Oral health condition according to distribution of periodontopathic bacterial complex / 대한구강보건학회지

OBJECTIVES: The purpose of this study was to evaluate the association between the distribution of periodontopathic bacteria and oral conditions.METHODS: Stimulated saliva was collected from 162 adults aged 60 years and above. The prevalence and amount of periodontopathic bacteria in the saliva were analyzed using real-time PCR. Pocket depth and clinical attachment loss were examined to evaluate the oral conditions of the subjects. Patients who had at least one tooth surface involved, with a pocket depth ≥4 mm or clinical attachment loss ≥5 mm were classified as having periodontal disease.RESULTS: The detection rates of most bacteria in the orange and green complexes were more than 90%, while those of P. gingivalis and T. forsythia in the red complex were 58.6% and 61.7%, respectively. The number of bacteria in the red complex positively correlated with each other. There were no significant differences in the number of types of red complex bacteria in the saliva and the distribution of residual number of teeth and periodontal disease (P>0.05). On the other hand, the number of remaining teeth in subjects with higher bacterial density were more than those with lesser bacterial density. In addition, the occurrence of dental disease differed significantly depending on the number of P. gingivalis and T. forsythia.CONCLUSIONS: The relative amount of periodontopathic bacteria is important in the occurrence of periodontal disease, and the number of these bacteria positively correlated with each other.

Quantitative Analysis of Oral Pathogenic Bacteria according to Smoking Using Real-Time PCR / 치위생과학회지

This study investigates the relationship between smoking and periodontal disease through quantitative analysis of intra-buccal oral pathogenic bacteria detected in smokers and aims to yield objective baseline data for applications in anti-smoking and dental health education programs. From April to May 2016, participants in an oral health management program within an intensive dental hygiene training course at Choonhae College of Health Sciences received an explanation of the study purposes and methods, after which male smokers aged 18~30 years agreed to participate voluntarily. Real-time polymerase chain reaction (PCR) analysis of oral pathogenic bacteria was performed after collecting gingival sulcus fluid samples from 67 smokers. The intra-buccal oral pathogenic bacteria distributions were analyzed based on the subjects' general characteristics, smoking behaviors, and oral care behaviors. The distribution results show that pathogens in the anterior teeth are affected (in this order) by age, toothbrush size, and smoking status; older people had fewer pathogens, those who used larger toothbrushes had more pathogens, and smokers had more pathogens, compared to non-smokers ((adj)R²=19.1). In the posterior teeth, pathogens were influenced (in this order) by smoking status, smoking duration, and the number of tooth brushings per day; smokers had more pathogens than non-smokers, and those who brushed their teeth more often had fewer pathogens ((adj)R²=25.1). The overall pathogen distribution was affected only by smoking status: smokers generally had more pathogens, compared to non-smokers. Therefore, it is necessary to provide information about the risk of periodontal disease due to smoking during anti-smoking or dental health education sessions; particularly, the use of smaller toothbrushes for anterior teeth and the need for smokers in their early twenties to quit smoking for dental health should be highly emphasized.

Changes in bisphenol A concentrations in urine according to sealant filling in children / 대한구강보건학회지

OBJECTIVES: The objectives of this study were to investigate the changes in bisphenol A (BPA) concentrations in urine from before to after sealant filling and the relationship between BPA and the number of teeth with sealed surfaces. METHODS: Thirty-one children aged 6 and 7 years from three elementary schools in Daegu city who did not have any sealant and resin filling were selected as subjects. Urine samples were collected before and after sealant filling until 24 hours, with informed consent from their caregivers. The BPA concentration in all the collected urine samples was analyzed at Seegene Medical. Statistical analysis was performed using the Friedman test, Scheirer-Ray-Hope test, and the repeated-measures generalized linear mixed model of SPSS version 22.0. RESULTS: The BPA concentrations increased from 3.49-μg/g creatinine before to 4.91-μg/g creatinine 2-3 hours later and to 4.15-μg/g creatinine after 24 hours. The more teeth with sealed surfaces, the higher the BPA concentration in children, but the difference was not statistically significant (P>0.05). CONCLUSIONS: The BPA concentrations were highest at 2–3 hours after sealant filling and decreased at 24 hours. Exposure to the sealant appears to have a meaningful correlation with the concentration of BPA in the urine of children.

Comparison of the whitening effect of toothpastes containing 0.25% hydroxyapatite and 0.75% hydrogen peroxide / 대한구강보건학회지

OBJECTIVES: The aim of this study was to compare the tooth bleaching effect of two whitening materials in toothpaste i.e., hydroxyapatite and hydrogen peroxide on. In a randomized, double blinded controlled clinical trial, 85 participants with tooth colorations were assigned to use one of three toothpastes containing either hydroxyapatite (0.25%), hydrogen peroxide (0.75%), or no active ingredient (placebo). The patients were examined at baseline and 1, 2, and 3 months after usage. METHODS: The patients underwent an oral examination, tooth shade measurement, and a subjective evaluation. During the oral examination, the patient's oral health status was determined. ShadeEye NCC and Vita classical shade guide were used to determine the tooth color. Further, the patients were asked to assess the color of their own teeth using a visual analog scale (VAS) scale (range, 1-5). RESULTS: According to the CIELAB system, a significantly greater color change (Deltab*) was observed in the hydrogen peroxide group (2.10+/-1.54) than in the hydroxyapatite (1.50+/-1.09) and control (0.94+/-0.75) groups after 3 months of toothpaste usage (P0.05). The subjective evaluation results of the hydroxyapatite (P=0.023) and hydrogen peroxide (P=0.047) groups were statistically significant at each time point. CONCLUSIONS: The hydrogen peroxide-containing toothpaste caused significant lightening of tooth coloration than the hydroxyapatite and placebo toothpastes.

Improved periodontal health aspects according to the tooth position through the non-surgical professional oral hygiene care in the diabetic youth / 대한구강보건학회지

OBJECTIVES: The aim of this study was to compare short-term and medium-term effects of gingival index (GI) and dental plaque index (PI), according to the tooth position through the oral hygiene education in the diabetic youth. METHODS: The total number of participants were 31 diabetics and 87 controls in the city of Daegu. Oral examination and professional oral hygiene care were performed among the 31 diabetic youth who consented to the study at the first visit. The professional oral hygiene care consisted of the tooth brushing method, oral prophylaxis, scaling, fluoride application, sealant and dental auxiliary education. We collected the data from all participants for the identification of oral condition at 2 weeks and 3 months. The #11, #14, #16, #31, #34, #36 teeth were selected for the measurement of the oral hygiene conditions. GI and PI were used for oral hygiene scores. The data was analyzed with SPSS 18.0 program. RESULTS: Both GI and PI were significantly decreased in the treatment group of the 31 diabetic youth in comparison to the controls, by tooth position compared to the baseline (P<0.001). In particular, GI measurements constantly decreased upto 3 months and the PI measurements decreased upto 2 weeks and increased slightly from 2 weeks to 3 months. In the GI measurements, the decrement of #14 was the highest (48.4%) and #36 was the lowest (25.2%) among all teeth. In the PI measurements, the decrement of #14 was the highest (45.5%) and #16 was the lowest (19.8%) among all teeth. In the control group, PI increased on all tooth positions, and GI increased on some tooth positions. CONCLUSIONS: The program of professional oral hygiene care in the diabetic youth has improved the oral health care when compared to the controls. We suggest that the sites where oral hygiene is more difficult to control have more oral hygiene education than the other sites.

Percutaneous Transseptal Left Atrial Drainage for Decompression of the Left Heart in an Adult Patient during Percutaneous Cardiopulmonary Support

A 28-year-old male with hemophagocytic lymphohistiocytosis presented with left ventricular dysfunction and cardiac arrest. Percutaneous cardiopulmonary support (PCPS) was initiated, but left heart distension developed with associated aggravation of pulmonary edema. Percutaneous transseptal left atrial sheath (28-Fr) drainage was incorporated into the PCPS venous circuit under fluoroscopic guidance to enable left heart decompression 1 days after PCPS initiation. The patient's pulmonary edema improved markedly, and distention of his left heart diminished. He was successfully weaned from PCPS 5 days later. Percutaneous transseptal left atrial drainage with large venous cannulae is feasible and effective in decompressing the left heart in adult patients during PCPS.

Current Status of Prophylaxis for Endocarditis

BACKGROUND AND OBJECTIVES: Antibiotic prophylaxis of infective endocarditis is required before high-risk procedures in patient with high-risk heart diseases. Although guidelines for the prevention of infective endocarditis were proposed by the American Heart Association in 1997, compliance to these recommendations has not been evaluated in Korea. SUBJECTS AND METHODS: This was a retrospective, multicentered study in 8 Korean university hospitals. Patients with high-risk heart diseases, having undergone invasive dental procedures between Jan. 1, 2000 and Dec. 31, 2003, were enrolled. The medical and dental records of the patients were reviewed to evaluate whether the prophylaxis had been appropriate. RESULTS: Of the initial 4,912 patients, 184 that had been treated with invasive dental procedures (255 total episodes, mean 1.4/patient) were evaluated. The most common high-risk heart disease was a prosthetic heart valve (233 procedures), followed by a previous history of infective endocarditis (22 procedures), cyanotic heart diseases (5 procedures) and systemic pulmonic venous shunts (2 procedures). Antibiotic prophylaxis was performed in 231 procedures (90.8%). Amoxicillin was the most common antibiotic used for prophylaxis (88.6%); however, the adequate dosage (2 gm) was administered in only 56% of these cases. Therefore, the appropriate prophylaxis, according to the AHA recommendations, was performed in only 14.1% (36 procedures). The mean duration of prophylaxis and number of antibiotic doses were 2.40 days (2.40+/-2.44) and 7.97 doses (7.97+/-7.18), respectively. A previous history of infective endocarditis (p=0.03) and dental extraction (p<0.01) resulted in a longer duration of prophylaxis. CONCLUSION: Only 14.1% of the high risk group procedures were given appropriate antibiotic prophylaxis according to the AHA recommendations. These data suggest that protocol-based education of both doctors and patients is required for appropriate antimicrobial therapy during high-risk procedures for the prevention of infective endocarditis in patients with high-risk heart disease.

A case of successful IVF in the patient with atypically low serum estradiol level / 대한산부인과학회잡지

It has been known that estradial(E2) level is concerned with the quality, number and growing of follicles. Determination of the serum levels of E2 has been used to predict the oocyte maturity. We experienced the rare case who has significantly low serum E2 level(551.26 pg/ml) in spite of multiple ovarian responses by sonographic finding, but from her we obtained 23 oocytes on MCD#16 after COH with ultrashort protocol(HP-FSH 150 IU, daily). The numbers of retrieved oocyte were 23 and fertilization rate was 56.6%, so the result of IVF-ET was successful twin pregnancy. Serum estradiol level and sonographic finding are essential to measure the number and growing of follicles, but E2 levels may be too unreliable to be used as sole parameter for the number and maturity of oocytes.

Gene Transfer into Cultured Cardiac Myocytes Mediated by Retrovirus

BACKGROUND: Transplantation of cardiac myocytes (CMs) into the injured heart emerges as a potential alternative for the treatment of heart failure. Genetic modification of CMs could enhance and/or modify its therapeutic effects. The characteristics of retroviral gene delivery, which is most commonly used in human trial, has been minimally studied in CMs due to its low efficiency in non-dividing cells. In this study, using newly developed high-titer retrovirus, we evaluated 1) the efficiency of gene transfer into CMs, 2) whether S phase during infection is necessary for the transduction, and 3) characteristics of gene delivery to mononucleated vs binucleated CMs. METHODS: Enriched CMs were cultured from the ventricles of 1 day-old rat hearts. The cells were transduced by MFG-nls-LacZ retroviruses (5x107 IU/ml) in the presence or absence of polybrene. 3H-thymidine was added to label cells in S phase. The cells were stained for b-galactosidase activity and then immunostained using MF20Ab to identify CMs. The cells were subsequently processed for in vitro autoradiography. RESULTS: 1)With 3 rounds of infection, 5.9% of total cultured cells were LacZ-positive. The efficiency of transduction reached upto 7.4% in the presence of polybrene 8 microgram/ml. 2)Nuclear morphology of LacZ-positive CMs was pleomorphic from mononucleated to multinucleated, mostly binucleated. 3)Among mononucleated CMs, 17% of cells were labelled with thymidine. Transduction efficiency (TDE) of thymidine-positive and -negative mononucleated CMs were 37.9% and 3.1%, respectively. Among binucleated cells, 28.9% of cells were labelled with thymidine. TDE of thymidine-positive and -negative binucleated CMs were 75.4% and 13.6%, respectively. 4)In total, TDE of binucleated cells were 3.5 times compared to the one of mononucleated cells (31.5% vs 9.0%). CONCLUSION: TDE of CMs using high-titer retrovirus is relatively low. S phase of cells during retroviral infection is not mandatory for the retroviral transduction. Binucleated CMs are susceptible to retroviral gene delivery and their TDE is higher than the one of mononucleated CMs.

Effects of Amino Acids in Simple Phosphate-Free Media on Pregnancy Rate in Human In Vitro Fertilization and Embryo Transfer(IVF-ET) / 대한불임학회지

The role of amino acids in culture media for IVF-ET was examined in a total of 76 cycles. Patients received clomiphene citrate (CC) followed by hMG or GnRH-a combined with gonadotropins (FSH/hMG) for controlled ovarian hyperstimulation. Severe male (39 y) patients were excluded in this study. Pregnancy was classified as clinical if a gestational sac or fetal cardiac activity was seen on ultrasound. No significant differences were found in age, duration of infertility, follicle size, the level of E2 on the day of hCG injection, the mean number of oocytes retrieved, total motile sperm count, fertilization rate and the mean number of embryos transferred between bHTF (without amino acids) and mHTF (with amino acids) groups. However, total ampules of gonadotropins were higher (p<0.01) in mHTF group than bHTF group. Significantly (p<0.05) more clinical pregnancies were recorded in mHTF group (13/30) compared with bHTF group (9/46). The multiple pregnancy rates were 11.1% in bHTF group and 77% in mHTF group. There were one ectopic pregnancy in mHTF group and one heterotopic pregnancy in bHTF group. Abortion rates were 22.2% in bHTF group and 7.7% in mHTF, respectively The ongoing pregnancy or livebirth .ate was significantly (p<0.05) higher in mHTF group (12/30) than bHTF group (7/46). These results suggest that the addition of amino acids in culture media is essential for culture of zygotes in vitro and adjustment of energy substrates in phosphate-free culture media appears to be beneficial for human IVF-ET procedure.

Comparison of Pregnancy Rates by Intrauterine Insemination after Ovulation Trigger with Endogenous LH Surge, GnRH Agonist or hCG in Stimulated Cycles / 대한불임학회지

OBJECTIVE: This study was designed to evaluate the effects of endogenous LH surge, GnRH agonist (GnRH-a) or human chorionic gonadotropin (hCG) as ovulation trigger on pregnancy rate by intrauterine insemination (IUI). METHOD: Patients received daily 100 mg of clomiphene citrate (CC) for 5 days stating on the third day of the menstrual cycle followed by human menopausal gonadotropin (hMG) for ovulation induction. Follicles larger than >16 mm in diameter were present in the ovary, frequent LH tests in urine were introduced to detect an endogenous LH surge. Final follicular maturation and ovulation were induced by GnRH-a 0.1 mg (s.c.) or hCG 5,000~10,000 IU (i.m.) administration except natural ovulation. Pregnancy was classified as clinical if a gestational sac or fetal cardiac activity was seen on ultrasound. RESULTS: There were no differences in age, duration of infertility and follicle size, but more ampules of hMG were used in GnRH-a group compared to hCG 10,000 IU treated group (p<0.05). Lower level of estradiol (E2) on the day of hCG or GnRH-a injection was observed in hCG 10,000 IU group than other treatment groups (p<0.01). The overall clinical pregnancy rate was 19.8% per cycle (32/162) and 22.2% per patient (32/144). Pregnancy rate was higher in natural-endogenous LH surge group (37.5%, 9/24) than GnRH-a (18.8%) or hCG treated group (20.9% & 13.9%), but this difference was not statistically significant. No patient developed ovarian hyperstimulation. Abortion rate was 22.2% (2/9) in hCG 5,000 IU group. Delivery or ongoing pregnancy rate was 37.5% (9/24), 18.8% (3/16), 16.3% (7/43) and 13.9% (11/79) in endogenous LH surge, GnRH-a, hCG 5,000 IU and hCG 10,000 IU treatment groups, respectively. CONCLUSION: These results support the concept that use of natural-endogenous LH surge in stimulated cycles may be more effective to obtain pregnancies by IUI than GnRH-a or hCG administration.

Sequential Clomiphene Citrate and FSH compared to Clomiphene Citrate and hMGon Pregnancy Rate in Intrauterine Insemination Cycles / 대한불임학회지

OBJECTIVE: To evaluate the effectiveness of CC+FSH or CC+hMG in intrauterine insemination (IUI) cycles for the treatment of infertility. METHOD: Patients received daily 100 mg of clomiphene citrate (CC) for 5 days followed by hMG or FSH. A single IUI was performed at 36 h after hCG. Clinical pregnancy was classified if a gestational sac or fetal cardiac activity was seen on ultrasound. RESULTS: The overall clinical pregnancy rate was 19.1% per cycle (17/89) and 21.5% per patient (17/79). More clinical pregnancies were recorded in CC+FSH (23.1%, 6/26) than CC+hMG cycles (17.5%, 11/63), but this difference was not statistically significant. No differences were found in age, duration of infertility, follicle size, levels of estradiol (E2) on the day of hCG injection and total motile sperm counts between pregnant and non-pregnant groups. However, more ampules of gonadotropins were used in pregnant group than non-pregnant group (p<0.05). CONCLUSION: Combination of CC and hMG may economically be more effective to induce ovulation for IUI compared to CC and FSH.