This study identified an effective control method for periodontitis by investigating the association between blood levels of vitamin D and periodontitis in Korean elderly based on raw data from the fifth Korea National Health & Nutrition Examination Survey of 2010 (KNHANES). In this study, 1,021 adults over 65 years of age were evaluated based on data from the KNHANES. Periodontal disease was assessed using community periodontal index (CPI), with CPI codes ≥3 defined as periodontitis. Blood levels of vitamin D were measured from blood samples and divided into four groups (first quartile: ≤13.23 ng/ml, second quartile: 13.24∼16.95 ng/ml, third quartile: 16.96∼21.58 ng/ml), and fourth quartile >21.59 ng/ml). Using multiple logistic regression analyses, the variables were adjusted for general characteristics, oral health-related characteristics, health-related characteristics, and bone mineral density. The statistical analysis was performed using the SAS (ver. 9.2). The results of this study are as follows: the prevalence of periodontitis was 42.6% in Korean elderly. After adjusting for general, oral health-related, and health-related, the risk of periodontitis in the first quartile group was 1.74 times (95% confidence interval [CI], 1.02∼2.98) higher than that of the fourth quartile group (p=0.041). After adjusting for general, oral health-related, and health-related characteristics as well as bone mineral density, the risk of periodontitis in the first quartile group was 1.73 times (95% CI, 1.02∼2.96) higher than that of the four quartile group (p=0.042). There was a significant relationship between blood vitamin D level and periodontitis in Korean elderly. For the prevention of periodontitis, factors related to vitamin D should be considered along with other risk factors.
Adult ; Aged* ; Bone Density ; Humans ; Korea ; Logistic Models ; Methods ; Periodontal Diseases ; Periodontal Index ; Periodontitis* ; Prevalence ; Risk Factors ; Vitamin D* ; Vitamins*

As noe of causes of epipora, anatomic abnormality of nasolacrimal duct, has been treated with dacryocystorhinostomy. Recently, the development of nasal endoscopy has made it easy to observe the intranasal sturcture. Thus, authors investigated the effect of nasal endoscopic dacryocystorhinostomy used in combination with microdrill and nasal endoscopy in those patients, with nasolcrimal obsturction at the time of dacryocystorhinography. From 1995 to April 1997, twenty-four patients have been treated by the intranasal dacryocystorhinostomy using the microdrill with follow up more than six months. All patients had been tested by preoperative intranasal exam and was measured radiologically preoperative`s size of lacrimal sac. The nasal endoscopy using microdrill had shown success rate of 83.3 percent and the surgerywas more successful as the size of preoperative lacrimal sac was larer without any complication. The formation of accurate bone foramen did not remarkably differ from the skin incisio at the time of operation. Therefore, dacryocystorhinostomy using microdrill can be useful for the treatment of lacrimal canal obstruction, especially with the proper operating equipment.
Dacryocystorhinostomy* ; Endoscopy ; Follow-Up Studies ; Humans ; Lacrimal Apparatus Diseases ; Nasolacrimal Duct ; Skin

PURPOSE: To report clinical features and optical coherence tomographic findings of presumed atypical ocular tuberculosis associated with tuberculosis lymphadenitis and encephalomeningitis. CASE SUMMARY: A 28-year-old female with lymphadenitis in the axillary area presented with a fever and headache of a one week duration. CSF study and MRI findings implied tuberculosis encephalomeningitis, and presumed tuberculosis uveitis manifested with visual disturbance after five days. Ocular symptoms were aggravated and showed anterior iridocyclitis, vitritis, macular edema, and multifocal retinitis with miliary granuloma that was distinct from choroiditis or typical tuberculosis granuloma. After the patient received anti-tuberculosis medication and systemic corticosteroids, significant improvements in visual acuity, ocular findings and OCT results were observed. CONCLUSIONS: Ocular tuberculosis can present with various clinical findings, and caution should be taken so as not to misdiagnose based on these characteristics. In the present case, anti-tuberculosis medication and systemic steroids resulted in the resolution of inflammation. In such cases, monitoring the posterior pole lesion via OCT may be helpful in determining improvement.
Adrenal Cortex Hormones ; Adult ; Choroid ; Choroiditis ; Female ; Fever ; Granuloma ; Headache ; Humans ; Inflammation ; Iridocyclitis ; Lymphadenitis ; Macular Edema ; Meningitis ; Meningoencephalitis ; Retinitis ; Steroids ; Tuberculosis ; Tuberculosis, Miliary ; Tuberculosis, Ocular ; Uveitis ; Visual Acuity

Purpose: To present a case of oculomotor nerve atrophy complicated by herpes zoster ophthalmicus (HZO).Case summary: A 68-year-old man with a history of type 2 diabetes and dyslipidemia complained of diplopia and deviation in left eye. On examination, visual acuity was 20/25 in right eye and 20/20 in left eye. Prism and alternate cover tests revealed right exotropia and hypertropia in the primary position. Examination of ductions and versions showed limitation of adduction and depression in the right eye. On detailed history taking, we found that his symptoms started after suffering HZO on right side about 2 years ago. He was prescribed antiviral agents from a dermatology clinic and was told that all symptoms would improve after medication so he didn't undergo an ophthalmologic examination at that time. Magnetic resonance imaging confirmed that diffuse atrophy of oculomotor nerve in cistern along with atrophic changes of medial rectus and inferior rectus muscles in right eye. A diagnosis of strabismus complicated by HZO-induced oculomotor nerve atrophy was done. Conclusions Ophthalmoplegia secondary to HZO may not be self-limiting and have a poor prognosis resulting in cranial nerve atrophy. A detailed imaging investigation of extraocular muscle and cranial nerves along with thorough history taking are required for proper diagnosis and better prognosis.

Purpose: To present a case of oculomotor nerve atrophy complicated by herpes zoster ophthalmicus (HZO).Case summary: A 68-year-old man with a history of type 2 diabetes and dyslipidemia complained of diplopia and deviation in left eye. On examination, visual acuity was 20/25 in right eye and 20/20 in left eye. Prism and alternate cover tests revealed right exotropia and hypertropia in the primary position. Examination of ductions and versions showed limitation of adduction and depression in the right eye. On detailed history taking, we found that his symptoms started after suffering HZO on right side about 2 years ago. He was prescribed antiviral agents from a dermatology clinic and was told that all symptoms would improve after medication so he didn't undergo an ophthalmologic examination at that time. Magnetic resonance imaging confirmed that diffuse atrophy of oculomotor nerve in cistern along with atrophic changes of medial rectus and inferior rectus muscles in right eye. A diagnosis of strabismus complicated by HZO-induced oculomotor nerve atrophy was done. Conclusions Ophthalmoplegia secondary to HZO may not be self-limiting and have a poor prognosis resulting in cranial nerve atrophy. A detailed imaging investigation of extraocular muscle and cranial nerves along with thorough history taking are required for proper diagnosis and better prognosis.

Purpose: To present a case of oculomotor nerve atrophy complicated by herpes zoster ophthalmicus (HZO).Case summary: A 68-year-old man with a history of type 2 diabetes and dyslipidemia complained of diplopia and deviation in left eye. On examination, visual acuity was 20/25 in right eye and 20/20 in left eye. Prism and alternate cover tests revealed right exotropia and hypertropia in the primary position. Examination of ductions and versions showed limitation of adduction and depression in the right eye. On detailed history taking, we found that his symptoms started after suffering HZO on right side about 2 years ago. He was prescribed antiviral agents from a dermatology clinic and was told that all symptoms would improve after medication so he didn't undergo an ophthalmologic examination at that time. Magnetic resonance imaging confirmed that diffuse atrophy of oculomotor nerve in cistern along with atrophic changes of medial rectus and inferior rectus muscles in right eye. A diagnosis of strabismus complicated by HZO-induced oculomotor nerve atrophy was done. Conclusions Ophthalmoplegia secondary to HZO may not be self-limiting and have a poor prognosis resulting in cranial nerve atrophy. A detailed imaging investigation of extraocular muscle and cranial nerves along with thorough history taking are required for proper diagnosis and better prognosis.

Purpose: To present a case of oculomotor nerve atrophy complicated by herpes zoster ophthalmicus (HZO).Case summary: A 68-year-old man with a history of type 2 diabetes and dyslipidemia complained of diplopia and deviation in left eye. On examination, visual acuity was 20/25 in right eye and 20/20 in left eye. Prism and alternate cover tests revealed right exotropia and hypertropia in the primary position. Examination of ductions and versions showed limitation of adduction and depression in the right eye. On detailed history taking, we found that his symptoms started after suffering HZO on right side about 2 years ago. He was prescribed antiviral agents from a dermatology clinic and was told that all symptoms would improve after medication so he didn't undergo an ophthalmologic examination at that time. Magnetic resonance imaging confirmed that diffuse atrophy of oculomotor nerve in cistern along with atrophic changes of medial rectus and inferior rectus muscles in right eye. A diagnosis of strabismus complicated by HZO-induced oculomotor nerve atrophy was done. Conclusions Ophthalmoplegia secondary to HZO may not be self-limiting and have a poor prognosis resulting in cranial nerve atrophy. A detailed imaging investigation of extraocular muscle and cranial nerves along with thorough history taking are required for proper diagnosis and better prognosis.

BACKGROUND: Pregabalin is an antiepileptic drug that is effective for treating postoperative pain, neuropathic pain, anxiety, and hemodynamic instability. The aim of this study was to investigate the effect of a single preoperative dose of pregabalin in patients with opioid-induced hyperalgesia (OIH). METHODS: Ninety ASA I-II patients undergoing laparoendoscopic single-site urologic surgery were randomly assigned to one of the following three groups that received either pregabalin or placebo 1 h before anesthesia and an intraoperative remifentanil infusion. Group plL received placebo and 0.05 microgram/kg/min remifentanil, group plH received placebo and 0.3 microgram/kg/min remifentanil, and group prH received 300 mg pregabalin plus 0.3 microgram/kg/min remifentanil. The primary endpoint was pain intensity upon movement 1, 6, 12, and 24 h after surgery. Secondary endpoints were the area of hyperalgesia and mechanical hyperalgesia threshold 24 h after surgery, time to first postoperative analgesic requirement, and cumulative postoperative volume of morphine administered via a patient-controlled analgesia (PCA) pump over 24 h. RESULTS: The time to first postoperative analgesic requirement in group plH was significantly shorter than that in group plL. The injected PCA volume was significantly greater in group plH than that in the other two groups. Postoperative pain intensity in group plH was significantly greater than that in the other two groups at 6, 12, and 24 h after surgery. The mechanical hyperalgesia threshold and the area of hyperalgesia around the surgical incision 24 h after surgery in group plH differed significantly from those in the other two groups, which were not significantly different. Adverse effects were comparable among groups. CONCLUSIONS: High-dose remifentanil induced hyperalgesia, including increased pain intensity, increased area of hyperalgesia, and decreased mechanical hyperalgesia threshold. These effects were attenuated by oral administration of a single preoperative dose of pregabalin (300 mg) in patients undergoing laparo-endoscopic single-site urologic surgery.
Administration, Oral ; Analgesia, Patient-Controlled ; Anesthesia ; Anxiety ; gamma-Aminobutyric Acid ; Hemodynamics ; Humans ; Hyperalgesia ; Morphine ; Neuralgia ; Pain, Postoperative ; Passive Cutaneous Anaphylaxis ; Piperidines ; Pregabalin

This case report introduces a 74-year-old male patient who visited retention deficiency of the mandibular implant overdenture, which was fabricated 20 years ago.When the existing dentures were used, the vertical dimension was reduced, the maxillary complete denture lacked lip support and retention, and the mandibular overdenture lacked clip retention due to damage to the bar attachment. After removing the damaged bar attachment, it was replaced with a ball attachment, and impressions were taken using the DENTCA TM Tray and then the vertical dimension was measured. The gothic arch tracing was performed to record the centric relation. Obtained impressions were scanned and the shape of final dentures was designed using software and try-in dentures were fabricated using 3D printer.After evaluating the occlusal plane, occlusal relationship, facial shape, and pronunciation using the try-in dentures, the bite registration was recorded, and the final denture was manufactured based on this. The inner surface of the denture was adjusted and bilateral balanced occlusion was formed, and the housing was connected to the mandibular denture by a direct method. This case reports have shown satisfactory resultin recovering improved retention and esthetic outcome by increasing the vertical dimension and the lip support using CAD-CAM technique and the ball attachment.