OBJECTIVES: The aim of this study is to analyze the factors that influence adults halitosis. METHODS: The subjects of this study were 186 adults aged from 35 to 69, between April 4 and May 30, 2012. Data were analyzed with t-test, one-way ANOVA, and binary logistic regression analysis SPSS 19.0. RESULTS: The most influential factor of VSCs was halitosis perceived by others (OR: 5.18; 95% CI: 1.82-14.70), which was followed by oral respiration (OR: 3.65; 95% CI: 1.28-10.41), and O'Leary index (OR: 3.40; 95% CI: 1.55-7.46) in the order. The influential factors of ammonia were respiratory disease (OR: 30.72; 95% CI: 1.85-51.37), gastrointestinal disease (OR: 12.28; 95% CI: 1.78-44.79), missing tooth (OR: 3.75; 95% CI: 1.57-8.92), periodontal pocket (OR: 2.61; 95% CI: 1.10-6.18), tongue brushing (OR: 0.38; 95% CI: 0.15-0.95), and oral prophylaxis (within a year) (OR: 0.31; 95% CI: 0.13-0.75). CONCLUSIONS: Halitosis is the result of complex actions among individual characteristics, systematic disease, oral health state, and health behavior.
Adult ; Aged ; Ammonia ; Dental Plaque Index ; Gastrointestinal Diseases ; Halitosis ; Health Behavior ; Humans ; Logistic Models ; Oral Health ; Periodontal Pocket ; Respiration ; Tongue ; Tooth

Purpose: To determine the effect of axial T2-weighted images (T2WIs) scanning order on the central canal, lateral recess, and related anatomical structures in the lumbar spine. Materials and Methods: After Institutional Review Board approval and informed consent, 45 patients with low back pain (22 males and 23 females, aged between 20–83 years with median age of 60 years) underwent lumbar spine magnetic resonance examination in the supine position on a 1.5 tesla scanner. Axial T2WIs were acquired both before and after the sagittal scans (pre- and post-sagittal axial T2WIs). Two radiologists assessed the grades of the central canal and lateral recess stenosis (CCS and LRS) at the L3/4, L4/5, and L5/S1 levels. The cross-sectional areas of spinal canal (SCCSA), dural sac (DSCSA), free cerebrospinal fluid (FCSA), and ligamentum flavum (LFCSA) were measured twice from a single representative image at each disc level using a threshold-based semiautomated method. The effect of time on the CCS and LRS grades as well as cross-sectional areas was evaluated using a generalized estimating equation. Results: Time had no significant effect on the CCS and LRS grades across the three disc levels (p = 0.178 for CCS, p = 0.383 for right LRS, p = 0.378 for left LRS). However, time significantly affected the DSCSA (p < 0.001), FCSA (p < 0.001), and LFCSA (p = 0.014), but not the SCCSA (p = 0.082). The DSCSA and FCSA were larger and the LFCSA was smaller on post-sagittal axial T2WIs than on pre-sagittal axial T2WIs; estimated differences were 2.9 mm 2 (2.3%) for DSCSA, 3.0 mm 2 (3.7%) for FCSA, and -2.4 mm 2 (-1.7%) for LFCSA. Conclusion The scanning order of axial T2WIs did not affect the CCS or LRS grades.However, the DSCSA, FCSA, and LFCSA in post-sagittal axial T2WIs showed significant differences compared to that of pre-sagittal axial T2WIs, although the relative percentage differences were less than 5%.

Purpose: To determine the effect of axial T2-weighted images (T2WIs) scanning order on the central canal, lateral recess, and related anatomical structures in the lumbar spine. Materials and Methods: After Institutional Review Board approval and informed consent, 45 patients with low back pain (22 males and 23 females, aged between 20–83 years with median age of 60 years) underwent lumbar spine magnetic resonance examination in the supine position on a 1.5 tesla scanner. Axial T2WIs were acquired both before and after the sagittal scans (pre- and post-sagittal axial T2WIs). Two radiologists assessed the grades of the central canal and lateral recess stenosis (CCS and LRS) at the L3/4, L4/5, and L5/S1 levels. The cross-sectional areas of spinal canal (SCCSA), dural sac (DSCSA), free cerebrospinal fluid (FCSA), and ligamentum flavum (LFCSA) were measured twice from a single representative image at each disc level using a threshold-based semiautomated method. The effect of time on the CCS and LRS grades as well as cross-sectional areas was evaluated using a generalized estimating equation. Results: Time had no significant effect on the CCS and LRS grades across the three disc levels (p = 0.178 for CCS, p = 0.383 for right LRS, p = 0.378 for left LRS). However, time significantly affected the DSCSA (p < 0.001), FCSA (p < 0.001), and LFCSA (p = 0.014), but not the SCCSA (p = 0.082). The DSCSA and FCSA were larger and the LFCSA was smaller on post-sagittal axial T2WIs than on pre-sagittal axial T2WIs; estimated differences were 2.9 mm 2 (2.3%) for DSCSA, 3.0 mm 2 (3.7%) for FCSA, and -2.4 mm 2 (-1.7%) for LFCSA. Conclusion The scanning order of axial T2WIs did not affect the CCS or LRS grades.However, the DSCSA, FCSA, and LFCSA in post-sagittal axial T2WIs showed significant differences compared to that of pre-sagittal axial T2WIs, although the relative percentage differences were less than 5%.

Purpose: To determine the effect of axial T2-weighted images (T2WIs) scanning order on the central canal, lateral recess, and related anatomical structures in the lumbar spine. Materials and Methods: After Institutional Review Board approval and informed consent, 45 patients with low back pain (22 males and 23 females, aged between 20–83 years with median age of 60 years) underwent lumbar spine magnetic resonance examination in the supine position on a 1.5 tesla scanner. Axial T2WIs were acquired both before and after the sagittal scans (pre- and post-sagittal axial T2WIs). Two radiologists assessed the grades of the central canal and lateral recess stenosis (CCS and LRS) at the L3/4, L4/5, and L5/S1 levels. The cross-sectional areas of spinal canal (SCCSA), dural sac (DSCSA), free cerebrospinal fluid (FCSA), and ligamentum flavum (LFCSA) were measured twice from a single representative image at each disc level using a threshold-based semiautomated method. The effect of time on the CCS and LRS grades as well as cross-sectional areas was evaluated using a generalized estimating equation. Results: Time had no significant effect on the CCS and LRS grades across the three disc levels (p = 0.178 for CCS, p = 0.383 for right LRS, p = 0.378 for left LRS). However, time significantly affected the DSCSA (p < 0.001), FCSA (p < 0.001), and LFCSA (p = 0.014), but not the SCCSA (p = 0.082). The DSCSA and FCSA were larger and the LFCSA was smaller on post-sagittal axial T2WIs than on pre-sagittal axial T2WIs; estimated differences were 2.9 mm 2 (2.3%) for DSCSA, 3.0 mm 2 (3.7%) for FCSA, and -2.4 mm 2 (-1.7%) for LFCSA. Conclusion The scanning order of axial T2WIs did not affect the CCS or LRS grades.However, the DSCSA, FCSA, and LFCSA in post-sagittal axial T2WIs showed significant differences compared to that of pre-sagittal axial T2WIs, although the relative percentage differences were less than 5%.

Purpose: To determine the effect of axial T2-weighted images (T2WIs) scanning order on the central canal, lateral recess, and related anatomical structures in the lumbar spine. Materials and Methods: After Institutional Review Board approval and informed consent, 45 patients with low back pain (22 males and 23 females, aged between 20–83 years with median age of 60 years) underwent lumbar spine magnetic resonance examination in the supine position on a 1.5 tesla scanner. Axial T2WIs were acquired both before and after the sagittal scans (pre- and post-sagittal axial T2WIs). Two radiologists assessed the grades of the central canal and lateral recess stenosis (CCS and LRS) at the L3/4, L4/5, and L5/S1 levels. The cross-sectional areas of spinal canal (SCCSA), dural sac (DSCSA), free cerebrospinal fluid (FCSA), and ligamentum flavum (LFCSA) were measured twice from a single representative image at each disc level using a threshold-based semiautomated method. The effect of time on the CCS and LRS grades as well as cross-sectional areas was evaluated using a generalized estimating equation. Results: Time had no significant effect on the CCS and LRS grades across the three disc levels (p = 0.178 for CCS, p = 0.383 for right LRS, p = 0.378 for left LRS). However, time significantly affected the DSCSA (p < 0.001), FCSA (p < 0.001), and LFCSA (p = 0.014), but not the SCCSA (p = 0.082). The DSCSA and FCSA were larger and the LFCSA was smaller on post-sagittal axial T2WIs than on pre-sagittal axial T2WIs; estimated differences were 2.9 mm 2 (2.3%) for DSCSA, 3.0 mm 2 (3.7%) for FCSA, and -2.4 mm 2 (-1.7%) for LFCSA. Conclusion The scanning order of axial T2WIs did not affect the CCS or LRS grades.However, the DSCSA, FCSA, and LFCSA in post-sagittal axial T2WIs showed significant differences compared to that of pre-sagittal axial T2WIs, although the relative percentage differences were less than 5%.

The purpose of this study was to identify the effect of providing toothbrushing by professionals as part of oral hygiene education for the elderly. We randomly visited 12 centers in the metropolitan city and analyzed the data of 114 participants among 310 early registrants aged >65 years, who participated in the study at all 3 time points. The subjects were categorized into an experimental group (odd-numbered visits) and a control group (even-numbered visits). Oral hygiene practices were provided for both experimental and control groups, but professional toothbrushing was performed in a different manner in the experimental group. Differences in plaque index (PI) according to the subjects' general characteristics and oral health status were assessed using the t-test, and the effect of PI difference between the experimental and control groups was assessed by repeated measure two-way analysis of variance. A stepwise multiple regression analysis was used to analyze factors affecting the PI. At baseline, the mean overall PI was 61.82. In both experimental and control groups, the PI significantly reduced from the baseline (p <0.01). At 5 weeks, the experimental group showed a decrease of 27.16 points from the baseline, and the 10-week PI was similar to the 5-week PI. The control group showed a decrease of 14.87 points from the baseline, and the PI increased by 5.74 points at 10 weeks. PI-related factors were gender and self-xerostomia. The PI was lower in the female group and the group with self-xerostomia (p <0.01). It is important to select an appropriate method to educate elderly subjects on proper removal of dental plaque and to habituate correct behavior, which requires inclusion of a direct toothbrushing intervention by a specialist.
Aged* ; Dental Plaque ; Education ; Female ; Humans ; Methods ; Oral Health ; Oral Hygiene ; Specialization ; Toothbrushing*

Heme oxygenase-1 (HO-1), an inducible heme-degrading enzyme, is expressed by macrophages and endothelial cells in response to inflammatory stresses. It has been known to show strong immunosuppressive properties although its mechanisms are not completely understood. This study was designed to determine the effects of HO-1 modulation on collagen induced arthritis (CIA) model. CIA model was induced by subcutaneous injection of collagen on tail of DBA/1J mice. For evaluation of HO-1 effects, an inducer of HO-1, cobalt protoporphyrin IX (CoPPIX), or an inhibitor of HO-1, tin protoporphyrin IX (SnPPIX), were administered every other days into peritoneal cavity from day 1 to day 42 after CIA induction. The macrocopic clinical findings of CIA were evaluated and histo-pathologic findings and radiographic analysis were carried out. The expressions of TNF-alpha, IL-6, and VEGF which have important roles in pathogenesis of rheumatoid arthritis were observed by immuno-histochemical staining. Collagen on DBA/1J mice induced arthritis at knee joint and ankle joint. Administration of CoPPIX significantly aggravated the severity of arthritis while SnPPIX protected collagen induced arthritis. SnPPIX strongly suppressed inflammatory cell infiltration, swelling of synovial membrane, and erosion and destruction of bone on CIA mice. Furthermore subcutaneous injection of collagen also increased expression of TNF-alpha, IL-6, and VEGF which are important pro-inflammatory mediators in rheumatoid arthritis. SnPPIX suppressed expression of the pro-inflammatory mediators on CIA mice. Finally, we suggest that HO-1 mediates the expression of pro-inflammatory mediators and bone destruction during pathogenesis of CIA, which indicates modulation of HO-1 can be a new therapeutic target of rheumatoid arthritis.
Animals ; Ankle Joint ; Arthritis* ; Arthritis, Rheumatoid ; Cobalt ; Collagen* ; Endothelial Cells ; Heme Oxygenase-1* ; Heme* ; Injections, Subcutaneous ; Interleukin-6 ; Knee Joint ; Macrophages ; Mice ; Peritoneal Cavity ; Synovial Membrane ; Tail ; Tin ; Tumor Necrosis Factor-alpha ; Vascular Endothelial Growth Factor A

Sphingosine 1-phosphate (S1P) is a bioactive lipid molecule that mediates cell proliferation, differentiation, migration, and angiogenesis in vivo. However, the roles of S1P on pathogenesis of arthritis have been not completely understood. This study was designed to determine the effects of S1P modulation on collageninduced arthritis (CIA) model. DBA/1J mice were injected with collagen into the tail for induction of CIA model. S1P was administered into the peritoneal cavity every other days from day 1 to day 42 after collagen injection. To determine the degree of damage in CIA, we examined macroscopic findings of CIA. The inflammation and bone destruction of CIA mice were evaluated by histo-patholigy and radiography (CT and microradiography). The expressions of TNF-alpha, IL-6, and RANKL which have important roles in pathogenesis of rheumatoid arthritis and bone destruction were observed by immuno-histochemical staining. After injection with collagen in the DBA/1J mice, CIA was induced by swelling in the knee and ankle joint. Administration of S1P suppressed damages and incidence of arthritis elicited by collagen. In histologic and radiographic studies, S1P strongly suppressed the infiltration of inflammatory cells, the swelling of synovial membrane, erosion, and the destruction of bone on CIA mice. Injection of S1P resulted in down-regulation of the expression of the pro-inflammatory and bone destruction mediators such as TNF-alpha, IL-6, and RANKL on CIA mice. Furthermore, S1P suppressed the differentiation of bone marrow cells into osteoclasts by RANKL. In conclusion, this study suggest that S1P has protective effects on inflammation and bone destruction during pathogenesis of CIA, which indicates S1P can be a new possible therapeutic strategy for rheumatoid arthritis
Animals ; Ankle Joint ; Arthritis ; Arthritis, Rheumatoid* ; Bone Marrow Cells ; Cell Proliferation ; Collagen ; Down-Regulation ; Incidence ; Inflammation* ; Interleukin-6 ; Knee ; Mice* ; Osteoclasts ; Peritoneal Cavity ; Radiography ; Sphingosine ; Synovial Membrane ; Tail ; Tumor Necrosis Factor-alpha

Purpose: Febrile neutropenia (FN) can cause suboptimal treatment and treatment-related mortality (TRM) in diffuse large B-cell lymphoma (DLBCL) patients treated with rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisolone (R-CHOP). Materials and methods: We conducted a prospective cohort study to evaluate the effectiveness of pegfilgrastim prophylaxis in DLBCL patients receiving R-CHOP, and we compared them with the PROCESS cohort (n=485). Results: Since January 2015, 986 patients with DLBCL were enrolled. Pegfilgrastim was administered at least once in 930 patients (94.3%), covering 90.3% of all cycles. FN developed in 137 patients (13.9%) in this cohort (23.7% in the PROCESS cohort, p<0.001), and 4.2% of all cycles (10.2% in the PROCESS cohort, p<0.001). Dose delay was less common (≥3 days: 18.1% vs. 23.7%, p=0.015; ≥5 days: 12.0% vs. 18.3%, p=0.023) in this cohort than in the PROCESS cohort. The incidence of TRM (3.2% vs. 5.6%, p=0.047) and infection-related death (1.8% vs. 4.5%, p=0.004) was lower in this cohort than in the PROCESS cohort. The 4-year overall survival (OS) and progression-free survival (PFS) rates of the two cohorts were not different (OS: 73.0% vs. 71.9%, p=0.545; PFS: 69.5% vs. 68.8%, p=0.616). However, in patients aged ≥75 years, the 4-year OS and PFS rates were higher in this cohort than in the PROCESS cohort (OS: 49.6% vs. 33.7%, p=0.032; PFS: 44.2% vs. 30.3% p=0.047). Conclusion Pegfilgrastim prophylaxis is effective in the prevention of FN and infection-related death in DLBCL patients receiving R-CHOP, and it also improves OS in patients aged ≥75 years.

Purpose: Diffuse large B-cell lymphoma (DLBCL) is the most common hematologic malignancy worldwide. Although substantial improvement has been achieved by the frontline rituximab-based chemoimmunotherapy, up to 40%-50% of patients will eventually have relapsed or refractory disease, whose prognosis is extremely dismal. Materials and Methods: We have carried out two prospective cohort studies that include over 1,500 DLBCL patients treated with rituximab plus CHOP (#NCT01202448 and #NCT02474550). In the current report, we describe the outcomes of refractory DLBCL patients. Patients were defined to have refractory DLBCL if they met one of the followings, not achieving at least partial response after 4 or more cycles of R-CHOP; not achieving at least partial response after 2 or more cycles of salvage therapy; progressive disease within 12 months after autologous stem cell transplantation. Results: Among 1,581 patients, a total of 260 patients met the criteria for the refractory disease after a median time to progression of 9.1 months. The objective response rate of salvage treatment was 26.4%, and the complete response rate was 9.6%. The median overall survival (OS) was 7.5 months (95% confidence interval, 6.4 to 8.6), and the 2-year survival rate was 22.1%±2.8%. The median OS for each refractory category was not significantly different (p=0.529). Conclusion In line with the previous studies, the outcomes of refractory DLBCL patients were extremely poor, which necessitates novel approaches for this population.