A Study on Treatment under General Anesthesia in Pediatric Dentistry at Seoul National University Dental Hospital / 대한소아치과학회지

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.

Effects of glutathione s-transferase (GST) M1 and T1 polymorphisms on antioxidant vitamins and oxidative stress-related parameters in Korean subclinical hypertensive subjects after kale juice (Brassica oleracea acephala) supplementation

BACKGROUND/OBJECTIVES: Glutathione s-transferase (GST) is involved in the formation of a multigene family comprising phase II detoxification enzymes, involved in the detoxification of reactive oxygen species. This study evaluated whether daily supplementation with kale juice could modulate levels of plasma antioxidant vitamins and oxidative stress-related parameters. We further examined whether this modulation was affected by combined GSTM1 and T1 polymorphisms. SUBJECTS/METHODS: Totally, 84 subclinical hypertensive patients having systolic blood pressure (BP) over 130 mmHg or diastolic BP over 85 mmHg, received 300 mL of kale juice daily for 6 weeks. Blood samples were drawn before start of study and after completion of 6 weeks. RESULTS: After supplementation, we observed significant decrease in DNA damage and increase in erythrocyte catalase activity in all genotypes. Plasma level of vitamin C was significantly increased in the wild/null and double null genotypes. The plasma levels of β-carotene, erythrocyte glutathione peroxidase activity, and nitric oxide were increased only in the wild/null genotype after kale juice supplementation. CONCLUSIONS: The effect of kale juice was significantly greater in the GSTM1 null genotype and wild/null genotype groups, suggesting possibility of personalized nutritional prescriptions based on personal genetics.

Lymphocyte DNA damage and plasma antioxidant status in Korean subclinical hypertensive patients by glutathione S-transferase polymorphism

BACKGROUND/OBJECTIVES: Glutathione S-transferase (GST) forms a multigene family of phase II detoxification enzymes which are involved in the detoxification of xenobiotics by conjugating substances with glutathione. The aim of this study is to assess the antioxidative status and the degree of DNA damage in the subclinical hypertensive patients in Korea using glutathione S-transferase polymorphisms. SUBJECTS/METHODS: We examined whether DNA damage and antioxidative status show a difference between GSTM1 or GSTT1 genotype in 227 newly diagnosed, untreated (systolic blood pressure (BP) ≥ 130 mmHg or diastolic BP ≥ 85 mmHg) subclinical hypertensive patients and 130 normotensive subjects (systolic BP < 120 mmHg and diastolic BP < 80 mmHg). From the blood of the subjects, the degree of the DNA damage in lymphocyte, the activities of erythrocyte superoxide dismutase, the catalase, and the glutathione peroxidase, the level of glutathione, plasma total radical-trapping antioxidant potential (TRAP), anti-oxidative vitamins, as well as plasma lipid profiles and conjugated diene (CD) were analyzed. RESULTS: Of the 227 subjects studied, 68.3% were GSTM1 null genotype and 66.5% were GSTT1 null genotype. GSTM1 null genotype had an increased risk of hypertension (OR: 2.104, CI: 1.38-3.35), but no significant association in GSTT1 null genotype (OR 0.982, CI: 0.62-1.55). No difference in erythrocyte activities of superoxide dismutase, catalase, or glutathione peroxidase, and plasma TRAP, CD, lipid profiles, and GSH levels were observed between GSTM1 or GSTT1 genotype. Plasma levels of α-tocopherol increased significantly in GSTT1 wild genotype (P < 0.05); however, plasma level of β-carotene increased significantly in GSTT1 null genotype (P < 0.01). DNA damage assessed by the Comet assay was significantly higher in GSTM1 null genotype than wild genotype (P < 0.05). CONCLUSIONS: These results confirm the association between GSTM1 null genotype and risk of hypertension as they suggest that GSTM1 null genotype leads to an increased oxidative stress compared with wild genotype.

Protective effect of Korean diet food groups on lymphocyte DNA damage and contribution of each food group to total dietary antioxidant capacity (TDAC) / 한국영양학회지

PURPOSE: This study was performed to compare total phenolic contents, in vitro antioxidant capacity, and reduction effect of Korean food groups on ex vivo DNA damage in human cells and analyze correlations between each indicator. METHODS: Vegetable foods in the Korean diet based the results of the KNHANES V-2 (2011) were classified into 10 food groups: cereals, fruits, vegetables, nuts, kimchi, seaweeds, potatoes, mushrooms, legumes, and oils. Eighty-four foods constituted more than 1% of the total intake in each food group and finally designated as vegetable foods in the Korean diet. Total phenolic content of each food group was measured. Further, in vitro antioxidant capacity was measured based on DPPH radical scavenging assay, TEAC assay, and ORAC(ROO)• assay. Ex vivo DNA damage in human lymphocytes was assessed using comet assay. RESULTS: Total phenolic contents of food groups of the Korean diet increased in the order of mushrooms, fruits, vegetables, seaweeds, and kimchi. Meanwhile, antioxidant rankings of food groups as mean values from the three in vitro test methods increased in the order of mushrooms, seaweeds, vegetables, kimchi, and fruits. Protection against ex vivo DNA damage in human lymphocytes was highest in mushrooms, followed by vegetables, fruits, seaweeds, and kimchi. The rankings of the food groups for total phenolic content, in vitro DAC, and ex vivo DNA protection activity were similar, and correlations between each indicator were significantly high. CONCLUSION: Mushrooms, fruits, vegetables, and seaweeds among the tested food groups in the Korean diet showed high total phenolic contents, in vitro antioxidant capacities, and protection against DNA damage. Correlations between each indicator in terms of total phenolic content, in vitro antioxidant capacity, and ex vivo DNA protection between each food group were found to be particularly high.

Dental treatment under general anesthesia in an intellectually disabled child with intellectually disabled parents

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.

The effect of glutathione S-transferase M1 and T1 polymorphisms on blood pressure, blood glucose, and lipid profiles following the supplementation of kale (Brassica oleracea acephala) juice in South Korean subclinical hypertensive patients

BACKGROUND/OBJECTIVES: Glutathione S-transferase (GST) forms a multigene family of phase II detoxification enzymes which are involved in the detoxification of reactive oxygen species. This study examines whether daily supplementation of kale juice can modulate blood pressure (BP), levels of lipid profiles, and blood glucose, and whether this modulation could be affected by the GSTM1 and GSTT1 polymorphisms. SUBJECTS/METHODS: 84 subclinical hypertensive patients showing systolic BP over 130 mmHg or diastolic BP over 85 mmHg received 300 ml/day of kale juice for 6 weeks, and blood samples were collected on 0-week and 6-week in order to evaluate plasma lipid profiles (total cholesterol, triglyceride, HDL-cholesterol, and LDL-cholesterol) and blood glucose. RESULTS: Systolic and diastolic blood pressure was significantly decreased in all patients regardless of their GSTM1 or GSTT1 polymorphisms after kale juice supplementation. Blood glucose level was decreased only in the GSTM1-present genotype, and plasma lipid profiles showed no difference in both the GSTM1-null and GSTM1-present genotypes. In the case of GSTT1, on the other hand, plasma HDL-C was increased and LDL-C was decreased only in the GSTT1-present type, while blood glucose was decreased only in the GSTT1-null genotype. CONCLUSIONS: These findings suggest that the supplementation of kale juice affected blood pressure, lipid profiles, and blood glucose in subclinical hypertensive patients depending on their GST genetic polymorphisms, and the improvement of lipid profiles was mainly greater in the GSTT1-present genotype and the decrease of blood glucose was greater in the GSTM1-present or GSTT1-null genotypes.

Total antioxidant capacity of the Korean diet

BACKGROUND/OBJECTIVES: The objective of this study was to measure and/or estimate the total antioxidant capacity of the Korean diet. MATERIALS/METHODS: Eighty-one plant foods that were expected to exhibit rather high antioxidant activities were selected from the Korean diet using the Fifth Korean National Health and Nutrition Survey (KNHANES V). These foods were categorized into 11 food groups: cereals, potatoes, legumes, nuts, vegetables, kimchies, mushrooms, fruits, fruit juices, sea weeds, and oils. The foods were mixed in the proportions specified in traditional Korean recipes and analyzed. The measured indicators for antioxidant capacities were total phenolics, 2,2-diphenyl-1-picrylhydrazyl (DPPH), oxygen radical absorbance capacity (ORAC), and Trolox equivalent antioxidant capacity (TEAC). RESULTS: Total phenolics were high in the fruit juices, nuts, vegetables, and fruits; and the average DPPH, ORAC, and TEAC values were high in the vegetables, fruits, fruit juices, and nuts. The correlation coefficient between the content of total phenolics of each food and the in vitro antioxidant capacity was relatively high at 0.851. The intake of total phenolics per capita per day in the Republic of Korea was estimated to be 127 mg. The total dietary antioxidant capacity (TDAC) values, which were obtained from the total antioxidant capacity of each food, taking into account the intake of each food, were 20,763, 54,335, and 876.4 micromol of Trolox equivalents using the DPPH, ORAC, and TEAC methods, respectively. The food group that contributed the most to the Korean TDAC was cereals at 39.7%, followed by fruits and vegetables at 27.8% and 13.9%, respectively. The contribution of legumes, nuts, fruit juices, and mushrooms was quite minimal at less than 2% each. CONCLUSIONS: The content of total phenolics and the antioxidant capacity of the Korean diet are significantly correlated and the high contributing food groups are cereals, fruits, and vegetables.

Association between oxidative stress and blood pressure in Korean subclinical hypertensive patients

This study was conducted in order to investigate the association between hypertension and oxidative stress-related parameters and to evaluate these parameters in subclinical hypertensive patients and normotensive subjects living in Korea. We attempted to determine whether oxidative stress-related parameters would differ between two groups of 227 newly-diagnosed, untreated (systolic blood pressure (BP) > or = 130 mmHg and diastolic BP > or = 85 mmHg) and 130 normotensive subjects (systolic BP < 120 mmHg and diastolic BP < 80 mmHg). General characteristics of the subjects were collected using a simple questionnaire. From subjects' blood, degree of DNA damage in lymphocytes, the activities of erythrocyte superoxide dismutase, catalase, and glutathione peroxidase, level of plasma total radical-trapping antioxidant potential (TRAP), glutathione, and anti-oxidative vitamins, as well as plasma lipid profiles and conjugated diene (CD) were analyzed. Evaluation of the associations of oxidative stress-related parameters with blood pressure of the subjects was performed using Pearson partial correlation and multivariate logistic regression analysis after adjusting for confounding factors. Several oxidative stress-related parameters were higher in subclinical hypertensive patients than in normotensive subjects. Plasma levels of alpha-tocopherol, beta-carotene, TRAP, and activity of GSH-px were significantly lower in subclinical hypertensive patients than in normotensive subjects. Increased levels of DNA damage, lipid peroxidation, triglyceride, total cholesterol, and LDL-cholesterol were observed in subclinical hypertensive patients. These results confirm an association between blood pressure and oxidative stress-related parameters and suggest that the pathogenic role of oxidative stress in hypertension might be significant.

Lymphocyte DNA Damage and Anti-Oxidative Parameters are Affected by the Glutathione S-Transferase (GST) M1 and T1 Polymorphism and Smoking Status in Korean Young Adults

Glutathione S-transferase (GST) is a multigene family of phase II detoxifying enzymes that metabolize a wide range of exogenous and endogenous electrophilic compounds. GSTM1 and GSTT1 gene polymorphisms may account for inter-individual variability in coping with oxidative stress. We investigated the relationships between the level of lymphocyte DNA and antioxidative parameters and the effect on GST genotypes. GSTM1 and GSTT1 were characterized in 301 young healthy Korean adults and compared with oxidative stress parameters such as the level of lymphocyte DNA, plasma antioxidant vitamins, and erythrocyte antioxidant enzymes in smokers and non smokers. GST genotype, degree of DNA damage in lymphocytes, erythrocyte activities of superoxide dismutase, catalase, and glutathione peroxidase (GSH-Px), and plasma concentrations of total radical-trapping antioxidant potential (TRAP), vitamin C, alpha- and gamma-tocopherol, alpha- and beta-carotene, and cryptoxanthin were analyzed. Lymphocyte DNA damage assessed by the comet assay was higher in smokers than that in non-smokers, but the levels of plasma vitamin C, beta-carotene, TRAP, erythrocyte catalase, and GSH-Px were lower than those of non-smokers (p < 0.05). Lymphocyte DNA damage was higher in subjects with the GSTM1-null or GSTT1-present genotype than those with the GSTM1-present or GSTT1-null genotype. No difference in erythrocyte antioxidant enzyme activities, plasma TRAP, or vitamin levels was observed in subjects with the GSTM1 or GSTT1 genotypes, except beta-carotene. Significant negative correlations were observed between lymphocyte DNA damage and plasma levels of TRAP and erythrocyte activities of catalase and GSH-Px after adjusting for smoking pack-years. Negative correlations were observed between plasma vitamin C and lymphocyte DNA damage only in individuals with the GSTM1-present or GSTT1-null genotype. The interesting finding was the significant positive correlations between lymphocyte DNA damage and plasma levels of alpha-carotene, beta-carotene, and cryptoxanthin. In conclusion, the GSTM1-null and GSTT1-present genotypes as well as smoking aggravated antioxidant status through lymphocyte DNA damage. This finding confirms that GST polymorphisms could be important determinants of antioxidant status in young smoking and non-smoking adults. Consequently, the protective effect of supplemental antioxidants on DNA damage in individuals carrying the GSTM1-null or GSTT1-present genotypes might show significantly higher values than expected.