• Journal of Korean Biological Nursing Science
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• 제17권2호
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• pp.97-103
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• 2015

Purpose: The aim of the study was to identify effects of oral care protocol on bacterial floras of the oral cavity and oral health status of intubated patients in an intensive care unit. Methods: The participants were 60 intubated patients who were recruited from an intensive care unit of a university hospital from Dec. 28, 2010 to Mar. 25, 2011. The participants were randomly assigned into 3 groups of 20 patients according to the application time of oral care (1-minute oral care, 2-minute oral care, and 3-minute oral care groups). The numbers of bacterial flora colonies in the oral cavity was assessed before and after the oral care. Oral health status was assessed using a Korean version of the Oral Assessment Guide developed by Elier et al. originally. Results: The numbers of bacterial flora colonies were less after oral care than those before the care, but there was no significant differences among the 3 groups after the care. Oral health status was better after the oral care than it was before the care, but there was also no significant differences among the 3 groups. Conclusion: If well-trained nurses perform oral care for 1 minute using a chlorhexidine swab on intubated patients, the numbers of bacterial flora colonies will be reduced and healthy oral status will be maintained.

• Journal of Dental Anesthesia and Pain Medicine
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• 제16권1호
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• pp.17-24
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• 2016

Background: To evaluate the antimicrobial activity of lidocaine (LD) topical anesthetic spray against oral microflora. Methods: Antimicrobial effects of 10% LD spray were assessed against six bacterial cultures obtained from volunteers: Escherichia coli, Enterococcus faecalis, Staphylococcus aureus, Streptococcus salivarius, Streptococcus pyogenes, and Streptococcus sanguinis. The filter papers contained $50-{\mu}l$ LD, brain heart infusion (BHI) broth, or 0.2% chlorhexidine. Papers were placed on the cultured blood plates for 1-3 min. After the papers were removed, plates were incubated for 24 h. Bacterial growth on the contact areas was recorded as the antimicrobial score. The split mouth technique was use in for sample collection in clinical study. Filter papers soaked with either BHI broth or LD were placed on the right or left buccal mucosa for 1 min, and replaced with other papers to imprint biofilms onto the contact areas. Papers were placed on blood plates, incubated for 24 h, and antimicrobial scores were determined. Experiments were conducted for 2- and 3-min exposure times with a 1-day washout period. Results: LD exhibited bactericidal effects against E. coli, S. sanguinis, and S. salivarius within 1 min but displayed no effect against S. aureus, E. faecalis, and S. pyogenes. The antimicrobial effect of LD on oral microflora depended upon exposure time, similar to the results obtained from the clinical study (P < 0.05). LD showed 60-95% biofilm reduction on buccal mucosa. Conclusions: Antimicrobial activity of 10% LD topical anesthetic spray was increased by exposure time. The 3 min application reduced oral microflora in the buccal mucosa.

• Journal of Periodontal and Implant Science
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• 제23권3호
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• pp.461-474
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• 1993

This study was performed to estimate the effect of plaque control on the progress of the repair pattern of the alveolar bone surface after bone surgery. In this experiment six mongrel dogs were used, four of them were as experimental group and others were as control. In the case of experimental group, dental floss ligature was tied over the neck of crown for permiting of plaque accumulation during one week before surgery and oral hygiene procedures were not performed. In control group, all the surgical intervention was done as same procedure with experimental except oral hygiene program. After surgery plaque was controlled during one week with using the chlorhexidine brushing. Animals were sacrificed at 1,2,4,6 weeks after osseous surgery. The results were as follows : 1. The alveolar bone defects were covered with regenerated epithelium at one week, matrix change of granulation tissue on subcutaneous area was observed, and new bone formation was initiated from the surface of the bone defects. 2. The connective tissue arrangement revealed more dense, new bone formation by osteoblasts was active at 2 weeks and proliferation of gingival epithelium and alveolar bone tissue were evident at 4 weeks, and almostly recovered to normal condition at 6 weeks. 3. In experimental group, inflammatory reaction was persistent in early stage and bone repair was delayed compared to control group. 4. In control group, matrix change of granulation tissue was initiated from one week, regeneration of gingival epithelium and maturation of subcutaneous conective tissue and new bone formation were evident at 2 weeks, so almost normal bone regeneration was observed at 4,6 weeks.

• Imaging Science in Dentistry
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• 제40권3호
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• pp.123-129
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• 2010

Purpose : To evaluate the effect of surgical treatment of ligature-induced peri-implantitis in dogs using fractal analysis. Also, the capabilities of fractal analysis as bone analysis techniques were compared with those of histomorphometric analysis. Materials and Methods : A total of 24 implants were inserted in 6 dogs. After a 3-months, experimental periimplantitis characterized by a bone loss of about 3 mm was established by inducing with wires. Surgical treatment involving flap procedure, debridement of implants surface with chlorhexidine and saline (group 1), guided bone regeneration (GBR) with absorbable collagen membrane and mineralized bone graft (group 2), and $CO_2$ laser application with GBR (group 3) were performed. After animals were sacrificed in 8 and 16 weeks respectively, bone sections including implants were made. Fractal dimensions were calculated by box-counting method on the skeletonized images, made from each region of interest, including five screws at medial and distal aspects of implant, were selected. Results : Statistically significant differences in the fractal dimensions between the group 1($0.9340{\pm}0.0126$) and group 3($0.9783{\pm}0.0118$) at 16 weeks were found (P<0.05). The fractal dimension was statistically significant different between 8($0.9395{\pm}0.0283$) and 16 weeks in group 3 (P<0.05). These results were similar with the result of the evaluation of new bone formation in histomorphometric analysis. Conclusions : Treatment of experimental peri-implantitis by using $CO_2$ laser with GBR is more useful than other treatments in the formation of new bone and also the tendency of fractal dimension to increase relative to healing time may be a useful means of evaluating.

• Tuberculosis and Respiratory Diseases
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• 제69권2호
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• pp.75-80
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• 2010

The year of 2009~2010 brought a number of concepts and new ideas were evaluated with promising results. However, some studies that challenged many beliefs. In acute respiratory distress syndrome (ARDS), recent clinical studies took into consideration of pathophysiologic changes of respiratory system compliance. Meta-analysis of positive end-expiratory pressure trials showed survival benefit of high positive end-expiratory pressure in ARDS. Until now, prone positioning did not show survival benefit in patients with ARDS. Extracorporeal membrane oxygenation (ECMO) based management improved survival in patients with severe ARDS. ECMO can be a management option in severe ARDS. Sedation is a standard practice in critically ill patients needing mechanical ventilation. However, Danish group reported less sedation of critically ill patients receiving mechanical ventilation was associated with an increase in days without ventilation. Although this single center study has some limitations, the overall results are promising. Use of maximal sterile barrier precautions (mask, sterile gown, sterile gloves, and large sterile drapes) with chlorhexidine-impregnated dressing reduced central venous catheter related infection. Selective oropharyngeal decontamination (application of topical antibiotics in the oropharynx) reduced the mortality rate of an intensive care unit (ICU) population. Normoglycemia in Intensive Care Evaluation and Survival Using Glucose Algorithm Regulation (NICE-SUGAR) trial reported intensive glucose control increased mortality among adults in the ICU. Some of the results of above papers are promising. However, some ideas may need for more frequent individual assessment and increase the workload of ICU staffs. Before implementation of new practice in ICU, we should take into consideration of individual hospital situation including human and material resources.

• Restorative Dentistry and Endodontics
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• 제45권3호
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• pp.26.1-26.18
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• 2020

Objectives: This study aimed to systematically review the pain and flare-up effects of calcium hydroxide (CH) as intracanal medication (ICM) in non-vital mature teeth. Materials and Methods: Electronic-databases searching for published and grey literature and manual searching were conducted. Only randomized clinical trials (RCTs) were included comparing CH to other ICMs in non-vital mature teeth. The risk of bias was assessed using the RoB 2.0 Cochrane tool. The main outcomes were pain and flare-up. Qualitative and quantitative analysis, wherever applicable, was performed. The certainty of evidence (CoE) was assessed using Grading of Recommendations Assessment, Development and Evaluation (GRADE). Results: Sixteen articles were included in 6 comparisons at different time points for different outcomes. CH reduced pain risk than no ICM within the 1-14-days interval (p < 0.05) and than triple-antibiotic paste within the first day (p < 0.05) and was similar to corticosteroid/antibiotics combination (p > 0.05). Chlorhexidine (CHX) or CH/CHX, however, reduced pain levels than CH alone (p < 0.05). CH showed higher flare-up risk than CHX (p < 0.05). CoE, however, ranged from very low to moderate. Conclusion: Most comparisons for different outcomes are based on very few studies, mostly low-powered, with an overall low CoE. Thus, the available evidence is considered insufficient to either support or refute CH effectiveness or to recommend one ICM over another. Therefore, further well-designed, larger RCTs are required.

• 한국임상수의학회지
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• 제28권5호
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• pp.538-541
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• 2011

8세의 중성화 수술을 한 요크셔테리어종견이 재발성표재성농피증을 호소하여 경북대학교 수의과대학 부속동물병원에 내원하였다. 내원 당시 전신에 다수의 농포와 구진이 관찰되었다. 농포의 압착도말염색 표본에서 다수의 간 균과 상대적으로 적은 수의 구균이 함께 관찰되어, 각각 세균을 분리 동정한 결과 Proteus mirabilis와 Staphylococcus pseudointermedius으로 확인되었다. 4% 농도의 클로르헥시딘 샴푸 약욕과 항생제감수성시험 결과에 의한 전신 enrofloxacin과 amoxicillin-clavulanic acid 치료를 병행한 결과 2주 후에는 임상증상이 현저히 개선되었고, 6주 후에는 임상증상이 완전히 사라졌다. 본 증례는 개에서 일반적인 항생제 치료에 응답하지 않는 재발성농피증의 경우 그람음성 간균의 혼합감염 가능성을 시사하였다.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제45권1호
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• pp.21-28
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• 2019

Objectives: Osteoradionecrosis (ORN) is one of the most severe complications resulting from radiotherapy (RT) in patients with head and neck cancer (HNC). It is characterized by persistent exposed and devitalized bone without proper healing for greater than 6 months after a high dose of radiation in the area. To describe the profile and dental management of ORN in HNC patients undergoing RT in an oncological clinical research center. Materials and Methods: A retrospective descriptive study was performed to analyze dental records from HNC patients with ORN treated at an oncological clinical research center from 2013 to 2017. A total of 158 dental records for HNC patients were selected from a total of 583 records. Afterwards, this number was distributed to three examiners for manual assessments. Each examiner was responsible for selecting dental records that contained an ORN description, resulting in 20 dental records. Results: Mean patient age was 60.3 years with males being the most affected sex (80.0%). The most affected area was the posterior region of the mandible (60.0%) followed by the anterior region of the mandible (20.0%) and the posterior region of the maxilla (10.0%). The factors most associated with ORN were dental conditions (70.0%) followed by isolated systemic factors (10.0%) and tumor resection (5.0%). There was total exposed bone closure in 50.0% of cases. The predominant treatment was curettage associated with chlorhexidine 0.12% irrigation (36.0%). Conclusion: Poor dental conditions were related to ORN occurrence. ORN management through less invasive therapies was effective for the closure of exposed bone areas and avoidance of infection.

• Journal of Korean Neurosurgical Society
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• 제62권2호
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• pp.209-216
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• 2019

Objective : Hydatid cyst disease is caused by the parasite Echinococcus granulosus. It is rarely seen in the vertebral system, occurring at a rate of 0.2-1%. The aim of this study is to present 12 spinal hydatid cyst cases, and propose a new type of drainage of the cyst. Methods : Twelve cases of spinal hydatid cysts, surgical operations, multiple operations, chronic recurrences, and spinal hydatic cyst excision methods are discussed in the context of the literature. Patients are operated between 2005 and 2016. All the patients are kept under routine follow up. Patient demographic data and clinicopathologic characteristics are examined. Results : Six male and six female patients with a median age of 38.6 at the time of surgery were included in the study. Spinal cyst hydatid infection sites were one odontoid, one cervical, five thoracic, two lumbar, and three sacral. In all cases, surgery was performed, with the aim of total excision of the cyst, decompression of the spinal cord, and if necessary, stabilization of the spinal column. Mean follow up was 61.3 months (10-156). All the patients were prescribed Albendazole. Three patients had secondary hydatid cyst infection (one lung and two hepatic). Conclusion : The two-way drainage catheter placed inside a cyst provides post-operative chlorhexidine washing inside the cavity. Although a spinal hydatid cyst is a benign pathology and seen rarely, it is extremely difficult to achieve a real cure for patients with this disease. Treatment modalities should be aggressive and include total excision of cyst without rupture, decompression of spinal cord, flushing of the area with scolicidal drugs, and ensuring spinal stabilization. After the operation the patients should be kept under routine follow up. Radiological and clinical examinations are useful in spotting a recurrence.

• 대한치과의료관리학회지
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• 제7권1호
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• pp.50-55
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• 2019

The purpose of this study was to compare the number of bacteria before and after the use of surface disinfectants, demonstrate the bactericidal effect of surface disinfectants, and emphasize on the importance of surface disinfectants by recognizing the importance of infection control in dentistry. Chlorhexidine, hydrogen peroxide, ethanol, and chemical disinfectants are commonly used in dentistry. NaOCl was selected as the experimental group, and the bacterium test results obtained by comparing the table without surface sterilization as a control group showed that all disinfectants had an effective bactericidal effect (p<0.05). In the growth inhibition test comparing the experimental and control groups, all results were 100%, proving the effectiveness of surface disinfectants. The results showed that all surface disinfectants preferred and used by medical institutions were effective. Therefore, all surface disinfectants used in the experimental group were effective for surface disinfection for infection control. Dental clinicians should be aware of the necessity of disinfection of surfaces, such as table, chairs, and unit chairs, and make an active effort to ensure that both clinicians and patients are safe from infection.