Purpose: In extensive deep burn of the lower limb, due to less amount of soft tissue, bone is easily exposed. When it happens, natural healing or reconstruction with skin graft only is not easy. Local flap is difficult to success, because adjacent skins are burnt or skin grafted tissues. Muscle flap or free flap are also limited and has high failure rate due to deep tissue damage. The authors acquired good outcome by performing one - stage operation on bone exposed soft tissue defect with AlloDerm$^{(R)}$(LifeCell, USA), an acellular dermal matrix producted from cadaveric skin. Methods: We studied 14 bone exposed soft tissue defect patients from March 2002 to March 2009. Average age, sex, cause of burn, location of wound, duration of admission period, and postoperative complications were studied. We removed bony cortex with burring, until conforming pinpoint bone bleeding. Then rehydrated AlloDerm$^{(R)}$(25 / 1000 inches, meshed type) was applicated on wound, and thin split thickness(6 ~ 8 / 1000 inches) skin graft was done at the immediately same operative time. Results: Average age of patients was 53.6 years(25 years ~ 80 years, SD = 16.8), and 13 patients were male(male : female = 13 : 1). Flame burn was the largest number. (Flame burn 6, electric burn 3, contact burn 4, and scalding burn 1). Tibia(8) was the most affected site. (tibia 8, toe 4, malleolus 1, and metatarsal bone 1). Thin STSC with AlloDerm$^{(R)}$ took without additional surgery in 12 of 14 patients. Partial graft loss was shown on four cases. Two cases were small in size under $1{\times}1cm$, easily healed with simple dressing, and other two cases needed additional surgery. But in case of additional surgery, granulation tissue has easily formed, and simple patch graft on AlloDerm$^{(R)}$ was enough. Average duration of admission period of patients without additional surgery was 15 days(13 ~ 19 days). Conclusion: AlloDerm$^{(R)}$ and thin split thickness skin graft give us an advantage in short surgery time and less limitations in donor site than flap surgery. Postoperative scar is less than in conventional skin graft because of more firm restoration of dermal structure with AlloDerm$^{(R)}$. We propose that AlloDerm$^{(R)}$ and thin split thickness skin graft could be a solution to bone exposured soft tissue defects in extensive deep burned patients on lower extremities, especially when adjacent tissue cannot be used for flap due to extensive burn.
Purpose: The aim of this study was to show the clinical results of combination of Nd-YAP (1340nm) laser therapy with conventional endodontic and periodontal treatment. Materials and Methods: Four patients with chronic advanced periodontitis and endodontic infection were treated with conventional treatment and Nd-YAP laser therapy. Occlusal adjustment and splinting were done for stabilization of the teeth with severe horizontal and vertical mobility. The protocol for periodontal treatment was followed as scaling and root planing, pocket irrigation with 3% $H_2O_2$ and exposure of Nd-YAP laser using 320${\mu}m$ optical fiber with 160mJ/pluse, 30Hz. The other protocol for endodontic treatment was followed as access opening, canal preparation by hand and rotary instrument, canal filling, and exposure of Nd-YAP laser using 200${\mu}m$ optical fiber with 200mJ/pluse, 10Hz and 180mJ/pluse, 5Hz which were used respectively for disinfection and canal filling. The assessments of probing depth, mobility, and radiography were made prior to and after treatment. Result: All of these four clinical cases showed good healing of periodontium, which presented decrease of mobility and pocket depth, and increase of bone regeneration and bone density on the radiography. Conclusion: The bactericidal effect of Nd-YAP laser would provide benefits for improving clinical results that are obtained from conventional therapy.
Kim, Dong-Yung;Kim, Jun-Hyung;Lee, Jae-Chul;Won, Moo-Ho;Yang, Se-Ran;Kim, Hyoung-Chun;Wie, Myung-Bok
Toxicological Research
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제35권1호
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pp.83-91
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2019
Nanoparticles (NPs) have been recognized as both useful tools and potentially toxic materials in various industrial and medicinal fields. Previously, we found that zinc oxide (ZnO) NPs that are neurotoxic to human dopaminergic neuroblastoma SH-SY5Y cells are mediated by lipoxygenase (LOX), not cyclooxygenase-2 (COX-2). Here, we examined whether human bone marrow-derived mesenchymal stem cells (MSCs), which are different from neuroblastoma cells, might exhibit COX-2- and/or LOX-dependent cytotoxicity of ZnO NPs. Additionally, changes in annexin V expression, caspase-3/7 activity, and mitochondrial membrane potential (MMP) induced by ZnO NPs and ZnO were compared at 12 hr and 24 hr after exposure using flow cytometry. Cytotoxicity was measured based on lactate dehydrogenase activity and confirmed by trypan blue staining. Rescue studies were executed using zinc or iron chelators. ZnO NPs and ZnO showed similar dose-dependent and significant cytotoxic effects at concentrations ${\geq}15{\mu}g/mL$, in accordance with annexin V expression, caspase-3/7 activity, and MMP results. Human MSCs exhibited both COX-2 and LOX-mediated cytotoxicity after exposure to ZnO NPs, which was different from human neuroblastoma cells. Zinc and iron chelators significantly attenuated ZnO NPs-induced toxicity. Conclusively, these results suggest that ZnO NPs exhibit both COX-2- and LOX-mediated apoptosis by the participation of mitochondrial dysfunction in human MSC cultures.
Background: The use of computed tomography (CT) device has increased in the past few decades in Japan. Dose optimization is strongly required in pediatric CT examinations, since there is concern that an unreasonably excessive medical radiation exposure might increase the risk of brain cancer and leukemia. To accelerate the process of dose optimization, continual assessment of the dose levels in actual hospitals and medical facilities is necessary. This study presents organ dose estimation using pediatric cerebral CT scans in the Kyushu region, Japan in 2012 and the web-based calculator, WAZA-ARI (https://waza-ari.nirs.qst.go.jp). Materials and Methods: We collected actual patient information and CT scan parameters from hospitals and medical facilities with more than 200 beds that perform pediatric CT in the Kyushu region, Japan through a questionnaire survey. To estimate the actual organ dose (brain dose, bone marrow dose, thyroid dose, lens dose), we divided the pediatric population into five age groups (0, 1, 5, 10, 15) based on body size, and inputted CT scan parameters into WAZA-ARI. Results and Discussion: Organ doses for each age group were obtained using WAZA-ARI. The brain dose, thyroid dose, and lens dose were the highest in the Age 0 group among the age groups, and the bone marrow and thyroid doses tended to decrease with increasing age groups. All organ doses showed differences among facilities, and this tendency was remarkable in the young group, especially in the Age 0 group. This study confirmed a difference of more than 10-fold in organ doses depending on the facility and CT scan parameters, even when the same CT device was used in the same age group. Conclusion: This study indicated that organ doses varied widely by age group, and also suggested that CT scan parameters are not optimized for children in some hospitals and medical facilities.
Byeong Jun Chae;Kyung-Seo Lee;Inhwa Hwang;Je-Wook Yu
IMMUNE NETWORK
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제23권3호
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pp.23.1-23.17
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2023
Inflammation is a series of host defense processes in response to microbial infection and tissue injury. Inflammatory processes frequently cause extracellular acidification in the inflamed region through increased glycolysis and lactate secretion. Therefore, the immune cells infiltrating the inflamed region encounter an acidic microenvironment. Extracellular acidosis can modulate the innate immune response of macrophages; however, its role for inflammasome signaling still remains elusive. In the present study, we demonstrated that macrophages exposed to an acidic microenvironment exhibited enhanced caspase-1 processing and IL-1β secretion compared with those under physiological pH. Moreover, exposure to an acidic pH increased the ability of macrophages to assemble the NLR family pyrin domain containing 3 (NLRP3) inflammasome in response to an NLRP3 agonist. This acidosis-mediated augmentation of NLRP3 inflammasome activation occurred in bone marrow-derived macrophages but not in bone marrow-derived neutrophils. Notably, exposure to an acidic environment caused a reduction in the intracellular pH of macrophages but not neutrophils. Concordantly, macrophages, but not neutrophils, exhibited NLRP3 agonist-mediated translocation of chloride intracellular channel protein 1 (CLIC1) into their plasma membranes under an acidic microenvironment. Collectively, our results demonstrate that extracellular acidosis during inflammation can increase the sensitivity of NLRP3 inflammasome formation and activation in a CLIC1-dependent manner. Thus, CLIC1 may be a potential therapeutic target for NLRP3 inflammasome-mediated pathological conditions.
Purpose: Facial trauma is increasing along with increasing popularity in sports, and increasing exposure to crimes or traffic accidents. Compared to the 3D CT of 1990s, the latest CT has made significant improvement thus resulting in higher accuracy of diagnosis. The objective of this study is to compare 64 channel 3 dimensional volume CT(3D VCT) with conventional 3D CT in the diagnosis and treatment of facial bone fractures. Methods: 45 patients with facial trauma were examined by 3D VCT from Jan. 2006 to Feb. 2007. 64 channel 3D VCT which consists of 64 detectors produce axial images of 0.625 mm slice and it scans 175 mm per second. These images are transformed into 3 dimensional image using software Rapidia 2.8. The axial image is reconstructed into 3 dimensional image by volume rendering method. The image is also reconstructed into coronal or sagittal image by multiplanar reformatting method. Results: Contrasting to the previous 3D CT which formulates 3D images by taking axial images of 1-2 mm, 64 channel 3D VCT takes 0.625 mm thin axial images to obtain full images without definite step ladder appearance. 64 channel 3D VCT is effective in diagnosis of thin linear bone fracture, depth and degree of fracture deviation. Conclusion: In its expense and speed, 3D VCT is superior to conventional 3D CT. Owing to its ability to reconstruct full images regardless of the direction using 2 times higher resolution power and 4 times higher speed of the previous 3D CT, 3D VCT allows for accurate evaluation of the exact site and deviation of fine fractures.
Background: Intravenous bisphosphonates have been used in metastatic breast cancer patients to reduce pathologic bone fracture and bone pain. However, necrosis of the jaw has been reported in those who received intravenous bisphosphonates. Bisphosphonate-related osteonecrosis of the jaw (BRONJ) is caused by dental extraction, dental implant surgery, and denture wearing; however, it occurs spontaneously. The purpose of this study was to report BRONJ in metastatic breast cancer patients. Methods: Consecutive 25 female patients were referred from the Department of Oncology from 2008 to 2014 for jaw bone discomfort. Staging of breast cancer, history of bisphosphonate infusion, etiology of BRONJ, and treatment results were reviewed. Average age of the patients was 55.4 years old (38-74). Twelve maxillae and 16 mandibles were involved. Conservative treatments such as irrigation, antibiotic medication, analgesics, and oral gargle were applied for all patients for the initial treatment. Patients who had sequestrum underwent debridement and primary closure. Results: The etiologies of BRONJ were dental extraction (19 cases), dental implant (2 cases), and endodontic treatment (1 case). However, three patients did not have any risk factors to cause BRONJ. Three patients died of progression of metastasis during follow-up periods. Surgical debridement was performed in 21 patients with success in 18 patients. Three patients showed recurred bone exposure and infection after operation. Conclusions: Prevention of the BRONJ is critical in metastatic breast cancer patients. Conservative treatment to reduce pain, discomfort, and infection is recommended for the initial therapy. However, if there is a sequestrum, surgical debridement and primary closure is the key to treat the BRONJ.
This study was performed in order to investigate the effects of taurine on cadmium poisoning in muscle, gill, and bone tissues of wild goldfish. For this experiment, 80 wild goldfish were divided into four experimental groups: 0.3 mg/L of cadmium and 0 mg/L of taurine (Group I), 0.3 mg/L of cadmium and 20 mg/kg of taurine (Group II), 0.3 mg/L of cadmium and 40 mg/L of taurine (Group III), and 0.3 mg/L of cadmium and 80 mg/L of taurine (Group IV). The results were as follows: The cadmium concentration in muscle tissue of wild goldfish was 0.65-3.21 mg/kg wet wt in Group I, whereas it decreased in Group IV. Levels of cadmium in gill tissue of wild goldfish were 16.57-42.39 mg/kg wet wt in Group I, 15.23-43.01 mg/kg wet wt in Group II, 15.11-39.56 mg/kg wet wt in Group III, and 13.15-38.55 mg/kg wet wt in Group IV (P < 0.05), suggesting that the cadmium concentration decreased in the experimental groups compared to control. The cadmium concentration in bone tissue of wild goldfish after 28 days was 0.52-9.75 mg/kg in Group II, whereas it increased in Group III (P < 0.05). In conclusion, taurine may have a preventive effect against cadmium accumulation in biological tissues.
The comparative detectability of the artificial periapical defects among Ektaspeed Plus film. digitized and digora images was evaluated. The artifical defects were made in the cancellous bone and cancellous-cortical junction with the size of 1.0×0.8mm², 1.4×1.1mm² and 2.8×2.2mm². The defects in cancellous-cortical junction extended into cortical bone with the depth of 0, 0.5 and 1.0 mm. The results were as follows : 1. In junctional defects Ektaspeed Plus film for 2.8×12.2mm² defect showed the highest detectability. But significant difference were only found between Ektaspeed Plus films and digitized images (p<0.05). 2. Almost all defects within cacellous bone were not detected except a few digitized and Digora images for the size of 2.8×2.2mm². Digora images for them showed significant differences with Ektaspeed Plus films and digitized images (p<0.05). 3. The sensitinity of all imaging modalities were 0.9 or 1.0 in junctional defects for the size of 1.4×2.2mm² and 2.8×2.2mm². For cancellous defects, Digora image showed the highest sensitivity of 0.6 for the size of 2.8×2.2mm². 4. Significant differences for change of exposure time were found in most group of Ektaspeed Plus films and digitized images (p<0.05) . But there was no significant differences in Digora images for cacellous defects.
Na, Yi Rang;Jung, Daun;Gu, Gyo Jeong;Seok, Seung Hyeok
Molecules and Cells
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제39권10호
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pp.734-741
/
2016
Granulocyte-macrophage colony stimulating factor (GM-CSF) has a role in inducing emergency hematopoiesis upon exposure to inflammatory stimuli. Although GM-CSF generated murine bone marrow derived cells have been widely used as macrophages or dendritic cells in research, the exact characteristics of each cell population have not yet been defined. Here we discriminated GM-CSF grown bone marrow derived macrophages (GM-BMMs) from dendritic cells (GM-BMDCs) in several criteria. After C57BL/6J mice bone marrow cell culture for 7 days with GM-CSF supplementation, two main populations were observed in the attached cells based on MHCII and F4/80 marker expressions. GM-BMMs had $MHCII^{low}F4/80^{high}$ as well as $CD11c^+CD11b^{high}CD80^-CD64^+MerTK^+$ phenotypes. In contrast, GM-BMDCs had $MHCII^{high}F4/80^{low}$ and $CD11c^{high}CD8{\alpha}^-CD11b^+CD80^+CD64^-MerTK^{low}$ phenotypes. Interestingly, the GM-BMM population increased but GM-BMDCs decreased in a GM-CSF dose-dependent manner. Functionally, GM-BMMs showed extremely high phagocytic abilities and produced higher IL-10 upon LPS stimulation. GM-BMDCs, however, could not phagocytose as well, but were efficient at producing $TNF{\alpha}$, $IL-1{\beta}$, IL-12p70 and IL-6 as well as inducing T cell proliferation. Finally, whole transcriptome analysis revealed that GM-BMMs and GM-BMDCs are overlap with in vivo resident macrophages and dendritic cells, respectively. Taken together, our study shows the heterogeneicity of GM-CSF derived cell populations, and specifically characterizes GM-CSF derived macrophages compared to dendritic cells.
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