The purpose of this study was to focus on the number of brushing strokes among the performance factors and identify if the 10 times stroke of the rolling method is rational. Moreover, we evaluated the changes in oral health knowledge, perception, and behavior after our rolling method instruction. The 10-stroke method of toothbrushing has been regarded as an effective method of removal of dental plaque, although there is little evidence to support this claim. We allocated 40 healthy subjects to two intervention groups. During five visits, we measured a score for dental plaque removal and instructed the subjects on a toothbrushing technique with 5 or 10 strokes per section. At the initial and final visits, subjects completed a questionnaire on one designed specifically for this study about oral health knowledge, perceptions, and behaviors. Repeated measures analysis of variance was used to compare the dental plaque removal score between the groups, and the changes in scores within each group over time. We also compared changes in mean scores in oral health knowledge, perceptions and behaviors before and after toothbrushing instruction. We found that the score for dental plaque removal increased with each additional toothbrushing instruction in both groups (p < 0.001). However, we found no differences in the dental plaque removal scores between the 5-stroke and 10-stroke groups (p=0.399). The levels of oral health knowledge, perceptions and behaviors increased after the toothbrushing instructions in both groups. Our findings suggest that there is no advantage in emphasizing the 10-stroke method of toothbrushing in an oral health education program.
Dental Plaque ; Education* ; Health Education ; Healthy Volunteers ; Methods ; Oral Health ; Stroke* ; Toothbrushing*

The aim of this study was to analyze in depth the standardized Clinical dental hygiene curriculum of the Fones School in the United States. We investigated the clinical dental hygiene curriculum in 2015~2016 including title, credit, hours, contents, goals, competencies, and evaluation. We obtained the course syllabus and data related to each subject, for each grade, from the professors and students at the university. The goals and competencies, of the clinical dental hygiene program, which were based on the goals of the Fones School and the mission of the University of Bridgeport, were developed in accordance with the dental hygienist practice standards proposed by the American Dental Hygienists Association. The curriculum consisted of theory to teach proper dental hygiene care procedures and incorporated practical exercises that modeled an actual clinical setting. The students had to document the procedures performed for each client/patient and improve their clinical competency through discussion with the professors. Dental hygiene care should be provided for children, adolescents, adults, elderly, and patients, which includes patients with moderate or severe periodontal status. Students were evaluated by a paper test or case study presentation and their clinical evaluation was based on their clinical competency. In particular, professors evaluated students on a rotational basis, so they could evaluate the level of achievement of clinical competency of all students and find ways to improve any weaknesses. Therefore, the current study suggested that clinical dental hygiene program in Korea could be improved if based on the curriculum of Fones School in the United States.
Adolescent ; Adult ; Aged ; Child ; Clinical Competence ; Curriculum* ; Dental Hygienists ; Exercise ; Humans ; Korea* ; Oral Hygiene* ; United States*

PURPOSE: Mumps meningitis is a common complication of mumps infection; however, information on mumps meningitis in the postvaccine era is limited. The purpose of the present study was to determine factors associated with mumps meningitis and to discuss the effect of vaccination on this disease. METHODS: We retrospectively reviewed patients younger than 19 years with mumps, diagnosed at a university hospital in Korea between 2003 and 2013. Patients were divided into groups with and without meningitis, and the clinical features of the 2 groups were compared. RESULTS: The study enrolled 119 patients: 19 patients with meningitis and 100 patients without. Univariate analysis showed that older age (median: 15 years vs. 9.5 years, respectively), a longer interval from last vaccination (median: 10.2 years vs. 4.8 years, respectively), and febrile presentation (94.7% vs. 31.0%, respectively) were significantly associated with mumps meningitis. Sex, number of vaccination doses, bilateral parotitis, and the presence of complications other than meningitis did not differ between the 2 groups. In multivariate logistic regression analysis, age (odds ratio, 1.38; 95% confidence interval, 1.01-1.89; P=0.04) and fever (odds ratio, 30.46; 95% confidence interval, 3.27-283.61; P<0.01) remained independent factors for mumps meningitis. CONCLUSION: Clinicians in the postvaccine era should be aware of the possibility of mumps meningitis in febrile cases of mumps in adolescents, regardless of the number of vaccination doses. To establish the role of vaccination in mumps meningitis, further studies will be necessary.
Adolescent ; Child ; Fever ; Humans ; Korea ; Logistic Models ; Measles-Mumps-Rubella Vaccine ; Meningitis* ; Meningitis, Viral ; Mumps* ; Parotitis ; Retrospective Studies ; Vaccination*

PURPOSE: To assess gastric pH and its relationship with urease-test positivity and histological findings in children with Helicobacter pylori infection. METHODS: Fasting gastric juices and endoscopic antral biopsy specimens were collected from 562 children and subjected to the urease test and histopathological examination. The subjects were divided into 3 age groups: 0-4, 5-9, and 10-15 years. The histopathological grade was assessed using the Updated Sydney System, while the gastric juice pH was determined using a pH meter. RESULTS: The median gastric juice pH did not differ significantly among the age groups (p=0.655). The proportion of individuals with gastric pH >4.0 was 1.3% in the 0-4 years group, 6.1% in the 5-9 years group, and 8.2% in 10-15 years (p=0.101). The proportions of moderate and severe chronic gastritis, active gastritis, and H. pylori infiltration increased with age (p<0.005). Urease-test positivity was higher in children with hypochlorhydria (77.8%) than in those with normal gastric pH (31.7%) (p<0.001). Chronic and active gastritis were more severe in the former than the latter (p<0.001), but the degree of H. pylori infiltration did not differ (20.9% vs. 38.9%; p=0.186). CONCLUSION: Gastric pH while fasting is normal in most children regardless of age. Urease-test positivity may be related to hypochlorhydria in children, and hypochlorhydria is in turn related to H. pylori infection.
Achlorhydria ; Biopsy ; Child* ; Fasting ; Gastric Juice ; Gastritis ; Helicobacter pylori* ; Helicobacter* ; Humans ; Hydrogen-Ion Concentration* ; Urease

Infantile hypertrophic pyloric stenosis (IHPS) is one of the common surgical abdomen in infancy, characterized by progressive non-bilious vomiting. The etiology is unknown, but it likely develops after birth. The pylorus of the stomach becomes thick and triggers progressive vomiting. Abdominal ultrasonography (US) is widely used as a diagnostic tool. Currently, there is a rare IHPS patient with severe metabolic derangement because of general use of abdominal US and its accuracy. We experienced a natural course of a 62- day-old male infant with IHPS who was suffering from intermittent vomiting, loss of weight but had not been properly treated for 1 month. It is needed to make an effort to diagnose differentially in recurrent vomiting infant and check-up regularly, and also educate parents properly.
Abdomen ; Education ; Humans ; Infant ; Male ; Parents ; Parturition ; Pyloric Stenosis, Hypertrophic* ; Pylorus ; Stomach ; Ultrasonography ; Vomiting

The incidence of anterior cruciate ligament (ACL) injuries among female ballet dancers is much lower than among female soccer players, there is currently little research examining the landing error scoring system (LESS) of female ballet dancers and female soccer players. The purpose of this study was to investigate the LESS during drop vertical jump on ACL injury risk factors in female ballet dancers and female soccer players. Thirteen professional female ballet dancers and elite female soccer players participated in the study. Independent sample t-test was used to compare the LESS score between the groups with Bonferroni collection. The elite female soccer player group showed significantly higher stance width-wide, foot position-toe out, symmetric initial foot contact, overall impression and total LESS score than those of the professional ballet dancers.
Anterior Cruciate Ligament* ; Female* ; Foot ; Humans ; Incidence ; Risk Factors* ; Soccer*

PURPOSE: To investigate the differences in clinical features and laboratory findings between group D and non-group D non-typhoidal Salmonella (NTS) gastroenteritis in children. METHODS: A retrospective chart review of children diagnosed with NTS confirmed by culture study was performed. The clinical features and laboratory findings of group D and non-group D NTS were compared. RESULTS: From 2003 to 2012, 75 cases were diagnosed as NTS at our center. The number of group D and non-group D patients was 45 and 30, respectively. The mean age was higher in group D than in non-group D patients (5.1 years vs. 3.4 years, p=0.038). Headaches were more frequently observed (p=0.046) and hematochezia was less frequently observed (p=0.017) in group D than in non-group D NTS gastroenteritis patients. A positive Widal test result was observed in 53.3% of group D and 6.7% of non-group D NTS cases (O-titer, p=0.030; H-titer, p=0.039). There were no differences in white blood cell counts, level of C-reactive protein and rate of antimicrobial resistance between group D and non-group D cases. CONCLUSION: The more severe clinical features such as headache, fever, and higher Widal titers were found to be indicative of group D NTS gastroenteritis. Additionally, group D NTS gastroenteritis was more commonly found in older patients. Therefore, old age, fever, headache, and a positive Widal test are more indicative of group D NTS than non-group D NTS gastroenteritis. Pathophysiological mechanisms may differ across serologic groups.
C-Reactive Protein ; Child* ; Fever ; Gastroenteritis* ; Gastrointestinal Hemorrhage ; Headache ; Humans ; Leukocyte Count ; Retrospective Studies ; Salmonella enterica ; Salmonella Infections ; Salmonella*

PURPOSE: To investigate the differences in clinical features and laboratory findings between group D and non-group D non-typhoidal Salmonella (NTS) gastroenteritis in children. METHODS: A retrospective chart review of children diagnosed with NTS confirmed by culture study was performed. The clinical features and laboratory findings of group D and non-group D NTS were compared. RESULTS: From 2003 to 2012, 75 cases were diagnosed as NTS at our center. The number of group D and non-group D patients was 45 and 30, respectively. The mean age was higher in group D than in non-group D patients (5.1 years vs. 3.4 years, p=0.038). Headaches were more frequently observed (p=0.046) and hematochezia was less frequently observed (p=0.017) in group D than in non-group D NTS gastroenteritis patients. A positive Widal test result was observed in 53.3% of group D and 6.7% of non-group D NTS cases (O-titer, p=0.030; H-titer, p=0.039). There were no differences in white blood cell counts, level of C-reactive protein and rate of antimicrobial resistance between group D and non-group D cases. CONCLUSION: The more severe clinical features such as headache, fever, and higher Widal titers were found to be indicative of group D NTS gastroenteritis. Additionally, group D NTS gastroenteritis was more commonly found in older patients. Therefore, old age, fever, headache, and a positive Widal test are more indicative of group D NTS than non-group D NTS gastroenteritis. Pathophysiological mechanisms may differ across serologic groups.
C-Reactive Protein ; Child* ; Fever ; Gastroenteritis* ; Gastrointestinal Hemorrhage ; Headache ; Humans ; Leukocyte Count ; Retrospective Studies ; Salmonella enterica ; Salmonella Infections ; Salmonella*

Lupus anticoagulant-hypoprothrombinemia syndrome (LA-HPS) is a rare disorder, and appears mostly in children. The primary concern is its potential development into systemic lupus erythematosus (SLE). A 5-year-old patient was hospitalized with multiple purpuric lesions. A markedly prolonged prothrombin time and activated partial thromboplastin time were observed and were not corrected after mixing with normal plasma. Decreased factor II activity was consistent with LA-HPS. Identifying risk factors that play an important role in the development of SLE in patients with LA-HPS is of importance. Based on the case described here, anti-double stranded (ds) DNA antibody and the Sapporo criteria for antiphospholipid syndrome are related to subsequent SLE development, whereas there is no correlation with the results of the lupus anticoagulant (LA) test. We recommend an early and serial examination of anti-ds DNA antibody and full evaluation of Sapporo criteria for the screening of patients with LA-HPS who may progress to SLE.
Antiphospholipid Syndrome ; Child ; Child, Preschool ; DNA ; Humans ; Lupus Coagulation Inhibitor ; Lupus Erythematosus, Systemic ; Mass Screening ; Partial Thromboplastin Time ; Plasma ; Prothrombin ; Prothrombin Time ; Risk Factors

Familial Mediterranean fever (FMF) is known to be a genetic disorder that prevalent among populations surrounding the Mediterranean Sea. Since Mediterranean fever gene (MEFV) was discovered at 1997, some cases have been reported in countries not related or close to this area like Japan. In addition it has been generally accepted that the clinical onset of FMF begins before 20 yr of age in most patients. Onset of the disease at an older age may occur but is rare. Adult-onset FMF may be a form of disease with distinct clinical, demographic and molecular characteristics. We describe a case of adult-onset FMF confirmed by DNA analysis of the MEFV gene in a Korean patient. A 32-yr-old man, who has no family history of FMF, presented with periodic fever, abdominal pain and vomiting. Though several various tests were thoroughly performed to evaluate the cause of his symptoms, there was no evidence of infectious, autoimmune or neoplastic diseases. Several gene analysis of periodic fever syndrome was finally performed and two point mutations (p.Leu110Pro, p.Glu148Gln) were identified. We confirmed the first adult case of FMF through detection of MEFV gene mutations in Korea and describe his clinical characteristics.
Abdominal Pain/etiology ; Adult ; Cytoskeletal Proteins/*genetics/metabolism ; DNA Mutational Analysis ; Familial Mediterranean Fever/*diagnosis/genetics ; Fever/etiology ; Humans ; Male ; Polymorphism, Single Nucleotide ; Republic of Korea ; Tomography, X-Ray Computed ; Vomiting/etiology