Mannosylerythritol lipids (MELs) are glycolipids and have several pharmacological efficacies. MELs also show skin-moisturizing efficacy through a yet-unknown underlying mechanism. Aquaporin-3 (AQP3) is a membrane protein that contributes to the water homeostasis of the epidermis, and decreased AQP3 expression following ultraviolet (UV)-irradiation of the skin is associated with reduced skin moisture. No previous study has examined whether the skin-moisturizing effect of MELs might act through the modulation of AQP3 expression. Here, we report for the first time that MELs ameliorate the UVA-induced downregulation of AQP3 in cultured human epidermal keratinocytes (HaCaT keratinocytes). Our results revealed that UVA irradiation decreases AQP3 expression at the protein and messenger RNA (mRNA) levels, but that MEL treatment significantly ameliorated these effects. Our mitogen-activated protein kinase inhibitor analysis revealed that phosphorylation of c-Jun N-terminal kinase (JNK), but not extracellular signal-regulated kinase or p38, mediates UVA-induced AQP3 downregulation, and that MEL treatment significantly suppressed the UVA-induced phosphorylation of JNK. To explore a possible mechanism, we tested whether MELs could regulate the expression of peroxidase proliferator-activated receptor gamma (PPAR-γ), which acts as a potent transcription factor for AQP3 expression. Interestingly, UVA irradiation significantly inhibited the mRNA expression of PPAR-γ in HaCaT keratinocytes, whereas a JNK inhibitor and MELs significantly rescued this effect. Taken together, these findings suggest that MELs ameliorate UVA-induced AQP3 downregulation in HaCaT keratinocytes by suppressing JNK activation to block the decrease of PPAR-γ. Collectively, our findings suggest that MELs can be used as a potential ingredient that modulates AQP3 expression to improve skin moisturization following UVA irradiation-induced damage.
Down-Regulation* ; Epidermis ; Glycolipids ; Homeostasis ; Humans* ; JNK Mitogen-Activated Protein Kinases* ; Keratinocytes* ; Membrane Proteins ; Peroxidase ; Phosphorylation* ; Phosphotransferases ; PPAR gamma ; Protein Kinases ; RNA, Messenger ; Skin ; Transcription Factors ; Water

OBJECTIVE: Minimal data exist regarding non-operative management of suspected pseudarthrosis after pedicle subtraction osteotomy (PSO). This study reports radiographic and clinical outcomes of non-operative management for post-PSO pseudarthrosis at a minimum 5 years post-detection.METHODS: Nineteen consecutive patients with implant breakage indicating probable pseudarthrosis after PSO surgery (13 women/six men; mean age at surgery, 58 years) without severe pain and disability were treated with non-operative management (mean follow-up, 5.8 years; range, 5–10 years). Non-operative management included medication, intermittent brace wearing and avoidance of excessive back strain. Radiographic and clinical outcomes analysis was performed.RESULTS: Sagittal vertical axis (SVA), proximal junctional angle, thoracic kyphosis achieved by a PSO were maintained after detection of pseudarthrosis through ultimate follow-up. Lumbar lordosis and PSO angle decreased at final follow-up. There was no significant change in Oswestry Disability Index (ODI) scores and Scoliosis Research Society (SRS) total score, or subscales of pain, self-image, function, satisfaction and mental health between detection of pseudarthrosis and ultimate follow-up. SVA greater than 11 cm showed poorer ODI and SRS total score, as well as the pain, self-image, and function subscales (p<0.05).CONCLUSION: Non-operative management of implant failure of probable pseudarthrosis after PSO offers acceptable outcomes even at 5 years after detection of implant breakage, provided SVA is maintained. As SVA increased, outcome scores decreased in this patient population.
Animals ; Braces ; Follow-Up Studies ; Humans ; Joint Deformities, Acquired ; Kyphosis ; Lordosis ; Male ; Mental Health ; Osteotomy ; Pseudarthrosis ; Scoliosis ; Spine

The mesenchymal stem cells (MSCs) that reside in dental tissues hold a great potential for future applications in regenerative dentistry. In this study, we used human dental pulp cells, isolated from the molars (DPCs), in order to establish the organoid culture. DPCs were established after growing pulp cells in an MSC expansion media (MSC-EM). DPCs were subjected to organoid growth media (OGM) in comparison with human dental pulp stem cells (DPSCs). Inside the extracellular matrix in the OGM, the DPCs and DPSCs readily formed vessel-like structures, which were not observed in the MSC-EM. Immunocytochemistry analysis and flow cytometry analysis showed the elevated expression of CD31 in the DPCs and DPSCs cultured in the OGM. These results suggest endothelial cell-prone differentiation of the DPCs and DPSCs in organoid culture condition.
Dental Pulp ; Dentistry ; Endothelial Cells ; Extracellular Matrix ; Flow Cytometry ; Humans ; Immunohistochemistry ; Mesenchymal Stromal Cells ; Molar ; Organoids ; Stem Cells

PURPOSE: The purpose of this study was to visualize and identify peri-implant bone defects in optical coherence tomography (OCT) images and to obtain quantitative measurements of the defect depth. METHODS: Dehiscence defects were intentionally formed in porcine mandibles and implants were simultaneously placed without flap elevation. Only the threads of the fixture could be seen at the bone defect site in the OCT images, so the depth of the peri-implant bone defect could be measured through the length of the visible threads. To analyze the reliability of the OCT measurements, the flaps were elevated and the depth of the dehiscence defects was measured with a digital caliper. RESULTS: The average defect depth measured by a digital caliper was 4.88±1.28 mm, and the corresponding OCT measurement was 5.11±1.33 mm. Very thin bone areas that were sufficiently transparent in the coronal portion were penetrated by the optical beam in OCT imaging and regarded as bone loss. The intraclass correlation coefficient between the 2 methods was high, with a 95% confidence interval (CI) close to 1. In the Bland-Altman analysis, most measured values were within the threshold of the 95% CI, suggesting close agreement of the OCT measurements with the caliper measurements. CONCLUSIONS: OCT images can be used to visualize the peri-implant bone level and to identify bone defects. The potential of quantitative non-invasive measurements of the amount of bone loss was also confirmed.
Dental Implants ; Diagnosis ; Intention ; Mandible ; Peri-Implantitis ; Tomography, Optical Coherence

STUDY DESIGN: Case report OBJECTIVES: This study introduces an interesting case of adolescent cervical myelopathy with atypical cervical magnetic resonance imaging (MRI) findings. A differential diagnosis was made, followed by successful surgical treatment. SUMMARY OF LITERATURE REVIEW: A careful differential diagnosis of high signal intensity on T2-weighted cervical MRI is necessary if there is no evidence of cervical stenosis. Recent reports have suggested that the differential diagnosis should be based on a comprehensive analysis of data, including brain MRI, a cerebrospinal fluid examination, and empirical steroid treatment. MATERIALS AND METHODS: A 17-year-old male patient complained of upper extremity weakness, gait disturbance, and decreased sensation in the upper extremity. Cervical spine MRI findings suggested C3/4 disc herniation, moderate cervical stenosis, and high signal intensity in the spinal cord. A differential diagnosis was made between cervical myelopathy and myelitis. RESULTS: Decompression and posterolateral fusion of C3/4 were performed in a 17-year-old patient with cervical myelopathy without significant cervical stenosis. Postoperatively, upper extremity sensation and weakness and gait disturbance showed improvement, and the Japanese Orthopedic Association score improved to 17 points at 6 months after surgery. CONCLUSIONS: In patients with cervical myelopathy showing high signal intensity on T2-weighted imaging without evident spinal stenosis, a differential diagnosis should be made between cervical myelopathy and myelitis; surgical decompression can be an effective treatment choice upon the diagnosis of cervical myelopathy.
Adolescent* ; Asian Continental Ancestry Group ; Brain ; Cerebrospinal Fluid ; Constriction, Pathologic ; Decompression ; Decompression, Surgical ; Diagnosis ; Diagnosis, Differential* ; Gait ; Humans ; Magnetic Resonance Imaging ; Male ; Myelitis* ; Orthopedics ; Sensation ; Spinal Cord ; Spinal Cord Diseases* ; Spinal Stenosis ; Spine ; Upper Extremity

PURPOSE: The purpose of this study was to examine whether periodontal pocket could be satisfactorily visualized by optical coherence tomography (OCT) and to suggest quantitative methods for measuring periodontal pocket depth. METHODS: We acquired OCT images of periodontal pockets in a porcine model and determined the actual axial resolution for measuring the exact periodontal pocket depth using a calibration method. Quantitative measurements of periodontal pockets were performed by real axial resolution and compared with the results from manual periodontal probing. RESULTS: The average periodontal pocket depth measured by OCT was 3.10±0.15 mm, 4.11±0.17 mm, 5.09±0.17 mm, and 6.05±0.21 mm for each periodontal pocket model, respectively. These values were similar to those obtained by manual periodontal probing. CONCLUSIONS: OCT was able to visualize periodontal pockets and show attachment loss. By calculating the calibration factor to determine the accurate axial resolution, quantitative standards for measuring periodontal pocket depth can be established regardless of the position of periodontal pocket in the OCT image.
Calibration ; Gingiva ; Image Interpretation, Computer-Assisted ; Methods ; Periodontal Pocket* ; Tomography, Optical Coherence*

Atypical hemolytic uremic syndrome (aHUS) is a rare syndrome characterized by micro-angiopathic hemolytic anemia, thrombocytopenia, and acute kidney injury. The major pathogenesis of aHUS involves dysregulation of the complement system. Eculizumab, which blocks complement C5 activation, has recently been proven as an effective agent. Delayed diagnosis and treatment of aHUS can cause death or end-stage renal disease. Therefore, a diagnosis that differentiates aHUS from other forms of thrombotic microangiopathy is very important for appropriate management. These guidelines aim to offer recommendations for the diagnosis and treatment of patients with aHUS in Korea. The guidelines have largely been adopted from the current guidelines due to the lack of evidence concerning the Korean population.
Acute Kidney Injury ; Anemia, Hemolytic ; Atypical Hemolytic Uremic Syndrome* ; Complement C5 ; Complement System Proteins ; Delayed Diagnosis ; Diagnosis ; Humans ; Kidney Failure, Chronic ; Korea* ; Thrombocytopenia ; Thrombotic Microangiopathies

BACKGROUND/AIMS: The purpose of this study is to investigate the recurrence rate of peptic ulcer disease (PUD) over a long follow-up period with PUD patients without Helicobacter pylori. METHODS: We retrospectively reviewed patients diagnosed with PUD on endoscopy and divided them into two groups: a H. pylori-negative group (HP-negative group), and a group of patients with untreated H. pylori (HP noneradicated group). We compared the recurrence rates of PUD in these two groups and analyzed the factors that affected ulcer recurrence. RESULTS: Total of nine hospitals in Korea participated, and a total of 1,761 patients were retrospectively reviewed. The HP-negative group included 553 patients, and the HP noneradicated group included 372 patients. The 5-year cumulative probabilities of PUD recurrence were 36.4% in the HP-negative group and 43.8% in the HP noneradicated group (p=0.113). The factors that were found to affect recurrence in the HP-negative group were elder, male, and comorbid chronic kidney disease. CONCLUSIONS: The 5-year cumulative probability of PUD recurrence without H. pylori infection after a long-term follow-up was 36.4% and the factors that affected recurrence were elder, male, and comorbid chronic kidney disease.
Endoscopy ; Follow-Up Studies ; Helicobacter pylori* ; Helicobacter* ; Humans ; Korea ; Male ; Peptic Ulcer* ; Recurrence* ; Renal Insufficiency, Chronic ; Retrospective Studies ; Ulcer

PURPOSE: The objective of this study was to investigate the relationships between primary implant stability as measured by impact response frequency and the structural parameters of trabecular bone using cone-beam computed tomography(CBCT), excluding the effect of cortical bone thickness. METHODS: We measured the impact response of a dental implant placed into swine bone specimens composed of only trabecular bone without the cortical bone layer using an inductive sensor. The peak frequency of the impact response spectrum was determined as an implant stability criterion (SPF). The 3D microstructural parameters were calculated from CT images of the bone specimens obtained using both micro-CT and CBCT. RESULTS: SPF had significant positive correlations with trabecular bone structural parameters (BV/TV, BV, BS, BSD, Tb.Th, Tb.N, FD, and BS/BV) (P<0.01) while SPF demonstrated significant negative correlations with other microstructural parameters (Tb.Sp, Tb.Pf, and SMI) using micro-CT and CBCT (P<0.01). CONCLUSIONS: There was an increase in implant stability prediction by combining BV/TV and SMI in the stepwise forward regression analysis. Bone with high volume density and low surface density shows high implant stability. Well-connected thick bone with small marrow spaces also shows high implant stability. The combination of bone density and architectural parameters measured using CBCT can predict the implant stability more accurately than the density alone in clinical diagnoses.
Bone and Bones ; Bone Density ; Bone Marrow ; Cone-Beam Computed Tomography* ; Dental Implants* ; Diagnosis ; Swine ; X-Ray Microtomography

BACKGROUND/AIMS: The effect of proton pump inhibitors (PPI) in Asian functional dyspepsia (FD) patients has not been well established as in Western countries. DA-9701, a novel prokinetic agent, stimulates gastric emptying and modulates visceral hypersensitivity in vivo and in human studies. This study was conducted to compare the efficacy of DA-9701 with a conventional PPI in mono or combination therapy in patients with FD. METHODS: In this double-blind, randomized, non-inferiority trial, 389 patients diagnosed with FD using Rome III criteria were allocated among 3 groups: 30-mg DA-9701 t.i.d (means 3 times a day), 40-mg pantoprazole, and 30-mg DA-9701 t.i.d + 40-mg pantoprazole. The primary efficacy end-point was a global assessment of the patient binary response or response on a 5-Likert scale after 4 weeks. RESULTS: The global symptomatic improvement was 60.5% in the DA-9701 group, 65.6% in the pantoprazole group, and 63.5% in the DA-9701 + pantoprazole group using a 5-Likert scale at week 4 with no significant difference among 3 groups (P = 0.685). Symptom improvement measured by binary outcome was significantly achieved in each of the 3 groups, but not different among groups. Patients in all treatment groups reported significant improvement in the response rate and symptoms according to FD subtypes and dyspepsia-related quality of life (P < 0.001), but there were no significant differences among the 3 groups. CONCLUSIONS: DA-9701 improves global and individual symptoms and increases dyspepsia-specific quality of life in patients with FD. The efficacy of DA-9701 monotherapy is comparable with pantoprazole and there is no additive effect with combination of DA-9701 and pantoprazole in patients with FD.
Asian Continental Ancestry Group ; Dyspepsia* ; Gastric Emptying ; Humans ; Hypersensitivity ; Proton Pump Inhibitors ; Quality of Life