PURPOSE: Platelet Rich Plasma(PRP) application is increasing with sinus inlay bone graft, but there is few research with radiographic ananlysis on effect of PRP in maxillary sinus. The author investigated the amount of bony changes of maxillary sinus for dental implantation among the patients with maxillary inlay graft. MATERIALS AND METHODS: With 10 patients who were treated with sinus inlay autologous bone grafting combined with PRP technique, and with 5 patients who were treated with sinus inlay grafting only without PRP, the panoramic radiographys which were taken at preoperation, immediate postoperation, 3months postoperation, and 4 months postoperation(a month after dental implantation)periods were analysed. The films had been scanned, and then proceeded throughout image analysis system. The bone density of maxillary grafted sites was compared with adjacent tooth enamel density and remeasured according to density luminosity of each film. The density changes on PRP group and bone graft only group were an lysed with non-parameteric statistics method. RESULTS: In PRP combined patients group, bone density on postoperation periods was increased totally. The remarkable enhanced change of bone density was observed on 3 months postoperation period, thereafter the increasing rate was slightly reduced . In only bone graft patients group, bone density on postoperation periods was also increased compared with preoperation period, but the bone density of 4 months postoperation period was decreased compared with 3 months postoperation period. The amount of bone density on PRP group was significantly changed according to periods in contrast to bone graft only group. CONCLUSION: The bone density on PRP group was remarkably increased at 3 months postoperation compared to bone graft only group and it was seemed to be associated with more new bone formation, less grafted bone resorption at bone grafted sites with PRP.
Blood Platelets* ; Bone Density ; Bone Resorption ; Bone Transplantation ; Dental Enamel ; Dental Implantation ; Dental Implants ; Humans ; Inlays ; Maxillary Sinus ; Osteogenesis ; Platelet-Rich Plasma ; Tooth ; Transplants

Purpose: To assess the prevalence of food allergy, with a focus on oral allergy syndrome (OAS) in a population of children and to investigate relevant allergen sensitization associated with these adverse reactions. Methods: This study involved 1,660 children (aged 4 to 13 years) experiencing seasonal allergy symptoms, who were enrolled in the 2015 prospective Seongnam Atopy Project (SAP 2015) in a South Korean municipality. Parents completed a structured questionnaire to assess children with OAS, collecting information on the duration, severity, and factors related to symptoms. Skin prick tests (n = 498) and blood sampling (n= 464) were performed to measure allergic sensitizations, total eosinophil counts, and levels both total immunoglobulin E (IgE) and birch-specific IgE. Results: The prevalence of OAS among the children enrolled in this study was 4.4% (95% confidence interval, 3.7%–5.1%). The most common symptom was mouth itching (n= 106, 65.0%), and the primary food allergen associated with symptoms was kiwi (n= 48, 29.5%). Peanut sensitization (14.8% vs. 57.1%, P< 0.001) and sensitization to other nut products (15.6% vs. 47.6%, P= 0.001) were linked to a higher incidence of systemic reactions. Conclusion The prevalence of 4.4% underscores the significant health impact of OAS, especially in children experiencing food allergy-related symptoms. Notably, common allergens, such as kiwi, and the potential for additional systemic reactions associated with this condition highlight the importance of raising awareness.

The purpose of this study is that evaluate the distribution and biological roles of TNF-a, interleukin-1beta(IL-1beta), interleukin-6(IL-6) and tissue inhibitors of metalloproteinase-1(TIMP-1) in the synovial fliud of patients with non-inflammatory chronic temporomandibular joint(TMJ) disorders in relation to pain during joint movements and magnetic resonance imaging(MRI) findings. TMJ synovial fluids aspirates were obtained from 36 patients (36 joints) with chronic TMJ disorders and from 8 controls(8 joints). Patients were divided to four groups. The control group was from healthy volunteers(8 joints), group I(18 joints) was patients with anterior disc displacement with reduction, group II(5 joints) was patients with disc displacement without reduction and group III (5 joints) was osteoarthritis. The TNF-alpha, IL-1beta and IL-6 levels in the aspirates were determined by using an enzyme-linked immunosorbent assay and the TIMP-1 level was measured by an enzyme immunoassay. Following examinations for pain during joint movements and MRI observations, these cytokines'level and frequencies of detection were compared. The level of IL-1beta was not significant different in all groups. but the level of TNF-alpha, IL-6 and TIMP-1 were significant different among groups. The level of IL-6 and TIMP-1 were correlated to pain during movement(p <0.01) and the level of TNF-a(p <0.05). Also, the level of IL-6 was correlated to the level of TIMP-1(p <0.01). Especially, The level of the TIMP-1 level was significantly correlated to the pain during movement and showed very high levle of Pearson's correlation coefficient (r=0.833)(p <0.001). The results indicated that the TNF-alpha, IL-6 and TIMP-1 levels in the TMJ aspirates of patients with chronic TMJ disorders have been raised. Especially, IL-6 and TIMP-1 were very high levels in the patients who were degraded in the TMJ. Also, TNF-alpha, IL-6 and TIMP-1 showed the significant correlation in the chronic temporomandibular joint disorders. Therefore I suggest that these cytokines were also correlated to the pain during movement in the chronic temporomandibular joint disorders.
Cytokines* ; Enzyme-Linked Immunosorbent Assay ; Humans ; Immunoenzyme Techniques ; Interleukin-6 ; Joints ; Magnetic Resonance Imaging ; Osteoarthritis ; Synovial Fluid ; Temporomandibular Joint Disorders* ; Temporomandibular Joint* ; Therapeutic Irrigation* ; Tissue Inhibitor of Metalloproteinase-1 ; Tumor Necrosis Factor-alpha

BACKGROUND: I-gel is a recently developed supraglottic airway device with many advantages. Like laryngeal mask airway (LMA), I-gel is an easier and quicker intubation alternative to endotracheal intubation in certain situations. In this study, we assessed the ease of I-gel insertion and compared the clinical performance of anesthetsiology residents (group R) experienced in endotracheal intubation versus that of interns (group I) with little intubation experience. METHODS: This prospective and randomized study included 60 patients. The ease of insertion, number of I-gel insertion attempts, presence of air leakage, and postoperative complications such as bleeding, dental trauma, hoarseness, and sore throat were evaluated in each group. RESULTS: Insertion was successful on the initial attempt in 29 of 30 cases in group R. In group I, 24 initial insertions were successful. The mean insertion times were 12.5 +/- 4.8 and 27.9 +/- 12.5 seconds for group R and group I, respectively (P < 0.001). No significant differences were observed between the two groups regarding postintubational air leakage. Regarding complications, two cases of bleeding, one case of dental trauma, and two cases of sore throat were recorded. No significant differences were observed between the two groups for any of the complications examined. CONCLUSIONS: I-gel is a suitable alternative insertion device that enables rapid and easy intubation by physicians who are experienced with endotracheal intubation. Moreover, this device also enables efficient and safe insertion during emergent situations for novice clinicians, even those who have little experience in intubation.
Airway Management ; Anesthesiology* ; Hemorrhage ; Hoarseness ; Humans ; Intubation ; Intubation, Intratracheal ; Laryngeal Masks ; Pharyngitis ; Postoperative Complications ; Prospective Studies

OBJECTIVE: Percutaneous vertebroplasty is often complicated by the presence of multiple fractures or non-localizing pain in the patients with osteoporotic vertebral fractures. The purpose of this study is to estimate the value of preoperative radiologic studies in the localization of symptomatic vertebrae and to determine the factors which can influence on the clinical results. MATERIALS AND METHODS: We retrospectively reviewed the clinical and radiologic data of 57 vertebrae in 30 patients underwent percutaneous vertebroplasty for osteoporotic vertebral compression fractures. Inclusion criteria was severe pain(McGill-Melzack score 3, 4 or 5) associated with the acute vertebral fractures and absence of spinal nerve root or cord compression sign. Acute symptomatic vertebral fracture was determined by the presence of signal change on MR images or increased uptake on whole body bone scan. RESULTS: Pain improvement was obtained immediately in all patients and favorable result was sustained in 26 patients(86.7%) during the mean follow-up duration of 4.7 months(5 complete pain relief, 21 marked pain relief). Those who underwent vertebroplasty for all acute symptomatic vertebrae had significantly better clinical result than those who did not. Further vertebral collapse and eventual bursting fracture occurred in 1 vertebra which showed intradiskal leakage of bone cement and disruption of cortical endplate on postoperative CT scan. CONCLUSION: Preoperative MR imaging and whole body bone scan are very useful in determining the symptomatic vertebrae, especially in the patients with multiple osteoporotic vertebral fractures. To obtain favorable clinical result, the careful radiologic evaluation as well as clinical assessment is required. Control of PMMA volume seems to be the most critical point for avoiding complications.
Follow-Up Studies ; Fractures, Compression* ; Humans ; Magnetic Resonance Imaging* ; Polymethyl Methacrylate ; Retrospective Studies ; Spinal Nerve Roots ; Spine ; Tomography, X-Ray Computed ; Vertebroplasty*

BACKGROUND: Pulmonary Kaposi's sarcoma (PKS) directly affects the life expectancy of those infected and yet the clinical and radiographic features of Kaposi's sarcoma (KS) with pulmonary involvement are nonspecific, which makes diagnosis difficult. In Uganda, pulmonary tuberculosis, which has clinical features that closely resemble those of PKS, also occurs commonly and thus confusion is bound to arise. Bronchoscopy is a recognized diagnostic investigatory modality for PKS. The aim of present study was to identify unique or useful points for the differential diagnosis of PKS and other opportunistic infections. METHODS: The clinical, radiologic, and bronchoscopic findings in thirty-five Ugandan patients (age 20-50, median 32) with PKS were analyzed. RESULTS: Cough and weight loss were most common and occurred in 97.1%, whereas fever occurred in 62.9%, and breathlessness in 57.1%. Thirty-four patients (97.1%) showed mucocutaneous KS, and palatal KS was most frequent and was observed in 74.3%. In addition, 25 patients (71.4%) showed the characteristic endobronchial plaques of KS. The most frequently observed radiographic abnormality was bilateral reticulonodular density. Histological examinations of bronchoscopic biopsies revealed KS in 7 (36.6%) cases. Five PFS patients (25%) also had co-existent tuberculosis. CONCLUSIONS: The majority of patients with PKS showed no specific findings on physical examination, apart from mucocutaneous KS. Our findings indicate that palatal KS may be a strong predictor of PKS. In Uganda, pulmonary tuberculosis may be the most common concomitant pulmonary infection in PKS patients.
Uganda ; Tuberculosis, Pulmonary/diagnosis ; Sarcoma, Kaposi/*diagnosis ; Middle Aged ; Male ; Lung Neoplasms/*diagnosis ; Humans ; Female ; Diagnosis, Differential ; *Bronchoscopy ; Adult

Telomerase activity has been detected in many human immortal cell lines and tumor tissues. We studied telomerase activity in a series of human musculoskeletal tumors. Twenty-eleven tumors from 27 patients were studied using a sensitive PCR (polymerase chain reaction)-based technique, the TRAP(telomeric repeat amplication protocol) assay. Telomerase activity was present in seven tumors(25.9%). Telomerase activity was present in six of 18 malignant tumors(33.3%), while telomerase was active in one of 9 benign tumors(11.1%). Telomerase was active in 40% for osteosarcomas, 25% for soft tissue sarcomas, 16.7% for giant cell tumors of bone, and none for benign tumors. These results are a remarkablely low positive rate of telomerase activity in comparing with other types of carcinoma. In conclusion, it suggests that the musculoskeletal tumors, arisen from mesenchymal cells, follow different pathways of neoplastic progression or it is due to tile specific characteristics stick of sarcomas-abundant extracellular matrix and lack of tumor cells-differed tumor those of carcinomas.
Cell Line ; Extracellular Matrix ; Giant Cell Tumors ; Humans ; Osteosarcoma ; Polymerase Chain Reaction ; Sarcoma ; Telomerase*

Several microvascular anastomotic techniques have been described with methodical effectiveness, patency rates, healing state of microscopic findings. This experimental study presents the comparison of three types of arterial microvascular anastomotic techniques: end-to-end(ETE) anastomosis, end-in-end(EIE) anastomosis, and continuous technique. Sixty male Sprague-Dawley rats, 60 femoral arteries were used for this study. Twenty rats per each technique were used and sacrificed at post-operation 1 day, 3 days, a week, 2 weeks for scanning electromicroscopic findings. The patency was monitored by miniDoppler throughout total experimental periods. The anastomotic time on each method was measured to compare the technical effectiveness. The final results were as follows: 1. The anastomotic time for the end-in-end technique was significantly shorter than another techniques. The average time for each technique was measured as 15 minutes on EIE technique, 20 minutes on continuous technique and 25 minutes on ETE technique. 2. The patency rate for the end-in-end technique at 2 weeks also was superior to another techniques. The patency rate for each technique was demonstrated as 90 % on EIE technique, 85 % on ETE technique and 80 % on continuous technique. 3. The scanning electromicroscopic findings on healing condition of vessel endothelium during the observation period showed that the end results of EIE technique, ETE technique and continuous technique in sequence were good. The end-in-end technique proved to be the superior with regard to anastomotic time and patency rate when compared to end-to-end technuqe, so EIE techniqe might be well available for the case of large discrepancy of vessel size. The patency rate, microscopic healing findings in continuous technique were seen as the lowest level among the three anastomotic techniques, therefore the application of continuous technique was recommended only on the inevitable case.
Animals ; Endothelium ; Femoral Artery ; Humans ; Male ; Rats ; Rats, Sprague-Dawley

The purposes of this retrospective study were to assess the change of serum parameters in oral and maxillofacial surgery patients after operation and to determine what laboratory parameters on treatment periods were associated with the recovery of systemic condition. For purposes of assessing systemic nutritional status, several serum parameters were chosen. The sample patients were randomsubjects extracted from three category patient groups- oral cancer, odontogenic abscess, facial bone fracture based on treated patients at department of oral and maxillofacial surgery in Pusan National University Hospital from September 1, 1998, to September 1, 2002. Each groups were consisted with 10 patients. Each patient chart was examined and blood sample parameters were reviewed with clinical signs, symptoms and vital sign at preoperative day, postoperative 1 day, postoperative 1 week. Several parameters were analyzed statistically for extraction of mean values and differences between the periods groups. The findings of serum parameters of cancer, abscess and fracture groups were as follows: 1. In cancer patients, Hb, MCV, albumin, cholesterol, LDH, AST, ALT, neutrophil, platelet, leukocyte, Na, K, Cl, BUN, creatinine were analyzed. Values of Hb, albumin, AST, neutrophil, leukocyte, Cl showed significantly differences according to periods. 2. In abscess patients, CRP, ESR, leukocyte, body temperature, neutrophil were analyzed. Values of CRP, leukocyte, body temperature, neutrophil showed significanlty differences according to periods. 3. In fracture patients, same arameters with cancer patient's were chosen. Values of platelet, Cl only showed significantly differences according to periods. 4. In cancer patients, data regarding correlation was analyzed statistically as Pearson's value. A positive correlation was found between Hb and albumin, K, Na(p<0.05). A positive correlation was also found between neutrophil and leukocyte(p<0.05). Positive correlations were found between cholesterol and ALT, LDH and platelet, creatinine both, Platelet and BUN, Na and K(p<0.01). 5. In abscess patients, Peason's correlation values were analyzed on parameters. A positive correlation was found only between CRP and neutrophil(p<0.05). 6. In fracture patients, The correlations of parameters also were statistically analyzed. Positive correlations were found between MCV and K, albumin and LDH, AST and three parameters of creatinine, Na, Cl, K and neutrophil, neutrophil and three parameters of leukocyte, BUN, K(p<0.05). Positive correlations were found between LDH and AST, ALT and AST, creatinine both(p<0.01). This retrospective clinical study showed the CRP levels only on abscess patients may be useful in determination of clinical infected status, but the levels of other parameters on cancer, fracture patients did not showed significant values as diagnostic aids for clinical status.
Abscess ; Blood Platelets ; Body Temperature ; Busan ; Cholesterol ; Creatinine ; Facial Bones ; Humans ; Leukocytes ; Mouth Neoplasms ; Neutrophils ; Nutritional Status ; Retrospective Studies ; Surgery, Oral* ; Vital Signs

PURPOSE: Neoadjuvant chemotherapy is commonly used to treat cancer patients as adjunct treatment, but if the microvascular tissue transfer is performed simulataneously with cancer resection surgery, the induction chemotherapy might affect the survival rate of vascularized free flap. Our study will focus on the effect of induction chemotherapy on the free flaps which were made on white rat abdomen after injection of 5-FU. MATERIALS AND METHODS: The experimental rat groups were divided into three groups (total 24 rats) as a normal control group, 24 hrs group after 5-FU injection, 3 days group after 5-FU injection. Inferior abdominal island flaps of 8 Sprague Dawley rats on each group were made and immediately were induced into an ischemic state by clamping the supplying inferior epigastric artery and vein with microvascular clamp for a hour to induce a similiar free flap circumstance, then the inferior abdominal skin flaps were reperfused by releasing the clamps. The flaps on abdomen were repositioned and sutured. The experimental data for flap survival rate was collected by digital photo taking, analysed by computer image program to compare with the flap luminosity. The rats were sacrificed at 3 days, 5 days, 7 days after flap preparation and specimens of the flap were taken and stained with H-E staining. The microscopic finding was made under magnification of 200 and 400. RESULTS: 1. Gross findings on each groups showed the healing condition was good as following sequences; normal, 24 hrs group after chemotherapy, 3 days group after chemotherpy. 2. The values of flap luminosity for evaluation of flap survival rate also showed the same sequences as gross findings of healing state. 3. The microscopic findings of epidermis necrosis, inflammation state, dermis fibrosis, vessel change, fatty tissue layer thinning were compared with each group. The 3 days group after chemotherapy showed remarkably poor healing condition compared to other groups. CONCULSION: Chemotherapy agents affected the healing process of free flap, but healing condition was recovered spontaneously as post-injection periods passed out. In opposite to our expectation, 3 days group showed the bad flap condition in comparing with 24 hours group which was considered as immatured body circulation state of chemotherapy agent. It showed that 3 weeks in human being after chemotherapy was not proper as timing of microvascular tissue transfer if 3 days group in rat was considered as same healing period of 3 weeks in human being. More delayed healing timing than 3 weeks might be required in clinical application of free tissue transfer.
Abdomen ; Adipose Tissue ; Animals ; Constriction ; Dermis ; Drug Therapy ; Epidermis ; Epigastric Arteries ; Fibrosis ; Fluorouracil ; Free Tissue Flaps ; Humans ; Induction Chemotherapy* ; Inflammation ; Microsurgery* ; Necrosis ; Rats ; Rats, Sprague-Dawley ; Skin ; Surgical Flaps ; Survival Rate* ; Veins