in HK-2 cells.

• PNF and Movement
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• v.9 no.3
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• pp.25-29
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• 2011

Purpose : We investigated the effect of anti-flexion taping at the proximal interphalangeal joints on the gait in stroke patients with clawing toe. Methods : Nineteen patients (mean age $63.26{\pm}9.16$ years) with clawing toe were studied. Gait performance was measured under two different conditions : (1) non-tape (2) application of tape. Gait velocity, step time and stride length were examined with the GAITRite system Results : Compared to the non-tape control condition, step time of the hemiparetic side increased significantly after the application of tape(p=0.03). There was no significant mean differences between the taped and control conditions for stride length of the hemiparetic side and velocity. Conclusion : Whilst the anti-flexion tape at the proximal interphalangeal joints changed the walking by providing significant step time effect, positive changes were noted in stride length of the hemiparetic side after tape application. These findings indicate that anti-flexion tape procedures do not significantly alter stride length of the hemiparetic side and velocity.

• Animal cells and systems
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• v.7 no.4
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• pp.309-315
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• 2003

Renal dipeptidase (RDPase, membrane dipeptidase, dehydropeptidase 1, EC 3.4.13.19) has been widely studied since it was first purified from porcine kidney brush border membrane. It was reported that RDPase activity in urine samples of acute and chronic renal failure patients decreases. Nitric oxide (NO) is a highly reactive free radical involved in a number of physiological and pathological processes. NO is able to act in a dual mode, leading either to induction of apoptosis or to blunted execution of programmed cell death. NO inhibited the RDPase release from porcine renal proximal tubules, which could be blocked by L-NAME. Chitosan, the linear polymer of D-glucosamine in $\beta$(1\longrightarrow4) linkage, not only reversed the decreased RDPase release by NO but also increased NO production in the proximal tubule cells. The stimulatory effect of NO on RDPase release from proximal tubules in the presence of chitosan must be different from the previously proposed mechanism of RDPase release via NO signaling pathway. Chitosan stimulated the RDPase release in the proximal tubules and increased RDPase activity to 220% and 250% at 0.1% and 1%, respectively. RDPase release was decreased to about 40% in the injured proximal tubules and was recovered in proportion to the increase of chitosan. Chitosan may be useful in recovery of renal function from $HgCl_2$injury.

• Journal of Korean Foot and Ankle Society
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• v.8 no.1
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• pp.64-70
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• 2004

Purpose: We compared the result of a proximal metatarsal closed wedge osteotomy and soft tissue procedure with a modified chevron osteotomy and soft tissue procedure in the treatment of hallux valgus. Materials and Methods: Between March 1999 and February 2003, we performed proximal metatarsal closed wedge osteotomy and soft tissue procedure on 17 feet (12 patients), and modified chevron osteotomy and soft tissue procedure on 12 feet (9 patients). Results: According to Mayo clinic forefoot scoring system (FFSS), group 1, with proximal metatarsal closed wedge osteotomy, shows 67.2 points postoperatively and group 2, with modified chevron osteotomy, shows 68.5 points postoperatively. In group 1, the average correction of hallux valgus angle and intermetatarsal angle was 20.8 degrees and 4.8 degrees, respectively. In group 2, the average correction of hallux valgus angle and intermetatarsal angle was 19.9 degrees and 4.7 degrees, respectively. The average shortening was 3.15 mm in group 1 and 1.38 mm in group 2. Conclusion: We obtained relatively good clinical and radiographic result in this study. The effect on shortening of the first metatarsal was greater in the proximal metatarsal closed wedge osteotomy than modified chevron osteotomy, but the metatarsal shortening did not related with metatarsalgia. So, both techniques seems optimal surgical treatment for hallux valgus deformity.

• Journal of Korean Neurosurgical Society
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• v.58 no.4
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• pp.316-320
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• 2015

Objective : The main concern during transfemoral carotid artery stenting (CAS) is preventing cerebral embolus dislodgement. We compared clinical outcomes and intraprocedural embolization rates of CAS using a distal filter protection device or proximal balloon occlusion device. Methods : From January 2011 to March 2015, a series of 58 patients with symptomatic or asymptomatic internal carotid artery stenosis ${\geq}70%$ were treated with CAS with embolic protection device in single center. All patients underwent post-CAS diffusion-weighted magnetic resonance imaging (DW-MRI) to detect new ischemic lesions. We compared clinical outcomes and postprocedural embolization rates. Results : CAS was performed in all 61 patients. Distal filter protection success rate was 96.6% (28/29), whose mean age was 70.9 years, and mean stenosis was 81%. Their preprocedural infarction rate was 39% (11/28). Subsequent DW-MRI revealed 96 new ischemic lesions in 71% (20/28) patients. In contrast, the proximal balloon occlusion device success rate was 93.8% (30/32), whose mean age was 68.8 years and mean stenosis was 86%. Preprocedure infarction rate was 47% (14/30). DW-MRI revealed 45 new ischemic lesions in 57% (17/30) patients. Compared with distal filter protection device, proximal balloon occlusion device resulted in fewer ischemic lesions per patient (p=0.028). In each group, type of stent during CAS had no significant effect on number of periprocedural embolisms. Only 2 neurologic events occurred in the successfully treated patients (one from each group). Conclusion : Transfemoral CAS with proximal balloon occlusion device achieves good results. Compared with distal filter protection, proximal balloon occlusion might be more effective in reducing cerebral embolism during CAS.

• Annals of Clinical Neurophysiology
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• v.5 no.2
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• pp.181-186
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• 2003

Background: Somatosensory evoked potential (SSEP) is valuable for the evaluation of the central pathway. However, peripheral neuropathy sometimes renders the test useless by preventing the conduction from reaching the CNS. We postulated that the peripheral conduction problems could be overcome by proximal stimulation in SSEP and wanted to verify this in the study. Methods: Twenty patients with diabetic sensorimotor polyneuropathy were included. SSEP was elicited by stimulating the median and posterior tibial nerves. We compared the effect of distal and proximal stimulations in each SSEP in the aspect of presence/absence and various latencies of resultant waves. Results: Among the 40 cases, proximal stimulation caused reappearance of subsided waves in 10 cases (25%). In the median nerve SSEP, proximal stimulation made EN1 and CN2 visible which were not evident when distally stimulated. In the posterior tibial nerve SSEP, there was also improvement of forming waves when proximally stimulated. Conclusions: In the diabetic polyneuropathy, proximal stimulation of SSEP is more effective than the conventional distal stimulation in evaluating central pathway.