As an alternative to the conventional fixed appliance that uses orthodontic brackets, a simple round tube without a bonding base can be bonded to the tooth surface by covering the tube with flowable resin. In this technique, bent wires cannot be inserted into the simple tubes; therefore, repositioning of the simple tubes is often required for adjustments. To reduce repositioning of simple tubes, a dome-shaped resin covering of the simple tube can be designed with a customized in-and-out compensation, using three-dimensional computer-aided design software based on digital simulation of orthodontic tooth movement. In the present case, the use of simple tubes bonded with customized resin coverings in a Class I nonextraction case is described in a 17-year-old male, in whom moderate crowding of the anterior teeth was treated over an 8-month period. This case shows that simple tubes can be used as an alternative to brackets in some Class I nonextraction cases, with the potential benefit of reducing decalcification.

Fabry disease is an X-linked recessive lysosomal storage disease that is caused by deficient activity of the lysosomal enzyme alpha-galactosidase A. This deficiency results in progressive lysosomal accumulation of glycosphingolipid with particular globotriaosylceramide which accumulates in the heart, kidneys, and the nervous system. The classic Fabry diease affects males, who typically experience an early onset of neuropathic pain, angiokeratoma, and anhydrosis or hypohydrosis. The introduction of enzyme replacement therapy necessitates early awareness of Fabry disease and knowledge of disease- related complications. We experienced a man presenting with acroparesthesia, anhydrosis and proteinuria, who had no residual alpha-galactosidase A activity on leukocytes and mutation analysis demonstrated thiamine deletion at position 1077, exon 7 of GLA gene. He was initially diagnosed as focal segmental glomerulosclerosis without electron microscopic examination three years ago. Now he is being treated with recombinant alpha-galactosidase A via intravenous administration for 1 month.
Administration, Intravenous ; alpha-Galactosidase ; Angiokeratoma ; Enzyme Replacement Therapy ; Exons ; Fabry Disease* ; Glomerulosclerosis, Focal Segmental* ; Heart ; Humans ; Kidney ; Leukocytes ; Lysosomal Storage Diseases ; Male ; Nervous System ; Neuralgia ; Proteinuria ; Thiamine

PURPOSE: This study was conducted to identify and analyze the trends of theory-based research published in Asian Oncology Nursing (AON) from 2011 to 2017. METHODS: We analyzed 22 theory-based studies taken from among the 232 studies published in AON for 7years. We analyzed the framework developed by researchers, descriptive summaries of theory, keyword classification of nursing meta-paradigms, the generic character of the studies, and the type of research designs. RESULTS: A total of 23 theories were applied in the 22 (9.5%) studies. ‘Nursing’ was the most prevalent field of study (34.8%). In the field of study of theory, nursing theory was the largest with eight (34.8%), and in the method of theory utilization, all 22 studies were theoretical applications 3 middle-range theories were most prevalent. In the keyword classification using meta-paradigm in nursing, we found 83 key words. Among them, ‘Health’ related key words were most frequent (53), followed by ‘Cancer’ keywords (13). CONCLUSION: AON has a high ratio of theoretical study compared to other journals, but the ratio is still less than 10%, which is still weak. Therefore, it is believed that the attention to, utilization of, application, and institutional establishment of nursing theory should be necessary.
Asian Continental Ancestry Group ; Classification ; Humans ; Methods ; Models, Theoretical ; Nursing ; Nursing Theory ; Oncology Nursing ; Research Design

Understanding the classification of malocclusion is a crucial issue in Orthodontics. It can also help us to diagnose, treat, and understand malocclusion to establish a standard for definite class of patients. Principal component analysis (PCA) and k-means algorithms have been emerging as data analytic methods for cephalometric measurements, due to their intuitive concepts and application potentials. This study analyzed the macro- and meso-scale classification structure and feature basis vectors of 1020 (415 male, 605 female; mean age, 25 years) orthodontic patients using statistical preprocessing, PCA, random matrix theory (RMT) and k-means algorithms. RMT results show that 7 principal components (PCs) are significant standard in the extraction of features. Using k-means algorithms, 3 and 6 clusters were identified and the axes of PC1~3 were determined to be significant for patient classification. Macro-scale classification denotes skeletal Class I, II, III and PC1 means anteroposterior discrepancy of the maxilla and mandible and mandibular position. PC2 and PC3 means vertical pattern and maxillary position respectively; they played significant roles in the meso-scale classification. In conclusion, the typical patient profile (TPP) of each class showed that the data-based classification corresponds with the clinical classification of orthodontic patients. This data-based study can provide insight into the development of new diagnostic classifications.
Cephalometry ; Classification ; Cluster Analysis ; Female ; Humans ; Male ; Malocclusion ; Mandible ; Maxilla ; Orthodontics ; Passive Cutaneous Anaphylaxis ; Principal Component Analysis

PURPOSE: The purpose of this study is to investigate the reliability and validity of new clinical performance examination (CPX) for assessing clinical reasoning skills and evaluating clinical reasoning ability of the students. METHODS: Third-year medical school students (n=313) in Busan-Gyeongnam consortium in 2014 were included in the study. One of 12 stations was developed to assess clinical reasoning abilities. The scenario and checklists of the station were revised by six experts. Chief complaint of the case was rhinorrhea, accompanied by fever, headache, and vomiting. Checklists focused on identifying of the main problem and systematic approach to the problem. Students interviewed the patient and recorded subjective and objective findings, assessments, plans (SOAP) note for 15 minutes. Two professors assessed students simultaneously. We performed statistical analysis on their scores and survey. RESULTS: The Cronbach α of subject station was 0.878 and Cohen κ coefficient between graders was 0.785. Students agreed on CPX as an adequate tool to evaluate students' performance, but some graders argued that the CPX failed to secure its validity due to their lack of understanding the case. One hundred eight students (34.5%) identified essential problem early and only 58 (18.5%) performed systematic history taking and physical examination. One hundred seventy-three of them (55.3%) communicated correct diagnosis with the patient. Most of them had trouble in writing SOAP notes. CONCLUSION: To gain reliability and validity, interrater agreement should be secured. Students' clinical reasoning skills were not enough. Students need to be trained on problem identification, reasoning skills and accurate record-keeping.
Checklist ; *Clinical Competence ; Communication ; Comprehension ; *Education, Medical, Undergraduate ; Educational Measurement/*standards ; Humans ; Medical History Taking ; Medical Records ; Observer Variation ; Physical Examination ; Physician-Patient Relations ; *Problem-Based Learning ; Reproducibility of Results ; Republic of Korea ; *Schools, Medical ; *Students, Medical ; Surveys and Questionnaires ; *Thinking ; Universities

BACKGROUND: Obesity not only does increase the incidence of breast cancer, but also affects the course of treatment, recurrence and mortality. This study aims to evaluate on the obesity status of Korean breast cancer survivors and their obesity-related lifestyles. METHODS: The study included 125 Korean female breast cancer survivors aged over 19 year old enrolled in the 2009-11 Korean National Health and Nutrition Examination Survey. Women who answered 'yes' to the question 'have you ever been diagnosed breast cancer by a physician?' was defined as a breast cancer survivors. Height, weight, and waist circumference were measured and Body mass index (BMI) was calculated. Body fat percent was assessed by dual X-ray absorptiometry (DXA). Standardized surveys by trained interviewers were used to investigate survivors' obesity-related lifestyles such as physical activities, sleeping hours and nutrients intake. RESULTS: 48.4% of Korean breast cancer survivors were obese. 44.7% had abdominal obesity and 89.2% had body fat percent over 30. Their physical activity level was generally low; only 22.5% maintained health-enhancing level of physical activities. Fat intake (14.4 [0.8] %) was as low and carbohydrate intake (74.2 [1.2] %) was high. However, daily dietary fiber intake was low (10.5 [1.1] g). Factors that were found to be significantly related with obesity in Korean breast cancer survivors were low education level (P=0.042), smoking (P<0.001), having chronic diseases (P=0.002) and short sleeping hours (P<0.001). CONCLUSIONS: It is mandatory for physician to evaluate obesity status of breast cancer survivors as soon as their diagnosis and give proper intervention to maintain healthy weight and healthy obesity related lifestyle.
Absorptiometry, Photon ; Adipose Tissue ; Body Mass Index ; Breast Neoplasms* ; Chronic Disease ; Diagnosis ; Dietary Fiber ; Education ; Female ; Humans ; Incidence ; Life Style* ; Metabolic Equivalent ; Mortality ; Motor Activity ; Nutrition Surveys ; Obesity* ; Obesity, Abdominal ; Recurrence ; Smoke ; Smoking ; Survivors* ; Waist Circumference

PURPOSE: Emergency physicians are often asked to predict a patient's functional outcome after an acute stroke. However, very little information is usually available to a physician to help predict the likelihood of severe permanent disability. The purpose of this study was to determine useful Initial prognostic predictors in patients with an acute stroke presenting to the emergency department. METHODS: Between March 1, 2004 and May 31, 2004, we analyzed 74 patients diagnosed to have an acute stroke by diffusion weighted magnetic resonance imaging obtained within 24 hours from symptom onset at the emergency department. Seven factors were evaluated as prospective variables including The National Institutes of Health Stroke Scale (NIHSS) measured by emergency physician (NIHSSEM) and neurologist (NIHSS-NR) at the time of presentation to the emergency department. The outcome variables were Barthel Index (BI), modified Rankin Scale (mRS), and the NIHSS measured at the time of discharge from hospital. RESULTS: The intraclass correlation coefficient between NIHSS-EM and NIHSS-NR was 0.94 (p < 0.001). History of stroke, gender, NIHSS-EM, large vessel disease and lacuna infarctions were statistically significant outcome predictors. In a multivariate logistic regression analyses, NIHSSEM was the only independent variable that correlated with NIHSS, mRS, and BI at hospital discharge. CONCLUSION: Among the many prognostic predictors studied, the NIHSS appeared to be the only independent variable showing a correlation with the patients's prognosis. The NIHSS perfomed in the emergency department may help emergency physicians provide more accurate initial prognosis in an acute stroke patient.
Diffusion ; Emergencies ; Emergency Service, Hospital ; Humans ; Infarction ; Logistic Models ; Magnetic Resonance Imaging ; National Institutes of Health (U.S.) ; Prognosis* ; Prospective Studies ; Stroke*

This study was performed to investigate the ameliorating effects of steamed soybeans (SS) and fermented SS (FSS) on lipid metabolism in high-fat diet-induced obese mice. ICR mice were divided into four groups and given the following different diets: normal diet (ND), high-fat diet (HFD), HFD with 1% SS (HFD + SS), and HFD with 1% FSS (HFD + FSS). After 14 weeks, the body weight gain was higher in the HFD group compared with the ND group but lower in the HFD + FSS group compared with the HFD group. Plasma levels of triglyceride (TG), total cholesterol (TC), low density lipoprotein-cholesterol, aspartate aminotransferase (AST), and alanine aminotransferase (ALT) were significantly higher in the HFD group compared to the ND group, but lower in the HFD + SS and HFD + FSS groups compared with the HFD group. In addition, leptin concentration in plasma was lower in the groups fed HFD + SS and HFD + FSS compared with the HFD group. The accumulation of hepatic TG and TC was significantly inhibited in the HFD + SS and HFD + FSS groups. Furthermore, SS and FSS attenuated lipid peroxidation and nitric oxide formation in the liver induced by the high-fat diet. These results suggest that soybeans, especially FSS, may be useful in preventing obesity-induced abnormalities in lipid metabolism.
Alanine Transaminase ; Animals ; Aspartate Aminotransferases ; Body Weight ; Cholesterol ; Diet ; Diet, High-Fat ; Leptin ; Lipid Metabolism ; Lipid Peroxidation ; Liver ; Mice ; Mice, Inbred ICR* ; Mice, Obese ; Nitric Oxide ; Obesity ; Oxidative Stress ; Plasma ; Soybeans* ; Steam* ; Triglycerides

Objective: This study aims to investigate the prevalence and psychological impact of social isolation and loneliness in South Korea. Loneliness and social isolation have been regarded as a risk to both physical and mental health. However, most studies have focused on the elderly; hence, there are limited studies on the characteristics of socially isolated or lonely people considering age. Methods: A sample of 1,700 participants was selected from three major cities in South Korea. In-person interviews were conducted to evaluate loneliness, social isolation and mental health status. Results: Among the participants, the prevalence of social isolation and loneliness was 17.8% and 4.1%, respectively. Males decreased the odds of loneliness (AOR 0.49, 95% CI=0.28–0.87), while increasing the odds of social isolation (AOR 1.44, 95% CI=1.12–1.86) after adjusting for age and sex. Greater depressive and social phobic symptoms were associated with increased odds of loneliness and social isolation. Conclusion Social isolation and loneliness are prevalent among Koreans and associated with depression, social phobic symptoms, and suicidality. This study provides a foundation for further research to investigate nationwide prevalence and a more in-depth analysis of loneliness and social isolation.

Objective: This study aims to investigate the prevalence and psychological impact of social isolation and loneliness in South Korea. Loneliness and social isolation have been regarded as a risk to both physical and mental health. However, most studies have focused on the elderly; hence, there are limited studies on the characteristics of socially isolated or lonely people considering age. Methods: A sample of 1,700 participants was selected from three major cities in South Korea. In-person interviews were conducted to evaluate loneliness, social isolation and mental health status. Results: Among the participants, the prevalence of social isolation and loneliness was 17.8% and 4.1%, respectively. Males decreased the odds of loneliness (AOR 0.49, 95% CI=0.28–0.87), while increasing the odds of social isolation (AOR 1.44, 95% CI=1.12–1.86) after adjusting for age and sex. Greater depressive and social phobic symptoms were associated with increased odds of loneliness and social isolation. Conclusion Social isolation and loneliness are prevalent among Koreans and associated with depression, social phobic symptoms, and suicidality. This study provides a foundation for further research to investigate nationwide prevalence and a more in-depth analysis of loneliness and social isolation.