BACKGROUND: Because of a lack of quality control (QC) materials, stool examination has not been standardised. This study examined intestinal parasites in diarrhea specimens to manufacture and evaluate the performance stability of QC materials for stool examination. METHODS: This study examined diarrhea specimens submitted for stool culture. Microscopic examination was performed using the direct smear and formalin-ether concentration method (Military General Laboratory, MGL). Enzyme-linked immunosorbent assay (ELISA) kits (R-Biopharm AG, Germany) and xTAG Gastrointestinal Pathogen Panel (Luminex Corp., USA) were used for the three major protozoa: Cryptosporidium parvum, Giardia lamblia, and Entamoeba histolytica. Polymerase chain reaction (PCR) was performed for Dientamoeba fragilis and Blastocystis hominis. The QC materials for stool examination were generated using Diphyllobothrium nihonkaiense ova. The manufactured QC materials were evaluated under different storage conditions, with varying preservatives, temperatures, and storage times. RESULTS: From November 2015 to April 2016, 82 diarrhea specimens were collected and tested. All results from microscopy and ELISA were negative; C. parvum (n=2) and G. lamblia (n=1) were detected by xTAG, while D. fragilis (n=10) and B. hominis (n=2) were detected by PCR. High- and low-concentration QC materials were manufactured. Using the high-concentration QC material, ova were observed in all storage conditions using MGL. Using the low-concentration QC material, the ova were observed until 14 days, but not after 3 weeks. CONCLUSIONS: It should be considered for making QC materials for stool examinations that focus on D. fragilis and B. hominis frequently found in Korea and with the caution to the low-concentration of QC materials could be unstable.
Blastocystis hominis ; Cryptosporidium parvum ; Diarrhea* ; Dientamoeba ; Diphyllobothrium ; Entamoeba histolytica ; Enzyme-Linked Immunosorbent Assay ; Giardia ; Giardia lamblia ; Korea ; Methods* ; Microscopy ; Ovum ; Parasites* ; Polymerase Chain Reaction ; Quality Control*

OBJECTIVES: The purpose of this study was to evaluate the effect of periodontal health promotion and oral hygiene in children using a vibrating toothbrush. METHODS: Forty-seven volunteers aged between 7-15 years participated in this study at local care centers from January to February 2013. A vibratory toothbrush for children was designed with the bristles operating on a self-vibration system that separated the head-neck part of the toothbrush from the handle. The toothbrush was designed with the aim of massaging the gingiva and reducing gingival inflammation. The papillary marginal attachment (PMA) index and O'Leary plaque index were measured by oral examinations before and at 4 weeks after brushing with the vibrating toothbrush. RESULTS: The PMA index and O'Leary plaque index were reduced from 39.20 to 25.42 (P<0.001) and from 5.56 to 2.78 (P<0.001), respectively. CONCLUSIONS: These results suggested that vibrating toothbrushes designed for children can be helpful in promoting gingival health and improving oral hygiene.
Aged ; Child ; Diagnosis, Oral ; Gingiva ; Gingivitis ; Health Promotion ; Humans ; Inflammation ; Oral Hygiene

Laryngo-tracheal perforation caused by the use of a stylet during tracheal intubation is a rare complication. We present a case of subcutaneous emphysema and connective tissue inflammation after tracheal intubation. The patient was a 41-year-old male undergoing general anesthesia for an appendectomy. The intubation was difficult during laryngoscopy (Cormack-Lehane Grade III). An assistant provided an endotracheal tube with a stylet inside while the laryngoscope was in place. During intubation, a short, dull sound was heard with a sudden loss of resistance after the distal tip of the endotracheal tube passed the rima glottis. A sonogram and computerized tomography revealed subcutaneous emphysema from the neck to the upper mediastinum and fluid collection between the trachea and the thyroid. This lesion appeared to have been caused by the protruded, loose stylet. Anesthesiologists should be aware of the damage a loose stylet protruding beyond the tip of the endotracheal tube can cause.
Adult ; Anesthesia, General ; Appendectomy ; Connective Tissue ; Glottis ; Humans ; Inflammation* ; Intubation ; Laryngoscopes ; Laryngoscopy ; Male ; Mediastinum ; Neck* ; Punctures* ; Subcutaneous Emphysema* ; Thyroid Gland ; Trachea

BACKGROUND AND OBJECTIVES: Microalbuminuria is associated with increased cardiovascular risk factors and mortality. The aims of this study were to clarify the relationship between the spot urine albumin-creatinine ratio (ACR) and coronary artery stenosis on diagnostic coronary angiograms and to investigate its association with inflammatory markers. SUBJECTS AND METHODS: One hundred thirteen consecutive patients, who underwent a diagnostic coronary angiogram, between April 2004 and July 2004, were divided into two groups: group I (n=89, 58+/-1 2 years, 6 1 male, no microalbuminuria) and group II (n=24, 65+/-10 years, 14 male, microalbuminuria). Microalbuminuria was diagnosed when the ACR was between 30 and 300 mg/g.cr. RESULTS: The mean age was higher in group II than group I (58+/-1 2 vs. 65+/-1 0 years, p=0.013), and group II also showed higher levels of white blood cell (7.0+/-2.4 vs. 9.5+/-4.1 x 103/mm3, p=0.009), monocyte (0.4+/-0.2 vs. 0.5+/-0.2 x 103/mm3, p=0.039), homocysteine (8.8+/-3.5 vs. 10.8+/-4.1 micro mol/L, p=0.02) and fasting plasma glucose (126.1+/-33.6 vs. 183.7+/-75.3mg/dL, p=0.001), and more frequent higher value of high sensitivity C-reactive protein (>0.5mg/dL) (16.9 vs. 66.7%, p<0.001 ) compared with those of group I. There was a correlation between the ACR and all the inflammatory markers tested. Significant coronary lesions, requiring percutaneous coronary intervention, were more frequently detected in group II than in group I (50.6 vs. 75%, p=0.032). CONCLUSION: The ACR was associated with significant coronary artery disease and the inflammatory markers.
Albuminuria ; Angina Pectoris* ; Blood Glucose ; C-Reactive Protein ; Coronary Artery Disease ; Coronary Disease ; Coronary Stenosis* ; Coronary Vessels* ; Fasting ; Homocysteine ; Humans ; Inflammation ; Leukocytes ; Male ; Monocytes ; Mortality ; Percutaneous Coronary Intervention ; Risk Factors

BACKGROUND AND OBJECTIVES: Increased QT dispersion (QTD) in patients with acute myocardial infarction (AMI) may be related with such adverse events as sudden cardiac death and ischemic heart failure. SUBJECTS AND METHODS: Two hundred eight patients (age : 62+/-10.4 years, 158 males), underwent diagnostic coronary angiography under the diagnosis of AMI between January and December 2001 at the Heart Center of Chonnam National University Hospital, and these patients were enrolled to evaluate the relationship between the QTD and myocardial injury and the complex coronary arterial lesion. RESULTS: A QTD of over 80 ms was observed in 89 patients (42.7%). There were in 61 patients with ST elevation myocardial infarction (STEMI, 68.5%) and 28 patients with non-ST elevation myocardial infarction (NSTEMI, 31.5%). There was no correlation between the QTD and such risk factors as hypertension, diabetes, gender, smoking, hyperlipidemia and family history. The level of CK-MB on admission was correlated with the QTD (112.5+/-98.1 U/L in the group with a QTD over 80 ms and 72.6+/-73.4 U/L in the group with a QTD under 80 ms, p<0.05). The ejection fraction measured by two dimensional echocardiography on admission showed correlation with the QTD (50.9+/-11.4% in the group with a QTD over 80 ms and 54.7+/-11.2% U/L in the group with a QTD under 80 ms, p<0.05). For the coronary angiographic findings, the lesion type, according to American College of Cardiology/American Heart Association classification, correlated with the QT dispersion (type B2 or C : 64.1% in the group with a QTD over 80 ms, 49.6% in the group with a QTD under 80 ms, p<0.05) CONCLUSION: There was significant correlation between the prolonged QTD and the severity of myocardial injury at admission, and the complex coronary arterial lesion in patients with AMI.
Classification ; Coronary Angiography ; Coronary Vessels* ; Death, Sudden, Cardiac ; Diagnosis ; Echocardiography ; Electrocardiography ; Heart ; Heart Failure ; Humans ; Hyperlipidemias ; Hypertension ; Jeollanam-do ; Myocardial Infarction* ; Risk Factors ; Smoke ; Smoking

BACKGROUND AND OBJECTIVES: There is serological and epidemiological evidence of an association between Chlamydia pneumoniae infection and coronary artery disease. We conducted a randomized study using azithromycin treatment in Korean patients with acute coronary syndrome (ACS) who underwent percutaneous coronary intervention (PCI) to determine whether azithromycin treatment reduced the inflammatory markers and major adverse cardiac events (MACE). SUBJECTS AND METHODS: One hundred twenty nine patients were randomly selected to receive 500 mg azithromycin daily for 3 days before and after PCI, followed by 500 mg/week for 2 weeks (Group l: 64 patients, 43 male, 60.0+/-10.0 years), or they received a placebo (Group ll: 65 patients, 45 male, 59.6+/-10.1 years). Patients were followed up for 12 months. The primary endpoints were cardiac death, recurrent myocardial infarction (MI), target lesion revascularization (TLR) and Non-TLR during the 12-month follow-up. RESULTS: There were no differences between the two groups in baseline characteristics, coronary angiography finding, lesion characteristics, baseline inflammatory markers and baseline antibody titers of Chlamydia pneumoniae, Helicobacter pyroli and Mycoplasma. After the antibiotic treatment, ESR and CRP decreased from 19.6+/-20.7 mg/dL and 0.75+/-0.99 mg/dL to 9.36+/-10.5 mg/dL and 0.22+/-0.20 mg/dL in group l (p=0.002, 0.001 respectively), and from 19.6+/-21.5 mg/dL, 1.44+/-2.69 mg/dL to 10.4+/-10.8 mg/dL, 0.55+/-1.48 mg/dL in group ll (p=0.052, <0.0001 respectively). However, there were no significant changes in the serologic markers. MACE developed in 17 (26.6%) out of 64 patients in group l with 2 death, 2 MI and 13 TLR. In group ll, 14 (21.5%) out of 65 patients had MACE with 2 death, 1 MI and 10 TLR during the 12-month clinical follow-up (p=NS). CONCLUSION: Short-term treatment with azithromycin does not reduce the major adverse cardiac events in Korean patients with ACS after PCI.
Acute Coronary Syndrome* ; Azithromycin* ; Chlamydophila pneumoniae ; Coronary Angiography ; Coronary Artery Disease ; Coronary Disease ; Death ; Follow-Up Studies ; Helicobacter ; Humans ; Inflammation ; Male ; Mycoplasma ; Myocardial Infarction ; Percutaneous Coronary Intervention* ; Secondary Prevention*

BACKGROUND: Cardiac troponin I (cTnI) is a sensitive and specific biomarker for myocardial injury. The aim of this study was to determine the significance of clinical and angiographic outcomes, success rate of the percutaneous coronary intervention (PCI), major adverse cardiac events and event-free survival rate after PCI according to the value of cTnI on admission in acute myocardial infarction (AMI) patients with multivessel lesions. METHODS: A total of 154 patients with AMI who underwent multivessel PCI between June 2000 and December 2001 at Chonnam National University Hospital were divided into two groups: Group I (n=70, 61.5+/-10.5 years, male 81.4%) with cTnI less than 10 ng/mL (6.9+/-4.7 ng/mL) and Group II (n=84, 60.8+/-10.0 years, male 75.0%) with cTnI higher than 10 ng/mL (57.4+/-40.0 ng/mL) on admission. RESULTS: Baseline ejection fraction of the left ventricle (LV) was lower in Group II than in Group I (Group I; 58.8+/-13.6% vs. Group II; 51.6+/-7.9%, p=0.002). Thrombolysis in Myocardial Infarction (TIMI) flow was higher in Group I than in Group II (2.86+/-1.24 vs. 2.42+/-1.37, p=0.024) and the diameter stenosis was less severe in Group I than in Group II (92.2+/-7.2% vs. 96.4+/-5.4%, p=0.020). The number of stents placed was lower in Group I than in Group II (1.45+/-0.50 vs. 1.63+/-0.70, p=0.023). The event-free survival rate was higher in Group I than in Group II during hospitalization and 12-month clinical follow-up after PCI (87.1% vs. 69.0%, 72.9% vs. 50.0%, p=0.008, 0.004, respectively). The independent predictors for target lesion revascularization were lesion length, CRP level on admission, stent use, diabetes mellitus, cTnI on admission (p=0.001, 0.009, 0.012, 0.019, 0.035, respectively) and the independent predictors for 1-year mortality were cardiogenic shock on admission, CRP level on admission, cTnI on admission (p<0.001, =0.005, 0.021, respectively). CONCLSUION: The high level of cTnI on admission is associated with LV dysfunction, low grade of TIMI flow and lower long-term event-free survival rate during hospitalization and at 12-month after PCI in patients with AMI.
Angioplasty ; Constriction, Pathologic ; Coronary Disease ; Diabetes Mellitus ; Disease-Free Survival ; Follow-Up Studies ; Heart Ventricles ; Hospitalization ; Humans ; Jeollanam-do ; Male ; Mortality ; Myocardial Infarction* ; Percutaneous Coronary Intervention* ; Prognosis ; Shock, Cardiogenic ; Stents ; Troponin I* ; Troponin*

BACKGROUND AND OBJECTIVES: The level of cardiac specific troponin (cTn) may be important in patients with acute coronary syndrome (ACS), but with normal electrocardiography (ECG). SUBJECTS AND METHODS: Three hundred and nineteen patients (61+/-11 years, M:F=212:107), with ACS and normal ECG, who underwent a diagnostic coronary angiogram (CAG), between July 2000 and June 2001, were analyzed according to their cTn level. The clinical characteristics, initial CAG findings and major adverse cardiac events (MACE), during a one-year clinical follow-up, were compared between positive and negative cTn groups. RESULTS: Of the enrolled patients, 191 had a negative cTn (group A, 61+/-10 years, M:F=131:60), and 128 a positive cTn (group B, 60+/-11 years, M:F=81:47), and 176 (55.2%) were shown to have significant coronary artery stenosis on CAG. There were no significant differences in risk factors between the two groups. The mean left ventricular ejection fraction was 64+/-9%, and was lower in group B than in group A (59+/-10% vs. 67+/-7%, p<0.05). cTn positivity was associated with the percentage of significant coronary artery stenosis present (88% vs. 32%, p<0.05), a smaller minimal luminal diameter (1.09+/-0.44 mm vs. 2.68+/-0.33 mm, p<0.05) and a larger diameter of stenosis (68+/-6% vs. 44+/-6%, p<0.05). A multi-vessel lesion was more common in group B than in group A (58.3% vs. 30.3%, p<0.05). During the one-year follow-up period, 36 patients developed MACE, resulting in 3 deaths, 7 acute myocardial infarctions and 34 patients with restenosis. MACE was observed in 9 patients of group A and in 27 of group B (4.7% vs. 21.1%, p<0.05). CONCLUSION: The troponin levels are valuable for the early diagnosis, and prediction of the long-term prognosis, in patients with ACS and a normal ECG.
Acute Coronary Syndrome* ; Angina, Unstable ; Constriction, Pathologic ; Coronary Disease ; Coronary Stenosis ; Early Diagnosis ; Electrocardiography* ; Follow-Up Studies ; Humans ; Myocardial Infarction ; Phenobarbital ; Prognosis ; Risk Factors ; Stroke Volume ; Troponin*

BACKGROUND: Antithrombotic therapy with heparin reduces the rate of ischemic events in patients with acute coronary syndrome. Low-molecular-weight heparin, given subcutaneously twice daily, has a more predictable anticoagulant effect than standard unfractionated heparin. Moreover, it is easier to administer and does not require monitoring. METHODS: We prospectively analyzed 180 patients with unstable angina who had undergone percutaneous coronary intervention (PCI) between 1999 and 2001 at Chonnam National University Hospital and had received either 120 U/kg of dalteparin (Fragmin (R) ), administered subcutaneously twice daily (Group I; n=90, 61.8 +/- 8.9 years, male 67.8%), or had received continuous intravenous unfractionated heparin (Group II; n=90, 62.6 +/- 9.7 years, male 70.0%). During hospitalization and at 6 month after PCI, major adverse cardiac events such as acute myocardial infarction, target vessel revascularization, death, and restenosis were examined. RESULTS: During hospitalization, the incidence of acute myocardial infarction, target vessel revascularization and death were not different between the two groups. At follow-up coronary angiography 6 months after PCI, the incidence of restenosis was lower in group I than in group II (Group I; 26/90, 28.8% vs. Group II; 32/90, 35.6%, p=0.041) and the incidence of target vessel revascularization was lower in group I than in group II (Group I; 21/90, 23.3% vs. Group II; 27/90, 30.0%, p=0.039). No difference was found in the rates of major and minor hemorrhages, ischemic strokes or thrombocytopenia between two groups. By multivariate analysis, the factors related to restenosis were lesion length, postprocedural minimal luminal diameter, CRP on admission, diabetes mellitus, the type of heparin, and stent use. CONCLUSION: Dalteparin, a low molecular weight heparin, is superior to standard unfractionated heparin in terms of reducing the restenosis rate and target vessel revascularization without increasing bleeding complications.
Angina, Unstable/radiography/*therapy ; *Angioplasty, Transluminal, Percutaneous Coronary/methods ; Anticoagulants/*administration & dosage/adverse effects ; Comparative Study ; Coronary Angiography ; Coronary Restenosis/prevention & control ; Female ; Human ; Infusions, Intravenous ; Male ; Middle Aged ; Postoperative Care ; Prospective Studies ; Tedelparin/*administration & dosage/adverse effects ; Treatment Outcome

BACKGROUND: The current techniques for percutaneous coronary interventions (PCI) remain limited by restenosis. Recent studies have provided evidence of inflammation playing a role in the pathogenesis of cardiovascular disease. METHODS: Whether inflammatory markers are predictors of subsequent restenosis were prospectively tested in 272 consecutive patients with angiographically proven coronary artery disease. Patients having undergone PCI at Chonnam National University Hospital, between Sept. 1999 and Mar. 2001, were divided into two groups according to the occurrence of restenosis on a follow-up coronary angiogram: Group I were patients with restenosis (n=99, 59.5 +/- 10.8 years, M: F=77: 22) and Group II were those without restenosis (n=173, 58.8 +/- 10.2 years, M: F=131: 42). The IgG seropositivity, cytomegalovirus (CMV) titers, C. pneumoniae, H. pylori and levels of C-reactive protein (CRP) were compared between the two groups. RESULTS: There were no statistical differences in the seropositivity of the CMV IgG C. pneumoniae IgG and H. pylori IgG between the two groups (Groups I vs. II: 100 vs. 100%, 24.7 vs. 25.7% and 62.2 vs. 63.7%, respectively). Of the angiographic parameters, a low Thrombolysis In Myocardial Infarction (TIMI) flow (TIMI 0 or I) was more common in Group I than Group II (p=0.038). The patients with an elevated CRP (> 0.5 mg/dL) were more common in Group I than Group II (57.6 vs. 36.4%, p=0.001), with the CRP values being higher in Group I than Group II (3.3 +/- 5.8 vs. 1.3 +/- 2.6 mg/dL, p=0.001). According to a multiple logistic regression analysis, the CRP was the only predictor of restenosis, with an odds ratio of 2.1169 (95% C.I. 1.2062-3.7154, p=0.009). CONCLUSION: The CRP value is the most important predictor of restenosis after PCI.
*Angioplasty, Transluminal, Percutaneous Coronary ; Antibodies, Bacterial/blood ; Antibodies, Viral/blood ; Biological Markers/analysis ; C-Reactive Protein/*analysis ; Chlamydophila pneumoniae/immunology ; Comparative Study ; Coronary Angiography ; Coronary Restenosis/*blood/diagnosis/*therapy ; Cytomegalovirus/immunology ; Female ; Helicobacter pylori/immunology ; Human ; Male ; Middle Aged ; Predictive Value of Tests ; Prognosis ; Prospective Studies ; Recurrence