The purpose of this study was to investigate the effect of blood contact and tooth mobility on volumetric changes of calcium silicate-based root-end filling materials using a micro-CT. Three calcium silicate-based materials (ProRoot MTA, Biodentine, and RetroMTA) were used in this study. Seventy-two extracted human single-rooted premolars were obturated with gutta percha. Root-end resection and root-end preparation were performed. After root-end filling with tested materials, the tooth specimens were immersed in saline or blood for 5 days in a 37 ℃ incubator (n=8). The tooth specimens were mounted in a chewing simulator to simulate tooth mobility with a force of 30 N and 20,000 cycles. Micro-CT scans were performed immediately after root-end filling and after exposure to storage media or simulation of tooth mobility. The volume loss (%) was obtained from difference in the percentage of defects of materials between first and second micro-CT scans. Apical volume loss (%; volume loss from resected surface to 1 mm from the surface) was calculated for tooth mobility simulating groups. Biodentine showed larger total volume loss than ProRoot MTA and RetroMTA in saline and blood. ProRoot MTA had smaller total volume loss in blood than in saline. Under the condition simulating tooth mobility, total volume loss was similar among materials, and apical volume loss of Biodentine was larger than that of RetroMTA. In conclusion, ProRoot MTA or Retro MTA is recommended in clinical situation of intentional replantation where tooth mobility or direct contact with blood may occur.

Background and Objectives: Prior studies have shown that stroke patients treated with percutaneous left atrial appendage occlusion (LAAO) for non-valvular atrial fibrillation (NVAF) experience better outcomes than similar patients treated with warfarin. We investigated the impact of percutaneous left atrial appendage closure on post-stroke neurological outcomes in NVAF patients, compared with non-vitamin K antagonist oral anticoagulant (NOAC) therapy. Methods: Medical records for 1,427 patients in multiple registries and for 1,792 consecutive patients at 6 Korean hospitals were reviewed with respect to LAAO or NOAC treatment.Stroke severity in patients who experienced ischemic stroke or transient ischemic attack after either treatment was assessed with modified Rankin Scale (mRS) scoring at hospital discharge and at 3 and 12 months post-stroke. Results: mRS scores were significantly lower in LAAO patients at 3 (p<0.01) and 12 months (p<0.01) post-stroke, despite no significant differences in scores before the ischemic cerebrovascular event (p=0.22). The occurrences of disabling ischemic stroke in the LAAO and NOAC groups were 36.7% and 44.2% at discharge (p=0.47), 23.3% and 44.2% at 3 months post-stroke (p=0.04), and 13.3% and 43.0% at 12 months post-stroke (p=0.01), respectively.Recovery rates for disabling ischemic stroke at discharge to 12 months post-stroke were significantly higher for LAAO patients (50.0%) than for NOAC patients (5.6%) (p<0.01). Conclusions Percutaneous LAAO was associated with more favorable neurological outcomes after ischemic cerebrovascular event than NOAC treatment.

Background and Objectives: Prior studies have shown that stroke patients treated with percutaneous left atrial appendage occlusion (LAAO) for non-valvular atrial fibrillation (NVAF) experience better outcomes than similar patients treated with warfarin. We investigated the impact of percutaneous left atrial appendage closure on post-stroke neurological outcomes in NVAF patients, compared with non-vitamin K antagonist oral anticoagulant (NOAC) therapy. Methods: Medical records for 1,427 patients in multiple registries and for 1,792 consecutive patients at 6 Korean hospitals were reviewed with respect to LAAO or NOAC treatment.Stroke severity in patients who experienced ischemic stroke or transient ischemic attack after either treatment was assessed with modified Rankin Scale (mRS) scoring at hospital discharge and at 3 and 12 months post-stroke. Results: mRS scores were significantly lower in LAAO patients at 3 (p<0.01) and 12 months (p<0.01) post-stroke, despite no significant differences in scores before the ischemic cerebrovascular event (p=0.22). The occurrences of disabling ischemic stroke in the LAAO and NOAC groups were 36.7% and 44.2% at discharge (p=0.47), 23.3% and 44.2% at 3 months post-stroke (p=0.04), and 13.3% and 43.0% at 12 months post-stroke (p=0.01), respectively.Recovery rates for disabling ischemic stroke at discharge to 12 months post-stroke were significantly higher for LAAO patients (50.0%) than for NOAC patients (5.6%) (p<0.01). Conclusions Percutaneous LAAO was associated with more favorable neurological outcomes after ischemic cerebrovascular event than NOAC treatment.

Flavonoids are plant pigments that have been demonstrated to exert various pharmacological effects including anti-cancer, anti-diabetic, anti-atherosclerotic, anti-bacterial, and anti-inflammatory activities. However, the molecular mechanisms in terms of exact target proteins of flavonoids are not fully elucidated yet. In this study, we aimed to evaluate the anti-inflammatory mechanism of scutellarein (SCT), a flavonoid isolated from Erigeron breviscapus, Clerodendrum phlomidis and Oroxylum indicum Vent that have been traditionally used to treat various inflammatory diseases in China and Brazil. For this purpose, a nitric oxide (NO) assay, polymerase chain reaction (PCR), nuclear fractionation, immunoblot analysis, a kinase assay, and an overexpression strategy were employed. Scutellarein significantly inhibited NO production in a dose-dependent manner and reduced the mRNA expression levels of inducible NO synthase (iNOS) and tumor necrosis factor (TNF)-alpha in lipopolysaccharide (LPS)-activated RAW264.7 cells. In addition, SCT also dampened nuclear factor (NF)-kappaB-driven expression of a luciferase reporter gene upon transfection of a TIR-domain-containing adapter-inducing interferon-beta (TRIF) construct into Human embryonic kidney 293 (HEK 293) cells; similarly, NF-kappa B nuclear translocation was inhibited by SCT. Moreover, the phosphorylation levels of various upstream signaling enzymes involved in NF-kappaB activation were decreased by SCT treatment in LPS-treated RAW264.7 cells. Finally, SCT strongly inhibited Src kinase activity and also inhibited the autophosphorylation of overexpressed Src. Therefore, our data suggest that SCT can block the inflammatory response by directly inhibiting Src kinase activity linked to NF-kappaB activation.
Brazil ; China ; Clerodendrum ; Erigeron ; Flavonoids ; Genes, Reporter ; Humans ; Interferon-beta ; Kidney ; Luciferases ; Macrophages ; NF-kappa B ; Nitric Oxide ; Nitric Oxide Synthase ; Phosphorylation ; Phosphotransferases* ; Plants ; Polymerase Chain Reaction ; RNA, Messenger ; Transfection ; Tumor Necrosis Factor-alpha

BACKGROUND: The purpose of this study was to determine the spectrum of locally prevalent pathogens and their susceptibility patterns responsible for bacteremia in pediatric hemato-oncologic patients for empiric antimicrobial therapy. MATERIALS AND METHODS: A one-year retrospective study of pediatric hematooncologic patients with bacteremia in Seoul St. Mary's Hospital, the Catholic University of Korea, from April 2009 to March 2010 was conducted using previous medical records. The findings were compared with our previous data obtained from 2004 to 2006. RESULTS: Sixty-five episodes of bacteremia were recorded in 41 patients. Of them, 55 (84.6%) occurred in neutropenic and 10 (15.4%) in non-neutropenic patients. Gram-positive organisms were more commonly isolated than Gram-negative organisms (56.9% vs. 41.5%) in the following order: viridans streptococci (23.1%), Klebsiella pneumoniae (21.6%), coagulase-negative staphylococci (12.3%), Staphylococcus aureus (7.7%), Enterococcus faecium (7.7%). Susceptibility rates of viridans streptococci to penicillin, cefotaxime and vancomycin were 33.3%, 60% and 100%, and those of Enterobacteriaceae to amikacin, ceftazidime, piperacillin/ tazobactam and meropenem were 94.7%, 73.7%, 78.9%, and 100%, respectively. Compared to our previous data, infection still contributed towards a major fraction of mortality and morbidity in the management of patients with cancer. No differences in mortality rate were observed between isolated organisms from bacteremia. CONCLUSIONS: Gram-positive organisms were more prevalent than Gram-negative organisms in our population. The monitoring of causative agents and antimicrobial resistance should be considered in therapeutic strategies of pediatric hemato-oncologic infection.
Amikacin ; Bacteremia ; Cefotaxime ; Ceftazidime ; Child ; Enterobacteriaceae ; Enterococcus faecium ; Humans ; Klebsiella pneumoniae ; Korea ; Medical Records ; Neutropenia ; Penicillanic Acid ; Penicillins ; Retrospective Studies ; Staphylococcus aureus ; Thienamycins ; Vancomycin ; Viridans Streptococci

The analysis of Y chromosome polymorphisms has become common place for the identification of male component in forensic cases. In male/female mixtures of many rape cases, Y-STRs are also very useful for the determination of contributors' number. During the analyses of 17 Y-STR haplotypes for forensic applications using the AmpFlSTR(R) Yfiler(TM) system, a number of null and duplicated alleles (40 out of 2144 subjects) were discovered. Interestingly, two haplotypes should focus the attention on forensic interpretation of Y-STR haplotype profiles, because multiple mutational events at various loci can be interpreted as a wrong mixed or allele drop-out profile.
Alleles ; Haplotypes ; Humans ; Hypogonadism ; Male ; Mitochondrial Diseases ; Ophthalmoplegia ; Rape ; Y Chromosome

BACKGROUND: Acute colonic pseudo-obstruction (ACPO) refers to dilatation of the colon and decreased bowel motility without evidence of mechanical obstruction. Neostigmine, an acetylcholinesterase inhibitor, has been used in patients in whom supportive therapy failed to resolve ACPO. Here, we report the results of administering neostigmine to treat ACPO in children with hematologic malignancies. METHODS: Between September 2005 and December 2009, 10 patients (8 male and 2 female) were diagnosed with ACPO at the Department of Pediatrics, Catholic University of Korea. Diagnosis of ACPO was based on typical clinical features as well as colonic dilatation found on abdominal CT imaging. Neostigmine was administered subcutaneously at a dosage of 0.01 mg/kg/dose (maximum 0.5 mg) twice daily for a maximum of 5 total doses. ACPO was determined to be responsive to neostigmine if the patient showed both stool passage and improvement of clinical symptoms. RESULTS: The study group included 8 acute lymphoblastic leukemia patients, 1 patient with malignant lymphoma, and 1 patient with juvenile myelomonocytic leukemia. The median age at ACPO diagnosis was 8.5 years (range, 3-14). Overall, 8 patients (80%) showed therapeutic response to neostigmine at a median of 29 hours after the initial administration (range, 1-70). Two patients (20%) showed side effects of grade 2 or above, but none complained of cardiovascular symptoms that required treatment. CONCLUSION: In this study, ACPO was diagnosed most often in late-childhood ALL patients. Subcutaneous neostigmine can be used to effectively treat ACPO diagnosed in children with hematologic malignancies without major cardiovascular complications.
Acetylcholinesterase ; Child ; Colon ; Colonic Pseudo-Obstruction ; Dilatation ; Hematologic Neoplasms ; Humans ; Korea ; Leukemia, Myelomonocytic, Juvenile ; Lymphoma ; Male ; Neostigmine ; Pediatrics ; Precursor Cell Lymphoblastic Leukemia-Lymphoma

The purpose of this study was to measure the polymerization shrinkage and hygroscopic expansion of resin-based temporary filling materials and to evaluate microleakage at the interface between the materials and cavity wall. Five resin-based temporary filing materials were investigated: Fermit (Vivadent), Quicks (Dentkist), Provifil (Promedica), Spacer (Vericom), Clip (Voco). Caviton (GC) was also included for comparison. Polymerization shrinkage of five resin-based temporary filling materials was measured using the bonded disc method. For the measurement of hygroscopic expansion, the discs of six cured temporary filling materials were immersed in saline and a LVDT displacement sensor was used to measure the expansion for 7 days. For estimating of microleakage, Class I cavities were prepared on 120 extracted human molars and randomly assigned to 6 groups of 20 each. The cavities in each group were filled with six temporary filling materials. All specimens were submitted to 1000 thermo-cycles, with temperature varying from 5degrees C/55degrees C. Microleakage was determined using a dye penetration test. The results were as follows: 1. Fermit had significantly less polymerization shrinkage than the other resin-based temporary filling materials. Fermit (0.22 %) < Spacer (0.38 %) < Quicks (0.64 %), Provifil (0.67 %), Clip (0.67 %) 2. Resin-based temporary filling materials showed 0.43 - 1.1 % expansion in 7 days. 3. Fermit showed the greatest leakage, while Quicks exhibited the least leakage. 4. There are no correlation between polymerization shrinkage or hygroscopic expansion and microleakage of resin-based temporary filling materials.
Calcium Sulfate ; Dental Cements ; Displacement (Psychology) ; Humans ; Molar ; Polymerization ; Polymers ; Polymethacrylic Acids ; Root Canal Filling Materials ; Vinyl Compounds ; Zinc Oxide

OBJECTIVES: Recently, there has been a growing enthusiasm in biological approach to personality; the identification of genes responsible for particular personality traits. The aim of this study was to investigate the association between the 5-HT1Dbeta G861C polymorphism and personality traits. METHODS: We recruited 218 normal subjects. The Korean version of the Temperament and Character Inventory (TCI) was used to assess personality traits. From blood samples taken from the subjects, DNA was isolated using standard techniques and the HT1Dbeta G861C polymorphism was genotyped by means of polymerase chain reaction and Homogeneous MassEXTEND method. We classified the subject into the GG, CG, and GG groups according to their genotypes. The differences in the temperament factors of the TCI between homozygote group (GG+CC genotype) and heterozygote group (CG genotype) were tested. RESULTS: The heterozygote group had significantly lower Harm avoidance (HA) scores and higher Self-directedness scores (SD) than the homozygote group. CONCLUSION: In conclusion, we found some associations between the 5-HT1Dbeta G861C polymorphism and the personality dimension HA and SD in a normal population.
DNA ; Genotype ; Heterozygote ; Homozygote ; Polymerase Chain Reaction ; Receptor, Serotonin, 5-HT1B* ; Temperament

PURPOSE: Hemophagocytic lymphohistiocytosis (HLH) is an important differential diagnosis in infants and children who present with prolonged fever, hepatosplenomegaly, marked hypertriglyceridemia and cytopenia. HLH is currently curable with immunomodulatory therapy, chemotherapy and stem cell transplantation. We evaluated the clinical characteristics and treatment outcomes in patients with HLH. METHODS: We reviewed retrospectively the medical records of 22 children with HLH from January 1996 to June 2003 at Catholic University St. Mary's Hospital. RESULTS: Among the 22 patients, 11 patients were male and the others were female. The median age of onset was 5.5 (0.6~14.4) years including 6 cases presenting before 2 years of age. Family history of suspicious HLH was observed in 3 patients and Epstein Barr virus (EBV) was demonstrated in 10 patients. The most frequent manifestation was fever and the median duration of fever at diagnosis was 18 (6~46) days. Common laboratory findings were neutropenia, anemia, thrombocytopenia, hypertriglyceridemia, hypofibrinogenemia and abnormal liver function tests. Bone marrow examinations showed significant hemophagocytic lymphohistiocytosis in all of these patients. No treatment was needed in 3 patients and 6 patients were treated with high dose immunoglobulin and antiviral agents, 9 cases with chemotherapy and 4 patients were transplanted with sibling bone marrow or unrelated cord blood. The causes of death were refusal to treatment in 1 patient, disease progression in 6 and pulmonary hemorrhage in 1. CONCLUSION: If the disease is familial or relapsing, progressive or persistent even without family history, hematopoietic stem cell transplantation from the best available donor is strongly recommended. In less severe secondary HLH cases, either no treatment or a short duration of therapy might suffice, but future studies are necessary to define these subsets, possibly with additional genetic markers.
Age of Onset ; Anemia ; Antiviral Agents ; Bone Marrow ; Bone Marrow Examination ; Cause of Death ; Child ; Diagnosis ; Diagnosis, Differential ; Disease Progression ; Drug Therapy ; Female ; Fetal Blood ; Fever ; Genetic Markers ; Hematopoietic Stem Cell Transplantation ; Hemorrhage ; Herpesvirus 4, Human ; Humans ; Hypertriglyceridemia ; Immunoglobulins ; Immunomodulation ; Infant ; Liver Function Tests ; Lymphohistiocytosis, Hemophagocytic* ; Male ; Medical Records ; Neutropenia ; Refusal to Treat ; Retrospective Studies ; Siblings ; Stem Cell Transplantation ; Thrombocytopenia ; Tissue Donors