STATEMENT OF PROBLEM: In cases where bony defects were present, guided bone regenerations have been performed to aid the placement of implants. Nowadays, the accepted concept is to isolate bone from soft tissue by using barrier membranes to allow room for generation of new bone. Nonresorbable membranes have been used extensively since the 1980's. However, this material has exhibited major shortcomings. To overcome these faults, efforts were made to develop resorbable membranes. Guided bone regenerations utilizing resorbable membranes were tried by a number of clinicians. Bio-Gide. is such a bioresorbable collagen that is easy to use and has shown fine clinical results. PURPOSE: The aim of this study was to evaluate the histological results of guided bone regenerations performed using resorbable collagen membrane(Bio-Gide.) with autogenous bone, bovine drived xenograft and combination of the two. Surface morphology and chemical composition was analyzed to understand the physical and chemical characteristics of bioresorbable collagen membrane and their effects on guided bone regeneration. MATERIAL AND METHODS: Bioresorbable collagen membrane (Bio-Gide.), Xenograft Bone(Bio-Oss), Two healthy, adult mongrel dogs were used. RESULTS: 1. Bioresorbable collagen membrane is pure collagen containing large amounts of Glysine, Alanine, Proline and Hydroxyproline. 2. Bioresorbable collagen membrane is a membrane with collagen fibers arranged more loosely and porously compared to the inner surface of canine mucosa : This allows for easier attachment by bone-forming cells. Blood can seep into these spaces between fibers and form clots that help stabilize the membrane. The result is improved healing. 3. Bioresorbable collagen membrane has a bilayered structure : The side to come in contact with soft tissue is smooth and compact. This prevents soft tissue penetration into bony defects. As the side in contact with bone is rough and porous, it serves as a stabilizing structure for bone regeneration by allowing attachment of bone-forming cells. 4. Regardless of whether a membrane had been used or not, the group with autogenous bone and Bio-Oss. filling showed the greatest amount of bone fill inside a hole, followed by the group with autogenous bone filling, the group with blood and the group with Bio-Oss. Filling in order. 5. When a membrane was inserted, regardless of the type of bone substitute used, a lesser amount of resorption occurred compared to when a membrane was not inserted. 6. The border between bone substitute and surrounding bone was the most indistinct with the group with autogenous bone filling, followed by the group with autogenous bone and Bio-Oss. filling, the group with blood, and the group with Bio-Oss. filling. 7. Three months after surgery, Bio-Gide. and Bio-Oss. were distinguishable. CONCLUSION: The best results were obtained with the group with autogenous bone and Bio-Oss. filling used in conjunction with a membrane.
Adult ; Alanine ; Animals ; Autografts* ; Bone Regeneration ; Bone Substitutes ; Collagen* ; Dogs ; Guided Tissue Regeneration ; Heterografts* ; Humans ; Hydroxyproline ; Membranes* ; Mucous Membrane ; Proline ; Regeneration*

STATEMENT OF PROBLEM: The success of implants depends on intimate and direct contact of implant material on bone tissue and on functional relationship with soft tissue contact. Creation and maintenance of osseointegration depend on the understanding of the tissue's healing, repairing, and remodeling capacity and these capacities rely on cellular behavior. Altering the surface properties can modify cellular responses such as cell adhesion, cell motility, bone deposition. Therefore, various implant surface treatment methods are being developed for the improved bone cell responses. PURPOSE: The purpose of this study was to evaluate the responses of osteoblast-like cells to surface- modified titanium. MATERIALS AND METHODS: The experiment was composed of four groups. Group 1 represented the electropolished surface. Group 2 surfaces were machined surface. Group 3 and Group 4 were anodized surfaces. Group 3 had low roughness and Group 4 had high roughness. Physicochemical properties and microstructures of the d iscs were examined and the responses of osteoblast-like cells to the discs were investigated. The microtopography was observed by SEM. The roughness was measured by three-dimension roughness measuring system. The microstructure was analyzed by XRD, AES. To evaluate cell responses to modified titanium surfaces, osteoblasts isolated from calvaria of neonatal rat were cultured. Cell count, morphology, total protein measurement and alkaline phosphatase activities of the cultures were examined. RESULTS AND CONCLUSION: The results were as follows 1. The four groups showed specific microtopography respectively. Anodized group showed grain structure with micropores. 2. Surface roughness values were, from the lowest to the highest, electropolished group, machined group, low roughness anodized group, and high roughness anodized group. 3. Highly roughened anodized group was found to have increased surface oxide thickness and surface crystallinity. 4. The morphology of cells, flattened or spherical, were different from ach other. In the electropolished group and machined group, the cells were almost flattened. In two anodized groups, some cells were spherical and other cells were flattened. And the 14 day culture cells of all of the groups were nearly flattened due to confluency. 5. The number of attached cells was highest in low roughness anodized group. And the machined group had significantly lower cell count than any other groups(P<.05). 6. Total protein contents showed no difference among groups. 7. The level of alkaline phosphatase activities was higher in the anodized groups than electropolished and machined groups(P<.05).
Alkaline Phosphatase ; Animals ; Bone and Bones ; Cell Adhesion ; Cell Count ; Cell Movement ; Edible Grain ; Crystallins ; Osseointegration ; Osteoblasts ; Rats ; Skull ; Surface Properties ; Titanium*

No abstract available.
Plasma* ; Prostate* ; Prostatic Neoplasms* ; Stomach Neoplasms*

Isometric contractions of muscles in upper extremities occur frequently during ordinary daily activities. The isometric handgrip exercise can be one of the best methods for the evaluation and treatment of patients with disability of upper extremity. However these isometric contractions can impose sudden and significant high stresses to the cardiovascular system. The purpose of this study was to document the torque patterns and cardiovascular responses of subjects by the isometric handgrip exercises and hopefully to provide a guidance for the safe evaluations and prescriptions of isometric exercises. Eighty healthy male subjects from 21 to 60 years of age performed isometric handgrip exercises using a Baltimore therapeutic equipment work simulator. The peak torque, time to peak torque, and torque at each second were measured by a six-second isometric strength trial program. The blood pressure and heart rate were measured simultaneously at rest and at each minute during isometric exercises at 30%, 50%, and 70% of the peak torque. There were no differences in the peak torque, time to peak torque, and torque at each second between age groups(p>0.05). After the onset of peak torque, the torque gradually decreased and recorded 72.8% of the peak torque at 6 seconds. The mean arterial pressure and heart rate increased significantly during exercise(p<0.001), but returned to the resting state immediately when the exercise stopped. The mean arterial pressures were significantly different when the duration of exercise prolonged at 50% and 70% of the peak torque(p<0.05). And also the mean arterial pressures increased significantly when the strength of exercise increased as well(p<0.001). We have concluded that attentions should be given to patient's cardiovascular state, and duration and strengh of exercise when the isometric handgrip exercises are prescribed for the evaluation and treatment of patients.
Arterial Pressure ; Attention ; Blood Pressure ; Cardiovascular System ; Exercise ; Heart Rate ; Humans ; Isometric Contraction ; Male ; Muscles ; Prescriptions ; Torque ; Upper Extremity

Diabetes mellitus (DM) is an important cause of organic impotence in man. The exact pathogenesis remains debatable although it has been focused on cavernosal neuropathy and/or endothelial dysfunction. This study was designed to investigate the effect of DM on penile erection, especially in association with nitric oxide synthase (NOS) in corpus cavernosum of diabetic rats. NOS studies of rat penis were performed in diabetic (DM was induced for 3, 6, 9, 12 weeks, respectively, by intraperitoneal administration of streptozotocin, 60mg/kg), in control and neurotomy group (3 weeks after bilateral cavernous nerve transection). The experiments consisted of nicotinamide dinucleotide phosphate (NADPH) diaphorase activity with spectrophotometric assay for NOS catalytic activity, NADPH diaphorase staining for the identification of NOS containing nerve fibers, and Western blotting analysis with anti-brain NOS antibody for the expression of neuronal NOS. Finally, these results were compared with erectile response to cavernous nerve stimulation in diabetic and in control rats. In assay of NADPH diaphorase activity, NOS activity decreased significantly in penis of diabetic rat as compared to that of controls. Between the diabetic groups, NOS activity was not seen significantly different, and in neurotomy groups it was similar to that of diabetic groups. On histochemical staining of penile tissues, the number of NADPH-positive nerve fibers in control group (a mean of 127+/-6 fibers recorded in 4 random fields on each corporal side) contrasted significantly with that of the bilateral cavernous nerve ablation group (a mean of 12+/-2). In diabetic group, the number of NOS-containing nerve fibers was gradually reduced along with duration of diabetes (from 92+/- 3 at 3 weeks to 28+/-3 at 12 weeks). In addition, analysis of blot density of neuronal NOS by Western blotting showed similar findings: 16% at 3 weeks and 8% at 12 weeks in diabetic group, 5% in neurotomy group and 27% in controls, based on the density of the rat cerebellum. Furthermore, erection response to cavernous nerve stimulation was also decreased in diabetic rats along with DM duration. The results, indicated that reduction of cavernous NOS, particularly, its neuronal form at the level of NO production plays an important role on the pathogenesis of erectile impotence in diabetic rats although the role of endothelial N0S in DM remains to be elucidated. Furthermore, cavernosal NADPH diaphorase staining and/or NOS activity may allow to characterize certain pathological condition, which comprise neurogenic impotence.
Animals ; Blotting, Western ; Cerebellum ; Diabetes Mellitus ; Erectile Dysfunction ; Male ; NADPH Dehydrogenase ; Nerve Fibers ; Neurons* ; Niacinamide ; Nitric Oxide ; Nitric Oxide Synthase ; Nitric Oxide Synthase Type I* ; Penile Erection* ; Penis ; Rats* ; Streptozocin

Physeal distraction is used for limb lengthening or correction of deformities in skeletally immature patients. But the effect of distraction on the physis is uncertain. The young rabbits were arranged into five groups according to the slow distraction rates: Group I (no distraction), Group II (distraction rate of 0.25mm per day), Group III (distraction rate of 0.5mm per day), Group IV (distraction rate of 0.75 mm per day), Group V (distraction rate of 1mm per day). The tibial length, size of proliferating zone, microscopic findings of physis immunostained with bromodeoxyuridine, and physeal response to physeal distraction on each group were studied. The results were as follows. 1. There was an increase in bone length on the distracted side (1.8 to 4.2mm). 2. There was an irregular increase in the thickness of the distracted physis. 3. There was an abnormal accumulation of hypertrophic chondrocytes in hypertrophic zone in distracted physis. 4. There was no evidence of anomalous cell proliferation, in the resting, proliferating and hypertrophic zones. These results conclude that the physeal distraction does not stimulate cell proliferation in the physis, even when it is seen to be thickened after the chondrodiatasis.
Bromodeoxyuridine ; Cell Proliferation ; Chondrocytes ; Congenital Abnormalities ; Extremities ; Humans ; Rabbits*

The recurrence of viral hepatitis B or C after liver transplantation is almost universal but their clinical courses and outcomes are vary widely. We investigated four cases of rapidly progressive and fatal recurrent viral hepatitis following liver transplantation, which were rapidly progressive and fatal. Case 1 was a 58-year-old male, who developed recurrent viral hepatitisC. Case 2, 3, and 4 were a 59-year-old female, a 42-year-old male, and a 50-year-old male, respectively, who developed recurrent viral hepatitis B. In cases 1 and 2, the histopathological features of the first liver biopsies were prominent ballooning degeneration of the hepatocytes but later biopsies revealed significant lobular activity. Case 3 began with a marked fatty change and mild lobular and porto-periportal activity and progressed to severe lobular activity and septal fibrosis. In case 4, the first liver biopsy revealed minimal lobular activity but the second biopsy revealed severe lobular activity.
Adult ; Biopsy ; Female ; Fibrosis ; Hepatitis B ; Hepatitis* ; Hepatocytes ; Humans ; Liver Transplantation* ; Liver* ; Male ; Middle Aged ; Recurrence

The epidural abscess, while rare, should be taken seriously, as it can result in permanent neurological complications. Fever, back pain, leukocytosis and elevation of Erythrocyte Sedimentation Rate (ESR) are major signs and symptoms of epidural abscesses. But clinical recognition of such abscesses may be very difficult because of nonspecific symptoms or signs as well as previous or underlying painful disorders. Few cases has been reported of epidural abscess and epidural fibrosis associated with back surgery or temporary epidural blocks. In these cases, however, fever, low back pain, sciatica and elevation of ESR were the major findings. Magnetic Resonance Imaging findings after Gadolinium- diethylenetriaminopenta-acetic acid (Gd-DTPA) enhancement show central low signal intensity and surrounding high signal intensity at the anterior epidural space between the 5th lumbar and 1st sacral vertebrae. We suspected an epidural abscess caused by epidural block, and so operated. But our operative finding was epidural fibrosis without abscess. Our final pathological diagnosis was epidural fibrosis.
Abscess ; Back Pain ; Blood Sedimentation ; Diagnosis* ; Epidural Abscess* ; Epidural Space ; Fever ; Fibrosis* ; Leukocytosis ; Low Back Pain ; Magnetic Resonance Imaging ; Sciatica ; Spine

Fifteen cases of diffuse axonal injury(DAI) brought about by nonmissile head injury in humans are analyzed. All cases were subjected to comprehensive clinical studies such as measurement of cerebral blood flow by SPECT, continuous intracranial pressure monitoring and multimodality evoked potentials(MEPs). In the patients with DAI, a high incidence of low cerebral perfusion and abnormal MEPs. especially auditory evoked potentials, were found, with high incidence of high velocity traffic accident injury mechanism. On the other hand, a low incidence of increased intracranial pressure was found and dehydrating agents such as glycerol and mannitol did not exert a beneficial influence upon the clinical courses or the outcomes. The outcome of the patients with DAI depended upon the duration of coma and whether or not brain stem signs were noted.
Accidents, Traffic ; Axons ; Brain Stem ; Coma ; Craniocerebral Trauma ; Diffuse Axonal Injury* ; Evoked Potentials* ; Evoked Potentials, Auditory ; Glycerol ; Hand ; Humans ; Incidence ; Intracranial Pressure* ; Mannitol ; Perfusion ; Tomography, Emission-Computed, Single-Photon

STATEMENT OF PROBLEM: The long-term success of implants is the development of a stable direct connection between bone and implant surface, which must be structural and functional. To improve a direct implant fixation to the bone, various strategies have been developed focusing on the surface of materials. Among them, altering the surface properties can modify cellular responses such as cell adhesion, cell motility and bone deposition. PURPOSE: This study was to evaluate the cellular behaviors on the surface-modified titanium by morphological observation, cellular proliferation and differentiation. MATERIAL AND METHODS: Specimens were divided into five groups, depending on their surface treatment: electropolishing(EP) anodizing(AN), machining(MA), blasting with hydroxyapatite particle(RBM) and electrical discharge machining(EDM). Physicochemical properties and microstructures of the specimens were examined and the responses of osteoblast-like cells were investigated. The microtopography of specimens was observed by scanning electron microscopy(SEM). Surface roughness was measured by a three-dimensional roughness measuring system. The microstructure was analyzed by X-ray diffractometer(XRD) and scanning auger electron microscopy(AES). To evaluate cellular responses to modified titanium surfaces, osteoblasts isolated from neonatal rat were cultured. The cellular morphology and total protein amounts of osteoblast-like cell were taken as the marker for cellular proliferation, while the expression of alkaline phosphatase was used as the early differentiation marker for osteoblast. In addition, the type I collagen production was determined to be a reliable indicator of bone matrix synthesis. RESULTS: 1. Each prepared specimen showed specific microtopography at SEM examination. The RBM group had a rough and irregular pattern with reticulated appearance. The EDM-treated surface had evident cracks and was heterogeneous consisting of broad sheet or plate with smooth edges and clusters of small grains, deep pores or craters. 2. Surface roughness values were, from the lowest to the highest, electropolished group, anodized group, machined group, RBM group and EDM group. 3. All groups showed amorphous structures. Especially anodized group was found to have increased surface oxide thickness and EDM group had titaniumcarbide(TiC) structure. 4. Cells on electropolished, anodized and machined surfaces developed flattened cell shape and cells on RBM appeared spherical and EDM showed both. After 14 days, the cells cultured from all groups were formed to be confluent and exhibited multilayer proliferation, often overlapped or stratified. 5. Total protein amounts were formed to be quite similar among all the group at 48 hours. At 14 days, the electropolished group and the anodized group induced more total protein amount than the RBM group(P<.05). 6. There was no significant difference among five groups for alkaline phosphatase(ALP) activity at 48 hours. The AN group showed significantly higher ALP activity than any other groups at 14 days(P<.05). 7. All the groups showed similar collagen synthesis except the EDM group. The amount of collagen on the electropolished and anodized surfaces were higher than that on the EDM surface(P<.05).
Alkaline Phosphatase ; Animals ; Bone Matrix ; Cell Adhesion ; Cell Movement ; Cell Proliferation ; Cell Shape ; Edible Grain ; Collagen ; Collagen Type I ; Durapatite ; Osteoblasts* ; Rats ; Surface Properties ; Titanium*