OBJECTIVES: Studies on oral health care in North Korea are being pursued in South Korea. However, the covertness of North Korea offers substantial resistance to the access of information from the country, including in the field of oral health care. In this study, we explored North Korea's oral health care policy and its status in the Kim Jong-Un Era. METHODS: We used existing information from Internet searches and also interviewed three health care professionals who had recently contact with North Korea. RESULTS: At present, there are four development policies of oral health care in North Korea: expansion of dental institutions and resource support, strengthening the prevention and treatment of dental diseases, improvement of dental prosthetics, and increasing the responsibility and role of the dental workforce. In addition, there has been an increasing interest in children's oral health with the development of a few programs. CONCLUSIONS In order to improve overall oral health care, cooperation is required from North Korea in accessing relevant information in the field of children's oral health, dental prosthetics, and dental materials. For this to occur, there should be a preliminary trust building process between North Korea and South Korea as well as access to information from reliable sources.

Several recent studies have reported that reactive oxygen species (ROS), superoxide anion and hydrogen peroxide (H2O2), play important roles in various cellular signaling networks. NADPH oxidase (Nox) isozymes have been shown to mediate receptor-mediated ROS generation for physiological signaling processes involved in cell growth, differentiation, apoptosis, and fibrosis. Detectable intracellular levels of ROS can be induced by the electron leakage from mitochondrial respiratory chain as well as by activation of cytochrome p450, glucose oxidase and xanthine oxidase, leading to oxidative stress. The up-regulation and the hyper-activation of NADPH oxidases (Nox) also likely contribute to oxidative stress in pathophysiologic stages. Elevation of the renal ROS level through hyperglycemia-mediated Nox activation results in the oxidative stress which induces a damage to kidney tissues, causing to diabetic nephropathy (DN). Nox inhibitors are currently being developed as the therapeutics of DN. In this review, we summarize Nox-mediated ROS generation and development of Nox inhibitors for therapeutics of DN treatment.

STUDY DESIGN: A prospective study. OBJECTIVES: To determine the usefulness of local bone obtained from laminectomy and decortication as graft bone instead of autogenous iliac bone in posterolateral lumbar spinal fusion. MATERIALS AND METHODS: Thirty-one patients underwent posterolateral lumbar spinal fusion with pedicle screw instrumentation. Local bone was inserted in the right side of intertransverse space and autogenous iliac bone was in the left side. We compared fusion rate in the radiographs at postoperative 6 week, 3 month, 6 month and 1 year. RESULTS: Radiographic fusion grading of local bone was 20 cases of grade 1, 8 cases of grade 2, 2 cases of grade 3 and 1 case of grade 4. Fusion grading of autogenous iliac bone was 24 cases of grade 1, 4 cases of grade 2 and 3 cases of grade 3. Bone fusion was complete after 9.1 months in local bone and 7.2 months in autogenous iliac bone. No significant differences was found between the two groups. CONCLUSION: The local bone in posterolateral lumbar fusion is appropriate for satisfactory fusion instead of autogenous iliac bone if the amount of local bone is sufficient and decortication of the fusion bed is proper.
Humans ; Laminectomy ; Prospective Studies ; Spinal Fusion ; Transplants*

PURPOSE: To verify the role of additional sonography on routine mammograms in the diagnosis of ductal carcinoma in situ (DCIS). MATERIALS AND METHODS: Between 2005 and 2008, a total of 105 breasts belonging to 102 patients were diagnosed with DCIS by surgery. Preoperative ultrasound and mammographic findings and reports using BI-RADS were retrospectively reviewed and analyzed. In both mammogram and ultrasound, BI-RADS categories 1, 2, and 3 were regarded as negative results and categories 4 and 5 as positive results. We analyzed the frequency in which additional ultrasound examinations aided in the diagnosis in each mammographic finding. RESULTS: Out of the 105 cases, 96 showed positive results on a mammogram and 9 cases showed negative results. Clustered microcalcifications, positive mammographic findings, were found most often (64/96, 66.67%). In those cases, ultrasound examinations gave no additional information, but did enablesonographically-guided biopsies in 38. In the 32 cases with other positive mammographic findings, ultrasound examinations were helpful in 15 cases. Of the 9 cases showing negative results on a mammogram, 8 cases were correctly diagnosed with DCIS because of the additionally-performed ultrasound examination, but 1 case returned a false negative on both the mammogram and ultrasound examination. CONCLUSION: Additional sonography contributes to a diagnosis of DCIS in patients with negative mammographic findings, nonspecific mammographic findings, or multifocal lesions.
Biopsy ; Breast ; Carcinoma, Ductal ; Carcinoma, Intraductal, Noninfiltrating ; Humans ; Retrospective Studies

PURPOSE: The purpose of this study is to analyze the clinical and radiological results of performing primary total hip arthroplasty (THA) in patients with a fused hip and to compare the results with that of patients with avascular necrosis of the femur head (AVNF). MATERIALS AND METHODS: 19 patients (21 hips) with a fused hip(s) were retrospectively reviewed. We analyzed them clinically with using the Harris hip score (HHS), and radiologically with performing serial radiograms and we then compared them with the results of the patients in the AVNF group. RESULTS: The mean HHS was improved from 59.2 to 85.8. The VAS improved from 6.5 to 2.2 and the leg length discrepancy (LLD) improved from 27.5 mm to 12.5 mm. As complications, wound infection occurred in 3 hips, heterotopic ossification occurred in 8 hips and recurrent dislocation occurred in one hip. Although a radiolucent line was found in 4 acetabular cups and 6 femoral stems, there was no progression. Osteolysis was found in 1 acetabular cup. CONCLUSION: The results of THA in patients with a fused hip were excellent. Comparing with the AVNF group, improvement of the hip motion and LLD were much better. The improvement of the VAS and HHS showed similar results between the groups. However, the final results of the HHS, VAS, LLD and the range of motion of the hip were worse, and the complication rate was higher.
Arthroplasty ; Dislocations ; Femur Head ; Femur Head Necrosis ; Hip ; Humans ; Leg ; Necrosis ; Ossification, Heterotopic ; Osteolysis ; Range of Motion, Articular ; Retrospective Studies ; Tacrine ; Wound Infection

BACKGROUND: The decision on whether or not to transfuse should be based on agreement from the patient's own understanding and free will. In Korea, the transfusion guideline first developed in 2009 specified that informed consent should be obtained before transfusion. The standard consent form has also been distributed since 2010. The purpose of this study was to evaluate the degree of improvement in obtaining informed consent for blood transfusion. METHODS: Prior to the development of the transfusion guideline in 2008, an e-mail survey was conducted on 105 clinicians. In 2015, questionnaires were sent to 1,179 clinicians, 32 academic societies, and 6 institutions. RESULTS: Forty-three and 374 answers were received in 2008 and 2015, respectively (response rate, 41.0% and 30.7%). Compared with 2008, the use of explanatory materials increased from 20.9% to 70.5%, and consent acquisitions using a written form increased from 27.9% to 81.7%. The number of respondents who answered that informed consent for transfusions is absolutely necessary also increased from 51.2% to 71.3%. Among the reasons why obtaining informed consent for transfusion can be difficult, the response that standardized consent form is unavailable decreased from 51.2% to 26.9%. CONCLUSION: The transfusion guideline and the standard consent form have contributed greatly to the improvement of obtaining informed consent before blood transfusion at medical institutions in Korea.
Blood Transfusion* ; Consent Forms ; Electronic Mail ; Informed Consent* ; Korea ; Personal Autonomy ; Surveys and Questionnaires

BACKGROUND: To determine the benefit of an extensively porous coated femoral stem in patients receiving revision total hip arthroplasty. METHODS: This study reviewed the results of 35 patients who received a revision total hip arthroplasty with extensively porous coated femoral stem between August, 1996, and December, 2002. The mean follow-up period was 77.5 months. The clinical and radiological results were evaluated by the Harris hip score and serial roentgenographic findings. RESULTS: The preoperative and postoperative Harris hip score was 68.3 and 92.5, respectively. Radiographically, none of the acetabular components showed any evidence of migration, tilt, rotation, or shedding of metal particles. In addition, none of the femoral components showed evidence of subsidence, pedestal, or shedding of metal particles. Twenty-two hips had a mild stress shield and 2 hips had a moderate stress shield. The perioperative complications encountered were deep vein thrombosis (1 case), mild heterotopic ossification (4 cases), intraoperative periprosthetic fractures (1 case), and nonunion of the trochanteric osteotomy site (2 cases). CONCLUSIONS: Extensively porous coated femoral stems and acetabular components produce excellent clinical and radiological results in revision total hip arthroplasty.
Aged ; *Arthroplasty, Replacement, Hip ; *Coated Materials, Biocompatible ; Female ; *Hip Prosthesis ; Humans ; Male ; Middle Aged ; Porosity ; Reoperation

BACKGROUND: Transfusion guidelines play an important role for the appropriate use and quality assurance of blood and transfusion services. The Korean national transfusion guideline was developed in 2009 and went under full amendment in 2016. The purpose of this study was to investigate the awareness and practicality of the transfusion guideline in Korea. METHODS: Questionnaires about the Korean national transfusion guideline were sent by traditional mail or e-mail to a total of 1,179 clinicians, 32 academic societies, and 6 institutions. RESULTS: Three hundred and seventy-four answers were received; a response rate of 30.7%. The proportion of respondents with good awareness of the guideline was 23.3%, which is a significant increase compared with 10.9% in 2008. Respondents with good awareness were more dependent on the transfusion guideline when making transfusion decisions. CONCLUSION: There was a considerable increase in the awareness of the national transfusion guideline in Korea.
Electronic Mail ; Korea* ; Postal Service ; Surveys and Questionnaires

OBJECTIVE: The purpose of this study is to evaluate the short term results of total hip arthroplasty (THA) for avascular necrosis in patients with systemic lupus erythematosus (SLE). METHODS: This is a retrospective case control, matched pair study. Ten patients (15 hips) with SLE and avascular necrosis of the femoral head (AVNFH) underwent THA. Eight patients (12hips) with a minimum follow up of 2 years were reviewed. To determine whether these patients had results similar to those of patients with other diagnosis, we formed a control group of 12 patients who had 12 THA. They were matched for age, sex, BMI, activity, follow-up period, and type of implant with SLE group. The clinical and radiographic results were evaluated by Harris hip score (HSS) and serial radiographic findings, respectively. RESULTS: There was no complication during the perioperative period. In the SLE group, HHS was from 67.3 preoperatively to 97.7 at last follow-up. In the control group, HHS was from 70.1 preoperatively to 97.8 at last follow-up. On the last roentgenograms, none of acetabular components demonstrated any evidence of migration, tilt, rotation or shedding of metal particles in both groups. All femoral components demonstrated no evidence of subsidence, pedestal, or shedding of metal particles in both groups. CONCLUSION: Patients with SLE and AVNFH had excellent results after THA. Results were not different from that of patients who had hip replacement for other diagnoses. Therefore, it is considered that uncemented THA was useful treatment method for the patient who had SLE and AVNFH.

A 41-year-old woman with a 2-month history of diffused swelling and persistent dull pain in her right shoulder was examined. Magnetic resonance imaging (MRI) findings revealed subdeltoid bursitis and rice bodies with normal surrounding tissue and shoulder joint. Arthoscopic debridement and biopsy of the subdeltoid bursa were performed. Histologic examination of the bursal tissue showed granulomatous tissue with typical caseous necrosis. A positive culture of Mycobacterium tuberculosis confirmed the diagnosis of tuberculosis. We report on the clinical, radiological and athological findings in a patient with tuberculous subdeltoid bursitis accompanied by multiple rice body formation without coexisting active bone and joint tuberculosis, and conduct a literature review.
Adult ; Bursitis/diagnosis/*pathology/surgery ; Case Report ; Female ; Human ; Magnetic Resonance Imaging ; Tuberculosis, Osteoarticular/diagnosis/*pathology/surgery