• Journal of Korean Dental Science
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• v.12 no.2
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• pp.58-65
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• 2019

Purpose: This study was aimed to investigate the possibility of utilizing smart device-based test (SBT) for competency evaluation in dental education and to analyze the student responses on overall competency evaluation using SBT method, in comparison to ubiquitous-based test (UBT). Materials and Methods: Questionnaire surveys have been conducted at Yonsei University College of Dentistry from 2015 to 2018 to obtain students' feedback on the application of SBT to competency evaluation. In addition, in order to supplement the competency evaluation procedure, considerations were explored by comparing the expected and actual difficulty of each item when preparing items for competency evaluation with SBT. Result: According to the survey results, student responses between the initial two years (2015 and 2016) differed from those in next two years (2017 and 2018). Students in 2017 and 2018 had more positive responses on competency evaluation with SBT. To determine the test validity, criterion-referenced evaluation was adopted to compare the data in 2017 and 2018 and slight differences in test difficulty in 2018 between the expected and actual difficulty of items were found. Conclusion: The results indicated that SBT was more appropriate for competency evaluation than UBT, based on four-year period of competency evaluation. The SBT was not affected by either the file size or the number of test-takers. Interestingly, students were not sensitive to test version of competency evaluation (paper-based test and SBT). This study suggests that the quality of the test items should be measured by continuous monitoring of the expected and actual difficulty of items for determining test validity. More detailed results and discussions of the findings are given for the development of test procedure and further potential research directions in dental education.

• Clinical and Experimental Pediatrics
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• v.49 no.3
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• pp.268-272
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• 2006

Purpose : The reinfection rate of H. pylori reported before $^{13}C$-urea breath test($^{13}C$-UBT) era was higher than that of the post $^{13}C$-UBT era. Children are usually reluctant to receive invasive endoscopic evaluation for the reinfection of H. pylori, particularly when they are asymptomatic. The aim of the study is to discover the reinfection rate by different diagnostic tests, and to find out what causes the difference. Methods : Children confirmed to be eradicated from H. pylori were included in the study. Reinfection was evaluated by endoscopic biopsy based tests(n=34, mean age $11.5{\pm}3.7$ years) and/or a $^{13}C$-UBT(n=38, mean age $10.0{\pm}3.6$ years) at the time of 18 months after eradication. At first visit, H. pylori infection had been diagnosed by positive results from a rapid urease test, Giemsa stain and Warthin-Starry stain and/or a positive culture. Eradication was defined as negative results from all above tests 1-3 months after eradication therapy. Results : Reinfection rate by endoscopic biopsy based tests was 35.3 percent(12/34). All patients had abdominal symptoms(P=0.000). Reinfection rate was 13.2 percent(5/38) by a $^{13}C$-UBT. Reinfection rate was higher in children with abdominal symptoms(P=0.008). There was no evidence that reinfection rate depended on the sex(P=0.694), age(P=0.827), diseases(peptic ulcers vs gastritis, P=0.730) and eradication regimen(P=0.087). Conclusion : Helocibacter pylori reinfection rate in Korean children was 13.2 percent per 18 months by a non-invasive test or $^{13}C$-UBT. Accurate determinations of the reinfection rate in children is affected by the compliance of the diagnostic tests. Non-invasive tests should be considered to investigate the reinfection rate in children.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.3
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• pp.979-984
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• 2016

The incidence rate of stomach cancer in Bali, Indonesia, is estimated to be strikingly lower than that in Japan. We conducted an on-site ecological study to investigate the association between the stomach cancer incidence and Helicobacter pylori (H. pylori) infection. Recruiting 291 healthy persons (136 men and 155 women) from the general population in Bali, Indonesia, we conducted a urea breath test (UBT) to examine H. pylori infection, along with a pepsinogen test to detect chronic atrophic gastritis and urine analysis to estimate sodium and potassium excretion. UBT positivities were 9% (2-15, 95% confidence interval) for men and 7% (1-12) for women, and positive cases for H. pylori IgG antibodies were 1% (0-3) for men and 3% (0-5) for women, significantly lower than the respective values in Japan. Positive pepsinogen tests in Bali were 0% (0-0) for men and 1% (0-4) for women, also significantly lower than the Japanese figures. Computed values for daily salt excretion were $13.3{\pm}4.1g$ (mean${\pm}$SD) for men and $11.1{\pm}3.1g$ for women, as high as corresponding Japanese consumption values. Moreover, the estimated potassium excretion was $3.2{\pm}0.7g$ for men and $2.8{\pm}0.6g$ for women in Bali, significantly higher than the figures in Japan. There were no associations across genetic polymorphisms of IL-beta, TNF-alpha, and PTPN11 with UBT positivity. The low incidence of stomach cancer in Bali may thus mainly be due to the rare H. pylori infection. Namely, the bacterium infection seems to be a critical factor for gastric cancer rather than host or other environmental factors.

• Proceedings of the PSK Conference
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• 2003.04a
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• pp.280.2-280.2
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• 2003

The applicability of liquid chromatography-atmospheric-pressure chemical-ionization mass spectrometry (LC-APCI-MS) for the determination of 13C-urea in 13C-urea/PEG capsules has been studied. It is essential to assess the stability of a newly developed low-dose (38 mg) 13C-urea/PEG capsule. which will be used for 13C-urea breath test (13C-UBT) to detect Helicobacter pylori infection. (omitted)

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.14
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• pp.6089-6092
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• 2015

Background: The prevalence of metronidazole-resistant H. pylori is almost 50% in Thailand which severely limits the use of this drug for eradication therapy. The aims of this study were to evaluate the efficacy and safety profiles of 7-day bismuth-based quadruple therapy including metronidazole as an initial treatment for H. pylori infection in a high metronidazole resistance area. Materials and Methods: This study was performed at Thammasat University Hospital and King Chulalongkorn Memorial Hospital during January 2009 to October 2010. Patients with non-ulcer dyspepsia (NUD) with active H. pylori infection were assigned to receive seven days of quadruple therapy (pantoprazole 40 mg bid, bismuth subsalicylate 1,048 mg bid, amoxicillin 1 gm bid and metronidazole 400 mg tid). H. pylori infection was defined as positive H. pylori culture or two positive tests (rapid urease test and histology). Antibiotic susceptibility test for metronidazole by Epsilometer test (E-test) was performed in all positive cultures. At least four weeks after treatment, $^{13}C$ urea breath test ($^{13}C-UBT$) was performed to confirm H. pylori eradication. Results: A total of 114 patients were enrolled in this study, 50 males and 64 females with a mean age of 49.8 years. All 114 patients had a diagnosis of NUD. Overall eradication as confirmed by negative $^{13}C-UBT$ was achieved in 94 out of 114 patients (82.5%). 44 patients had positive cultures and success for E-test. In vitro metronidazole resistance was observed in 22/44 (50%) patients. Eradication rate in patients with metronidazole resistant strains was 16/22 (72.7%) and 20/22 (90.1%) with metronidazole sensitive strains (72.7% vs 90.1%, p-value=0.12; OR=3.75 [95%CI=0.6-31.5]). Minor adverse reactions included nausea, bitter taste, diarrhea and black stools but none of the patients dropped out from the study. Conclusions: Initial treatment with 7-day bismuth-based quadruple therapy including metronidazole, amoxycillin and pantoprazole is highly effective and well tolerated for metronidazole-sensitive H. pylori infections. However, the efficacy markedly decline with metronidazole resistance. Longer duration of this regimen might be required to improve the eradication rate and larger multi-center studies are needed to confirm this hypothesis.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.10
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• pp.4747-4753
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• 2016

Background: The prevalence of Helicobacter pylori (H. pylori) infection in Indonesia has been reported to be exceedingly low. The purpose of our study was to confirm whether this is the case in Northern Jakarta using a sensitive 13C-urea breath test (UBT), and to examine any associations with lifestyle/environment factors and potential routes of transmission. Methods: We recruited a total of 196 subjects from a low-income community in Northern Jakarta, Indonesia, data from 193 who completed a questionnaire about their lifestyle/environment and had UBT being included as the final. Odds ratios (ORs) adjusted for sex and age with 95% confidence intervals (CIs) were calculated using a logistic regression model. Results: The overall H. pylori infection rate was 15.0% (95%CI, 10.3-20.9), with variation among Javanese (9.1%, total=77), Buginese (40.0%, 35), Betawi (9.1%, 33), Sundanese (3.7%, 27), and Batak (40.0%, 5). On multivariate analysis, the ORs for intake of soybean milk, cucumber more than once a week, infrequent hand washing practice before meals, and alcohol consumption were 0.10 (95%CI: 0.01-0.97), 6.61 (95%CI: 1.87-23.3), 4.10 (95%CI: 1.15-14.6), and 61.9 (95%CI: 1.67-2300.8), respectively. Rates for Buginese (OR=7.84; 95%CI: 1.82-33.8) and Batak (OR=20.1; 95%CI: 1.90-213.2) were significantly higher than for Javanese. Conclusions: The H. pylori infection rate in this study was relatively low, in line with previous studies. Regarding ethnicity factors, Buginese and Batak reported eating food using fingers more frequently than Javanese, Betawi, and Sundanese. Our study indicated that person-person transmission is possible in this low prevalence area. The low infection rates for H. pylori among Javanese, Betawi, and Sundanese ethnics could be partly due to their sanitary practices.

• Journal of Oral Medicine and Pain
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• v.35 no.2
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• pp.101-110
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• 2010

Helicobacter pylori(H. pylori) is bacterial infection, with more than half of the world population infected and oral cavity is considered second reservoir of H. pylori infection. The purpose of this study was to evaluate role of oral cavity in H. pylori infection by comparison of the mode H. pylori infection in oral cavity and stomach. We recruited 100 subjects without systemic disease including gastrointestinal disease. Samples in oral cavity taken on gingival sulcus fluid(GSF) of lower left central incisor and 1st molar, area of buccal mucosa, dorsum of the tongue, palatal and saliva. We analyzed by Nested polymerase chain reaction(PCR) for oral infection and Urea Breath Test(UBT) for gastric infection. The results were as follows : 1. Among these 100 subjects, 36(36%) were positive by Nested PCR and 33(33%) were positive by UBT(p>0.05). 2. In detection rate of H. pylori in sites taken sample, 11(11%), 8(8%), 9(9%), 3(3%), 9(9%), 7(7%) were positive on GSF of lower left central incisor and 1st molar, area of buccal mucosa, dorsum of the tongue, palatal and saliva, respectively. Statical significance was observed in samples of GSF of lower left central incisor and area of dorsum of the tongue(p<0.05). 3. In comparison of the mode of H. pylori infection in oral cavity and stomach by analytic method, positive in oral cavity and stomach was 10(10%), negative in oral cavity and positive in stomach was 23(23%), positive in oral cavity and negative in stomach was 26(26%) and negative in oral cavity and stomach was 41(41%)(p>0.05). Conclusively, we can guess that oral H. pylori is not associated with gastric H. pylori infection and normal flora.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.9
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• pp.4469-4475
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• 2016

Indonesia is a developing country, in most of which the infection rates of Helicobacter pylori (H. pylori) have been reported to be high. However, the prevalence of H. pylori infection in Indonesia has been unexpectedly reported to be low. The purpose of our study was to confirm whether the prevalence of H. pylori infection is low among healthy inhabitants in Northern Jakarta by 13C-urea breath test (UBT), and to examine the association of their lifestyle/environmental factors with H. pylori infection and to identify potential routes of transmission. We recruited a total of 196 subjects from a low-income community in Northern Jakarta, Indonesia. Of them, 193 subjects who completed a questionnaire about their lifestyle/environment and had UBT were included in this study. Odds ratios (ORs) adjusted for sex and age with 95% confidence intervals (CIs) were calculated using logistic regression model. The overall H. pylori infection rate was 15.0%. There was difference in H. pylori infection rates among Buginese (40.0%), Betawi (9.1%), Sundanese (3.7%), and Batak (9.1%). After multivariate analysis, the ORs of intake of soybean milk, cucumber more than one time a week, infrequent hand washing before meals, and alcohol consumption were 0.10 (95%CI: 0.01-0.97), 6.61 (95%CI: 1.87-23.3), 4.10 (95%CI: 1.15-14.6), and 61.9 for former drinkers (95%CI: 1.67-2300.8), respectively. Buginese (OR=7.84; 95%CI: 1.82-33.8) and Batak ethnic groups (OR=20.1; 95%CI: 1.90-213.2) were infected more frequently, compared with Javanese. The H. pylori infection rate in this study was low, as reported previously. After we scrutinized the factors, Buginese and Batak ethnic groups eat food using fingers more frequently than Javanese, Betawi, and Sundanese. In addition, infrequent hand wash practice before meal increased the risk. Our study indicated that person-person transmission was possible in this low prevalence area. The low infection rates of H. pylori among those of Javanese, Betawi, and Sundanese ethnicity could be partly due to sanitary practice.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.15 no.1
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• pp.23-28
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• 2012

Purpose: Interest in peptic ulcer in children has been relatively low because the disease is rarer in children than in adults and there were restrictions in the application of endoscopy to children, but the recent development of pediatric endoscopy is activating research on pediatric peptic ulcer. Thus, this study compared the $H.$ $pylori$ infection rate and clinical and endoscopic findings among pediatric patients diagnosed with peptic ulcer. Methods: We analyzed retrospectively 58 pediatric patients for whom whether to be infected with $H.$ $pylori$ was confirmed selected out of pediatric patients diagnosed with gastric ulcer or duodenal ulcer through upper gastrointestinal endoscopy at the Department of Pediatrics of Gachon University Gil Hospital during the period from January 2002 to December 2007. A case was considered $H.$ $pylori$ positive if $H.$ $pylori$ was detected in the Giemsa stain of tissue or the results of UBT (urea breath test) and CLO (rapid urease test) were both positive. Results: Of the pediatric patients, 37 were infected with $H.$ $pylori$ and 21 were not. The $H.$ $pylori$ infection rate increased with aging and the result was statistically significant ($p$<0.05). However, $H.$ $pylori$ infection was not in a statistically significant correlation with sex, chief complaint, and gastroduodenal ulcer ($p$>0.05). Conclusion: $H.$ $pylori$ infection increased with aging, but was not significantly correlated with gastroduodenal ulcer. Further research may need to examine prospectively the relation between $H.$ $pylori$ and gastroduodenal ulcer in the Incheon area.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.4
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• pp.1247-1251
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• 2012

Background: Helicobacter pylori is an important gastrointestinal pathogen related to the development of not only atrophic gastritis and peptic ulcer, but also gastric cancer. Human leukocyte antigens (HLA) may play particular roles in host immune responses to bacterial antigens. This study aimed to investigate the association between HLA-DQA1 and DQB1 genotypes and haplotypes vs H. pylori infection in an Indonesian population. Methods: We selected 294 healthy participants in Mataram, Lombok Island, Indonesia. H. pylori infection was determined by urea breath test (UBT). We analyzed HLA-DQA1 and DQB1 genotypes by PCR-RFLP and constructed haplotypes of HLA-DQA1 and DQB1 genes. Multiple comparisons were conducted according to the Bonferroni method. Results: The H. pylori infection rate was 11.2% in this Indonesian population. The DQB1*0401 genotype was noted to be associated with a high risk of H. pylori infection, compared with the DQB1*0301 genotype. None of the HLA-DQA1 or DQB1 haplotypes were related to the risk of H. pylori infection. Conclusions: The study suggests that HLADQB1 genes play important roles in H. pylori infection, but there was no statistically significant association between HLA-DQA1 or DQB1 haplotypes and H.pylori infection in our Lombok Indonesian population.