Background: Endodontic sealers or their toxic components may become inflamed and lead to delayed wound healing when in direct contact with periapical tissues over an extended period. Moreover, an overfilled sealer can directly interact with adjacent tissues and may cause immediate necrosis or further resorption. Therefore, the treatment outcome conceivably depends on the endodontic sealer’s biocompatibility and osteogenic potential. This study aimed to evaluate the cell viability and osteogenic effects of four different sealers in osteoblastic cells. Methods: AH Plus (resin-based sealer), Pulp Canal Sealer EWT (zinc oxide-eugenol sealer), BioRoot RCS (calcium silicate-based sealer), and Well-Root ST (MTA-based calcium silicate sealer) were mixed strictly according to the manufacturer’s instructions, and dilutions of sealer extracts (1/2, 1/5 and 1/10) were determined. Cell viability was measured using the water-soluble tetrazolium-8 (WST-8) assay. Differentiation was assessed by alkaline phosphatase (ALP) activity and mineralized nodule formation by Alizarin Red S staining. Results: The cell viability of the extracts derived from the sealers excluding Well-Root ST was concentration dependent, with sealer extracts having the least viability at a 1/2 dilution. At sealer extract dilution of 1/10, the test groups showed the same survival rate as that control group, with the exception of BioRoot RCS. Among all experimental groups, BioRoot RCS showed the highest cell viability after 48 hours. The ALP activity was significantly higher in a concentration-dependent manner. Furthemore, all four materials promoted ALP activity and mineralized nodule formation compared to the control at 1/10 dilutions. Conclusion This is the first study to highlight the differences in biological activity of these four materials. These results suggest that the composition of root canal sealers appears to alter the form of biocompatibility and osteoblastic differentiation.

Percutaneous transhepatic cholangioscopy (PTCS) is the primary treatment option for general cases of intrahepatic duct stones. However, there are no reports on the use of PTCS for intrahepatic duct stones in patients who had undergone living donor liver transplantation (LDLT). We experienced two cases of successful intrahepatic stone removal by the use of PTCS in LDLT patients. With these cases, we have confirmed that PTCS management can be safely performed not only for a general bile duct stone, but also for a bile duct stone that develops in a patient that had previously undergone liver transplantation.
Bile Ducts ; Factor IX ; Humans ; Liver ; Liver Transplantation ; Living Donors

BACKGROUND: Aging process causes several changes in the typical sleep patterns. Elderly people complain frequently about sleep duration, changes of sleep/wake rhythm and day time sleepiness. This study was performed to evaluate improvement of sleep quality after laughter therapy. METHODS: On July 2007, the study participants aged over 65 were recruited through a community center in Daegu. There were 48 subjects in the experimental group and 61 in the control group. The laughter therapy program was applied to the experimental group. We compared Insomnia Severity Index (ISI) and Pittsburgh Sleep Quality Index (PSQI) before and after laughter therapy. Data were analyzed by independent t-test, chi-square test, paired t-test, and ANCOVA using SPSS windows ver. 14.0. RESULTS: At initial study, there were no significant differences in baseline characteristics. The ISI scores were 8.00 +/- 6.29 and 8.36 +/- 6.38; the PSQI scores were 6.98 +/- 3.41 and 7.38 +/- 3.70; The Geriatric Depression Seals (GDS) scores were 7.98 +/- 3.58 and 8.08 +/- 3.95 in experimental and control groups, respectively. After laughter therapy, the ISI scores were 7.58 +/- 5.38 (P = 0.327) and 9.31 +/- 6.35 (P = 0.019), PSQI scores were 6.04 +/- 2.35 (P = 0.019) and 7.30 +/- 3.74 (P = 0.847), GDS scores were 6.94 +/- 3.19 (P = 0.027), 8.43 +/- 3.44 (P = 0.422) in experimental and control groups, respectively. CONCLUSION: The laughter therapy is considered to be useful for the elderly people in a community that improves insomnia and sleep quality.
Aged ; Aging ; Depression ; Humans ; Laughter ; Laughter Therapy ; Sleep Initiation and Maintenance Disorders

Background: When cells are damaged by nicotine, cellular senescence due to oxidative stress accelerates. In addition, stress-induced inflammatory response and cellular senescence cause the accumulation of damaged organelles in cells, and autophagy appears to remove them. Conversely, when autophagy is reduced, harmful cell components accumulate, and aging is accelerated. This study aimed to determine the association between nicotine-induced cellular senescence and autophagy expression patterns in human gingival fibroblasts. Methods: Cells were treated with various concentrations of nicotine (0, 0.1, 0.5, 1, 2, and 5 mM) and 10 nM rapamycin was added to 1 mM nicotine to investigate the relationship between autophagy and cellular senescence. Cell viability was confirmed using WST-8 and the degree of cellular senescence was measured by SA-β-gal staining. The expression of the inflammatory proteins (COX-2 and iNOS) and autophagy markers (LC3-II, p62, and Beclin-1) was analyzed by western blotting. Results: The cell viability tended to decrease in a concentration-dependent manner. COX-2 showed no concentration-dependent expression and iNOS increased in the 0.5 mM nicotine treated group. The degree of cellular senescence was the highest in the 1 mM nicotine treatment group. In the group treated with rapamycin and nicotine, the conversion ratio of LC3-II to LC3-I was the highest, that of p62 was the lowest, and the level of Beclin-1 proteins was significantly increased. Furthermore, the degree of cellular senescence was reduced in the group in which rapamycin was added to nicotine compared to that in the group treated with nicotine alone. Conclusion This study provides evidence that autophagy activated in an aging environment reduces cellular senescence to a certain some extent.

BACKGROUND/AIMS: Irritable bowel syndrome (IBS) is a functional gastrointestinal (GI) tract disorder that has heterogeneous clinical presentations such as abdominal pain, diarrhea, constipation, and abdominal distension. It is known that several mechanisms are involved in the pathogenesis of IBS. Probiotics may target one or more pathophysiologic pathways in IBS and may improve the symptoms of IBS. However, the results of studies about probiotics on IBS are controversial. Therefore, the aim of this study was to evaluate the effect of probiotics on GI symptoms and intestinal gas volume changes in patients with IBS. METHODS: Forty patients were randomly allocated to be treated with medilac DS(R) (Bacillus subtilis, Streptococcus faecium) (n=20) or placebo (n=20) in a double-blind, prospective manner. The change in intestinal gas volume and symptom scores after 4-week treatment were evaluated for the efficacy. RESULTS: There was no significant difference in bloating, frequency of gas expulsion, frequency of defecation, and hardness of stool before and after the treatment. However, the severity of abdominal pain and the frequency of abdominal pain decreased significantly in medilac DS(R)group (2.4+/-1.3 cm/day -> 1.6+/-1.6 cm/day, 1.7+/-1.3/day -> 1.0+/-1.0/day) (p=0.044, p=0.038), but not in placebo group (2.1+/-2.0 cm/day -> 1.8+/-2.1 cm/day, 1.3+/-1.2/day -> 1.4+/-1.9/day). In both groups, intestinal gas volume at baseline, after 2-week treatment, and after 4-week treatment did not show significant change. Medilac DS(R)was well tolerated without adverse events. CONCLUSIONS: Medilac DS(R)is a safe and useful probiotic agent for the treatment of abdominal pain in patients with IBS.
Abdominal Pain/etiology/therapy ; Adult ; Bacillus subtilis ; Double-Blind Method ; Enterococcus faecium ; Female ; Humans ; Irritable Bowel Syndrome/*therapy ; Male ; Middle Aged ; Probiotics/*therapeutic use

BACKGROUND/AIMS: Irritable bowel syndrome (IBS) is a functional gastrointestinal (GI) tract disorder that has heterogeneous clinical presentations such as abdominal pain, diarrhea, constipation, and abdominal distension. It is known that several mechanisms are involved in the pathogenesis of IBS. Probiotics may target one or more pathophysiologic pathways in IBS and may improve the symptoms of IBS. However, the results of studies about probiotics on IBS are controversial. Therefore, the aim of this study was to evaluate the effect of probiotics on GI symptoms and intestinal gas volume changes in patients with IBS. METHODS: Forty patients were randomly allocated to be treated with medilac DS(R) (Bacillus subtilis, Streptococcus faecium) (n=20) or placebo (n=20) in a double-blind, prospective manner. The change in intestinal gas volume and symptom scores after 4-week treatment were evaluated for the efficacy. RESULTS: There was no significant difference in bloating, frequency of gas expulsion, frequency of defecation, and hardness of stool before and after the treatment. However, the severity of abdominal pain and the frequency of abdominal pain decreased significantly in medilac DS(R)group (2.4+/-1.3 cm/day -> 1.6+/-1.6 cm/day, 1.7+/-1.3/day -> 1.0+/-1.0/day) (p=0.044, p=0.038), but not in placebo group (2.1+/-2.0 cm/day -> 1.8+/-2.1 cm/day, 1.3+/-1.2/day -> 1.4+/-1.9/day). In both groups, intestinal gas volume at baseline, after 2-week treatment, and after 4-week treatment did not show significant change. Medilac DS(R)was well tolerated without adverse events. CONCLUSIONS: Medilac DS(R)is a safe and useful probiotic agent for the treatment of abdominal pain in patients with IBS.
Abdominal Pain/etiology/therapy ; Adult ; Bacillus subtilis ; Double-Blind Method ; Enterococcus faecium ; Female ; Humans ; Irritable Bowel Syndrome/*therapy ; Male ; Middle Aged ; Probiotics/*therapeutic use

BACKGROUND/AIMS: There are limited therapeutic options available for irritable bowel syndrome with diarrhea (IBS-D). We tested the effects of Atractylodes japonica rhizome, a perennial plant native to North Asia, on both upper and lower gastrointestinal (GI) motility in guinea pigs. METHODS: The extract of A. japonica rhizome was administered orally at different doses to test its effects on upper GI motility as determined from charcoal transit in native guinea pigs and in guinea pigs pretreated with thyrotropin-releasing hormone or mustard oil. Regarding its effect on lower GI motility, the removed guinea pig colon was suspended in a chamber containing Krebs-Henseleit solution and the transit time of artificial feces was measured with various dilutions of the extract. As for in vivo assay, weight and number of fecal pellets expelled were determined under the same drug preparation used in upper GI motility experiment. RESULTS: The extract of A. japonica rhizome had no significant effect on upper GI motility in either normal or altered physiological states. However, the extract increased colonic transit time in the in vitro model. In the fecal expulsion study, the cumulative weight and number of pellets did not differ significantly between the control group and groups treated with the extracts. In the animals pretreated in vivo with thyrotropin-releasing hormone, however, the weight and number of fecal pellets were significantly decreased in animals treated with 300 mg/kg and 600 mg/kg doses of extract. CONCLUSIONS: Our findings suggest that the extract of A. japonica rhizome can be a potential agent for IBS-D.
Animals ; Asia, Northern ; Atractylodes* ; Charcoal ; Colon ; Diarrhea ; Drug Compounding ; Feces ; Gastrointestinal Motility* ; Guinea Pigs* ; Irritable Bowel Syndrome ; Mustard Plant ; Plants ; Rhizome* ; Thyrotropin-Releasing Hormone

BACKGROUND: Severe forefoot deformities, particularly those involving the dorsum of the foot, cause inconvenience in daily activities of living including moderate pain on the dorsal aspect of the contracted foot while walking and difficulty in wearing nonsupportive shoes due to toe contractures. This paper presents clinical results of reconstruction of severe forefoot deformity using the anterolateral thigh (ALT) free flap. METHODS: Severe forefoot deformities were reconstructed using ALT flaps in 7 patients (8 cases) between March 2012 and December 2015. The mean contracture duration was 28.6 years. RESULTS: All the flaps survived completely. The size of the flaps ranged from 8 cm × 5 cm to 19 cm × 8 cm. The mean follow-up period was 10 months (range, 7 to 15 months). There was no specific complication at both the recipient and donor sites. There was one case where the toe contracture could not be completely treated after surgery. All of the patients were able to wear shoes and walk without pain. Also, the patients were highly satisfied with cosmetic results. CONCLUSIONS: The ALT flap may be considered ideal for the treatment of severe forefoot deformity.
Congenital Abnormalities ; Contracture* ; Follow-Up Studies ; Foot ; Foot Deformities ; Free Tissue Flaps ; Humans ; Shoes ; Thigh* ; Tissue Donors ; Toes ; Walking

Pneumatosis coli (PC) is a rare disease that is characterized by multiple, varying-sized cysts at the mucosa or submucosa in the colon and sigmoid colon. About 85% of PC is associated in other gastrointestinal, pulmonary and connective diseases. Ischemic colitis is rarely associated with PC. The symptoms of PC are not specific, and the patients with this malady present with hematochezia, abdominal pain, diarrhea and other symptoms associated with their underlying diseases. Colonoscopy and computed tomography are recommended for making the diagnosis. The underlying diseases should be treated and oxygen therapy, intra-venous antibiotics and/or surgical treatment can be used. The prognosis is generally good, but volvulus, intussusception, intestinal obstruction, bleeding and perforation can occur in 3% of these patients. We experienced two patients who initially presented with hematochezia and they were found to have PC and ischemic colitis according to the colonoscopy exams; these are the first such reported cases in Korea. Both patients were treated conservatively with low-dose oxygen therapy and intra-venous metronidazole. We report here on 2 cases of PC associated with ischemic colitis, and we review the relevant literature.
Abdominal Pain ; Anti-Bacterial Agents ; Colitis, Ischemic ; Colon ; Colon, Sigmoid ; Colonoscopy ; Diarrhea ; Gastrointestinal Hemorrhage ; Hemorrhage ; Humans ; Intestinal Obstruction ; Intestinal Volvulus ; Intussusception ; Korea ; Metronidazole ; Mucous Membrane ; Oxygen ; Prognosis ; Rare Diseases

Gynandroblastoma is an extremely rare sex cord-stromal tumor with both female (granulosa cell tumor) and male (Sertoli-Leydig cell tumor) elements. Juvenile granulosa cell tumors are also very rare and are so named because they usually occur in children and adolescents. A 71-year-old woman with right upper quadrant abdominal pain visited our hospital. Pelvic computed tomography showed a large multilocular cystic mass, suspected to be of ovarian origin. We performed a total abdominal hysterectomy (total abdominal hysterectomy was performed) with bilateral salpingo-oophorectomy. A 13-cm multilocular cystic mass with serous fluid was observed in her right ovary. Upon microscopic examination, the solid component of the mass showed both Sertoli-Leydig cell and juvenile granulosa cell differentiation, which we diagnosed as gynandroblastoma. Gynandroblastoma with a juvenile granulosa cell tumor component is extremely rare and, until now, only six cases have been reported in the English literature. We report the first gynandroblastoma with a juvenile granulosa cell tumor component diagnosed in an elderly patient, along with a literature review.
Abdominal Pain ; Adolescent ; Aged ; Child ; Female ; Granulosa Cell Tumor ; Granulosa Cells ; Humans ; Hysterectomy ; Male ; Ovary ; Postmenopause ; Sex Cord-Gonadal Stromal Tumors