Pericardial adhesions following open heart surgery pose a special problems, increasing the risk of cardiac reoperation because of the danger of damaging the heart, coronary artery and veins, or grafts and also the fibrous tissue may obliterate the pericardial space and eventually constrict the heart. This study was undertaken to evaluate the effect of intrapericardial urokinase and dextran 40 on the formation of pericardial adhesions in an animal model. latrogenic traumas on the pericardium were surgically induced in 30 rabbits, simulating injuries possible during actual surgery. In all rabbits, blood [1 ml] was obtained from an ear vessel and injected into the pericardium. Control group of ten rabbits did not receive any further medication, urokinase group of ten received 15, 000-20, 000 IU of urokinase, and remained ten received 1 ml of 10% dextran 40. All rabbits were sacrificed at 4 weeks. At autopsy, the development of adhesions were graded as none [Grade I], minimal [Grade II], moderate [Grade III], and severe [Grade IV]. Histological studies of the parietal pericardium and epicardium were performed. The results were as follows: 1. Group 1[Control group] showed minimal adhesion in 40%, moderate in 50%, and severe in 10% of the group. Sharp dissections were necessary in 60% of adhesions. 2. Group II [Dextran group] showed no adhesions in 20%, minimal in 60%, and moderate in 20% of the group. 3. Group III [Urokinase group] showed no adhesions in 40%, minimal in 40%, and moderate in 20% of the group. Considering in this group, the adhesion activity was significantly suppressed [60% adhesions] compared to the control group [100% adhesions] [P < 0.05]. 4. Histological findings revealed mild serosal fibrosis in none adherent group, loose fibrous connections between two layers of pericardium in minimal adhesion group, tight fibrous connections in moderate adhesion group, and marked fibrous thickening and close attachment of two surfaces were noted in severe adhesion group. These data have revealed the decreased incidence of pericardial adhesions with urokinase and dextran 40.
The purpose of this study was to compare clinical results of guided tissue regeneration(GTR) using either a nonresorbable ePTFE membrane or a resorbable membrane made from a synthetic copolymer of glycolide and lactide(PLGA) in the treatment of human class Ⅱ furcation defects. The ePTEE membranes were applied to 16 patients with maxillary molar buccal class Ⅱ furcation defects as Group I, PLGA membranes were applied to 15 patients with maxillary molar buccal class Ⅱ furcation defects as Group Ⅱ, ePTFE membranes were applied to 20 patients with mandibular molar buccal class Ⅱ furcation defects as Group Ⅲ and PLGA membranes were applied to 20 patients with mandibular molar buccal class Ⅱ furcation defects as Group Ⅳ and bone graft materials(DFDBA) were applied in all groups. Probing depth, gingival recession, clinical attachment level, tooth mobility and sulcus bleeding index(SBI) were measured at baseline, 3, 6 and 12months postoperatively. In addition, membrane exposure levels were measured at surgery, 1, 2 and 6weeks postoperatively and postoperative complications were evaluated. The results were as follows: In all groups, there were statistically significant differences in probing depth reduction, gain of clinical attachment and mobility reduction at values of 3, 6 and 12months postoperatively compared to values of baseline, whereas no significant differences in SBI except Group I and gingival recession(p<0.05). Membrane exposure levels were increased at 1, 2 and 6weeks postopratively compared to value of baseline in Group I(p<0.05). There were no statistically significant differences between ePTFE and PLGA membrane in probing depth, clinical attachment level and SBI. There were minimal gingival recession and membrane exposure in Group Ⅳ and pain and swelling were the most common postoperative complications in Group Ⅱ, Ⅲ(p<0.05). In conclusion, this study showed that both nonresorbable membrane and resorbable membrane were effective similarly in the treatment of class Ⅱ furcation defects, without statistical differences in clinical measurements.
Journal of Dental Rehabilitation and Applied Science
/
v.29
no.2
/
pp.153-162
/
2013
This study compared the marginal bone loss around dental implants that were placed in the canine areas of the mandibles and finded the survival rate of the implants, marginal bone loss around implants and prosthetic complications in 20 patients treated with overdentures retained with Locator attachments. Implants placed in this study showed a 95% survival rate and the average marginal bone loss was 1.21 mm($SD{\pm}0.60mm$) in 94.3 weeks of functional loading. Implant-retained overdentures had various prosthetic complications such as male change, metal cap loosening, Locator attachment loosening, denture teeth change, relining and denture fracture. Implant-retained overdentures using two implants and Locator attachments in the edentulous mandibles is considered as a stable way for long terms because of minimal invasive operation, simple prosthetic process and easy repair.
Propose: There have been many debates about the ideal surgical technique for acute Achilles tendon rupture. The purpose of this study is to review and analyze the clinical outcome of the acute Achilles tendon ruptures that had been repaired by indirect suture technique with minimal incision that utilized an instrument called Achillon (Newdeal, France). Materials and Methods: This study is based on the 14 cases (14 patients) of acute Achilles tendon total ruptures that have been repaired by minimal incision technique utilizing Achillon instrument from June 2003 to December 2004. Two cases were reruptured before 8 weeks and repaired again using Krackow suture which left 12 feet for postoperative functional evaluation with at least 6 months of follow-up. Ten cases were men and average age at time of injury was 34.4 (26-49) years. The time from injury to surgery was an average of 4.5 (1-9) days and the postoperative evaluations were done by an Arner-Lindholm scale and AOFAS score. The ability to return to original work and sports activities as well as patient satisfaction were also evaluated. Results: The follow-up period was averaged for 13.2 (6-24) months. Seventy-one percent of cases were ruptured during sports activities. The ruptured level was the average of 5.1 cm (3.2-8 cm) above calcaneal attachment and the skin incision was averaged for 2.7 cm (2.5-3.0 cm) long. At final follow-up, standing on tip-toe was possible in all cases while the heel-floor height on ruptured side was shorter by 0.7 cm (0-2 cm). By Arner-Lindholm evaluation scale, 9 cases were excellent, and 3 cases were good. Overall AOFAS score was an average of 96.1 (94-100), and all patients were satisfied with the result. Patients returned to work at an average of 1.3 months after the surgery and pre-injury sports activities were all possible from at 6 months after operation. Conclusion: Since we have treated acute Achilles tendon ruptures with minimal incision technique utilizing the Achillon and gained encouraging functional results with all patients returning to previous work with high patient satisfaction, this technique could be recommended as one of the ideal surgical options for the Achilles tendon ruptures.
Due to the limitations of conventional removable partial denture prostheses to treat a cleft lip & palate patient who shows scar tissue on upper lip, excessive absorption of the maxillary residual alveolar ridge, and class III malocclusion with narrow palate and undergrowth of the maxilla, 4 implants were placed on the maxillary edentulous region and a maxillary removable implant-supported partial denture was planned using a CAD/CAM milled titanium bar. Unlike metal or gold casting technique which has shrinkage after the molding, CAD/CAM milled titanium bar is highly-precise, economical and lightweight. In practice, however, it is very hard to obtain accurate friction-fit from the milled bar and reduction in retention can occur due to repetitive insertion and removal of the denture. Various auxiliary retention systems (e.g. $ERA^{(R)}$, $CEKA^{(R)}$, magnetics, $Locator^{(R)}$ attachment), in order to deal with these problems, can be used to obtain additional retention, cost-effectiveness and ease of replacement. Out of diverse auxiliary attachments, $Locator^{(R)}$ has characteristics that are dual retentive, minimal in vertical height and convenient of attachment replacement. Drill and tapping method is simple and the replacement of the metal female part of $Locator^{(R)}$ attachment is convenient. In this case, the $Locator^{(R)}$ attachment is connected to the milled titanium bar fabricated by CAD/CAM, using the drill and tapping technique. Afterward, screw holes were formed and 3 $Locator^{(R)}$ attachments were secured with 20 Ncm holding force for additional retention. Following this procedure, satisfactory results were obtained in terms of aesthetic facial form, masticatory function and denture retention, and I hereby report this case.
Purpose: The single-flap approach (SFA) is a minimally invasive technique with limited mucoperiosteal flap elevation to gain access to the buccal/palatal aspects, thus limiting post-surgical complications. The purpose of the present study was to gain insights into the impact of the SFA over the double-flap approach (DFA) on periodontal flap treatment outcomes and patient compliance in terms of discomfort and time taken for surgical procedures. Methods: Twenty patients with persistent probing pocket depths of ≥5 mm were scheduled for the SFA (test site) and for the DFA (control site). All the clinical periodontal parameters were recorded at baseline, 3 months, and 6 months. Radiographic bone level (cone-beam computed tomography) was evaluated at baseline and 6 months. Patients' postoperative pain perception and wound healing were also assessed. Results: The SFA showed a significant reduction in periodontal pocket depth, gain in clinical attachment level (CAL), and gain in bone level when compared with the DFA. The SFA substantially improved wound healing and induced less postoperative pain than the DFA. Conclusions: The SFA resulted in substantial improvement in the composite outcome measures, as shown by a reduction in pocket depth with minimal gingival recession, gain in CAL, early wound healing, less postoperative discomfort, and better patient-centered outcomes.
The initial events required for periodontal regeneration is the attachment, spreading, and proliferation of appropriated cells at the healing sites. These have been reported that minocycline stimulates the attachment of periodontal ligament cells, and also $TGF-{\beta}1$ enhances the proliferation of periodontal ligament cells. The purpose of the present study was to evaluate the effects of $TGF-{\beta}1$ on the cellular activity of minocycline treated human periodontal ligament cells. Periodontal ligament cells were obtained from the explants of healthy periodontal ligaments of extracted 3rd molars or premolar teeth extracted from the patients for orthodontic treatment. The cells were cultured in minimal essential medium(${\alpha}-MEM$) supplemented with 10.000units/ml penicillin, $10,000{\mu}g/ml$ streptomycin and 10% FBS(fetal bovine serum) at $37^{\circ}C$ in a humidified atmosphere of 5% carbon dioxide and the 5th to the 8th passages of the cells were used. To evaluate the effect of minocycline on cell attachment, the cells were seeded at a cell density of $1.5{\times}10^4$ cells/well in 24-well culture plates and treated with $20{\mu}g/ml$ and $100{\mu}g/ml$ of minocycline for 1.5 h. After trypsinization, the cells were counted with hemocytometer and were taken photographs for observation of cellular morphology. To evaluate the effect of $TGF-{\beta}1$ on minocycline-pretreated periodontal ligament cells, the cells were seeded at a cell density of $1{\times}10^4$ cells/ well in 24-well culture plates and treated with $20{\mu}g/ml$ and $100{\mu}g/ml$ of minocycline for 1.5 h. After incubation, 1 and 10ng/ml of $rh-TGF-{\beta}1$ were also added to the each well and incubated for 1 and 2 days, respectively. Then, MTT assay, DNA synthesis($^3H-thymidine\;assay$), and protein and collagen assay(3H-proline assay) were carried out. In the MIT assay, after 200ul MTT solutionlconeentration of 5mg/ml) were added to the each well of the 24-well plates and incubated for 3 hours, and 200 ul DMSO were added so as to dissolve insoluble blue formazan crystals which was formed in incubated period. Then it read plates on a ELISA reader. For mitogenic assay, 1 uCi/ml $^3H-thymidine$ was added to each well for the final 2 hours of the incubation periods. After labeling, the wells were washed 3 times with ice cold PBS and 4 times with 5% TCA to remove unincorporated label and precipitate the cellular DNA. DNA, with the incorporated $^3H-thymidine$, was solubilized with 500 ul of 0.1% NaOH/0.1% SDS. A 250 ul aliquot was removed from each well and placed in a scintillation vial with 4ml of scintillation cocktail. Using an liguid scintillation counter, counts per minute(CPM) were determined for each samples. 3 uCi/ml $^3H-proline$ was added to each well for the final 4 hours of the incubation periods and total protein and percent collagen synthesis were carried out. The results indicate that minocycline treated group with $100{\mu}g/ml$ concentration for 1.5 hours significantly increased than that of control in cell attachment, and cell process is also evident compared with that of control in cell morphology, and the cellular activity and DNA synthesis rate of cells treated minocycline and $TGF-{\beta}1$ significantly increased than that of control values, but were below to values of the $TGF-{\beta}1$ only treated group in MIT assay and $^3H-thymidine\;assay$, and the total protein synthesis of minocycline and $TGF-{\beta}1$ treated group also significantly increased than that of control values, but the percent collagen synthesis of tested group significantly decreased to compared with control. On the above the findings, the tested group of minocycline and $TGF-{\beta}1$ did not increase the effect on the cell activity than $TGF-{\beta}1$ only tested group and the tested group of minocycline inhibited cell activity. This results indicate that minocycline was effective on cell attachment in early stage, but it is harmful to cell activity, that inhibitory effect of minocycline was compensated with stimulatory effect of $TGF-{\beta}1$.
Park, Sung-Hee;Cha, Min-Ho;Kim, Eun-Jung;Yoon, Yeo-Joon;Sohng, Jae-Kyung;Lee, Hee-Chan;Liou, Kwang-Kyoung;Kim, Byung-Gee
KSBB Journal
/
v.23
no.1
/
pp.44-47
/
2008
Anthracycline antibiotics doxorubicin (DXR) is clinically important cancer therapeutic agent produced by Streptomyces peucetius. DXR result by further metabolism of rhodomycin D (RHOD) and require a deoxy-sugar component for their biological activity. In this study, production of TDP-L-daunosamine and its attachment to ${\varepsilon}$-rhodomycinone (RHO) to generate RHOD has been achieved by bioconversion in Streptomyces venezuelae that bears eleven genes. S. peucetius seven genes (dnmUTJVZQS) were transformed by plasmid and S. venezuelae two genes desIII, IV and two more S. peucetius drrA, B genes were integrated into chromosomal DNA. To generate the feeding substrate RHO, 6L S. peucetius grown on agar plate was harvested, extracted with organic solvent and then purified using preparative HPLC. Recombinant S. venezuelae grown on agar plate containing RHO was harvested and its n-butanol soluble components were extracted. The glycosylated product of aromatic polyketide RHO using heterologous host S. venezuelae presents the minimal information for TDP-L-daunosamine biosynthesis and its attachment onto aglycone. Moreover, the structure of auxiliary protein, DnrQ, was predicted by fold recognition and homology modeling in this study. This is a general approach to further expand of new glycosides of antitumor anthracycline antibiotics.
Journal of the Korean Association of Oral and Maxillofacial Surgeons
/
v.29
no.3
/
pp.151-156
/
2003
This study was performed to develop a useful nerve conduit which provides favorable environment for Schwann cell viability and proliferation. Milipore membrane of $0.45{\mu}m$ pore size was selected because it permits nutritional inflow from the outside of the conduit and prevents from invading the fibrotic tissue into the conduit. The membrane was rolled and sealed to form a conduit of 2mm diameter and 20mm length. To improve the axonal regeneration and to render better environment for endogenous and exogenous Schwann cell behaviour, the microgeometry and surface of conduit was modified by coating with thin film of calcium phosphate. Cellular viability within the conduit and attachment to its wall were assessed with MTT assay and SEM study. Milipore filter conduit showed significantly higher rate of Schwann cell attachment and viability than the culture dish. However, the reverse was true in case of fibroblast. Coating with thin film of low crystalline calcium phosphate made more favorable environment for both cells with minimal change of pore size. These findings means the porous calcium phosphate coated milipore nerve conduit can provide much favorable environment for endogenous Schwann cell proliferation and exogenous ones, which are filled within the conduit for the more advanced strategy of peripheral nerve regeneration, with potential of reducing fibrotic tissue production.
Purpose: This study compared the marginal bone loss around dental implant that were placed in the canine areas of the mandibles and finded the survival rate of implants, marginal bone loss around implants and prosthetic complications in 10 patients treated with overdentures retained with Locator attachments. Materials and methods: Ten patients who had received implant retained overdentures in the mandibules using two implants and Locator attachments at Daegu Catholic University Medical Center from 2004 to 2010 were included in this study. Evaluations of the survival rate of implants, marginal bone loss and prosthetic complications were performed. Results: Implants placed in this study showed a 100% survival rate and the average annual bone loss was 1.03 mm ${\pm}$ 0.20 mm in the first year. The patients have verbally indicated that they are comfortable and that their overdentures function well. But, implant retained overdentures had various prosthetic complications such as male change, relining, rebasing and denture fracture. Conclusion: Implant retained overdentures using two implant and Locator attachments in the fully edentulous mandibles is considered as a stable way for long terms because of minimal invasive operation, simple prosthetic process and easy repair.
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