The Korean Endocrine Society (KES) published clinical practice guidelines for the treatment of acromegaly in 2011. Since then, the number of acromegaly cases, publications on studies addressing medical treatment of acromegaly, and demands for improvements in insurance coverage have been dramatically increasing. In 2017, the KES Committee of Health Insurance decided to publish a position statement regarding the use of somatostatin analogues in acromegaly. Accordingly, consensus opinions for the position statement were collected after intensive review of the relevant literature and discussions among experts affiliated with the KES, and the Korean Neuroendocrine Study Group. This position statement includes the characteristics, indications, dose, interval (including extended dose interval in case of lanreotide autogel), switching and preoperative use of somatostatin analogues in medical treatment of acromegaly. The recommended approach is based on the expert opinions in case of insufficient clinical evidence, and where discrepancies among the expert opinions were found, the experts voted to determine the recommended approach.
Acromegaly ; Consensus ; Expert Testimony ; Insurance Coverage ; Insurance, Health ; Octreotide ; Somatostatin

Acromegaly is a chronic disorder caused by excessive growth hormone (GH) secretion. In most cases, the excess GH originates from GH-producing pituitary adenomas. Surgery is the preferred first-line treatment for patients with acromegaly, but medical management is considered when the disease persists after surgery or in cases where patients refuse surgery or are poor candidates for surgery. Somatostatin analogues are commonly used to treat acromegaly. The Korean Endocrine Society and the Korean Neuroendocrine Study Group have developed a position statement for the use of somatostatin analogues in the medical treatment of acromegaly. This position statement is based on evidence from the current literature and expert opinions. In the case of discrepancies among expert opinions, the experts voted to determine the recommended approach.
Acromegaly ; Expert Testimony ; Growth Hormone ; Humans ; Octreotide ; Pituitary Neoplasms ; Somatostatin

PURPOSE: Fibronectin (FN) has been shown to stimulate bone regeneration in animal models. The aim of this study was to evaluate the capacity of bovine bone mineral coated with synthetic oligopeptides to enhance bone regeneration in rabbit calvarial defects. METHODS: Oligopeptides including fibrin-binding sequences of FN repeats were synthesized on the basis of primary and tertiary human plasma FN structures. Peptide coated and uncoated bone minerals were implanted into 10 mm calvarial defects in New Zealand white rabbits, and the animals were sacrificed at 4 or 8 weeks after surgery. After specimens were prepared, histologic examination and histomorphometric analysis were performed. RESULTS: At 4 weeks after surgery, the uncoated groups showed a limited amount of osteoid formation at the periphery of the defect and the oligopeptide coated groups showed more osteoid formation and new bone formation in the center of the defect as well as at the periphery. At 8 weeks, both sites showed increased new bone formation. However, the difference between the two sites had reduced. CONCLUSIONS: Fibrin-binding synthetic oligopeptide derived from FN on deproteinized bovine bone enhanced new bone formation in rabbit calvarial defects at the early healing stage. This result suggests that these oligopeptides can be beneficial in reconstructing oral and maxillofacial deformities or in regenerating osseous bone defects.
Animals ; Bone Regeneration ; Congenital Abnormalities ; Fibrin ; Fibronectins ; Humans ; Minerals ; Models, Animal ; Oligopeptides ; Osteogenesis ; Plasma ; Rabbits

PURPOSE: To prolong the degradation time of collagen membranes, various cross-linking techniques have been developed. For cross-linking, chemicals such as formaldehyde and glutaraldehyde are added to collagen membranes, but these chemicals could adversely affect surrounding tissues. The aim of this study is to evaluate the ability of porous non-chemical cross-linking porcine-derived collagen nanofibrous membrane to enhance bone and associated tissue regeneration in one-wall intrabony defects in beagle dogs. METHODS: The second and third mandibular premolars and the first molars of 2 adult beagles were extracted bilaterally and the extraction sites were allowed to heal for 10 weeks. One-wall intrabony defects were prepared bilaterally on the mesial and distal side of the fourth mandibular premolars. Among eight defects, four defects were not covered with membrane as controls and the other four defects were covered with membrane as the experimental group. The animals were sacrificed 10 weeks after surgery. RESULTS: Wound healing was generally uneventful. For all parameters evaluating bone regeneration, the experimental group showed significantly superior results compared to the control. In new bone height (NBh), the experimental group exhibited a greater mean value than the control (3.04 +/- 0.23 mm/1.57 +/- 0.59, P = 0.003). Also, in new bone area (NBa) and new bone volume (NBv), the experimental group showed superior results compared to the control (NBa, 34.48 +/- 10.21% vs. 5.09 +/- 5.76%, P = 0.014; and NBv, 28.04 +/- 12.96 vs. 1.55 +/- 0.57, P = 0.041). On the other hand, for parameters evaluating periodontal tissue regeneration, including junctional epithelium migration and new cementum height, there were no statistically significant differences between two groups. CONCLUSIONS: Within the limitations of this study, this collagen membrane enhanced bone regeneration at one-wall intrabony defects. On the other hand, no influence of this membrane on periodontal tissue regeneration could be ascertained in this study.
Absorbable Implants ; Adult ; Animals ; Bicuspid ; Bone Regeneration ; Collagen ; Dental Cementum ; Dogs ; Epithelial Attachment ; Formaldehyde ; Glutaral ; Guided Tissue Regeneration ; Hand ; Humans ; Membranes ; Molar ; Regeneration ; Wound Healing

PURPOSE: Fibronectin(FN), one of the major components of ECM, mediates wide variety of cellular interactions including cell adhesion, migration, proliferation and differentiation. In this study, we used synthetic peptides based on fibrin binding sites of amino-terminal of FN and evaluated their biologic effects on periodontal ligament(PDL) cells. MATERIALS AND METHODS: PDL cells were cultured on synthetic oligopeptides coated dishes and examined for cell adhesion, proliferation via confocal microscope. For detection of ERK1/2, cells were plated and Western blot analysis was performed. RESULTS: PDL cells on synthetic oligopeptide coated dishes showed enhanced cell adhesion and proliferation. Western blot analysis revealed increased level of ERK1/2 phosphorylation in cells plated on FN fragment containing fibrin-binding domain(FF1 and FF5) coated dishes. CONCLUSION: These results reveals that FN fragment containing fibrin-binding domain possess an enhanced biologic effect of PDL ligament cells.
Binding Sites ; Blotting, Western ; Cell Adhesion ; Fibrin ; Fibronectins ; Ligaments ; Oligopeptides ; Peptides ; Periodontal Ligament ; Phosphorylation

PURPOSE: To evaluate the usefulness of the retrograde intramedullary nailing for the treatment of segmental femoral shaft fracture including distal part. MATERIALS AND METHODS: We reviewed 15 patients of segmental femoral fracture, who had treated with retrograde intramedullary nailing and followed-up more than 1 year from January 2003 to October 2007. There were 10 men, 5 women, and the mean age was 45 years old. There were associated fracture in 10 cases. We evaluate the time for union, non-union and malunion by radiologic finding and functional assessment by Sanders' criteria. RESULTS: The mean time of union was 21 weeks. There was one delayed union in proximal fracture site. There was no shortening more than 1.5 cm, no angular deformity more than 10 degrees, no postoperative infection or instability. According to Sanders' criteria, there were excellent clinical results in 9 cases, good results in 5 cases and fair result in 1 case. CONCLUSION: The retrograde intramedullary nailing can be a useful method for treatment of segmental femoral shaft fracture including distal part.
Congenital Abnormalities ; Female ; Femoral Fractures ; Femur ; Fracture Fixation, Intramedullary ; Humans ; Male

Naked DNA and standard vectors have been previously used for gene delivery. Among these, PEI can efficiently condense DNA and has high intrinsic endosomal activities. The aim of this study is to investigate whether the cationic polycation PEI could increase the transfection efficiency of BMP expressing DNA using a vector-loaded collagen sponge model. BMP-2/pcDNA3.1 plasmid was constructed by subcloning human BMP-2 cDNA into the pcDNA3.1 plasmid vector. PEI/DNA complexes were prepared by mixing PEI and BMP-2/pcDNA3.1 and the constructed complexes were loaded into the collagen sponges. In vitro studies, BMSCs were transfected with the PEI/BMP-2/pcDNA3.1 complexes from collgen sponge. The level of secreted BMP-2 and alkaline phosphatase activities of transfected BMSCs were significantly higher in PEI/BMP-2/pcDNA3.1 group than in BMP-2/pcDNA3.1 group (p<0.05). Transfected BMSCs were cultured and mineralization was observed only in cells treated with PEI/BMP-2/pcDNA3.1 complexes. In vivo studies, PEI/BMP-2/pcDNA3.1/collagen, BMP-2/pcDNA3.1/collagen and blank collagen were grafted in skeletal muscle of nude mice. Ectopic bone formation was shown in PEI/BMP-2/pcDNA3.1/collagen grafted mouse 4 weeks postimplantation, while not in BMP-2/pcDNA3.1 grafted tissue. This study suggests that PEI-condensed DNA encoding for BMP-2 is capable of inducing bone formation in ectopic site and might increase the transfection rate of BMP-2/pcDNA3.1. As a non-viral vector, PEI offers the potential in gene therapy for bone engineering.
Alkaline Phosphatase ; Animals ; Collagen ; DNA ; DNA, Complementary ; Genetic Therapy ; Humans ; Mice ; Mice, Nude ; Muscle, Skeletal ; Osteogenesis ; Plasmids ; Porifera ; Transfection ; Transplants

The regeneration of lost periodontal tissue is a major goal of therapy. Periodontal ligament cell(PDL) is a specialized connective tissue that connects cementum and alveolar bone to maintain and support teeth in situ and preserve tissue homoeostasis. Bone morphogenetic proteins(BMPs) have shown much potential in the reconstruction of the periodontum by stimulate new bone and new cementum formation. Limitiations of BMP administration to periodontal lesions is high dose delivery, BMP transient biological activity, and low bioavailability of factors at the wound site. Gene delivery method can be alternative treatment strategy to deliver BMPs to periodontal tissue. The purpose of this study is to investigate efficiency of BMP-2 gene delivery with cell-based therapy using PDL cells. PDL cell were transduced with adenoviruses encoding either BMP-2 or Lac-Z gene. To evaluate osteogenic activity of expressed BMP-2 on PDL cells, we investigated secreted BMP-2, cellular activity, ALPase, produced mineralized nodules. To evaluate collagen scaffold as carrier for transduced cell delivery, we examined morphology and secreted BMP-2 of transducd PDL cells on it. BMP-2 transducd PDL cells produced higher levels of BMP-2, ALPase, mineralized nodules than non transduced cells. Cellular activity of transduced cells was showed similar activity to non transduced cells. Transduce cells attached on collagen scaffold secreted BMP-2 at 7day and was showed similar morphology to non transduced cells. These results demonstrated that transduced PDL cells produced biologically active BMP-2 and collagen scaffold could be carrier of transducd cells.
Adenoviridae* ; Biological Availability ; Collagen ; Connective Tissue ; Dental Cementum ; Humans* ; Periodontal Ligament* ; Regeneration ; Tooth ; Wounds and Injuries

Inorganic bovine bone mineral has been widely researched as bone substitution materials in orthopedic and oral and maxillofacial application. OCS-B(NIBEC, Korea) is newly-developed inorganic bovine bone mineral. The aim of this study is to evaluate the safety and efficacy of bovine bone-derived bone graft material(OCS-B). Micro-structure of newly-developed inorganic bovine bone mineral(OCS-B) was analyzed by scanning electron microscope(SEM). Round cranial defects with eight mm diameter were made and filled with OCS-B in rabbits. OCS-B was inserted into femoral quadrant muscle in mouse. In scanning electron microscope, OCS-B was equal to natural hydroxyapatite. Rabbits were sacrificed at 2 weeks and 4 weeks after surgery and mice were sacrificed at 1 week and 2 weeks after surgery. Decalcified specimens were prepared and observed by microscope. In calvarial defects, osteoid and new bone were formed in the neighborhood of OCS-B at 2 weeks after surgery. And at 4 weeks after surgery osteoid and new bone bridge formed flourishingly. No inflammatory cells were seen on the surface of OCS-B at 1 week and 2 weeks in mouse experimental group. It is concluded that newly-developed inorganic bovine bone mineral(OCS-B) is a flourishing bone-forming material and biocompatible material.
Animals ; Bone Regeneration ; Durapatite ; Mice ; Orthopedics ; Rabbits ; Residence Characteristics ; Transplants*

No abstract available.
Chitosan* ; Osteoblasts* ; Transforming Growth Factor beta1 ; Transforming Growth Factors*