No Abstract available.
Infection Control*

PURPOSE: This study evaluated the prevalence of distolingual roots in mandibular molars among Koreans, the root canal system associated with distolingual roots, and the concurrent appearance of a distolingual root in the mandibular first molar and a C-shaped canal in the mandibular second molar. MATERIALS AND METHODS: Cone-beam computed tomographic images of 264 patients were screened and examined. Axial sections of 1056 mandibular molars were evaluated to determine the number of roots. The interorifice distances from the distolingual canal to the distobuccal canal were also estimated. Using an image analysis program, the root canal curvature was calculated. Pearson's chi-square test, the paired t-test, one-way analysis of variance, and post-hoc analysis were performed. RESULTS: Distolingual roots were observed in 26.1% of the subjects. In cases where a distolingual root was observed in the mandibular molar, a significant difference was observed in the root canal curvature between the buccolingual and mesiodistal orientations. The maximum root canal curvature was most commonly observed in the mesiodistal orientation in the coronal portion, but in the apical portion, maximum root canal curvature was most often observed in the buccolingual orientation. CONCLUSION: The canal curvature of distolingual roots was found to be very complex, with a different direction in each portion. No correlation was found between the presence of a distolingual root in the mandibular first molar and the presence of a C-shaped canal in the mandibular second molar.
Cone-Beam Computed Tomography* ; Dental Pulp Cavity ; Humans ; Mandible ; Molar* ; Prevalence*

No abstract available.
Humans

BACKGROUND: Community-acquired pneumonia is one of the main causes of hospitalization and death, especially in elderly patients. There have been many studies on prognosis for community-acquired pneumonia, but few in Korea. We sought to identify characteristics on admission predicting mortality in elderly patients hospitalized with community-acquired pneumonia and to compare mortality rates by PORT score with PORT study's ones. METHODS: We performed a retrospective study of 267 patients aged 65 years and over admitted with community- acquired pneumonia from January 2000 to December 2002. We reviewed demographic, clinical, laboratory, microbiological and radiologic data and identified independent factors associated with the mortality using logistic regression analysis. We classified patients into risk classes by PORT score and calculated the mortality rate. RESULTS: Among of 267 patients, 48 (18.0%) died. We identified six independent predictors of mortality; male (OR, 2,496; 95% CI, 1,012~6,153), lung cancer (OR, 3,409; 95% CI, 1,302~8,920), general weakness (OR, 5.218; 95% CI, 2,140~12,718), unable to walk (OR, 9,232; 95% CI, 2,228~38,257), BUN > or =30 mg/dL (OR, 3,327; 95% CI, 1.072~10.327), albumin <3 g/dL (OR, 3,219; 95% CI, 1,351~7,670) and pleural effusion (OR, 3.135; 95% CI, 1,052~9,342). Mortality rates of risk class II-V by PORT score were 6.7%, 9.5%, 30.4% and 34.4%, respectively. CONCLUSION: There were factors that were associated with mortality in elderly patients hospitalized with community-acquired pneumonia.
Aged* ; Hospitalization ; Humans ; Korea ; Logistic Models ; Lung Neoplasms ; Male ; Mortality* ; Pleural Effusion ; Pneumonia* ; Prognosis ; Retrospective Studies

BACKGROUND: Numerous disinfectants are available for disinfection and sterilization in the hospital environment but it is difficult to select an appropriate one. Biospot(R) is a chlorine-based disinfectant that consists of sodium dichloroisocyanurates. We evaluated the bactericidal effect of Biospot(R) against clinical isolates and compared it with that of other disinfectants. METHOD: Biospot(R), Wydex(R), HiCLO-S(R), Vipon(R), 70% ethanol, and 3% boric acid were evaluated. Clinical isolates were cultured from the patients in Kangnam St. Mary's hospital. There were two strains of Escherichia coli, methicillin-susceptible Staphylococcus aureus, methicillin-resistant Staphylococcus aureus, Klebsiella pneumoniae, vancomycin-resistant Enterococcus faecium, Pseudomonas aeruginosa, coagulase-negative staphylococcus, Streptococcus pneumoniae, and Bacillus subtilis. One strain of Candida albicans was included. Each strain was exposed to disinfectants for 0.5, 1, 2, 4, 8, and 15 minutes. RESULTS: All the non-spore forming bacteria were killed within 30 seconds in Biospot(R) (30 ppm of sodium dichloroisocyanurate). Wydex(R) (2% glutaraldehyde), HiCLO-S(R) (hypochlorous add 30ppm and electrolyzed oxidized water), Vipon(R) (50ppm of sodium hypochlorite), and 70% ethanol, but not in boric acid. Candida albicans were killed in 30 seconds with 100 ppm of BiOSpot(R) and all of disinfectants except boric acid. Bacillus subtilis, the spore forming bacteria, was killed in 4 minutes with 50 ppm, 2 minutes with 100 ppm of Btospot. Other disinfectants such as Vipon(R) killed Bacillus subtilis in 8 minutes. But Wydex(R), HiCLO-S(R), 70% ethanol, and boric acid could not kill the strain until 15 minutes. CONCLUSIONS: Biospot(R) was an effective and useful disinfectant against most common clinical isolates including fungus and spore forming bacteria.
Bacillus subtilis ; Bacteria ; Candida albicans ; Disinfectants ; Disinfection ; Enterococcus faecium ; Escherichia coli ; Ethanol ; Fungi ; Humans ; Klebsiella pneumoniae ; Methicillin-Resistant Staphylococcus aureus ; Pseudomonas aeruginosa ; Sodium ; Spores ; Staphylococcus ; Staphylococcus aureus ; Sterilization ; Streptococcus pneumoniae

BACKGROUND: Means to measure death anxiety, death depression and sense of symbolic immortality with approved validity and reliability does not yet exist in Korea. METHODS: Existing English questionnaires such as Templer Death Anxiety Scale (TDAS), Death Depression Scale (DDS), Sense of Symbolic Immortaligy Scale (SSIS) were translated into Korean by 5 translators, and then reviewed by 3 non-participants of translation for collegial summary and this summary was counter-translated again by another 2 non-participants. Another 3 non-participants of translation and counter-translation were chosen to examine the two sentences of each item. Then reexamination was done by retranslating and counter-translating the parts with errors. Aftr pretest on ordinary people. the completed questionnaires were given to medical students, residents and nurses of a university hospital. Pastors and missionaries were selected as comparison group. RESULTS: Kuder-Richardson or Cronbach-alpha that represent internal consistency of TDAS, DDS and SSIs was 0.69, 0.84 and 0.78. The three sentences that lowered internal consistency of SSIS was deleted. BDI and DDS showed a positive correlation (0.32, P=0.02), suggesting proved construct validity. Correlation coefficient that proves construct validity of TDAS and DDS was 0.54 (P<0.01), of SSIS and TDAS -0.23(P=0.04), of SSIS and DDS -0.29(P=0.01). The TDAS and DDS(P<0.01), DDS and BDI(P=0.02) have shown a positive correlation were shown. There was significant difference in the score of SSIS(P<0.01). The same results in cases where the 3 sentences was deleted. CONCLUSION: Korean versions of TDAS, DDS and SSIS were reliable and valid.
Anxiety* ; Attitude to Death ; Depression* ; Humans ; Korea ; Missions and Missionaries ; Reproducibility of Results* ; Students, Medical ; Surveys and Questionnaires

BACKGROUND: Many patients discontinue peritoneal dialysis because they suffer from peritonitis associated with biofilm, which is mainly composed of microorganisms and glycocalyx. Pseudomonas aeruginosa produces more glycocalyx than any other gram-negative organism. Macrolide antibiotics are known to be effective against such glycocalyx-producing organisms. METHODS: We evaluated the effect of subinhibitory concentrations of roxithromycin on the biofilm formed by P. aeruginosa obtained from the clinical specimen of a patient with peritonitis. After seeding the organism in the dialysis fluid on silicone discs attached to the sampling plugs of a modified Robbins device for 18 hours, subinhibitory concentrations of roxithromycin-containing dialysis fluid were passed through the device. Sampling plugs were removed at 0, 4-, 24-, 48- hour intervals. Quantifications of the organisms and the glycocalyx were performed, and silicone discs were examined with scanning electron microscope. RESULTS: The colony count decreased at 4 hours of exposure to 1/2xMIC roxithromycin, and at 24 hours after exposure to 1/4xMIC or 1/8xMIC(P<0.05). At 48 hours, the colony count was the lowest in 1/2xMIC, followed by 1/4xMIC and 1/8xMIC, in successive order. The effect seemed to be concentration-dependent. On scanning electron microscopic examination, the production of glycocalyx decreased definitely as time passed, but it was not easy to exactly differentiate the amounts of the three concentration groups. Furthermore, quantification of glycocalyx by tryptophan assay was influenced by time (P<0.05). CONCLUSION: The subinhibitory concentrations of roxithromycin are effectively enough to decrease the biofilm formed by P. aeruginosa colonized on a silicone disc in this in vitro model of peritoneal dialysis.
Anti-Bacterial Agents ; Biofilms* ; Colon ; Dialysis ; Glycocalyx ; Humans ; Peritoneal Dialysis ; Peritonitis ; Pseudomonas aeruginosa* ; Pseudomonas* ; Roxithromycin* ; Silicones ; Tryptophan

The spinal cord is a commonly affected site in human immunodeficiency virus (HIV) infection. Even though the most common disease of the spinal cord is vacuolar myelopathy, there is no case report yet in Korea. We experienced a case of suspicious vacuolar myelopathy in a 33 year-old male patient with acquired immunodeficiency syndrome. The patient presented with progressive paraparesis, gait disturbance, urinary difficulty, and the loss of sensation below thoracic spine 6~7 dermatome. Cerebrospinal fluid showed mild pleocytosis, increased protein level, and normal glucose content. The spine MRI showed extensive ill defined areas of increased signal intensity through the visualized lower cervical and thoracic spinal cord. Steroid therapy with antiretroviral drugs appeared to be ineffective to improve the symptoms of the patient.
Acquired Immunodeficiency Syndrome* ; Adult ; Cerebrospinal Fluid ; Gait ; Glucose ; HIV ; Humans ; Korea ; Leukocytosis ; Magnetic Resonance Imaging ; Male ; Paraparesis ; Sensation ; Spinal Cord ; Spinal Cord Diseases* ; Spine

Background: This study aimed to determine the parameters for worsening oxygenation in non-severe coronavirus disease 2019 (COVID-19) pneumonia. Methods: This retrospective cohort study included cases of confirmed COVID-19 pneumonia in a public hospital in South Korea. The worsening oxygenation group was defined as that with SpO2 ≤94% or received oxygen or mechanical ventilation (MV) throughout the clinical course versus the non-worsening oxygenation group that did not experience any respiratory event. Parameters were compared, and the extent of viral pneumonia from an initial chest computed tomography (CT) was calculated using artificial intelligence (AI) and measured visually by a radiologist. Results: We included 136 patients, with 32 (23.5%) patients in the worsening oxygenation group; of whom, two needed MV and one died. Initial vital signs and duration of symptoms showed no difference between the two groups; however, univariate logistic regression analysis revealed that a variety of parameters on admission were associated with an increased risk of a desaturation event. A subset of patients was studied to eliminate potential bias, that ferritin ≥280 μg/L (p=0.029), lactate dehydrogenase ≥240 U/L (p=0.029), pneumonia volume (p=0.021), and extent (p=0.030) by AI, and visual severity scores (p=0.042) were the predictive parameters for worsening oxygenation in a sex-, age-, and comorbid illness-matched case-control study using propensity score (n=52). Conclusion Our study suggests that initial CT evaluated by AI or visual severity scoring as well as serum markers of inflammation on admission are significantly associated with worsening oxygenation in this COVID-19 pneumonia cohort.

Plasmodium vivax has many stages in the life cycle, and shows different susceptibilities to anti-malarial drugs at each stage. Of these drugs, primaquine is only drug that has anti-malarial activity to hypnozoite. Generally, primaquine is administered for the prevention of relapse by hypnozoite following the treatment with chloroquine in tertian malaria, at the dosage of 15mg/ day for 14 days. But Plasmodium vivax has different susceptibility to primaquine in different areas (so as to strains), and the resistance to primaquine is increasing in endemic areas. We recently experienced a case of imported tertian malaria that relapsed two times after the completions of chloroquine-primaquine therapy. The patient was treated with 22.5 mg of primaquine for 2 weeks at the first relapse, and 3 weeks course of 30 mg of primaquine in the second relapsing episode. Therefore we report this primaquine-resistant tertian malaria with review.
Chloroquine ; Humans ; Life Cycle Stages ; Malaria* ; Plasmodium vivax ; Primaquine ; Recurrence