• 대한치과보존학회:학술대회논문집
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• 대한치과보존학회 2003년도 제120회 추계학술대회 제 5차 한ㆍ일 치과보존학회 공동학술대회
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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?

• Parasites, Hosts and Diseases
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• 제61권2호
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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.

• Parasites, Hosts and Diseases
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• 제61권2호
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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.

• 농촌의학ㆍ지역보건
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• 제30권2호
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• pp.205-211
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• 2005

울릉도의 피부 진균증 환자들은 타 지역에 비해 중복 감염율이 높은데, 이는 피부 진균증에 대한 환자들의 인식도가 낮기 때문으로 생각된다. 또한 가족 내 감염율도 타지역 보다 높아서 피부 진균증에 대한 예방 교육이 절실하다. 그러나, 피부 진균증 환자들의 나이가 고령화, 여성화 되고 있어 피부 진균증에 대한 인식을 높이기 위한 보건 교육을 고령 환자들과 여성 환자들에 맞추어 시행할 필요가 있다. 주위 동료들의 감염율도 높으므로 적절한 예방 교육이 이루어 진다면 피부 진균증의 예방 효과는 클 것으로 예상된다. 부족하나마 설문 조사로 피부 진균증 환자들의 피부 진균증에 대한 인식도가 미흡다는 사실은 울릉군 지역의 피부 진균증 예방교육의 필요성을 제시 할 것으로 생각된다. 추후에도 울릉군 지역의 피부 진균증에 대한 여러 가지 방면에서의 연구가 필요할 것으로 생각되며, 인식도 조사도 많은 환자와 주민을 대상으로 시행하여 통계적인 유의성을 찾아야 할 것으로 생각된다.

• Archives of Plastic Surgery
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• 제47권5호
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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.

• Parasites, Hosts and Diseases
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• 제23권2호
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• pp.241-246
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• 1985

우리나라 8개 농촌지역의 회충 감염율, 감염 량 및 기초산란율(basic reproductive rate)등 역학적 변수의 상관관계를 관찰함으로써 우리나라 회충감염 실태를 분석하였다. 이들 감염율, 감염량 등은 대변검사는 물론 pyrantel pamoate투여후 충체 회수결과에 의해 측정하였으며 그 결과는 다음과 같다. 1. 각 조사지역의 충체양성률(감염율)은 16.5~79.5%의 범위에 있었고 이것은 대변검사에 의한 충란양성률 3.3~66.7%보다 9~18%가 높은 수치이었다. 조사대상 주민의 평균 회충 감염량은 지역에 따라 0.21에서 8.44로 나타났고 개인별 감염량 분포는 'k'치가 0.38~0.54인 부이항분포(negative binomial distribution)를 보였다. 2. 이 조사에서 나타난 충체양성률은 Anderson과 May의 수식 $p=1-(1+M^{*}/k)^{-k}$ (p : 충체양성률, $M^*$ : 평형상태의 평균 감염량)에 의해 구한 이론치와 거의 일치하여 우리나라 농촌지역의 회충감염률과 감염량의 상관관계는 이 수식에 의해 매우 정확히 표현됨을 알 수 있었다. 또 회충 암컷 1마리가 평생 산출하는 무수한 충란중 다음 숙주에 성공적으로 감염되고 성숙되는 암컷의 수를 표시하는 기초산란을(R)은 지역에 따라 1.03에서 2.11까지인 것으로 나타났다. 이상의 결과로 보아 'R'치가 1에 가까운 지역은 역학적으로 재감염의 breakpoin떼 도달하고 있는 것으로 판정되므로 회충 박멸이 매우 희망적이지만 전국적으로 'R'치가 1이하로 될 때까지 우리나라 회충관리사업은 계속되어야 할 것으로 생각된다.

• Restorative Dentistry and Endodontics
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• 제26권2호
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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.

• 한국식물병리학회:학술대회논문집
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• 한국식물병리학회 1994년도 Proceedings of International Symposium on BIOLOGICAL CONTROL OF PLANT DISEASES Korean Society of Plant Pathology
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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.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제1권1호
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• pp.37-44
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• 1998

목 적: H. pylori 감염증에 대한 치료요법은 성인의 경우 여러가지 방법이 알려져 있으나 국내에서 소아를 대상으로 한 H. pylori 치료결과에 대한 연구보고는 미미하다. 이에 저자들은 소아에서의 H. pylori 감염증에 대한 치료결과 및 재발률을 조사하고, 아울러 효과적이고 경제적인 치료방법을 찾아보고자 하였다. 대상 및 방법: 1993년 11월부터 1997년 8월까지 복통 또는 상부위장관 출혈을 주소로 연세의대 세브란스병원 소아과에 내원하여 상부위장관 내시경검사와 Warthin-Starry 은염색, CLO검사 결과 H. pylori 감염증으로 진단된 환아 120례 중 치료 후 추적관찰이 가능하였던 75례를 대상으로 하였다. 대상환아는 남아가 39례, 여아가 36례였으며, 평균연령은 $11.4{\pm}2.5$세였다. 대상환아들은 초기약제로 DA($Denol^{(R)}$과 amoxycillin), OA(omeprazole과 amoxycillin) 또는 DC($Denol^{(R)}$과 clarithromycin) 등 세가지 요법중 한가지를 투여하였고, 제균에 실패한 환아에 대해서는 DAM($Denol^{(R)}$과 amoxycillin, metronidazole), DC, OA, OC(omeprazole과 clarithromycin) 중 한가지를 2~4주간 투여하였으며, 치료종결 4주 후 H. pylori 제균 여부를 진단시와 동일한 방법으로 판정하였다. 결 과: 대상환아의 상부위장관질환은 만성 결절성위염 46례, 위궤양 9례, 십이지장궤양 6례, 표재성위염 6례 및 정상 8례 등이었다. DA는 69례에서 투여되어 이중 63례(91%)에서 H. pylori가 제균되었고, DAM은 DA에 실패한 2례중 1례, DC는 초기 치료한 4례중 3례(75%)와 DA에 실패한 2례중 1례(50%)에서, OA는 초기치료한 2례에서, OC는 DA에 실패한 1례에서 모두 제균되였다. 치료 후 H. pylori 제균에 실패한 환아는 7례(DA 6례, DC 1례) 였으며, 이중 3례는 2차 치료(DAM, DA 및 DC 각 각 1례)로 제균되었고, 나머지 4례(DAM 2차요법 1례, 추적 불능 3례)에서는 제균되지 않았다. 치료 후 H. pylori가 제균되었으나 수 개월이 지나 재발된 환아는 4례(5.3%)로 치료 종결 후 3개월에서 3년 사이에 재발되었다. 재발된 4례중 2례는 2차 요법(OC, DA 각각 1례)으로 제균되었고, 나머지 2례(DC 2차요법 1례, 추적불능 1례)에서는 제균되지 않았다. 결 론: bismuth subcitrate와 amoxycillin의 두약제 요법은 H. pylori의 제균율이 91%로 높고 재발률도 5.3%로 낮으며, 또한 경제적이기 때문에 소아의 H. pylori 감염증에 대한 초기 치료제로 선택되어 질 수 있는 유용한 치료방법중의 하나로 생각된다.

• 농촌의학ㆍ지역보건
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• 제29권1호
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• pp.163-175
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• 2004

섬진강 유역 곡성군 및 순창군 지역은 주민의 간흡충증 유병률이 약 10~40%이다. 이 지역의 간흡충 질환의 퇴치를 위해 지역 주민을 대상으로 간흡충 간염자를 진단 및 치료하고 예방교육을 통해 이 질환의 관리효과를 관찰 하였다. 간흡충 집중관리 이전의 제1차 간흡충증 유병률 조사를 실시하였다. 비확률 표본추출의 방법에 따랐다. 전남 곡성군 주민 1,243명에 대하여 대변을 받아 Formalin-ether 집란법으로, 전북 순창군 주민 1,004명에 대해서는 혈청을 받아 ELISA 검사로 간흡충증을 진단함으로써 두 지역의 간흡충증 유병률을 파악하였다. 간흡충 감염자 전원을 디스토시드 약물로 치료해 주고 재감염 방지를 위한 예방교육을 실시하였다. 간흡충 집중관리 이후의 제2차 간흡충증 유병률 조사를 1차 조사 후 9개월 뒤에 곡성군 주민 616명, 순창군 주민 2,637명을 대상으로 1차 조사 때와 같은 방법으로 실시하여 얼마나 유의하게 유병률이 감소하였는지를 판정하였다. 조사 결과는 다음과 같다. 1. 곡성군 및 순창군의 집중관리 이전의 제1차 간흡충 유병 각각 평균 39.0%, 30.1% 이었고 두 군을 통 털어 면 단위별로는 61.5%에서 8.9% 범위이었다. 두 군 모두 섬진강변에 위치한 면에서 강으로부터 먼 면보다 유병률이 높았다. 또한 대변검사와 ELISA의 Field survey 상의 진단적 신뢰도에 큰 문제가 없다고 판단하였다. 2. 간흡충 감염자 전원을 약물 치료 및 예방교육을 실시하고 9개윌 후에 실시한 제2차 조사 결과, 곡성군 및 순창군의 간흡충 유병률은 22.4%, 16.3%로 집중관리 이전과 비교하여 통계적으로 두 군 공히 유의하세 감소한 것으로 나타났다(P<0.0001). 이상의 결과에서, 섬진강 유역의 곡성군, 순창군 지역은 간흡충 감염이 고도로 유행하고 있었고, 집중관리에 의해 유병률이 유의하게 감소함을 확인하였다. 따라서, 섬진강 유역의 다른 지역도 간흡충증의 집중관리가 이루어져야 하며 본 연구의 간흡충증 관리 모형을 적용할 것을 제언한다.