• Title/Summary/Keyword: Reinfection

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New trends of root canal disinfection and treatment strategies for infected root canal based upon evidence-based dentistry

  • Cho, Yong-Bum
    • Proceedings of the KACD Conference
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    • 2003.11a
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    • pp.608-608
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    • 2003
  • The main objectives of root canal therapy are cleaning and shaping and then obturating the root canal system in 3 dimensions to prevent reinfection. Many instrumentation techniques and devices, supported by an irrigation system capable of removing pulp tissue remnants and dentin debris, have been proposed to shape root canals. But current regimens in chemomechanical debridement using instrumentation and irrigation with NaOCl are not predictably effective in root canal disinfection. These findings are not surprising because the root canal system is complex and contains numerous ramifications and anatomical irregularities. The microorganisms in root canals not only invade the anatomic irregularities of the root canal system but also are present in the dentinal tubules. Therefore further disinfection with an effective antimicrobial agent may be necessary and it well1mown that use of intracanal medication will lower bacterial count in infected root canals. Calcium hydroxide has a long history of use in endodontics, and more attention has been given to the use of calcium hydroxide as intracanal dressing for the treatment of infected pulp. However, when treatment is completed in one visit, no intracanal medications other than intracanal irrigants are used. Recently, a mixture of a tetracycline isomer, an acid, and a detergent(MTAD), has been introduced as a final rinse for disinfuction of the root canal system. It has been shown that MTAD is able to remove the smear layer with minimal erosive changes on the surface of dentin, and is effective against Enterococcus faecalis, a microorganism resistant to the action of other antimicrobial medications. In another study, the ability of MTAD was investigated to disinfect contaminated root canals with whole saliva and compared its efficacy to that of NaOCl Based on the results, it seems that MTAD is significantly more effective than 5.25% NaOCl in eradicating bacteria from infected root canals. In the cytotoxicity evaluation, MTAD is less cytotoxic than engenol, 3% $H20_2,\;Ca(OH)_2$ paste, 5.25% NaGCl, Peridex, and EDTA and more cytotoxic than 2.63%,1.31% and 0.66% NaOCl. Is it promising or transient?

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Implications for selecting persistent hot spots of schistosomiasis from community- and school-based surveys in Blue Nile, North Kordofan, and Sennar States, Sudan

  • Hassan Ahmed Hassan Ahmed Ismail;Seungman Cha;Yan Jin;Sung-Tae Hong
    • Parasites, Hosts and Diseases
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    • v.61 no.2
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    • pp.216-224
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    • 2023
  • In several schistosomiasis-endemic countries, the prevalence has remained high in some areas owing to reinfection despite repeated mass drug administration (MDA) interventions; these areas are referred to as persistent hot spots. Identifying hotspots is critical for interrupting transmission. This study aimed to determine an effective means of identifying persistent hot spots. First, we investigated the differences between Schistosoma haematobium and Schistosoma mansoni prevalence among school-aged children (SAC) estimated by a community-based survey, for which local key informants purposively selected communities, and a randomly sampled school-based survey. A total of 6,225 individuals residing in 60 villages in 8 districts of North Kordofan, Blue Nile, or Sennar States, Sudan participated in a community-based survey in March 2018. Additionally, the data of 3,959 students attending 71 schools in the same 8 districts were extracted from a nationwide school-based survey conducted in January 2017. The community-based survey identified 3 districts wherein the prevalence of S. haematobium or S. mansoni infection among SAC was significantly higher than that determined by the randomly sampled school survey (e.g., S. haematobium in the Sennar district: 10.8% vs. 1.1%, P<0.001). At the state level, the prevalence of schistosomiasis among SAC, as determined by the community-based survey, was consistently significantly higher than that determined by the school-based survey. Purposeful selection of villages or schools based on a history of MDA, latrine coverage, open defecation, and the prevalence of bloody urine improved the ability for identifying persistent hot spots.

What was the main factor in successful control of ascariasis in Korea?

  • Seung-Yull Cho;Sung-Tae Hong
    • Parasites, Hosts and Diseases
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    • v.61 no.2
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    • pp.103-126
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    • 2023
  • In the l950s, under the legacy of traditional agriculture, Ascaris lumbricoides, spread epidemically in the war-bitten society of Korea. Consensus on the parasite control was drafted in the Parasite Disease Prevention Act, which passed a parliamentary agreement in 1966, and established safe disposal of feces and mass chemotherapy as control strategies. Biannual stool examinations and treating infected schoolchildren were basic scheme of the control activity through which revenue could be secured for organized business. In the 27 years following 1969, a maximum of 16 million stool examinations had been done every year. Cellophane thick smear enabled the task. The infection declined remarkably in the 1970s when industrialization and green revolution proceeded. A population study of A. lumbricoides in the late 1970s helped us better understand its epidemiology. The data also settled down the understandable protest of teachers against the repeated stool examinations. In the 9 years following 1987, the target population was gradually reduced when the egg positive rate was below 0.1%. An article in the Korean Law, stipulating obligatory stool examinations, was made optional. Although the long-term Korean effort of Ascaris control was a success, the effect of mass chemotherapy was not as succinct in terms of lowering reinfection. In the period of control, Korean agricultural technology changed, and the economy grew and supplied sanitary facilities by which the vicious cycle was disconnected. Reduction of morbidity was a benefit of mass chemotherapy, which is the only control method feasible in economically difficult countries. The most important hurdle of parasite control in the 1960s was poverty of general population and limited financial resources in Korea but the society formed a consensus on the priority of intestinal helminthiasis control during the ordeal period. The national consensus in the 1960s was the critical milestone for Ascaris control in Korea. Under the social agreement, application of timely technical and research advancements in parasitology achieved the success of ascariasis elimination. The successful experience of ascariasis elimination in Korea can be a benchmark for countries where neglected tropical diseases are endemically recycled.

Case Control Study of Recognition level for Dermatomycosis of Dermatomycosis Patient to be Treated in Ulleung Hospital of Ulleung island (울릉도의 일개 병원을 내원한 피부 진균증 환자들의 피부 진균증에 대한 인식도에 관한 사례 연구)

  • Bae, Jung-Min;Jung, Man-Jin;Ha, Dong-Yeup;Jung, Ho-Keun;Jung, Ki-Hun;Jung, Byung-Wook;Oh, Min-Koo;Bae, Sung-Han;An, Woo-Sup
    • Journal of agricultural medicine and community health
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    • v.30 no.2
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    • pp.205-211
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    • 2005
  • Objectives: In Ulleung island, many people was suffered from dermatomycosis. But many patients was not recognized to dermatomycosis due to little symptom. So, public health education was needed. We will plan education direction based on evidence. So, in one way, the recognition level was needed to determine education direction. Methods: From June to July in 2005, 45 patients was made a question. The questionnaire was composed of chief complaint, site, duration, similar disease in family, 5 questiones and so on. If patients was recognized to 1 question, 1 score was added. Remain 4 question was done in same manner. Results: The low score group were that total socre was beyond 2. And The high score group were that total score was above 3. The low score group was 24 persons, average age was 59. The high score group was 21 persons and average age was 42. Male and female ratio was 7 : 17 in low score group and 10 : 11 in high score group. Coinfection was 17 patients in low score group and 2 patients in high score group. There was only 17 patients that wete recognized that dermatomycosis and "Moozom" were same disease. And, many patients was not recognized to possibility of reinfection after treatment of dermatomycosis. Conclusions: In Ulleung island, coinfection rate was higher than other area bacause of low recognition level. And infection rate in family was higher too. So, there was essential to educate of dermatomycosis prevention. Dermatomycosis patient became older and was more female than other area, so there was need to centralize people to be needed of public health education. Finally, many statistical study for dermatomycosis should be needed for many patients and general populations in Ulleung island.

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A multi-institutional analysis of sternoclavicular joint coverage following osteomyelitis

  • Othman, Sammy;Elfanagely, Omar;Azoury, Said C.;Kozak, Geoffrey M.;Cunning, Jessica;Rios-Diaz, Arturo J.;Palvannan, Prashanth;Greaney, Patrick;Jenkins, Matthew P.;Jarrar, Doraid;Kovach, Stephen J.;Fischer, John P.
    • Archives of Plastic Surgery
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    • v.47 no.5
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    • pp.460-466
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    • 2020
  • Background Sternoclavicular joint (SCJ) osteomyelitis is a rare pathology requiring urgent intervention. Several operative approaches have been described with conflicting reports. Here, we present a multi-institutional study utilizing multiple surgical pathways for SCJ reconstruction. Methods A multi-institutional retrospective cohort study was conducted to identify patients who underwent surgical repair for sternoclavicular osteomyelitis between 2008 and 2019. Patients were stratified according to reconstruction approach: single-stage reconstruction with advancement flap and delayed-reconstruction with flap following initial debridement. Demographics, operative approach, type of reconstruction, and postoperative outcomes were analyzed. Results Thirty-two patients were identified. Mean patient age was 56.2±13.8 years and 68.8% were male. The average body mass index (BMI) was 30.0±8.8 kg/㎡. The most common infection etiologies were intravenous drug use and bacteremia (both 25%). Fourteen patients (43.8%) underwent one-stage reconstruction and 18 (56.2%) underwent delayed two-staged reconstruction. Both single and delayed-stage groups had comparable rates of reinfection (7.1% vs. 11.1%, respectively), surgical site complications (21.4% vs. 27.8%), readmissions (7.1% vs. 16.6%), and reoperations (7.1% vs. 5.6%; all P>0.05). The single-stage reconstruction group had a significantly lower BMI (26.2±5.7 kg/㎡ vs. 32.9±9.1 kg/㎡; P<0.05) and trended towards shorter hospital length of stay (11.3 days vs. 17.9 days; P=0.01). Conclusions Both single and delayed-stage approaches are appropriate methods with comparable outcomes for reconstruction for SCJ osteomyelitis. When clinically indicated, a single-stage reconstruction approach may be preferable in order to avoid a second operation as associated with the delayed phase, and possibly shortening total hospital length of stay.

Prevalence, Worm Burden and Other Epidemiological Parameters of Ascaris lumbricoides Infection in Rural Communities in Korea (한국 농촌지역의 회충 감염율, 감염량 및 역학적 변수)

  • 채종일;금구진
    • Parasites, Hosts and Diseases
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    • v.23 no.2
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    • pp.241-246
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    • 1985
  • The epidemiological status of ascariasis was analyzed in 8 rural villages in Korea, through observation of its epidemiological parameters such as prevalence, worm burden and basic reproductive rate. Total 978 inhabitants were subjected to stool examination and recovery of worms after chemotherapy with pyrantel pamoate. The results were as follows: 1. The worm positive rate in each village was 16.5~79.5%, while the egg positive rate was 9~18% lower, 3.3~66.7%. The average worm burden (among all inhabitants) ranged from O. 21 to 8. 44 by villages and the frequency of cases with each worm burden showed negative binomial distributions with 'k' values of O. 38-0. 54. 2. The prevalence rates (worm) in each village was almost identical with the theoretical ones from Anderson and May's equation; $p=1-(1+M^*/k)^{-k}$, where 'p' is worm prevalence and '$M^*$' equilibrium average worm burden. The basic reproductive rate 'R' was calculated from 1.03 to 2.11. lt is suggested that, although 'R' in lower endemic areas is approaching to the breakpoint of reinfection (R=1), control programs of ascariasis in Korea should be continued until it becomes below the level nationwidely.

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EFFECT OF POLYPHOSPHATE IN ROOT CANAL SEALERS ON THE GROWTH OF ORAL BACTERIA (Polyphosphate가 함유된 근관충전재가 구강세균의 성장에 미치는 영향)

  • 박석범;최기운;최호영
    • Restorative Dentistry and Endodontics
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    • v.26 no.2
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    • pp.141-152
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    • 2001
  • Eliminating the infecting bacteria of the root canal system and preventing reinfection must be the main objectives of all endodontic works. None of commercially available root canal sealers have the properties of desirable tissue compatibility and strong antibacterial activity. The purpose of this study is to develope an ideal root canal sealer using commercially available polyphosphate (polyP), Calgon, which is known to be antibacterial and safe. For the study. resin type AH26, zinc oxide eugenol type Tubli Seal. Ca(OH)$_2$ type Apexit as base sealers for polyP (0~3%) and para formaldehyde containing N2 as a control base were selected. Specimens (3$\times$4mm) of the sealers were prepared in a 37$^{\circ}C$ incubator for 3 and 10 days and their antibacterial activity against streptococci and black pigmented anaerobic rods was observed using an agar diffusion method. The result were as follows: 1. Among 3 day old root canal sealers. N2 as a positive control showed the strongest antibacterial effect. followed by AH26. Tubli Seal and. Apexit which barely showed antibacterial activity against the test bacteria. In contrast. 10 day old AH26 showed a greater antibacterial activity than 10 day old N2. 2. All sealer specimens showed a greater antibacterial activity against black pigmented anaerobic rods than streptococci. Three day old ones appeared to be more antibacterial than 10 day old ones except for Apexit. 3. As compared to N2, 3 day old AH26 demonstrated a similar antibacterial activity against black pig mented anaerobic rods but to a lesser extent to streptococci. Ten day old AH26 showed a greater antibacterial activity against black pigmented anaerobic rods than 10 day old N2. 4. As compared to AH26. Tubli Seal generally revealed a lower antibacterial activity but it showed a greater antibacterial activity aginst S. gordonii Challis. 5. Enhancement of antibacterial activity by polyP was more clearly observed when it was added to Ca(OH)$^{\circ}C$ based root canal sealers. Tubli Seal and N2. 6. The addition of polyP enhanced the antibacterial activity of 3 day old AH26 against S. gordonii G9B (16%) and Challis (29%), and P. gingivalis 2561 (24%) only. Moreover, polyP failed to increase antibacterial activity of 10 day old AH26 against the test strains but P. gingivalis A7A1 28(13%). 7. The addition of polyP increased the antibacterial effect of 3 day old Tubli Seal on several test bacteria including s. mutans GS 5 (50%). s. gordonii G9B (47%) and Challis (122%). and all the test strains of P. gingivalis (13~35%) except for 9 14K 1. The addition of polyP to 10 day old Tubli Seal increased antibacterial activity of the root canal sealer against most test strains. 8. 3 day old Apexit failed to show antibacterial activity. if any very little against S. mutans GS 5 and Pr. intermedia ATCC 49046. However. polyP increased its antibacterial activity by 50 and 69%, respectively. Increase of antibacterial activity of 10 day old Apexit by polyP was more clearly observed than that of 3 day old one.

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Biological Control of Crown Gall

  • Kerr, Allen;Biggs, John;Ophel, Kathy
    • Proceedings of the Korean Society of Plant Pathology Conference
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    • 1994.06a
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    • pp.11-26
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    • 1994
  • Crown gall of stonefruit and nut trees is one of the very few plant diseases subject to efficient biological control. The disease is caused by the soil-inhabiting bacteria Agrobacterium tumefaciens and Agrobacterium rhizogenes and the original control organism was a non-pathogenic isolate of A. rhizogenes strain K84. Control is achieved by dipping planting material in a cell suspension of strain K84 which specifically inhibits pathogenic strains containing a nopaline Ti plasmid. Because the agrocin 84-encoding plasmid (pAgK84) is conjugative, it can be transmitted from the control strain to pathogenic strains which, as a result, become immune to agrocin 84 and cannot be controlled. To prevent this happening, the transfer genes on pAgK84 were located and then largely eliminated by recombinant DNA technology. The resulting construct, strain K1026, is transfer deficient but controls crown gall just as effectively as does strain K84. Field data from Spain confirm that pAgK84 can transfer to pathogenic recipients from strain K84 but not from strain K1026. The latter has been registered in Australia as a pesticide and is the first genetically engineered organism in the world to be released fro commercial use. It is recommended as a replacement for strain K84 to prevent a breakdown in the effectiveness of biological control of crown gall. Several reports indicate that both strains K84 and K1026 sometimes control crown gall pathogens that are resistant to agrocin 84. A possible reason for this is that both strains produce a second antibiotic called 434 which inhibits growth of nearly all isolates of A. rhizogenes, both pathogens and non-pathogens. Crown gall of grapevine is caused by another species, Agrobacterium vitis. It is resistant to agrocin 84 and cannot be controlled by strains K84 or K1026. It is different from other crown gall pathogens in several characteristics, including the fact that, although a rhizosphere coloniser, its also lives systemically in the vascular tissue of grapevine. Pathogen free propagating material can be obtained from tissue culture or, less surely, by heat therapy of dormant cuttings. A number of laboratories are searching for a biocontrol strain that will prevent, or at least delay, reinfection. A non-pathogenic A. vitis strain F/25 from South Africa looks very promising in this regard.

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Therapeutic Outcome and Recurrence Rate of Helicobacter pylori Infection in Children (소아에서 Helicobacter pylori 감염에 대한 치료결과 및 재발률)

  • Choi, Won-Jun;Kim, Je-Woo;Chung, Ki-Sup
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.1 no.1
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    • pp.37-44
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    • 1998
  • Purpose: This study aimed at evaluating the therapeutic outcome, cost effectiveness and recurrence rate in children with H. pylori infection after the treatment using various medications. Methods: Seventy five children (mean age $11.4{\pm}2.5$ years) were given an endoscopy with biopsy and H. pylori status assessed by CLO test and histologic examination (Warthin Starry stain). Children were given one of following medications such as DA ($Denol^{(R)}$ and amoxycillin), OA (omeprazole and amoxycillin), DC ($Denol^{(R)}$ and clarithromycin) as primary treatment. And one of following medications such as DAM ($Denol^{(R)}$, amoxycillin and metronidazole), DC, OA, OC (omeprazole and clarithromycin) were used in children who failed the eradication of H. pylori. Results: The endoscopic diagnoses were: nodular gastritis (46 cases), gastric ulcer (9), duodenal ulcer (6), superficial gastritis (6), and normal (8). H. pylori eradication rate was 91% (63 of 69 children) on 4 weeks course of DA, 50% (1 of 2 cases who had treatment failure on DA) on DAM, and 75% (3 of 4 cases who treated on DC primarily) and 50% (1 of 2 cases who had treatment failure on DA) on DC, and 100% on OA (all of 2) and on OC (all of 1 who failed on DA). In 3 of 7 children in whom H. pylori had not been eradicated by primary medications (DA 6 and DC 1 case), H. pylori was re-eradicated by secondary medications (DA 1, DAM 1 and DC 1 case). But in remaining 4 cases, H. pylori infection persisted. Reinfection of H. pylori was found in 4 of 75 children between 3 months and 3 years after completion of the treatment of DA, yielding recurrence rate of 5.3%. In 2 of 4 cases who had relapsed, H. pylori was re-eradicated by secondary medications (OC 1 and DA 1 case). But in remaining 2 cases, H. pylori infection persisted. Conclusion: These results suggest that dual therapy with $Denol^{(R)}$ and amoxycillin is the effective medications in treating H. pylori infection in children. Concerning the cost effectiveness, it can be recommended as first line treatment of choice as well.

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Control of Human Clonorchiasis at Gokseong-gun and Sunchang-gun near the Sumjin River in Korea (섬진강 유역 곡성군, 순창군 지역 주민의 간흡충증 관리)

  • Kim, Suk-Il;Yun, Woo-Sang
    • Journal of agricultural medicine and community health
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    • v.29 no.1
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    • pp.163-175
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    • 2004
  • Objectives: This study was carried out to decrease the prevalence of human clonorchiasis and to evaluate the control effect in two Clonorchis sinensis-endemic area of Gokseong-gun and Sunchang-gun adjacent to the Sumjin River in Korea. Methods: The formalin-ether concentration method for stool egg examination or ELISA was applied for the diagnosis of clonorchiasis. As a primary survey, according to the non-probability sampling, a total of 1,2.13 inhabitants at Gokseong-gun were screened through the stool examination, and 1,004 inhabitants at Sunchang-gun were screened through the ELISA. The humans infected with C. sinensis were medicated with praziquantel and educated for the prevention of reinfection with the fluke. After 9 months, as a secondary survey, each prevalence of 616 inhabitants at Gokseong-gun and 2.637 inhabitants at Sunchang-gun was followed-up for the decrease of human clonorchiasis. Results: The prevalence before the mass control was 39.0% at Gokseong-gun and 30.1% at Sunchang-gun in average from 61.5% to 8.9% according to the villages (Myeon) of the survey. In the riverside villages to the Sumjin River the prevalences were higher than other villages located far from the river. The prevalence after the control was decreased to the level of 22.4% at Gokseong-gun(P<0.0001) and 16,3% at Sunchang-gun (P<0.0001). Conclusions: These results suggested that human clonorchiasis was still highly endemic in riverside area of the Sumjin River and could be decreased through the control activities such as diagnosis, medication and education. It was highly recommended that a integrated control such as those of the present study must be adopted in other localities along the Sumjin River for the eradication of human clonorchiasis.

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