The systematic school dental health programmes have been recognized as one of the most effective national dental health measures. This study was conducted to estimate the number of dentists required for the systematic school dental programmes in Korea applying the methodology recommended by WHO. Information necessary for the study was obtained by a mass oral examination to the 1241 primary and middle school students in Kang Wha area. First and 6th grade students from primary school and 3rd year students from middle school were specifically selected for the examination. The results are summarized below: 1) For the Type I program recommended by WHO, 1.8 dentists per 10,000 primary school children were estimated to be necessary. For the Type II program 2.5 dentists, Type III program 2.0 dentists, Type IV program 3.6 dentists per 10,000 primary school children were estimated to be necessary. In order to extend the systematic school dental programmes to the middle students, 2.0 dentists for the Type I program and 2.4 dentists for the Type II program 2.2 dentists for the Type III program, 3.6 dentists for the Type IV program per 10,000 students were estimated to be necessary. 2) If we assume that prophylaxis are done by hygienist, for the Type I program 1.3 dentists and 0.5 hygienist, for the Type II program 1.8 dentists and 0.7 hygienist, for the Type III program 1.3 dentists and 0.7 hygienist, for the Type III program 2.2 dentists and 1.4 hygienists per 10,000 primary school students were estimated to be necessary. In order to extend this program to the middle school, 1.4 dentists and 0.6 hygienist for the Type I program, 1.6 dentists and 0.8 hygienist for the Type II program, 1.4 dentists and 0.8 hygienist for the Type III program, 2.2 dentists and 1.4 hygienist for the Type IV program per 10.000 students were estimated to be necessary.
Purpose: The prevalence of skin cancers and cutaneous premalignant lesions are increasing recently. It is necessary to treat cutaneous premalignant lesions, because these can progress to invasive skin cancers. We conducted a retrospective study to evaluate the usefulness of $CO_2$ laser resurfacing in skin tumor surgery. Methods: From 2005 to 2008, 14 patients with skin cancers, photodamaged skin and cutaneous premalignant lesions were treated with skin cancer excision, immediate reconstruction, and $CO_2$ facial laser resurfacing. Mean average follow-up period was 15.6 months (5 months - 36 months). Biopsy and clinical photograph were taken preoperatively, intraoperatively and through follow-up period to assess the effectiveness of laser resurfacing. Recurrence and side effects were evaluated through follow-up period. Results: Histologic examination shows the abolition of actinic atypia, regeneration of epidermis and normalization of cellular differentiation after laser resurfacing. Clinical photographs shows elimination of keratoses and spots, and the homogeneous, smoothening change of skin surface, indicating healthy and younger faces. All patients had remained free of skin cancers and premalignant lesions in laser-treated field through follow-up period. Conclusion: $CO_2$ laser resurfacing in skin tumor surgery can treat not only premalignant lesions but also subclinical lesions of photodamaged skin. Moreover it may be helpful in prophylaxis against skin cancers and premalignant lesions, providing rejuvenation and cosmetic improvement.
Jin, Hye Il;Lee, Yoo Mi;Choi, You Jin;Jeong, Su Jin
Clinical and Experimental Pediatrics
/
v.59
no.3
/
pp.120-125
/
2016
Purpose: Viral gastroenteritis among children is mainly caused by rotavirus, norovirus, astrovirus, or adenovirus strains. However, changing socioeconomic conditions and a rotavirus vaccination program may be affecting the prevalence of these viral infections. Therefore, we aimed to elucidate the season-specific trends in viral infections for facilitating prophylaxis and surveillance in our region. Methods: We evaluated 345 pediatric patients (203 males, 142 females; age, 1 month to 16 years) who visited the CHA Bundang Medical Center because of gastroenteric symptoms between June 2014 and May 2015. The specimens were simultaneously tested for norovirus, rotavirus, astrovirus, and adenovirus via multiplex reverse transcription polymerase chain reaction. Clinical characteristics of patients were analyzed retrospectively. Results: The most common virus was norovirus, followed by rotavirus, adenovirus, and astrovirus. Of all viral infections, 45.2% occurred mainly between 6 and 24 months of age; in particular, norovirus infection mostly occurred in all age groups except those below 6 months of age, when rotavirus was most prevalent. In addition, seasonal variation was observed, such as norovirus infection from December to February, rotavirus infection from February to April, and adenovirus infection from July to October. Conclusion: Our results showed that the most common cause of acute pediatric viral gastroenteritis had changed from rotavirus to norovirus in our patients, because of effective rotaviral vaccination. We recommend the management of food and personal hygiene in accordance with age or seasons as well as active vaccination for preventing viral gastroenteritis.
Cytomegalovirus (CMV) is the single most common infection following kidney transplantation and despite prophylactic strategies and the development of new antiviral agents, it still remains a cause of considerable morbidity and mortality. Current literature suggests that CMV infection may trigger rejection. We report a case of late CMV disease in a preemptive seropositive recipient who did not receive CMV prophylaxis. Diarrhea and abdominal cramping persisted after the administration of mycophenolate mofetil (MMF) six months after transplantation and resulted in ileal perforation at eight months after transplantation. The boy recovered after six weeks of treatment with ganciclovir. MMF has been mooted as a risk factor for CMV infection since its introduction, and further investigations are required to confirm its role. More attention to infectious complications is necessary and serial monitoring of viral load is recommended when MMF is administered.
Background: Carcinoid crisis is a life-threating syndrome of neuroendocrine tumors (NETs) characterized by dramatic blood pressure fluctuation, arrhythmias, and bronchospasm. In the era of booming anti-tumor therapeutics, this has become more important since associated stresses can trigger carcinoid crisis. Somatostatin analogues (SSTA) have been recommended for prophylactic administration before intervention procedures for functioning NETs. However, the efficacy is still controversial. The aim of this article is to review efficacy of SSTA for preventing carcinoid crisis. Materials and Methods: PubMed, Cochrane Controlled trials Register, and EMBASE were searched using 'carcinoid crisis' as a search term combining terms with 'somatostatin'; 'octreotide'; 'lanreotide' and 'pasireotide' until December 2013. Results: Twenty-eight articles were retrieved with a total of fifty-three unique patients identified for carcinoid crisis. The most common primary sites of NETs were the small intestine and respiratory tract. The triggering factors for carcinoid crisis included anesthesia/surgery (63.5%), interventional therapy (11.5%), radionuclide therapy (9.6%), examination (7.7%), medication (3.8%), biopsy (2%) and spontaneous (2%). No randomized controlled trials (RCTs) were identified and two case-control studies were included to assess the efficacy of SSTA for preventing carcinoid crisis by meta-analysis. The overall pooled risk of perioperative carcinoid crisis was similar despite the prophylactic administration of SSTA (OR 0.44, 95% CI: 0.14 to 1.35, p=0.15). Conclusions: SSTA wasnot helpful for preventing carcinoid crisis based on a meta-analysis of retrospective studies. Attentive monitoring and careful intervention are essential. Future studies with better quality are needed to clarify any effect of SSTA for preventing carcinoid crisis.
Diabetic nephropathy (DN) is the leading cause of end-stage failure of the kidney, but the efficacy of currently available strategies for the prevention of DN remains unsatisfactory. In this study, we investigated the effects of free anthraquinones (FARs) extract, which was extracted from the rhubarb and purified by macroporous resin DM130 with gradient mixtures of ethanol/water as the lelution solvents, in high glucose-cultured glomerular mesangial cells (MCs). The cell proliferation was determined by CCK-8 assay, the levels of TGF-${\beta}1$, CTGF, ColIV and FN proteins in the supernatant of MCs were measured by ELISA assays, and the mRNA levels of these four genes were detected by RT-PCR. The results showed that the increased proliferation of MCs, the mRNA levels and protein expression of TGF-${\beta}1$, CTGF, ColIV and FN induced by high glucose were inhibited after the treatment with the FARs extract. This indicated that FARs extract could inhibit cell proliferation and the expression of main extracellular matrix induced by high glucose in MCs. The FARs extract exhibited potential values for prophylaxis and therapy of DN.
Purpose: To retrospectively evaluate the outcome and toxicity of total lymphoid irradiation (TLI) based conditioning regimen for allogeneic hematopoietic stem cell transplantation (HSCT) in severe aplastic anemia (SAA) patients who experienced an engraftment failure from prior HSCT or were heavily transfused. Materials and Methods: Between 1995 and 2006, 20 SAA patients received TLI for conditioning of HSCT. All patients were multi-transfused or had long duration of disease. Fifteen (75%) patients had graft failure from prior HSCT. In 18 (90%) patients, the donors were human leukocyte antigen identical siblings. The stem cell source was the peripheral blood stem cell in 15 (75%) patients. The conditioning regimen was composed of antithymocyte globulin plus TLI with a median dose of 750 cGy in 1 fraction. The graft-versus-host disease (GVHD) prophylaxis used cyclosporine with methotrexate. Results: With a median follow-up of 10.8 years, graft failures developed in 6 patients. Among them, 3 patients received their third HSCT to be engrafted finally. The Kaplan-Meier overall survival rate was 85.0% and 83.1% at 5 and 10 years, respectively. The incidence of acute and chronic GVHD was 20% and 20%, respectively. None of the patients have developed a malignancy after HSCT. Conclusion: In our study, TLI based conditioning in allogeneic HSCT was feasible with acceptable rates of GVHD in SAA patients who experienced graft failure from prior HSCT or was at a high risk of graft rejection. We achieved relatively better results of engraftment and survival with a long term follow-up.
PURPOSE. To determine the extent of treatment traces, the roughness depth, and the quantity of titanium nitride (TiN) removed from the surface of CAD/CAM abutments after treatment with various instruments. MATERIALS AND METHODS. Twelve TiN coated CAD/CAM abutments were investigated for an in vitro study. In the test group (9), each abutment surface was subjected twice (150 g vs. 200 g pressure) to standardized treatment in a simulated prophylaxis measure with the following instruments: acrylic scaler, titanium curette, and ultrasonic scaler with steel tip. Three abutments were used as control group. Average surface roughness (Sa) and developed interfacial area ratio (Sdr) of treated and untreated surfaces were measured with a profilometer. The extent of treatment traces were analyzed by scanning electron microscopy. RESULTS. Manipulation with ultrasonic scalers resulted in a significant increase of average surface roughness (Sa, P<.05) and developed interfacial area ratio (Sdr, P<.018). Variable contact pressure did not yield any statistically significant difference on Sa-values for all instruments (P=.8). Ultrasonic treatment resulted in pronounced surface traces and partially detachment of the TiN coating. While titanium curettes caused predominantly moderate treatment traces, no traces or detectable substance removal has been determined after manipulation with acrylic curettes. CONCLUSION. Inappropriate instruments during regular plaque control may have an adverse effect on the integrity of the TiN coating of CAD/CAM abutments. To prevent defects and an increased surface roughness at the transmucosal zone of TiN abutments, only acrylic scaling instruments can be recommended for regular maintenance care.
Journal of The Korean Dental Society of Anesthesiology
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v.2
no.2
s.3
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pp.101-106
/
2002
Background: The management of the behavior of handicapped children when providing required dental care is often a problem, whether in the dental office or in a hospital setting. Because of the high incidence of poor cooperation, many of these patients are scheduled for dental care under general anesthesia with preoperative medical assessment. The purpose of this study was to carry out a clinico-statistical survey on dental treatment for handicapped children under general anesthesia. Methods: After approval from the institutional review board, the medical records of 64 handicapped children between 1997 and 2002 were reviewed to determine the patient profiles, anesthesia management, and complications. The charts of these patients, who underwent dental examination, scaling and prophylaxis, and restoration and extraction of teeth under general anesthesia, were reviewed. Results: The mean age was 12.8 years old, and males (53%) predominated females (47%). Twenty-four patients had mental retardation, twelve had autism, six had cerebral palsy, 4 had behavior disorder, others had heart disease, convulsive disorder, etc. Sixty-two had intravenous thiopental with neuromuscular blocker, 2 had intravenous ketamine induction. Nasotracheal intubation was uneventful in 55 patients, nine had orotracheal intubation because of difficult visualization of the larynx. Twenty-one patients experienced postoperative complications in the recovery room, including epistaxis, nasal obstruction, vomiting, airway obstruction, respiratory depression. Conclusions: General anesthesia is a very effective way of completing the dental treatments for disabled children. We emphasize the need to train anesthesiologists in the care of disabled patients.
Kim, Nam-Kyun;Kim, Hyun-Sil;Kim, Jin;Nam, Woong;Cha, In-Ho;Kim, Hyung-Jun
Journal of the Korean Association of Oral and Maxillofacial Surgeons
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v.37
no.6
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pp.515-519
/
2011
Cemento-osseous dysplasia occurs in the tooth bearing areas of the jaws and is probably the most common fibro-osseous manifestation. They are usually classified into three main groups according to their extent and radiographic appearance: periapical (surrounds the periapical region of teeth and are bilateral), focal (single lesion) and florid (scleroticsymmetrical masses) cemental-osseous dysplasias. Florid cemento-osseous dysplasia clearly appears to be a form of bone and cemental dysplasia that is limited to the jaws. Patients do not have laboratory or radiologic evidence of bone disease in other parts of the skeleton. For asymptomatic patients, the best management consists of regular recall examinations with prophylaxis and the reinforcement of good home hygiene care to control periodontal disease and prevent tooth loss. The treatment of symptomatic patients is more difficult. At this stage, there is an inflammatory component caused by the disease and the process is basically a chronic osteomyelitis involving dysplastic bone and cementum. Antibiotics might be suggested, but are not always effective. Two cases of florid cemento-osseous dysplasia diagnosed in two Korean females are reported with a review of the relevant literature.
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