No abstract available.
Dapsone*

Objectives: Loneliness was associated with not only social status but also general health. Psychological conditions in older people have negative effects on general health and oral health. The purpose of the study was to investigate the relationship between loneliness and subjective chewing discomfort in the elderly. Methods: This cross-sectional study analyzed the Korean Social Life, Health, and Aging Project (KSHAP) for the questionnaire, UCLA loneliness scale data of 1,511 older adults living in a rural community. Logistic regression was conducted to identify the relevance of subjective chewing discomfort in the elderly according to the level of loneliness. Results: According to the final model that after adjustment for other risk factors (age, gender, level of education, smoking, drinking, etc.), in the elderly who rarely feel loneliness group compared to the elderly who never feel loneliness was Odds ratio (OR) 1.256 (95% Confidence Interval [CI]: 0.99-1.60) and sometimes+often feel loneliness was OR 2.110 (95% CI: 1.39-3.21). Conclusions Loneliness is associated with subjective chewing discomfort in the elderly. Older people feeling loneliness are likely to have more subjective chewing discomfort.

PURPOSE: Epstein-Barr virus (EBV) hepatitis is a usually asymptomatic and self-limiting disease in immunocompetent patients. However, the range of severity is wide, and the serological diagnosis is typically difficult until the convalescent phase. Thus, we examined the value of plasma EBV DNA real-time quantitative polymerase chain reaction (RT-qPCR) in EBV hepatitis for the timely diagnosis and the relationship between EBV viral load and clinical severity. METHODS: Sixty samples were confirmed as having EBV infection by RT-qPCR with the EBV BALF5 gene sequence. We examined the clinical characteristics of EBV hepatitis by reviewing medical records. RESULTS: The median total duration of fever was 8 days (range: 0-13 days). The mean peak value of aspartate aminotransferase (AST) was 241+/-214 U/L, and the mean peak value of alanine aminotransferase (ALT) was 298+/-312 U/L. There was no correlation between the serum levels of liver enzyme and plasma EBV DNA titer (p=0.1) or between median total duration of fever and EBV DNA titer (p=0.056). The median age of the EBV VCA IgM-negative group was lower compared with the EBV VCA IgM-positive group in EBV hepatitis (2 years vs. 6 years, p=0.0009). CONCLUSION: The severity of EBV hepatitis does not correlate with circulating EBV DNA load according to our data. Furthermore, we suggest that plasma EBV PCR may be valuable in young infants in whom the results of serology test for EBV infection commonly are negative.
Alanine Transaminase ; Aspartate Aminotransferases ; DNA ; Epstein-Barr Virus Infections ; Fever ; Hepatitis ; Herpesvirus 4, Human ; Humans ; Infant ; Liver ; Plasma ; Polymerase Chain Reaction ; Viral Load

OBJECTIVES: The aim of this study was to examine the relationship between periodontal health and chronic obstructive pulmonary disease (COPD) in a Korean population. METHODS: The Community Periodontal Index (CPI) data of 7,264 subjects, aged over 25 years, who participated in the Fourth Korea National Health and Nutrition Examination Survey was used to assess the periodontal status of the population. Severity of COPD in the subjects was classified according to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) definition. RESULTS: Subjects with more severe COPD were more likely to have severe periodontal disease. After adjustment for gender, age, monthly income, education, economic activity, and occupation, the odds ratio of COPD was 1.18 (95% Confidence interval [CI], 0.63-2.21) for severe periodontal disease in the study sample. When stratified by smoking status, the odds ratio of current smokers was 0.92 (95% CI, 0.41-2.05) and that of non-smokers was 1.29 (95% CI, 0.64-2.59). CONCLUSIONS: Periodontal health was not significantly related to the severity of the COPD, even though smoking was a common risk factor. This is the first study examining the relationship between periodontal health and COPD in a Korean population. Studies that further investigate the causal relationship between the two are recommended.
Aged ; Humans ; Korea ; Nutrition Surveys ; Occupations ; Odds Ratio ; Periodontal Diseases ; Periodontal Index ; Pulmonary Disease, Chronic Obstructive ; Risk Factors ; Smoke ; Smoking

We investigated characteristics associated with the efficacy of dipeptidyl peptidase-4 inhibitors (DPP4i) in Korean patients with type 2 diabetes. We reviewed medical records of 477 patients who had taken sitagliptin or vildagliptin longer than 40 weeks. Response to DPP4i was evaluated with HbA1c change after therapy (DeltaHbA1c). The Student's t-test between good responders (GR: DeltaHbA1c > 1.0%) and poor responders (PR: DeltaHbA1c < 0.5%), a correlation analysis among clinical parameters, and a linear multivariate regression analysis were performed. The mean age was 60 yr, duration of diabetes 11 yr and HbA1c was 8.1%. Baseline fasting plasma glucose (FPG), HbA1c, C-peptide, and creatinine were significantly higher in the GR compared to the PR. Duration of diabetes, FPG, HbA1c, C-peptide and creatinine were significantly correlated with DeltaHbA1c. In the multivariate analysis, age (r2 = 0.006), duration of diabetes (r2 = 0.019), HbA1c (r2 = 0.296), and creatinine levels (r2 = 0.024) were independent predictors for the response to DPP4i. Body mass index and insulin resistance were not associated with the response to DPP4i. In conclusion, better response to DPP4i would be expected in Korean patients with type 2 diabetes who have higher baseline HbA1c and creatinine levels with shorter duration of diabetes.
Adamantane/*analogs & derivatives/therapeutic use ; Blood Glucose/analysis ; Body Mass Index ; C-Peptide/analysis ; Creatinine/blood ; Diabetes Mellitus, Type 2/*drug therapy/pathology ; Dipeptidyl-Peptidase IV Inhibitors/*therapeutic use ; Hemoglobin A, Glycosylated/analysis ; Humans ; Insulin Resistance ; Male ; Middle Aged ; Multivariate Analysis ; Nitriles/*therapeutic use ; Pyrazines/*therapeutic use ; Pyrrolidines/*therapeutic use ; Retrospective Studies ; Triazoles/*therapeutic use

We report here the cases of two females with Graves' disease who developed insulin autoimmune syndrome after treatment with methimazole. The patients exhibited a sudden altered mental state after treatment with methimazole for approximately 4 weeks. Patients had hypoglycemia with serum glucose below 70 mg/dL, and laboratory findings showed both high levels of serum insulin and high titers of insulin autoantibodies. The two women had never been exposed to insulin or oral antidiabetic agents, and there was no evidence of insulinoma in imaging studies. After glucose loading, serum glucose, and total insulin levels increased abnormally. One of the patient was found to have HLA-DRB1*0406, which is known to be strongly associated with methimazole-induced insulin autoimmune syndrome. After discontinuation of methimazole, hypoglycemic events disappeared within 1 month. Insulin autoantibody titer and insulin levels decreased within 5 months and there was no further development of hypoglycemic events. We present these cases with a review of the relevant literature.
Autoantibodies ; Female ; Glucose ; Graves Disease ; HLA-DRB1 Chains ; Humans ; Hypoglycemia ; Hypoglycemic Agents ; Insulin ; Insulinoma ; Methimazole

When neurological symptoms occur during the treatment of acute lymphoblastic leukemia, the differential diagnosis includes a leukemic infiltration of the nervous system, drug toxicity, infection, and other neurological disorders. We describe a 16-year-old girl with acute lymphoblastic leukemia that appeared to be complicated by vincristine-induced peripheral and cranial polyneuropathy after induction chemotherapy. She presented with right ptosis six weeks after the first dose of vincristine, and her neurological symptoms progressed to peripheral polyneuropathy. She recovered from these neurological symptoms over the next three months. Leukemic involvement of the nervous system and other neurological disorders could be excluded as potential causes of the neurological symptoms. This report shows that vincristine-induced neurotoxicity should be considered as a cause of cranial neuropathy that develops during the treatment of acute lymphoblastic leukemia.
Adolescent ; Cranial Nerve Diseases ; Diagnosis, Differential ; Drug Toxicity ; Humans ; Induction Chemotherapy ; Leukemia ; Leukemic Infiltration ; Nervous System ; Nervous System Diseases ; Polyneuropathies ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; Vincristine

OBJECTIVES: This pilot study aimed to evaluate the effect of dental amalgam, a restorative material, on children by measuring the mercury concentration in the urine as well as the number of teeth filled with dental amalgam. METHODS: Twenty children enrolled in grades 1-4 of two elementary schools in Daegu participated in this study. One trained dentist performed oral examinations and removed amalgam restorations from the teeth with a high and low speed handpiece. In order to measure the urinary mercury concentrations, urine samples were collected from all participants at baseline and immediately and 24 hours after removal of the dental amalgam restorations. RESULTS: The mean number of teeth from which the amalgam restorations was removed was 9.8 while the mean urinary mercury concentrations at baseline, immediately, and 24 hours after removal of dental amalgam restorations were 2.66, 2.76, and 2.76 microg/g creatinine, respectively. The mean urinary mercury concentration increased consistently after amalgam restoration removal. For those participants whose removed amalgamated surfaces were more than 11, the mean urinary mercury concentration immediately after amalgam restoration removal and 24 hours after removal increased consistently but showed no significant difference. CONCLUSIONS: This study demonstrated that dental amalgam restoration was related to urinary mercury concentration, and these findings present a possibility of mercury accumulation in the body. Therefore, we suggest future longitudinal studies to ensure the safety of children exposed to mercury by establishing criteria for amalgam removal.
Child* ; Creatinine ; Daegu ; Dental Amalgam ; Dentists ; Diagnosis, Oral ; Humans ; Longitudinal Studies ; Pilot Projects* ; Tooth

OBJECTIVES: Rheumatoid arthritis (RA) has been associated with systemic diseases, such as periodontal diseases. Periodontal diseases and RA appear to share many pathologic features. The etiology of the two diseases may differ, but they share similar pathological characteristics. Therefore, the aim of this study was to evaluate the correlation between RA and periodontal diseases. METHODS: Data from the Fifth Korea National Health and Nutrition Examination Survey (KNHNES) were used to analyze periodontal status according to the presence of RA. Demographics and oral behaviors were analyzed using the complex chi-square test to compare participants with RA with those without RA. Complex logistic regression was used to analyze relationships of periodontal diseases with RA and other covariates. RESULTS: The odds ratio for periodontal diseases was 1.91 (95% confidence interval: 1.05-3.48) in participants with RA compared with participants without RA. CONCLUSIONS: The results of this study provide evidence of a significant association between periodontal diseases and RA.
Arthritis, Rheumatoid* ; Demography ; Korea ; Logistic Models ; Nutrition Surveys* ; Odds Ratio ; Periodontal Diseases*

Background: To compare the efficacy and safety of two insulin self-titration algorithms, Implementing New Strategies with Insulin Glargine for Hyperglycemia Treatment (INSIGHT) and EDITION, for insulin glargine 300 units/mL (Gla-300) in Korean individuals with uncontrolled type 2 diabetes mellitus (T2DM). Methods: In a 12-week, randomized, open-label trial, individuals with uncontrolled T2DM requiring basal insulin were randomized to either the INSIGHT (adjusted by 1 unit/day) or EDITION (adjusted by 3 units/week) algorithm to achieve a fasting self-monitoring of blood glucose (SMBG) in the range of 4.4 to 5.6 mmol/L. The primary outcome was the proportion of individuals achieving a fasting SMBG ≤5.6 mmol/L without noct urnal hypoglycemia at week 12. Results: Of 129 individuals (age, 64.1±9.5 years; 66 [51.2%] women), 65 and 64 were randomized to the INSIGHT and EDITION algorithms, respectively. The primary outcome of achievement was comparable between the two groups (24.6% vs. 23.4%, P=0.876). Compared with the EDITION group, the INSIGHT group had a greater reduction in 7-point SMBG but a similar decrease in fasting plasma glucose and glycosylated hemoglobin. The increment of total daily insulin dose was significantly higher in the INSIGHT group than in the EDITION group (between-group difference: 5.8±2.7 units/day, P=0.033). However, body weight was significantly increased only in the EDITION group (0.6±2.4 kg, P=0.038). There was no difference in the occurrence of hypoglycemia between the two groups. Patient satisfaction was significantly increased in the INSIGHT group (P=0.014). Conclusion The self-titration of Gla-300 using the INSIGHT algorithm was effective and safe compared with that using the EDITION algorithm in Korean individuals with uncontrolled T2DM (ClinicalTrials.gov number: NCT03406663).