OBJECTIVES: Xylitol is an effective anticarious natural sugar substitute, by inhibiting the virulence of Streptococcus mutans (S. mutans). However, long-term xylitol consumption leads to an emergence of the xylitol-resistant (XR) strains. This study aimed to confirm the general characteristics, mRNA expression of gtf genes, and adhesive ability of the xylitol-sensitive (XS) and XR S. mutans , by xylitol-treated concentrations. METHODS: S. mutans KCTC3065 was maintained in TYE medium, containing 0.4% glucose with 1% xylitol for 30 days at 37degrees C, 10% CO2 to form XR strain and the same procedures, without xylitol, were repeated for the formation of XS S. mutans. Both XS and XR were cultured by xylitol-treated concentrations (0%, 0.1% and 1%), then, general characteristics, such as growth and acid production, mRNA expression of gtf genes and adhesive ability were analyzed. RESULTS: Xylitol reduced the cell growth of XS S. mutans in a dose-dependent manner, but did not reduce the XR. Xylitol inhibited acid production of XS in a dose-dependent manner. However, it did not inhibit that of XR. Xylitol reduced the gtfB and gtfD mRNA expression of the XS S. mutans, which the genes synthesized soluble and insoluble extracellular polysaccharides, but not reduced that of the XR. By a microtiter plate assay, biofilm formation was more reduced in the XR strains, which means biofilm's adhesive ability of XR S. mutans was lower than that of the XS. CONCLUSIONS: These results indicate that a lower level of adhesive ability for XR S. mutans is related with mRNA expression level of gtf genes, which suggested that the XR strains may be less cariogenic than that of the XS.
Adhesives ; Biofilms ; Glucose ; Glucosyltransferases ; Polysaccharides ; RNA, Messenger ; Sprains and Strains ; Streptococcus ; Streptococcus mutans ; Sweetening Agents ; Xylitol

No abstract available.
Child* ; Humans ; Urinary Tract Infections* ; Urinary Tract*

OBJECTIVE: To evaluate the effect of the Whirlpool hydrotherapy on pain and anxiety in chronic myofascial pain syndrome (MPS) patients, compared to the conventional hydrocollator pack therapy. METHODS: Forty-one subjects who have MPS in the upper trapezius muscles without depression were recruited. The patients were randomly assigned into two groups: the whirlpool therapy group whose bodies were immersed in a whirlpool bath at 34degrees C-36degrees C for 30 minutes; the hydrocollator group who took a 30-minute application of a standard hot hydrocollator pack. Patients in both groups received therapy three days a week for 2 weeks and underwent several evaluations at baseline and after treatment. The variables we analyzed during evaluations were as follows: the primary outcome we considered was pain severity using a visual analogue scale. And the secondary outcomes examined included anxiety using the Korean version of the Beck Anxiety Inventory and quality of life (QoL) using the Korean version of the World Health Organization QoL Assessment, Brief Form. All follow-up values were compared with the baseline values. RESULTS: The baseline parameters did not show significant differences between two groups. And after 2-week treatment, both groups revealed significant improvement in anxiety levels and QoL, as well as in pain. However, the improvement on pain (p=0.002) and anxiety (p=0.010) was significantly greater in the whirlpool group, compared to the hydrocollator group. CONCLUSION: The whirlpool hydrotherapy can be used as a more effective therapeutic method to reduce pain and anxiety in chronic MPS patients without depression.
Anxiety ; Depression ; Follow-Up Studies ; Humans ; Hydrotherapy ; Muscles ; Myofascial Pain Syndromes ; Quality of Life ; World Health Organization

Osteoid Osteoma occurs anywhere in skeleton. They are most common in lower extremity, particularly femur about 40%. Two-thirds of femoral lesions is in the intertrochanter or intracapsular regions of the hip. The lesion is usually cortical and may extend into the periosteal or endosteal surface of the bone. It is rare in the cancellous bone. We experienced a case of osteoid osteoma in intertrochanteric cancellous portion of the femur in 50 year old man. Many complained right hip pain worsend three weeks before his visit. Radiograph shows sclerosis around a lucent nidus in cancellous portion. The lesion did not extend to the endosteal surface. We have removed nidus and surrounding reactive portion completely with curettage. Follow up radiographic results after 20 weeks, showed no evidence of recurrence.
Adult* ; Curettage ; Femur* ; Follow-Up Studies ; Hip ; Humans ; Lower Extremity ; Middle Aged ; Osteoma, Osteoid* ; Recurrence ; Sclerosis ; Skeleton

Purpose: To assess changes in the tear film and delayed tear drainage after upper or lower, or combined upper and lower, punctal occlusion using dissolvable polydioxanone plugs in patients with dry eye. Methods: In total, 40 dry eye patients (80 eyes) were enrolled: four groups of 10 (20 eyes) with no, lower, upper, and lower and upper punctal occlusions. Dissolvable polydioxanone plugs were placed. The tear break-up time (tBUT) and the tear meniscus height (TMH) were measured, and the Schirmer I test and dye disappearance test (DDT) were performed at baseline and 2 weeks after the procedure. Results: Compared to the control group, all three test groups exhibited significant changes in the tBUT, the DDT test, and the TMH after polydioxanone plug placement (all p < 0.05). The group with both upper and lower punctal occlusions exhibited more delayed tear drainage than the other test groups. A lower punctal occlusion significantly delayed tear drainage to a greater extent than did an upper punctal occlusion (p = 0.010). Conclusions In dry eye patients, a polydioxanone plug improved the tBUT and TMH, and the DDT score. The tear drainage delay increased in the order: both, lower, and upper punctal occlusion(s).

Early detection and intervention is critical in improving prognosis of developmental disorders. Developmental delay can have many different causes and the clinical features of developmental delay are diverse according to its etiologic causes and severity. The vast and rapid growth of the child's neurobehavioral repertoire from birth through adolescence requires the physician's abundant experience, knowledge, and understanding of development. Here, we summarize instruments for use in neurodevelopmental assessment of infants and toddlers, focusing on motor development, which is the most frequent complaint listed in the developmental clinic.
Adolescent ; Humans ; Infant ; Parturition ; Prognosis

BACKGROUND: Pain after upper abdominal surgery may cause shallow and rapid breathing, resulting in postoperative pulmonary complications. Intramuscular injection of narcotics may increase mortality and morbidity of pulmonary complications. Continuous epidural infusion of opioid with local anesthetic mixture may produce good analgesic action without hypoventilation and hypoxia. METHODS: Forty patients for upper abdominal surgery, chosen at random, were studied for postoperative pain relief. In grouop 1 (n=20), pain was managed by intramuscular injection with meperidine and in group 2 (n=20), it was managed by continuous thoracic epidural block with morphine and bupivacaine mixture. In both groups, pulmonary functions were assessed before operation, on the 1st postoperative day. the 2nd day and the 3rd day. RESULTS: In group 1 and 2, On the 1st postoperative day, FEV was 32.1% and 45.4% of the preoperative value, FVC was 31.9% and 42.4% and MEF was 34.4% and 46.7%, respectively(P<0.05). On the 2nd postoperative day, FEV was 38.6% and 54.8%(P<0.01), PEF was 31.7% and 42.5%, FVC was 37.1% and 49.8% and MEF was 43.2% and 59.6%(P<0.05). on the 3rd postoperative day, FEV was 46.3% and 68.7%, PEF was 38.7% and 54.4%, FVC was 43.8% and 63.1%(P<0.01) MEF was 56.1% and 69.7% of the preoperative value(P<0.05). CONCLUSIONS: As a result of pulmonary function test, we suggest that continuous epidural infusion of morphine with bupivacaine mixture will be an appropriate way of postoperative pain relief methods, with its potential effectiveness in aged, smoking, obese and debilitated patients with ventilatory dysfunction.
Analgesia ; Anesthetics ; Anoxia ; Bupivacaine* ; Humans ; Hypoventilation ; Injections, Intramuscular ; Lung ; Meperidine* ; Morphine* ; Mortality ; Narcotics ; Pain, Postoperative ; Respiration ; Respiratory Function Tests ; Smoke ; Smoking

BACKGROUND: There are only a few studies regarding the causes of treatment failure for tuberculosis. Therefore, this study aimed to determine the causes of intractable tuberculosis. METHODS: M.tuberculosis, differentiated MOTT (Tycobacterium Other Than Tuberculosis) were isolated, and the RFLP (Restriction fragments length polymorphisms) pattern was analyzed from 204 patients with pulmonary tuberculosis and 53 suffering from neck tuberculosis. The IL-1β, IL-12, *1 IFNγ and *2 TNFαblood levels were measured. All patients were regularly followed for 18 months after treatment. RESULTS: There was no correlation between the RFLP patterns of M.tuberculosis treatment failure. From the 204 cases, 31.9% were intractable. The characteristics of patients with intractable tuberculosis were old age, being male and recurrent cases. The causes of treatment failure were identified as follows ; a decrease in the IL-12(59.4%) concentration, drug resistant strain(54.7%), irregular medication(15.4%), MOTT(6.2%) and a heavy infection(4.6%). The causes of all cases of intractable tuberculosis could be investigated. The IL-12 concentration in the blood was significantly lower in the intractable cases, where it disclosed a maximum sensitivity(64.7%) and specificity(75.4%) at 165.0 pg/ml. Most of the 53 cases on neck node tuberculosis were treated successfully. Therefore, we were unable to analyze the cause of treatment failure. CONCLUSION: A decrease in the blood IL-12 concentration and drug resistant strains were identified as the most significant causes of treatment failure for tuberculosis. In Korea, infection by clusters were prevalent, but no difference in the clinical course between clusters and non-clusters could be found.
Humans ; Interleukin-12 ; Korea ; Male ; Neck* ; Polymorphism, Restriction Fragment Length ; Treatment Failure* ; Tuberculosis* ; Tuberculosis, Pulmonary

The ultraviolet radiation (UVR) is known to be a potent modulator of many host immune functions and the exposure of experimental animals to the inflammatory effects of UVR induces depressions in their ability to initiate and effectuate various types of cellular immune responses. In this study, the effects of UV-B (280 320 nm) radiation on resistance to a facultative intracellular bacterium, Listeria monocytogenes (LM), were examined at the cellular level. The numbers of cultivable LM recovered from the spleens of UV-B-irradiated mice were decreased at 2 days postinfection compared with those of untreated control mice. However, the acquired immunity, developed 7 days after immunization with streptomycin (SM)-sensitive LM, in either UV-irradiated, LPS- or IL-1-pretreated mice was less stronger than that developed in untreated, control mice. To elucidate the possible mechanisms underlying the observation that UVR did increase innate immunity but decreased acquired immunity of mice to the infection with LM, the effects of UVR of mice on the production of IFN-r by activated splenocytes and TNF-a by peritoneal macrophages were assessed. Activated splenocytes from UV-irradiated mice exhibited a reduced capacity to produce IFN-r and cultured peritoneal macrophages produced more TNF-a in the presence of LPS during 24 hours after UV radiation. Though TNF-r activity was not detected in the sera of LM-infected mice, intravenous LPS injection induced TNF-r production and UVR decreased TNF activity in sera obtained from LM-infected mice with LPS induction 9 days after irradiation. Although Ia-negative macrophages were predominant in the peritoneal macrophages from untreated control mice, the infection of mice with LM caused a marked increase in Ia expression on peritoneal macrophages. However, UVR resulted in decreased expression of Ia molecule on the peritoneal macrophages during the LM infection. These findings suggest that the dual effects of UVR on the innate and acquired immunity of mice to the LM infection may be associated with altered capacities of splenocytes and peritoneal macrophages of the mice to produce cytokines, in addition to decrease of la molecule expression on the macrophages.
Adaptive Immunity ; Animals ; Cytokines ; Depression ; Immunity, Cellular ; Immunity, Innate ; Immunization ; Listeria monocytogenes* ; Listeria* ; Macrophages ; Macrophages, Peritoneal ; Mice* ; Spleen ; Streptomycin ; Tumor Necrosis Factor-alpha*

PURPOSE: Intrarenal reflux (IRR) occurs in 3-10% of cases of total reflux and can lead to renal injury, which may eventually result in renal scarring. In this study, we evaluated the clinical importance of IRR detected by voiding cystourethrography and evaluated the relationship between IRR and renal scarring. MATERIALS AND METHODS: From January 2002 to May 2008, 50 patients who were diagnosed with vesicoureteral reflux (VUR) and showed IRR in voiding cystourethrography were enrolled. IRR was seen in 59 renal units in our enrolled patients. A 99mTc 2,3-dimercaptosuccinic acid (DMSA) renal scan was performed after VUR was detected in all cases. Nine patients were conservatively treated with prophylactic antibiotics, whereas 41 patients received an anti-reflux operation. A follow-up renal scan was performed after 3 to 6 months to check for any changes in renal scarring. RESULTS: The average patient age was 9.2 months (range, 1-42 months). Forty-nine patients were male; only one patient was female. The mean duration until surgery was 2.9 months. Generally, the IRR sites corresponded to the sites of photon defects on DMSA renal scans (76.3%). Furthermore, the photon defects on IRR sites tended to progress to renal scarring (65.2%). The rate of change in scarring was lower in the surgery group (47.1%) than in the prophylactic antibiotic group (75%). CONCLUSIONS: IRR sites and the sites of photon defects on DMSA renal scans showed a high correspondence, and these sites tended to progress to renal scarring. We suggest that VUR with IRR should be actively managed to decrease the chances of renal scarring.
Anti-Bacterial Agents ; Cicatrix ; Female ; Follow-Up Studies ; Humans ; Kidney Tubules ; Receptor, Insulin ; Succimer ; Vesico-Ureteral Reflux