No abstract available.

BACKGROUND: Surgery may have a role when medical treatment alone is not successful in patients with multi-drug resistant (MDR) pulmonary tuberculosis (PTB). To document the role of resection in MDR PTB, we analyzed 4 years of our experience. METHODS: A retrospective review was performed on thirteen patients that underwent pulmonary resection for MDR PTB between May 1996 and February 2000. All patients had organisms resistant to many of the first-line drugs including isoniazid (INH) and rifampicin (RFP). RESULTS: The thirteen patients were 37.5±12.4 years old (mean±S.D.)(M:F=5:8), and their sputum was culture positive even with adequate medication for prolonged periods (109.7±132.0 months), resistant to 2-8 drugs including isoniazid and rifampin. All patients had localized lesion(s) and most (92.3%) had cavities. At least 3 sensitive anti-TB medications were started before surgery in all patients according to the drug sensitivity test. The preoperative FE1 was 2.37±0.83 L. Lobectomy was performed in 11 patients and pleuropneumonectomy in two. Postoperative mortality did not occur, but pneumonia occurred as a complication in one (7.7%). After 41.5±58.9 days (range 1~150 days) follow up, negative conversion of sputum culture was achieved in all patients within 5 months. Only one patient (7.7%) recurred 32 months after lung resection. CONCLUSION: When medical treatment alone is not successful, surgical resection can be a good treatment option in patients with localized MDR PTB.
Follow-Up Studies ; Humans ; Isoniazid ; Lung ; Mortality ; Pneumonia ; Retreatment* ; Retrospective Studies ; Rifampin ; Risk Factors* ; Sputum ; Tuberculosis, Pulmonary*

The 35 patients of femur neck fracture treated with bipolar hemiarthroplasty were followed up for an average of 18 months with the range of 12 months to 5 years after bipolar hemiarthroplasty from Jan. 1986 to Dec. 1992. 1. Mean age of the patient was 68 years old(25-93) and mean hospitalization period was 55 days. 2. Associated medical problems were diabetes mellitus in 6 cases, cerebrovascular disease in 5 cases, rectal cancer in 1 case and pulmonary tuberculosis in 1 case. 3. An anterior dislocation, one of the early complication occured in 1 case, and superficial infection in 3 cases(8.5%), a deep infection, one of the late complication occured in 1 case. 4. The clinical result was focus on the functional hip assessment of bipolar hemiarthroplasty after femur neck fracture, and the functional results evaluated by Lunceford's Method were excellent in 22 cases(63%), good in 5 cases(14.3%), fair in 5 cases(14.3%), poor in 3 cases(8.6%). 5. The bipolar hemiarthroplasty was satisfactory method for the displaced femur neck fracture in the elderly patients, but to return the patient's preinjury activity level, more active postoperative rehabilitation should be required.
Aged ; Cerebrovascular Disorders ; Diabetes Mellitus ; Dislocations ; Femoral Neck Fractures ; Femur Neck ; Femur ; Hemiarthroplasty ; Hip ; Hospitalization ; Humans ; Methods ; Rectal Neoplasms ; Rehabilitation ; Tuberculosis, Pulmonary

This in vitro study monitored MMP-8 production on PMN by stimulated with the following three groups; Sonicated extracts of E. faecalis (SEF), SEF treated with Ca(OH)2 (12.5mg/ml) for 7 days, and lipopolysaccharides (LPS) of E. coli. The level of MMP-8 in each group was immediately measured by ELISA. The data were analyzed with Kruskal-Wallis test and Mann-Whitney U test. In the SEF group, the level of production of MMP-8 was higher than the negative control group in low concentration (0.05microg/ml) of SEF (p < 0.05), but it decreased with an increase in the concentration of SEF (p < 0.05). In the case of SEF treated with Ca(OH)2, all of the MMP levels were higher than negative control group (p < 0.05), but no statistical difference was found among the different SEF concentrations (p > 0.05). All of the levels in E. coli LPS were increased with increasing concentrations (p < 0.05). According to this study we could summarize as follows: 1. MMP-8 was expressed at low level in untreated PMN group and the levels of MMP-8 were upregulated in PMN stimulated by E. coli LPS groups. 2. In the SEF groups, the level of production of MMP-8 decreased with an increase in the concentration of SEF (p < 0.05). So E. faecalis may have suppressive effect on the production of MMP-8 by PMN. 3. In the case of SEF treated with Ca(OH)2, all of the MMP levels at different SEF concentrations were higher than untreated PMN group (p < 0.05), but no statistical difference was found among the different SEF concentrations (p > 0.05).
Calcium Hydroxide ; Enterococcus faecalis* ; Enterococcus* ; Enzyme-Linked Immunosorbent Assay ; Humans* ; Lipopolysaccharides ; Matrix Metalloproteinase 8* ; Neutrophils*

OBJECTIVES: This study evaluated the effects of adhesion variables such as the priming concepts of canal wall and the curing modes of adhesives on the sealing ability of a resin-based root canal filling system. MATERIALS AND METHODS: Apical microleakage of the Resilon-RealSeal systems filled with 3 different combinations of adhesion variables was compared with the conventional gutta-percha filling using a dye penetration method. Experimental groups were SEDC, Resilon (Resilon Research LLC) filling with self-etch RealSeal (SybronEndo) primer and dual-cure RealSeal sealer; NELC, Resilon filling with no etching, Scotchbond Multi-Purpose (3M ESPE) primer application and light-curing adhesive; and TELC, Resilon filling with Scotchbond Multi-Purpose primer and adhesive used under total etch / wet bonding and light-cure protocols. GPCS, gutta-percha filling with conventional AH26 plus sealer, was the control group. RESULTS: The median longitudinal dye penetration length of TELC was significantly shorter than those of GPCS and SEDC (Kruskal-Wallis test, p < 0.05). In the cross-sectional microleakage scores, TELC showed significant differences from other groups at 2 to 5 mm from the apical foramen (Kruskal-Wallis test, p < 0.05). CONCLUSIONS: When a resin-based root canal filling material was used, compared to the self-etching primer and the dual-cure sealer, the total etch/wet-bonding with primer and light-curing of adhesive showed improved apical sealing and was highly recommended.
Adhesives ; Dental Pulp Cavity ; Gutta-Percha ; Resin Cements ; Tooth Apex

OBJECTIVES: This study was conducted to determine, by reviewing the literature, whether treatment of Helicobacter pylori infection in patients with non-ulcer dyspepsia affects symptoms. METHODS: We retrieved the literature using MEDLINE search, with nonulcer dyspepsia and Hericobacter pylori and treatment as key words, which were reported from 1984 to 1998, and manual literature search. The criteria for inclusion was as follows; 1) The paper should have confirmed nonulcer dyspepsia as case definition. 2) The paper should have performed a randomized, blind trial. 3) Confirmation of Helicobacter pylori eradication should be done 4 weeks after treatment. 4) studies with no information on measurement of symptoms after treatment were not accepted. The percentage of patients with symptom improvement after eradication therapy for Helicobacter pylori infection was calculated. Cumulative odds ratio was compared by fixed effect model and random effect model as sensitivity and funnel plot was used to evaluate publication bias. RESULTS: The overall effect size of symptom improvement was calculated by cumulative odds ratio. Cumulative odds ratio of random effect model was 4.16(95% CI: 1.55-11.19). Before integrating each effect sizes into common effect size, the homogeneity test was conducted and random effect model was selected(Cochran's Q=41.08 (d.f=10, p<0.001)). The heterogeneity across studies was evaluated and the different methodological aspects of studies led to differences between study results. CONCLUSIONS: The results suggest that the eradication of Helicobacter pylori in patients with non-ulcer dyspepsia results more symptom improvement. In studies that shows the opposite results there are methodological aspects explaining the heterogeneity.
Dyspepsia* ; Helicobacter pylori* ; Helicobacter* ; Humans ; Odds Ratio ; Population Characteristics ; Publication Bias

Early detection of carious lesions increases the possibility of treatment without the need for surgical intervention. Optical coherence tomography (OCT) is an emerging three-dimensional imaging technique that has been successfully used in other medical fields, such as ophthalmology for optical biopsy, and is a prospective candidate for early caries detection. The technique is based on low coherence interferometry and is advantageous in that it is non-invasive, does not use ionizing radiation, and can render three-dimensional images. A brief history of the development of this technique and its principles are discussed in this paper. There have been numerous studies on caries detection, which were mostly in vitro or ex vivo experiments. Through these studies, the feasibility of OCT for caries detection was confirmed. However, further research should be performed, including in vivo studies of OCT applications, in order to prove the clinical usefulness of this technique. In addition, some technological problems must be resolved in the near future to allow for the use of OCT in everyday practice.
Biopsy ; Dental Caries ; Imaging, Three-Dimensional ; Interferometry ; Ophthalmology ; Radiation, Ionizing ; Tomography, Optical Coherence

OBJECTIVES: This study investigated changes in gene expressions concerning of differentiation, proliferation, mineralization and inflammation using Human-8 expression bead arrays when white Mineral Trioxide Aggregate and calcium hydroxide-containing cement were applied in vitro to human dental pulp cells (HDPCs). MATERIALS AND METHODS: wMTA (white ProRoot MTA, Dentsply) and Dycal (Dentsply Caulk) in a Teflon tube (inner diameter 10 mm, height 1 mm) were applied to HDPCs. Empty tube-applied HDPCs were used as negative control. Total RNA was extracted at 3, 6, 9 and 24 hr after wMTA and Dycal application. The results of microarray were confirmed by reverse transcriptase polymerase chain reaction. RESULTS: Out of the 24,546 genes, 43 genes (e.g., BMP2, FOSB, THBS1, EDN1, IL11, COL10A1, TUFT1, HMOX1) were up-regulated greater than two-fold and 25 genes (e.g., SMAD6, TIMP2, DCN, SOCS2, CEBPD, KIAA1199) were down-regulated below 50% by wMTA. Two hundred thirty nine genes (e.g., BMP2, BMP6, SMAD6, IL11, FOS, VEGFA, PlGF, HMOX1, SOCS2, CEBPD, KIAA1199) were up-regulated greater than two-fold and 358 genes (e.g., EDN1, FGF) were down-regulated below 50% by Dycal. CONCLUSIONS: Both wMTA and Dycal induced changes in gene expressions related with differentiation and proliferation of pulp cells. wMTA induced changes in gene expressions related with mineralization, and Dycal induced those related with angiogenesis. The genes related with inflammation were more expressed by Dycal than by wMTA. It was confirmed that both wMTA and Dycal were able to induce gene expression changes concerned with the pulp repair in different ways.
Aluminum Compounds ; Calcium ; Calcium Compounds ; Calcium Hydroxide ; Dental Pulp ; Dental Pulp Capping ; Drug Combinations ; Gene Expression ; Glutamates ; Guanine ; Humans ; Hydroxides ; Inflammation ; Interleukin-11 ; Minerals ; Oxides ; Polytetrafluoroethylene ; Reverse Transcriptase Polymerase Chain Reaction ; RNA ; RNA-Directed DNA Polymerase ; Silicates ; Transcriptome ; Pemetrexed

The purpose of this study was to compare mineral trioxide aggregate (MTA; Dentsply, Tulsa Dental, Tulsa, OK, USA), which is widely used as root-end filling material, with DiaRoot BioAggregate (DB; Innovative BioCaramix Inc, Vancouver, BC, Canada), newly developed product, by using MG63 osteoblast-like cells. MTA, DB, and Intermediate Restorative Material (IRM; Dentsply Caulk, Milford, DE, USA) were used for root-end filling material while tissue culture plastic was used for control group. Each material was mixed and, the mixtures were left to set for 24 hours. MG63 cells were seeded to each group and then they were cultured for attachment for 4 hours. Following the attachment of cells to the root-end filling material, early cellular response was observed. After another 12 hours'culture, the level of attachment between cells and material was observed and in order to identify the effect of each material to bone formation, transforming growth factor beta1 (TGFbeta1) and osteocalin (OC) were estimated by using enzyme-linked immunosorbent assay (ELISA), and the amount of alkaline phosphatase (ALP) was also measured. The data were analyzed using one-way ANOVA. As a result, only at OC and the number of cells which were attached to materials, there was no statistical difference between MTA and DB. At other items, there was statistically significant difference in all groups. Although DB has not shown exactly the same cellular response like that of MTA, the number of attached cells shows that biocompatibility of the material and OC indicates bone formation rate. Therefore, if DB is used for root end filling material, it is expected to lead to similar results to MTA.
Alkaline Phosphatase ; Aluminum Compounds ; Calcium Compounds ; Calcium Hydroxide ; Drug Combinations ; Enzyme-Linked Immunosorbent Assay ; Glutamates ; Guanine ; Hydroxyapatites ; Osteogenesis ; Oxides ; Plastics ; Polymethyl Methacrylate ; Seeds ; Silicates ; Transforming Growth Factor beta1 ; Pemetrexed

OBJECTIVES: The purpose of this retrospective study was to evaluate the success rate of intentionally replanted mandibular second molar with C-shaped canal configurations and to access the impact of preoperative periapical lesion on the success of intentional replantation procedure. MATERIALS AND METHODS: This retrospective chart review study evaluated 52 intentionally replanted mandibular second molar teeth treated at Seoul National University Dental Hospital Department of Conservative Dentistry from January 2005 to December 2007. Seventeen teeth were lost for the follow-up, and another 6 teeth did not meet inclusion criteria of C-shaped root canal configurations. Healing outcome such as success, uncertain healing, and failure after follow-up was evaluated by clinical criteria and radiographs. RESULTS: The overall success rate was 72.4% for the 29 intentionally replanted C-shaped mandibular second molars. The success rate of replanted teeth with preoperative periapical lesions was similar to that of replanted teeth which have no periapical lesions. CONCLUSIONS: Therefore, root canal treatment failure on C-shaped mandibular second molar can be predictably treated by intentional replantation regardless of the presence of periapical lesion.
Dental Pulp Cavity ; Dentistry ; Follow-Up Studies ; Hospital Departments ; Intention ; Molar ; Replantation ; Retrospective Studies ; Tooth ; Treatment Failure