Purpose: Vitamin D deficiency may cause bone loss and increased inflammation, which are well-known symptoms of periodontal disease. This study investigated whether serum 25-hydroxyvitamin D (25(OH)D) levels are associated with periodontal disease status and tooth loss. Methods: Cross-sectional data from 5,405 individuals aged ≥50 years (2,253 males and 3,152 females) were obtained from the 2008–2010 Dong-gu study, a prospective cohort study of risk factors for chronic diseases. Periodontal examinations were conducted to evaluate the number of remaining teeth, the periodontal probing depth (PPD), the clinical attachment level (CAL), and bleeding on probing. The percentages of sites with PPD ≥4 mm and CAL ≥4 mm were recorded for each participant. The severity of periodontitis was classified using the Centers for Disease Control and Prevention and the American Academy of Periodontology case definitions.Serum 25(OH)D levels were classified as reflecting severe deficiency, deficiency, insufficiency, or sufficiency. Multivariate linear regression analysis was performed to assess the associations of serum 25(OH)D levels with periodontal parameters and the number of remaining teeth after adjusting for confounders including age, smoking status, alcohol consumption status, month of blood collection, and physical activity. Multivariate logistic regression was used to evaluate the association between serum vitamin D levels and severe periodontitis. An overall statistical analysis and a stratified analysis by sex were performed. Results: Overall, the rates of severe deficiency, deficiency, insufficiency, and sufficiency were 6.5%, 67.9%, 22.4%, and 3.2%, respectively. After adjustment for confounders, vitamin D levels were directly associated with the number of remaining teeth, an association that was significant in males, but not in females. Sufficient serum 25(OH)D was associated with a low frequency of severe periodontitis. Conclusions This population-based cross-sectional study indicates that low serum 25(OH) D is significantly associated with tooth loss and severe periodontitis in Koreans aged 50 years and older.

PURPOSE: This study aims to analyze the stress distribution of mandibular molar restoration supported by the implants with external hex and internal taper abutment connection design. MATERIALS AND METHODS: Models of external connection (EXHEX) and internal connection (INCON) implants, corresponding abutment/crowns, and screws were developed. Supporting edentulous mandibular bony structures were designed. All the components were assembled and a finite element analysis was performed to predict the magnitude and pattern of stresses generated by occlusal loading. A total of 120 N static force was applied both by axial (L1) and oblique (L2) direction. RESULTS: Peak von Mises stresses produced in the implants by L2 load produced 6 – 15 times greater than those by L1 load. The INCON model showed 2.2 times greater total amount of crown cusp deflection than the EXHEX model. Fastening screw in EXHEX model and upside margin of implant fixture in INCON model generated the peak von Mises stresses by oblique occlusal force. EXHEX model and INCON model showed the similar opening gap between abutment and fixture, but intimate sealing inside the contact interface was maintained in INCON model. CONCLUSION: Oblique force produced grater magnitudes of deflection and stress than those by axial force. The maximum stress area at the implant was different between the INCON and EXHEX models.
Bite Force ; Crowns ; Finite Element Analysis* ; Molar

PURPOSE: To analyze stress distribution in premolars restored with inlays or onlays using various materials. MATERIALS AND METHODS: Three-dimensional maxillary premolar models of abutments were designed to include the following: 1) inlay with O cavity (O group), 2) inlay with MO cavity (MO group), 3) inlay with MOD cavity (MOD group), and 4) onlay (ONLAY group). A restoration of each inlay or onlay cavity was simulated using gold alloy, e.max ceramic, or composite resin for restoration. To simulate masticatory forces, a total of 140 N static axial force was applied onto the tooth at the occlusal contact areas. A finite element analysis was performed to predict the magnitude and pattern of stresses generated by occlusal loading. RESULTS: Maximum von Mises stress values generated in the abutment teeth of the ONLAY group were ranged from 26.1 to 26.8 MPa, which were significantly lower than those of inlay groups (O group: 260.3–260.7 MPa; MO group: 252.1–262.4 MPa; MOD group: 281.4–298.8 MPa). Maximum von Mises stresses generated with ceramic, gold, and composite restorations were 280.1, 269.9, and 286.6 MPa, respectively, in the MOD group. They were 252.2, 248.0, 255.1 MPa, respectively, in the ONLAY group. CONCLUSION: The onlay design (ONLAY group) protected tooth structures more effectively than inlay designs (O, MO, and MOD groups). However, stress magnitudes in restorations with various dental materials exhibited no significant difference among groups (O, MO, MOD, ONLAY).
Alloys ; Bicuspid ; Bite Force ; Ceramics ; Dental Materials ; Finite Element Analysis ; Inlays ; Tooth

To directly test if elevated glucocorticoids are required for fasting-induced regulation of growth hormone (GH)-releasing hormone (GHRH), GHRH receptors (GHRH-R) and ghrelin receptors (GHS-R) expression, male rats were bilaterally adrenalectomized or sham operated. After 7 days, animals were fed ad libitum or fasted for 48 h. Bilateral adrenalectomy increased hypothalamic GHRH to 146% and decreased neuropeptide Y (NPY) mRNA to 54% of SHAM controls. Pituitary GHRH-R and GHS-R mRNA levels were decreased by adrenalectomy to 30% and 80% of sham-operated controls. In sham- operated rats, fasting suppressed hypothalamic GHRH (49%) and stimulated NPY (166%) mRNA levels, while fasting increased pituitary GHRH-R (391%) and GHS-R (218%) mRNA levels. However, in adrenalectomized rats, fasting failed to alter pituitary GHRH-R mRNA levels, while the fasting-induced suppression of GHRH and elevation of NPY and GHS-R mRNA levels remained intact. In fasted adrenalectomized rats, corticosterone replacement increased GHRH-R mRNA levels and intensified the fasting-induced decrease in GHRH, but did not alter NPY or GHS-R response. These data suggest that elevated glucocorticoids mediate the effects of fasting on hypothalamic GHRH and pituitary GHRH-R expression, while glucocorticoids are likely not the major determinant in fasting-induced increases in hypothalamic NPY and pituitary GHS-R expression.
Adrenalectomy ; Animals ; Corticosterone ; Fasting ; Glucocorticoids ; Growth Hormone ; Humans ; Male ; Neuropeptide Y ; Rats ; Receptors, Ghrelin ; Receptors, Neuropeptide ; Receptors, Pituitary Hormone-Regulating Hormone ; RNA, Messenger ; Salicylamides

Objectives: The incidence of Guillain-Barré syndrome (GBS) changed significantly during the coronavirus disease 2019 (COVID-19) pandemic. Emerging reports suggest that viral vector-based vaccines may be associated with an elevated risk of GBS. Methods: In this nationwide time-series correlation study, we examined the age-specific incidence of GBS from January 2011 to August 2022, as well as data on severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccinations and infections from February 2021 to August 2022. We compared the forecasted estimates of age-specific GBS incidence, using the pre-SARS-CoV-2 period as a benchmark, with the actual incidence observed during the post-vaccination period of the pandemic. Furthermore, we assessed the temporal association between GBS, SARS-CoV-2 vaccinations, and COVID-19 for different age groups. Results: In the age group of 60 and older, the rate ratio was significantly elevated during June-August and November 2021. A significant, strong positive association was observed between viral vector-based vaccines and GBS incidence trends in this age group (r=0.52, p=0.022). For the 30 to 59 years age group, the rate ratio was notably high in September 2021. A statistically significant, strong positive association was found between mRNA-based vaccines and GBS incidence in this age group (r=0.61, p=0.006). Conclusion Viral vector-based SARS-CoV-2 vaccines were found to be temporally associated with an increased risk of GBS, particularly in older adults. To minimize age-specific and biological mechanism-specific adverse events, future vaccination campaigns should adopt a more personalized approach, such as recommending homologous mRNA-based SARS-CoV-2 vaccines for older adults to reduce the heightened risk of GBS.

Purpose: To evaluate the effects of load direction, number of implants, and alignment of implant position on stress distribution in implant, prosthesis, and bone tissue. Materials and Methods: Four 3D models were made to simulate posterior mandible bone block: two implants and 3-unit fixed dental prosthesis (FDP) with a pontic in the center (model M1), two implants and 3-unit FDP with a cantilever pontic at one end (model M2), FDP supported by three implants with straight line placement (model M3) and FDP supported by three implants with staggered implant configuration (model M4). The applied force was 120 N axially or 120 N obliquely. Results: Peak von Mises stresses caused by oblique occlusal force were 3.4 to 5.1 times higher in the implant and 3.5 to 8.3 times higher in the alveolar bone than those stresses caused by axial occlusal force. In model M2, the connector area of the distal cantilever in the prosthesis generated the highest von Mises stresses among all models. With the design of a large number of implants, low stresses were generated. When three implants were placed, there were no significant differences in the magnitude of stress between staggered arrangement and straight arrangement. Conclusion The effect of staggering alignment on implant stress was negligible. However, the number of implants had a significant effect on stress magnitude.

The incidence of invasive diseases, including meningitis caused by Haemophilus influenzae type b (Hib) was markedly decreased after routine immunization of Hib vaccine through diverse schedules in many countries. The purpose of this study was to evaluate the immunogenicity and safety of Hib conjugate vaccines in Korean children before the implementation of a national immunization program against Hib in Korea. A multicenter controlled trial was performed on two different Hib vaccines in Korean children. A total of 319 infants were enrolled: 199 infants were immunized with the Hib polysaccharide conjugated to the tetanus toxoid (PRP-T) and 120 infants with the Hib polysaccharide conjugated to the outer-membrane protein of Neisseria meningitides (PRP-OMP). Immunogenicity was evaluated by enzyme-linked immunosorbent assay (ELISA) and serum bactericidal assay. Both vaccines showed good immunologic responses after primary immunization. After 2 doses of PRP-T or PRP-OMP, 78.9% and 91.7% of infants achieved an antibody level of > or = 1.0 microgram/mL, respectively. Both vaccines were safe and well-tolerated. No serious adverse events were observed. Thus, Hib conjugate vaccines appear to be safe and show good immunogenicity in Korean infants. These results will be important reference data for the implementation of Hib vaccine in the national immunization program of Korea.
Bacterial Outer Membrane Proteins/administration & dosage/*adverse ; Enzyme-Linked Immunosorbent Assay ; Haemophilus Vaccines/administration & dosage/*adverse effects/*immunology ; Haemophilus influenzae type b/*immunology ; Humans ; Infant ; Korea ; Polysaccharides, Bacterial/administration & dosage/*adverse effects/*immunology ; Tetanus Toxoid/administration & dosage/*adverse effects/*immunology

Familial benign hypocalciuric hypercalcemia (FBHH) is an autosomal dominant trait with high penetrance, clinically manifestating a relatively benign, lifelong, persistent hypercalcemia and hypocalciuria without hypercalcemic related complications. The calcium-sensing receptor (CaSR) plays an important role in the regulation of PTH secretion and calcium metabolism. Here we present a family with FBHH of an autosomal dominant inheritance. A heterozygous mutation of E297K (GAG -> AAG, exon 4) of CaSR gene was found in 3 family members. To our knowledge, it is the first confirmed case of FBHH with CaSR gene mutation in Korea.
Sequence Analysis, DNA ; Receptors, Calcium-Sensing/*genetics ; Pedigree ; Parathyroid Hormone/analogs & derivatives/genetics/metabolism ; *Mutation ; Metabolism, Inborn Errors/*genetics ; Male ; Korea ; Hypercalcemia/*genetics ; Humans ; Heterozygote ; Genes, Dominant ; Female ; Family Health ; Exons ; DNA Restriction Enzymes/metabolism ; DNA/metabolism ; Adult

Background and Objectives: Thyroid cancer (TC) and renal cell carcinoma (RCC) display more frequent co-occurrence than would be expected by chance. We investigated clinicopathological features of patients with both primary TC and primary RCC (TC/RCC) group to facilitate a greater understanding of the relationship between two cancers. Materials and Methods: A total of 53 patients who diagnosed with TC/RCC were enrolled. 13,663 TC-alone and 3279 RCC-alone patients who had undergone surgery at Samsung Medical Center between 1994 and 2014 were included as control groups. The clinicopathological characteristics of these patients were retrospectively reviewed. Results The median age at the time of TC or RCC diagnosis was 54 years in TC/RCC group and the RCC-alone group, while the patients in TC-alone group were significantly younger (47 years). The TC/RCC group showed a nearly equal sex prevalence (49% male), significantly different than the results of the TC-alone group (80% female) and RCC-alone group (71% male). A higher grade of pathologic stage (56.6% in stage 3) and greater number of patients with multifocality of thyroid tumors (45 vs. 32%), and more family history of cancer (32 vs. 0.4%) were revealed in TC/RCC group than in TC-alone group. In addition, 15.1% of patients in TC/RCC group presented with additional primary cancers such as prostate, colon, stomach, breast, and lung cancers. Conclusion: Patients in the TC/RCC group have a high rate of cancer family history, multifocality of thyroid tumors, and additional cancers. To understand this unique subset group, additional studies for environmental and genetic factors would be helpful for earlier diagnosis of combined cancers.