The aim of this study was to evaluate the color stability of bulk-fill and conventional resin composites with respect to different storage media and thickness of composites.Filtek™ Z250 and Filtek™ Z350XT were evaluated as conventional resin composites. Filtek™ Bulk-fill Posterior Restorative and Tetric® N-Ceram Bulk Fill were evaluated as bulk-fill resin composites.CIE L*a*b* values of baseline were measured after 24 hours of storage in distilled water, and each resin composite group was divided into three subgroups and stored in distilled water, red wine, and coffee media respectively. Again after 1, 7 and 28 days of immersion, color changes (ΔE*) were calculated using the CIE L*a*b* values.The greatest ΔE* was observed in red wine for all resin composites, and the mean color changes were ranked in the increasing order of distilled water, coffee, red wine. Filtek™ Z350XT exhibited the greatest color change in all media, followed by Filtek™ Bulk-fill Posterior Restorative. Filtek™ Z250 and Tetric® N-Ceram Bulk Fill followed with similar mean color change values. According to the 2 different thicknesses of 2 mm and 4 mm of bulk-fill resin composites, there was no thickness-related difference on color changes.
Coffee ; Immersion ; Water ; Wine

Background: University students have been known as having a higher rate of problem drinking than the general population in South Korea. In particular, the university freshmen may experience problem drinking from increased occasions of frequent social gatherings at the first school year as they have increased time to freely use compared to the high school days. Problem drinking among university freshmen may be influenced by multiple factors. The present study aimed to examine the prevalence of problem drinking and to identify individualand family-level factors associated with university freshmen's problem drinking. Methods: A cross-sectional, correlation study was conducted. Participants were 227 university freshmen (70 men and 157 women) under the parenting of mother and father from 10 universities in Seoul. The problem drinking was evaluated by using the Alcohol Use Disorder Identification Test. Alcohol Abstinence Self-Efficacy Scale and Parental Authority Questionnaire for parenting behaviors were used. Results: The prevalence of problem drinking was 58.6% among university freshmen. An individual-level factor of alcohol abstinence self-efficacy was significantly associated with the prevalence of problem drinking (odds ratio, 0.94; 95% confidence interval, 0.91-0.96) among university freshmen. However, any of family-level factors including types of parenting behaviors were not significantly associated with the prevalence of problem drinking. Conclusions Alcohol abstinence self-efficacy may be a strong protective factor against university freshmen's problem drinking. University-based alcohol abstinence programs should comprise of nursing strategies including the enhancement of abstinence self-efficacy at the first school year.

Atopic dermatitis (AD) is a chronically relapsing inflammatory disorder of the skin. It is characterized by severe pruritus, sleep disturbance, and poor quality of life. In addition, AD frequently occurs in childhood and is considered the first manifestation of atopic march, which progresses into respiratory allergic diseases, such as asthma and allergic rhinitis, as the patient grow older. In this regard, the early diagnosis and active treatment of AD are required to lower the severity of disease and to prevent the development of atopic march. The proper management of AD includes avoidance of aggravating factors, barrier repair by skin care, and control of inflammation and infection with appropriate medications. Among them, identification and elimination of environmental risk factors responsible for worsening skin symptoms are essential. They include temperature, humidity, food and inhalant allergens, microorganisms, air pollutants, ultraviolet radiation, water hardness, and so forth. In particular, there is growing concern about indoor environment because time spent indoors and exposure to various kinds of pollutants is increasing with modernization and industrialization. In this review, we summarize the hazardous effect of temperature, humidity, cigarette smoke, volatile organic compounds, formaldehyde, and phthalates on the development or aggravation of AD. Current epidemiological studies and animal experiments suggest possible contributions of various indoor environmental factors to the development and aggravation of AD. However, further studies are needed to demonstrate a causal relationship between indoor environmental factors and AD.

Background: University students have been known as having a higher rate of problem drinking than the general population in South Korea. In particular, the university freshmen may experience problem drinking from increased occasions of frequent social gatherings at the first school year as they have increased time to freely use compared to the high school days. Problem drinking among university freshmen may be influenced by multiple factors. The present study aimed to examine the prevalence of problem drinking and to identify individualand family-level factors associated with university freshmen's problem drinking. Methods: A cross-sectional, correlation study was conducted. Participants were 227 university freshmen (70 men and 157 women) under the parenting of mother and father from 10 universities in Seoul. The problem drinking was evaluated by using the Alcohol Use Disorder Identification Test. Alcohol Abstinence Self-Efficacy Scale and Parental Authority Questionnaire for parenting behaviors were used. Results: The prevalence of problem drinking was 58.6% among university freshmen. An individual-level factor of alcohol abstinence self-efficacy was significantly associated with the prevalence of problem drinking (odds ratio, 0.94; 95% confidence interval, 0.91-0.96) among university freshmen. However, any of family-level factors including types of parenting behaviors were not significantly associated with the prevalence of problem drinking. Conclusions Alcohol abstinence self-efficacy may be a strong protective factor against university freshmen's problem drinking. University-based alcohol abstinence programs should comprise of nursing strategies including the enhancement of abstinence self-efficacy at the first school year.

OBJECTIVE: Body composition is measured using bioelectrical impedance analysis (BIA), and correlation between the result of BIA and cognitive function is analyzed. METHODS: A total of 118 elderly (46 male, 72 female) were recruited. They were divided into three groups; normal (n=33), mild cognitive impairment (n=42), and Alzheimer's dementia (n=43) according to the diagnostic criteria. Skeletal muscle mass, body fat mass, and fat-free mass were measured using a BIA device, and were converted to the ratio of body weight. All participants underwent Korean version of Mini-Mental State Examination (MMSE-K). RESULTS: In pearson correlation analysis, skeletal muscle percentage (SMP) and fat-free mass percentage (FFMP) were positively correlated with MMSE-K score (r=0.309, p=0.001; r=0.245, p=0.008), and body fat percentage was negatively correlated (r=−0.258, p=0.005). In multiple regression analysis, SMP (β=2.012, t=4.457, p < 0.001) and FFMP (β=−1.733, t=−3.838, p < 0.001) were selected as the best predictors of changes in MMSE-K score (R2=0.198). CONCLUSION: Reduced skeletal muscle and increased body fat correlate with decreased cognitive function, suggesting the need for prevention of frailty and early diagnosis of cognitive impairment.
Adipose Tissue ; Aged ; Body Composition* ; Body Weight ; Cognition Disorders ; Cognition* ; Dementia ; Early Diagnosis ; Electric Impedance* ; Humans ; Male ; Mild Cognitive Impairment ; Muscle, Skeletal ; Sarcopenia

Hyper-IgE syndrome (HIES) is a very rare primary immune deficiency characterized by elevated serum IgE levels, recurrent bacterial infections, chronic dermatitis, and connective tissue abnormalities. Autosomal dominant (AD) HIES involves a mutation in signal transducer and activator of transcription 3 (STAT3) that leads to an impaired T(H)17 response. STAT3 signaling is also involved in the function of RORγt⁺ type 3 innate lymphoid cells (ILC3s) and RORγt⁺T(H)17 cells. The aim of this study was to investigate the role of innate immune cells such as innate lymphoid cells (ILCs), granulocytes, and monocytes in a patient with HIES. Peripheral blood mononuclear cells (PBMCs) from a patient with HIES and three age-matched healthy controls were obtained for the analysis of the innate and adaptive immune cells. The frequencies of ILCs in PBMCs were lower in the patient with HIES than in the controls. Moreover, granulocyte-macrophage colony-stimulating factor (GM-CSF) and IL-17A produced by ILC3s in PBMCs were lower in the patient with HIES than the controls. Compared with the controls, classical monocytes (CD14⁺CD16(low)), which have a high antimicrobial capability, were also lower in the patient with HIES, while non-classical monocytes (CD14(low)CD16⁺) as well as intermediate monocytes (CD14⁺CD16(intermediate)) were higher. Taken together, these results indicate that the impaired immune defense against pathogenic microbes in the patient with HIES might be partially explained by functional defects in ILC3s and inflammatory monocytes.
Bacterial Infections ; Connective Tissue ; Cytokines ; Dermatitis ; Granulocyte-Macrophage Colony-Stimulating Factor ; Granulocytes ; Humans ; Immunity, Innate ; Immunoglobulin E ; Interleukin-17 ; Job Syndrome* ; Lymphocytes* ; Monocytes* ; STAT3 Transcription Factor

Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is a severe cutaneous adverse reaction involving various internal organs. Flare-ups after recovery from the initial presentation of DRESS are caused by relapse of drug-induced T-cell-mediated reactions. However, the specific underlying mechanism is unclear. Here, we report a case of a 60-year-old man with allopurinol-induced DRESS who suffered recurrent episodes of generalized rash with eosinophilia, which mimicked immune reconstitution inflammatory syndrome. Analysis of immunological profiles revealed that the percentages of T lymphocytes and regulatory T cells in the patient with DRESS were higher than those in healthy controls. In addition, there was a notable change in the subtype of monocytes in the patient with DRESS; the percentage of nonclassical monocytes increased, whereas that of classical monocytes decreased. Upon viral infection, nonclassical monocytes exhibited strong pro-inflammatory properties that skewed the immune response toward a Th2 profile, which was associated with persistent flare-ups of DRESS. Taken together, the results increase our understanding of the pathogenesis of DRESS as they suggest that expansion of nonclassical monocytes and Th2 cells drives disease pathogenesis.
Allopurinol ; Drug Hypersensitivity Syndrome ; Eosinophilia ; Exanthema ; Herpesviridae ; Humans ; Immune Reconstitution Inflammatory Syndrome ; Middle Aged ; Monocytes ; Recurrence ; T-Lymphocytes ; T-Lymphocytes, Regulatory ; Th2 Cells

Objectives: In this paper, we aimed to investigate the evolving debate over border closure in Korea during the coronavirus disease 2019 (COVID-19) pandemic, to address the main themes associated with border closure, and to discuss the factors that need to be considered when making such decisions. Methods: We collated and reviewed previously conducted review studies on border closures during infectious disease outbreaks to derive relevant themes and factors. Results: According to our systematic review on border closures and travel restrictions, the effects of such containment efforts are limited. We suggest considering the following factors when determining whether to impose border closure measures: (1) disease characteristics, (2) timeliness of implementation, (3) transmission delay and the basic reproduction number, (4) globalization and pandemics, and (5) social and economic costs. Conclusions Our assessment indicates that the effects of border closures are at best temporary and limited. Alternative measures must be contemplated and implemented to suppress the spread of COVID-19 in particular and infectious diseases more broadly.

BACKGROUND: The Mini-Mental State Examination (MMSE) has been commonly used to measure cognitive change over time. The aim of present study was to investigate the normative rates of change for the MMSE across test-retest intervals. METHODS: We administered the Korean MMSE (K-MMSE) to 1055 community-dwelling middle aged and older adults three times over 6 years. Based on the Christensen's health screening criteria (1991), 234 middle-aged healthy adults (104 men, 130 women; mean age 55.95+/-6.20 years; age range 45-64 years; mean education 7.63+/-4.06 years) and 505 healthy elderly (200 men, 305 women; mean age 71.00+/-4.62 years; age range 65-79 years; mean education 5.61+/-5.12 years) were selected for the statistical analysis. Reliable change indices were computed using two different statistical methods, the Reliable Change Index adjusted for practice effects (RCIPE; Chelune et al., 1993) and the Standardized Regression-Based Change Index (SRBCI; McSweeny et al., 1993). RESULTS: For the middle-aged healthy adult group, the 90% confidence intervals of the RCIPE and SRBCI were the same such as +/-4 in 2-year, +/-5 in 4-year, and +/-6 in 6-year test-retest intervals. For the healthy elderly group, the 90% confidence intervals of the RCIPE were -5 and +4 in 2-year interval and -7 and +5 in 4- & 6-year intervals. The 90% confidence intervals of the SRB change index were +/-4 in 2-year interval and +/-6 in 4- & 6-year intervals. CONCLUSIONS: The result provides the normative data of the reliable change scores for the K-MMSE for the middle-aged and older adults. It shows that the reliable change indices were varied across different age groups as well as test-retest intervals.
Adult ; Aged ; Humans ; Male ; Mass Screening ; Middle Aged

Bleeding from pancreatic pseudocyst is a rare complication. Furthermore, massive upper gastrointestinal (GI) bleeding from gastro-cystic fistula formation and intracystic bleeding are both extremely rare and are also potentially fatal. A 53-year-old male was referred to the emergency room with melena and hematemesis. An urgent endoscopy revealed a massive gastric hematoma but showed no specific bleeding focus. Gastrocystic fistula formation and intracystic bleeding leakage to the stomach were suspicious in the follow-up endoscopy. A contrast-enhanced computed tomography scan demonstrated splenic artery pseudoaneurysm and extravasation of contrast media into the cyst that was abutted to the greater curvature side of the stomach. A splenic artery embolization was performed and no further bleeding occurred after embolization. Upper GI bleeding from gastro-cystic fistula and intracystic bleeding are rare but possible. Therefore, this possibility should be considered in the unknown cause of an upper GI bleeding in a patient with pancreatic pseudocyst.
Aneurysm, False ; Emergency Service, Hospital ; Endoscopy ; Extravasation of Diagnostic and Therapeutic Materials ; Fistula* ; Follow-Up Studies ; Hematemesis ; Hematoma ; Hemorrhage* ; Humans ; Male ; Melena ; Middle Aged ; Pancreatic Pseudocyst* ; Splenic Artery ; Stomach