STATEMENT OF PROBLEM: Resonance frequency analysis (RFA) has been increasingly served as a non-invasive and objective method for clinical monitoring of implant stability. Many clinical studies must be required for standardized baseline data using RFA. PURPOSE: This study was performed to evaluate RFA value changes in two stage surgery group and one stage surgery group in patients. MATERIAL AND METHOD: Forty-seven mandibles in consecutively implant installed patients were selected for this study and 141 fixtures were installed. Ninety-three fixtures were double threaded, machined surface design (Bra.nemark. MK III, Nobel Biocare AB, Go teborg, Sweden) and 48 fixtures were root form, threaded, HA-coated surface one (Replace(TM), Steri-Oss/Nobel Biocare AB, USA). Among those, each 10 fixture was installed in one stage group patients. ISQ values were measured using Osstell(TM) (Integration Diagnostics Ltd. Sweden) during fixture installation, at healing abutment connection and in the loading period for two stage surgery group patients and during at each 4, 6, 8, 10, 12 week and in the loading phase for one stage surgery group patients and evaluated the changes according to the time and fixture type. RESULTS: In two stage surgery group, mean and SD of ISQ values of machined surface implants were 76.85 +/- 3.74, 75.76 +/- 5.04, 75.73 +/- 4.41 and those of HA-coated surface implant were 75.05 +/- 6.23, 77.58 +/- 5.23, 78.32 +/- 4.29 during fixtures installation, at healing abutment connection and in the loading period, respectively. In one-stage surgery group, the ISQ values of machined surface and HA-coated surface implants decreased until 4 or 6 week and maintained at plateau for 1-3 week and increased to the loading period. CONCLUSIONS: Machined and HA-coated surface implants showed minimal ISQ changes with time if they were installed at the sites showing at least intact cortical plate and good bone qualities. And HA-coated implants had a tendency to show somewhat increased ISQ values with time.
Humans ; Mandible

Adhesion through microbial surface components that recognize adhesive matrix molecules is an essential step in infection for most pathogenic bacteria. In this study, we report that LigB interacts with fibronectin (Fn) through its variable region. A possible role for LigB in bacterial attachment to host cells during the course of infection is supported by the following observations: (i) binding of the variable region of LigB to Madin-Darby canine kidney (MDCK) cells in a dose-dependent manner reduces the adhesion of Leptospira, (ii) inhibition of leptospiral attachment to Fn by the variable region of LigB, and (iii) decrease in binding of the variable region of LigB to the MDCK cells in the presence of Fn. Furthermore, we found a significant reduction in binding of the variable region of LigB to Fn using small interfering RNA (siRNA). Finally, the isothermal titration calorimetric results confirmed the interaction between the variable region of LigB and Fn. This is the first report to demonstrate that LigB binds to MDCK cells. In addition, the reduction of Fn expression in the MDCK cells, by siRNA, reduced the binding of LigB. Taken together, the data from the present study showed that LigB is a Fn-binding protein of pathogenic Leptospira spp. and may play a pivotal role in Leptospira-host interaction during the initial stage of infection.
Animals ; Antigens, Bacterial/*genetics/metabolism ; Cell Line ; Dogs ; Enzyme-Linked Immunosorbent Assay ; Fibronectins/*metabolism ; Immunoglobulin Variable Region/genetics/*metabolism ; Leptospira/*genetics/metabolism ; Microscopy, Confocal ; Protein Binding/*genetics ; *Protein Structure, Tertiary ; RNA, Small Interfering/genetics

OBJECTIVE: To examine the pattern of gestational weight gain using maternal characteristics and pregnancy outcomes. METHODS: We used maternal weight data from 1,825 women who had noncomplicated pregnancy between Jan. 2002 and Aug. 2009. The rate of maternal weight gain in each trimester, the associations between gestational weight gain per trimester and maternal characteristics and pregnancy outcomes, and the relationship between maternal characteristics and trimester weight gain were analyzed. RESULTS: The average rate of weight gain (kg/week) was lowest during the first trimester (0.06+/-0.30), peaked during the second trimester (0.52+/-0.23), and slowed slightly in the third trimester (0.47+/-0.23). With the exception of infant sex, all six maternal characteristics and pregnancy outcomes included in the multivariate analyses (parity, maternal age, height, BMI, preeclampsia, gestational DM) were associated significantly with maternal weight gain in at least one trimester. The important maternal predictors of weight gain per trimester were prepregnancy BMI, height and age in the first trimester; prepregnacy BMI, parity and height in the second; and height, age and parity in the third. CONCLUSION: The pattern of gestational weight gain is associated with a number of maternal characteristics and pregnancy outcomes, and these relationships vary according to which trimester is being examined.
Female ; Humans ; Infant ; Maternal Age ; Multivariate Analysis ; Parity ; Pre-Eclampsia ; Pregnancy ; Pregnancy Outcome ; Pregnancy Trimester, First ; Pregnancy Trimester, Second ; Pregnancy Trimester, Third ; Weight Gain

OBJECTIVE: The purposes of this study were to determine the renal function by radioisotope renography and to compare the findings of radioisotope renography in the spinal cord injured patients to the clinical presentations and findings of other conventional urologic examinations. METHOD: Intravenous pyelogram(IVP), voiding cystourethrogram(VCUG) and urodynamic study were performed in twenty-five spinal cord injured patients along with serum BUN/Creatinine levels and 24 hour creatinine clearance tests. Technetium-99 m mercaptoacetyltriglycine was used for the radioisotope renography. RESULTS: One abnormal radioisotope renography finding was noted among 22 normal findings by IVP and VCUG studies, while no abnormal finding by IVP and VCUG studies was noted among the subjects with a normal radioisotope renography. Effective renal plasma flow(ERPF) was significantly lower in patients with lower creatinine clearance. ERPF, cortical retention and creatinine clearance values for hyperreflexic bladders were significantly different from areflexic bladders. ERPF was significantly higher in a clean intermittent catheterization group than in a percussion and Cred method group for the hyperreflexic bladders. CONCLUSION: The study proves that the radioisotope renography is a sensitive and valuable study to evaluate the renal dysfunction in the spinal cord injured patients.
Creatinine ; Humans ; Intermittent Urethral Catheterization ; Percussion ; Plasma ; Radioisotope Renography* ; Renal Plasma Flow, Effective ; Spinal Cord Injuries* ; Spinal Cord* ; Urinary Bladder ; Urodynamics

We describe a case of congenital nephrogenic diabetes insipidus with severe dilatation of bilateral urinary tracts without anatomical obstructions. Functional obstruction can be occurred when polyuria surpasses the transporting ability of urine in the urinary tract. The patient was admitted to our hospital due to decreased mentality developed after traffic accident. On radiologic study, bilateral hydronephrosis and hydroureter were noted. Because the patient excreted copious dilute urine, we performed water deprivation test and the result was consistent with nephrogenic diabetes insipidus. We are presenting this case in an attempt to describe strong association between congenital diabetes insipidus and nonobstructive hydronephrosis in which polyuria is responsible for the hydronephrosis.
Accidents, Traffic ; Diabetes Insipidus ; Diabetes Insipidus, Nephrogenic* ; Dilatation ; Humans ; Hydronephrosis* ; Polyuria ; Urinary Tract ; Water Deprivation

Nociceptin/orphanin FQ (N/OFQ) and its receptor, nociceptin opioid peptide (NOP) receptor, are localized in brain areas implicated in depression including the amygdala, bed nucleus of the stria terminalis, habenula, and monoaminergic nuclei in the brain stem. N/OFQ inhibits neuronal excitability of monoaminergic neurons and monoamine release from their terminals by activation of G protein-coupled inwardly rectifying K⁺ channels and inhibition of voltage sensitive calcium channels, respectively. Therefore, NOP receptor antagonists have been proposed as a potential antidepressant. Indeed, mounting evidence shows that NOP receptor antagonists have antidepressant-like effects in various preclinical animal models of depression, and recent clinical studies again confirmed the idea that blockade of NOP receptor signaling could provide a novel strategy for the treatment of depression. In this review, we describe the pharmacological effects of N/OFQ in relation to depression and explore the possible mechanism of NOP receptor antagonists as potential antidepressants.
Amygdala ; Antidepressive Agents ; Brain ; Brain Stem ; Calcium Channels ; Depression ; Habenula ; Models, Animal ; Neurons ; Neuropeptides ; Opioid Peptides ; Receptors, Drug ; Septal Nuclei

Background/Aims: Hypopharyngeal multichannel intraluminal impedance-pH (HMII-pH) technology incorporating 2 trans-upper esophageal sphincter impedance channels has been developed to detect pharyngeal reflux. We used the HMII-pH technique to validate the candidate pharyngeal acid reflux (PAR) episodes based on the dual-pH tracings and determined the interobserver reproducibility. Methods: We conducted a cross-sectional study in tertiary centers in Taiwan. Ninety patients with suspected laryngopharyngeal reflux and 28 healthy volunteers underwent HMII-pH test when off acid suppressants. Candidate PAR episodes were characterized by pharyngeal pH drops of at least 2 units and reaching a nadir pH of 5 within 30 seconds during esophageal acidification. Two experts manually independently identified candidate PAR episodes based on the dual-pH tracings. By reviewing the HMII-pH tracings, HMII-pH-proven PAR episodes were subsequently confirmed. The consensus reviews of HMII-pH-proven PAR episodes were considered to be the reference standard diagnosis. The interobserver reproducibility was assessed. Results: A total of 105 candidate PAR episodes were identified. Among them 84 (80.0%; 95% CI, 71.0-87.0%) were HMII-pH-proven PAR episodes (82 in 16 patients and 2 in 1 healthy subject). Patients tended to have more HMII-pH-proven PAR episodes than healthy controls (median and percentile values [25th, 75th, and 95th percentiles]: 0 [0, 0, 3] vs 0 [0, 0, 0], P = 0.067). The concordance rate in diagnosing HMII-pH-proven PAR episodes between 2 independent observers was 92.2%. Conclusion Our preliminary data showed that 80.0% (71.0-87.0%) of the proposed candidate PAR episodes were HMII-pH-proven PAR episodes, among which the interobserver reproducibility was good.

Background/Aims: Diagnosis of isolated laryngopharyngeal reflux symptoms (ILPRS), ie, without concomitant typical reflux symptoms (CTRS), remains difficult. Mean nocturnal baseline impedance (MNBI) reflects impaired mucosal integrity. We determined whether esophageal MNBI could predict pathological esophagopharyngeal reflux (pH+) in patients with ILPRS. Methods: In this cross-sectional study conducted in Taiwan, non-erosive or low-grade esophagitis patients with predominant laryngopharyngeal reflux symptoms underwent combined hypopharyngeal multichannel intraluminal impedance-pH monitoring when off acid suppressants. Participants were divided into the ILPRS (n = 94) and CTRS (n = 63) groups. Asymptomatic subjects without esophagitis (n = 25) served as healthy controls. The MNBI values at 3 cm and 5 cm above the lower esophageal sphincter (LES) and the proximal esophagus were measured. Results: Distal but not proximal esophageal median MNBI values were significantly lower in patients with pH+ than in those with pH– (ILPRS in pH+ vs pH–: 1607 Ω vs 2709 Ω and 1885 Ω vs 2563 Ω at 3 cm and 5 cm above LES, respectively; CTRS in pH+ vs pH–: 1476 vs 2307 Ω and 1500 vs 2301 Ω at 3 cm and 5 cm above LES, respectively, P < 0.05 for all). No significant differences of any MNBI exist between any pH– subgroups and healthy controls. The areas under the receiver operating characteristic curve in the ILPRS group were 0.75 and 0.80, compared to the pH– subgroup and healthy controls (P < 0.001 for both), respectively. Interobserver reproducibility was good (Spearman correlation 0.93, P < 0.0001). Conclusion Distal esophageal MNBI predicts pathological reflux in patients with ILPRS.

Hyperpolarized (HP) carbon-13 ( 13C) MRI represents an innovative approach for noninvasive, real-time assessment of dynamic metabolic flux, with potential integration into routine clinical MRI. The use of [1- 13C]pyruvate as a probe and its conversion to [1- 13C]lactate constitute an extensively explored metabolic pathway. This review comprehensively outlines the establishment of HP 13C-MRI, covering multidisciplinary team collaboration, hardware prerequisites, probe preparation, hyperpolarization techniques, imaging acquisition, and data analysis. This article discusses the clinical applications of HP 13C-MRI across various anatomical domains, including the brain, heart, skeletal muscle, breast, liver, kidney, pancreas, andprostate. Each section highlights the specific applications and findings pertinent to these regions, emphasizing the potential versatility of HP 13C-MRI in diverse clinical contexts. This review serves as a comprehensive update, bridging technical aspects with clinical applications and offering insights into the ongoing advancements in HP 13C-MRI.

Bipolar disorder (BD) is a major psychiatric disorder that is easily misdiagnosed. Patient adherence to a treatment regimen is of utmost importance for successful outcomes in BD. Several trials of antipsychotics suggested that depot antipsychotics, including long-acting first- and second-generation agents, are effective in preventing non-adherence, partial adherence, and in reducing relapse in BD. Various long-acting injectable (LAI) antipsychotics are available, including fluphenazine decanoate, haloperidol decanoate, olanzapine pamoate, risperidone microspheres, paliperidone palmitate, and aripiprazole monohydrate. Due to the increasing number of BD patients receiving LAI antipsychotics, treatment guidelines have been developed. However, the clinical applicability of LAI antipsychotics remains a global cause for concern, particularly in Asian countries. Expert physicians from Taiwan participated in a consensus meeting, which was held to review key areas based on both current literature and clinical practice. The purpose of this meeting was to generate a practical and implementable set of recommendations for LAI antipsychotic use to treat BD; target patient groups, dosage, administration, and adverse effects were considered. Experts recommended using LAI antipsychotics in patients with schizophrenia, rapid cycling BD, BD I, and bipolar-type schizoaffective disorder. LAI antipsychotic use was recommended in BD patients with the following characteristics: multiple episodes and low adherence; seldom yet serious episodes; low adherence potential per a physician's clinical judgment; preference for injectable agents over oral agents; and multiple oral agent users still experiencing residual symptoms.
Antipsychotic Agents* ; Asian Continental Ancestry Group ; Bipolar Disorder* ; Consensus* ; Fluphenazine ; Haloperidol ; Humans ; Judgment ; Microspheres ; Patient Compliance ; Psychotic Disorders ; Recurrence ; Risperidone ; Schizophrenia ; Taiwan ; Aripiprazole ; Paliperidone Palmitate