OBJECTIVES: The purpose of this study was to evaluate the effect of periodontal health promotion and oral hygiene in children using a vibrating toothbrush. METHODS: Forty-seven volunteers aged between 7-15 years participated in this study at local care centers from January to February 2013. A vibratory toothbrush for children was designed with the bristles operating on a self-vibration system that separated the head-neck part of the toothbrush from the handle. The toothbrush was designed with the aim of massaging the gingiva and reducing gingival inflammation. The papillary marginal attachment (PMA) index and O'Leary plaque index were measured by oral examinations before and at 4 weeks after brushing with the vibrating toothbrush. RESULTS: The PMA index and O'Leary plaque index were reduced from 39.20 to 25.42 (P<0.001) and from 5.56 to 2.78 (P<0.001), respectively. CONCLUSIONS: These results suggested that vibrating toothbrushes designed for children can be helpful in promoting gingival health and improving oral hygiene.
Aged ; Child ; Diagnosis, Oral ; Gingiva ; Gingivitis ; Health Promotion ; Humans ; Inflammation ; Oral Hygiene

BACKGROUND: Because of a lack of quality control (QC) materials, stool examination has not been standardised. This study examined intestinal parasites in diarrhea specimens to manufacture and evaluate the performance stability of QC materials for stool examination. METHODS: This study examined diarrhea specimens submitted for stool culture. Microscopic examination was performed using the direct smear and formalin-ether concentration method (Military General Laboratory, MGL). Enzyme-linked immunosorbent assay (ELISA) kits (R-Biopharm AG, Germany) and xTAG Gastrointestinal Pathogen Panel (Luminex Corp., USA) were used for the three major protozoa: Cryptosporidium parvum, Giardia lamblia, and Entamoeba histolytica. Polymerase chain reaction (PCR) was performed for Dientamoeba fragilis and Blastocystis hominis. The QC materials for stool examination were generated using Diphyllobothrium nihonkaiense ova. The manufactured QC materials were evaluated under different storage conditions, with varying preservatives, temperatures, and storage times. RESULTS: From November 2015 to April 2016, 82 diarrhea specimens were collected and tested. All results from microscopy and ELISA were negative; C. parvum (n=2) and G. lamblia (n=1) were detected by xTAG, while D. fragilis (n=10) and B. hominis (n=2) were detected by PCR. High- and low-concentration QC materials were manufactured. Using the high-concentration QC material, ova were observed in all storage conditions using MGL. Using the low-concentration QC material, the ova were observed until 14 days, but not after 3 weeks. CONCLUSIONS: It should be considered for making QC materials for stool examinations that focus on D. fragilis and B. hominis frequently found in Korea and with the caution to the low-concentration of QC materials could be unstable.
Blastocystis hominis ; Cryptosporidium parvum ; Diarrhea* ; Dientamoeba ; Diphyllobothrium ; Entamoeba histolytica ; Enzyme-Linked Immunosorbent Assay ; Giardia ; Giardia lamblia ; Korea ; Methods* ; Microscopy ; Ovum ; Parasites* ; Polymerase Chain Reaction ; Quality Control*

BACKGROUND: The inflammation is an important feature of atherosclerotic lesions, and high level of C-reactive protein (CRP) is known to be associated with increased coronary events and poor prognosis in acute myocardial infarction (AMI). We examined the clinical and angiographic outcomes, success rate of the percutaneous coronary intervention (PCI), and long-term survival rate after PCI according to the level of CRP on admission. METHODS: Two hundred and eight patients with AMI who underwent primary or rescue PCI between 1997 and 1999 at Chonnam National University Hospital were divided into two groups: Group I (n=86, 59.9+/-9.3 years, male 74.4%) with normal CRP (<1.0 mg/dL, mean value=0.43+/-0.14 mg/dL) on admission and Group II (n=122, 59.1+/-10.4 years, male 83.6%) with elevated CRP (> or = 1.0 mg/dL, mean value=3.50+/-0.93 mg/dL) on admission. RESULTS: There were no significant differences in baseline characteristics between two groups. The incidence of cardiogenic shock was higher in Group II than in Group I (Group I; 3/86, 3.5% vs Group II; 15/122, 12.3%, p=0.026). The coronary angiographic findings were not different between two groups. The ejection fraction and Thrombolysis In Myocardial Infarction flow were improved after PCI in both groups (Group I; 49.4+/-10.5 to 52.0+/-9.0%, 1.52+/-1.13 to 2.77+/-0.55, p<0.001 vs Group II; 50.1+/-11.2 to 52.7+/-9.7, 1.55+/-1.11 to 2.76+/-0.53, p<0.001). Primary success rate of PCI was 94.2% (81/86) in Group I and 95.1% (116/122) in Group II (p=0.776). The survival rates of Group I was 97.7%, 97.7% and 96.5%, and those of Group II was 91.8%, 91.0% and 86.9% at 1, 6 and 12 months, respectively (p=0.043 at 1 month, p=0.040 at 6 months, p=0.018 at 12 months). CONCLUSION: Higher incidence of cardiogenic shock and worse long-term survival after PCI are observed in AMI patients with elevated CRP.
C-Reactive Protein* ; Humans ; Incidence ; Inflammation ; Jeollanam-do ; Male ; Myocardial Infarction* ; Percutaneous Coronary Intervention ; Prognosis ; Shock, Cardiogenic ; Survival Rate

BACKGROUND AND OBJECTIVES: Hyperhomocyt(e)inemia is known to be one of independent risk factors for atherosclerosis. The relationship between hyperhomocysteinemia and coronary artery diseases was evaluated in Korean adults. MATERIALS AND METHOD: Basal fasting plasma homocysteine level was measured in 307 patients (174 males, 58+/-11 years; 133 females, 60+/-11 years). Coronary artery disease (CAD) was diagnosed in 194 patients. According to the clinical presentation of CAD and the number of significantly stenotic coronary artery, the plasma homocysteine level was analyzed. RESULTS: The plasma homocysteine level was 9.4+/-3.0 micromol/L in male and 8.5+/-3.5 micromol/L in female (P=.016). Homocysteine was 10.0+/-3.3 micromol/L in 130 smokers, 8.3+/-3.0 micromol/L in 162 non-smokers (P<0.001). The plasma homocysteine level was 9.4+/-3.2 micromol/L in 194 patients with CAD and 8.4+/-3.2 micromol/L in 113 patients without CAD (P=.008). The homocysteine was 10.2+/-3.2 micromol/L in 63 patients with acute myocardial infarction (MI), 9.8+/-3.1 micromol/L in 37 old MI, 8.7+/-3.0 micromol/L in 67 unstable angina, and 8.8+/-3.7 micromol/L in 27 stable angina. The plasma homocysteine was related with the clinical presentation of CAD(P=.035) but was not an independent risk factor for coronary artery diseases. CONCLUSIONS: The elevated value of plasma homocysteine level is a risk factor for pateint with clinical severity of the coronary artery diseases, and male and smokers had higher plasma homocysteine level than those in female and nonsmokers.
Adult ; Angina, Stable ; Angina, Unstable ; Atherosclerosis ; Coronary Artery Disease* ; Coronary Vessels* ; Fasting ; Female ; Homocysteine* ; Humans ; Hyperhomocysteinemia ; Male ; Myocardial Infarction ; Plasma ; Risk Factors

BACKGROUND: Lipoprotein (a) [Lp(a)] contains apolipoprotein(a), which is a structural homologue of plasminogen and competes with it for binding sites. It also acts by increasing plasminogen activator inhibitor-1 expression. The objective of this study was to evaluate the relationship between Lp(a) levels and restenosis rate after successful coronary stent placement. METHODS: The study included 306 patients who underwent coronary stent placement and follow-up coronary angiogram at Chonnam National University Hospital from August 1996 to June 2000. Restenosis rate was analyzed according to the level of Lp(a); Group I with high Lp(a) (n=7, Lp(a) 36 mg/dL, 58.98.8 years, female: 35.1%) and Group II with low Lp(a) (n=29, Lp(a) < 36 mg/dL, 57.79.8 years, female: 18.8%). RESULTS: 1) There was no significant differences in risk factors of atherosclerosis, clinical diagnosis, the number of involved coronary artery, left ventricular function, angiographic lesion characteristics by American College of Cardiology/American Heart Association clasification and Thrombolysis In Myocardial Infarction flow in two groups. 2) Angiographic restenosis rates were not different between two groups (group I : 33.8%, group II : 35.4%). CONCLUSION: Plasma Lp(a) levels are not related with the angiographic restenosis rate after coronary stent placement.
Apoprotein(a) ; Atherosclerosis ; Binding Sites ; Coronary Vessels ; Diagnosis ; Female ; Follow-Up Studies ; Heart ; Humans ; Jeollanam-do ; Lipoprotein(a)* ; Myocardial Infarction ; Plasma ; Plasminogen ; Plasminogen Activators ; Risk Factors ; Stents* ; Ventricular Function, Left

BACKGROUND: Acute thrombotic occlusion after percutaneous coronary intervention (PCI) is a serious complication that provokes acute myocardial infarction, cardiac death or emergent bypass surgery. The role of fibrinogen, C-reactive protein (CRP) and lipoprotein (a) [Lp(a)] in the patients who developed acute thrombotic occlusion after PCI was investigated. METHODS: The patients with acute coronary syndrome who underwent PCI at Chonnam National University Hospital between Jan. 1999 and Jun. 2000 were divided into two groups according to the occurrence of acute thrombotic occlusion: patients with thrombotic occlusion after PCI (Group I; 62.3+/-8.8 years, M:F=19:8) and patients without thrombotic occlusion after PCI (Group II; 59.6+/-10.6 years, M:F=271:95). Clinical and angiographic characteristics, levels of fibrinogen, CRP and Lp(a) were compared between two groups. RESULTS: There were no significant differences in the level of fibrinogen between two groups. The patients with elevated CRP (>0.5mg/dL) were more common in Group I than those in Group II (88.9% vs. 42.3%, p=0.0001) and the value of CRP was higher in Group I than in Group II (4.97+/-5.18 mg/dL vs. 2.27+/-4.23 mg/dL, p=0.002). The patients with high Lp(a) (>30mg/dL) were more prevalent in Group I than those in Group II (44.4% vs 18.6%, p=0.001). There were no significant differences in the risk factors for coronary artery disease, except for diabetes mellitus (Group I : Group II, 40.7% : 16.9%, p=0.002). Thrombolysis in Myocardial Infarction (TIMI) flow of Group I was lower than in Group II (p=0.0001). Multiple regression analysis after the adjustment for age, sex and other cardiovascular risk factors, diabetes mellitus, low TIMI flow, high CRP and Lp(a) were independently associated with the occurrence of acute thrombotic occlusion (p=0.008, 0.0001, 0.031, 0.035, respectively). CONCLUSION:The elevated values of CRP and Lp(a), diabetes mellitus, and low TIMI flow are significant predictive factors for the acute thrombotic occlusion in patients with acute coronary syndrome after PCI.
Acute Coronary Syndrome ; C-Reactive Protein* ; Coronary Artery Disease ; Death ; Diabetes Mellitus ; Fibrinogen* ; Humans ; Jeollanam-do ; Lipoprotein(a)* ; Lipoproteins* ; Myocardial Infarction ; Percutaneous Coronary Intervention* ; Risk Factors ; Thrombosis

BACKGROUND AND OBJECTIVES: The level of cardiac specific troponin (cTn) may be important in patients with acute coronary syndrome (ACS), but with normal electrocardiography (ECG). SUBJECTS AND METHODS: Three hundred and nineteen patients (61+/-11 years, M:F=212:107), with ACS and normal ECG, who underwent a diagnostic coronary angiogram (CAG), between July 2000 and June 2001, were analyzed according to their cTn level. The clinical characteristics, initial CAG findings and major adverse cardiac events (MACE), during a one-year clinical follow-up, were compared between positive and negative cTn groups. RESULTS: Of the enrolled patients, 191 had a negative cTn (group A, 61+/-10 years, M:F=131:60), and 128 a positive cTn (group B, 60+/-11 years, M:F=81:47), and 176 (55.2%) were shown to have significant coronary artery stenosis on CAG. There were no significant differences in risk factors between the two groups. The mean left ventricular ejection fraction was 64+/-9%, and was lower in group B than in group A (59+/-10% vs. 67+/-7%, p<0.05). cTn positivity was associated with the percentage of significant coronary artery stenosis present (88% vs. 32%, p<0.05), a smaller minimal luminal diameter (1.09+/-0.44 mm vs. 2.68+/-0.33 mm, p<0.05) and a larger diameter of stenosis (68+/-6% vs. 44+/-6%, p<0.05). A multi-vessel lesion was more common in group B than in group A (58.3% vs. 30.3%, p<0.05). During the one-year follow-up period, 36 patients developed MACE, resulting in 3 deaths, 7 acute myocardial infarctions and 34 patients with restenosis. MACE was observed in 9 patients of group A and in 27 of group B (4.7% vs. 21.1%, p<0.05). CONCLUSION: The troponin levels are valuable for the early diagnosis, and prediction of the long-term prognosis, in patients with ACS and a normal ECG.
Acute Coronary Syndrome* ; Angina, Unstable ; Constriction, Pathologic ; Coronary Disease ; Coronary Stenosis ; Early Diagnosis ; Electrocardiography* ; Follow-Up Studies ; Humans ; Myocardial Infarction ; Phenobarbital ; Prognosis ; Risk Factors ; Stroke Volume ; Troponin*

Laryngo-tracheal perforation caused by the use of a stylet during tracheal intubation is a rare complication. We present a case of subcutaneous emphysema and connective tissue inflammation after tracheal intubation. The patient was a 41-year-old male undergoing general anesthesia for an appendectomy. The intubation was difficult during laryngoscopy (Cormack-Lehane Grade III). An assistant provided an endotracheal tube with a stylet inside while the laryngoscope was in place. During intubation, a short, dull sound was heard with a sudden loss of resistance after the distal tip of the endotracheal tube passed the rima glottis. A sonogram and computerized tomography revealed subcutaneous emphysema from the neck to the upper mediastinum and fluid collection between the trachea and the thyroid. This lesion appeared to have been caused by the protruded, loose stylet. Anesthesiologists should be aware of the damage a loose stylet protruding beyond the tip of the endotracheal tube can cause.
Adult ; Anesthesia, General ; Appendectomy ; Connective Tissue ; Glottis ; Humans ; Inflammation* ; Intubation ; Laryngoscopes ; Laryngoscopy ; Male ; Mediastinum ; Neck* ; Punctures* ; Subcutaneous Emphysema* ; Thyroid Gland ; Trachea

BACKGROUND: Antithrombotic therapy with heparin reduces the rate of ischemic events in patients with acute coronary syndrome. Low-molecular-weight heparin (LMWH), given subcutaneously twice daily, has a more predictable anticoagulant effect than standard unfractionated heparin, is easier to administer and does not require monitoring. METHODS: We prospectively analyzed 180 patients with unstable angina who underwent percutaneous coronary intervention (PCI) between 1999 and 2001 at Chonnam National University Hospital to receive either 120 U/kg of Dalteparin (Fragmin ), administered subcutaneously twice daily (group I; n=90, 61.8+/-8.9 years, male 67.8%), or continuous intravenous unfractionated heparin (group II; n=90, 62.6+/-9.7 years, male 70.0%). During hospitalization and at 6 month after PCI, major adverse cardiac events such as acute myocardial infarction, target vessel revascularization, death, or restenosis were examined. RESULTS: During hospitalization, the incidence of acute myocardial infarction, target vessel revascularization and death were not different between two groups. At follow-up coronary angiography at 6 month after PCI, the incidence of restenosis was lower in group I than in group II (Group I; 26/90, 28.8% vs. Group II; 32/90, 35.6%, p=0.041) and the incidence of target vessel revascularization was lower in group I than in group II (Group I; 21/90, 23.3% vs Group II; 27/90, 30.0%, p=0.039). There was no difference in the rate of major and minor hemorrhage, ischemic stroke and thrombocytopenia between two groups. In the multivariate analysis, factors relating to restenosis were lesion length, postprocedural minimal luminal diameter, CRP on admission, diabetes mellitus, type of hepairn, stent use. CONCLUSION: Dalteparin, a LMWH, is superior to standard unfractionated heparin for reducing restenosis rate and target vessel revascularization without increasing bleeding complications.
Acute Coronary Syndrome ; Angina, Unstable* ; Coronary Angiography ; Dalteparin ; Diabetes Mellitus ; Follow-Up Studies ; Hemorrhage ; Heparin ; Heparin, Low-Molecular-Weight* ; Hospitalization ; Humans ; Incidence ; Jeollanam-do ; Male ; Multivariate Analysis ; Myocardial Infarction ; Percutaneous Coronary Intervention* ; Phenobarbital ; Prospective Studies ; Stents ; Stroke ; Thrombocytopenia

BACKGROUND: The inflammation is an important feature of atherosclerotic lesions, and peripheral monocytosis is known to be associated with increased coronary events and poor prognosis in acute myocardial infarction (AMI). The aim of this study was to determine the significance in clinical and angiographic outcomes, success rate of the percutaneous coronary intervention (PCI) and major adverse cardiac events and event-free survival rate after PCI according to the value of peripheral monocyte on admission. METHODS: A total of 127 patients with AMI who underwent PCI between June 2000 and June 2001 at Chonnam National University Hospital were divided into two groups: Group I (n=63, 61.7+/-10.9 years, male 71.4%) with normal monocyte count (<900/mm3, mean value=536+/-202/mm3) on admission and Group II (n=64, 61.7+/-13.4 years, male 78.1%) with elevated monocyte count ( 900/mm3, mean value=1,140+/-260/mm3) on admission. RESULTS: Baseline ejection fraction was lower in Group II than in Group I (Group I; 53.3+/-13.0% vs Group II; 45.0+/-11.7%, p=0.014). The value of C-reactive protein, troponin-T and troponin-I was higher in Group II than in Group I (Group I; 2.8+/-1.9 mg/dL, 1.98+/-1.53 ng/mL, 18.3+/-17.7 ng/mL vs Group II; 5.3+/-5.0 mg/dL, 3.34+/-2.54 ng/mL, 43.1+/-24.0 ng/mL, p=0.034, 0.020, 0.006, respectively). The incidence of target lesion revascularization was higher in Group II than in Group I during hospitalization and during 6-month clinical follow-up after PCI (1.6% vs 12.5%, 19.0% vs 31.3%, p=0.012, 0.015, respectively). The event-free survival rates were lower in Group II than in Group I during hospitalization and during 6-month follow-up after PCI (96.8% vs 84.4%, 71.4% vs 53.1%, p=0.006, 0.008, respectively). CONCLUSION: Peripheral monocytosis is associated with LV dysfunction and higher incidence of target lesion revascularization and worse mid-term event-free survival during hospitalization and at 6 months after PCI in patients with AMI.
Angioplasty ; C-Reactive Protein ; Coronary Disease ; Disease-Free Survival ; Follow-Up Studies ; Hospitalization ; Humans ; Incidence ; Inflammation ; Jeollanam-do ; Male ; Monocytes ; Myocardial Infarction* ; Percutaneous Coronary Intervention ; Prognosis ; Troponin I ; Troponin T