OBJECTIVES: This study aims to compare home care dental devices for their dental plaque removal ability. METHODS: A single blinded randomized crossover clinical study design was used to measure plaque index (Turesky Modification Quigley-Hein Plaque Index). RESULTS: All 3 groups showed a statistically significant decrease in the plaque index after usage (P<0.001). In manual tooth-brushing group, the teeth on the right dental arch showed a greater decrease in the plaque index than on the left arch (P=0.041). All appliances showed greater plaque reduction in the upper right posterior teeth than in the lower right posterior teeth (P=0.009, 0.004, 0.007). CONCLUSIONS: The results of this study support development of more effective oral hygiene appliances and emphasis on oral hygienic education.
Dental Arch ; Dental Devices, Home Care ; Dental Plaque Index ; Dental Plaque* ; Education ; Health Education ; Oral Hygiene* ; Tooth ; Vibration*

Objectives: This study aims to suggest ways to improve the oral care competencies of caregivers by strengthening oral care services for the elderly with mobility difficulties in long-term care facilities. Methods: Through a web survey, 215 caregivers were invited, their actual situation was identified, and necessary educational tasks were listed. We developed 16 types of card news, two types of songs, and four types of video clips that can be used in the field for the listed educational topics. Several meetings with expert developers resulted in developing the components and design of an oral health management platform for caregivers in long-term care facilities. Results: As a result of the web survey, many caregivers in long-term care facilities needed education or information on oral care methods, and many people felt difficulties in oral care for the elderly. About 40% of the caregivers had no experience in oral health education, and many learned how to care through unsystematic apprenticeships. Most of the education content that caregivers prioritized were brushing teeth and denture management, but there were also needs such as management of dementia and bedridden patients, non-cooperative oral care, nutrition management, and oral auxiliary products use. Conclusions In conclusion, this study reviewed and suggested digital platforms such as strengthening caregivers’ competency in long-term care facilities, providing customized educational information, discovering oral problems of the elderly, and reporting oral difficulties to experts.

Objectives: This study aims to explore the experience of caregivers in oral health care of the elderly in long-term care facilities, identify the problems, and collect opinions, and to seek improvement directions for strengthening competency and improving services of oral health care for the elderly. Methods: Data on the experience in oral health care of the elderly were collected through focus group interviews (FGI) targeting caregivers in long-term care facilities. The grounded theory method was used. The interview content was categorized by open coding, and a paradigm model was presented by identifying the relationship between the categories through axial coding. Selective coding found core categories. Results: As a result of categorizing the caregivers’ oral care experience of the elderly, 15 categories, 40 sub-categories, and 125 concept/phenomena codes were derived. The central phenomenon was the difficulty of implementing sustainable oral health care. The deterioration of the mental and physical functions of the elderly, the work characteristics of caregivers, and the lack of linkage with internal and external resources of the facility acted as causal conditions for the central phenomenon. The caregiver’s oral health education experience acted as an intervening condition. In an effort to improve the problem, an interaction strategy was derived. Conclusions It is possible to seek delivery of sustainable oral health care services by caregivers by improving the quality of oral health education and establishing an oral health care service system for the elderly.

PURPOSE: The study was designed to identify how different types of transfer student personality would be constituted in Seoul National University School of Dentistry (SNU SD) and delve into what personal types were often observed more competent in academic performance. METHODS: Among 40 students who transferred to SNU SD in 2004, 15 students voluntarily participated in completing the Myers-Briggs type indicator (MBTI; GS form); then, it was tested whether or not their MBTI types would be dependent upon their final grades. In addition, another 32 out of the 50 students who were enrolled through a traditional pre-den system served as a control group. RESULTS: It was mainly found that ISTJ type was the most typical one for those transfer dental students as well as for other native dental students who excelled in their academic performance. The noticeable majority of transfer students were Introverted (67%), Sensing (80%), Thinking (86%), and Judging (80%), with S-J pattern being statistically significant. CONCLUSION: SNU SD has been in a rebuilding process in terms of student/outcome centered dental education to have it up to the global standards. For this reason, it is ultimately a crucial part of that process to understand what personality types of the dental students with different backgrounds in major are observed and thus recognize how to support their learning according to different patterns of individual personality.
Dentistry ; Education, Dental ; Humans ; Learning ; Personality Inventory ; Schools, Dental ; Students, Dental ; Thinking

This report describes a patient with lipoma arborescens presenting as hemarthrosis of a knee with intraosseous lesions. A 44-year old woman complained of pain and swelling of left knee. Arthrocentesis resulted in bloody effusion. Magnetic resonance images showed villous projecting frondlike fatty soft tissue proliferation in the suprapatellar pouch and ovoid intraosseous lesions in proximal tibia. The soft tissue mass was removed through arthroscopic synovectomy and the biopsy of the mass confirmed the diagnosis. The intraosseous lesions were not considered as a cause of hemarthrosis. We failed to find the exact cause of hemarthrosis. The patient remained asymptomatic after removal of the mass for 10 months. As far as we know, this is the first report of hemarthrosis associated with lipoma arborescens in korea.
Adult ; Biopsy ; Diagnosis ; Female ; Hemarthrosis* ; Humans ; Knee* ; Korea ; Lipoma* ; Tibia

Systemic lupus erythematosus (SLE) is an autoimmune disease characterized by autoantibodies and immune complex depositions, has been known that it could be aggravated during pregnancy. We report a case who developed massive pericardial effusion, pleural effusion, and proteinuria during the second trimester of pregnancy. This patient had a history of leukopenia for several years and showed several features of SLE before pregnancy, however, no specific diagnosis was made before pregnancy. High dose oral glucocorticoid with intravenous immunoglobulin administration was done, but serositis and nephritis did not improve. The induced abortion and the use of immunosuppresive agent resulted in remission. We emphasize the importance of the early diagnosis and management of SLE before pregnancy in the patients with the features of autoimmune disease such as leukopenia, skin lesion and Raynaud phenomenon for successful outcome.
Abortion, Induced ; Antigen-Antibody Complex ; Autoantibodies ; Autoimmune Diseases ; Diagnosis ; Early Diagnosis ; Female ; Humans ; Immunoglobulins ; Leukopenia ; Lupus Erythematosus, Systemic* ; Lupus Nephritis ; Nephritis* ; Pericardial Effusion ; Pleural Effusion ; Pregnancy Trimester, Second ; Pregnancy* ; Proteinuria ; Raynaud Disease ; Serositis* ; Skin

OBJECTIVE: Ultrasonography (USG) of joints has a unique position for the diagnosis of joint diseases. Bone surface, cartilage, periarticular soft tissue and their pathologic changes can be assessed by USG. This study was aimed to compare the radiographic and ultrasonographic findings in osteoarthritis (OA) of the knee joint and to evaluate the usefulness of each modality to evaluate the disease early and determine the severity of the arthritis. METHODS: Fifty osteoarthritis patients classified by the American College of Rheumatology (ACR) clinical criteria from December 2002 to April 2003 were included in the study. Routine radiography (standing anteroposterior, lateral, skyline view) and systemic USG examination of both knee were performed. We compared the incidence of the radiographic and ultrasonographic abnormality related to the pathologic change of the knee OA and suggesting the severity of the OA which would help to decide the therapeutic modality. RESULTS: In patient with knee OA, plain radiography showed abnormal findings in 37/50 (74%) patients, but USG showed at least five abnormal findings in all 50 patients. The abnormal findings detected only by plain radiography were subchondral sclerosis and subchondral cyst (14% and 4% each). But, the thinning of cartilage (94%), Baker's cyst (94%), cartilage degeneration (54%), meniscal protrusion (44%), meniscal tear (34%), meniscal cyst (32%), and the pannus (22%) were detected only by USG. Among the findings shared by both method, joint space narrowing was detected better by plain radiography than USG, but fluid accumulation, spur, meniscal calcification and osteochondroma were detected more frequently by USG. CONCLUSION: USG is more sensitive to find the pathologic changes related to the knee OA and to diagnose OA than the plain radiography. But each of the plain radiography and USG have their own unique value for the evaluation of OA in the knee. So the USG supplements the plain radiography in the examination of the knee OA.
Arthritis ; Bone Cysts ; Cartilage ; Diagnosis ; Humans ; Incidence ; Joint Diseases ; Joints ; Knee Joint ; Knee* ; Osteoarthritis ; Osteoarthritis, Knee* ; Osteochondroma ; Popliteal Cyst ; Radiography* ; Rheumatology ; Sclerosis ; Ultrasonography*

BACKGROUND: Calcineurin plays a crucial role in T cell activation, cell growth, apoptosis, and angiogenesis, and its over-expression has been implicated in the pathogenesis of cardiomyopathy and stroke. However, the expression and function of calcineurin in the pathologic lesion of chronic inflammatory diseases, like rheumatoid synovium, remain to be defined. This study was aimed to determine the role of calcineurin in inflammatory arthritis and investigate the expression and function of calcineurin in the rheumatoid synovium and synoviocytes, the actual site of chronic inflammation. METHODS: Immunohistochemical staining using specific antibody to calcineurin was perfomed in the synovium of rheumatoid arthritis (RA). Fibroblast-like synoviocytes (FLS) from RA and osteoarthritis (OA) patients were isolated from RA and OA patients, and cultured with IL-1beta and TNF-alpha in the presence or absence of cyclosporin A, a calcineurin inhibitor. The calcineurin expression was assessed by phosphatase assay and Western blotting analysis. IL-6, -10, -17, matrix metalloproteinase (MMP)-1, -2, -3, and -9 released into the culture supernatants were measured by ELISA. After transfection with GFP-Cabin 1 gene into synoviocytes, the levels of IL-6 and MMPs were measured by ELISA. RESULTS: Calcineurin was highly expressed in the lining layer of synovium and cultured synoviocytes of RA patients. The elevated calcineurin activity in the rheumatoid synoviocytes was triggered by proinflammatory cytokines such as IL-1beta and TNF-alpha. In contrast, IL-10, an anti-inflammatory cytokine, failed to increase the calcineurin activity. The targeted inhibition of calcineurin by the over-expression of Cabin 1, a natural calcineurin antagonist, inhibited the production of IL-6 and MMP-2 by rheumatoid synoviocytes in a similar manner to the calcineurin inhibitor, cyclosporin A. CONCLUSION: These data suggest that abnormal activation of calcineurin in the synoviocytes may contribute to the pathogenesis of chronic arthritis, and thus provide a potential target for controlling inflammatory arthritis.
Apoptosis ; Arthritis* ; Arthritis, Rheumatoid ; Blotting, Western ; Calcineurin* ; Cardiomyopathies ; Cyclosporine ; Cytokines ; Enzyme-Linked Immunosorbent Assay ; Humans ; Inflammation ; Interleukin-10 ; Interleukin-6 ; Matrix Metalloproteinases ; Osteoarthritis ; Stroke ; Synovial Membrane ; Transfection ; Tumor Necrosis Factor-alpha

OBJECTIVE: This study was performed to evaluate the influence of low dose corticosteroid (CS) on bone turnover and osteoporosis in patients with rheumatoid arthritis (RA). METHODS: Bone mineral density (BMD), erythrocyte sedimentation rate, C-reactive protein, serum osteocalcin, and urinary deoxypyridinoline were measured in 63 patients with RA. According to daily prednisolone dose, patients were divided into low dose DI (< or = 5.0 mg) and medium dose DII (7.5~20.0 mg) groups. According to cumulated prednisolone dose, patients were divided into CI (<5.0 gm) and CII (>5.0 gm) groups. Then we analyzed each groups in relation to several indicators. RESULTS: Most RA patients had low BMD. BMD of DI and DII groups were low without significant difference. Urinary excretion of deoxypyridinoline was high in DI and DII group while serum osteocalcin level was normal in both groups. It suggested patients with RA have an imbalance between bone absorption and bone formation contributing the development of osteoporosis, even though low dose steroid therapy. CONCLUSION: Patients with low dose CS had significantly high urinary deoxypyridinoline excretion, normal serum osteocalcin, and low BMD, as well as patients with medium dose CS. Even though low dose CS use, intensive prevention and treatment for generalized osteoporosis are recommended in patients with RA.
Absorption ; Arthritis, Rheumatoid* ; Blood Sedimentation ; Bone Density ; C-Reactive Protein ; Humans ; Osteocalcin ; Osteogenesis ; Osteoporosis ; Prednisolone

OBJECTIVE: TNF-alpha related apoptosis inducing ligand (TRAIL) is a member of TNF superfamily that promotes apoptosis by binding to the transmembrane receptors. The effects of TRAIL in patients with rhematoid arthritis (RA) are still debatable. This study was performed to evaluate the effects of TRAIL on RA by measuring serum concentration of TRAIL in patients with RA and assessing relationships between the TRAIL concentration and various clinical parameters of RA. METHODS: A total of 105 patients with RA, 34 patients with osteoarthritis (OA), and 35 age- and gender-matched healthy controls were enrolled in this study. Data from the RA patients included subject's age, duration of disease, daily steroid doses, ESR, CRP, rheumatoid factor, leukocyte count, lymphocyte count, tender joint count, swollen joint count, and serum TRAIL concentration. Serum TRAIL concentration was measured by enzyme immunoassay (EIA) method. The serum concentration of TRAIL in RA patients was compared to those of OA patients and healthy controls. Relationships of TRAIL concentration with various clinical parameters were evaluated. RESULTS: Serum concentration of TRAIL in patients with RA was significantly decreased compared to that in healthy controls (RA: 42.60+/-26.39 pg/mL, control: 57.21+/-19.49 pg/mL, p=0.029). Serum concentration of TRAIL in patients with OA (50.79+/-15.92 pg/mL) was not different from that in normal controls (p=0.115). There were no significant differences in serum TRAIL concentration between patients with RA and those with OA (p=0.360). In patients with RA, serum TRAIL concentration showed no difference between high- and normal ESR subgroups, as well as high- and normal CRP subgroups. Serum TRAIL concentration correlated significantly with ESR (r=0.406, p<0.001). However, other clinical parameters, such as subject's age, duration of disease, daily steroid doses, CRP, leukocyte count, lymphocyte count, tender joint count, swollen joint count revealed no significant correlation with serum TRAIL concentration. CONCLUSION: Serum concentrations of TRAIL in RA patients were significantly lower than those in healthy controls, suggesting that apoptotic ability is decreased in the patients with RA. Serum TRAIL concentration does not seem to reflect disease activity of RA.
Apoptosis ; Arthritis ; Arthritis, Rheumatoid ; Humans ; Immunoenzyme Techniques ; Joints ; Leukocyte Count ; Lymphocyte Count ; Osteoarthritis ; Rheumatoid Factor ; Tumor Necrosis Factor-alpha