Three-dimensional finite element model was made from adult skull to find desirable direction of retraction force to treat skeletal class II malocclusion. The retraction force of 400g was applied to the first molar. The direction of the force application was 23degrees downward, parallel, 23degrees upward and 45` upward to the occlusal plane. The stress distribution and the displacement within the maxilla were analyzed by three-dimensional finite element method. The findings obtained were as follows: 1. Maxillary first molar was displaced posteriorly and inferiorly in 23degrees downward, parallel, 23degrees upward retraction but it was displaced posteriorly and superiorly in 45degrees upward retraction. 2. ANS, A point and prosthion were moved posteriorly and inferiorly and pterygornaxillary fissure was moved posteriorly and superiorly. Clockwise rotation of maxilla occurred when retraction force was applied. 3. The degree of clockwise rotation of maxilla was greatest when the force was applied 23degrees upward to the occlusal plane and was least when the force was applied 23degrees downward to the occlusal plane. 4. Large tensile stress appeared in maxillary first molar and alveolar bone and the infraorbital region of maxilla when the force was applied 23degrees downward to the occlusal plane. Tensile stress was smaller as the direction of force move upward. 5. Large compressive stress was appeared in maxillary first molar and infraorbital region in 45degrees upward case and large compressive stress occurred in the posterior part of maxilla as the retraction force was upward.
Adult ; Dental Occlusion ; Humans ; Malocclusion ; Maxilla* ; Molar ; Skull

The elastin metabolism in systemic sclerosis (SSc) has been known to be abnormal. The authors investigated relationship between the clinical manifestations of systemic sclerosis (SSc) and serum levels of soluble elastin-derived peptide (S-EDP) and anti-elastin antibodies. Serum samples were obtained from 79 patients with SSc and 79 age- and sex-matched healthy controls. Concentrations of serum S-EDP and anti-elastin antibodies were measured by ELISA. The serum concentrations of S-EDP in SSc patients were significantly higher than in healthy controls (median, 144.44 ng/mL vs 79.59 ng/mL, P < 0.001). Serum EDP concentrations were found to be correlated with disease duration in SSc (P = 0.002) and particularly in diffuse cutaneous SSc (P = 0.005). Levels of anti-elastin antibodies were found to be more elevated in SSc patients than in healthy controls (median, 0.222 U vs 0.191 U, P = 0.049), more increased in diffuse cutaneous SSc than limited cutaneous SSc (median, 0.368 U vs 0.204 U, P = 0.031). In addition, levels of anti-elastin antibodies were also found to be negatively associated with presence of anti-centromere antibody (P = 0.023). The S-EDP levels were not found to be correlated with levels of anti-elastin antibodies. The increased S-EDP and anti-elastin antibody levels and association with clinical and laboratory characteristics may reflect the abnormal metabolism in SSc.
Adult ; Antibodies, Anti-Idiotypic/*blood/immunology ; Centromere/immunology ; Elastin/*blood/immunology ; Enzyme-Linked Immunosorbent Assay ; Female ; Humans ; Male ; Middle Aged ; Peptides/*blood/immunology ; Scleroderma, Systemic/*metabolism/pathology

Objective: This study was to evaluate the effectiveness of an individually tailored program based on self-measurement of blood glucose on health behavior and HbA1c in diabetes and pre-diabetes patients. Methods: The program consisted of seven sessions for 12 weeks which were carried out every two weeks. Almost all sessions were progressed on untact method except for the first and last session. The 71 subjects were assessed for their knowledge of diabetes, health behavior, the experience of self-measurement of blood glucose, body mass Index (BMI) and hemoglobin A1c (HbA1c) at before and after the program. They were also evaluated on their degree of utilization of blood glucose measurements after the program. Results: Each mean score on their knowledge of diabetes, health behavior and the experience of self-measurement of blood glucose was significantly increased from 14.77, 25.50, and 2.70 to 15.41, 28.40, and 4.81, respectively. Each mean score on both BMI and HbA1c (n=53) was significantly decreased from 24.47kg/m2 and 7.27% to 24.01kg/m2 and 6.67%, respectively. The post-HbA1c had a significant negative correlation(r=-0.415) with the degree of utilization of blood glucose measurements. The degree of utilization of blood glucose measurements had a significant positive correlation(r=0.581) with post-health behavior. Conclusions The program shows effectiveness in improving HbA1c in Type 2 diabetes and pre-diabetes patients. The post-HbA1c might be related to the degree of utilization of blood glucose measurements which might be related to the health behavior.

Background: Tracking national croup trends can provide important insights for childhood health management. This study aimed to analyze the incidence and drug prescription trends in Korean children over a two-decade period. Methods: This population-based study encompassed 479,783 children aged < 5 years from 2002–2019, utilizing the National Health Insurance Service-National Sample Cohort. We identified participants with a primary croup diagnosis who were admitted to or visited the emergency room. Age-specific and age-adjusted incidence rates/10,000 person-years were calculated. We assessed using orthogonal polynomial contrasts and stratified by various factors (sex, age, residential area, economic status, comorbidities, and healthcare facility types). We observed changes in the use of five medications: inhaled steroids, systemic steroids, inhaled epinephrine, antibiotics, and short-acting bronchodilators. Generalized binomial logistic regression was used to analyze factors influencing prescription strategies. Results: In 2002, the croup-related visits were 16.1/10,000 person-years, increasing to 98.3 in 2019 (Pfor trend < 0.001). This trend persisted, regardless of age, sex, region, and economic status. Children with comorbid atopic dermatitis or asthma maintained consistent croup rates, while those without comorbidities increased. Treatment trends showed decreasing antibiotic (73–47%) and oxygen use (21.3–3.4%), with increasing nebulized epinephrine (9.3–41.5%) and multiple drug prescriptions (67.8–80.3%). Primary care centers exhibited a greater increase in prescription usage and hospitalization duration than did tertiary healthcare institutions. Conclusion Over the past two decades, croup incidence has risen, accompanied by increased epinephrine use and decreased antibiotic prescriptions. Longer hospitalization and higher medication use were mainly observed in primary care facilities.

Objectives: The Korea Centers for Disease Control and Prevention has published “A Guideline for Unknown Disease Outbreaks (UDO).” The aim of this report was to introduce tabletop exercises (TTX) to prepare for UDO in the future. Methods: The UDO Laboratory Analyses Task Force in Korea Centers for Disease Control and Prevention in April 2018, assigned unknown diseases into 5 syndromes, designed an algorithm for diagnosis, and made a panel list for diagnosis by exclusion. Using the guidelines and laboratory analyses for UDO, TTX were introduced. Results: Since September 9th , 2018, the UDO Laboratory Analyses Task Force has been preparing TTX based on a scenario of an outbreak caused by a novel coronavirus. In December 2019, through TTX, individual missions, epidemiological investigations, sample treatments, diagnosis by exclusions, and next generation sequencing analysis were discussed, and a novel coronavirus was identified as the causal pathogen. Conclusion Guideline and laboratory analyses for UDO successfully applied in TTX. Conclusions drawn from TTX could be applied effectively in the analyses for the initial response to COVID-19, an ongoing epidemic of 2019 - 2020. Therefore, TTX should continuously be conducted for the response and preparation against UDO.