OBJECTIVES: Although nerve growth factor (NGF) could promote the functional regeneration of an injured peripheral nerve, it is very difficult for NGF to sustain the therapeutic dose in the defect due to its short half-life. In this study, we loaded the NGF-bound heparin-conjugated fibrin (HCF) gel in the NGF-delivering implants and analyzed the time-dependent release of NGF and its bioactivity to evaluate the clinical effectiveness. MATERIALS AND METHODS: NGF solution was made of 1.0 mg of NGF and 1.0 mL of phosphate buffered saline (PBS). Experimental group A consisted of three implants, in which 0.25 microL of NGF solution, 0.75 microL of HCF, 1.0 microL of fibrinogen and 2.0 microL of thrombin was injected via apex hole with micropipette and gelated, were put into the centrifuge tube. Three implants of experimental group B were prepared with the mixture of 0.5 microL of NGF solution, 0.5 microL HCF, 1.0 microL of fibrinogen and 2.0 microL of thrombin. These six centrifuge tubes were filled with 1.0 mL of PBS and stirred in the water-filled beaker at 50 rpm. At 1, 3, 5, 7, 10, and 14 days, 1.0 mL of solution in each tubes was collected and preserved at -20degrees C with adding same amount of fresh PBS. Enzyme-linked immunosorbent assay (ELISA) was done to determine in vitro release profile of NGF and its bioactivity was evaluated with neural differentiation of pheochromocytoma (PC12) cells. RESULTS: The average concentration of released NGF in the group A and B increased for the first 5 days and then gradually decreased. Almost all of NGF was released during 10 days. Released NGF from two groups could promote neural differentiation and neurite outgrowth of PC12 cells and these bioactivity was maintained over 14 days. CONCLUSION: Controlled release system using NGF-HCF gel via NGF-delivering implant could be an another vehicle of delivering NGF to promote the nerve regeneration of dental implant related nerve damage.
Animals ; Dental Implants ; Enzyme-Linked Immunosorbent Assay ; Fibrin* ; Fibrinogen ; Half-Life ; Nerve Growth Factor* ; Nerve Regeneration ; Neurites ; PC12 Cells ; Peripheral Nerves ; Pheochromocytoma ; Regeneration ; Thrombin

OBJECTIVES: This study was conducted in order to assess the efficacy of 1st generation cephalosporin as use as a single-dose preoperative prophylactic antibiotic for surgical wound infections resulting from intra-oral bone grafting procedures. MATERIALS AND METHODS: A total of 23 patients who were to undergo intra-oral bone graft procedures participated in this study. After randomization, 2 grams of 1st generation cephalosporin was orally administered to both the experimental and placebo groups one hour prior to surgery in a double-blind fashion. Post-operatively, the experimental group (12 patients) was orally administered placebo three times a day for three days. The control group (11 patients) was orally administered 1st generation cephalosporin three times a day for three days. The postoperative course was observed for one month including the clinical parameters associated with infection. RESULTS: Postoperative infections were noted in 1 out of 11 patients in the experimental group. No infections occurred in the control group. CONCLUSION: There was no significant difference in the incidence of postoperative infections between the two groups. Two grams of 1st generation cephalosporin administered orally one hour before surgery served as an effective prophylactic antibiotics therapy for intra-oral bone graft surgery
Anti-Bacterial Agents ; Bone Transplantation ; Humans ; Incidence ; Prospective Studies ; Random Allocation ; Surgical Wound Infection ; Transplants

BACKGROUND AND OBJECTIVES: Fibroblasts play an indirectly augmenting effector role in allergic inflammatory response by releasing different proinflammatory cytokines, including RANTES, GM-CSF, IL-8 after stimulation by other inflammatory cytokines such as IFN-gamma, TNF-alpha. The aim of this study was to investigate expression of RANTES in allergic and non-allergic nasal fibroblasts after stimulation with IFN-gamma and TNF-alpha, and to study the effect of dexamethasone on the RANTES expression of nasal fibroblast cell. MATERIALS AND METHODS: Using the 3rd passage of fibroblasts taken from the inferior turbinates of allergic and non-allergic patients, we evaluated the RANTES expression of fibroblasts after the IFN-gamma, TNF-alpha stimulation in the presence or in the absence of dexamethasone by ELISA. RESULTS: The expression of RANTES in allergic nasal fibroblasts stimulated by cytokines was stronger than in non-allergic nasal fibroblasts stimulated by cytokines. And dexamethasone suppressed the RANTES expression in allergic nasal fibroblasts stimulated by IFN-gamma. However, dexamethasone did not affect the RANTES expression in allergic fibroblasts stimulated by TNF-alpha and non-allergic fibroblasts stimulated by IFN-gamma and TNF-alpha. CONCLUSION: This study shows different responses of the RANTES production in nasal fibroblasts to dexamethasone, perhaps reflecting heterogeneity of nasal fibroblasts.
Chemokine CCL5* ; Cytokines ; Dexamethasone* ; Enzyme-Linked Immunosorbent Assay ; Fibroblasts* ; Granulocyte-Macrophage Colony-Stimulating Factor ; Humans ; Interleukin-8 ; Population Characteristics ; Tumor Necrosis Factor-alpha ; Turbinates

PURPOSE: To evaluate airway changes in ovalbumin-induced asthmatic mice in terms of postmortem micro-CT images and pathological findings. METHODS: Asthma was induced in mice by intraperitoneal injection and nasal instillation of ovalbumin aluminium hydroxide into mice (experimental group, n=6), and another group of mice received intraperitoneal injection and nasal instillation of distilled phosphate-buffered saline (control group, n=6). Bronchial lumen area was measured in the main bronchial lumen of the distal third bronchial branch level (6 parts per each mouse) on axial scans of Micro-CT, using a Lucion's smart pen (semi-automated) and a curve pen (manual). Bronchial wall thickness was obtained in 4 sections (2 levels on either side) after the third bronchial branch by measuring the diameter which was perpendicular to the longitudinal axis of the main bronchus on curved Multi-planar reconstruction (MPR) images. Histologic slides were obtained from the lesion that was matched with its CT images, and bronchial wall thicknesses were determined. RESULTS: The mean bronchial lumen area was 0.196+/-0.072 mm2 in the experimental group and 0.243+/-0.116 mm2 in the control group; the difference was significant. Bronchial wall thickness on micro-CT images (mean, 0.119+/-0.01 vs. 0.108+/-0.013 mm) and in pathological specimens (mean, 0.066+/-0.011 vs. 0.041+/-0.009 mm) were thicker in the experimental group than in the control group; bronchial wall thickness on micro-CT images correlated well with pathological thickness (for the experimental group, r=0.712; for the control group, r=0.46). The thick bronchial wall in the experimental group demonstrated submucosal hypertrophy along with goblet cell hyperplasia and smooth muscle hyperplasia. CONCLUSIONS: The results of this study suggest that asthma may induce thickening of bronchial wall and narrowing of the lumen area on micro-CT images and that these results may significantly correlate with pathological findings.
Airway Remodeling ; Animals ; Asthma* ; Axis, Cervical Vertebra ; Bronchi ; Case-Control Studies ; Evaluation Studies as Topic ; Goblet Cells ; Hyperplasia ; Hypertrophy ; Injections, Intraperitoneal ; Mice* ; Muscle, Smooth ; Ovalbumin ; X-Ray Microtomography

BACKGROUND: Core hypothermia after the induction of general anesthesia results largely from core-to- peripheral redistribution of body heat and anesthetic-induced inhibition of tonic thermoregulatory vasoconstriction. Because most metabolic heat is lost via the skin surface, covering the skin surface with an insulator is a way of minimizing heat loss. We therefore evaluated core and peripheral temperature changes with and without wrapping the lower extremity in cotton and elastic bandages during open abdominal surgery under general anesthesia. METHODS: Eighty-five patients of ASA physical status 1 or 2 who underwent open abdominal surgery under general anesthesia were investigated in this study. They were randomly assigned based on wrapping of the lower extremity in cotton and elastic bandages (group 2, n = 37) or not (group 1, n = 48). Anesthesia in both groups was induced with propofol and maintained with enflurane and 50% nitrous oxide in oxygen. The temperatures of the nasopharynx, forehead, chest, back, palm and sole were measured before and 10, 30, 60, 90, 120, 150 and 180 min after induction. RESULTS: Core temperature decreased significantly after the induction of anesthesia in both groups (P <0.05), but no significant difference was found between the groups in terms of core, palm, back and forehead skin temperature changes. However, the core and chest temperatures of group 2 at 150 and 180 min after induction were significantly lower than those of group 1 (P <0.05), and sole temperature changes were significantly different between the groups (P <0.05). CONCLUSIONS: Wrapping the lower extremity in cotton and elastic bandages during open abdominal surgery under general anesthesia was not effective at preventing the core temperature from decreasing. It is possible that wrapping the lower extremity causes peripheral vasodilation before anesthesia, stimulating the barorecepter, and shifting the body core temperature threshold for hypothermia inducing peripheral vasoconstriction to lower the body core temperature.
Anesthesia ; Anesthesia, General* ; Body Temperature Regulation ; Compression Bandages ; Enflurane ; Forehead ; Hot Temperature ; Humans ; Hypothermia ; Lower Extremity* ; Nasopharynx ; Nitrous Oxide ; Oxygen ; Propofol ; Skin ; Skin Temperature ; Thorax ; Vasoconstriction ; Vasodilation

BACKGROUND: Although used for obtund pain, bupivacaine may itself initially produce pain on injection. This study was designed to evaluate the effect of diluting bupivacaine with normal saline, lactated Ringer's solution, 5% dextrous in water and distilled water on perception of pain associated with intramuscular injection. METHODS: Twenty-five healthy volunteers were involved in this study. Each subject received 4 injections in random order: 0.25% bupivacaine in normal saline, lactated Ringer's solution, 5% dextrous in water and distilled water. Both upper trapezius muscles were used for the intramuscular injection site. Needle size (25-gauge), injection depth (1.5-2 cm), injection volume (2.5 ml), administration speed (0.5 ml/sec), and temperature (room) were controlled for each of the four injections. The intensity of pain was rated on a 0 to 10 visual analogue scale (VAS) score at the point of needle insertion and injecting solutions. RESULTS: There was no statistical difference among each solution in VAS score. However, the VAS scores of drug administration were higher than those of needle insertion in all diluting solutions (P<0.05). CONCLUSIONS: There was no difference in the intensity of pain of an intramuscular injection of bupivacaine between four different kinds of solutions. However, it might be suggested that more effort and investigation will be needed to reduce pain with an intramuscular injection.
Bupivacaine* ; Healthy Volunteers ; Injections, Intramuscular* ; Needles ; Superficial Back Muscles ; Water

Venous air embolism(VAE) can occur by the entry of air into open veins, being facilitated if the operative field is above the level of the heart. Among the many diagnostic methods, precordial ultrasonic Doppler is currently the more sensitive. Thus we have attempted to define the incidence of VAE using this device. 103 ASA physical status 1 or 2 parturients undergoing Cesarean section with general anesthesia in 73 parturients and epidural anesthesia in 30 parturients were studied with the ultrasonic Doppler transducer placed parasternally over the 4th right intercostal space. Total incidence of venous emboli was 31%(32/103) during surgery. In some parturients, embolism occurred more than once during operation and leaded to total 45 episodes of venous emboli. The incidence of venous emboli was 26%(19/73 ) during general anesthesia and 43.3%(13/30 ) during epidural anesthesia. No statistical difference existed in the incidence of venous emboli detected related to the type of anesthesia. Among the 45 episodes of venous emboli, 19 episodes(42.2%) were detected during repair of the hysterotomy. As even small air bubbles in the circulation are potentially harmful especially in patent foramen ovale and emboli events may occur at risk cases involving profound hypovolemia, abruptio placenta, or placenta previa, clinically insignificant venous air emboli, although low, is still worrisome. Thus above the cases, the use of additional precordial Doppler monitoring may be considered during cesarean section to detect VAE promptly, efficiently.
Anesthesia ; Anesthesia, Epidural ; Anesthesia, General ; Cesarean Section* ; Embolism ; Embolism, Air* ; Female ; Foramen Ovale, Patent ; Heart ; Hypovolemia ; Hysterotomy ; Incidence* ; Placenta ; Placenta Previa ; Pregnancy ; Transducers ; Ultrasonics* ; Veins

BACKGROUND AND OBJECTIVES: Nasal paraffinoma originating from the liquid paraffin injected for the purpose of augmentation rhinoplasty has many complications such as itching sensation, pain and tenderness, hardness, erythema and telangiectasia, protrusion of lump and even psychologic problems. The only method of improvement is surgical removal of paraffinoma and reconstructive rhinoplasty. The aim of this study is to investigate patients' satisfaction about symptoms and signs in aesthetic aspects through analyzing survey papers following surgery. MATERIALS AND METHOD: We have treated 11 cases of nasal paraffinoma by contemporary augmentation rhinoplasty with autogenous cartilage grafts after removal of nasal paraffinoma from October, 1996 to May, 2000. The patients' ages ranged from 36 to 62 years and all were women. Patients' satisfaction about symptoms and signs in aesthetic aspects was investigated through analyzing survey papers at 6 months after surgery. We also have observed changes after surgery by conducting serial photographic documentation. RESULTS: All patients were satisfied with the results about symptoms and signs in aesthetic aspects. Serial photographic documentation showed the subsided skin lesion and nasal dorsum narrowing. CONCLUSION: Our results indicated that contemporary augmentation rhinoplasty with autogenous cartilage grafts after removal of nasal paraffinoma is one of the effective treatment for nasal paraffinoma.
Cartilage* ; Erythema ; Female ; Hardness ; Humans ; Mineral Oil ; Paraffin ; Pruritus ; Rhinoplasty* ; Sensation ; Skin ; Telangiectasis ; Transplants*

Non-Hodgkin's lymphoma is a heterogenous group of neoplasm affecting the lymphoid system. About 10% of Non-Hodgkin's lymphoma occur in the extra-nodal region in the head and neck area and more than half of extra-nodal lymphoma in the head and neck area involves the Waldeyer's ring. Localization in the oral cavity is rare. We experienced one rare case of Non-Hodgkin's lymphoma in the oral cavity, with trismus and persistent ulcerated swelling in the right-side cheek as the chief complaint.
Cheek ; Head ; Lymphoma ; Lymphoma, Non-Hodgkin* ; Mouth* ; Neck ; Oral Manifestations ; Trismus ; Ulcer

BACKGROUND AND OBJECTIVES: The effect of nasal exposure to staphylococcal enterotoxin in the pathogenesis of allergic rhinitis remains controversial. We sought to determine the effect of increasing doses of intranasally applied Staphylococcus aureus enterotoxin B (SEB) on the respiratory mucosa, especially the nasal mucosa. MATERIALS AND METHODS: Nasal application of SEB was performed on four occasions (days 0-4-8-12) in unsensitized BALB/c mice. Control mice were intranasally treated with phosphate buffered saline (PBS), and 5 ng, 50 ng, 500 ng, and 5 microg of SEB was applied to the respective experimental group. The concentrations of IL-4, IL-5, and IFN-gamma in bronchoalveolar lavage fluid (BALF), nasal lavage fluid (NLF) and serum were compared among groups. Also, the counts of total inflammatory cells, macrophages, lymphocytes, neutrophils, eosinophils, and basophils in BALF and NLF were compared among the groups. Pathologic studies for inflammatory cell infiltration in the nasal mucosa and peribronchial area were conducted. RESULTS: IL-4 and IFN-gamma showed higher concentrations with increasing stimulation dose of SEB in NLF and serum. The IL-5 concentration showed a tendency to increase in NLF and serum, but these changes were not statistically significant. Total inflammatory cell count, especially macrophage count, in BALF and NLF was higher with increasing stimulation dose of SEB. Infiltration of inflammatory cells into the nasal mucosa showed a tendency to increase in a dose-dependent manner. CONCLUSION: These results suggest that nasal exposure to SEB may induce Th1 and Th2 inflammatory responses in the respiratory mucosa, especially the nasal mucosa.
Animals ; Basophils ; Bronchoalveolar Lavage Fluid ; Cell Count ; Enterotoxins ; Eosinophils ; Interleukin-4 ; Interleukin-5 ; Lymphocytes ; Macrophages ; Mice ; Mucous Membrane ; Nasal Lavage Fluid ; Nasal Mucosa ; Neutrophils ; Respiratory Mucosa ; Rhinitis ; Rhinitis, Allergic, Perennial ; Staphylococcus aureus