Purpose: Placing dental implants in areas with low bone density or in conditions where bone healing is suppressed is challenging for clinicians. An experiment using a rodent model was performed with the aim of determining the efficacy of host modulation by increasing the systemic level of cholesterol sulfate (CS) using Irosustat in the context of the bone healing process around dental implants. Methods: In 16 ovariectomised female Sprague-Dawley rats, 2 implant fixtures were placed in the tibial bones (1 fixture on each side). At 1 week after surgery, the high-CS group (n=8) received Irosustat-mixed feed, while the control group (n=8) was fed conventionally. Block specimens were obtained at 5 weeks post-surgery for histologic analysis and the data were evaluated statistically (P<0.05). Results: Unlike the high-CS group, half of the specimens in the control group demonstrated severe bone resorption along with a periosteal reaction in the cortex. The mean percentages of bone-to-implant contact (21.5%) and bone density (28.1%) near the implant surface were significantly higher in the high-CS group than in the control group (P<0.05), as was the number of Haversian canals (by 5.3). Conclusions Host modulation by increasing the CS level may enhance the osseointegration of dental implants placed under conditions of impaired bone healing.

Behavior management of the child constitutes an important part of pediatric dentistry. The majority of children can be treated with adequate behavior management. However, some children who have extensive dental problems or mental, physical disabilities cannot cooperate. So, the need for general anesthesia as a special method of behavior management has increased recently. This study analyzes the records of patients who received dental treatment under general anesthesia.The 1378 cases of 1322 patients under 18 years of age, who received dental treatment under general anesthesia in department of pediatric dentistry at the Seoul National University dental hospital, from October, 2011 to December, 2015 were included.In this study, male (60.9%) was more than female (39.1%). The mean age of patients was 5.9 years and age from 5 to 9 years was the most frequent (56.0%). The primary dental treatment which patients received was dental caries treatment (51.1%), followed by surgical treatment (42.2%).The dental treatment under general anesthesia has many advantages including of performing a lot of treatments at once, producing good quality of treatment, and reducing the number of visits. General anesthesia may be a useful method of behavior management.
Anesthesia, General ; Child ; Dental Caries ; Female ; Humans ; Male ; Methods ; Pediatric Dentistry ; Seoul

An indirect inguinal hernia containing the fallopian tube alone is extremely rare in reproductive-aged women without any genital tract anomalies. Despite this rarity, early diagnosis and adequate management is important to prevent strangulation and recurrence. We present a case of an indirect inguinal hernia containing only the fallopian tube in the hernia sac, which was successfully reduced by using a laparoscopic total extraperitoneal approach and repaired with a polypropylene mesh.
Early Diagnosis ; Fallopian Tubes* ; Female ; Hernia* ; Hernia, Inguinal* ; Herniorrhaphy* ; Humans ; Laparoscopy ; Polypropylenes ; Recurrence

Children with an intellectual disability often demonstrate lack of cooperation during dental treatment and require behavioral management. A child with mild intellectual disability can be managed adequately using restraints and medication. However, in cases of profound intellectual disability, dental treatment under general anesthesia is usually required. In cases where the patient is an intellectually disabled child who has intellectually disabled parents, it is difficult to evaluate the patient's preoperative condition and to obtain consent for treatment under general anesthesia. Furthermore, they are unable to respond to emergencies after treatment. Therefore, dental treatment should be performed under general anesthesia with hospitalization for children with an intellectual disability. This case presents the dental treatment of an intellectually disabled child, who has intellectually disabled parents, and who required general anesthesia and hospitalization.
Anesthesia, General* ; Child ; Dental Care for Disabled ; Disabled Children* ; Emergencies ; Hospitalization ; Humans ; Intellectual Disability ; Parents*

Unilateral femoral neck factures are common and their incidence is increasing. However, simultaneous bilateral femoral neck fractures are rare. Although cases of simultaneous bilateral femoral neck fractures have been reported, most were caused by strong muscle contractions during electroconvulsive therapy. Simultaneous bilateral femoral neck fractures caused by a simple fall are an extremely rare injury; therefore, limited literature is available, and no case has been reported in Korea. We report herein a case of simultaneous bilateral femoral neck fractures caused by a simple fall. An 83-year-old woman visited the emergency department with bilateral hip joint pain and gait disturbance, which developed 1 day after a fall. Tenderness and severe limitation in left hip joint range of motion and mild limitation in right hip joint range of motion were observed on a physical examination. A Garden type IV femoral neck fracture in the left hip joint and a Garden type I femoral neck fracture in the right hip joint were observed on plain radiography. She underwent right screw fixation and left bipolar hemiarthroplasty 2 days after admission. The patient could walk using a walker 4 weeks postoperatively. Bone union in the right femoral neck was observed at the 3 month follow-up. No specific findings were observed at the left hip hemiarthroplasty site.
Aged, 80 and over ; Electroconvulsive Therapy ; Emergency Service, Hospital ; Female ; Femoral Neck Fractures ; Femur Neck* ; Follow-Up Studies ; Gait ; Hemiarthroplasty ; Hip ; Hip Joint ; Humans ; Incidence ; Korea ; Muscle Contraction ; Physical Examination ; Radiography ; Range of Motion, Articular ; Walkers

OBJECTIVES: The purpose of this analysis is to study whether the factors including bone mineral density (BMD) and age which influence fracture occurrence is involved in proximal femur fracture type. Any correlation of body mass index (BMI) and obesity to fractures of the proximal femur was investigated in particular. METHODS: Two hundred fifty two patients hospitalized for femur neck fracture and intertrochanteric fracture over 60 under 90 years old were examined. Only simple fall down trauma for excluding pathologic fractures was included. About 225 patients, past medical, drug and social history were investigated and BMD and BMI (body mass index) were measured. Patients were classified into two groups (femoral neck fracture and intertrochanteric fracture). Significant differences in BMD and BMI between these two groups were investigated. RESULTS: There was no statistically significant difference between two proximal femur fracture type with regard to age, sex and BMD. But two groups seem to have statistically significant different with BMI. Most patients had normal weight, thus no significant differences were found in degree of obesity between two groups. CONCLUSIONS: This study shows that the higher the patients have BMI, the more frequently intertrochanteric fracture is occurred. But, owing to normal obesity levels seen in most patients in this study, any definitive correlation between obesity and each type of proximal femur fracture could not be found.
Body Mass Index ; Bone Density ; Femoral Neck Fractures ; Femur ; Fractures, Spontaneous ; Humans ; Neck ; Obesity

PURPOSE: Recurrence is one of the most common complications after primary correction for hallux valgus deformities. The purpose of this study was to evaluate the usefulness of Scarf osteotomy with axial decompression in the treatment of recurrent hallux valgus. MATERIALS AND METHODS: From April 2006 to April 2011, 14 cases (12 patients) of recurrent hallux valgus were managed with shortening Scarf osteotomy. Preoperative and postoperative radiographs were reviewed for the measurement of the hallux valgus angle (HVA), intermetatarsal angle (IMA), and the amount of the 1st metatarsal shortening. Clinical outcomes including the visual analogue scale (VAS), the AOFAS score, and the range of motion [ROM] of the 1st metatarsophalangeal (MTP) joint were evaluated. RESULTS: The mean HVA decreased from 27.9 degrees to 5.2 and the mean IMA decreased from 12.9 to 3.4. The mean VAS improved from 5.3 to 0.3 and the mean AOFAS score improved from 41 to 90. The mean amount of the 1st metatarsal shortening was 3.4 mm (2-5). The mean ROM of the 1st MTP joint improved from 22 degrees (15-35) to 68 (55-75). CONCLUSION: Scarf osteotomy associated with axial decompression can be a useful revision procedure for the treatment of recurrent hallux valgus deformity.
Congenital Abnormalities ; Decompression ; Hallux Valgus* ; Hallux* ; Joints ; Metatarsal Bones ; Osteotomy* ; Range of Motion, Articular ; Recurrence

OBJECTIVES: The purpose of present study is to identify the differences between temperament and character traits among adolescents classified by ego resilience and ego control level. METHODS: A Junior Temperament and Character Inventory (TCI) was performed on participants, and a California Child Q-Test (CCQ) was tested for by the parents of the adolescent participants. RESULTS: The result of the factor analysis and discriminant analysis show that the participants are classified into three different groups based on CCQ score and item response patterns. The three groups are named the ego resilience group, the undercontrolled group, and the overcontrolled group. The ego resilience group indicates that they have a high level of interest and curiosity but yet they are not easily tempered. Moreover, they behave proactively with a reasonable level of responsibility in order to improve themselves. In contrast, among the undercontrolled group, it is observed that, although the group shows even higher level of interest, curiosity and honesty, they are careless, more impulsive, and have a lack of delayed gratification and shame. CONCLUSION: The overcontrolled group shows that they are the most cautious and reflective group among the three but also show emotional instability such as strong criticism and passive-aggressiveness. In this study, implications and limitations are discussed.
Adolescent ; California ; Child ; Ego ; Exploratory Behavior ; Humans ; Parents ; Temperament

In this study, the synergistic effect of 6-[4-(1-cyclohexyl-1H-tetrazol-5-yl) butoxy]-3,4-dihydro-2(1H)-quinolinone (cilostazol) and Ginkgo biloba extract (GbE) was examined in apolipoprotein E (ApoE) null mice. Co-treatment with GbE and cilostazol synergistically decreased reactive oxygen species (ROS) production in ApoE null mice fed a high-fat diet. Co-treatment resulted in a significantly decreased atherosclerotic lesion area compared to untreated ApoE mice. The inflammatory cytokines and adhesion molecules such as monocyte chemoattractant-1 (MCP-1), soluble vascular cell adhesion molecule-1 (sVCAM-1), and VCAM-1 which can initiate atherosclerosis were significantly reduced by the co-treatment of cilostazol with GbE. Further, the infiltration of macrophages into the intima was decreased by co-treatment. These results suggest that co-treatment of GbE with cilostazol has a more potent anti-atherosclerotic effect than treatment with cilostazol alone in hyperlipidemic ApoE null mice and could be a valuable therapeutic strategy for the treatment of atherosclerosis.
Animals ; Apolipoproteins E/genetics/physiology ; Atherosclerosis/*drug therapy ; Cytokines/metabolism ; Disease Models, Animal ; Drug Synergism ; Ginkgo biloba/*chemistry ; Humans ; Macrophages/cytology/drug effects ; Male ; Mice ; Mice, Nude ; Plant Extracts/*administration & dosage/chemistry ; Reactive Oxygen Species/*metabolism ; Tetrazoles/*administration & dosage

In a preliminary study, we found that benzyloxycarbonyl-Val-Ala-Asp(OMe)-fluoromethylketone (zVAD- fmk), unlike Boc-aspartyl(OMe)-fluoromethylketone (BocD-fmk), at usual dosage could not prevent genistein-induced apoptosis of p815 mastocytoma cells. This study was undertaken to reveal the mechanism underlying the incapability of zVAD-fmk in preventing this type of apoptosis. We observed that 14-3-3 protein level was reduced in genistein-treated cells and that BocD-fmk but not zVAD-fmk prevented the reduction of 14-3-3 protein level and the release of Bad from 14-3-3. We also demonstrated that truncated Bad to Bcl-xL interaction in genistein- treated cells was prevented by BocD-fmk but not by zVAD-fmk treatment. Our data indicate that BocD- fmk, compared to zVAD-fmk, has a certain preference for inhibiting 14-3-3/Bad signalling pathway. We also elucidated that this differential efficacy of BocD-fmk and zVAD-fmk resulted from the different effect in inhibiting caspase-6 and that co-treatment of zVAD-fmk and caspase-6 specific inhibitor substantially prevented genistein-induced apoptosis. Our data shows that caspase-6 plays a role on Bad/14-3-3 pathway in genistein-induced apoptosis of p815 cells, and that the usual dose of zVAD-fmk, in contrast to BocD-fmk, did not prevent caspase-6 acting on 14-3-3/Bad-mediated event.
bcl-Associated Death Protein/*metabolism ; *Signal Transduction/drug effects ; Mitochondria/drug effects ; Mice ; Mastocytoma ; Hydrocarbons, Fluorinated/*pharmacology ; Genistein/pharmacology ; Enzyme Inhibitors/*pharmacology ; Cell Line, Tumor ; Caspase 6/antagonists & inhibitors/*metabolism ; Benzyl Compounds/*pharmacology ; Apoptosis/*drug effects ; Animals ; Amino Acid Chloromethyl Ketones/pharmacology ; 14-3-3 Proteins/*metabolism