In clinical surgery, there are frequent needs for communication between the house staff and the attending physician in an emergency situation. It's often insufficient for the house staff to make a decision through the information which is delivered in the form of only voice through the telephone line. To overcome the limitation of voice communication, we have designed an emergency teleradiology system which can be used for emergency surgical and medical decision making. The system can transmit the high quality images of CT, MRI, and other X-ray data using a PC attached to a modem through the conventional telephone line. Progressive transmission adopted in the system enables us to efficiently utilize the band-width of telephone line which is typically very low. The iterative residual coding/decoding algorithm compresses various medical images effectively, and thus fast-transmission of images date helps the house staff to perceive the status of emergent patient and make a fast and correct decision about the patient. The system also satisfies design requirements such as low-cost, ease of operation and interactive image communication including voice. 'Teleradiology system' proposed in this paper has been installed and operated in the emergency care unit of Severance Hospital, and as a result, it is effective in the emergency situations.
Decision Making ; Emergencies ; Emergency Medical Services ; Humans ; Internship and Residency ; Magnetic Resonance Imaging ; Modems ; Telephone ; Teleradiology* ; Voice

This case report describes the treatment of a 23-year, 8-month-old female patient with a Class II malocclusion who showed severe bidentoalveolar protrusion and anterior crowding. The treatment plan consisted of extracting all the first premolars, decrowding and en masse retraction of the upper six anterior teeth and lower anteriors. The upper C-plate placed in the midpalatal area combined with lingual sheath fixtures were used as substitutes for posterior anchorage teeth during upper anterior retraction. Preadjusted brackets (0.022-inch) were used for upper anterior decrowding. A 0.9 mm diameter stainless steel lever-arm soldered to the main arch wire facilitated controlled retraction of upper anteriors. The upper and lower dentition was detailed using a tooth positioner during the finishing stage. Correct overbite and overjet were obtained by decrowding and retraction of the upper six anterior teeth into their proper positions. Use of the C-plate and lingual appliances provided ideal anchorage to enhance the improvement in facial balance. The active treatment period was 19 months. The treatment result was stable 13 months after debonding.
Bicuspid ; Crowding ; Dentition ; Female ; Humans ; Infant ; Malocclusion ; Overbite ; Stainless Steel ; Tooth

A modified removable appliance for molar distalization called C-activator was used in a 10-year old male patient with a Class II anterior deep bite malocclusion with upper arch discrepancy. The treatment plan involved correcting the Class II relationship, distalizing both upper first molars, and regaining space for the erupting canines. The C-activator, which was used for 6 months, consisted of a labial framework formed from .036-in stainless steel wire and an acrylic monobloc. Both the closed helices of the labial framework were compressed for reactivation during the C-activator treatment period. C-activator mechanics simultaneously achieved distalization of the upper first molars into their proper positions and repositioning of the mandible. After 21 months of treatment, the correct overbite and overjet was obtained and contributed to an improvement in facial balance. The treatment results were stable 6 months after debonding. Fabrication and placement of the new appliance and clinical procedures are detailed, and the treatment sequence and results of this case are presented as follows.
Child ; Humans ; Male ; Malocclusion* ; Mandible ; Mechanics ; Molar* ; Overbite* ; Stainless Steel

During orthodontic treatment of impacted teeth, use of appropriate anchorage against the traction force is important. Tooth anchorage with multi-bracket appliances is commonly used but sometimes it causes unwanted movements of adjacent teeth. Skeletal anchorage devices are therefore considered to minimize such side effects. Still their survival rate and positioning are highly limited according to the bone density and the interradicular space. This case report presents a case of two impacted teeth, one of which is dilacerated and horizontally angulated. Using the microplate with short screws and a bendable neck, negative effects on adjacent teeth were minimized and impacted teeth were repositioned with good stability.

3-Deazaadenosine (DZA), a cellular methylation blocker was reported to induce the caspase-3-like activities-dependent apoptosis in U-937 cells. In this study, we analyzed the activation pathway of the caspase cascade involved in the DZA-induced apoptosis using specific inhibitors of caspases. In the U-937 cells treated with DZA, cytochrome c release from mitochondria and subsequent activation of caspase-9, -8 and -3 were observed before the induction of apoptosis. zDEVD-Fmk, a specific inhibitor of caspase-3, and zLEHD-Fmk, a specific inhibitor of caspase-9, prevented the activation of caspase-8 but neither caspase-3 nor caspase-9, indicating that caspase-8 is downstream of both caspase-3 and caspase-9, which are activated by independent pathways. zVAD-Fmk, a universal inhibitor of caspases, kept the caspase-3 from being activated but not caspase-9. Moreover, ZB4, an antagonistic Fas-antibody, exerted no effect on the activation of caspase-8 and induction of apoptosis by DZA. In addition, zVAD-Fmk and mitochondrial permeability transition pore (MPTP) inhibitors such as cyclosporin A (CsA) and bongkrekic acid (BA) did not block the release of cytochrome c from mitochondria. Taken together, these results suggest that in the DZA-induced apoptosis, caspase-8 may serve as an executioner caspase and be activated downstream of both caspase-3 and caspase-9, independently of Fas receptor-ligand interaction. And caspase-3 seems to be activated by other caspses including IETDase-like enzyme and caspse-9 seems to be activated by cytochrome c released from mitochondria without the involvement of caspases and CsA- and BA- inhibitory MPTP.
Amino Acid Chloromethyl Ketones/pharmacology ; Apoptosis/*drug effects ; Bongkrekic Acid/pharmacology ; Caspases/*metabolism ; Cell Line ; Cyclosporine/pharmacology ; Cytochrome c/drug effects/metabolism ; Enzyme Activation ; Human ; Leukocytes, Mononuclear/cytology ; Ligands ; Membrane Glycoproteins/metabolism ; Tubercidin/*pharmacology ; U937 Cells

3-Deazaadenosine (DZA), a cellular methylation blocker was reported to induce the caspase-3-like activities-dependent apoptosis in U-937 cells. In this study, we analyzed the activation pathway of the caspase cascade involved in the DZA-induced apoptosis using specific inhibitors of caspases. In the U-937 cells treated with DZA, cytochrome c release from mitochondria and subsequent activation of caspase-9, -8 and -3 were observed before the induction of apoptosis. zDEVD-Fmk, a specific inhibitor of caspase-3, and zLEHD-Fmk, a specific inhibitor of caspase-9, prevented the activation of caspase-8 but neither caspase-3 nor caspase-9, indicating that caspase-8 is downstream of both caspase-3 and caspase-9, which are activated by independent pathways. zVAD-Fmk, a universal inhibitor of caspases, kept the caspase-3 from being activated but not caspase-9. Moreover, ZB4, an antagonistic Fas-antibody, exerted no effect on the activation of caspase-8 and induction of apoptosis by DZA. In addition, zVAD-Fmk and mitochondrial permeability transition pore (MPTP) inhibitors such as cyclosporin A (CsA) and bongkrekic acid (BA) did not block the release of cytochrome c from mitochondria. Taken together, these results suggest that in the DZA-induced apoptosis, caspase-8 may serve as an executioner caspase and be activated downstream of both caspase-3 and caspase-9, independently of Fas receptor-ligand interaction. And caspase-3 seems to be activated by other caspses including IETDase-like enzyme and caspse-9 seems to be activated by cytochrome c released from mitochondria without the involvement of caspases and CsA- and BA- inhibitory MPTP.
Amino Acid Chloromethyl Ketones/pharmacology ; Apoptosis/*drug effects ; Bongkrekic Acid/pharmacology ; Caspases/*metabolism ; Cell Line ; Cyclosporine/pharmacology ; Cytochrome c/drug effects/metabolism ; Enzyme Activation ; Human ; Leukocytes, Mononuclear/cytology ; Ligands ; Membrane Glycoproteins/metabolism ; Tubercidin/*pharmacology ; U937 Cells

We investigated the question of whether 7-oxygenated cholesterol derivatives could affect inflammatory and/or immune responses in atherosclerosis by examining their effects on expression of IL-23 in monocytic cells. 7alpha-Hydroxycholesterol (7alphaOHChol) induced transcription of the TLR6 gene and elevated the level of cell surface TLR6 protein in THP-1 monocytic cells. Addition of an agonist of TLR6, FSL-1, to TLR6-expressing cells by treatment with 7alphaOHChol resulted in enhanced production of IL-23 and transcription of genes encoding the IL-23 subunit alpha (p19) and the IL-12 subunit beta (p40). However, treatment with 7-ketocholesterol (7K) and 7beta-hydroxycholesterol (7betaOHChol) did not affect TLR6 expression, and addition of FSL-1 to cells treated with either 7K or 7betaOHChol did not influence transcription of the genes. Pharmacological inhibition of ERK, Akt, or PI3K resulted in attenuated transcription of TLR6 induced by 7alphaOHChol as well as secretion of IL-23 enhanced by 7alphaOHChol plus FSL-1. Inhibition of p38 MAPK or JNK resulted in attenuated secretion of IL-23. These results indicate that a certain type of 7-oxygenated cholesterol like 7alphaOHChol can elicit TLR6-mediated expression of IL-23 by monocytic cells via PI3K/Akt and MAPKs pathways.
Atherosclerosis ; Cholesterol ; Interleukin-12 ; Interleukin-23* ; Macrophages ; p38 Mitogen-Activated Protein Kinases ; Toll-Like Receptor 6

The purpose of the current report is to present 6-year long-term stability and 10-year follow-up data for an adult patient who was treated with a tongue elevator for relapsed anterior open-bite. The 19-year-old male patient presented with the chief complaint of difficulty in chewing his food. Collectively, clinical and radiographic examinations revealed an anterior open-bite, low tongue posture, and tongue-tie. The patient opted for orthodontic treatment alone, without any surgical procedure. A lingual frenectomy was recommended to avoid the risk of relapse, but the patient declined because he was not experiencing tongue discomfort. Initial treatment of the anterior open-bite with molar intrusion and tongue exercises was successful, but relapse occurred during the retention period. A tongue elevator was used for retreatment, because the approach was minimally invasive and suited the patient's requirements regarding discomfort, cost, and time. The appliance changed the tongue posture and generated an altered tongue force, which ultimately resulted in intrusive dentoalveolar effects, and a subsequent counterclockwise rotation of the mandible. The results showed long-term stability and were maintained for six years through continual use of the tongue elevator. The results of this case indicated that a tongue elevator could be used not only as an alternative treatment for open-bite, but also as an active retainer.
Adult ; Elevators and Escalators ; Exercise ; Follow-Up Studies* ; Humans ; Male ; Mandible ; Mastication ; Molar ; Posture* ; Recurrence ; Retreatment ; Tongue* ; Young Adult

This paper describes the case of a 50-year-old female with a Class II malocclusion who presented with severe bimaxillary protrusion and generalized alveolar bone loss due to adult periodontitis. The treatment plan consisted of extracting both upper and lower first premolars and periodontal treatment. Anterior segmental osteotomy (ASO) of the mandible and upper anterior segment retraction using compression osteogenesis after peri-segmental corticotomy (Speedy orthodontics) was performed. Correct overbite and overjet, facial balance, and improvement of lip protrusion were obtained. However, a slight root resorption tendency was observed on the lower anterior dentition. The active treatment period was 9 months and the results were stable for 27 months after debonding. This new type of treatment mechanics can be an effective alternative to orthognathic surgery.
Adult ; Alveolar Bone Loss ; Bicuspid ; Chronic Periodontitis ; Dentition ; Female ; Humans ; Lip ; Malocclusion ; Mandible ; Mechanics ; Middle Aged ; Orthognathic Surgery ; Osteogenesis ; Osteotomy ; Overbite ; Root Resorption

OBJECTIVE: Speedy surgical orthodontics (SSO), an innovative orthodontic treatment, involves the application of orthopedic forces against temporary skeletal anchorage devices following perisegmental corticotomy to induce movement of specific dental segments. Herein, we report the biological effects of SSO on the teeth and periodontal structures. METHODS: Five beagle dogs were divided into 2 groups and their 6 maxillary incisors were retracted en masse by applying 500 g orthopedic force against a single palatal mini-plate. Retraction was performed without and with perisegmental corticotomy in groups I and II, respectively. All animals were killed on the 70th day, and their periodontal structures were processed for histologic analyses and scanning electronic microscopy (SEM). The linear distance between the third maxillary incisor and canine was used as a benchmark to quantify the retraction amount. RESULTS: Retraction was markedly faster and retraction amount greater in group II than in Group I. Surprisingly, Group II did not show any root resorption despite extensive retraction, while Group I showed prominent root surface irregularities. Similarly, SEM showed multiple resorption lacunae in Group I, but not in Group II. CONCLUSIONS: SSO is an effective and favorable orthodontic approach for major en masse retraction of the maxillary anterior teeth.
Animals ; Dogs ; Electronics ; Electrons ; Incisor ; Microscopy ; Orthodontics ; Orthopedics ; Root Resorption ; Tooth