Objective To investigate the efficacy of percutaneous endoscopic laser-assisted discectomy (PELD) on L5S1 herniated nucleus pulposus by posterior paramedian trans-interlaminar approach (PEILD). Methods 168 consecutive patients underwent PEILD between May 2002 and December 2003, and were analyzed retrospectively. All cases were operated in outpatient department under local anesthesia in Wooridul Spine Hospital of Korea. Of the 168 cases, 92 were males, and 76 females with a mean age of 42.8 years (range,18 to 73 years ). The classification of herniated disc position related to spinal canal and pedicle, was central in 22, para-central in 120, foraminal in 23, and extraforaminal in 3. The average of iliosacral distance was 38.6 mm. "C" arm fluoroscopy was needed during operation. All of the patients were given conservative management for 6 to 8 weeks without relief of radiculalgia. The AP film was used to make sure to have enough working interlaminar space of posterior percutaneous approach for L5S1 herniated nucleus pulposus. Results The operative time was 30 to 90 mins with an average of 45 mins, and the mean hospitalization was 1.3 days. The average follow-up duration was 8.3 months (range, 5 to 19 months), and the patients were evaluated at 2 day, 2 week, and 1, 2, 6 and 12 month respectively. The clinical results were assessed by MacNab criteria, there were excellent in 43.5%, good in 47.0%, fair in 4.8%, and poor in 4.8%, and successful rate was 90.5%. 8 cases showed incomplete removal of the pathological disc on postoperative MRI without changes of symptoms and signs, then open laminectomy and microdiscectomy (OLM) were performed, including 4 of foraminal type, 3 of extraforaminal type and 1 of central type. 1 case displayed discitis, which was improved one month later by intravenous antibiotics, immobilization and bedrest. 26 cases showed transient postoperative paresthesia, improved by conservative treatment. Conclusion L5S1 disc herniation can be effectively treated with percutaneous endoscopic laser discectomy through posterior paramedian trans-interlaminar approach, which is easier for the patients with higher iliac spines.

PURPOSE: Lumbar degenerative kyphosis (LDK) is a subgroup of the flatback syndrome, which is a condition caused by spinal degeneration. LDK is reported to be the most frequent cause of lumbar spine deformity in the farming districts of the 'Oriental' countries. We investigated the relationship between the cross-sectional area (CSA) and the moment arm length (MAL) of the erector spinae muscle and the thickness of the psoas major muscle (PT) and the body mass index (BMI) by performing statistical analysis, and we tried to show the crucial role of these variables for diagnosing LDK. MATERIALS AND METHODS: From July 2004 to April 2005, we retrospectively reviewed 17 LDK patients who had undergone anterior lumbar interbody fusion (ALIF) with posterior stabilization. We measured both the CSA & MAL on the transverse cross-sectional MR image of the trunk at the fourth to fifth vertebrae (L4/5). The MAL was defined as the anterior-posterior distance between the center of the erector spinae muscle and that of the vertebral body. A comparative study was undertaken between the LDK group and the matched (according to age & gender) control group with regard to the CSA, MAL, PT and BMI. RESULTS: The 17 LDK patients were all females [age: 62.5+/-4.93 years, height: 157+/-6.19 cm, weight: 55.59+/-4.7 kg, and BMI: 22.58+/-2.08 kg/m2]. The control group patients were all females [age: 63.6+/-2.27 years, height: 156+/-5.05 cm, weight: 59.65+/-7.39 kg and BMI: 24.38+/-2.94 kg/m2]. Spearman's rho indicated a positive association between the CSA & BMI (rho=0.49, p=0.046), between the MAL & BMI (rho=0.808, p=0.000) and between the CSA & PT (rho=0.566, p=0.018) in the LDK patients. In terms of the CSA versus MAL, there was a positive association in both groups (rho=0.67, p=0.000, MAL=0.023CSA+5.454 in the LDK group; rho=0.564, p=0.018, MAL=0.02CSA+5.832 in the control group with using linear regression analysis). Independent t-tests revealed that both groups had statistically different mean values (p=0.000) in terms of the CSA & MAL. CONCLUSION: This study showed that the patients with LDK not only had atrophied erector spinae muscles, but also atrophied psoas major muscles and short MALs, which is harmful because of the increased lower back load in the aged patients. Along with BMI, measurement of the CSA, MAL & PT on the MR images provides an objective assessment of the dimension & severity of the muscle atrophy in the LDK patients.
Arm* ; Body Mass Index* ; Congenital Abnormalities ; Female ; Humans ; Kyphosis* ; Linear Models ; Magnetic Resonance Imaging* ; Muscles ; Muscular Atrophy ; Retrospective Studies ; Spine

The purpose of this study was to compare the success rates of two pulp capping materials, BiodentineTM and RetroMTA®, used for partial pulpotomy in permanent molars after carious exposures and to compare the final restorative outcome of using composite resin to that of using a stainless steel crown. We studied children who were diagnosed with dental caries of permanent molars and underwent partial pulpotomy. The patients were followed up for more than 1 year. Clinical and radiographic evaluation were used to evaluate the success of each treatment. Fisher's exact test was used to compare the outcomes of two groups. For pulp capping agents, the success rate of using RetroMTA® was lower than that of using BiodentineTM(p < 0.05). Final restoration with composite resin was less successful than restoration with an stainless steel crown(p < 0.05). In combination of pulp capping agents and final restoration material, RetroMTA®- composite resin shows the lowest success rate(p < 0.05).

Human malignant melanoma is an aggressive skin cancer which has been rising at a greater rate than any other cancers. Although various new therapeutic methods have been developed in previous studies, this disease has properties of high proliferation and metastasis rate which remain obstacles that have lead to a poor prognosis in patients. It has been reported that a specific Lactobacillus extract has anti-cancer and –metastasis effect in vitro and in vivo. However, previous research has not specified precisely what effect the Lactobacillus rhamnosus GG (LGG) extract has had on human malignant melanomas. In this study, we showed that the LGG extract has anti-cancer and –metastasis effects on the human malignant melanoma cell lines, A375P and A375SM. At first, it was found that, while the LGG extract affects human neonatal dermal fibroblasts slightly, it induced the dose-dependent anti-cancer effect on A375P and A375SM by a WST-1 proliferation assay. As a result of a real-time PCR analysis, the expression patterns of several genes related to cell cycle, proliferation, and apoptosis were modulating in a manner that inhibited the growth of both malignant melanoma cell lines after the treatment of the LGG extract. Furthermore, genes related to the epithelialmesenchymal transition were down-regulated, and migration rates were also decreased significantly by the LGG extract. Our study showed that the LGG extract could be used as a potential therapeutic source.
Apoptosis ; Cell Cycle ; Cell Line ; Epithelial-Mesenchymal Transition ; Fibroblasts ; Humans* ; In Vitro Techniques ; Lactobacillus rhamnosus* ; Lactobacillus* ; Melanoma* ; Neoplasm Metastasis ; Prognosis ; Real-Time Polymerase Chain Reaction ; Skin Neoplasms

Human dental pulp stem cells (DPSCs) are multi-potent mesenchymal stem cells that have several differentiation potentials. An understanding of the tissues that differentiate from these cells can provide insights for future regenerative therapeutics and tissue engineering strategies. The mesiodens is the most frequent form of supernumerary tooth from which DPSCs can differentiate into several lineages similar to cells from normal deciduous teeth. Recently, it has been shown that nanoscale structures can affect stem cell differentiation. In our presentstudy, we investigated the effects of a 250-nm nanoscale ridge/groove pattern array on the osteogenic and adipogenic differentiation of dental pulp cells from mesiodenscontaining human DPSCs. To this end, the expression of lineage specific markers after differentiation induction was analyzed by lineage specific staining and RT-PCR. The nanoscale pattern arrayed surface showed apositive effect on the adipogenic differentiation of DPSCs. There was no difference between nanoscale pattern arrayed surface and conventional surface groups onosteogenic differentiation. In conclusion, the nanoscale ridge/groove pattern arrayed surface can be used to enhance the adipogenic differentiation of DPSCs derived from mesiodens. This finding provides an improved understanding of the effects of topography on cell differentiation as well as the potential use of supernumerary tooth in regenerative dental medicine.
Cell Differentiation ; Dental Pulp ; Humans* ; Mesenchymal Stromal Cells ; Stem Cells ; Tissue Engineering ; Tooth, Deciduous ; Tooth, Supernumerary*

The purpose of this study is to evaluate changes of occlusion following the placement of preformed metal crown in the permanent first molar affected by severe caries or hypomineralization.
The study was conducted on 24 patients who met the criteria among the patients with occlusion in the permanent first molar reaching the occlusal plane. Restorative treatment was performed on one first molar using preformed metal crown. Before treatment, immediately after treatment, after 4 weeks, and after 8 weeks, the T-scan Ⅲ was used for measuring distribution of bite force at the maximum intercuspal position, and overbite was measured with digital vernier calipers and change of dental midline was surveyed. After 8 weeks, questionnaires survey was conducted.
In most cases, immediately after treatment, the distribution of bite force between the restored side and non-restored side of arch was reversed compared to before treatment, and the overbite was decreased. However, after 4 weeks, bite force of the left and right side was balanced and the distribution of bite force on the restored and non-restored permanent first molars had similar values. Also, the changed overbite and midline were returned to pre-treatment status and there was no significant temporomandibular joint and masticatory discomfort after treatment.
In this study, it was confirmed that spontaneous occlusal equilibrium was achieved one month after the placement of preformed metal crown.

Tooth eruption involves a complex developmental process of tooth migration from the dental follicular origin to the final occlusion position in the oral cavity via the alveolar process. Disturbance of tooth eruption can occur at any point in a series of eruption stages; however, horizontal impaction of the mandibular first molar and primary retention of the primary mandibular second molar are rarely observed simultaneously. This study describes the treatment for two cases of horizontally impacted first molar with primary retention of primary molar. The primary retention of the primary mandibular second molar was extracted, and orthodontic traction was applied to the horizontally impacted primary mandibular first molar. Subsequently, displacement of the premolar tooth bud was improved and space regaining for eruption was achieved, guiding to normal eruption of the first molar.

This study was performed to evaluate the effectiveness of the 2-step needle insertion technique to reduce pain during local anesthesia in children. Local anesthesia was performed bilaterally using conventional technique and a 2-step technique, and to compare the degree of pain using the 2-step with that using the conventional technique during local anesthesia using a pain scale.
The pain scores were significantly different between the conventional technique and the 2-step insertion technique at 5.82 ± 2.14 and 2.57 ± 2.09, respectively (p < 0.001). The subjective degree of pain based on gender, age, and Frankl’s behavior rating scale was significantly lower in the 2-step insertion technique (p < 0.001). Subjective pain levels in the area of maxilla and mandible, anterior and posterior parts were lower in the group treated using the 2-step insertion technique (p < 0.001).
The 2-step insertion technique is a simple and effective way to reduce pain during local anesthesia not only in children with a positive attitude to dental treatment, but also in children with negative attitudes, and is thought to be more effective if combined with application of topical anesthesia or distraction.

Traumatic bone cyst (TBC) is an asymptomatic lesion seen most in adolescents. TBC is found incidentally on routine panoramic examinations and appears as a relatively well-demarcated unilocular radiolucency with scalloped margins. Histological examination reveals a vacant cavity of cancellous bone usually unlined or very occasionally lined with a thin connective tissue layer. The lack of lining epithelial membrane is common histological feature. The most affected site is between the mandibular canine and third molar. The involvement of the mandibular symphysis is rare. The etiopathogenesis of the TBC is unclear. TBC is treated with surgical exploration and curettage; new bone is formed in place of the lesion within 6 - 12 months of surgery. Diagnosis of TBC prior to surgical intervention has limitations in most of the cases. Both of our patients were diagnosed through radiological examination and biopsy. Neither patient had a history of trauma. After surgery, the panoramic radiograph and CBCT were used to confirm bone healing.

Background: The aim of this study was to analyze the clinical results of minimal single palmar-incision carpal tunnel release without a tourniquet. Methods: We reviewed the medical records of 75 patients (90 cases of carpal tunnel syndrome) who underwent minimal single-palmar incision carpal tunnel release without a tourniquet from June 2010 to January 2018. Ten patients had a bleeding tendency. We compared the preoperative and postoperative Boston Carpal Tunnel Syndrome Questionnaire (BCTQ) scores. We also analyzed outcomes and complications according to the presence of a bleeding tendency. Results: In all cases, there was a complete disappearance or marked improvement in symptoms within 6 months, with no recurrence. The postoperative BCTQ score showed a significant improvement compared to the preoperative score, and no statistically significant difference in BCTQ scores was detected according to the presence of a bleeding tendency. Conclusions Carpal tunnel release without a tourniquet using a minimal single palmar incision is effective and reliable. This technique prevents unnecessary pain associated with the tourniquet and is especially helpful in patients with a bleeding tendency or those treated with hemodialysis.