As the morbidity of chronic diseases such as diabetes and high blood pressure has increased, the frequency of oral dryness upon taking drugs for a long time or several drugs at the same time has greatly increased. This study was conducted to investigate the status of oral dryness and utilize the data to develop treatment products. Surveys were assembled from October to December 2018, and a statistical analysis of the 144 responses was conducted. The surveyed consisted of 60 males and 84 females, with 31.3% of those in their 70s and older. Among them, 100 people took drugs for chronic diseases, while 27 people took drugs for more than 10 years and less than 20 years. Exactly 23 respondents who took drugs suffered from more than two types of chronic diseases, of which high blood pressure was the most cited, followed by hyperlipidemia and diabetes. Regarding complications, oral dryness (33.8%) was the most frequent, and there were significant differences in the degree of discomfort when taking medicine, especially for oral dryness depending on the age (P＜0.05). Groups that took medicine showed severe symptoms of dry mouth, especially when waking up at night or in the morning (P＜0.001) and eating food (P＜0.01), and had difficulty in swallowing food (P＜0.01) and speaking (P＜0.01). Exactly 89.6% of the respondents didn’t take lozenges (candy) for improvement of oral dryness, and the type of the product that they wanted to purchase the most was candy (45.1%). Respondents worried about rising blood sugar, dental caries, and calories when eating candy for relieving dryness (P＜0.01).

Biofilms are commonly associated with an increased risk of catheter-associated infection. To study the efficacy of materials designed to reduce biofilm formation, microbial biofilms on clinically used urinary catheter were examined. We performed 2, 3-bis (2-methyoxy-4-nitro-5-sulfo-phenyl)-2H-tetrazolium-5-carboxanilide (XTT) reduction assay to determine of biofilm formation ability and observed with scanning electron microscopy (SEM) to analyze biofilm architecture. Additionally, we calculated relative cell surface hydrophobicity (CSH) to measure hydrophobicity of microorganisms. On SEM, catheter surfaces made of latex or anti-infective (IC)-latex were rough but those of silicone, hydrogel-coated silicone (HCS), or silver-alloy-coated silicone (SCS) were relatively smoother. According to XTT reduction assay, biofilm formation was reduced on the surface of smooth silicone-based catheters compared to rough latex-based catheters. The greatest to lowest formation of microbial biofilm were as follows for these material types: silicone-elastomer-coated (SEC) latex > latex > silicone > IC-latex > HCS > SCS. Catheter materials can affect the microbial biofilm formations. First, rougher surfaces on the catheter made the microbial attachment easier and a greater amount of biofilm was formed. Second, when chemicals that inhibit growth and attachment of microorganisms on the inner and outer surfaces of the catheters were applied, the biofilm formation was inhibited. SCS was found to be the most effective in reducing the microbial biofilm formation. These results indicate that microbial biofilm formation may be closely related to the surface roughness and microbial CSH.
Biofilms* ; Catheter-Related Infections ; Catheters ; Hydrophobic and Hydrophilic Interactions ; Latex ; Microscopy, Electron, Scanning ; Silicon ; Silicones ; Urinary Catheters*

The syndromes of left atrial isomerism and right atrial isomerism, called polysplenia and asplenia syndromes, respectively, consist of congenital heart defects with disturbances in normal left right isometry, and the etiology of atrial isomerism remains unclear. Right atrial isomerism is traditionally associated with severe cardiac defects, especially complete atrioventricular septal defect, transposition of great arteries, pulmonary atresia, and total anomalous pulmonary venous return. Recently, we encountered one case of asplenia diagnosed by prenatal ultrasonography. We report a case with brief review of the literatures.
Heart Defects, Congenital ; Heterotaxy Syndrome ; Isomerism ; Pulmonary Atresia ; Scimitar Syndrome ; Transposition of Great Vessels ; Ultrasonography, Prenatal*

PURPOSE: Candida albicans is an opportunistic pathogen that is commonly found in human microflora. Biofilm formation (BF) is known as a major virulence factor of C. albicans. The aim of this study was to examine the influence of bacterial presence on biofilm formation of C. albicans. MATERIALS AND METHODS: The BF of Candida was investigated when it was co-cultured with C. albicans (C. albicans 53, a yeast with a low BF ability, and C. albicans 163, a yeast with high BF ability) and bacteria. BF was assessed with XTT reduction assay. A scanning electron microscope was used to determine the structure of the biofilm, and real-time reverse transcriptase polymerase chain reaction was used to amplify and quantify hyphae-associated genes. RESULTS: Co-culturing with two different types of bacteria increased the BF value. Co-culturing with C. albicans 53 and 163 also increased the BF value compared to the value that was obtained when the C. albicans was cultured individually. However, co-culturing with bacteria decreased the BF value of C. albicans, and the BF of C. albicans 163 was markedly inhibited. The expression of adherence and morphology transition related genes were significantly inhibited by co-culturing with live bacteria. CONCLUSION: Bacteria have a negative effect on the formation of biofilm by C. albicans. This mechanism is the result of the suppression of genes associated with the hyphae transition of C. albicans, and bacteria particles physically affected the biofilm architecture and biofilm formation.
Architecture as Topic ; Bacteria ; Biofilms* ; Candida albicans* ; Candida* ; Coculture Techniques ; Humans ; Hyphae ; Methods ; Reverse Transcriptase Polymerase Chain Reaction ; Virulence ; Yeasts

PURPOSE: In the anterior maxilla, hard and soft tissue augmentations are sometimes required to meet esthetic and functional demands. In such cases, primary soft tissue closure after bone grafting procedures is indispensable for a successful outcome. This report describes a simple method for soft tissue coverage of a guided bone regeneration (GBR) site using the double-rotated palatal subepithelial connective tissue graft (RPSCTG) technique for a maxillary anterior defect. METHODS: We present a 60-year-old man with a defect in the anterior maxilla requiring hard and soft tissue augmentations. The bone graft materials were filled above the alveolar defect and a titanium-reinforced nonresorbable membrane was placed to cover the graft materials. We used the RPSCTG technique to achieve primary soft tissue closure over the graft materials and the barrier membrane. Additional soft tissue augmentation using a contralateral RPSCTG and membrane removal were simultaneously performed 7 weeks after the stage 1 surgery to establish more abundant soft tissue architecture. RESULTS: Flap necrosis occurred after the stage 1 surgery. Signs of infection or suppuration were not observed in the donor or recipient sites after the stage 2 surgery. These procedures enhanced the alveolar ridge volume, increased the amount of keratinized tissue, and improved the esthetic profile for restorative treatment. CONCLUSIONS: The use of RPSCTG could assist the soft tissue closure of the GBR sites because it provides sufficient soft tissue thickness, an ample vascular supply, protection of anatomical structures, and patient comfort. The treatment outcome was acceptable, despite membrane exposure, and the RPSCTG allowed for vitalization and harmonization with the recipient tissue.
Alveolar Process ; Alveolar Ridge Augmentation ; Bone Regeneration ; Bone Transplantation ; Connective Tissue ; Guided Tissue Regeneration ; Humans ; Maxilla ; Membranes ; Middle Aged ; Necrosis ; Palate ; Suppuration ; Surgical Flaps ; Tissue Donors ; Transplants* ; Treatment Outcome

Baerobic, spore forming, and rod-shaped bacterium. Anthrax spores are introduced into macrophage by phagocytosis and multiply after germination. The anthrax spores infected in macrophage produce lethal toxin eventually caused cell death. In this study, we analyzed apoptosis and cytokine TNF-alpha and IL-12 secretion after the infection of spores of B. anthracis Sterne in the murine macrophage RAW264.7 cells and in the primary human macrophages. In murine macrophage RAW264.7 cells infected by spore of B. anthracis Sterne, the cells were markedly changed in secretion of TNF-alpha (482~6,213 pg/ml) by lethal toxin, and induced apoptosis. In case of RAW264.7 cells infected by formalin-inactivated spores of B. anthracis, the cells were not able to produce lethal toxin, which released lower level concentration of TNF-alpha (7.7~97.2 pg/ml), and rarely induced apoptosis. When primary human macrophage cells infected with spores of B. anthracis Sterne, they secreted TNF-alpha (5~16 pg/ml), and induced apoptosis about 1% of total cells. We presented that inducing apoptosis by spores of B. anthracis Sterne capable of expressing lethal toxin is related with the secretion of TNF-alpha in murine macrophage RAW264.7 cells. These studies revealed that human and murine macrophages has affected differently by anthrax lethal toxin produced by spores of B. anthracis Sterne.
Anthrax ; Apoptosis ; Bacillus anthracis* ; Bacillus* ; Cell Death ; Germination ; Humans ; Interleukin-12* ; Macrophages* ; Phagocytosis ; Spores* ; Tumor Necrosis Factor-alpha*

BACKGROUND: Among all gastric cancers, the most frequent malignant tumor in Korea, the proportion of early gastric cancer is increasing. This increase is bringing about controversy on the necessity of gastrectomy with extensive lymph node dissection for treatment. METHODS: Of 923 gastric cancer cases operated on at EulJi Medical Hospital from Jan. 1988 to Dec. 1996, we observed retrospectively 198 cases diagnosed as early gastric cancer on pathological biopsies. We performed this study in order to analyze the prognostic factors affecting recurrence and survival rate and to determine which characteristic of early gastric cancer influences lymph node metastasis. RESULTS: The rate of lymph node metastasis of early gastric cancer was 9.5% and it was revealed that depth of tumor invasion (p<0.0001) and tumor size (p=0.05) affected lymph node metastasis. This comprehensive study on the correlation between lymph node metastasis and such factors as gross type of tumor, depth of tumor invasion, tumor size, and histologic type of tumor indicated that the larger in size, a submucosal cancer in depth, the more depressed in gross type, the poorer in differentiation, the higher the rates of lymph node metastasis were. The 5-year recurrence rate was 4.9%, and the 10-year recurrence rate was 9.6%. Lymph node metastasis had the greatest effect on recurrence, compared with other factors influencing recurrence: depth of tumor invasion (p=0.0358), tumor size (p=0.0054) and lymph node metastasis (p=0.0003). The 5-year survival rate was 95.6% and 10-year survival rate was 91.9%. These survival rates didn't correlate with the depth of tumor invasion (p=0.099), the histologic type (p=0.963) or the gross type (p=0.1324) while the survival rates revealed significant differences (p=0.0337, 0.0032) based on tumor size (<1 100%, 1-2 100%, >2 89.6%) and lymph node metastasis (n 96.3%, n 88.9%). CONCLUSIONS: Lymph mode metastasis is the most influential factor in the survival rate and the recurrence rate of early gastric cancer. We conclude that limited surgery is a reasonable treatment for differentiated mucosal cancers less than 5 cm and selectively for submucosal cancers less than 2 cm with elevation, which have the least possibility of recurrence and lymph node metastasis. However, a gas-trectomy with extensive regional lymph node dissection is still considered to be essential for either submucosal cancer with a depression or the submucosal cancer measuring more than 2 cm in size with elevation since recurrence and lymph node metastasis were frequently seen with these variants.
Biopsy ; Depression ; Gastrectomy ; Korea ; Lymph Node Excision ; Lymph Nodes ; Lymphatic Metastasis* ; Neoplasm Metastasis ; Recurrence* ; Retrospective Studies ; Stomach Neoplasms* ; Survival Rate

Purpose: To report a case of both ocular perforation due to periocular acupuncture therapy with vitrectomy in the right eye andbarrier laser photocoagulation without vitrectomy in the left eye.Case summary: A 58-year-old female presented with ocular pain and decreased visual acuity in both eye. She had received periocularacupuncture therapy 4 days earlier. Dilated fundoscopy revealed vitreous hemorrhage. B-scan ultrasonography revealedvitreous opacity. Thus, at the request of the patient, vitrectomy was performed in only the right eye, and did not performed in theleft eye. Intraoperatively, we identified retinal laceration in the temporal and inferior retina. In the left eye, the sites of retinal hemorrhagewere observed in the temporal and inferior retina in the fundus examination, and a barrier laser photocoagulation wasperformed around the lesion. At the three-month postoperative follow-up, the patient’s visual acuity was 0.5 in the right eye withoutmacular edema. In the left eye, visual acuity was 0.01 with macular edema observed on optical coherence tomography. Conclusions Authors present a case of a patient with vitreous hemorrhage and ocular perforations caused by periocular acupuncturetherapy in both eye, able to compare the results of eyes that performed vitrectomy and that did not performed vitrectomyin a same patient. The recovery of visual acuity in eye that performed vitrectomy was better than eye that did not performedvitrectomy. Therefore, we consider performing vitrectomy in patients with eye perforation.

Color Doppler echocardiographic examination was performed to detect and evaluate semiquantitatively the severity of mitral regurgitation in 38 patients who underwent left ventriculography. The sensitivity and specificity of the technique in the detection of mitral regurgitation was 84% and 100% as compared with left ventriculography.Mitral regurgitation in the false negative cases was mostly mild. On the bases of the farthest distance reached by the regurgitation flow signal from the mitral value orifice, the severity of regurgitation was graded on a four point scale and these results were compared with those of angiography. A significant correlation(r=0.87) was found between Doppler imaging and angiography in the evaluation of the severity of mitral regurgitation.Also results was obtained for the evaluation based on the area covered by the regurgitant signals in the left atrial cavity & the regurgitant jet area(RJA) experssed as a percentage of the left atrial are(LLA) obtained in the same plane(RJA/LLA%). In conclusion, Color Doppler echocardiography is a useful noninvasvive thechique that is not only sensitive and specific in the identification of mitral regurgitation but also provides accurate estimation og its severity.
Angiography ; Echocardiography ; Echocardiography, Doppler, Color ; Humans ; Mitral Valve Insufficiency* ; Sensitivity and Specificity

OBJECTIVES: To evaluate the histologic effects of tamoxifen on the endometrium using hysteroscopy in postmenopausal women with breast cancer. METHODS: The study included 46 postmenopausal patients who were referred from another clinic due to thickening or bleeding of the endometrium after taking tamoxifen for breast cancer. All patients underwent transvaginal sonography (TVS) and hysteroscopic endometrial biopsy with a 5-mm, continuous-flow, operating hysteroscope. RESULTS: The incidence of malignancy was high (20%) in cases of abnormal uterine bleeding (AUB) after taking tamoxifen. However, in the non-AUB group with thick endometrium after taking tamoxifen, the incidence of adenocarcinoma was 3.2%. CONCLUSIONS: Our findings confirm the estrogen-like effect of tamoxifen on the endometrium. Endometrial evaluation with TVS suggests further diagnostic procedures; moreover, histologic examination is necessary under hysteroscopy, especially in cases of endometrial bleeding after taking tamoxifen.
Adenocarcinoma ; Biopsy ; Breast Neoplasms ; Endometrium ; Female ; Hemorrhage ; Humans ; Hysteroscopes ; Hysteroscopy ; Incidence ; Postmenopause ; Tamoxifen ; Uterine Hemorrhage