Frequency of Mycobacterium tuberculosis Among M. tuberculosis Complex Strains Isolated from Clinical Specimen / 대한임상미생물학회지

BACKGROUND: Rapid and accurate detection of Mycobacterium tuberculosis (MTB) is of primary importance for infection control and selection of anti-tuberculosis drugs. However, most clinical laboratories report MTB complex (MTC) without reporting MTB because MTC comprising MTB, Mycobacterium bovis, Mycobacterium africanum, Mycobacterium microti, Mycobacterium caprae and Mycobacterium pinnipedii have 99.9% similarity at the nucleotide level and identical 16S rRNA sequences. This study was conducted to analyze the species frequency of MTC isolates obtained from clinical specimen.METHODS: Of 310 MTC isolates obtained from clinical samples in a tertiary care hospital from February 2017 to August 2018, MolecuTech Real TB-Taq (YD Diagnostics, Korea) real-time PCR was performed, specifically to detect MTB. For DNA showing MTB negative results by MTB-specific real-time PCR or pyrazinamide-resistant strains, PCR-based MTC typing, spoligotyping, and exact tandem repeat D gene sequencing were performed.RESULTS: All the 310 MTC isolates were identified to be MTB. Two MTB strains of East-African-Indian 4-Vietnam genotype, which have not been reported in Korea, were also found.CONCLUSION: There was no zoonotic tuberculosis in this study. Since we investigated only 310 MTC isolates detected in only one medical institution, multi-center study is needed to accurately know the prevalence of zoonotic tuberculosis in Korea.

Carbohydrate Composition Associated with the 2-Year Incidence of Metabolic Syndrome in Korean Adults

The aim of this study was to investigate the association between macronutrient composition and metabolic syndrome (MetS) incidence in Korean adults. Data were obtained from a cohort of 10,030 members aged 40 to 69 years who were enrolled from the 2 cities (Ansung and Ansan) between 2001 and 2002 to participate in the Korean Genome Epidemiology Study. Of these members, 5,565 participants, who were free of MetS and reported no diagnosis of cardiovascular disease at baseline, were included in this study. MetS was defined using the criteria of the National Cholesterol Education Program-Adult Treatment Panel III and Asia-Pacific criteria for waist circumference. MetS incidence rate were identified during a 2-year follow-up period. Baseline dietary information was obtained using a semi-quantitative food frequency questionnaire. Multivariate logistic regression analysis was used to evaluate the association between the quartiles of percentages of total calorie from macronutrients consumed and MetS incidence. In analyses, baseline information, including age, sex, body mass index, income status, educational status, smoking status, alcohol drinking status, and physical activity level was considered as confounding variables. Participants with the second quartile of the percentages of carbohydrate calorie (67%–70%) had a 23% reduced odds ratio (95% confidence interval, 0.61–0.97) for MetS incidence compared with those with the fourth quartile after adjusting for confounding variables. The findings suggest that middle aged or elderly Korean adults who consume approximately 67%–70% of calorie from carbohydrate have a reduced risk of MetS.

Logistic regression analysis of factors affecting the survival of first molars in Korean adults / 대한구강보건학회지

OBJECTIVES: This study aimed to analyze the variables affecting the survival of the four permanent first molars in an adult Korean population using logistic regression analysis. METHODS: The Korean government has been collecting oral health data at the national level at 3-year intervals since 2000. In addition, a national survey was conducted in 2006 among 15,777 persons aged 2-95 years who were stratified by age, gender, and region. The relationship between each of nine objective variables and tooth survival was analyzed by frequency, cross-tabulation, and logistic regression analysis, with age, gender, and economic status as functional variables. The inclusion level was alpha=0.05 and the exclusion level was alpha=0.10. The nine variables were age, occupational status, monthly family income, gender, frequency of brushing the teeth, snack intake per day, presence of diabetes, education level, and smoking (packs per year). RESULTS: The survival rate of the molars decreased with increased age. In individuals who engaged in farming, stock breeding, and fishing, the rate was 2-5 times lower than that of individuals in higher positions in terms of jobs and society. Furthermore, the survival rate for smokers was 5-10 percent lower, compared with non-smokers. CONCLUSIONS: The most significant predictor of the survival rate of the four permanent molars in Korean adults was age, followed by jobs, smoking, and gender.

Management of traumatic neuralgia in a patient with the extracted teeth and alveoloplasty: a case report

A majority of patients who sustain injuries to the peripheral sensory nerves of the face and jaws experience a slow but gradual return of sensation that is functional and tolerable, if not the same as before the injuries. However, long-term effects of such injuries are aggravating for many patients, and a few patients experience significant suffering. In some of these patients, posttraumatic symptoms become pathological and are painful. The predominant painful components are (1) numbing anesthesia dolorosa pain, (2) triggered neuralgiaform pain, (3) burning and aching causalgiaform pain, and (4) phantom pain. This is a case report of conservative management of traumatic neuralgia and neuritis as part of posttraumatic pain syndromes in geriatric patients who have undergone the teeth extraction and alveoloplasty.

Erratum: In vitro and in vivo anti-Helicobacter pylori activities of FEMY-R7 composed of fucoidan and evening primrose extract / 한국실험동물학회지

As the request of the authors, Acknowledgments section has been changed.

Evaluation of PCR-Reverse Blot Hybridization Assay, REBA Sepsis-ID Test, for Simultaneous Identification of Bacterial Pathogens and mecA and van Genes from Blood Culture Bottles

BACKGROUND: The aim of this study was to evaluate a newly developed PCR-based reverse blot hybridization assay (PCR-REBA), REBA Sepsis-ID (M&D, Wonju, Korea), to rapidly detect the presence of bacteremia and antimicrobial resistance gene in blood culture samples. METHODS: One thousand four hundred consecutive blood culture samples from patients with a delta neutrophil index greater than 2.7% were selected from March to July in 2013. Three hundred positive and 1,100 negative for bacterial growth in blood culture bottles samples were tested by conventional and real-time PCR-REBA, respectively. RESULTS: The overall agreement between the conventional identification test and the REBA Sepsis-ID test was 95.3% (286/300). Agreement for gram-positive bacteria, gram-negative bacteria, fungi, and polymicrobials was 94.5% (190/201), 97.3% (71/73), 100% (14/14), and 91.7% (11/12), respectively. The detection rate of the mecA gene from methicillin-resistant Staphylococcus isolates was 97.8% (90/92). The vanA gene was detected in one blood culture sample from which vancomycin-resistant Enterococcus was isolated. When the cycle threshold for real-time PCR was defined as 30.0, 2.4% (26/1,100) of negative blood culture samples tested positive by real-time PCR. CONCLUSIONS: The REBA Sepsis-ID test is capable of simultaneously and quickly detecting both causative agents and antimicrobial resistance genes, such as mecA and van, in blood culture positive samples.

Logistic regression analysis of factors affecting the survival of central incisors in Korean adults / 대한구강보건학회지

OBJECTIVES: This study aimed to analyze the variables affecting the survival of the four permanent central incisors in an adult Korean population using logistic regression analysis. METHODS: The Korean government has been collecting oral health data at the national level at 3-yearly intervals since 2000. In addition, a national survey was conducted in 2006 of 15,777 persons aged 2 to 95 years old who were stratified by age, gender, and region. The raw data were input and the relationship between each of eight objective variables and tooth survival was analyzed by frequency, crosstabulation, and logistic regression analysis, with age, gender, and economic status as functional variables. The inclusion level was alpha=0.05 and the exclusion level was alpha=0.10. The eight variables were age, economic status (jobs), monthly family income, gender, frequency of toothbrushing per day, presence of diabetes, education level, and smoking years. RESULTS: The survival rate of the incisors decreased with an increase in age, while that in individuals who engaged in farming, stock breeding, and fishing was 5 to 7 times lower than that in individuals in top positions in terms of jobs and society. Further, the survival rate in individuals with diabetes was 2 to 3 times higher than in those without diabetes. CONCLUSIONS: The most significant predictor of the survival rate of the four permanent incisors in Korean adults was age, followed by economic status and presence of diabetes.

In vitro and in vivo anti-Helicobacter pylori activities of FEMY-R7 composed of fucoidan and evening primrose extract / 한국실험동물학회지

Effects of FEMY-R7, composed of fucoidan and evening primrose extract, on the bacterial growth and intragastric infection of Helicobacter pylori as well as gastric secretion were investigated in comparison with a proton-pump inhibitor pantoprazole. For in vitro anti-bacterial activity test, H. pylori (1x10(8) CFU/mL) was incubated with a serially-diluted FEMY-R7 for 3 days. As a result, FEMY-R7 fully inhibited the bacterial growth at 100 microg/mL, which was determined to be a minimal inhibitory concentration. In addition, 6-hour incubation with H. pylori, FEMY-R7 inhibited urease activity in a concentration-dependent manner, showing a median inhibitory concentration of 1,500 microg/mL. In vivo elimination study, male C57BL/6 mice were infected with the bacteria by intragastric inoculation (5x10(9) CFU/mouse) 3 times at 2-day intervals, and simultaneously, orally treated twice a day with 10, 30 or 100 mg/kg FEMY-R7 for 7 days. In Campylobcter-like organism-detection test and bacterial identification, FEMY-R7 exerted a high bacteria-eliminating capacity at 30-100 mg/kg, comparably to 30 mg/kg pantoprazole. In contrast to a strong antacid activity of pantoprazole in a pylorus-ligation study, FEMY-R7 did not significantly affect gastric pH, free HCl, and total acidity, although it significantly decreased fluid volume at a low dose (10 mg/kg). The results indicate that FEMY-R7 eliminate H. pylori from gastric mucosa by directly killing the bacteria and preventing their adhesion and invasion, rather than by inhibiting gastric secretion or mucosal damage.

Treatment of dental implant-related maxillary sinusitis with functional endoscopic sinus surgery in combination with an intra-oral approach

The present report describes the case of a patient who underwent maxillary sinusitis right after dental implant installation with sinus lifting. Computed tomography scan revealed a dental implant (#16) was protruded inside the right maxillary sinus and confirmed the obstruction of ostium. A symptom remission was gained with the dual approaches combined by functional endoscopic sinus surgery and an intra-oral approach. Fully recovered function and healing of sinus were identified after 10 months follow-up. We report the case of sinusitis caused by protrusion of implants with sinus floor lift procedures and propose that practitioners should be aware of the possible its complications and management.

Analysis of Gene Mutations Associated with Antibiotic Resistance in Helicobacter pylori Strains Isolated from Korean Patients

BACKGROUND/AIMS: This study aims to identify the gene mutation pattern associated with antibiotic resistance for mainly used antibiotics in Helicobacter pylori strains isolated from Koreans. MATERIALS AND METHODS: Seventy-one H. pylori strains were isolated from gastric mucosal biopsy specimens. The specimens were cultivated and the resistance to 5 antibiotics were assessed by using agar gel dilution method. DNA sequencing was carried out to detect the resistance-related gene mutations. RESULTS: A point mutation at A2143G of 23S rRNA was observed in all of the clarithromycin resistant strains, but tetracycline resistant strains were not found. Substitution N562Y in penicillin binding protein 1 were observed in an amoxicillin resistant strain (minimum inhibitory concentration [MIC] 2.0microg/mL). Eleven (57.8%) out of 19 levofloxacin resistant strains showed amino acid substitution at N87K (8 strains), N87I, A88V and D91N in GyrA. The truncation in rdxA was detected in 8 (25.0%) out of 32 metronidazole resistant strains. Two out of the 7 patients who failed in first-line treatment of clarithromycin and amoxicillin showed A2143G mutation. CONCLUSIONS: 23S rRNA mutation is closely related to the failure of eradication, however, the fact that five people who have no gene mutation failed eradication implies that other factors are related. As MIC levels in clarithromycin and levofloxacin resistance strains are getting higher, their appropriate gene mutation is more correlated.

Analysis of Gene Mutations Associated with Antibiotic Resistance in Helicobacter pylori Strains Isolated from Korean Patients

BACKGROUND/AIMS: This study aims to identify the gene mutation pattern associated with antibiotic resistance for mainly used antibiotics in Helicobacter pylori strains isolated from Koreans. MATERIALS AND METHODS: Seventy-one H. pylori strains were isolated from gastric mucosal biopsy specimens. The specimens were cultivated and the resistance to 5 antibiotics were assessed by using agar gel dilution method. DNA sequencing was carried out to detect the resistance-related gene mutations. RESULTS: A point mutation at A2143G of 23S rRNA was observed in all of the clarithromycin resistant strains, but tetracycline resistant strains were not found. Substitution N562Y in penicillin binding protein 1 were observed in an amoxicillin resistant strain (minimum inhibitory concentration [MIC] 2.0microg/mL). Eleven (57.8%) out of 19 levofloxacin resistant strains showed amino acid substitution at N87K (8 strains), N87I, A88V and D91N in GyrA. The truncation in rdxA was detected in 8 (25.0%) out of 32 metronidazole resistant strains. Two out of the 7 patients who failed in first-line treatment of clarithromycin and amoxicillin showed A2143G mutation. CONCLUSIONS: 23S rRNA mutation is closely related to the failure of eradication, however, the fact that five people who have no gene mutation failed eradication implies that other factors are related. As MIC levels in clarithromycin and levofloxacin resistance strains are getting higher, their appropriate gene mutation is more correlated.

Antibiotic Resistance in Helicobacter pylori Strains and its Effect on H. pylori Eradication Rates in a Single Center in Korea

BACKGROUND: Clarithromycin, amoxicillin, metronidazole, tetracycline, and levofloxacin have been commonly used for the eradication of Helicobacter pylori. We compared the change in antibiotic resistance of H. pylori strains during two separate periods and investigated the effect of antibiotic resistance on H. pylori eradication. METHODS: H. pylori strains were isolated from 71 patients between 2009 and 2010 and from 94 patients between 2011 and 2012. The distribution of minimal inhibitory concentration (MIC) of 5 antibiotics was assessed using the agar dilution method, and H. pylori eradication based on the antimicrobial susceptibility of the isolates was investigated retrospectively. RESULTS: Antibiotic resistance rate against clarithromycin, amoxicillin, tetracycline, metronidazole, and levofloxacin for the 2009-2010 isolates were 7.0% (5/71), 2.8% (2/71), 0% (0/71), 45.1% (32/71), and 26.8% (19/71), respectively, and for the 2011-2012 isolates were 16.0% (15/94), 2.1% (2/94), 0% (0/94), 56.3% (53/94), and 22.3% (21/94), respectively. Multi-drug resistance for 2 or more antibiotics increased slightly from 16.9% (12/71) in the 2009-2010 isolates to 23.4% (22/94) in the 2011-2012 isolates. In follow-up testing of 66 patients, first-line treatment successfully eradicated H. pylori in 50 patients (75.8%) and failed in 4 of 7 patients (57.1%) in a clarithromycin-resistant and amoxicillin-susceptible group. CONCLUSIONS: We observed an increase in resistance to clarithromycin and an overall increase in multi-drug resistance during the 2 study periods. The effectiveness of the eradication regimen was low with combinations of clarithromycin and amoxicillin, particularly in the clarithromycin-resistant group. Thus, eradication of H. pylori depends upon periodic monitoring of antimicrobial susceptibility.

Inflammatory granuloma caused by injectable soft tissue filler (Artecoll)

Artecoll (Artes Medical Inc., San Diego, CA, USA) has recently been developed as a permanent synthetic cosmetic filler. We experienced an inflammatory granuloma resulting from a previous injection of Artecoll at the upper lip, which was regarded as a rare side effect of this filler. A 50-year-old female patient complained of swelling, dull pain, and heat in the right upper nasolabial fold area, which had started one week before her visit to Kyungpook National University Hospital. The patient received topical steroid therapy at a local clinic, which was not effective. At the injection site, a hard nodule was palpated and erythema was observed with mild tenderness. Antibiotic treatment and subsequent incision and drainage did not result in complete cure of the facial swelling, and the facial swelling and pain persisted. Computed tomography showed a lesion approximately 1-cm in size without clear boundaries and relatively increased nodular thickening. Finally, a subdermal lesion was removed via an intraoral vestibular approach. The lesion was diagnosed as inflammatory granuloma by a permanent biopsy. The patient had healed at two months after the filler injection. Although the soft tissue filler is widely used for cosmetic purposes, there is potential for complication, such as the inflammatory granuloma should be considered before treatment.

Molecular Characteristics of blaOXA-23-Producing Acinetobacter baumannii Isolated from a University Hospital / 대한임상미생물학회지

BACKGROUND: Multi-drug resistant (MDR) Acinetobacter baumannii has emerged as a significant infectious agent in hospitals worldwide. The purpose of this study was to determine the molecular characterization of MDR A. baumannii clinical isolates. METHODS: Two hundred eighty-five strains of non-duplicated A. baumannii collected from March to November 2011 from a university hospital laboratory located in the Wonju area of the Gangwon province of Korea were analyzed for MDR genes. RESULTS: All of the 285 imipenem-resistant A. baumannii isolates were encoded by a blaOXA-23-like gene, and all isolates with the blaOXA-23-like gene had the upstream element ISAba1. The 16S rRNA methylase gene armA was detected in 153 (50.2%) clinical isolates, but rmtA, rmtB, rmtC, rmtD and npmA were not detected in any isolates in the present study. The gene encoding aac(6')-Ib was the most prevalent aminoglycoside-modifying enzyme. The sequencing data for the quinolone resistance-determining region of gyrA and parC revealed the presence of Ser (TCA) 83 to Leu (TTA) and Ser (TCG) 80 to Leu (TTG) substitutions. All but one of the 285 A. baumannii isolates showed similar band patterns on repetitive extragenic palindromic-PCR profiles. CONCLUSION: The molecular characteristics of the resistance genes of MDR A. baumannii isolates obtained from the Wonju area of Gangwon province were similar to those of other areas in Korea.

Nerve Injury from Overfilled Calcium Hydroxide Root Canal Filling Paste for Maxillary Lateral Incisor Endodontic Treatment

Pseudoaneurysm of the Inferior Alveolar Artery after Surgical Curettage for Keratocystic Odontogenic Tumor: A Case Report

Endodontic Drainage in Delayed Replantation after Prolonged Extra-alveolar Period of the Avulsed Teeth: Report of a Case

Morphological analysis of maxillary sinus septum using computed tomography

INTRODUCTION: The current study examined the morphological characteristics of maxillary sinus septum by computed tomography (CT). MATERIALS AND METHODS: Two hundred and four patients (408 maxillary sinuses) who visited dental clinic were evaluated. CT were examined. The height of the septum measured from the sinus floor to the apex of the septum more than 3 mm was defined as "sinus septum". RESULTS: The prevalence of sinus septa was 21.3% (87/408), and 31.4% (64/204) of patients had more than 1 sinus septum. Females showed higher and thinner sinus septa than males. The anatomic location of the septa were distributed in the 2nd molar region (43.7%), 1st molar region (31.0%), 2nd premolar region (21.8%) and 1st premolar region (3.5%). In 57 patients with chronic disease, there was no significant difference between sinus disease and the presence of sinus septa. The loss of remaining teeth and teeth adjacent to the sinus septum area was not related to the presence of sinus septa. Older subjects showed a reduced height and length of the septum, and a thicker septum. CONCLUSION: These results show that the maxillary sinus septum undergoes atrophy with age.

Evaluation of an Alveolar Bone Graft for Cleft Patients

Conservative infection control on acute pericoronitis in mandibular third molar patients referred from the prison

In the presence of acute pericoronitis of mandilbular third molar, antibiotic therapy and early incision and drainage are the method of choice, followed by definitive surgical extraction of the tooth as soon as it becomes subacute. If excision of the overlying tissues is decided on, it should be done adequately. All overlying tissues must be throughly excised, and the crown portion of the unerupted tooth should be completely exposed. After excision has been completed, the wound should be managed with a surgical dressing. This should be allowed to remain approximately 7 days. And then, surgical extraction of the impacted mandibular third molar can be done usually. In this operation, there are many complications, such as, postoperative bleeding, infection, trismus, dysphasia and paresthesia. The surgeon are discredited and medicolegal problem may be occurred in the presence of many distressed complications. Therefore, the relatively nonsurgical treatment is the method of choice. So, authors selected the conservative treatment methods of incision and drainage, primary endodontic drainage, operculectomy without surgical extraction of the mandibular third molars. The results were more favorable without the postoperative complication in Wonju old offender prison.