• Clinical and Experimental Pediatrics
• /
• v.56 no.2
• /
• pp.68-74
• /
• 2013

Purpose: To evaluate the effectiveness of new management policies on the incidence of invasive Candida infections Methods: This observational study involved a retrospective analysis of the patients' medical records. In total, 99 very low birth weight infants, who were admitted to the neonatal intensive care unit at Ajou University Hospital from January 2010 to December 2011, were enrolled for the study. Period I, defined as the period before the revision of management policies, comprised 57 infants; whereas, period II, defined as the period after the implementation of new management policies, comprised 42 infants. The new management policies entailed a reduction in antibiotic and histamine type 2 receptor blocker (H2 blocker) use, duration of central venous catheterization, and duration of endotracheal intubation. Results: There was a significant overall decrease in the use of antibiotics including 3rd generation cephalosporin and H2 blockers (P<0.05), and a significantly lower incidence of invasive Candida infections in period II as compared to period I (0/42 vs. 6/57, respectively; P=0.037). Comparison between infants with invasive Candida infections (n=6) and those without (n=93) showed that gestational age (odds ratio [OR], 0.909; 95% confidence interval [CI], 0.829 to 0.996; P=0.042) and the duration of 3rd generation cephalosporin use (OR, 1.093; 95% CI, 1.009 to 1.183; P=0.029) were statistically significant risk factors. Conclusion: The new management policies effectively decreased overall use of antibiotics, especially 3rd generation cephalosporin, and H2 blockers, which led to a significantly lower incidence of invasive Candida infections.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• v.43 no.6
• /
• pp.388-394
• /
• 2017

Objectives: The objective of this study was to investigate the presence of oral lesions in human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) patients in a descriptive cross-sectional study, and to establish their presence according to levels of CD4+ cells (including the CD4+/CD8+ cell ratio). Materials and Methods: A total of 75 patients infected with HIV were included. Oral lesions were observed and classified using World Health Organization classification guidelines. Potential correlations between the presence and severity of oral lesions and CD4+ cells, including the CD4+/CD8+ cell ratio, were studied. Results: The most frequent oral lesion detected was oral pseudomembranous candidiasis (80.0%), followed by periodontal disease (40.0%), herpetic lesions (16.0%), hairy leukoplakia (16.0%), gingivitis (20.0%), oral ulceration (12.0%), Kaposi's sarcoma (8.0%), and non-Hodgkin's lymphoma (4.0%). The CD4+ count was <$200cells/mm^3$ in 45 cases (60.0%), between $200-500cells/mm^3$ in 18 cases (24.0%), and >$500cells/mm^3$ in 12 cases (16.0%). The mean CD4+ count was $182.18cells/mm^3$. The mean ratio of CD4+/CD8+ cells was 0.26. All patients showed at least one oral manifestation. Conclusion: There was no correlation between the CD4+/CD8+ cell ratio and the presence of oral lesions. The severity of the lesions was more pronounced when the CD4+ cell count was less than $200cells/mm^3$.

• Journal of Microbiology and Biotechnology
• /
• v.26 no.12
• /
• pp.2206-2213
• /
• 2016

Recently, several studies have revealed that commercial microbial identification systems do not accurately identify the uncommon causative species of candidiasis, including Candida famata, Meyerozyma guilliermondii, and C. auris. We investigated the accuracy of species-level identification in a collection of clinical isolates previously identified as C. famata (N = 38), C. lusitaniae (N = 1 2), and M. guilliermondii (N = 5) by the Vitek 2 system. All 55 isolates were re-analyzed by the Phoenix system (Becton Dickinson Diagnostics), two matrix-assisted laser desorption ionization-time of flight mass spectrometry analyzers (a Vitek MS and a Bruker Biotyper), and by sequencing of internal transcribed spacer (ITS) regions or 26S rRNA gene D1/D2 domains. Among 38 isolates previously identified as C. famata by the Vitek 2 system, the majority (27/38 isolates, 71.1%) were identified as C. tropicalis (20 isolates) or C. albicans (7 isolates) by ITS sequencing, and none was identified as C. famata. Among 20 isolates that were identified as C. tropicalis, 17 (85%) were isolated from urine. The two isolates that were identified as C. auris by ITS sequencing originated from ear discharge. The Phoenix system did not accurately identify C. lusitaniae, C. krusei, or C. auris. The correct identification rate for 55 isolates was 92.7% (51/55 isolates) for the Vitek MS and 94.6% (52/55 isolates) for the Bruker Biotyper, as compared with results from ITS sequencing. These results suggest that C. famata is very rare in Korea, and that the possibility of misidentification should be noted when an uncommon Candida species is identified.

• The Journal of the Korean Society for Microbiology
• /
• v.21 no.2
• /
• pp.251-259
• /
• 1986

This study was performed to assess the effect of inosiplex(ISP) on the resistance of mice Candida albicans infection, the migration of chicken leukocytes, the production of leukocyte migration inhibitory factor(LIF), and the cell-mediated immunity(CMI) to lepomin in multibacillary lepromatous leprosy patients. The treatment with ISP before or on the time of infection with C. albicans had no or deliterious effect, and treatment with ISP after infection had no effect on the recovery of C. albicans from the kidneys of mice. The migratory ability of chicken leukocytes and the production of LIF from splenocytes of mice were not affected by ISP treatment. However, ISP decreased the migration of chicken leukocytes in vitro, and this decrease was dose-dependent. The therapy of lepromatous leprosy patients with ISP for 10 or 30 days clearly showed the increase of the significant positive rate of Mitsuda skin test to lepromin. The immune recovery as a result of the therapy was found to be the best in the group of patients treated for 30 days. This results suggest that (1) the effect of ISP in renal candidiasis can vary depending on the time of treatment relative to infection, (2) ISP can primarily change the migratory ability of chicken leukocytes but does not affect the production of LIF in mice, and (3) the classical therapy combined with ISP can reinforce or restore the defences of lepromatous leprosy patients against Mycobacterium leprae.

• The Journal of the Korean Society for Microbiology
• /
• v.35 no.4
• /
• pp.317-324
• /
• 2000

Candida albicans is one of the most frequently isolated fungal pathogens in human. Recently, the prevalence of candida infection has markedly increased, partially due to the increase of immunocompromised hosts. Proposed virulence factors of the pathogenic Candida are the ability to form hyphae to adhere to epithelial cell surfaces, and to secrete acid proteinases and phospholipases. We measured the relative cell surface hydrophobicity (CSH) and the ability of proteinase production (PROT), phospholipase production (PLase), adherence to host epithelium (ADH), and hyphal transition (Germ). The relative risk of virulence factors was analyzed by lethality test in murine model of hematogeneously disseminated candidal infection. According to Cox's proportional hazard analysis, the statistically significant virulence factors were PROT, ADH, and CSH. PROT was the highest risk factor of them. To evaluate the applicability for the diagnosis and treatment of Candidiasis, we examined the protective effect of the active and passive immunizations with the materials purified from virulence factors and antibodies to them in Candia-infected mice model. The mean survival times of active and passive immunized groups were slightly longer than those of non-immunized groups.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• v.35 no.3
• /
• pp.182-186
• /
• 2009

There are several oral lesions related with AIDS, such as candidiasis, hairy leukoplakia, Kaposi's sarcoma, aphthous stomatitis, lichen planus, and other opportunistic infectious diseases. Among the others, Kaposi's sarcoma, the most common malignant tumor associated with AIDS, is closely linked to the number of CD4+ T cell. Kaposi's sarcoma often occurs in palate, the most prone site, and has characteristic clinical features in most cases. Sometimes, the tumor induces underlying bone destruction at late stage. We report a case of a 27 year-old man with AIDS-associated Kaposi's sarcoma at left lower retromolar triangle, parapharyngeal area and discuss the management of AIDS patients in dentistry.

• Biomedical Science Letters
• /
• v.24 no.4
• /
• pp.430-434
• /
• 2018

Candida glabrata is the second most prevalent causative agent for candidiasis following C. albicans. The opportunistic yeast, C. glabrata, is able to cause the critical bloodstream infections in hospitalized patients. Conventional identification methods for yeasts are often time consuming and labor intensive. Therefore, recent studies on sequence-based identification have been conducted. Recently, sequencing the D1/D2 domain of the large subunit ribosomal RNA gene and the internal transcribed spacers (ITS) 1 and ITS2 regions of the ribosomal DNA has proven useful for DNA-based identification of most species of fungi. In the present study, therefore, fungal ITS and D1/D2 domain regions were targeted and analyzed by DNA sequencing for the accurate identification of C. glabrata clinical isolates. A total of 102 C. glabrata clinical isolates from various clinical samples including bloodstream, catheterized urine, bile and other body fluids were used in the study. The results of the DNA sequence analysis showed that the mean standard deviation of species identity percent score between ITS and D1/D2 domain regions was $97.8%{\pm}2.9$ and $99.7%{\pm}0.46$, respectively. These results revealed that the D1/D2 domain region might be a better target for identifying C. glabrata clinical isolates based on DNA sequences than the ITS1 and ITS2 regions. However, in order to evaluate the usefulness of D1/D2 domain region for species identification of all Candida species, other Candida species such as C. albicans, C. tropicalis, C. dubliniensis, and C. krusei should be verified in further studies additionally.

• Journal of Oral Medicine and Pain
• /
• v.44 no.1
• /
• pp.1-10
• /
• 2019

Purpose: The aim of this study was to evaluate the optimal doses of intralesional triamcinolone acetonide (TA) in the treatment of oral lichen planus (OLP). Methods: A randomized clinical trial was performed. Sixty-two lesions of OLP were received 12 mg (group A) or 20 mg (group B) of TA intralesionally weekly for 2 weeks. Subjective symptoms, lesion size, favorable conversion of clinical subtypes, and clinical response were evaluated at weeks 0, 1, 2, and 4. Results: After two consecutive injections of TA, group B showed significant reduction in burning sensation and reticular area (p<0.01). Favorable conversion and complete response were greater in group B. Mild oral candidiasis was developed in group B (10.7%). Conclusions: A 20-mg injection of TA was much more effective compared with 12-mg injection of TA in the treatment of OLP.

• Journal of Korean Dental Science
• /
• v.16 no.1
• /
• pp.9-22
• /
• 2023

Xerostomia is defined as the subjective complaint of dry mouth with or without hyposalivation, which is insufficient salivary secretion from salivary gland. Xerostomia can lead to multiple oral symptoms such as dental caries, halitosis, burning mouth syndrome, and oral candidiasis, which can significantly impact the well-being of patients, especially in geriatric patients who may already have compromised health. Clinical findings of xerostomia include decreased salivary flow and alterations in salivary composition. These changes can lead to various oral health problems such as dental caries, periodontitis, swallowing and speaking difficulties, taste disturbances, halitosis, mucosal diseases, and burning mouth syndrome. Recognizing these clinical manifestations is essential for early diagnosis and appropriate management. Although several reasons and risk factors have been suggested for xerostomia such as aging, chemo-radiation therapy, systemic disease, and Sjögren's syndrome, the polypharmacy is recently highlighted especially in elderly patients. Understanding the etiology and risk factors associated with xerostomia is crucial for effective management. To manage xerostomia patients, a multidisciplinary guideline should be established beyond dental care. Through this literature review, we summarized consideration for diagnostic, therapeutic, nursing essentials for the clinical guideline. By addressing the underlying causes and implementing appropriate treatment strategies, healthcare professionals can improve the quality of life for individuals suffering from xerostomia.

• Journal of Oral Medicine and Pain
• /
• v.26 no.1
• /
• pp.1-10
• /
• 2001

To investigate the relationship between several intraoral soft tissue lesions(hairy tongue, lichen planus, recurrent aphthous stomatitis, oral candidiasis, glossitis and oral herpetic lesion) and oral mucosal keratinization, exfoliative cytological smear on intraoral mucosal surfaces were performed on each number of patients and 25 controls keratinization cell (yellow-stained cell) ratio was then measured. In hairy tongue, there was no significant difference between patient group and control group in all kind of cells. Only blue cell ratio of women was more than of men in patient group. In lichen planus, there was no difference between patient and control group in yellow cell ratio. Red cell ratio in the control group was more than in the patient group. Blue cell ratio in the patient group was more than that in control group. But there was no sex predilection between both groups in the ratio of all kind of cells. In recurrent aphthous stomatitis, Yellow cell ratio in the control group was more than that in the patient group. Red cell ratio in the control group was more than that in control group. Blue cell ratio in the patient group was more than that in control group. But there was no sex predilection between both groups in the ratio of all kind of cells. In oral candidiasis, Yellow cell ratio in the control group was more than that in the patient group. Red cell ratio in the control group was more than that in control group. Blue cell ratio in the patient group was more than that in control group. There was no sex predilection between both groups in yellow cell ratio. Red cell ratio of women was more than of men in patient group. Blue cell ratio of men was more than of women in patient group. In herpetic lesions, there was no difference between patient and control group in yellow cell ratio. Red cell ratio in the control group was more than in the patient group. Blue cell ratio in the patient group was more than that in control group. Yellow cell ratio of women was more than of men in control group. Red cell ratio of men was more than of women in control group. Blue cell ratio of men was more than of women in patient group. In glossitis, Yellow cell ratio in the control group was more than in the patient group. There was no difference between patient and control group in red cell ratio. Blue cell ratio in the patient group was more than that in control group. Yellow cell ratio of women was more than of men in control group. Red cell ratio and blue cell ratio of men were more than of women in control group. According to above results, the ratio of keratinized cell in atrophic, ulcerated, or pseudomembranous lesions was lowered than in control, but the ratio of keratinized cell in keratotic, vesicular or lesions on keratinized surface lesions had no difference to control group. Thus, keratotic, vesicular or lesions on keratinized surface lesions have not closely relation to mucosal keratinization. And, there was a little sex predilection between men and wemen in mucosal keratinization.