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.
Otitis Media* ; Otitis* ; Tuberculosis*

Significant traumatic disruption of the ligaments about the knee can occur in a child. Recently several reports have described knee ligament, injuries with open growth plates. And these reports contradict the notion that complete tears of knee ligaments occur only after growth plates have closed. The youngest patient with medial collateral ligament injury reported before was a 4-year-old boy by Joseph and Pogrund in 1978. But authors experienced a case of ruptured medial collateral ligament of the knee in a 2-year and 1-month old boy, who seemed to be youngest with the ligament injury.
Child ; Child, Preschool ; Collateral Ligaments ; Growth Plate ; Humans ; Infant, Newborn ; Knee ; Ligaments ; Male ; Rupture ; Tears

Fractures in the subtrochanteric region of the femur present more formidable problems in treatment than do other trochanteric fractures, because such severe stresses exit at the fracture site. Therefore, as a rule we prefer to treat subtrochanteric fractures by operative means if possible. Many internal fixation devices have been recommanded for use in subtrochanteric fractures and each of these devices have advantages in certain types of subtrochanteric fractures, and their selection should be based on the individual fracture anatomy. A total of 20 patients with fracture of the subtrochanteric region of the femur, who were treated by internal fixation with Judet plate between January 1982 and December 1988 have been reviewed. Our conclusions were as follows; 1. Average age was 38 years old and most common cause of injury was traffic accident. 2. Cast immobilization was done after Judet plate fixation. Partial weight bearing ambulation was enabled from POD 10 weeks and full weight bearing ambulation was enabled from POD 16 weeks. 3. 18 in 20 cases, primary bony union was happened and the mean duration of radiological bony union was 24 weeks. 4. 3 cases of complications, metal failure with refracture (2 cases) and screw loosening (1 case), were occured due to early weight bearing in the post operative course. 5. Judet plate fixation was gave satisfactory result in uncomminuted subtrochanteric fracture, especially Seinsheimer's type I, II-A,B,C or Fieldings type I, II. 6. From a consideration of these series, Judet plate showed easy to use, perfect adaptation and rigid fixation. We thought Judet plate is one of a good implants for rigid fixation of subtrochanteric fracture without severe medial cortical disruption.
Accidents, Traffic ; Clinical Study ; Femur ; Hip Fractures ; Humans ; Immobilization ; Internal Fixators ; Walking ; Weight-Bearing

MR imaging was performed in 40 patients of aortic disease from March 1988 to February 1990. Transverse, coronal and oblique sagital views were obtained with ECG gating and even echo technique using 0.5 T and 2.0 T MR systems. In 12 patients of aortic aneurysm, the location, the size and the extent of aneurysm could be assessed in all cases. In the cases of six abdominal aortic aneurysm, the relation of aneurysm to renal arteries was evaluated. In 18 cases of aortic dissection, the extent of involvement as well as associated abnormalities was well evaluated in all cases. In the 8 cases of congenital aortic anomalies, the vascular anatomy was well demonstrated. However, the abnormalities of major branches could not be assessed with MR imaging especially in 2 cases of Takayasu's arteritis. With our experiences, MR imaging is regarded as a primary diagnostic modality for aortic disease and expected to be developed as the alternative measure to the angiography in the future.
Aneurysm ; Angiography ; Aorta ; Aortic Aneurysm ; Aortic Aneurysm, Abdominal ; Aortic Diseases* ; Electrocardiography ; Humans ; Magnetic Resonance Imaging* ; Renal Artery ; Takayasu Arteritis

There is increasing tendency to use epinephrine injection or topical application to obtain clear operative field and hemostasis under general anesthesia. But excessive catecholamines due to inadvertent administration are known to cause a wide spectrum of cardiotoxicity. The authors have experienced a case of reversible cardiomyopathy due to accidental epinephrine overdose during mastoidectomy. This report is the first recorded case of the nearly fatal conseguences of inadvertent administration of a very large dose of epinephrine, with the subsequent development of a severe catecholamine induced "cardiomyopathy". After the initial phase of massive catecholamine excess, this patient required exogenous catecholamines to support the injured, dysfunctional myocardium and maintain adequate perfusion pressure to vital organs. These abnormalities are also transient in nature with complete recovery documented. The case suggests the need for aggressive support of patients received accidental epinephrine overdose with the expectation that, while cardiar. function may be extremely impaired early in the course of the illness, recovery is virtually complete over time.
Anesthesia, General ; Cardiomyopathies ; Catecholamines ; Epinephrine* ; Hemostasis ; Humans ; Myocardium ; Perfusion ; Ventricular Fibrillation

OBJECTIVE: The aim of this study is to investigate abnormal findings of social brain network in Korean children with autism spectrum disorder (ASD) compared with typically developing children (TDC). METHODS: Functional magnetic resonance imaging (fMRI) was performed to examine brain activations during the processing of emotional faces (happy, fearful, and neutral) in 17 children with ASD, 24 TDC. RESULTS: When emotional face stimuli were given to children with ASD, various areas of the social brain relevant to social cognition showed reduced activation. Specifically, ASD children exhibited less activation in the right amygdala (AMY), right superior temporal sulcus (STS) and right inferior frontal gyrus (IFG) than TDC group when fearful faces were shown. Activation of left insular cortex and right IFG in response to happy faces was less in the ASD group. Similar findings were also found in left superior insular gyrus and right insula in case of neutral stimulation. CONCLUSION: These findings suggest that children with ASD have different processing of social and emotional experience at the neural level. In other words, the deficit of social cognition in ASD could be explained by the deterioration of the capacity for visual analysis of emotional faces, the subsequent inner imitation through mirror neuron system (MNS), and the ability to transmit it to the limbic system and to process the transmitted emotion.
Amygdala ; Brain* ; Autism Spectrum Disorder* ; Child* ; Cognition ; Humans ; Limbic System ; Magnetic Resonance Imaging* ; Mirror Neurons

PURPOSE: To report drug-resistant fungal keratitis that was treated with voriconazole. CASE SUMMARY: A 31-year-old man was admitted to hospital because of ocular pain, conjunctival injection, and visual weakness 7 days after LASIK surgery. At that time, his vision was counting finger at 30 cm and he presented with corneal epithelial defects, stromal infiltration, and inflammation in the anterior chamber of his eye. He was transferred to our hospital because his infection was resistant to gatifloxacin, tobramycin, amphotericin B, and natamycin eyedrops. At the time of transfer, his vision was counting finger at 30 cm and he presented with corneal epithelial defects, stromal infiltration, and hypopyon. He was treated with topical 2% voriconazole every 2 hours and the lesion improved. However, the hypopyon recurred after 12 days. He was then treated with intracameral voriconazole injection (50 microgram/0.1 cc) and topical 5% voriconazole every hour causing the hypopyon to disappear. His vision improved from counting finger to 20/40 six months after this treatment.
Adult ; Amphotericin B ; Anterior Chamber ; Eye ; Fingers ; Fluoroquinolones ; Humans ; Inflammation ; Keratectomy, Subepithelial, Laser-Assisted ; Keratitis ; Keratomileusis, Laser In Situ ; Natamycin ; Ophthalmic Solutions ; Pyrimidines ; Tobramycin ; Triazoles ; Vision, Ocular

To evaluate the change of working length with various instrumentation techniques in curved canals, working length and canal curvature were determined before and after canal instrumentation in buccal or mesial canals of extracted human molars. Stainless steel K-files (MANI(R), Matsutani Seisakusho Co. Takanezawa, Japan), nickel-titanium K-files (Naviflex NT(TM), Brassler, Savannah, USA), ProFile(R), and ProTaper(TM) (Dentsply-Maillefer, Ballaigues, Switzerland) were used to prepare the canals with crown-down technique. In two hand instrumentation groups, coronal flaring was made with Gates Glidden burs. Apical canals were instrumented until apical diameter had attained a size of 30. Positional relation between the tooth apex and the #10 K-file tip was examined by using AutoCAD 2000 (Autodesk Corp., San Rafael. CA, USA) under a stereomicroscope before and after coronal flaring, and after apical instrumentation. Degree of canal curvature was also measured with Schneider's method in radiographs. Data of working length and canal curvature changes were statistically analyzed with one-way ANOVA and Tukey's studentized range test. Working length and canal curvature were decreased significantly in each step in all instrumentation groups. Coronal flaring using Gates Glidden burs in hand instrument groups and whole canal instrumentation using stainless steel hand K-files caused significantly more working length change than in ProFile instrumentation group (p < 0.05). The result of this study demonstrates that all of the above kinds of instrumentation in curved canals cause reduction of working length and canal curvature at each instrumentation steps, and hand instrumentation causes more working length change than ProFile.
Dental Instruments ; Hand ; Humans ; Molar ; Stainless Steel ; Tooth Apex

Infestation of tissue by fly larvae is termed myiasis, and it is unusual in humans. Nasal myiasis is common in low socioeconomic status individuals due to poor nasal hygiene. It commonly affects the skin and rarely the nasal and paranasal sinuses. Recently an 82-year-old female was admitted to the emergency department because of discharge of live maggots from the nasal cavity. She had been diagnosed with brain infarction and Alzheimer's disease several years previous. We successfully removed all the maggots from the patient's nasal cavity and sinuses via endoscopic surgery under local anesthesia. Subsequently, the patient's nasal problem resolved completely.
Aged, 80 and over ; Alzheimer Disease ; Anesthesia, Local ; Brain Infarction ; Cerebral Infarction* ; Diptera ; Emergency Service, Hospital ; Female ; Humans ; Hygiene ; Larva ; Myiasis* ; Nasal Cavity ; Paranasal Sinuses ; Skin ; Social Class