• 약학회지
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• 제46권4호
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• pp.276-282
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• 2002

Morphine has been used widely on the treatment of many types of chronic pain. However the development of tolerance to morphine by repeat application is a major problem in pain therapy. The purpose of the present study was to investigate whether combined administration of nalbuphine with morphine affects the development of tolerance to and dependence on morphine. We hypothesize that the use of nalbuphine, k-agonist may prove to be useful adjunct therapy to prevent morphine-induced undesirable effects in the management of some forms of chronic pain. Morphine (10 mg/kg) was injected to rats intraperitoneally for 5 days. The variable dose of nalbuphine (0.1, 1.0 and 5.0 mg/kg) was administered (i.p.) in combination with morphine injection. The development of tolerance to morphine was assessed by measuring the antinociceptive effect with the Randall-Selitto apparatus. The development of dependence on morphine was determined by the scoring the precipitated withdrawal signs for 20 min after injection of naloxone (10 mg/kg, i.p.). Nalbuphine did not attenuate antinociceptive effect of morphine in rats. Interestingly, combined administration of morphine with nalbuphine (100:1) significantly attenuated the development of morphine tolerance and dependence. These results suggest that the co-administration of nalbuphine with morphine in chronic morphine treatment can be one of therapies to reduce the development of dependence on morphine.

• Journal of Periodontal and Implant Science
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• 제30권4호
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• pp.725-736
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• 2000

It is becoming increasingly apparent that periodontitis consists of mixture of diseases, most of which respond favorably to traditional mechanical therapy. Among these variants of the disease, some appear to be associated with unusual microbial infections and defective host defenses. Many of these fail to respond to conventional treatment. The recognition that some forms of periodontitis are refractory to standard periodontal therapy has given rise to a new classification of peridontitis. A series of 1692 subgingival microbial samples sent to a diagnostic microbiology laboratory included 738 samples that could be identified as compatible with a clinical diagnosis of refractory or recurrent periodontitis. In descending order of prevalence the associated microbiota included Bacteroides forsythus(85%) ,Fusobacterium species(78%), Spirochetes(67%), Campylobacter rectus(64%), Porphyromonas gingivalis(59%), Peptostreptococcus micros(58%), motile rods(46%), Prevotella intermedia(33%), Eikenella corrodens(13%), Capnocytophaga species(12%) ,and Actinobacillus actinomycetemcomitans(6%). Antibiotic resistance to tetracycline, penicillin G, or metronidazole was particularly noticeable for Fusobacterium species, Capnocytophaga species, and Actinobacillus actinomycetemcomitans. It was largely absent for Campylobacter rectus. No antibiotic data were obtained for Porphyromonas gingivalis or Bacteroides forsythus, as these species were detected by immunofluorescence. The results indicate that a substantial number of microorganisms associated with refractory periodontitis are variably resistant to commonly-used antibiotics. Diagnostic microbiology must be considered an essential adjunct to the therapist faced with periodontal lesions refractory to conventional treatment.

• Archives of Plastic Surgery
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• 제50권6호
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• pp.563-567
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• 2023

Ear keloids are challenging lesions to treat due to high recurrence rates postexcision. Conservative compression techniques as adjunct treatment have been reported to be effective. An innovative technique of using computer-aided design/computed-aided manufacturing to print a customized auricular splint improves efficiency and comfort level for patients compared with conventional methods. The ear is scanned using an intraoral scanning 2 weeks postsurgery. A two-piece auricular splint is designed on the digital model, incorporating perforated projections for three nylon screws for retention of the splint. The splint is printed with clear acrylic material, postprocessed, and finished. The patient is taught to assemble the components of the splint and instructed to wear for at least 8 hours daily. The surgery site reviewed for any ulceration, pain, or recurrence of keloid for 6 months. During the 6-month review, the excision scar remained flat and pink. The patient also reports unrestricted daily activities. The digital workflow increases comfort for the patient and reduces the number of hours required to produce a customized auricular splint compared with conventional methods. A fully digital workflow for a printed auricular splint should be considered for adjunctive treatment to excision of ear keloids.

• Clinics in Shoulder and Elbow
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• 제1권1호
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• pp.40-45
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• 1998

Multidirectional instability of the shoulder joint is an unusual entity which is not yet well understood. Traditionally recommended treatment is non-operative, but recently arthroscopic treatment has been performed. This is a retrospective review of 20 patients who had multidirectional instability, who had been treated with arthroscopic capsular shift(7 cases), and arthroscopic treatment using Ho:YAG laser(l3 cases) at Department of Orthopaedic Surgery, Chungnam National University Hospital from July, 1988to February, 1997. Results of this study were as follows: 1. In five patients who were treated with arthroscopic anterior capsular shift only, all cases had redislocation of the shoulder joint. But there was no redislocation in two patients who were treated with arthroscopic anterior and posterior capsular shift. 2. ln three patients who were treated with laser-assisted capsular shift only, all cases had redislocation of the shoulder joint. But there was only one redislocation in ten patients treated with laser-assisted capsular shrinkage and capsular plication. Ho: Y AG laser has been found to be a safe and efficacious adjunct to many arthroscopic shoulder procedures. We had satisfactory results by combining a transglenoid capsular shift with laser-assisted capsular shrinkage. Arthroscopic laser-assisted capsular shrinkage and capsular plication is a one of recommendable treatment options in multidirectional instability of the shoulder joint.

• Journal of Periodontal and Implant Science
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• 제51권6호
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• pp.374-385
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• 2021

Purpose: The aim of this study was to evaluate the effects of locally delivered 1% alendronate (ALN) gel used as an adjunct to non-invasive periodontal therapy. Methods: Ligature-induced periodontitis was performed in 96 rats. The ligature was tied in the cervical area of the mandibular left first molar. The animals were randomly divided into 4 groups: 1) NT, no treatment; 2) SRP, scaling and root planning; 3) SRP/PLA, SRP followed by filling the periodontal pocket with placebo gel (PLA); and 4) SRP/ALN, SRP followed by filling the periodontal pockets with 1% ALN gel. Histomorphometric (percentage of bone in the furcation region [PBF]) and immunohistochemical (receptor activator of nuclear factor-κB ligand, osteoprotegerin, and tartrate-resistant acid phosphatase) analyses were performed. Data were statistically analyzed, with the threshold of statistical significance set at P≤0.05. Results: The SRP, SRP/PLA, and SRP/ALN groups presented a higher PBF than the NT group (P≤0.01) at 7, 15, and 30 days. The SRP/ALN group presented a higher PBF than the SRP/PLA group in all experimental periods, as well as a higher PBF than the SRP group at 15 and 30 days. No differences were observed in the immunohistochemical analyses (P>0.05 for all). Conclusions: Locally delivered 1% ALN gel used as an adjunct to SRP enhanced bone regeneration in the furcation region in a rat model of experimental periodontitis.

• 치위생과학회지
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• 제19권4호
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• pp.254-260
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• 2019

Background: The primary aims of periodontal disease treatment is to remove dental plaque and calculus, the main causes of tooth loss, and restore periodontal tissue destroyed by inflammation. Periodontal disease treatment should also help maintain the alveolar bone, alleviate inflammation, and promote periodontal ligament cell proliferation, which is essential for tissue regeneration. Conventional antibiotics and anti-inflammatories have adverse side effects, especially during long-term use, so there is a need for adjunct treatment agents derived from natural products. The purpose of this study was to investigate whether the herbal flavone baicalein has the osteogenic activity under inflammatory conditions, and assess the involvement of osteoblast immediate early response 3 (IER3) expression. Methods: Human osteoblastic MG-63 cells were cultured with the pro-inflammatory cytokines tumor necrosis factor α and interleukin 1β in the presence and absence of baicalein. Proliferation was assessed using the 3-[4,5-dimethylthiazol-2-yl]-2,5-diphenyltetrazolium bromide assay, and expression of IER3 mRNA was assessed using real-time polymerase chain reaction. The expression of IER3 protein levels and activation of associated signal transduction pathways were assessed using western blotting. Results: Baicalein increased IER3 mRNA and protein expression synergistically. In addition, baicalein reversed the suppression of cell proliferation, and the downregulation of osteogenic transcription factor runt-related transcription factor 2 and osterix induced by pro-inflammatory cytokines. Baicalein also upregulated the phosphorylation of c-Jun N-terminal kinase (JNK) and extracellular signal-regulated kinase (ERK 1/2). The upregulation of IER3 by pro-inflammatory cytokines was blocked by pretreatment with inhibitors of AKT, p38, JNK, and ERK 1/2. Conclusion: Baicalein mitigates the deleterious responses of osteoblasts to pro-inflammatory cytokines. Further, IER3 enhanced the effect of baicalein via activation of AKT, p38, JNK, and ERK pathways.

• Journal of Korean Neurosurgical Society
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• 제29권8호
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• pp.1113-1120
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• 2000

Objectives : Despite advance in the surgical treatment of the intracranial aneurysm, we have to be surgical complication. The aim of this report is to evaluate the complication and its management in intracranial aneurysm operation. Methods : We reviewed our exprience with interesting cases of surgical complication of intracranial aneurysm : 1) rebleeding, 2) intra-operative premature rupture, 3) missed aneurysm in angiography, 4) vasospasm. Results : The risk of rebleeding was not related to the patients' initial comdition, but all other intracranial complications occurred significantly more often in patients graded poor compared with patients in good clinical condition. Rebleeding before early surgery remains as major cause of unfavorable outcome. The causes of intraoperative premature ruptures were as follows : 1) dural opening and arachnoid opening(8.3%), 2) hematoma removal(12.5%), 3) brain retraction(16.7%) 4) aneurysm dissection(62.5%). The double suction technique and primary hemostasis using a small piece of cotton or temporary clip resulted in good outcome even in cases with premature rupture. The incidence of missed aneurysm in angiography occurred in 10%. The causes were as thrombosed aneurysm, vasospasm on feeder artery. The most common missed aneurysm is also the most common aneurysm(anterior communicating artery aneurysm). The repeated angiography were documented in missed aneurysm. Balloon angioplasty is superior topapaverine for treatment of proximal vessel vasospasm by viture of a more sustained effect on the vessel. Papaverine can be useful as an adjunct to ballon angioplasty and also for the treatment of distal vessels that are not accessible for ballon angioplasty. Conclusion : The minimization of the complications and active treatment can reduced the mortality and morbidity of ruptured aneurysm patients.

• Journal of Acupuncture Research
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• 제37권4호
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• pp.254-258
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• 2020

Background: Scapulohumeral periarthritis causes pain and stiffness, and limits movement but it is a treatable condition. This was a clinical study of acupotomy treatment for scapulohumeral periarthritis. Methods: There were 80 patients randomly assigned to the traditional Chinese Medicine group (acupotomy) and the Western medicine group (naproxen), with 40 cases in each group. All patients had adjunct physiotherapy exercises for 14 days. Patients received acupotomy treatment 3 times for 14 days (Day 0, 7 and 14) or naproxen (0.22 g capsule; a non-steroidal anti-inflammatory drug) 3 times a day, for 14 days. The visual analogue scale (VAS) scores, range of motion (ROM) values, and the Melle scale, together with the therapeutic standard of diseases and syndromes in traditional Chinese Medicine were used for diagnosis and evaluation. Results: There were significant differences in the VAS scores, ROM, Melle scores, cure rate and total effective rate in the group which took naproxen and the acupotomy group, before and after treatment (p < 0.01). There were significant differences in the changes in VAS, ROM and Melle scores between the 2 groups (p < 0.01), and the acupotomy group was better than the naproxen group. Conclusion: Traditional Chinese Medicine and Western medicine can improve functional activity and reduce the level of pain experienced by patients suffering from scapulohumeral periarthritis. However, improvement of functional activity of the shoulder joint following acupotomy treatment was more obvious than the use of a non-steroidal anti-inflammatory drug, and the cure rate, and total effective rate of acupotomy was better.

• 대한치과의사협회지
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• 제54권6호
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• pp.429-437
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• 2016

Objectives: Photodynamic therapy has been proven to promote additional clinical and microbiological benefits in the treatment of chronic periodontitis and aggressive periodontitis. The purpose of this study is to assess the effectiveness of the photodynamic therapy for patient with periodontitis. Methods: We searched the eight Korean databases and Ovid-MEDLINE, Ovid-EMBASE, Cochrane Library. Total 300 studies were searched and 13 studies were included in the final assessment. Each of the stages from literature search and extraction of data were carried out independently by 2 researchers. We used tools of Scottish Intercollegiate Guidelines Networks for assessment of the quality of studies. Results: The safety of the photodynamic therapy was assessed by bleeding. The effectiveness of the photodynamic therapy was assessed by the reduction of Probing pocket depth (PPD) and the gain of Clinical attachment level (CAL). The mean difference of PPD was 0.46(95% CI 0.09~0.82), (p=.01).). The mean difference of CAL was ?0.49(95% CI ?1.12~0.14), (p=.13). Conclusion: The additional use of $^{\circ}{\infty}$Antimicrobial Photodynamic Therapy for Periodontitis$^{\circ}{\pm}$ caused hemorrhage to similar extents to conventional treatment modalities, where scaling and root planing are solely performed, in patients with periodontitis who are expected to have a lower degree of treatment response to non-surgical or surgical periodontal therapies (implant or refractory periodontitis) and those where there is a concern for the possible occurrence of antimicrobial side effects or resistance. This indicates that there are no problems with its safety. But there were no consistent reports about the effects of the additional use of photodynamic therapy. This led to a decision that the safety and efficacy of the current technology deserve further studies (Recommendation rating of A, Classification of technology II-a).

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제41권4호
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• pp.181-189
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• 2015

Objectives: The purpose of this study was to compare the microbial and clinical effects of mechanical debridement (MD) alone or in combination with the application of enamel matrix derivative (EMD) and sustained-release micro-spherical minocycline (MSM) for treatment of peri-implant mucosal inflammation (PIMI). Materials and Methods: Subjects with at least one implant with PIMI were included and divided into control and two different test groups. In all three groups, MD was performed. In the MSM group, following MD, MSM was placed subgingivally around the implants. In the EMD group, after MD, EMD was placed in the sulcus around the implants. Sampling of peri-implant crevicular fluid for microbial analysis with real-time polymerase chain reaction and recording of probing depth (PD) and bleeding on probing (BOP) were performed prior to as well as two weeks and three months after treatment. Median values and interquartile range were estimated for each variable during the various assessment intervals of the study. Results: In all groups, at two weeks and three months, the counts of Porphyromonas gingivalis decreased significantly compared to baseline. Levels of P. gingivalis were significantly reduced in MSM (P<0.001) and EMD (P=0.026) groups compared to the control group. Also, clinical parameters improved significantly at two weeks and three months. Reduction of PD was significant in MSM (P<0.001) and EMD (P<0.001) groups. The decrease in BOP in the MSM, EMD, and control groups was 60%, 50%, and 20%, respectively. Conclusion: The use of MSM and EMD can be an adjunctive treatment for management of PIMI and improves clinical parameters and reduces P. gingivalis burden three months after treatment.