In neurogenic equinovarus deformity, surgical intervention such as tendon transfer or osteotomy can be expected to improve symptoms. However, in rare cases of hereditary spastic paraplegia, the deformity and paralysis gradually progress. So limited operation and early post-operative rehabilitation are preferred to aggressive operation. We would like to report our clinical experience with one case of hereditary spastic paraplegia patient with reference review. A 40 year-old male, given tendon transfer of ankle and foot and tendo achilles lengthening 10 years ago, complained about aggravated spastic paraplegia which resulted in dynamic equinovarus and limited walking ability since his operation. Family history showed limited walking ability of his father with gradually progressing spastic paralysis and he was diagnosed as hereditary spastic paraplegia type I. We had performed a limited operation such as tendo achilles and tibialis posterior lengthening to induce plantigrade standing and walking with crutch. As a result, the patient was able to maintain a stabilized standing posture and walk after the operation. Hereditary spastic paraplegia presents with a progressive paralysis which limits rehabilitation after tendon transfer, and the symptoms can be aggravated. Therefore, considering potential hereditary neurogenic disorders in paients with equinovarus deformity and performing limited operative procedures seem to be important.
Adult ; Ankle ; Clubfoot* ; Congenital Abnormalities* ; Fathers ; Foot ; Humans ; Male ; Muscle Spasticity ; Osteotomy ; Paralysis ; Paraplegia ; Posture ; Rehabilitation ; Spastic Paraplegia, Hereditary* ; Surgical Procedures, Operative ; Tendon Transfer ; Walking

OBJECTIVES: The aim of this study was to compare root canal volume change and canal transportation by Vortex Blue (VB; Dentsply Tulsa Dental Specialties), ProTaper Next (PTN; Dentsply Maillefer), and ProTaper Universal (PTU; Dentsply Maillefer) nickel-titanium rotary files in curved root canals. MATERIALS AND METHODS: Thirty canals with 20°–45° of curvature from extracted human molars were used. Root canal instrumentation was performed with VB, PTN, and PTU files up to #30.06, X3, and F3, respectively. Changes in root canal volume before and after the instrumentation, and the amount and direction of canal transportation at 1, 3, and 5 mm from the root apex were measured by using micro-computed tomography. Data of canal volume change were statistically analyzed using one-way analysis of variance and Tukey test, while data of amount and direction of transportation were analyzed using Kruskal-Wallis and Mann-Whitney U test. RESULTS: There were no significant differences among 3 groups in terms of canal volume change (p > 0.05). For the amount of transportation, PTN showed significantly less transportation than PTU at 3 mm level (p = 0.005). VB files showed no significant difference in canal transportation at all 3 levels with either PTN or PTU files. Also, VB files showed unique inward transportation tendency in the apical area. CONCLUSIONS: Other than PTN produced less amount of transportation than PTU at 3 mm level, all 3 file systems showed similar level of canal volume change and transportation, and VB file system could prepare the curved canals without significant shaping errors.
Dental Pulp Cavity ; Humans ; Molar ; Transportation ; X-Ray Microtomography

OBJECTIVES: We analyzed gene-expression profiles after 14 day odontogenic induction of human dental pulp cells (DPCs) using a DNA microarray and sought candidate genes possibly associated with mineralization. MATERIALS AND METHODS: Induced human dental pulp cells were obtained by culturing DPCs in odontogenic induction medium (OM) for 14 day. Cells exposed to normal culture medium were used as controls. Total RNA was extracted from cells and analyzed by microarray analysis and the key results were confirmed selectively by reverse-transcriptase polymerase chain reaction (RT-PCR). We also performed a gene set enrichment analysis (GSEA) of the microarray data. RESULTS: Six hundred and five genes among the 47,320 probes on the BeadChip differed by a factor of more than two-fold in the induced cells. Of these, 217 genes were upregulated, and 388 were down-regulated. GSEA revealed that in the induced cells, genes implicated in Apoptosis and Signaling by wingless MMTV integration (Wnt) were significantly upregulated. CONCLUSIONS: Genes implicated in Apoptosis and Signaling by Wnt are highly connected to the differentiation of dental pulp cells into odontoblast.
Apoptosis ; Dental Pulp ; Gene Expression ; Genes, vif ; Humans ; Microarray Analysis ; Odontoblasts ; Oligonucleotide Array Sequence Analysis ; Polymerase Chain Reaction ; RNA

PURPOSE: The infected diabetic foot patients were reviewed to analyze the result of new dressing methods using a wall-suction instruments. MATERIALS AND METHODS: Eighteen patients treated with wall-suction assisted vacuum dressing were included. After debridement under local anesthesia, a sponge pad, a drain, and a surgical drape were used to seal the wound. Negative pressure applied by the wall-suction at around 200 mmHg and dressing were repeated in every two to three days. The results of repeated wound cultures, growth of granulation tissues, and CRP level were closely observed on the regular basis. RESULTS: Rapid growth of granulation tissues was noticed around the wound in 16 cases. No organism was obtained in an average 5 days and wound coverage was possible in an average 18 days. The CRP level returned to normal in an average 4 weeks. Two patients with end stage renal disease, who were regularly hemodialised, underwent major amputation. CONCLUSION: New dressing method has the following advantages: a rapid wound improvement in the patients with infected diabetic foot, less expensive, less painful, impediment of bacterial contamination in the hospital room. However, further study will be needed for the end stage renal disease patients.
Amputation ; Anesthesia, Local ; Bandages ; Debridement ; Diabetic Foot* ; Granulation Tissue ; Humans ; Kidney Failure, Chronic ; Porifera ; Surgical Drapes ; Ulcer* ; Vacuum* ; Wounds and Injuries

Corrections to the funding. In this article, the year is missing from the funding information.

Background: Obesity weakens acquired immunity and causes infection. This study aimed to investigate the relationship between the inflammatory markers in the gingival crevicular fluid and serum and periodontal bacteria in saliva through obesity control for 4 weeks. Methods: Forty-six subjects with a body mass index (BMI) of ≥23 kg/m2 stayed in the camp for 4 weeks, followed by exercise and a low salt-low fat diet. Body size measurements, oral examinations, blood, saliva, and gingival crevicular fluid were collected before and after the program. C-reactive protein (CRP) in serum, matrix metalloproteinase (MMP)-8, MMP-9, and interleukin (IL)-1b in the gingival sulcus fluid were measured. After extracting bacterial genomic DNA from saliva, the presence of periodontal bacteria were detected using Taq probe. The relationship of each index before and after the program was analyzed through paired t-test and partial correlation analysis. Results: Campylobacter rectus (Cr) increased after the program, and there was no significant change in other bacteria. Serum CRP and Fusobacterium nucleatum (Fn), Aggregatibacter actinomycetemcomitans, Cr, ratio of Fn, and ratio of Cr had a positive relationship at baseline; however, the relationship was not significant after the program. Ratio of Prevotella intermedia had a positive relationship with MMP-9, MMP-8, IL-1b at baseline. Moreover, the ratio of Treponema denticola and the ratio of Tannerella forsythia showed a positive relationship with MMP-8, MMP-9, and IL-1b. The relationship between the ratio of Porphyromonas gingivalis and IL-1β showed a constant positive relationship at baseline and after the program. Conclusion Obesity control program in subjects with a BMI of ≥23 kg/m2 accompanied by diet and exercise did not affect the changes in periodontal bacteria itself, but changes in the relationship between periodontal bacteria and serum CRP, the relationship between the inflammatory index in the gingival crevicular fluid and periodontal bacteria was observed.

Alcohol withdrawal syndrome (AWS) is the most common and well-known condition occurring after intentional or unintentionalcessation or decreasing heavy drinking. Approximately 5-10% of these people are suffering from serious medical and psychiatricproblems, withdrawal seizures, perceptual disturbances, and delirium tremens. Despite acute medical conditions with the highmortality of severe AWS, proper management could decrease the severity and mortality of AWS. The Clinical Institute withdrawalassessment for alcohol-revised version is a valid, reliable, and sensitive instrument for assessing the clinical course and thetreatment monitoring of alcohol withdrawal. Benzodiazepine is the pharmacotherapy of choice for alcohol withdrawal. Diazepamor lorazepam treatment is best initiated early in the course of alcohol withdrawal to prevent progression to more severewithdrawal. There are three strategies for the pharmacotherapy of AWS. After the treatment of AWS, most patients should bemanaged or treated by the continuing care, including the psychosocial treatments, community-based management, and programsfor preventing recurrence of AWS.

PURPOSE: This study evaluated the prevalence of distolingual roots in mandibular molars among Koreans, the root canal system associated with distolingual roots, and the concurrent appearance of a distolingual root in the mandibular first molar and a C-shaped canal in the mandibular second molar. MATERIALS AND METHODS: Cone-beam computed tomographic images of 264 patients were screened and examined. Axial sections of 1056 mandibular molars were evaluated to determine the number of roots. The interorifice distances from the distolingual canal to the distobuccal canal were also estimated. Using an image analysis program, the root canal curvature was calculated. Pearson's chi-square test, the paired t-test, one-way analysis of variance, and post-hoc analysis were performed. RESULTS: Distolingual roots were observed in 26.1% of the subjects. In cases where a distolingual root was observed in the mandibular molar, a significant difference was observed in the root canal curvature between the buccolingual and mesiodistal orientations. The maximum root canal curvature was most commonly observed in the mesiodistal orientation in the coronal portion, but in the apical portion, maximum root canal curvature was most often observed in the buccolingual orientation. CONCLUSION: The canal curvature of distolingual roots was found to be very complex, with a different direction in each portion. No correlation was found between the presence of a distolingual root in the mandibular first molar and the presence of a C-shaped canal in the mandibular second molar.
Cone-Beam Computed Tomography* ; Dental Pulp Cavity ; Humans ; Mandible ; Molar* ; Prevalence*

OBJECTIVES: The aim of this study was to investigate the relationship between social exclusion and paranoid ideation, and to explore moderating and mediating effects of depression and self-esteem in that relationship. METHODS: Ninety seven neurosis patients receiving treatment in a psychiatric outpatient setting were selected. Social Exclusion Scale, Beck Depression Inventory, paranoia scale of Symptom Checklist-90-Revised, and Rosenberg Self-Esteem Scale were used for evaluation. RESULTS: Social exclusion showed highly positive correlation with paranoid ideation, and had significant influence. Among three types of social exclusion, contempt, bullying, and isolation, only isolation showed significant influence on paranoid ideation. Depression showed a partial mediating effect on that relationship indicating that social exclusion affects paranoid ideation not only directly, but also indirectly. On the other hand, self-esteem showed no moderating or mediating effects on that relationship. CONCLUSION: Depression mediates the influence of social exclusion on paranoid ideation. This finding provides an opportunity to decrease paranoid ideation of neurosis patients by not only prescription of antipsychotic agents but also therapeutic approach to social exclusion and depression. An experimental study to verify these findings seems to be needed.
Antipsychotic Agents ; Bullying ; Depression* ; Hand ; Humans ; Negotiating* ; Outpatients ; Paranoid Disorders ; Prescriptions ; Social Isolation

BACKGROUND: This study reports findings from the ITC Korea Survey, which was conducted to evaluate the characteristics in Korean adult smokers as part of the ITC Project. METHODS: Adult male and female smokers were randomly selected using telephone survey from November to December 2005. The ITC Korea Survey contained a wide range of questions on smoking behavior and smoking history. The data reported are weighted on the basis of age and gender, and they are nationally representative of smokers in Korea. RESULTS: A total of 1,002 smokers among the selected 1,402 subjects (71.5%) were interviewed; 96.2% were males. Daily smokers comprised 94.5% of the sample. The mean of cigarettes per day was 17.9. The average minutes after waking before the first cigarette was smoked was lower (50.6 minutes) than it was in other countries of the ITC Project. Over 90% considered themselves addicted to cigarettes and 86.5% expressed regret over smoking. Smokers reported that the norms against smoking in Korea were very strong both personal norms (89.4%) and perceived norms in Korean society (86.3%). Among the smokers, 80.8% had tried to quit smoking, and 76.1% were planning to quit. Only 5.8% of the Korean smokers indicated that the warning labels made them a lot more likely to quit smoking. When the price of cigarettes increased by 500 won (25%) in December 2004, 34.3% reported trying to quit smoking. Only 17.7% supported a complete workplace ban and 15.8% supported a complete ban in restaurants. Although knowledge of the harms of smoking was high, nearly 80% of the Koreans wrongly believed that "nicotine causes most of the cancer in smokers." Finally, the great majority (85.2%) of smokers in Korea believed that "the government should do more to tackle the harm done by smoking" and 62.5% believed that "tobacco products should be more tightly regulated." CONCLUSION: The results from the baseline wave of the ITC Korea Survey have identified where tobacco control in Korea has been done. Future waves of the ITC Korea Survey will be able to evaluate the impact of important tobacco control policies that Korea will be required to implement over the next few years, as a party to the FCTC.
Adult ; Female ; Humans ; Korea ; Male ; Restaurants ; Smoke ; Smoking ; Telephone ; Tobacco ; Tobacco Products