A study on the significant caries (SiC) index of Lao students / 대한구강보건학회지

Objective@#This study aimed to investigate the characteristics of the high-risk group for dental caries among 12- and 15-year-old children in Laos. @*Methods@#Oral health survey was conducted on 12-year-old (N=537) and 15-year-old (N=490) children in Laos. The oral examination data were listed from highest to highest based on the permanent caries experience index. Then the caries experience permanent index of the participants corresponding to the top third was calculated. In the final high-risk group, 179 and 163 children aged 12 and 15 years, respectively, were analyzed for the Significant Caries (SiC) Index. @*Results@#The Decayed, Missing and Filled Teeth (DMFT) index of 12-year-old children in Laos was 1.59 (urban area 1.72, rural area 1.46), and the SiC index of the high-risk group for dental caries was 3.93 (urban area 4.01, rural area 3.85). DMFT index of the 15-year-old group was 2.04 (2.37 in urban areas, 1.74 in rural areas), and the SiC index of the high-risk group for dental caries was 5.17 (5.90 in urban areas, 4.49 in rural areas). @*Conclusions@#Children aged 12 and 15 in the high-risk group for dental caries in Laos showed a higher caries experience permanence index than the overall average in the high-risk group. Based on the outcome of the investigation that the high-risk group had a lot of experience with dental caries, it is thought that the priority dental caries prevention project for the high-risk group of dental caries should be carried out.

In silico evaluation of the acute occlusion effect of coronary artery on cardiac electrophysiology and the body surface potential map

Body surface potential map, an electric potential distribution on the body torso surface, enables us to infer the electrical activities of the heart. Therefore, observing electric potential projected to the torso surface can be highly useful for diagnosing heart diseases such as coronary occlusion. The BSPM for the heart of a patient show a higher level of sensitivity than 12-lead ECG. Relevant research has been mostly based on clinical statistics obtained from patients, and, therefore, a simulation for a variety of pathological phenomena of the heart is required. In this study, by using computer simulation, a body surface potential map was implemented according to various occlusion locations (distal, mid, proximal occlusion) in the left anterior descending coronary artery. Electrophysiological characteristics of the body surface during the ST segment period were observed and analyzed based on an ST isointegral map. We developed an integrated system that takes into account the cellular to organ levels, and performed simulation regarding the electrophysiological phenomena of the heart that occur during the first 5 minutes (stage 1) and 10 minutes (stage 2) after commencement of coronary occlusion. Subsequently, we calculated the bipolar angle and amplitude of the ST isointegral map, and observed the correlation between the relevant characteristics and the location of coronary occlusion. In the result, in the ventricle model during the stage 1, a wider area of ischemia led to counterclockwise rotation of the bipolar angle; and, during the stage 2, the amplitude increased when the ischemia area exceeded a certain size.

Deletion of 20p13 and Duplication of 20p13p12.3 in a Patient with Delayed Speech and Development

No abstract available.

SCN1A Variants in Patients with Dravet Syndrome

PURPOSE: The aim of this study is to examine the SCN1A variants in Korean patients with Dravet syndrome. METHODS: We conducted a retrospective study of clinically confirmed thirty-nine patients with Dravet syndrome who visit our hospital from January 2007 to May 2015. We analyzed the SCN1A variants by direct sequencing. We analyzed and classified SCN1A variants according to ACMG/AMP (American College of Medical Genetics and Genomics and the Association for Molecular Pathology) guideline. RESULTS: A total thirty-nine patients (female 22, male 17) were included. Among them, twenty patients (51.2%) with Dravet syndrome had pathogenic or likely pathogenic SCN1A mutations including fifteen truncating mutations (12 nonsense and 3 splice region mutations), 5 missense mutations. The remained variants in nineteen patients with Dravet syndrome classified into ten variants of unknown significances, and 9 benign variants. In our study, truncation mutations are located whole span of SCN1A protein, while half of missense mutations are located at higher density on pore loop (S5-S6) regions. CONCLUSION: Unlike previous known study, lower positive rate of SCN1A mutation of Dravet syndrome was revealed in our study. The importance of parental test (trio test) and other additional tests have been emphasized.

SCN1A Variants in Patients with Dravet Syndrome

PURPOSE: The aim of this study is to examine the SCN1A variants in Korean patients with Dravet syndrome. METHODS: We conducted a retrospective study of clinically confirmed thirty-nine patients with Dravet syndrome who visit our hospital from January 2007 to May 2015. We analyzed the SCN1A variants by direct sequencing. We analyzed and classified SCN1A variants according to ACMG/AMP (American College of Medical Genetics and Genomics and the Association for Molecular Pathology) guideline. RESULTS: A total thirty-nine patients (female 22, male 17) were included. Among them, twenty patients (51.2%) with Dravet syndrome had pathogenic or likely pathogenic SCN1A mutations including fifteen truncating mutations (12 nonsense and 3 splice region mutations), 5 missense mutations. The remained variants in nineteen patients with Dravet syndrome classified into ten variants of unknown significances, and 9 benign variants. In our study, truncation mutations are located whole span of SCN1A protein, while half of missense mutations are located at higher density on pore loop (S5-S6) regions. CONCLUSION: Unlike previous known study, lower positive rate of SCN1A mutation of Dravet syndrome was revealed in our study. The importance of parental test (trio test) and other additional tests have been emphasized.

Performance of Matrix-Assisted Laser Desorption Ionization Time-of-Fight Mass Spectrometry for Rapid Discrimination of Methicillin-Resistant Staphylococcus aureus (MRSA): First Report of a Relation Between Protein Peaks and MRSA spa Type

No abstract available.

Perforator Based Tibialis Anterior Segmental Muscle Island Flap in Lower Extremity Reconstruction

Reconstruction of the lower extremities is difficult due to a lack of skin laxity and muscular tissues. Here, we present a case of lower extremity reconstruction via the anterior tibial artery perforator based segmental muscle island flap. Our patient was a 75-year-old male with a chronic ulcerative wound on the right lower leg from an old car accident. A 5.0×0.5 cm size ulcerative wound with tibial bone exposure was noted. We planned to reconstruct the lower extremity defect with a free flap, but the vessel status was severely compromised intraoperatively. Thus, we found the anterior tibial artery perforator using Doppler ultrasound, elevated the tibialis anterior muscle segment flap, and transposed it to cover the defect successfully. The flap presented with a nice contour and the skin graft covering the flap survived completely. There were no complications of the surgical site at three months follow-up and no gait morbidity. This is a meaningful case applying the concept of segmental muscle flap based on a perforator that had advantages including proper bulkiness, vascularization, and preservation of function, which were well applied, leading to great success.

The Keystone Flap in Greater Trochanter Pressure Sore

The keystone flap is a fascia-based island flap with two conjoined V-Y flaps. Here, we report a case of successful treatment of a trochanter pressure sore patient with the traditional keystone flap. A 50-year-old male patient visited our department with a 3×5 cm pressure sore (grade III) to the left of the greater trochanter that was covered with eschar. Debridement was done and the defect size increased to 5×8 cm in an elliptical shape. Doppler ultrasound was then used to locate the inferior gluteal artery perforator near the wound. The keystone flap was designed to the medial side. The perforator based keystone island flap covered the defect without resistance. The site remained clean, and no dehiscence, infection, hematoma, or seroma developed. In general, greater trochanter pressure sores are covered with a perforator based propeller flap or fascia lata flap. However, these flaps have the risk of pedicle kinking and require a large operation site. For the first time, we successfully applied the keystone flap to treat a greater trochanter pressure sore patient. Our design was also favorable with the relaxation skin tension lines. We conclude that the keystone flap including a perforator is a reliable option to reconstruct trochanteric pressure sores.

Persistent Bordetella petrii Infection Related to Bone Fractures

No abstract available.

Gemella morbillorum Infection after Acupuncture Therapy

No abstract available.

Intraparotid Facial Nerve Schwannoma

Intraparotid facial nerve schwannoma is a rare benign neoplasm. Due to its rarity, it is not usually a prioritized diagnosis before surgery and may therefore lead to an unintentional treatment error. In this article, we report a single case of intraparotid facial nerve schwannoma. We were able to make a diagnosis with frozen biopsy. A complete resection of the mass while preserving the facial nerve was performed. Herein we present our clinical experience with regards to the treatment process of intraparotid facial nerve schwannoma.

Antimicrobial Effects of Oleanolic Acid against Streptococcus mutans and Streptococcus sobrinus Isolated from a Korean Population

Oleanolic acid is a natural triterpenoid that exists widely in foods and some medicinal herbs. The purpose of this study was to determine the antimicrobial activity of oleanolic acid against Streptococcus mutans strains isolated from a Korean population. Antimicrobial activity against these bacteria was evaluated by minimal inhibitory concentration (MIC) and time kill curves. The tolerance of human gingival fibroblasts and human periodontal ligaments to oleanolic acid was tested using a methyl thiazolyl tetrazolium (MTT) assay. The MIC90 value of oleanolic acid for both S. mutans and S. sobrinus isolated from Koreans was 8 microg/ml. Oleanolic acid showed bactericidal effects against S. mutans ATCC 25175T and S. sobrinus ATCC 33478T at 1 x MIC (8 microg/ml) and had no cytotoxic effects against KB cells at this dose. The results suggest that oleanolic acid could be useful in the future development of oral hygiene products for the prevention of dental caries.

Effect of Progesterone on Cultured Human Dermal Fibroblast

PURPOSE: The mechanism of scar formation is not fully understood. Fibroblast is an important cell in wound healing process. We experienced a patient who was taking progesterone orally. Upper blepharoplasty was performed on her but, wound healing was delayed. We hypothesized that progesterone was the cause of delayed wound healing and fibroblast proliferation inhibition. We investigated the effect of progesterone in vitro on human dermal fibroblasts to study the effects on fibroblast proliferation. METHODS: Human dermal fibroblasts from four persons were cultured initially. Progesterone is mixed to them at various concentrations, and fibroblast cell count was measured by MTT assay method at 570nm. We confirmed that progesterone has some inhibitory effect on fibroblast proliferation and maximal inhibitory concentration of progesterone was determined. Then fibroblasts from a total of nineteen persons were cultured and the effects of progesterone were studied. RESULTS: The initial study showed the maximal inhibitory concentration of progesterone to be 50 microgram/ml. The main study showed that progesterone had 70.9% inhibitory effect on human dermal fibroblast in vitro. CONCLUSION: Progesterone has inhibitory effect on cultured human dermal fibroblast proliferation in vitro.

Gluteal Perforator Flaps for Coverage of Sacral Pressure Sores

PURPOSE: Gluteal perforator is easily identified in the gluteal region and gluteal perforator flap is a very versatile flap in sacral sore reconstruction. We obtained satisfying results using the gluteal perforator flap, so we report this clinical experiences with a review of the literature. METHODS: Between November of 2003 and April 2006, the authors used 16 gluteal perforator flaps in 16 consecutive patients for coverage of sacral pressure sores. The mean age of the patients was 47.4 years (range, 14 to 78 years), and there were 9 male and 7 female patients. All flaps in the series were supplied by musculocutaneous arteries and its venae comitantes penetrating the gluteus maximus muscle and reaching the intrafascial and suprafascial planes, and the overlying skin forming a rich vascular plexus arising from gluteal muscles. Patients were followed up for a mean period of 11.5 months. RESULTS: All flaps survived except one that had undergone total necrosis by patient's negligence. Wound dehiscence was observed in three patients and treated by secondary closure. There was no recurrence during the follow-up period. CONCLUSION: Gluteal perforator flaps allow safe and reliable options for coverage of sacral pressure sores with minimal donor site morbidity, and do not sacrifice the gluteus maximus muscle and rarely lead to post- operative complications. Freedom in flap design and easy-to perform make gluteal perforator flap an excellent choice for selected patients.

Training of Microanastomosis with Chicken Wing Brachial Artery

PURPOSE: Microsuturing is a difficult job for beginners of microsurgery. It is because they are not familiar with microscopic environment and, it needs much time for them to get used to microanastomosis. Before the real microsurgery, sometimes a surgeon wants rehearsal. But, microsurgical exercise has been performed with surgical glove, silastic drain or rat femoral artery. Rat femoral artery is a very good training material. But, it needs animal laboratory, anesthesia and its keeping facilities. And the surgeon should appoint the time to exercise with the laboratory. METHODS: We used chicken wing brachial artery for education material of microsuturing. The artery is 5cm long and the diameter is about 1mm. Monofilament 10-0 was used for suture material. RESULTS: Six persons of Seoul National University medical school students and one resident attended in this program. Each of them performed arterial anastomosis ten times. They were satisfied with chicken wing brachial artery for anastomosis training under the magnification environment. CONCLUSION: We think that chicken wing brachial artery is a very cheap and an effective training material for the beginners of microsurgery.

Case Report of Verrucous Carcinoma Arising in Sacral Pressure Sore

PURPOSE: Verrucous carcinoma is a rare, low-grade and well-differentiated squamous cell carcinoma, representing as a warty tumor. Estimation of the incidence for cutaneous lesions is not available because they are rare. We describe a case of verrucous carcinoma, a rare type, complication of a chronic pressure ulcer of duration more than 15 years. METHODS: A 17-year-old boy presented with a large lesion involving the sacral area, which had been neglected for about 15 years. He had a history of surgical extirpation 2 years ago, but not cured. Examination revealed a cauliflower-like mass arising from an irregularly oval-shaped tumor which was 6.0x4.5cm in size with signs of infection and ulcer. The lesion involved the sacrococcygeal area, spreading to both medial gluteal regions. The perianal skin did not appear to be directly affected. RESULTS: A preoperative punch biopsy revealed a extremely well differentiated verrucous carcinoma. There were positive results in immunohistochemistry in the items of p53, p63, Ki-67. An 'en-bloc' excision of the tumor with the clinically normal surrounding tissue was carried out. Reconstruction was achieved by local regional flap. Histopathological findings of the excised area fully confirmed the preoperative biopsy report. It remained free of recurrence for a period of about 8 months. CONCLUSION: We believe that in patients with buttock involvement, regardless of the extent of such tumors, surgical therapy should be considered as the first-choice of treatment as reconstruction can be performed without excessive impairment for the patient.

Treatment of Buffalo Hump Using Liposuction

Buffalo hump is a manifestation of Cushing's syndrome. Herb medicine is popular in Korea, and it might cause Cushing's syndrome. Using power-assisted liposuction device, we treated a woman with buffalo hump deformity due to herb medication for 2 years. The histologic study of hump was normal fat cell. So, the hump can be removed easily using liposuction, and it may be an effective method to treat the facial and cervical deformity in Cushing's syndrome.

3-Dimensional Model Simulation Craniomaxillofacial Surgery using Rapid Prototyping Technique

In plastic and reconstructive craniomaxillofacial surgery, careful preoperative planning is essential to get a successful outcome. Many craniomaxillofacial surgeons have used imaging modalities like conventional radiographs, computed tomography(CT) and magnetic resonance imaging(MRI) for supporting the planning process. But, there are a lot of limitations in the comprehension of the surgical anatomy with these modalities. Medical models made with rapid prototyping (RP) technique represent a new approach for preoperative planning and simulation surgery. With rapid prototyping models, surgical procedures can be simulated and performed interactively so that surgeon can get a realistic impression of complex structures before surgical intervention. The great advantage of rapid prototyping technique is the precise reproduction of objects from a 3-dimensional reconstruction image as a physical model. Craniomaxillofacial surgeon can establish treatment strategy through preoperative simulation surgery and predict the postoperative result.

Dressing with a Splint in Osmidrosis

For the surgical treatment of osmidrosis with subdermal excision in adolescent patients, immobilization of the axilla after the surgery is very important to prevent hematoma. Skin necrosis may occur when hematoma develops in the axilla after subdermal shaving. However, in case of young patients, they cannot maintain immobilization of the axilla after surgery for a long time, so they are relatively vulnerable to skin necrosis of the axilla due to hematoma after surgery. We used Yogips(R) splint for the dressing in 21 patients from January, 2002 to December, 2002 in our institute to prevent hematoma. The control group was composed of 46 patients only with tie-over dressing after subdermal excision for the dressing. We compared the incidence of hematoma 5 days after the surgery with that of the control group. There was no evident hematoma observed in the patients with Yogips(R)splint, but in case of the control group, hematoma developed in 16 patients of total 46 patients(33%). In this 16 patients with hematoma, 12 patients(75%) were adolescents. In conclusion, the dressing with a Yogips(R)splint seems to be a good method for immobilization of axilla and preventing hematoma after subdermal excision in young patients with osmidrosis.

Palatoplasty with AlloDerm(R) Graft

Recently, Furlow's palatoplasty, intravelar veloplasty and other procedures have become popular for cleft palate. However, the push-back method holds an important position among the various palatoplasties because it is safe and reliable. Previous reports have shown that normal or nearly normal speech is attained in between 70 and 90 percent of the patients of push-back method. Early palatoplasty might influence maxillary growth more than late palatoplasty. There are some problems after operation of push-back method. The raw surface causes bleeding, pain, poor oral intake, growth interference for scar contracture and tension on central suture line. This lateral defect can be closed directly but tension on central suture area is increased, and the risk of wound dehiscence is increased. We used AlloDerm(R) graft for covering of this bony exposed raw surface on both lateral palatal area. Thus exposed surface was protected by AlloDerm(R) graft and then patient suffered from pain less than conventional method. The bony surface was compressed by AlloDerm(R) and bleeding was not found after AlloDerm(R) graft. Patient was not irritable and intake of patient was good after operation. The recovery was faster than conventional push-back method.