OBJECTIVE: To compare the visibility and procedural parameters between a standard spinal needle and a new laser-etched needle (LEN) in real-time ultrasonography guided lumbar medial branch access in a phantom of the lumbosacral spine. METHODS: We conducted a prospective single-blinded observational study at a rehabilitation medicine center. A new model of LEN was manufactured with a standard 22-gauge spinal needle and a laser etching machine. Thirty-two inexperienced polyclinic medical students performed ultrasonography-guided lumbar medial branch access using both a standard spinal needle and a LEN with scanning protocol. The outcomes included needle visibility score, needle elapsed time, first-pass success rate, and number of needle sticks. RESULTS: The LEN received significantly better visibility scores and shorter needle elapsed time compared to the standard spinal needle. First-pass success rate and the number of needle sticks were not significantly different between needles. CONCLUSION: A new LEN is expected to offer better visibility and enable inexperienced users to perform an ultrasonography-guided lumbar medial branch block more quickly. However, further study of variables may be necessary for clinical application.
Humans ; Needles* ; Needlestick Injuries ; Observational Study ; Phantoms, Imaging ; Prospective Studies ; Rehabilitation ; Spine ; Students, Medical ; Ultrasonography ; Zygapophyseal Joint

This study was undertaken to achieve a high bleaching efficacy with plasma, through longer application and reparative bleaching processes, by different shade evaluation methods. Extracted human teeth were divided into 6 groups (n=10). All teeth were treated in pairs. Low concentration of 15% carbamide peroxide (CP) was applied, with and without plasma, for 10, 20, and 30-min tooth bleaching, respectively. The bleaching procedure was repeated once daily for four days. The teeth were maintained in a moist environment provided by artificial saliva. The Vitapan Classical shade guide and Commission Internationale de L'Eclairage (CIELAB) color system were collectively used to measure the bleaching efficacy. Color evaluation was statistically analyzed using Student t-test and one-way analysis of variance (ANOVA) complemented by Tukey's test. Combining the plasma with 15% CP showed significantly greater color changes compared to bleaching without plasma (p<0.05). A high bleaching efficacy with plasma is proportional to the repetitive application and the treatment time. A 30-min application with plasma provided the best bleaching. Repetitive bleaching showed lower probability of color relapse of the bleached tooth. The color change by shade guide correlated with the changes in CIELAB color system. A value of 1 color change units (CCU) conversion factor for overall color change (ΔE) values comparisons was 3.724 values. The two measuring methods provide a more accurate correspondence of color change. The repetitive and longer application for tooth bleaching, combined with plasma, has a strong bleaching effect and produces whiter teeth.
Atmospheric Pressure* ; Complement System Proteins ; Humans ; Plasma* ; Recurrence ; Saliva, Artificial ; Tooth Bleaching* ; Tooth* ; Urea

OBJECTIVES: To investigate whether the cytotoxic effect of Cimicifuga rhizoma extract is associated with cell death in the human keratinocyte (HaCaT) and human melanoma cell lines (G361). METHODS: Apoptosis induced by Cimicifuga rhizoma extract was confirmed by water-soluble tetrazolium salts-1 (WST-1) assay, immunocytochemistry, and western blot. Additionally, the release of cytochrome c and apoptosis-inducing factor (AIF) was visualized by confocal laser scanning microscopy. RESULTS: The results showed that Cimicifuga rhizoma extract significantly reduced the viability of G361 cells with half-maximal inhibitory concentration (IC 50) of 200 µg/ml, and the apoptotic process was found to occur via the activation of caspase-3 and caspase-9 pathways. Besides, the release of cytochrome c and AIF was also detected. CONCLUSIONS: This study suggests that Cimicifuga rhizoma extract causes apoptosis of human melanoma cells through the intrinsic apoptotic pathway.
Apoptosis Inducing Factor ; Apoptosis ; Blotting, Western ; Caspase 3 ; Caspase 9 ; Cell Death ; Cell Line ; Cimicifuga ; Cytochromes c ; Humans ; Immunohistochemistry ; Keratinocytes ; Melanoma ; Microscopy, Confocal

The authors conducted an in-Vivo experimental study using sciatic nerve of 200-300 grammed rats to verify clinical applicability of Silicone cuffing method, by which scar adhesion of repaired nerve in crushed limb is assumed hopefully to be reduced. The following observations were obtainable. 1. Nerve conduction velocity was noted faster in Silicone cuff group than in control group significantly after 6 weeks postoperatively. 2. Adhesion of repaired nerve with surrounding scar tissue was far less present in Silicone cuff group than in control group when observed grossly. 3. The amount of scar formation and axonal degeneration were noted reduced remarkably in Silicone cuff group than in control group after 3 weeks postoperatively. 4. The intraneural vascularity was noted reduced either in Silicone cuff group and in control group, but definitely less reduced in the former than in the latter. Clinical relevance: Above results may be taken as an experimental basis supporting clinical applicability of Silicone cuff wrapping method for neurorraphy in crushed limb.
Animals ; Axons ; Cicatrix ; Extremities ; Methods ; Neural Conduction ; Peripheral Nerves ; Rats ; Sciatic Nerve ; Silicon ; Silicones

Patients who have repaired cleft lip and palate generally undergo restriction of maxillary growth. Concave facial profile is often exhibited with relatively normalized mandible. Horizontal and sagittal deficiency of the maxilla could cause anterior and posterior crossbites. In growing patients, orthodontic and orthopedic treatment is acceptable with maxillary expansion and protraction. However, surgical approach has to be accompanied with orthodontic treatment in skeletally matured patients. We used SARPE and BSSRO to expand the constricted maxilla and retract the mandible in a patient who had cleft palate repaired in infancy. Through SARPE, orthodontic treatment and BSSRO, we sufficiently expanded the maxillla and improved facial profile.
Cleft Lip ; Cleft Palate ; Humans ; Malocclusion ; Mandible ; Maxilla ; Orthopedics ; Palatal Expansion Technique ; Palate

Patients who have repaired cleft lip and palate generally undergo restriction of maxillary growth. Concave facial profile is often exhibited with relatively normalized mandible. Horizontal and sagittal deficiency of the maxilla could cause anterior and posterior crossbites. In growing patients, orthodontic and orthopedic treatment is acceptable with maxillary expansion and protraction. However, surgical approach has to be accompanied with orthodontic treatment in skeletally matured patients. We used SARPE and BSSRO to expand the constricted maxilla and retract the mandible in a patient who had cleft palate repaired in infancy. Through SARPE, orthodontic treatment and BSSRO, we sufficiently expanded the maxillla and improved facial profile.
Cleft Lip ; Cleft Palate ; Humans ; Malocclusion ; Mandible ; Maxilla ; Orthopedics ; Palatal Expansion Technique ; Palate

When soft tissue circular or elliptical pathologic lesions are located around the nasolabial fold, the most appropriate method is to make the excision parallel with the scar or along a natural wrinkle-crease. For this purpose, simple elliptical excision following primary closure is recommended. But when its long axis of elliptical defects is located vertically to the nasolabial fold, these will bring a bad aesthetic result after elliptical excision following primary closure due to long vertical straight scar to nasolabial fold. If soft tissue defect is larger, we should depend on the wide dissection for the closure of elliptical excised area. As a result, it is inevitable to make postoperative deformity due to tension around the eyelids, oral commissures, canthal fold, and alar nose. V-Y-S plasty was introduced by Algamaso in 1974 for closure of a round defect. It adopted some aspects of the double rotation flaps(or S-plasty) and some of the V-Y advancements. The authors applied from March 1998 to December 2000 to use single rotation flaps(or half-S plasty) and V-Y advancement for closure of a round defect, around nasolabial folds in 12 patients, named it half V-Y-S plasty, by modifying of Argamaso's V-Y-S plasty. We could obtain sufficient coverage of round defects and placement postoperative scar on the nasolabial fold and alar crease area using single V-Y-S plasty. Even in case of hypertrophic scars, we could obtain the same result and symmetric postoperative supralabium contour. The average soft tissue defect diameter was 1.9 cm (biggest one: 3.2 cm), and advanced gain of V-S advancement was 1.34 cm. As a result, we could obtain the final result more aesthetic and functional than that of straight line closure or other type of local flap. We described the experience of half V-Y-S plasty with a review of literature.
Axis, Cervical Vertebra ; Cicatrix ; Cicatrix, Hypertrophic ; Congenital Abnormalities ; Eyelids ; Humans ; Nasolabial Fold* ; Nose

Nonthermal atmospheric pressure plasma has attracted great interest for biomedical applications. The plasma consists of charged particles, radicals, and a strong electric field as the fourth state of matter. This study evaluated the change in the surface roughness after tooth bleaching by plasma in combination with a low concentration (15%) of carbamide peroxide, specifically whether the application of plasma produced detriments, such as demineralization and structural change, with the goal of efficient and safe tooth bleaching. After being combined with plasma and 15% carbamide peroxide, the hydroxyapatite surface was significantly smoother with a low roughness average value. Tooth bleaching with 15% carbamide peroxide alone produced an irregular surface and increased the surface roughness with high roughness average value. Tooth bleaching with plasma resulted in no significant variations in hydroxyapatite in terms of change in surface roughness and surface topography. The application of tooth bleaching with plasma is not deleterious to dental hard tissue, implicating it as a safe tooth bleaching technique.
Atmospheric Pressure* ; Durapatite* ; Plasma* ; Streptococcus mutans ; Tooth Bleaching* ; Urea

PURPOSE: Cooling and rewarming have been described to contribute to the pathogenesis of exercise induced asthma. However, little is known about the cellular response to cooling and rewarming of respiratory epithelial cells. Hypersecretion of mucus and allergic inflammation are important pathologic finding of patients who suffered from asthma. We investigated whether cooling and rewarming of respiratory epithelial cells induce mucin gene (MUC5AC, MUC5B) expression and IL-8 production. METHODS: NCI-H292 (human lung mucoepidermoid carcinoma cell line) cells were cultured in 6 well plates. Experimental groups were preserved at 1degree C, 4degrees C, 18degrees C and control groups at 37degrees C for 2 hours. And then both group were kept at 37degrees C. MUC5AC, MUC5B and IL-8 mRNA expressions were examined by RT-PCR. IL-8 concentration in the cell culture medium after rewarming was measured by ELISA. RESULTS: Cooling and cooling-rewarming stimuli did not increase MUC5AC and MUC5B expression. IL-8 concentration was remarkably decreased in experimental groups after cooling and then markedly increased during first 6 hours. IL-8 concentration of 1degrees C, 4degrees Cgroups were significantly increased compared to control group at 6 hour, of 18degrees C group at 12 hour and then persisted until 24 hour. CONCLUSION: Cooling and rewarming stimuli to respiratory epithelial cells did not increase MUC gene expression. However, increased IL-8 production provides evidence of cooling and rewarming induced airway inflammation. Further investigation will be needed to support this result.
Asthma ; Asthma, Exercise-Induced ; Carcinoma, Mucoepidermoid ; Cell Culture Techniques ; Enzyme-Linked Immunosorbent Assay ; Epithelial Cells* ; Gene Expression ; Humans ; Inflammation ; Interleukin-8* ; Interleukins* ; Lung ; Mucins ; Mucus ; Rewarming* ; RNA, Messenger

Twenty-six primary hip prostheses were implanted in nineteen patients with a diagnosis of aplastic anemia between January 1990 and December 1992. The preoperative diagnosis were osteonecrosis of the femoral head in twenty-five hips and femoral neck fracture in one. The duration of follow-up was minimum of fours years. Preoperatively, the average Harris hip score was 56. At four years postoperatively, the average score reached 87. At this time, twelve hips were rated excellent, eleven good, two fair, and one poor. One patient who received a bipolar arthroplasty showed an intrapelvic protrusion of the acetabular component. Another bipolar fixed with Boneloc cement was performed due to femoral neck fracture. There was no migration of component, subsidence, radiolucency or osteolysis in three hips with hybrid fixation. No sign of migration of acetabular component was seen with uncemented prosthesis. Two hips with HA coated acetabular components showed a progressive radiolucent line. Progressive retroacetabular osteolysis was found in one hip at zone I and II. There were neither cases of infection nor hemorrhage complications. Two patients died of pneumonia and sepsis, respectively, at fifty-three and fifty-seven months postoperatively. It appears that fatty marrow conversion of proximal femur and pelvis does not affect the survival of cemented and uncemented fixation, but long-term follow-up is needed to validate our view. We have demonstrated that the hip arthroplasty in most patients with aplastic anemia can be successful despite the fact that hematologic characteristics of aplastic anemia seem to indicated a high risk for hemorrhagic complication and infection. In conclusion, we strongly recommend hip arthro-plasty if the patients has a painful hip joint, regardless of severity of aplastic anemia whose prognosis may be disappointing.
Acetabulum ; Anemia, Aplastic* ; Arthroplasty* ; Bone Marrow ; Diagnosis ; Femoral Neck Fractures ; Femur ; Follow-Up Studies ; Head ; Hemorrhage ; Hip Joint ; Hip Prosthesis ; Hip* ; Humans ; Osteolysis ; Osteonecrosis ; Pelvis ; Pneumonia ; Prognosis ; Prostheses and Implants ; Sepsis