• Title/Summary/Keyword: Systemic therapy

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Effects of locally-delivered minocycline hcl on controlled periodontal disease (Minocycline 국소 약물 방출 제제의 치주질환 치료 효과)

  • Chung, Mi-Hyun;Kwon, Young-Hyuk;Herr, Yeek;Lee, Man-Sup;Park, Joon-Bong
    • Journal of Periodontal and Implant Science
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    • v.28 no.1
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    • pp.37-56
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    • 1998
  • The purpose of this study was to evaluate the clinical and microbiological outcomes following the use of 30% minocycline-loaded polycaprolacton film and 2% minocycline-loaded gel that was applied locally into pockets combined with scaling and root planing. 25 human subjects who were non-pregnant, non-lactating, aged 20-50 and diagnosed as moderate to advanced adult periodontitis were enrolled. Subjects were excluded if they had a history of severe acute or chronic systemic disease, if they required antibiotic prophylaxis for dental treatment for any reason, or if they reported a history suggestive of hypersensitivity reactions to minocycline or tetracycline. 4quadrants that had several teeth with a 5-8mm probing pocket depth and radiographic evidence of alveolar bone loss for each patient were selected and divided into test sites and control sites according to the split-mouth design. Scaling and root planing was done for each site at baseline(0week). Test sites received the minocycline gel and strip and control sites had saline irrigation. The patients received both treatments simyltaneously. Subgingival irrigation of sterile saline was applied to the control sites for approximately 30 seconds. Minocycline strip and gel was applied into the periodontal pocket at 1, 2, 3, 4 weeks each after scaling and root planing in the test sites. The clinical and microbiological measurements were made at baseline and at the follow-up visits 6, 10, 14, 20 weeks. The results of this study were as follows; 1. The sulcular bleeding index, probing pocket depth and Periocheck test was significantly reduced and the relative proportions of spirochetes and motile rods were significantly reduced and the proportion of cocci was correspondingly increased, in locally delivered minocycline strip group compared to saline irrigation group. 2. In locally delivered minocycline gel group, The effect was the same with minocycline strip group as compared with saline irrigation therapy. 3. There was no significant differences between minocycline strip group and minocycline gelgroup. In conclusion, minocycline HCl local drug delivery combined with scaling and root planing may provide added improvement of clinical and microbiological responses by inhibiting bacterial recolonization of treated sites. It is suggested that the local administration of minocycline-HCl in the periodontal pocket is effective when combined with subgingival mechanical debridement.

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A Case of Peripheral Bronchopleural Fistula Treated by Flexible Bronchoscopy with Gelfoam Occlusion (굴곡형 기관지내시경을 이용한 Gelfoam 폐쇄로 치료한 말단부 기관지흉막루 1예)

  • Lee, Seung-Heon;Hur, Gyu-Young;Kim, Je-Hyeong;Lee, Sang-Yeub;Shin, Chol;Shim, Jae-Jeong;In, Kwang-Ho;Kang, Kyung-Ho;Yoo, Se-Hwa
    • Tuberculosis and Respiratory Diseases
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    • v.53 no.2
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    • pp.221-226
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    • 2002
  • A 58-year-old man was admitted after suffering dyspnea and pleuritic chest pain on his right side for one week. A chest X-ray revealed necrotizing pneumonia and a lung abscess on right upper lobe. Despite of antibiotics and supportive care, a complicated parapneumonic effusion developed on his right side. Closed thoracostomy was performed for drainage. However, after the thoracostomy, a bronchopleural fistula (BPF) occurred with a continuous air leak. After 30 days intensive therapy, the underlying necrotizing pneumonia and lung abscess resolved, but the BPF continued. Bronchoscopic treatment was performed because the patient was a poor candidate for surgery. After localizing the BPF with a systemic occlusion of the segmental bronchi, small strips of Gelfoam were placed in the suction channel of the flexible bronchoscopy, and either flushed with a saline solution or inserted with forceps until the cessation of air leak. The patient was discharged 10 days after the bronchoscopic treatment.

Atypical Nodular Granulomatous Episclerokeratitis in a Dog (개에서 발생한 비정형의 결절성 육아종성 상공막염 1례)

  • Kim, Tae-Hyun;Jeong, Man-Bok;Park, Shin-Ae;Kim, Won-Tae;Kim, Se-Eun;Park, Young-Woo;Ahn, Jae-Sang;Kim, Hyung-Jin;Chang, Jin-Hwa;Kim, Dae-Yong;Yoon, Jung-Hee;Seo, Kang-Moon
    • Journal of Veterinary Clinics
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    • v.27 no.1
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    • pp.102-106
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    • 2010
  • A 5-year-old castrated male Cocker Spaniel was referred to Veterinary Medical Teaching Hospital of Seoul National University with a history of chronic conjunctival hyperemia and a fleshy corneal mass in the right eye. On ophthalmic examinations, it was observed that a well-vascularized fleshy mass at the dorsolateral limbus extended into the clear cornea. The lesion regressed by initial medications, including both topical and systemic corticosteroids, and topical cyclosporine A. However, the lesion relapsed and grossly infiltrated to cornea in a short period of time without improvement in spite of the immunosuppressive therapy, leading to the vision loss. The eye was enucleated and nodular granulomatous episclerokeratitis was confirmed on histopathological examination.

A Study on Adherence to Dental Revisit of Scaling Patients (치석제거 환자의 치과 재방문 준수에 관한 연구)

  • Gu, Ja-Young;Lim, Soon Ryun;Lee, Su-Young
    • Journal of dental hygiene science
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    • v.15 no.3
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    • pp.318-324
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    • 2015
  • The purpose of this study is to provide the basic date which is increase the number of revisits for scaling after analyzing factors that influence trend of dental revisits for 7 years. Research data was about 1,471 patients who visited S dental clinic in Seoul at 2007 for scaling. Data from January 2007 to December 2013 was collected. The subjects were divided into 3 groups by their trend in number of dental revisits for scaling: once, 2 times, 3~7 times. The data were analyzed using the chi-squire, independent-samples t-test and one-way ANOVA, binary logistic regression analysis. As a result, the trend of dental revisit for scaling is significantly decreased from first time to second time, and after 3rd time dental revisits were steadily continued. Factors affecting dental revisits for scaling are distance, family hospital, systemic disease, presence or absence of periodontal therapy. According to the results of the study, providing dental service in accordance with the patients' characteristics and increasing the dental revisits for scaling could give a positive influence to improvement of oral health.

A Case of Successful Management of Sarcoidosis with Chylothorax Using Octreotide (옥트레오타이드를 이용한 유육종증과 동반된 유미흉의 보존적 치료 1예)

  • Jung, Kyung Soo;Moon, Ji Ae;Yoon, Sul hee;Byun, Min Kwang;Jung, Woo Young;Jung, Jae Hee;Choi, Sang Bong;Kim, Dae Joon;Pyo, Ju Yeon;Kim, Young Sam;Kim, Se Kyu;Chang, Joon;Kim, Sung Kyu;Park, Moo Suk
    • Tuberculosis and Respiratory Diseases
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    • v.62 no.2
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    • pp.119-124
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    • 2007
  • Sarcoidosis is a multi-system granulomatous disorder of an unknown etiology and affects individuals worldwide. It is characterized pathologically by the presence of non-caseating granulomas in more than one involved organ. However, pleural involvement of sarcoidosis is rare and there are no reported cases in Korea. Traditionally, sarcoidosis has often been treated with systemic corticosteroids or cytotoxic agents. In particular, chylothorax with sarcoidosis is usually treated with corticosteroid for approximately 3~6 months, followed by repeated therapeutic thoracentesis, talc pleurodesis, dietary treatment, or thoracic duct ligation where needed. We encountered a 46 years old female patient presenting with cough, dyspnea and both hilar lymphadenopathy (stage I) on chest radiograph. The patient was diagnosed with a non-caseating granuloma, sarcoidosis by a mediastinoscopic biopsy. For one month, she had suffered from dyspnea due to right side pleural effusion, which was clearly identified as a chylothorax on thoracentesis. Corticosteroid therapy with dietary adjustment was ineffective. She was treated successfully with a subcutaneous injection of octreotide for 3 weeks and oral corticosteroid. We report a case of successful and rapid treatment of chylothorax associated with sarcoidosis using octreotide and oral corticosteroid.

Antifungal Activity of Rheum undulatum on Candida albicans by the Changes in Membrane Permeability (막투과성 변화로 인한 대황의 Candida albicans에 대한 항진균 활성)

  • Lee, Heung-Shick;Kim, Younhee
    • Korean Journal of Microbiology
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    • v.50 no.4
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    • pp.360-367
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    • 2014
  • Candida albicans is an opportunistic and the most prevalent fungal pathogen that can cause superficial and systemic infections in immunocompromised patients. C. albicans can promote the transition from budding yeast to filamentous form, generating biofilms. Infections associated with C. albicans biofilms are frequently resistant to conventional antifungal therapy. Therefore, the development of more effective antifungal drugs related with biofilm formation is required urgently. The roots of Rheum undulatum have been used for medicinal purposes in Korea and China traditionally. The aim of present study was to evaluate the effect of R. undulatum extract upon preformed biofilms of 12 clinical C. albicans isolates and the antifungal activities. Its effect on preformed biofilms was evaluated using XTT reduction assay, and metabolic activity of all tested strains was reduced significantly ($49.4{\pm}6.0%$) at 0.098 mg/ml R. undulatum. The R. undulatum extract blocked the adhesion of C. albicans biofilms to polystyrene surfaces, and damaged the cell membrane integrity of C. albicans which was analyzed by CFDA, AM, and propidium iodide double staining. It caused cell lysis which was observed by Confocal laser scanning and phase contrast microscope after propidium iodide and neutral red staining, respectively. Membrane permeability was changed as evidenced by crystal violet uptake. The data suggest that R. undulatum inhibits biofilm formation by C. albicans, which can be associated with the damage of the cell membrane integrity, the changes in the membrane permeability and the cell lysis of C. albicans.

Epidemiologic Study on the Elderly Patients Visited Oral Medicine (고령환자의 구강내과 진료실태)

  • Hong, Seong-Ju;Kang, Seung-Woo;Ryu, Ji-Won;Yoon, Chang-Lyuk;Cho, Young-Gon;Ahn, Jong-Mo
    • Journal of Oral Medicine and Pain
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    • v.34 no.2
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    • pp.133-141
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    • 2009
  • We reviewed retrospectively the medical records of 600 elderly patients, over 65 years old who visited oral medicine. The ratio of the age group was composed of 65${\sim}$74 years old group was 63.7%, 75${\sim}$84 years old group was 32.2%, over 85years old group was 4.2%, and the patients were mostly females. The main chief complaint was composed of oral soft tissue problem(44.1%) and oromaxillofacial pain(39.0%). The majority of systemic diseases was composed of diseases of the circulatory system(30.1%), diseases of the musculoskeletal system and connective tissue(16.8%), endocrine, nutritional and metabolic diseases, and diseases of the digestive system(10.1%). The numerous pateints were diagnosed as soft tissue disease(32.0%), arthrogenous disease(24.1%), and myogenous disease(18.1%) of temporomandibular disease.Principally medication(43.9%), physical therapy(24.2%) were performed. 14.2% of all patients visited oral medicine with a letter of request written by other medical departments or local dental clinics, or referred from other departments in Chosun university dental hospital. These findings indicate epidemiologic characteristics on the elderly patients visited oral medicine. We hope that this study will play a basis in the future research about the elderly patients.

Bioequivalence Test of Gabapentin 400 mg Capsules (가바펜틴 400밀리그람 캡슐의 생물학적동등성시험)

  • Kim, Se-Mi;Kang, Hyun-Ah;Cho, Hea-Young;Shin, Sae-Byeok;Yoo, Hee-Doo;Yoon, Hwa;Lee, Yong-Bok
    • YAKHAK HOEJI
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    • v.52 no.3
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    • pp.195-200
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    • 2008
  • Gabapentin, [1-(aminomethyl) cyclohexaneacetic acid], a structural analog of $\gamma$-aminobutyric acid (GABA), is being developed for the treatment of epilepsy. Unlike GABA, gabapentin crosses the blood-brain barrier after systemic administration. Gabapentin is an effective antiepileptic drug in patients with partial and secondarily generalized seizures who are uncontrolled with use of existing anticonvulsant drug therapy. The purpose of the present study was to evaluate the bioequivalence of two gabapentin 400 mg capsules, $Neurontin^{(R)}$ capsule 400 mg (Pfizer Inc.) and Gabatin capsule 400 mg (Korean Drug Co. Ltd), according to the guidelines of the Korea Food and Drug Administration (KFDA). The release of gabapentin from the two gabapentin formulations in vitro was tested using KP VIII Apparatus II method with various dissolution media (pH 1.2, 4.0, 6.8 buffer solution and water). Twenty six healthy male subjects, 23.58$\pm$1.50 years in age and 66.74$\pm$8.31 kg in body weight, were divided into two groups and a randomized 2$\times$2 cross-over study was employed. After one capsule containing 400 mg as gabapentin were orally administered, blood was taken at predetermined time intervals and the concentrations of gabapentin in serum were determined using HPLC with fluorescence detector. The dissolution profiles of two formulations were similar at all dissolution media. In addition, the pharmacokinetic parameters such as $AUC_t$, $C_{max}$ and $T_{max}$ were calculated and ANOVA test was utilized for the statistical analysis of the parameters using logarithmically transformed $AUC_t$, $C_{max}$ and untransformed $T_{max}$. The results showed that the differences between two formulations based on the reference drug, $Neurontin^{(R)}$ capsule 400 mg, were 2.04, -3.68 and 16.79% for $AUC_t$, $C_{max}$ and $T_{max}$, respectively. There were no sequence effects between two formulations in these parameters. The 90% confidence intervals using logarithmically transformed data were within the acceptance range of log 0.8 to log 1.25 (e.g., log 0.91$\sim$log 1.16 and log 0.87$\sim$log 1.11 for $AUC_t$ and $C_{max}$, respectively). Thus, the criteria of the KFDA bioequivalence guideline were satisfied, indicating Gabatin capsule 400 mg was bioequivalent to $Neurontin^{(R)}$ capsule 400 mg.

Radiologic evaluation and survival rate of taper-straight designed implant with SLA surface: A 1-year follow-up retrospective study (SLA surface를 가진 taper straight designed implant의 방사선학적 평가와 생존율: 1년 추적 관찰을 통한 후향적 연구)

  • Kim, Jee Eun;Kim, Ye Seul;Kim, Ok-Su
    • The Journal of Korean Academy of Prosthodontics
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    • v.59 no.4
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    • pp.405-414
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    • 2021
  • Purpose. This study was conducted to evaluate clinical usefulness by evaluating the marginal bone resorption and survival rate of an implant with a taper straight type SLA surface domestically available on the market recently. Materials and methods. 40 implants satisfying the including criteria were observed for one year of 125 implants of 83 adult men and women who had KISPLANT® implanted from August 2016 to December 2019 at the Department of Periodontology, Chonnam National University Dental Hospital. The marginal bone level was measured on periapical radiographs taken initially and 1 year later and we analyzed implant survival and success rates. A t-test was used for the analysis of the association between the marginal bone resorption and the severity of periodontitis, supportive periodontal therapy, the inserted site, the cause of extraction, immediate placement, and systemic disease. Results. After 1 year of loading, the mesial bone resorption was 0.74 ± 1.07 mm, and the distal bone resorption was 0.53 ± 1.04 mm. The marginal bone resorption of 2 mm or more occurred at 3 implants out of 40 implants after 1 year, so the success rate of implant was 92.5% and survival rate was 100%. There was a significant difference in mesial marginal bone resorption according to the inserted site and no significant differences were found between marginal bone resorption and the other factors. Conclusion. As a result of marginal bone resorption, success rate, and survival rate in this study, we found little marginal bone resorption and high survival and success rate. It can be concluded that they represent excellent clinical results.

Diagnosis and Prognosis of Sepsis (패혈증의 진단 및 예후예측)

  • Park, Chang-Eun
    • Korean Journal of Clinical Laboratory Science
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    • v.53 no.4
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    • pp.309-316
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    • 2021
  • Sepsis is a physiological response to a source of infection that triggers mechanisms that compromise organ function, leading to death if not treated early. Biomarkers with high sensitivity, specificity, speed, and accuracy that could differentiate sepsis from non-infectious systemic inflammatory response syndrome (SIRS) could bring about a revolution in sepsis treatment. Given the limitations and time required for microbial verification of pathogens, the accurate diagnosis of infection before employing antibiotic therapy is important and clinically necessary. Procalcitonin (PCT), lactate, C-reactive protein (CRP), cytokines, and proadrenomedullin (ProADM) are the common biomarkers used for diagnosis. The procalcitonin (PCT)-guided antibiotic treatment in patients with acute respiratory infections effectively reduces antibiotic exposure and side effects while improving survival rates. The evidence regarding sepsis screening in hospitalized patients is limited. Clinicians, researchers, and healthcare decision-makers should consider these findings and limitations when implementing screening tools, future research, or policy on sepsis recognition in hospitalized patients. The use of biomarkers in pediatric sepsis is promising, although such use should always be correlated with clinical evaluation. Biomarkers may also improve the prediction of mortality, especially in the early phase of sepsis, when the levels of certain pro-inflammatory cytokines and proteins are elevated.