The fine structure of cells in the trigeminal mesencephalic (Me5) nucleus in the rat was studied by transmission electron microscopy. This nucleus located in the mid-brain and the rostral portion of the pons, most neurons in the caudal part of Me5 nucleus were sufficiently large (40~50micrometer) and appeared as round-shaped unipolar cells. The Me5 neurons had a large, round, centrally located nucleus, and their cytoplasm contained numerous mitochondria, dense granular endoplasmic reticulum, abundant Golgi apparatus, groups of free ribosomes, some heterogeneous particles and neurofilaments. Cell surfaces were studded irregularly with small spinouts processes, and they contained a few fine irregularly arranged neurofilaments and some granular endoplasmic reticulum. Boutons contacting the soma of Me5 neurons were defined as axosomatic synapses and bostons contacting dendrites located between the Me5 neurons were defined as axodendritic synapses. Based on differences in bouton and vesicle morphology, the four synaptic bouton types were identified. 1. Asymmetrical as well as symmetrical synapses with small round vesicles. 2. Asymmetrical synapses with pleomorphic admixture contained predominantlyspherical vesicles. 3. Symmetrical synapses with pleomorphic vesicles of flattened, spherical and dense-core vesicles. 4. Asymmetrical as well as symmetrical synapses with heterogeneous and large dense-core vesicles. Synaptic boutons containing round vesicles and large dense-core vesicles were most frequently observed.
Animals ; Carisoprodol ; Cytoplasm ; Dendrites ; Endoplasmic Reticulum, Rough ; Golgi Apparatus ; Microscopy, Electron, Transmission ; Mitochondria ; Neurons ; Pons ; Presynaptic Terminals ; Rats* ; Ribosomes ; Synapses

STATEMENT OF PROBLEM: When veneering composite resin-metal restoration is prepared, the fact that bond strength between Ti and composite resin is relatively weak should be considered. PURPOSE: The purpose of this study is to evaluate the shear bond strength between the veneering composite resin and commercial pure (CP) Ti / Ti-6Al-4V alloy according to the method of surface treatment. MATERIAL AND METHODS: The disks were cast by two types of metal. Their surfaces were treated by sandblasting, metal conditioner, TiN coating and silicoating respectively. After surface treatment, the disks were veneered by composite resin (Tescera(TM), Bisco, USA) which is 5 mm in diameter and 3 mm in thickness. The specimens were stored in water at 25degrees C for 24 hours, and then evaluated for their shear bond strength by universal testing machine (STM-5(R), United Calibration, USA). These values were statistically analyzed. RESULTS: 1. All methods of surface treatment were used in this study satisfied the requirements of ISO 10477 which is the standard of polymer-based crown and bridge materials. 2. The metal conditioner treated group showed the highest value in shear bond strength of CP Ti, silicoated group, TiN coated group, sandblasted group, in following order. 3. The silicoated group showed the highest value in shear bond strength of Ti-6Al-4V alloy, metal conditioner treated group, sandblasted group, TiN coated group, in following order. CONCLUSION: Within the limitations of this study, all methods of surface treatment used in this study are clinically available.
Alloys ; Calibration ; Collodion ; Crowns ; Tin ; Titanium ; Water

BACKGROUND: Epidural blocks are widely used for the management of acute and chronic pain. The technique of loss of resistance is frequently adopted to determine the epidural space. A discontinuity of the ligamentum flavum may increase the risk of failure to identify the epidural space. The purpose of this study was to investigate the anatomic variations of the cervical and high thoracic ligamentum flavum in embalmed cadavers. METHODS: Vertebral column specimens of 15 human cadavers were obtained. After vertebral arches were detached from pedicles, the dural sac and epidural connective tissue were removed. The ligamentum flavum from C3 to T6 was directly examined anteriorly. RESULTS: The incidence of midline gaps in the ligamentum flavum was 87%-100% between C3 and T2. The incidence decreased below this level and was the lowest at T4-T5 (8%). Among the levels with a gap, the location of a gap in the caudal third of the ligamentum flavum was more frequent than in the middle or cephalic portion of the ligamentum flavum. CONCLUSIONS: The cervical and high thoracic ligamentum flavum frequently has midline intervals with various features, especially in the caudal portion of the intervertebral space. Therefore, the ligamentum flavum is not always reliable as a perceptible barrier to identify the epidural space at these vertebral levels. Additionally, it may be more useful to insert the needle into the cephalic portion of the intervertebral space than in the caudal portion.
Analgesia, Epidural ; Cadaver ; Chronic Pain ; Connective Tissue ; Epidural Space ; Humans ; Incidence ; Ligamentum Flavum* ; Needles ; Spine

BACKGROUND: Epidural blocks are widely used for the management of acute and chronic pain. The technique of loss of resistance is frequently adopted to determine the epidural space. A discontinuity of the ligamentum flavum may increase the risk of failure to identify the epidural space. The purpose of this study was to investigate the anatomic variations of the cervical and high thoracic ligamentum flavum in embalmed cadavers. METHODS: Vertebral column specimens of 15 human cadavers were obtained. After vertebral arches were detached from pedicles, the dural sac and epidural connective tissue were removed. The ligamentum flavum from C3 to T6 was directly examined anteriorly. RESULTS: The incidence of midline gaps in the ligamentum flavum was 87%-100% between C3 and T2. The incidence decreased below this level and was the lowest at T4-T5 (8%). Among the levels with a gap, the location of a gap in the caudal third of the ligamentum flavum was more frequent than in the middle or cephalic portion of the ligamentum flavum. CONCLUSIONS: The cervical and high thoracic ligamentum flavum frequently has midline intervals with various features, especially in the caudal portion of the intervertebral space. Therefore, the ligamentum flavum is not always reliable as a perceptible barrier to identify the epidural space at these vertebral levels. Additionally, it may be more useful to insert the needle into the cephalic portion of the intervertebral space than in the caudal portion.
Analgesia, Epidural ; Cadaver ; Chronic Pain ; Connective Tissue ; Epidural Space ; Humans ; Incidence ; Ligamentum Flavum ; Needles ; Spine

BACKGROUND: The purpose of this study was to evaluate the clinical outcomes of treatment of non-odontogenic atypical orofacial pain using botulinum toxin-A. METHODS: This study involved seven patients (seven females, mean age 65.1 years) who had non-odontogenic orofacial pain (neuropathic pain and atypical orofacial pain) and visited the Seoul National University Bundang Hospital between 2015 and 2017. All medication therapies were preceded by botulinum toxin-A injections, followed by injections in the insignificant effects of medication therapies. Five of the seven patients received intraoral injections in the gingival vestibule or mucosa, while the remaining two received extraoral injections in the masseter and temporal muscle areas. RESULTS: In five of the seven patients, pain after botulinum toxin-A injection was significantly reduced. Most of the patients who underwent surgery for dental implantation or facial nerve reconstruction recovered after injections. However, the pain did not disappear in two patients who reported experiencing persistent pain without any cause. CONCLUSIONS: The use of botulinum toxin-A for the treatment of non-odontogenic neuropathic orofacial pain is clinically useful. It is more effective to administer botulinum toxin-A in combination with other medications and physical therapy to improve pain. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s40902-018-0159-z) contains supplementary material, which is available to authorized users.
Botulinum Toxins ; Dental Implantation ; Dental Implants ; Facial Nerve ; Facial Pain ; Female ; Humans ; Mucous Membrane ; Retrospective Studies ; Seoul ; Temporal Muscle

Abnormalities of body fluid and electrolyte balance, acute renal failure, nephrotic syndrome, interstitial nephritis and papillary necrosis are well known disease of wide spectrum of NSAID induced renal side effect. Many different mechanism such as inhibition of prostaglandin pathway, delayed hypersensitivity reaction and direct toxicity are reported to relate to development of disease. Recently, overuse of NSAID has steadily increased the cases of NSAID induced side effects and in some cases permanent damage to kidney has been reported. Authors experienced a 67-year-old male patient who presented with gross hematuria, edema and azotemia and diagnosed as interstitial nephritis accompanying nephrotic syndrome. Kidney biopsy shows the edema and the diffuse infiltration of lymphocytes in the interstitium. The glomerular changes suggest minimal change lesion or focal segmental glomerular sclerosis in early stage. The patient had continuously consumed piroxicam for 6 months and had improved after discontinuation of this drug as well as treatment with steroid but remained renal damage. This case suggest that piroxicam may be an agent that causes interstitial nephritis and nephrotic syndrome. Therefore clinician should use it with caution especially in patients with high risk factors.
Acute Kidney Injury ; Aged ; Azotemia ; Biopsy ; Body Fluids ; Edema ; Hematuria ; Humans ; Hypersensitivity, Delayed ; Kidney ; Lymphocytes ; Male ; Necrosis ; Nephritis, Interstitial* ; Nephrotic Syndrome* ; Piroxicam* ; Risk Factors ; Sclerosis ; Water-Electrolyte Balance

BACKGROUND: Doxylamine, an antihistamine with sleep inducing property, is the most commonly intoxicated drug in the urban ED. This drug is relatively safe but is known to induce rhabdomyolysis in rare occasion. The purpose of this study is to determine the incidence of rhabdomyolysis after doxylamine overdose and prognostic factors that contributes to this complication. METHOD: This study was conducted from 26 patients admitted to our hospital after doxylamine intoxication during the period from April 1999 to June 1999. Using the protocol made beforehand, the amount ingested, past history, laboratory results were recorded. Rhabdomyolysis was defined as serum myoglobin over 300 ng/mL or serum creatine phosphokinase(CK) over 1,000 IU/L. Data were analyzed using SPSS program with t-test, Fisher's exact test and discriminant analysis. RESULTS: The rhabdomyolysis was diagnosed in 57.7% of patients. The amount ingested per body weight, prehospital vomiting and low arterial pCO2 predicted occurrence of rhabdomyolysis. The sensitivity of serum CK and myoglobin were 67% and 80% respectively and specificity was 100% for both. The diagnosis was possible for CK after an average of 14hr 20min time after ingestion and 8hr 12min for myoglobin. CONCLUSION: Rhabdomyolysis is a common complication of doxylamine intoxication and if the amount ingested was more than 1 tablet(25mg) per body weight, the incidence of rhabdomyolysis was higher. So, CK measurement after 14 hour postingestion and myoglobin after 8 hour is recommended to decide whether rhabdomyolysis occur.
Body Weight ; Creatine ; Diagnosis ; Doxylamine* ; Eating ; Humans ; Incidence* ; Myoglobin ; Rhabdomyolysis* ; Sensitivity and Specificity ; Vomiting

Complications increases when crown height space is excessive and one should be careful of choosing type of fixed prosthesis in case crown height space is over 12 mm. In this condition, tooth seems to be longer, therefore, it is needed to use gingival shade in aesthetically important area for fixed prosthesis. In this case, fixed prosthesis which has inappropriate maintenance and hygiene could hold food, plaque, calculus, thus increase incidence of inflammation and infection. Moreover, it could lead to chronic inflammation and infection and in that case surgical improvement could be necessary. In present case report, gingival inflammation and swelling developed around prosthesis after having made it considering articulation and aesthetic view in patient who had excessive crown height space. Finding out that design of prosthesis is a factor to make it hard to maintain oral hygiene, a temporary prosthesis which has enough interproximal space and proper emergence profile was fabricated. After two months of observation, significant abnormal symptoms are not found and oral reconstruction is performed using fixed prosthesis with zircornia infrastructure and porcelain build-up based on convenient self hygiene design. Through serial treatment, inappropriate soft tissue response is not observed and satisfactory result in functional aspect comes out.
Calculi ; Crowns ; Dental Porcelain ; Humans ; Hygiene ; Incidence ; Inflammation ; Oral Hygiene ; Prostheses and Implants ; Tooth

Emphysematous cystitis is a rare disease that is associated with diabetes mellitus, neurogenic bladder, chronic genitourinary infection, and malignancy. Fever, chill, abdominal pain, and urinary difficulties were the most frequent presenting symptoms associated with emphysematous cystitis. We report a case of incidentally detected asymptomatic emphysematous cystitis in a 67 years old female patient with diabetic nephropathy. We review characteristic features of all 19 cases that has been reported in korean medical journals till now. Risk factors for this condition appear to be female sex, old age, and diabetes mellitus.
Abdominal Pain ; Aged ; Cystitis* ; Diabetes Mellitus ; Diabetic Nephropathies ; Female ; Fever ; Humans ; Korea* ; Rare Diseases ; Risk Factors ; Urinary Bladder, Neurogenic

Schwannomas are benign, usually slow-growing tumors that originate from Schwann cells surrounding peripheral, cranial, or autonomic nerves. The most common form of these tumors is acoustic neuroma. Schwannomas of the brachial plexus are quite rare, and symptomatic schwannomas of the brachial plexus are even rarer. A 47-year-old woman presented with a 1-year history of dysesthesia, neuropathic pain, and mild weakness of the right upper limb. Results of physical examination and electrodiagnostic studies supported a diagnosis as thoracic outlet syndrome. Conservative treatment did not relieve her symptoms. After 9 months, a soft mass was found at the upper margin of the right clavicle. Magnetic resonance imaging showed a 3.0x1.8x1.7 cm ovoid mass between the inferior trunk and the anterior division of the brachial plexus. Surgical mass excision and biopsy were performed. Pathological findings revealed the presence of schwannoma. After schwannoma removal, the right hand weakness did not progress any further and neuropathic pain gradually reduced. However, dysesthesia at the right C8 and T1 dermatome did not improve.
Autonomic Pathways ; Biopsy ; Brachial Plexus* ; Clavicle ; Diagnosis ; Female ; Hand ; Humans ; Magnetic Resonance Imaging ; Middle Aged ; Neuralgia ; Neurilemmoma* ; Neuroma, Acoustic ; Paresthesia ; Physical Examination ; Schwann Cells ; Thoracic Outlet Syndrome* ; Upper Extremity