Porphyromonas gingivalis is strongly implicated in the pathogenesis of adult periodontitis, the major cause of tooth loss in adults. Use of an antibacterial agent controlling P. gingivalis as a periodontal therapeutic agent has been rationalized. The present study was performed to observe the antibacterial effect of inorganic polyphosphates (polyP) on P. gingivalis. P. gingivalis 2561 was grown in half-strength brain-heart infusion broth containing hemin and vitamin K with or without polyP. Minimal inhibitory concentration (MIC) of polyP with various chain lengths was determined by measuring the absorbance of the grown cells at 540 nm. MIC of polyP for the bacterium was determined to be 0.05%. The effect of polyP with a chain length of 75 (polyP 75) was further examined. PolyP 75 added to the growing culture of P. gingivalis at its exponential phase was as effective in inhibiting the growth of P. gingivalis as polyP 75 added at the very beginning of the culture. More than 99% of the cells lost their viability determined by viable cell count when polyP 75 was added to the culture of growing P. gingivalis at the concentration of 0.06%, suggesting that polyP 75 has a bactericidal effect on the bacterium. Intracellular nucleotide release from the cells was increased by approx. 20% in the presence of polyP 75 but was not reversed by the addition of divalent cations like Ca++ and Mg++. Under the transmission electron microscope, only a small number of the growing P. gingivalis cells were actually lysed. However, the majority of the cells appeared to be atypical in their shape, demonstrating accumulation of highly electron-dense granules and bodies of condensed nucleic acid-like material in the cytoplasm. In the presence of polyP 75, the protein profile of P. gingivalis was changed as determined by SDS-polyacrylamide gel electrophoresis and immunoblot, and the proteolytic activity of the bacterium demostrated on the zymograms was decreased. The overall results suggest that polyP have a strong bactericidal activity against P. gingivalis in which lysis in relation to chelation may not play the major role but unknown mechanism that possibly affects the viability of the bacterium may be involved. PolyP may be used as an agent for prevention and treatment of periodontitis.
Adult ; Cations, Divalent ; Cell Count ; Chronic Periodontitis ; Cytoplasm ; Electrophoresis ; Hemin ; Humans ; Periodontitis ; Polyphosphates* ; Polyps ; Porphyromonas gingivalis* ; Porphyromonas* ; Tooth Loss ; Vitamin K

BACKGROUND: Urinary tract infections (UTIs) are the most frequent nosocomial infections and are frequently associated with indwelling urinary catheters. It is known that adherence to standard infection control measures for urinary catheters can reduce UTIs in hospitals. This study was performed to evaluate the effect of education in reducing catheter-related UTIs (CR-UTIs) in intensive care units (ICUs) of a university hospital. METHODS: CR-UTIs were prospectively monitored for all patients with indwelling urinary catheters in ICUs from July 2006 through December 2007. Recommendations based on previously known guidelines for catheter insertion, catheter management, and specimen collection to prevent CR-UTIs were formulated and educated in March 2007. Knowledge and adherence level were evaluated before and after educating healthcare workers about the recommendations using questionnaire. Changes in knowledge and adherence level before and after education were compared by Chi-square test. Changes in the rate of CR-UTIs and urinary catheter utilization ratios were also analyzed by Fisher's exact test. RESULTS: After education, knowledge level of and adherence level to most of the recommendations were improved significantly. The rate of CR-UTIs significantly decreased by 48% from 7.43/1,000 catheter-days before intervention to 3.87/1,000 catheter-days after intervention (P=0.02). CONCLUSION: Surveillance for nosocomial infections and education for standard infection control measures are very important in preventing CR-UTIs in ICUs.
Catheters ; Cross Infection ; Delivery of Health Care ; Humans ; Infection Control ; Critical Care ; Intensive Care Units ; Prospective Studies ; Specimen Handling ; Urinary Catheterization ; Urinary Catheters ; Urinary Tract ; Urinary Tract Infections ; Surveys and Questionnaires

Objectives: . Although unilateral hearing loss (UHL) has been proven to be associated with educational and behavioral problems, few studies have investigated psychopathological abnormalities in this population. The aim of this study was to evaluate the psychopathological influence of UHL among Korean 19-year-old males. Methods: . The authors retrospectively compared the objective personality test profiles of 602 subjects with UHL with those of 23,790 peers with normal hearing. All participants in the current study were 19-year-old males who underwent a physical examination and completed the Korean Military Multiphasic Personality Inventory for conscription at the Military Manpower Administration from February 2015 to December 2016. Results: . Significantly higher scores were found on neurosis scales in the UHL group than in the normal-hearing group (50.9± 10.8 vs. 44.9±6.0 for anxiety; 51.0±10.5 vs. 44.9±5.2 for depression; 51.1±10.4 vs. 45.1±6.81 for somatization, all P<0.001). The psychopathy scales were also significantly higher in the UHL group than in the normal-hearing group (49.3±9.4 vs. 46.3±5.7 for schizophrenia; 51.1±11.2 vs. 44.3±5.8 for personality disorders; 51.1±10.5 vs. 45.7±3.7 for paranoia, all P<0.001). Conclusion . Nineteen-year-old males with UHL tended to have more abnormal results on personality tests than controls with normal hearing, suggesting that UHL may be related with a higher risk of psychopathology.

BACKGROUND: Postoperative nausea and vomiting (PONV) commonly occur after general anesthesia, especially in women. In this study, we evaluated the antiemetic efficacy of propofol administered at the end of surgery in highly susceptible patients undergoing a laparoscopy-assisted vaginal hysterectomy. METHODS: A total of 107 women undergoing a laparoscopy-assisted vaginal hysterectomy under general anesthesia were enrolled for this prospective, double-blind, randomized study. Fifteen minutes before the end of surgery, all patients received 50 microg fentanyl and 1 of following 3 doses; 0.5 mg/kg of propofol (propofol 0.5 group), 1 mg/kg of propofol (propofol 1.0 group), and normal saline (control group). All patients received intravenous patient-controlled analgesia (PCA). Emergence time, a visual analog scale for pain and nausea, duration of postanesthesia care unit (PACU) stay, and frequency of antiemetic use were recorded at 0-2, 2-24, and 24-48 hours postoperatively. RESULTS: The incidence of nausea significantly lower in the propofol 0.5 and propofol 1.0 groups than in the control group (12.1 vs 14.7 vs 40%). During the first postoperative 2 hours, antiemetics were less frequently administered in the propofol 0.5 and propofol 1.0 groups than in the control group (3.0 vs 5.9 vs 22.5%). Emergence time was slightly longer in the propofol 0.5 and propofol 1.0 groups than in the control group, but there was no significant difference in PACU stay time was observed between the 3 groups. CONCLUSIONS: The results of this study suggest that low-dose propofol administration at the end of surgery may effectively reduce the incidence of PONV within 2 hours postoperatively in highly susceptible women undergoing a laparoscopiy-assisted vaginal hysterectomy and receiving opioid-based PCA.
Analgesia, Patient-Controlled ; Anesthesia, General ; Antiemetics* ; Female ; Fentanyl ; Humans ; Hysterectomy, Vaginal* ; Incidence ; Laparoscopy ; Nausea ; Passive Cutaneous Anaphylaxis ; Postoperative Nausea and Vomiting ; Propofol* ; Prospective Studies ; Visual Analog Scale

Abdominal actinomycosis is a rare and chronic progressive disease, especially in children. Clinically, it has non-specific symptoms and diagnostic findings as well as low prevalence, making it very difficult to diagnose prior to intraoperative pathological confirmation. For this reason, abdominal actinomycosis is commonly misdiagnosed as appendicitis. After the histopathological diagnosis of abdominal actinomycosis is made, patients should be administered an appropriate antibiotic such as penicillin. Here we describe a case of appendiceal actinomycosis in an 18-year-old girl who was initially diagnosed with acute appendicitis.
Actinomycosis* ; Adolescent ; Appendiceal Neoplasms ; Appendicitis* ; Child ; Diagnosis ; Female ; Humans ; Penicillins ; Prevalence

BACKGROUND: Intravenous administration of rocuronium induces intense pain in most patients (60-100%). This could be harmful during anesthesia induction because of the unintended reflex movement of an unconscious patient in response to the pain. Previous studies have reported that remifentanil effectively reduces rocuronium-induced pain and withdrawal movements. This study was designed to evaluate the EC50 and EC95 of remifentanil to prevent withdrawal movements in children. METHODS: We enrolled a total of 171 pediatric patients scheduled for general anesthesia in this study. Remifentanil was administrated by target-controlled infusion. Effect-site target concentrations ranged from 0.5 to 3.0 ng/ml. At each concentration, experiments were repeated in 10-20 patients. Propofol 2 mg/kg and rocuronium 0.9 mg/kg were administrated after equilibration of plasma and effect-site target remifentanil concentration. The withdrawal movements were graded on a 4-point scale. The EC50 and EC95 of remifentanil to prevent rocuronium-induced withdrawal movements were determined by using a logistic regression model. RESULTS: The logistic regression model showed that the probability of preventing rocuronium-induced withdrawal movement was as follows: exp (-3.49 + 2.07 x remifentanil concentration) / (1 + exp [-3.49 + 2.07 x remifentanil concentration]). EC50 and EC95 were 1.69 ng/ml (95% confidence intervals [CIs], 1.42-1.87) and 3.11 ng/ml (95% CIs, 2.79-3.72), respectively. CONCLUSIONS: Administration of remifentanil at an effect-site target concentration of 3.1 ng/ml could effectively prevent rocuronium-induced withdrawal movements.
Administration, Intravenous ; Anesthesia ; Anesthesia, General ; Child* ; Humans ; Logistic Models ; Pediatrics ; Plasma ; Propofol ; Reflex

Along with the enactment of a law separating the prescribing and dispensing of drugs in Korea in 2000, attempts at reducing medical expenses by generic substitution have been allowed since August 2001 so long as generic products are bioequivalent to the original products. In the pharmaceutical industry, the required development and investment to make generic products are much less in terms of time and money. Thus, the number of bioequivalence studies in Korea has increased. This has resulted in the need for bioequivalence recommendations (guidelines), taking into account the circumstances of the Korean pharmaceutical industry. In this paper, we provide procedures for making bioequivalence determinations for individual products acting on the circulatory system (30 drugs, 2011), the components of which are widely accepted for the development of generic products in Korea. These recommendations correspond with international guidelines, such as those of the US FDA and EMEA. For the 30 drugs that act on the circulatory system, we examined each in terms of subject selection (healthy volunteers vs. patients), dosage strength, dosage route, analytes to measure, and evaluation parameters, and prepared bioequivalence recommendations for individual products through an analysis of many published papers, US FDA and EMEA guidelines, and clinical trial websites. Based on the bioequivalence recommendations for individual products, we had several meetings in which KFDA officers (members of the New Drug Research team and the Office of Generic Drugs), three pharmacy professors with expertise in drug analysis and pharmacokinetics, and three professors of medicine with extensive experience in clinical trials participated to confirm and discuss the contents. Finally, the bioequivalence recommendations for individual products were provided on the KFDA website. The individual bioequivalence recommendations have been used by KFDA officers in drug evaluations and bioequivalency testing to improve consistency, clarity, and professionalism in the drug evaluation process. These recommendations will be useful for domestic pharmaceutical companies by shortening the time and cost associated with bioequivalence studies, especially in terms of standardized trial designs, dosage forms, and analytical methods.
Dosage Forms ; Drug Evaluation ; Drug Industry ; Drug Substitution ; Drugs, Generic ; Investments ; Jurisprudence ; Korea ; Pharmacy ; Therapeutic Equivalency

BACKGROUND: There is a clinical need for a simpler measurement of global cardiac function incorporating elements of both systole and diastole. Doppler time index is theoretically regarded as a sensitive index of global left ventricular perfomance and defined as the sum of isovolumetric contraction time (IVCT) and isovolumetric relaxation time (IVRT) divided by ejection time (ET). This study was designed to determine the clinical usefulness of the Doppler time index in patients with left ventricular diastolic dysfunction as well as systolic dysfunction. METHODS: The study population consisted of 23 patients with hypertension as a diastolic dysfunction group, 16 patients with low ejection fraction as a systolic dysfunction group and 31 subjects with normal LV function. The ejection fraction (EF) was measured using M-mode echocardiography. Doppler profiles such as IVCT, IVRT and ET were obtained from Doppler echocardiography. The Doppler time index [ (IVCT+RT)/ET] was calculated from each Doppler velocity profiles. RESULTS: IVRT, IVRT/ET and (IVCT+VRT)/ET were significantly increased in the diastolic dysfunction group (120.5+/-19.5 msec, 0.45+/-0.1, 0.64+/-0.2, respectively:p<0.001, p<0.001, p<0.001, respectively) compared with normal subjects (66.1+/-17.4 msec, 0.25+/-0.0, 0.41+/-0.1). IVCT and IVRT were significantly increased and ET was significantly shortened in systolic dysfunction group (75.4+/-25.7, 144.0+/-39.5 msec, 242.7+/-46.5 msec respectively:p<0.001, p<0.05, p<0.05, respectively) compared with diastolic dysfunction group (50.4+/-23.0 msec, 120.5+/-19.5 msec, 276.8+/-44.6 msec, respectively). IVCT/ET, IVRT/ET and (IVCT+IVRT)/ET also were increased in patients with systolic dysfunction group (0.32+/-0.1, 0.61+/-0.2, 0.93+/-0.2 respectively:p<0.01, p<0.01, p<0.001, res-pectively) compared with diastolic dysfunction group (0.19+/-0.1, 0.45+/-0.1, 0.64+/-0.2). Ejection fraction calculated by M-mode parameters was significantly correlated with (IVCT+IVRT)/ET (correlation coefficient - 0.605, p<0.001). CONCLUSION: The Doppler time index was significantly difficient from normal subjects in patients with isolated LV diastolic dysfunction as well as in those with systolic dysfunction. Thus, this index can be used as a sensitive indicator of myocardial performance.
Diastole ; Echocardiography ; Echocardiography, Doppler ; Humans ; Hypertension ; Relaxation ; Systole ; Ventricular Dysfunction, Left

Salmonellae have been recognized as uncommon etiological organisms causing osteomyelitis in patients with sickle cell anemia and other immunocompromised conditions. A 34-year old man who had no underlying illness except for congenital block vertebrae at T10-11 vertebrae was admitted to the hospital due to lower back pain and fever for a week. Vertebral osteomyelitis was diagnosed and surgical drainage was performed. Salmonella enterica serovar Othmarschen was isolated from the drained pus. Therapy with ciprofloxacin for 8 weeks was successful without relapse. We describe here a case of vertebral osteomyelitis which was caused by S. Othmarschen in an immunocompetent patient.
Anemia, Sickle Cell ; Ciprofloxacin ; Drainage ; Fever ; Humans ; Low Back Pain ; Osteomyelitis ; Recurrence ; Salmonella ; Salmonella enterica ; Spine ; Suppuration

Salmonellae have been recognized as uncommon etiological organisms causing osteomyelitis in patients with sickle cell anemia and other immunocompromised conditions. A 34-year old man who had no underlying illness except for congenital block vertebrae at T10-11 vertebrae was admitted to the hospital due to lower back pain and fever for a week. Vertebral osteomyelitis was diagnosed and surgical drainage was performed. Salmonella enterica serovar Othmarschen was isolated from the drained pus. Therapy with ciprofloxacin for 8 weeks was successful without relapse. We describe here a case of vertebral osteomyelitis which was caused by S. Othmarschen in an immunocompetent patient.
Anemia, Sickle Cell ; Ciprofloxacin ; Drainage ; Fever ; Humans ; Low Back Pain ; Osteomyelitis ; Recurrence ; Salmonella ; Salmonella enterica ; Spine ; Suppuration