Yoo, Yeon Sik;Yoon, Eul Sik;Lee, Byung Il;Dhong, Eun Sang
Archives of Plastic Surgery
/
v.36
no.1
/
pp.61-65
/
2009
Purpose: Most nasal bone fractures involve the septum; either or both of the ethmoidal perpendicular plate(EPP) and quadrangular cartilage(QC). Unlocked tension from the underlying quadrangular cartilage and poorly reducted bony septum are obstacles to the successful reduction of nasal bone. So we compared the preliminary outcome of septoplasty as a primary treatment with the untreated septum in nasal bone fractures. Methods: We performed a retrospective study of 215 patients underwent reduction of nasal fracture between January 2002 and February 2008. We graded patients into four groups according to the amount of deviation and direction of force by CT. Our indication for septoplasty and combined procedures was the deviation of EPP or QC over 50% from the midline. We interviewed part of the patients by telephone regarding the subjective esthetic and functional outcomes. Results: Forty five of 215 patients (21 percent) underwent septoplasty and combined procedures (cartilage graft, etc) after the informed consent. Patients who underwent septoplasty significantly satisfied with the outcome of esthetic appearance and nasal patency compared with patients who underwent simple closed reduction despite of having septal deviation over 50 percent from the midline. (p < 0.05) Conclusion: Septal surgery and esthetic consideration shoud be made even in simple nasal reductions. And if CT scans reveal severe deviation of septum, septoplasty should be considered as a primary treatment.
Objectives : In cases of osteoarthritis, the hypofunction of the cartilage and joint leads to a limited range of joint motion, swelling, and pain, which is generally treated using pharmaceutical drugs (e.g., anti-inflammatory agents, cartilage protectants, and nonsteroidal anti-inflammatory drugs) or replacement arthroplasty. However, long-term drug treatment is associated with adverse effects on the gastrointestinal systems. The present study aimed to evaluate the ability of Giheolsotong-hwan to treat of osteoarthritis symptoms in the MIA-induced rat model based on histological analysis, and factors that are associated with inflammation and bone mineral metabolism. Methods : Giheolsotong-hwan was administered orally at doses of 200 mg/kg/day or 400 mg/kg/day for 2 weeks before direct injection of monosodium iodoacetate ($3mg/50{\mu}{\ell}$ of 0.9% saline) into the intra-articular space of the rats' right knee. The rats subsequently received the same doses of oral Giheolsotong-hwan for another 4 weeks. We evaluated the treatment effects based on serum biomarkers and histopathological analysis of the knee joints. Results : Compared to those in control rats, the Giheolsotong-hwan treatments significantly decreased the serum concentration of inflammation factors (i.e., $IL-1{\beta}$, IL-6, $TNF-{\alpha}$, $PGE_2$, and $LTB_4$), and bone degrade factors (i.e., MMP-9, CTX-II, and COMP). In addition, the Giheolsotong-hwan treatments significantly increased the concentration of glycosaminoglycans of bone defence factors, but no chage the TIMP-1. Furthermore, the Giheolsotong-hwan treatments effectively preserved the knee cartilage and proteoglycan. Conclusion : The results indicate that Giheolsotong-hwan treated osteoarthritis symptoms. Thus, Giheolsotong-hwan may be a novel oriental therapeutic option for the management of osteoarthritis.
Kim, Jino;Seul, Chul Hwan;Roh, Tae Suk;Yoo, Woon Min
Archives of Plastic Surgery
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v.33
no.4
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pp.499-502
/
2006
Purpose: Grave's disease is an autoimmune disease with chronic and systemic features. It affects the orbital fat and muscle bringing about defect in extrinsic eye motility, diplopia, optic nerve defect and lid retraction. In patients with lagopthalmos and resulting facial deformity, treatment can be done by rectus muscle recession or filling with various material. Autogenous auricular cartilage graft is often used and synthetic material such as synthetic acellular dermis, polyethylene meshs are also used for filling of the depressed area. Nevertheless, autogenous auricular cartilage grafts are difficult to utilize and synthetic materials sometimes result in protrusion or infection. Therefore, hard palate mucosa was considered as an alternative. We report two cases of patients with lower eyelid retraction corrected with autogenous hard palate mucosa. Methods: We performed this operation in two patients of Graves' ophthalmopathy. The capsulopalpebral fascia was incised and elevated through an incision on the conjunctiva. Then, the harvested hard palate mucosa was sutured to the inferior border of the tarsus and covered with the conjunctiva. Results: The lower eyelid retraction was corrected successfully. No hypertrophy or deformation of the transplanted hard palate mucosa was noted 6 months after the surgery. Conclusions: From the results above, we may conclude that the hard palate mucosa serves as an ideal spacer for the curvature and the inner lining in lower lid retraction. Hard palate mucosa is as sturdy as the autogenous cartilage but is much easier to utilize. It can be also used for lid retraction after lower lid aesthetic surgeries or traumas.
For the purpose of reuse the wasted by-products from the skate process to the health functional food or medicinal material, chondroitin sulfate was extracted from the skate cartilage with the method of hydrolysis with protease enzyme, and the contents of chondroitin sulfate and hydrolyzed protein were measured qualitatively and quantitatively. The effects of chondroitin sulfate on body weight or liver weight changes, hepatotoxicity elimination and anti-inflammatory actions were measured from in vivo test with feed-treated mice. From the hydrolytic extraction of skate cartilage with the mixture of 1% alcalase and 1% protease for 4 hours, the extraction yield of chondroitin sulfate was about 32.55%. The content and molecular weight of chondroitin sulfate was 26.63% and $2.85{\times}10^5Da$., respectively and the content ratio of chondroitin sulfate to protein was measured to 1 to 2.76 with gel permeation chromatography. For the odor component, trimethylamine decreased about 30% but almost not ammonia from chondroitin sulfate with the treatment of activated carbon. From the feeding chondroitin sulfate to mice, the control effect of body and liver weights decrease was measured, anti-inflammatory action and hepatotoxicity elimination action were also measured. From these results, process operation conditions for manufacturing of chondroitin sulfate were suggested.
Osteoarthritis (OA) is the most common form of joint disease, characterized by articular cartilage, osteonecrosis, and osteochondral bone erosion. It is an early, progressive disease that combines joint stiffness and joint pain and reduces cartilage function and condition. Interleukin-1 beta ($IL-1{\beta}$) is thought to be important to the pathogenesis of OA and significantly increases the expression of matrix metalloproteinases (MMPs), which play an important role in cartilage degradation in OA. Sparassis crispa (Wulf.) is an edible / medicinal mushroom that has been reported to variety of biological activities. In this study, investigated the Anti-inflammatory effect of Sparassis crispa (Wulf.) ethanol extract (SCE) on $IL-1{\beta}$ stimulated SW1353 chondrocytes. SCE decreased the expression and activity of MMPs by $IL-1{\beta}$ and decreased the levels of cyclooxygenase-2 (COX-2) and inducible nitric oxide synthase (iNOS) associated with the inhibition of prostaglandin E2($PGE_2$) in $IL-1{\beta}$ stimulated SW-1353 chondrocytes. In addition, SCE inhibits the expression of MAPK (mitogen-activated protein kinase) and $NF-{\kappa}B$ (nuclear factor-kappa B) signaling in $IL-1{\beta}$ stimulated SW-1353 cells, and SCE inhibits the production of reactive oxygen species (ROS) through heme oxygenase-1 (HO-1) expression. Thus, it is suggested that SCE has a potential as an anti-inflammatory agent in osteoarthritis treatments.
Objective: Since Ulmus davidiana Planch (Ulmaceae) has been known to have anti-inflammatory and protective effects on damaged tissue, inflammation and bone among other functions, this study was undertaken to address whether the water extract of the bark of Ulmus davidiana Planch (Ulmaceae) (UD) could modulate the expression of inducible inflammatory cytokines in mice. The present study was also done in order to assess the therapeutic effects of UD in collagen-induced arthritis (CIA) in mice. Methods : DBA/1 mice were immunized with bovine type II collagen. After a second collagen immunization, mice were treated with UD orally at 100 mg/kg once a day for 3 weeks. Paws were evaluated macroscopically for redness, swelling and deformities. The levels of $TNF-{\alpha}\;and\;IL-1{\beta}$ in the ankle were examined. The severity of arthritis within the knee joints was evaluated by histological assessment of cartilage destruction and pannus formation. Results : Administration of UD significantly suppressed the progression of CIA and inhibited the production of $TNF-{\alpha}\;and\;IL-1{\beta}$ in the paws. The erosion of cartilage was dramatically reduced in mouse knees after treatment with UD. In the serum of UD-treated mice, the levels of IL-4 and IL-10, anti-inflammatory cytokines, were increased. Conclusion : From the results, it was concluded that administration of UD has therapeutic effects on CIA including protection of cartilage and RA for a potential therapy.
A number of experimental studies have been carried out in order to clarify the question as to how temporomandibular joint adapt to the changes of mandibular movement and occlusal equilibration. Recently, the studies on the interrelations between anatomical structure of temporomandibular joint and the state of occlusion have been actively performed in dentistry particularly in prosthodontic field. Author performed extraction of unilateral mandibular molars in 30 mature male rats, and observed histological changes of temporomandibular joint through the light microscope. Following results were obtained. 1. The loss of unilateral teeth gave rise to the changes in the location of condylar head, that is, interior displacement of condylar head in the extraction side and upper displacement in the non-extraction side. 2. Articular disk was compressed by the interior surface of condylar head, resulting in its extension below the condylar neck in the extraction side, and the histological arrangement of the compressed area showed irregular feature. 3. The extension of articular disk below the condylar neck was accompanied with the contraction of muscle fibers which were originated from the articular disk. 4. The cartilage layer of articular fossa to the exterior of the extraction side showed hypertropy. 5. Early in the experiment, the inernal extremity of condylar head of extract ion side showed bone resorption, and cartilage layer of condylar head showed hypertropy. At 12 weeks after experiment, the condylar surface showed flattened, and the cartilage layer of condylar head was replaced by the compact bone. 6. The articular disk showed the formation of pannus in the extraction side as well as in the non-extraction side. 7. The occlusal disturbance due to unilateral missing teeth has brought about the non-inflammatory retrogressive change and osteoarthrotic change late in the experiment.
Kim, Hyun-Ho;Kim, Su-Gwan;Lim, Sung-Chul;Chung, Hae-Man;Kim, Sang-Gon
Journal of the Korean Association of Oral and Maxillofacial Surgeons
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v.29
no.2
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pp.79-85
/
2003
The purpose of this study is to observe histopathologic changes in the bilateral craniomandibular joints after allowing 6 weeks of consolidation by varying the amount of distraction in rabbit mandible. Eight rabbits weighing about 2 to 3 kg were used. After corticotomy was performed on the left mandibular body between the first premolar and the second premolar region, a unilateral fixation device was placed. Then, a 7-day period was allowed without distraction of the device. The mandible was lengthened 0.5 mm/day. Corticotomy and lengthening of mandible were not performed in control group. After the completion of the lengthening process, a 6-week-consolidation period was allowed. Then, the rabbits were sacrificed, and histologic examination of the craniomandibular joints was performed. Proliferative changes were observed in the craniomandibular joints in all groups. With the increasing amount of distraction, hypertrophy of the cartilage layer became more severe, bone formed was dense and enchondral ossification was clearly shown in subchondral bone. Hypertrophy of the cartilage layer was also seen in the non-distracted side as the distracted side in the experimental group. These results indicate that when physical force is applied constantly to joints, the proliferation of articular cartilage and bone formation are present. When more than 6 weeks of consolidation period is allowed at the time of performing distraction for more than 5 mm, articular changes, especially, in the contralateral side should also be noted.
Wide vertical hemilaryngopharyngectomy with immediate glottic and pharyngeal reconstruction using a radial forearm free flap is reported in 1991 by Chantrain et al. This procedure was designed for the preservation of healthy hemilarynx and resection of pharynx with safe oncological margin in especially piriform sinus cancer or supraglottic cancer invading the hypopharynx. In the original paper, they used palmaris longus tendon for reconstruction of neoglottis. In other groups, they used rib cartilage instead of palmaris longus tendon. In this paper, we report two cases of piriform sinus cancer patients who treated with wide vertical hemilaryngectomy with radial forearm free flap reconstruction. In one case, the operation was performed as Chantrain et al described. But in another case, the ipsilateral forearm was impossible due to the positive Allen's test. So the contralateral forearm flap and rib cartilage graft was done. This reconstructive technique make large resection possible. As the dissection of thyroid cartilage and lateral displacement makes direct visualization and manipulation of piriform sinus lesions, sufficient resection margin in lateral and inferior pharyngeal wall cab be obtained.
The purpose of this study was to observe the effect of intermaxillary fixation on the chondrocytes of the mandibular condyle under the light and the electron microscope. For this study, twenty rabbits were placed in maxillomandibular fixation, and two were used as a control group. The experimental group was subdivided into 3, 7, 14, 21 and 28 day group. After the experimental period of 3, 7, 14, 21 and 28 days, the animals were sacrificed with a vascular perfusion of 2.5% glutaraldehyde. The condylar processes were exenterated, and decalcified in 0.1M EDTA with 2.5% glutaraldehyde solution for two weeks. The specimens were rinsed with phosphate buffer solution and the post-fixation was carried out with 2% osmium tetroxide at $4^{\circ}C$ for two hours. Thereafter the specimens were dehydrated in alcohol series, cleared with propylene oxide and embedded in Epon 812 resin. Thin sections and ultra-thin sections were made, and the cellular structures of the condylar cartilages were observed with light and electron microscope. The results were as follows: 1. In the intermaxillary fixation group, the cartilaginous tissues of mandibular condyles showed a marked decrease in the thickness compared to the control group. 2. A remarkable change was noticed in the proliferating and the hypertrophic zone of the condylar cartilages in the experimental group. 3. An atrophic change of the condylar cartilage was appeared in the 3 day experimental group and degenerative change was observed in the 7 day experimental group, and recovery was seen in thereafter 14 day experimental group. 4. Calcification, degeneration and resorption of condylar cartilage were recognizable, and the cellular zone of the condylar cartilage was appeared indistinctly in 3 day and 7 day experimental group. The chondroblasts, however, were differentiated into chondrocytes and resumed mitosis, and then the cellular zones of the condylar cartilage were reorganized from the 14 day experimental group under the findings of light microscope. 5. Under the findings of electron microscope, atrophic changes and decrease in number of intracellular organelles, degenerative changes of cytoplasm, and pyknosis of nuclei were observed in early stage, however, a gradual regeneration and reorganization of the intracellular organelles were observed from 14 day experimental group.
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