[Show abstract][Hide abstract] ABSTRACT: Vitamin D is considered essential for bone and muscle health, and some studies have demonstrated the positive effects of vitamin D on metabolic diseases and cancer. Nevertheless, a high prevalence of vitamin D deficiency has been reported in various populations, regardless of country or race. However, no studies regarding the prevalence of vitamin D deficiency in Korean orthopedic patients currently exist. This cross-sectional study included 272 male and 937 female patients aged 50 years and older who were consecutively admitted to the authors' orthopedic department. Vitamin D (25-hydroxy vitamin D), bone turnover markers (osteocalcin, c-telopeptide), and bone mineral density were measured. The prevalence of vitamin D deficiency and its association with other factors were evaluated. Mean patient age was 67.2±8.9 years, and mean level of vitamin D was 16.1±9.1 ng/mL. Overall, 91.2% of patients had deficient (<20 ng/mL; 70.6%) or insufficient (20-30 ng/mL; 20.6%) levels of vitamin D. Vitamin D level did not vary by age group or sex. The level of vitamin D was significantly associated with osteocalcin, c-telopeptide, calcium, alkaline phosphatase, total cholesterol, triglycerides, low-density lipoprotein cholesterol, and glucose (P<.01). Vitamin D level in Korean orthopedic patients of this region was extremely low, regardless of sex and age. Although vitamin D was not directly associated with bone mineral density, there were significant associations between vitamin D and other factors related to bone health and metabolic diseases. [Orthopedics. 2015; 38(10):e898-e903.].
[Show abstract][Hide abstract] ABSTRACT: Objective:
The objective of this study was to evaluate the variation in the condition referred to as molar root-incisor malformation (MRIM) and elucidate the distribution of affected teeth. This study further aimed to identify associated environmental stressors.
Individuals were identified through retrospective review of dental radiographs and through referral to the investigators. Histologic evaluation included examination of mineralized and decalcified sections of affected first permanent molar teeth.
Thirty cases of MRIM were identified, with all having affected first permanent molars with dysplastic root formation. The primary second molars were affected in 57% of the cases, with permanent anterior teeth being involved in 40% of the cases. A variety of medical conditions were associated with MRIM, the most common being neurologic. Several affected individuals reported no significant past medical history or environmental stressors.
The etiology of MRIM remains unclear, and this unique developmental defect of the first permanent molar roots appears to occur in populations throughout the world. Clinicians identifying the MRIM phenotype should carefully evaluate the permanent incisors for associated developmental defects that could result in pulpal necrosis.
No preview · Article · Sep 2015 · Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology
[Show abstract][Hide abstract] ABSTRACT: Halibut is served on sushi and as sliced raw fish fillets. We investigated the optimal conditions of the Maillard reaction (MR) with ribose using response surface methodology to reduce the allergenicity of its protein. A 3-factored and 5-leveled central composite design was used, where the independent variables were substrate (ribose) concentration (X1, %), reaction time (X2, min), and pH (X3), while the dependent variables were browning index (Y1, absorbance at 420 nm), DPPH scavenging (Y2, EC50 mg/mL), FRAP (Y3, mM FeSO4/mg extract) and β-hexosaminidase release (Y4, %). The optimal conditions were obtained as follows: X1, 28.36%; X2, 38.09 min; X3, 8.26. Maillard reaction products of fish protein hydrolysate (MFPH) reduced the amount of nitric oxide synthesis compared to the untreated FPH, and had a significant anti-allergy effect on β-hexosaminidase and histamine release, compared with that of the FPH control. We concluded that MFPH, which had better antioxidant and anti-allergy activities than untreated FPH, can be used as an improved dietary source.
[Show abstract][Hide abstract] ABSTRACT: The cholesterol-lowering effect of taurine differs based on species, types of hypercholesterolemia, and, in particular, the presence or absence of cholate in an individual’s diet. In this study, the cholesterol-lowering and anti-obesity effects of taurine were tested in rats fed a lard-based, high-fat diet, which was intended to be qualitatively similar to the diets of obese patients, rather than a high cholesterol/sodium diet with cholate intake. Sprague-Dawley (SD) rats were fed either a normal diet, a high-fat (HF) diet, or a taurine (2 %) diet for 12 weeks. After the experimental period, the rats’ organs were harvested and sera were collected to analyze changes in organ weight, histological changes, and serum lipid levels. The HF diet increased body-weight gain (g/day) and weight of epididymal and retroperitoneal fat tissue, while a taurine supplement did not influence weight increased by HF diet. Additionally, histological changes were not detected in the pancreas, liver, or adipose tissue. In contrast, the serum levels of triglycerides, total cholesterol, and LDL-cholesterol levels were significantly increased among rats fed a HF diet, while these levels decreased among rats fed a taurine diet. This result suggests that taurine supplementation is not effective at reducing obesity but it can reduce serum lipid levels that were previously elevated due to a high-fat diet. In conclusion, taurine supplementation may be helpful in ameliorating hyperlipidemia, one of the major risk factors of cardiovascular disease (CVD).
No preview · Article · Apr 2015 · Advances in Experimental Medicine and Biology
[Show abstract][Hide abstract] ABSTRACT: Although the Proseal laryngeal mask airway (PLMA) has been widely used in anesthesia, little is known about its clinical effectiveness during dental procedures. We describe the clinical feasibility of the PLMA for managing airways in the field of pediatric dentistry. .
We reviewed the medical records of children who underwent airway management with the use of the PLMA from January 2011 to December 2012 at an outpatient facility at Seoul National Dental University Hospital.
During the study period, the airways of 19 children were managed with the PLMA for dental procedures. During its placement, blood pressure and heart rate were stably maintained. There were no interruptions of the dental procedures. None of the children experienced oxygen desaturation or ventilation difficulty. In one patient, the PLMA was dislodged for a short time, but the problem was easily solved with repositioning. After transferring to the post-anesthetic care unit, there were no incidences of oxygen desaturation or vomiting. All of the children were discharged from the hospital without complications.
The PLMA can be successfully used in airway management during dental treatment in children.
Full-text · Article · Mar 2015 · The Journal of clinical pediatric dentistry
[Show abstract][Hide abstract] ABSTRACT: Dickkopf-3 (DKK3) may act as a tumor suppressor as it is down-regulated in various types of cancer. This study assessed the DKK3 protein expression in gastric cancer and its potential value as a prognostic marker.
DKK3 expression was evaluated by immunohistochemistry in 158 gastric cancer samples from patients who underwent gastrectomy from 2002 to 2008. Clinicopathological parameters and survival data were analyzed.
Loss of DKK3 expression was found in 64 of 158 (40.5 %) samples, and it was associated with advanced T stage (p < 0.001), lymph node metastasis (p < 0.001), UICC TNM stage (p < 0.001), tumor location (p = 0.029), lymphovascular invasion (p = 0.035), and perineural invasion (p = 0.032). Patients without DKK3 expression in tumor cells had a significantly worse disease-free and overall survival than those with DKK3 expression (p < 0.001, and p = 0.001, respectively). TNM stage (p = 0.028 and p < 0.001, respectively) and residual tumor (p < 0.001 and p = 0.003, respectively) were independent predictors of disease-free and overall survival. Based on the preoperative clinical stage assessed by computed tomography (CT), loss of DKK3 expression was predominantly associated with worse prognosis in patients with clinically node-negative advanced gastric cancer (AGC). The combination of DKK3 expression status and CT increased the accuracy of CT staging for predicting lymph node involvement from 71.5 to 80.0 % in AGC patients.
Loss of DKK3 protein expression was significantly associated with poor survival in patients with gastric cancer and was strongly correlated with the TNM stage. DKK3 might be a potential biomarker of lymph node involvement that can improve the predictive power of CT.
No preview · Article · Jan 2015 · World Journal of Surgery
[Show abstract][Hide abstract] ABSTRACT: SAPHO syndrome is a rare inflammatory, pseudoinfectious disease. Initially it was an acronym for Syndrome Acne Pustulosis Hyperostosis Osteitis, and the meaning of S was later changed to synovitis. It occurs predominantly in children and adults and is not common over 60 years. The most common clinical presentation is osteoarticular involvement at the anterior chest wall and skin manifestations may be evident, but it could occur years earlier or develop later. We report on two cases of mother and daughter. A 51-year-old female was diagnosed with SAPHO syndrome with costochondritis and palmoplantar pustulosis. Five years later, her 31-year-old daughter presented with similar skin manifestations of the hand and foot.
[Show abstract][Hide abstract] ABSTRACT: This study was performed to evaluate whether endocan expression, which is known to be involved in tumor angiogenesis, was increased in rheumatoid arthritic tissues. In addition, the involvement of adiponectin in the regulation of endocan expression in arthritic joints was examined. Arthritic synovial tissues from patients with rheumatoid arthritis (RA) or osteoarthritis (OA) were immunostained with antibodies to endocan and vascular endothelial growth factor (VEGF). Subsequently, synovial cells and human umbilical vein endothelial cells were cultured and stimulated with interleukin-1 β (IL-1β) or adiponectin. The mRNA and protein levels of endocan were evaluated by polymerase chain reaction and ELISA, respectively. Endocan expression was markedly increased in the inflammatory sites of RA synovial tissues. In OA tissues, endocan expression was higher in tissues displaying moderate and severe inflammation than in those with mild inflammation. In vitro expression levels of endocan and VEGF in endothelial and synovial cells were differentially increased in response to IL-1β stimulation. Adiponectin was a more potent stimulant of endocan than IL-1β at their respective physiological concentrations in synovial cells. Endocan silencing by small interfering RNA transfection of synovial cells decreased in vitro cell migration and invasion. In conclusion, adiponectin is an important factor in the stimulation of endocan expression in synovial cells. Adiponectin-induced endocan expression in synovial cells may stimulate cell migration and invasion as well as angiogenesis in the pannus of arthritic joints.
No preview · Article · Dec 2014 · Molecular Medicine Reports
[Show abstract][Hide abstract] ABSTRACT: This study was performed to evaluate the contribution of adiponectin to the production of interleukin (IL)-6, IL-8, vascular endothelial growth factor (VEGF), matrix metalloproteinase (MMP)-1 and MMP-13 in human endothelial cells and osteoblasts in arthritic joints. Cultured human umbilical vascular endothelial cells (HUVECs) and osteoblasts were stimulated with adiponectin (1 or 10 μg ml(-1)) or IL-1β (0.1 ng ml(-1)) in the presence or absence of hypoxia for 24 h. The protein expression patterns were examined by analyzing culture supernatants using the enzyme-linked immunosorbent assay (ELISA). Adiponectin significantly stimulated the production of VEGF, MMP-1 and MMP-13 in osteoblasts but not in endothelial cells, whereas it significantly stimulated the production of IL-6 and IL-8 in both endothelial cells and osteoblasts. The increase in VEGF production induced by adiponectin was significantly greater than that induced by IL-1β. The production of IL-6 and IL-8 in adiponectin-stimulated endothelial cells was approximately 10-fold higher than that in IL-1β-stimulated endothelial cells; in osteoblasts, adiponectin-induced IL-6 and IL-8 secretion was approximately twofold higher than that induced by IL-1β. In addition, IL-8 production in endothelial cells was approximately sevenfold higher than in osteoblasts. However, IL-6 levels were similar between the two cell types, suggesting that adiponectin may be involved in the production of IL-8 in endothelial cells, which may have an important role in neutrophil recruitment to arthritic joints. Furthermore, the increases in protein expression induced by adiponectin were differentially regulated by hypoxia. In conclusion, adiponectin has a more important role than does IL-1β in the production of mediators that drive synovitis and joint destruction in endothelial cells and osteoblasts at physiological concentrations.
[Show abstract][Hide abstract] ABSTRACT: The purpose of this study is to examine the difference between the numbers of patients in rheumatoid arthritis (RA) who are eligible to TNF inhibitors by the past Korean National Health Insurance reimbursement guideline and by the disease activity score with 28-joint assessment (DAS28) based criteria.
[Show abstract][Hide abstract] ABSTRACT: Adrenoleukodystrophy (ALD) is a rare, inherited disorder that leads to progressive brain damage and failure of the adrenal glands. It is passed down from parents to their children as an X-linked genetic trait. Therefore, it affects primarily males especially under the age of 10. People with ALD have excessive accumulation of very long chain fatty acids (VLCFAs) in their brain because they do not have the enzyme which break down these fatty acids. Special method for treatment of ALD is not available. Eating a diet low in VLCFAs and taking special oils, called Lorenzo's oil, can lower the blood levels of VLCFAs. But this oil cannot stop the destruction of nerve cell. This article presents a case report: Dental treatment of a 11-year-old male patient with ALD under general anesthesia. Careful management must be required during treatment procedure because of difficulty in cooperation, seizure disorders, gastroesophageal reflux, pulmonary aspiration and airway complications.
[Show abstract][Hide abstract] ABSTRACT: Hypoxic ischemic encephalopathy (HIE) is an important cause of permanent damage to central nervous system cells, most cases with oxygen deprivation in the nenonate due to birth asphyxia. Survival children with HIE develop problems such as cerebral palsy, mental retardation, learning difficulties, and other permanent neuro-developmental disabilities. This article report two cases of the children with HIE who had be traumatized on their teeth from oropharyngeal airway (OPA) in the emergency situation. The patients with the disease accompanying seizure or convulsion, needs special consideration for the prevention from dental trauma in emergency airway management.
[Show abstract][Hide abstract] ABSTRACT: A nation-wide, outpatient-based, cross-sectional survey with the use of questionnaires.
To evaluate the pain, disability and satisfaction of patients with osteoporotic vertebral compression fractures (OVCFs).
There are no nation-wide data in Korea on the degree of pain, disability and satisfaction with treatment in patients with OVCFs.
We performed a cross-sectional survey of 573 patients with OVCFs. After excluding incomplete questionnaires (missing more than 30% of the variables), 430 patient-physician-matched data sets were collected for this survey.
Patients with OVCFs were managed with conservative treatment in 63% and with a vertebroplasty in 37%. The means of the latest visual analogue scale (VAS, 5.2) and Oswestry Disability Index (ODI, 47.7) scores checked at the time of survey were significantly higher than those VAS and ODI scores prior to OVCFs (the prefracture VAS and ODI scores, 3.6 and 26.3, respectively; p<0.001 for both comparisons). However, the means of the latest VAS and ODI scores were insignificantly different between the conservative and vertebroplasty groups, irrespective of the duration from the fractures. Overall, 75% of patients were satisfied with their clinical outcomes. However, the percentages of patient's satisfaction were not significantly different between the conservative and vertebroplasty groups. Eighty-eight percent of patients felt some or marked deterioration of their general health condition following OVCFs.
These results indicate that although most patients with OVCFs were satisfied with their clinical outcomes, their subjective general health conditions, as well as their pain and disability, did not recover to the prefracture state.
Full-text · Article · Dec 2013 · Asian spine journal
[Show abstract][Hide abstract] ABSTRACT: Osteopontin (OPN) is known to be significantly involved in the pathogenesis of rheumatoid arthritis (RA). This study aimed to evaluate if the serum concentration of OPN in patients with RA before and after therapeutic treatments was correlated to disease activity and response to therapy. Blood samples from 40 patients with RA were collected at baseline and six months after starting treatment with disease-modifying antirheumatic drugs (DMARDs) and/or tumor necrosis factor (TNF)-α blockers. Serum levels of OPN were measured by ELISA. At baseline, the serum OPN level in RA patients was significantly higher than that of the healthy group. The OPN level at baseline in RA patients with severe disease activity as evaluated by DAS28 was slightly higher than that of those with moderate disease activity. The serum OPN level in RA patients was not significantly correlated with the DAS28 level. The serum OPN level in both responders and non-responders after therapy was significantly decreased regardless of responsiveness to therapy. Also, the OPN level at baseline did not affect the responsiveness to therapeutic treatments. In conclusion, serum OPN level was not correlated with disease activity or responsiveness of RA patients to therapeutic treatments.
No preview · Article · Sep 2013 · Clinical Rheumatology
[Show abstract][Hide abstract] ABSTRACT: Sedation of uncooperative children for dental treatment is difficult since treatment is mainly carried out inside the oral cavity. Dexmedetomidine (DEX), recently introduced into clinical practice, has little influence on respiratory system even at high doses. We present cases of patients who underwent dental treatment under sedation using DEX infusion. DEX at a dose of 1 microg/kg was administered over 10 min after intravenous cannulation. DEX was infused to maintain sedation level within the range of the Observer's Assessment of Alertness and Sedation (OAA/S) scale 3- 4 throughout dental treatments. They were successfully treated under DEX sedation without any complications. Their uncooperative behaviors were successfully managed under DEX sedation.
No preview · Article · Sep 2013 · The Journal of clinical pediatric dentistry
[Show abstract][Hide abstract] ABSTRACT: Study Design. Retrospective, radiographic analysisObjective. Evaluate pedicle subtraction osteotomy (PSO) as a means of correcting severe degenerative sagittal imbalance in elderly patients.Summary of Background Data. PSO in patients with degenerative sagittal imbalance is likely to cause more complications than in patients with iatrogenic flatback deformity.Methods. This study analyzed thirty four patients who underwent fusion to the sacrum, with a minimum 2-year follow up. Ages ranged from 58 to 73 with the mean at 65.5 years. PSO was performed at one segment in all cases, consisting of L3 (n = 26), L4 (n = 4), L2 (n = 3), and L1 (n = 1). The average number of levels fused was 8.15. Ten patients had structural interbody fusion at the lumbosacral junction.Results. Applying PSO at one segment, the mean correction of the lordotic angle at the osteotomy site was 33.3, of which the loss of correction (LOC) was 4.0 at the last visit. The correction of lumbar lordosis was 33.7 and the LOC was 8.5. The sagittal C7 plumb was 215.9mm before surgery, corrected to 35.1mm after surgery, and changed to 95.9mm by the last visit. The correction of the sagittal C7 plumb was 119.9mm and the LOC was 60.9mm. There was substantial LOC in lumbar lordosis and sagittal C7 plumb. In 10 patients with addition of posterior lumbar interbody fusion, the LOC of lumbar lordosis was 7.4, which was less than 9 in those who had not it.Conclusion. Pedicle subtraction osteotomy for the correction of degenerative sagittal imbalance in elderly patients resulted in correction of sagittal alignment with a significant LOC of lumbar lordosis and sagittal C7 plumb. The LOC of lumbar lordosis occurred at both the osteotomy and non-osteotomy site. The addition of anterior column support is helpful to maintain correction and reduce complications.
[Show abstract][Hide abstract] ABSTRACT: A 76-year-old woman with about a 13-month history of bradykinesia, gait disturbance and resting tremor of right upper extremity was referred to Nuclear Medicine Department. A PET-CT with 229 MBq of F FP-CIT was performed to diagnose suspected early Parkinson's disease (PD). The PET-CT showed a mass lesion with highly intense focal dopamine transporter uptake in the right frontal lobe. A subsequent brain magnetic resonance image also showed a mass in the right frontal lobe demonstrating homogeneous enhancement and extensive surrounding edema, highly suggestive of a brain tumor.
No preview · Article · Jul 2013 · Clinical nuclear medicine
[Show abstract][Hide abstract] ABSTRACT: Type 1 myotonic dystrophy (DM1) is an autosomal-dominant inherited disorder with a multisystem involvement, caused by an abnormal expansion of the CTG sequence of the dystrophic myotonia protein kinase (DMPK) gene. DM1 is a variable multisystem disorder with muscular and nonmuscular abnormalities. Increasingly, endocrine abnormalities, such as gonadal, pancreatic, and adrenal dysfunction are being reported. But, Electrolytes imbalance is a very rare condition in patients with DM1 yet. Herein we present a 42-yr-old Korean male of DM1 with abnormally elevated serum sodium and potassium. The patient had minimum volume of maximally concentrated urine without water loss. It was only cured by normal saline hydration. The cause of hypernatremia was considered by primary hypodipsia. Hyperkalemic conditions such as renal failure, pseudohyperkalemia, cortisol deficiency and hyperkalemic periodic paralysis were excluded. Further endocrine evaluation suggested selective hyperreninemic hypoaldosteronism as a cause of hyperkalemia.
Preview · Article · Jul 2013 · Journal of Korean medical science
[Show abstract][Hide abstract] ABSTRACT: Lennox-Gastaut syndrome (LGS) is a severe form of childhood epilepsy that is defined by generalized multiple type seizures, slowness of intellectual growth, and a specific EEG disturbance. Children affected might previously have infantile spasms or underlying brain disorder but etiology can be idiopathic. LGS seizures are often treatment resistant and the long term prognosis is poor. A 14-year-3-month old, 20.5 kg girl with LGS was scheduled for dental treatment under general anesthesia. The patient presented with multiple caries and heavy calculus. General anesthesia was induced and maintained with inhalation agent, Sevoflurane. And caries treatment, scaling, subgingival curretage were performed. LGS patients usually have poor oral hygiene due to mental retardation and have high risk of seizure during dental treatment. In dental treatment under general anesthesia for LGS, it must be considered of seizure control during peri-operative period. Also periodic recall check, instruction of oral hygiene must be performed.