A 27-year-old female presented to our hospital with a slow growing, hard and soft palate mass on the right that had been present for the several months. Physical examination showed a 2 cm, firm, well-circumscribed, painless mass on the right side of the palate. PNS computer tomographic imaging showed a $1.5{\times}1.3{\times}2$ cm well-defined cystic mass on the right side of both the hard and soft palate without any underlying bone change. The lesion was completely excised under general anesthesia. In order to preserve the palatal mucosa, trapdoor approach for removal of the pleomorphic adenoma was done. This technique provided more comfortable healing of the operative site. Three years after surgery, there was no evidence of recurrence. If pleomorphic adenoma without bony and mucosal destruction exists, we suggest consideration of the trapdoor approach to protect the palatal mucosa. In view of the potential for tumour recurrence, long-term follow-up and careful examination are necessary.
In order to verify the acceleration effect of low level laser (LLL) on oral mucosal wound healing process at cell biological level, the author studied growth pattern and ultrastructure in human gingival fibroblasts flashed by GaAlAs LLL-830 nm, 15mW for 10 minutes/flash one to three times at interval of 3-4 days through the evaluation of cell growth rate, protein conent/cell, DNA content/cell and ultrastructural changes for 14 days. The results were as follows : 1. The growth rate in gingival fibloblasts treated by LLL showed 4 orderly stages-decreasing stage after LLL treatment, acute increasing stage 3 days after LLL treatment, restring stage and recovering stage. 2. The effect of multiple flashes on LLL at interval of 3 days more or less was not proportional to times of flash on acceleration of growth in gingival fibroblasts. 3. The total protein content per gingival fibroblast was not significantly changed by LLL treatment in comparison with control group. But some kinds of protein which might be cell growth promoting factors were decreased immediately after LLL treatment, thereafter were acutely increased in cellular protein profile. 4. In ultrastructural changes of gingival fibroblasts treated by LLL, more prominent rough endoplasmic reticulum, mitochondrial hyperplasia/hypertrophy and increased extracellular fibrillar matrix were observed in comparison with control group under same experimental period.
In order to study the effects of Jengjengamiyjintang on the duodenal ulcer induced by HCl-aspirin in rats, the changes of histological profiles, goblet cells(PAS-positive cells), and the distribution and frequency of cholecystokinin(CCK)-8 and serotonin-producing gastro-entero-endocrine cells were observed after oral administration of Jengjengamiyjintang. Histologically, very severe injury to duodenal epithelium were observed in control groups and these injuries were increased with time intervals. But in the Jengjengamiyjintang administrated groups, no gross lesion of ulcer were demonstrated and histologically minor injury to the mucosal epithelium were observed. PAS-positive cells were increased in the Jengjengamiyjintang administrated groups compared to that of control groups. Severe degranulation of CCK-8- and serotonin-immunoreactive cells were observed in control groups but these phenomenon was seldom in the Jengjengamiyjintang administrated groups. Serotonin-immunoreactive cells were significantly decreased in control groups but increased in Jengjengamiyjintang administrated groups compared with control groups. According to these result, it is suggested that Jengjengamiyjintang would accelerat the healing of the duodenal ulcer but the functional mechanisms were unknown.
Mok, Wan Loong James;Goh, Ming Hui;Tang, Choong Leong;Tan, Bien Keem
Archives of Plastic Surgery
/
v.46
no.3
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pp.277-281
/
2019
Recto-vaginal fistulas are difficult to treat due to their high recurrence rate. Currently, no single surgical intervention is universally regarded as the best treatment option for recto-vaginal fistulas. We present a case of recurrent recto-vaginal fistula surgically treated with a gracilis pull-through flap. The surgical goals in this patient were complete excision of the recto-vaginal fistula and introduction of fresh, vascularized muscle to seal the fistula. A defunctioning colostomy was performed 1 month prior to the present procedure. The gracilis muscle and tendon were mobilized, pulled through the freshened recto-vaginal fistula, passed through the anus, and anchored externally. Excess muscle and tendon were trimmed 1 week after the procedure. Follow-up at 4 weeks demonstrated complete mucosal coverage over an intact gracilis muscle, and no leakage. At 8 weeks post-procedure, the patient resumed sexual intercourse with no dyspareunia. At 6 months post-procedure, her stoma was closed. The patient reported transient fecal staining of her vagina after stoma reversal, which resolved with conservative treatment. The fistula had not recurred at 20 months post-procedure. The gracilis pull-through flap is a reliable technique for a scarred vagina with an attenuated recto-vaginal septum. It can function as a well-vascularized tissue plug to promote healing.
Recently, frequently using hyperbaric oxygen therapy is known for its effectiveness on the healing of problem wounds such as osteomyelitis, osteoradionecrosis and gas gangrenous wound etc. The main objectives of this study was to determine the best protocol of its application of hyperbaric oxygen therapy. Author used 238 rats (Sprague-Dawley strain) deviding into 2 Groups, experimental I group for skin and experimental II group for palatal mucosal ischemic wounds, and observed its effects by microscopically. The obtained results summarized as follows; 1. Severe infiltration of inflammatory cells was observed in initial stages of both control and experimental I group. The infiltration showed decreasing tendency at 5th day of experimental D, E, F group while at 8th day in control group In d, f of experimental II group showed decreasing tendency at 8th experimental day while at 12th day in control group. 2. Macrophages appeared at 2nd day in D of experimental I group while at 6th day in control group. In d, f of experimental II group appeared at 6th day while at 10th day in control group. 3. As to the proliferation of capillary blood vessels showed at 3-4 day in most of experimental I group severely while at 8th day in control group. In experimental II group, it was at 8th day and 12th day respectively. 4. The proliferation of fibroblasts showed rather rapider in experimental I group, at 4-6th day, while at 8th day in control group. In experimental II group, it was at 8th day and 12th day respectively. 5. As to the collagen formations, it was at 4th day in experimental I group while at 8th day in control group. In experimental II group, it was at 6th day and 10th day respectively. 6. 5 rats (2.0 %) in E group and 8 rats (3.4 %) in f group showed oxygen toxic reaction, such as unstable attitude and tremor, during the experiments. This hyperbaric oxygen animal experiments disclosed excellent effects on the ischemic wound healing and it is thought to be the best protocol of its application was on D group (2.5 ATM. and 2 hrs, exposure).
Journal of the Korean Association of Oral and Maxillofacial Surgeons
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v.37
no.1
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pp.1-8
/
2011
Introduction: The utility of the C-terminal cross-linking telopeptide test (CTX) as a method for staging Bisphosphonate-related osteonecrosis of the jaws (BRONJ) and its healing process was examined. Materials and Methods: A total 19 patients who were diagnosed with BRONJ underwent a fasted morning CTX test, were enrolled in this study. The serum CTX values ranged from 50 to 630 pg/mL (mean 60). The risk assessment was rated according to the CTX values of the individual patient (minimal risk, ${\geq}$ 150 pg/mL, moderate, 100 to 150 pg/mL, high, ${\leq}$100 pg/mL). The BRONJ scores were then calculated according to the number of BRONJ lesions and their stage. The operation was done as soon as possible, regardless of BORNJ stage. Results: The mean duration of bisphosphonate therapy was 4.1 years. Of the 19 patients, 15, 2 ans 2 received alendronate, risedronate and zoledronate, respecively. Of the 19 patients who underwent a sequestrectomy, saucerization and smoothing, 15 healed after the initial surgery, 1 patient healed after one more surgical procedure, 3 patients did not heal completely but showed improvement in symptoms. Therefore, 17 out of the 19 patients healed completely with complete mucosal coverage and the elimination of pain. The risk assessment using the CTX value and disease severity were not correlated (r=-0.264, P=0.275). In addition, the risk assessment using CTX value and healing after surgery were not correlated (r=-0.147, P=0.547). Conclusion: The serum CTX should be considered carefully by clinicians as part of overall management. Early surgical intervention is of benefit in the treatment of stage II BRONJ.
Kim, Se-Mi;Cho, Hea-Young;Kang, Hyun-Ah;Lee, Yong-Bok
Korean Journal of Clinical Pharmacy
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v.18
no.1
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pp.38-44
/
2008
Rebamipide, ($\pm$)-2-(4-chlorobenzoylamino)-3-[2(1H)-quinolinon-4-yl] propionic acid, is used for mucosal protection, healing of gastroduodenal ulcers, and treatment of gastritis. It works by enhancing mucosal defense, scavenging free radicals and temporarily activating genes encoding cyclooxygenase-2. The purpose of the present study was to evaluate the bioequivalence of two rebamipide tablets, $Mucosta^{(R)}$ (Korea Otsuca Pharmaceuticals Co., Ltd.) and Mustar (Korean Drug Co., Ltd.), according to the guidelines of the Korea Food and Drug Administration (KFDA). The release of rebamipide from the two rebamipide formulations in vitro was tested using KP VIII Apparatus II method with pH 6.8 dissolution medium. Twenty six healthy male subjects, $23.46{\pm}2.63$ years in age and $66.62{\pm}8.97\;kg$ in body weight, were divided into two groups and a randomized $2{\times}2$ cross-over study was employed. After a single tablet containing 100 mg as rebamipide was orally administered, blood samples were taken at predetermined time intervals and the concentrations of rebamipide in serum were determined using HPLC with fluorescence detector. The dissolution profiles of two formulations were similar in the tested dissolution medium. The pharmacokinetic parameters such as $AUC_t$, $C_{max}$ and $T_{max}$ were calculated, and ANOVA test was utilized for the statistical analysis of the parameters using logarithmically transformed $AUC_t$, $C_{max}$ and untransformed $T_{max}$. The results showed that the differences between two formulations based on the reference drug, $Mucosta^{(R)}$ were -5.08, 3.52 and -9.71 % for $AUC_t$, $C_{max}$ and $T_{max}$, respectively. There were no sequence effects between two formulations in these parameters. The 90% confidence intervals using logarithmically transformed data were within the acceptance range of log 0.8 to log 1.25 (e.g., log 0.84$\sim$log 1.07 and log 0.90$\sim$log 1.17 for $AUC_t$ and $C_{max}$, respectively). Thus, the criteria of the KFDA bioequivalence guideline were satisfied, indicating Mustar tablet was bioequivalent to $Mucosta^{(R)}$ tablet.
Kim, Jae-Yoon;Lee, Jin-Yong;Bae, Kwang-Hak;Lee, Jong-Ho
Journal of the Korean Association of Oral and Maxillofacial Surgeons
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v.34
no.2
/
pp.157-165
/
2008
The aim of this study was to evaluate the efficacy of a topical 0.2% hyaluronic acid (HA) preparation in the management of wound after removal of arch bar for facial bone fracture and a suture site after orthognatic, oral cancer or oral surgery. Forty patients participated in a randomized, placebo controlled, double-blind trial to evaluate the efficacy of the topical HA and preparation. HA topically applied to the wound after removal of arch bar or stitch out, 3 times a day for 4 weeks. Evaluation is performed once a week for 4 weeks. For subjective evaluation, relative pain reduction in visual analog scale (VAS) and existence of heat sensation was accessed. For objective evaluation, gross evaluation, papilla index, existence of wound dehiscence, redness and swelling was checked. The same evaluation was performed in each arch bar group and suture group. For whole subject, 0.2% HA group resulted higher reduction than placebo group in pain of site in first week with significancy. Same findings were seen other weeks but there was no significancy. 0.2% HA group had better result than placebo in objective evaluation (papilla index, wound dehiscence, redness and swelling), but in gross evaluation placebo had better result than 0.2% HA group with no significancy. Subject was divided into suture group and arch bar group. Same aspect was seen, but only suture group had significancy not arch bar group in pain reduction score. 0.2% HA group resulted higher reduction than placebo group in pain of site in first week with significancy, especially in suture group. It reveals topical application of HA in wound especially suture site reduced pain in early stage. And 0.2% HA group had better result than placebo in papilla index, redness and swelling with no statistical significancy. In conclusion, HA has effect of pain reduction and healing promotion in the mucosal wound after oral surgery.
Journal of Dental Rehabilitation and Applied Science
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v.27
no.4
/
pp.449-454
/
2011
Recently, jawbone osteonecrosis has been largely reported as a potential adverse effect of bisphosphonate (BP)administration. Currently available published incidence data for BRONJ are based on retrospective studies and estimates of cumulative incidence range from 0.8 to 12%. The mandible is more commonly affected than the maxilla (2:1 ratio), and 60-70% of cases are preceded by a dental surgical procedure. The signs and symptoms that may occur before the appearance of clinical evident osteonecrosis include changes in the health of periodontal tissues, non-healing mucosal ulcers, loose teeth and unexplained soft-tissue infection. Tooth extraction as a precipitating event is a common observation. The significant benefits that bisphosphonates offer to patients clearly surpass the risk of potential side effects; however, any patient for whom prolonged bisphosphonate therapy is indicated, should be provided with preventive dental care in order to minimize the risk of developing this severe condition.
Purpose: The aim of this study was to determine the effect of overlaying titanium mesh (TM) with an adjunctive collagen membrane (CM) for preserving the buccal bone when used in association with immediate implant placement in dogs. Methods: Immediate implant placements were performed in the mesial sockets of the third premolars of five dogs. At one site the TM was attached to the fixture with the aid of its own stabilizers and then covered by a CM (CM group), while the contralateral site received only TM (TM group). Biopsy specimens were retrieved for histologic and histomorphometric analyses after 16 weeks. Results: All samples exhibited pronounced buccal bone resorption, and a high rate of TM exposure was noted (in three and four cases of the five samples in each of the TM and CM groups, respectively). A dense fibrous tissue with little vascularity or cellularity had infiltrated through the pores of the TM irrespective of the presence of a CM. The distances between the fixture platform and the first bone-implant contact and the bone crest did not differ significantly between the TM and CM groups. Conclusions: Our study suggests that the additional use of a CM over TM does not offer added benefit for mucosal healing and buccal bone preservation.
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