PURPOSE: This study was to compare health behaviors, DM management and HRQoL among Diabetic patients according to education experience. METHODS: Data were obtained from Community health Survey(CHS) of 2015. The participants were 22,937 diabetic patients who had education experience or not. Data were analyzed on complex sample anaysis using SPSS 24 program. RESULTS: The education experience group showed higher percentages of health behaviors and DM Management and higher HRQoL. The significant negative factors influencing HRQoL were Bed ridden experience, higher subjective stress, depression expereince, age, low education and positive factors were good subjective health status, walking, mod-exercise, drinking, employment, spouse, good subjective happiness. CONCLUSION: These results show that education experience is a way to help diabetic patients' health behavior, DM management, HRQoL.
Depression ; Diabetes Mellitus ; Diagnostic Self Evaluation ; Drinking ; Education* ; Employment ; Happiness ; Health Behavior* ; Humans ; Spouses ; Walking

OBJECTIVES: In this study, the destabilizing effect of glycyrrhetinic acid on pre-formed biofilms of Streptococcus mutans (S. mutans) was observed. METHODS: Alamar blue assay was used to determine the toxicity of glycyrrhetinic acid on pre-formed biofilms of S. mutans. Four different concentrations (0, 3.75, 7.5, 15 µg/ml) of glycyrrhetinic acid were tested. Changes in the biofilm architecture after exposure to glycyrrhetinic acid were analyzed by scanning electron microscopy (SEM). Moreover, the role of glycyrrhetinic acid in enhancing the antimicrobial activity of cetylpyridinium chloride (CPC), an antimicrobial agent commonly used in oral health care products, was evaluated. RESULTS: Glycyrrhetinic acid concentration of up to 15 µg/ml had little cytotoxic effect but significantly changed the biofilm architecture. SEM analysis revealed destabilized biofilm structure after the preformed biofilms were exposed to glycyrrhetinic acid. Supplementing 2.5 µg/ml CPC with 15 µg/ml glycyrrhetinic acid significantly enhanced the bactericidal effect of CPC on the pre-formed biofilms than that in the non-supplemented CPC treated control. This indicates that glycyrrhetinic acid enhanced the antimicrobial activity of CPC by modifying the structure, thus facilitating the penetration of CPC into the biofilm. CONCLUSIONS: Glycyrrhetinic acid could be a potential agent to effectively control S. mutans biofilms responsible for dental caries.
Biofilms* ; Cetylpyridinium ; Dental Caries ; Glycyrrhetinic Acid* ; Microscopy, Electron, Scanning ; Oral Health ; Streptococcus mutans* ; Streptococcus*

OBJECTIVES: The present study aimed at investigating the potential of using 18β-glycyrrhetinic acid against the cariogenic characteristics of Streptococcus mutans UA159. METHODS: The effects of 18β-glycyrrhetinic acid on biofilm formation and acid production were evaluated; the latter are indicators of cariogenicity of S. mutans. Biofilm architecture was also analyzed by scanning electron microscopy (SEM), and changes in gene expression related to biofilm formation were studied by quantitative RT-PCR. RESULTS: Treatment with 18β-glycyrrhetinic acid at a concentration of 20 µg/ml inhibited biofilm formation by 95% in the absence of sucrose and 60% in its presence, reduced acid production by 88.8%, and significantly suppressed the gene expression of comDE, gbpB, gtfC and vicR, which are thought to be involved in the virulence of S. mutans. CONCLUSIONS: These results suggest that 18β-glycyrrhetinic acid could be used as a complementary or alternative agent for preventing dental caries by interfering with the virulence properties of S. mutans without affecting the viability of the bacterial population.
Biofilms ; Dental Caries ; Gene Expression ; Microscopy, Electron, Scanning ; Streptococcus mutans ; Streptococcus ; Sucrose ; Virulence

Purpose: Fish allergy is rare in children, and there have been few studies on childhood fish allergy. This study aims to investigate the clinical characteristics and laboratory findings of white meat fish (WMF) allergy in Korean children. Methods: In this study, we enrolled 150 children with a history of WMF consumption who underwent serum specific immunoglobulin E to cod (cod-sIgE) at Ajou University Hospital from January 2019 to December 2022. The demographic characteristics, clinical symptoms, history of consuming 6 major Korean WMF (cod, cutlass, yellow croaker, brown sole, olive flounder, and anchovy), and cod-sIgE were investigated. Results: Sixty-five subjects (43.3%) had clinical responses to at least 1 of the 6 WMF (WMF-allergic), and 85 subjects had no allergic reaction to all 6 WMF (WMF-tolerant). The median age of first symptom onset in the WMF-allergic group was 15 months. Major causative WMF were yellow croaker (30.6%), cutlass (28.7%), cod (26.1%), brown sole (20.4%), anchovy (14.7%), and olive flounder (6.5%). Twenty-three of 65 WMF-allergic children (35.4%) had anaphylaxis. The median level of cod-sIgE was 4.61 kUA/L (range, 0.04–100.10 kUA/L) in the WMF-allergic group, and this value was significantly higher (P < 0.001) than that of the WMF-tolerant group (0.04 kUA/L; range, 0.04–3.08 kUA/L). The positive rates ( ≥ class 2, 0.7 kUA/L) of cod-sIgE for the 6 individual WMF ranged from 69% to 90%. Conclusion We propose that WMF allergy can develop in young children, with 35.4% experiencing anaphylaxis. Cod-sIgE is considered a useful tool for diagnosing not only cod allergy but also other WMF allergy in children.

Purpose: Fish allergy is rare in children, and there have been few studies on childhood fish allergy. This study aims to investigate the clinical characteristics and laboratory findings of white meat fish (WMF) allergy in Korean children. Methods: In this study, we enrolled 150 children with a history of WMF consumption who underwent serum specific immunoglobulin E to cod (cod-sIgE) at Ajou University Hospital from January 2019 to December 2022. The demographic characteristics, clinical symptoms, history of consuming 6 major Korean WMF (cod, cutlass, yellow croaker, brown sole, olive flounder, and anchovy), and cod-sIgE were investigated. Results: Sixty-five subjects (43.3%) had clinical responses to at least 1 of the 6 WMF (WMF-allergic), and 85 subjects had no allergic reaction to all 6 WMF (WMF-tolerant). The median age of first symptom onset in the WMF-allergic group was 15 months. Major causative WMF were yellow croaker (30.6%), cutlass (28.7%), cod (26.1%), brown sole (20.4%), anchovy (14.7%), and olive flounder (6.5%). Twenty-three of 65 WMF-allergic children (35.4%) had anaphylaxis. The median level of cod-sIgE was 4.61 kUA/L (range, 0.04–100.10 kUA/L) in the WMF-allergic group, and this value was significantly higher (P < 0.001) than that of the WMF-tolerant group (0.04 kUA/L; range, 0.04–3.08 kUA/L). The positive rates ( ≥ class 2, 0.7 kUA/L) of cod-sIgE for the 6 individual WMF ranged from 69% to 90%. Conclusion We propose that WMF allergy can develop in young children, with 35.4% experiencing anaphylaxis. Cod-sIgE is considered a useful tool for diagnosing not only cod allergy but also other WMF allergy in children.

Purpose: Fish allergy is rare in children, and there have been few studies on childhood fish allergy. This study aims to investigate the clinical characteristics and laboratory findings of white meat fish (WMF) allergy in Korean children. Methods: In this study, we enrolled 150 children with a history of WMF consumption who underwent serum specific immunoglobulin E to cod (cod-sIgE) at Ajou University Hospital from January 2019 to December 2022. The demographic characteristics, clinical symptoms, history of consuming 6 major Korean WMF (cod, cutlass, yellow croaker, brown sole, olive flounder, and anchovy), and cod-sIgE were investigated. Results: Sixty-five subjects (43.3%) had clinical responses to at least 1 of the 6 WMF (WMF-allergic), and 85 subjects had no allergic reaction to all 6 WMF (WMF-tolerant). The median age of first symptom onset in the WMF-allergic group was 15 months. Major causative WMF were yellow croaker (30.6%), cutlass (28.7%), cod (26.1%), brown sole (20.4%), anchovy (14.7%), and olive flounder (6.5%). Twenty-three of 65 WMF-allergic children (35.4%) had anaphylaxis. The median level of cod-sIgE was 4.61 kUA/L (range, 0.04–100.10 kUA/L) in the WMF-allergic group, and this value was significantly higher (P < 0.001) than that of the WMF-tolerant group (0.04 kUA/L; range, 0.04–3.08 kUA/L). The positive rates ( ≥ class 2, 0.7 kUA/L) of cod-sIgE for the 6 individual WMF ranged from 69% to 90%. Conclusion We propose that WMF allergy can develop in young children, with 35.4% experiencing anaphylaxis. Cod-sIgE is considered a useful tool for diagnosing not only cod allergy but also other WMF allergy in children.

Providing a protocol in the case of multiple food allergies is difficult although the demand of immunotherapy for patients with wheat anaphylaxis is increasing. This case series study aimed to report the wheat oral immunotherapy successfully achieving the maintenance dose along with immunological changes in children with multiple food anaphylaxis. In oral food immunotherapy, personalized therapeutic protocol, which sets the initial dose using the oral food provocation test and increase the dose considering the patients’ needs and compliance, for each patient is essential.

Background: Axillary evaluation is unnecessary for pure ductal carcinoma in situ (DCIS);however, it is performed because of the risk of upstaging to invasive cancer. We assessed the role of intraoperative frozen section (IOF) biopsy in reducing invasive cancer upstaging and axillary evaluation in preoperative DCIS patients. Methods: We reviewed patients with preoperative DCIS who underwent breast-conserving surgery (BCS) with IOF biopsy. Positive IOF biopsy findings were defined as the presence of invasive or micro-invasive cancer. The IOF biopsy and permanent pathology findings were compared. Results: Seventy-eight patients underwent BCS with IOF biopsy. Six patients showed positive IOF biopsy findings; five of these patients showed concordant permanent pathology findings.Sentinel lymph node biopsy (SLNB) was positive in one patient. Thirteen patients with invasive breast cancer were missed by IOF biopsy; they underwent SLNB during the second surgery. None of them had metastatic lymph nodes. The sensitivity and specificity of IOF biopsy were 27.7% and 98.3%, respectively, with 82.1% accuracy. None of the other factors showed statistically significant relationships with the permanent pathology findings, except for the IOF biopsy findings. Conclusion IOF evaluation can aid in detecting the invasiveness of tumors in patients with preoperative DCIS.

OBJECTIVES: To assess the absorption of α-tocopherol acetate and 18β-glycyrrhetinic acid, which are used as active ingredients in toothpaste, into a reconstructed gingival tissue. METHODS: EpiGingival™ tissues were treated with a 25% slurry of toothpaste containing 2% α-tocopherol acetate and 0.3% 18β-glycyrrhetinic acid, for 2 minutes. The treatment was repeated up to 6 times, with 1 hour intervals. After completion of all treatments, the active ingredients in the tissue extracts and receiver solutions were measured by high performance liquid chromatography. RESULTS: Although α-tocopherol acetate was not detected, α-tocopherol was detected in the tissue extracts, indicating that α-tocopherol acetate was bioconverted to α-tocopherol after absorption. We could detect 18β-glycyrrhetinic acid both in the tissue extracts and in the receiver solutions, with a positive correlation to the number of treatments. CONCLUSIONS: We found that our toothpaste effectively delivered α-tocopherol acetate and 18β-glycyrrhetinic acid to a reconstructed gingival tissue in vitro.
Absorption* ; Chromatography, Liquid ; In Vitro Techniques* ; Periodontal Diseases ; Tissue Extracts ; Toothpastes

PURPOSE: Newly developed extra-mammary multiple primary cancers (MPCs) are an issue of concern when considering the management of breast cancer survivors. This study aimed to investigate the prevalence of MPCs and to evaluate the implications of MPCs on the survival of breast cancer patients. MATERIALS AND METHODS: A total of 8204 patients who underwent surgery at Severance Hospital between 1990 and 2012 were retrospectively selected. Clinicopathologic features and survival over follow-up periods of < or =5 and >5 years were investigated using univariate and multivariate analyses. RESULTS: During a mean follow-up of 67.3 months, 962 MPCs in 858 patients (10.5%) were detected. Synchronous and metachronous MPCs were identified in 23.8% and 79.0% of patients, respectively. Thyroid cancer was the most prevalent, and the second most common was gynecologic cancer. At < or =5 years, patients with MPCs were older and demonstrated significantly worse survival despite a higher proportion of patients with lower-stage MPCs. Nevertheless, an increased risk of death in patients with MPCs did not reach statistical significance at >5 years. The causes of death in many of the patients with MPCs were not related to breast cancer. Stage-matched analysis revealed that the implications of MPCs on survival were more evident in the early stages of breast disease. CONCLUSION: Breast cancer patients with MPCs showed worse survival, especially when early-stage disease was identified. Therefore, it is necessary to follow screening programs in breast cancer survivors and to establish guidelines for improving prognosis and quality of life.
Adult ; Aged ; Breast/pathology ; Breast Neoplasms/diagnosis/*mortality ; Female ; Humans ; Middle Aged ; Multivariate Analysis ; Neoplasm Metastasis ; Neoplasm Staging ; Neoplasms, Multiple Primary/diagnosis/*mortality ; Neoplasms, Second Primary/diagnosis/*mortality ; Prognosis ; *Quality of Life ; Republic of Korea/epidemiology ; Retrospective Studies ; Survival Analysis