Objectives: This study investigated the contents and structure of chapters on oral health to determine the quality of middle and high school health textbooks. We also comparatively analyzed the learning objectives of these textbooks according to the oral health curriculum proposed by the Virginia Department of Health (VDH) and South Carolina Department of Education (SCDE). Methods: The structure and educational contents of eight health textbooks (middle school, five; high school, three) published in 2019 were analyzed methodologically. We compared the structure and contents between the middle and high school curricula. We also carried out comparisons among five publishing companies. Results: Of the eight health textbooks examined, five (middle school, four; high school, one) had chapters on oral health. In terms of structure, textbooks published by company A had the lowest percentage (0.96%) of pages on oral health. The highest percentage (1.50%) was found in a middle school textbook published by company D. We noted subject-level differences between the curriculum proposed by VDH, SCDE, and that of the published textbooks. There were more keywords pertaining to the definition and development of oral diseases than those for its prevention and management. Conclusions It is critically important to impart oral health education to middle and high school students for self-management of oral health during adolescence, a period characterized by both rapid physical and psychological development. Therefore, we recommend that all health textbooks should include chapters on oral health. Further, in the health textbooks that already include oral health information, we propose that the revised curricula should include key learning objectives.

Left atrial dissection is one of extremely rare complications associated with mitral valve surgery. We reported a case of left atrial dissection, which was developed after mechanical mitral valve replacement and was demonstrated by transesophargeal echocardiography. The cause of dissection was due to excessive traction of left atrial endocardial layer during surgery.
Echocardiography ; Echocardiography, Transesophageal* ; Heart Atria ; Mitral Valve* ; Traction

BACKGROUND: Coronary flow reserve (CFR) was defined as the ability to increase coronary blood flow maximally in response to demand. The presence of viable myocardium in an infarcted zone indicates the presence of an intact microvasculature. We hypothesized that coronary flow reserve, which assesses the microcirculation, might be associated with the presence of viable myocardium. METHODS: Thirty seven patients with acute anterior myocardial infarction (mean age 55+/-10, 25 males) were enrolled and abnormal 127 segments were analyzed. Dobutamine stress echocard-iography (5 to 20 g/kg/min) was performed before coronary angiography (6+/-3 days after acute myocardial infarction (AMI)). Coronary flow reserve in infarct-related artery was measured at distal site to lesion immediately after successful angioplasty (7+/-2 days after AMI, with residual stenosis less than 20%) by using intracoronary Doppler flow wire. And follow-up 2-dimentional transthoracic echocardiography was performed in 26 patients during 333+/-161 (range of 109-780) days after acute myocardial infarction. Improvement of wall motion at least one segment by one more grade in dobutamine stress echocardiography was defined as contractile reserve. Viable myocardium was defined as the improvement of wall motion in transthoracic echocardiography during follow-up periods. RESULTS: In 26 patients, viable myocardium was detected in 19 patients (73%) and their mean CFR was 1.74+/-0.42, which was significantly increased than 1.16+/-0.14 of CFR of patients without viable myocardium (p<0.001). The agreement of CFR score and presence of viable myocardium in AMI was excellent when CFR was above 1.3 (Area under the curve was 0.906 in receiver operating characteristic (ROC) curve). Sensitivity and specificity to detect viable myocardium in CFR more than 1.3 were 84% & 85% respectively. CONCLUSION: CFR was increased in patients with viable myocardium, and the cut-off value of CFR more than 1.3 was agreed excellently to detect viable myocardium.
Angioplasty ; Arteries ; Constriction, Pathologic ; Coronary Angiography ; Dobutamine ; Echocardiography ; Echocardiography, Stress ; Follow-Up Studies ; Humans ; Microcirculation ; Microvessels ; Myocardial Infarction* ; Myocardium* ; ROC Curve ; Sensitivity and Specificity

BACKGROUND: Stress echocardiography have been emerged as an important non-invasive diagnostic tool to detect coronary artery disease. Previous studies indicated that adenosine triphosphate(ATP) is a potent coronary vasodilator as adenosine, the time of action onset and half-life is shorter than dipyridamole, the duration of adverse effect is transient and the use of aminophylline is not needed when side effects develop. The purpose of this study was to evaluate the feasibility and diagnostic accuracy of ATP stress echocardiography in patient with suspected coronary artery disease. METHOD: We investigated 20 patients(mean age 56+/-11, male 11, female 9) who underwent stress echocardiography with ATP infusion(0.15 mg/kg/min for 4 min) and quantitative coronary angiography(QCA). The digitized echocardiographic images were analyzed using wall motion score(1: normal, 2: hypokinesia, 3: akinesia, 4: dyskinesia) in 16 segments. Positivity of ATP stress echocardiography was based on the detection of transient regional wall motion abnormality. The hemodynamic changes and occurrence of adverse effects was carefully monitored. RESULTS: Forteen out of 20 patients had coronary artery disease(>50% diameter stenosis by QCA). Nine out of 14 patients had transient regional wall motion abnormality at coronary artery disease territory(sensitivity 64%). The mean wall motion score index in patients mth positive test was 1.01+0.01 at base and 1.20+0.08 during ATP infusion(p<0.05). Six out of 20 patients who had no regional wall motion abnormality had no coronary artery disease (specificity 100%) with overall diagnostic accuracy of 75%. ATP stress echocardiography showed good agreernent with QCA(kappa value 0.52). Side effect profile revealed chest pain in 6 patients(30%), facial flushing in 3 patients(15%), Wenchebach type AV block in 2 patients(10%) and significant ST-segrnent depression in 1 patients(5%). The mean heart rate, mean systolic and diastolic blood pressure, and mean rate-pressure product were not changed significantly. CONCLUSION: ATP stress echocardiography is feasible and has a diagnostic value similar to that of adenosine and dipyridamole for detecting coronary artery disease with low cost. In addition, it may have minimal side effects and insignificant clinical consequences.
Adenosine Triphosphate* ; Adenosine* ; Aminophylline ; Atrioventricular Block ; Blood Pressure ; Chest Pain ; Constriction, Pathologic ; Coronary Artery Disease ; Coronary Vessels ; Depression ; Dipyridamole ; Echocardiography ; Echocardiography, Stress* ; Female ; Flushing ; Half-Life ; Heart Rate ; Hemodynamics ; Humans ; Hypokinesia ; Male

The effects of oxidized low-density lipoprotein (OxLDL) and its major lipid constituent lysophosphatidylcholine (LPC) on Ca2+ entry were investigated in cultured human umbilical endothelial cells (HUVECs) using fura-2 fluorescence and patch-clamp methods. OxLDL or LPC increased intracellular Ca2+ concentration ([Ca2+]i), and the increase of [Ca2+]i by OxLDL or by LPC was inhibited by La3+ or heparin. LPC failed to increase [Ca2+]i in the presence of an antioxidant tempol. In addition, store-operated Ca2+ entry (SOC), which was evoked by intracellular Ca2+ store depletion in Ca2+-free solution using the sarcoplasmic reticulum Ca2+ pump blocker, 2, 5-di-t-butyl-1, 4-benzohydroquinone (BHQ), was further enhanced by OxLDL or by LPC. Increased SOC by OxLDL or by LPC was inhibited by U73122. In voltage-clamped cells, OxLDL or LPC increased [Ca2+]i and simultaneously activated non-selective cation (NSC) currents. LPC-induced NSC currents were inhibited by 2-APB, La3+ or U73122, and NSC currents were not activated by LPC in the presence of tempol. Furthermore, in voltage-clamped HUVECs, OxLDL enhanced SOC and evoked outward currents simultaneously. Clamping intracellular Ca2+ to 1 micrometer activated large-conductance Ca2+-activated K+ (BKCa) current spontaneously, and this activated BKCa current was further enhanced by OxLDL or by LPC. From these results, we concluded that OxLDL or its main component LPC activates Ca2+-permeable Ca2+-activated NSC current and BKCa current simultaneously, thereby increasing SOC.
Constriction ; Cyclic N-Oxides ; Endothelial Cells ; Estrenes ; Fluorescence ; Fura-2 ; Heparin ; Humans ; Lipoproteins ; Lipoproteins, LDL ; Lysophosphatidylcholines ; Pyrrolidinones ; Sarcoplasmic Reticulum ; Spin Labels

BACKGROUND/AIMS: The co-occurrence of obesity aggravates asthma symptoms. Diet-induced obesity increases helper T cell (TH) 17 cell differentiation in adipose tissue and the spleen. The 3-hydroxy-3-methylglutaryl-coenzyme A reductase inhibitor pravastatin can potentially be used to treat asthma in obese patients by inhibiting interleukin 17 (IL-17) expression. This study investigated the combined effects of pravastatin and anti-IL-17 antibody treatment on allergic inflammation in a mouse model of obesity-related asthma. METHODS: High-fat diet (HFD)-induced obesity was induced in C57BL/6 mice with or without ovalbumin (OVA) sensitization and challenge. Mice were administered the anti-IL-17 antibody, pravastatin, or both, and pathophysiological and immunological responses were analyzed. RESULTS: HFD exacerbated allergic airway inflammation in the bronchoalveolar lavage fluid of HFD-OVA mice as compared to OVA mice. Blockading of the IL-17 in the HFD-OVA mice decreased airway hyper-responsiveness (AHR) and airway inflammation compared to the HFD-OVA mice. Moreover, the administration of the anti-IL-17 antibody decreased the leptin/adiponectin ratio in the HFD-OVA but not the OVA mice. Co-administration of pravastatin and anti-IL-17 inhibited airway inflammation and AHR, decreased goblet cell numbers, and increased adipokine levels in obese asthmatic mice. CONCLUSIONS: These results suggest that the IL-17–leptin/adiponectin axis plays a key role in airway inflammation in obesity-related asthma. Our findings suggest a potential new treatment for IL-17 as a target that may benefit obesity-related asthma patients who respond poorly to typical asthma medications.
Adipokines ; Adipose Tissue ; Animals ; Asthma* ; Bronchoalveolar Lavage Fluid ; Cell Differentiation ; Diet, High-Fat ; Goblet Cells ; Humans ; Inflammation* ; Interleukin-17 ; Mice ; Obesity ; Ovalbumin ; Ovum ; Oxidoreductases ; Pravastatin ; Respiratory Hypersensitivity ; Spleen

Isolation rearing (IR) enhances aggressive behavior, and the central serotonin (5-hydroxytryptamine, 5-HT) system has been linked to IR-induced aggression. However, whether the alteration of central serotonin is the cause or consequence of enhanced aggression is still unknown. In the present study, using mice deficient in central serotonin Tph2 and Lmx1b, we examined the association between central serotonin and aggression with or without social isolation. We demonstrated that central serotonergic neurons are critical for the enhanced aggression after IR. 5-HT depletion in wild-type mice increased aggression. On the other hand, application of 5-HT in Lmx1b mice inhibited the enhancement of aggression under social isolation conditions. Dopamine was downregulated in Lmx1b mice. Similar to 5-HT, L-DOPA decreased aggression in Lmx1b mice. Our results link the serotoninergic system directly to aggression and this may have clinical implications for aggression-related human conditions.