METHODS: A nationwide, population-based, retrospective cohort study was conducted using patient records from the Korean National Health Insurance Service database. For the period 2004-2019, patient data were categorized into 2 groups: a diagnosis of OSA (747 subjects) and no diagnosis of OSA (1,494 subjects). Subsequently, 1:2 propensity score matching was performed to ensure the homogeneity of the 2 groups. To analyze the risk of incident chronic periodontitis, a Cox proportional-hazards model was used to calculate hazard ratios (HRs) with 95% confidence intervals (CIs). RESULTS: In the Kaplan-Meier curve, the disease-free probability was significantly lower in the OSA group than in the non-OSA group (p for log-rank test=0.001). The crude HR for the association between OSA and chronic periodontitis was 1.29 (95% CI, 1.16 to 1.43). The multivariable-adjusted HR was calculated at 1.28 (95% CI, 1.15 to 1.42). CONCLUSIONS This study confirmed a relationship between OSA and chronic periodontitis. Therefore, OSA patients require oral care to prevent the progression of chronic periodontitis from mild to severe.

Malignant neoplasm associated with chronic empyema is rare. Most squamous cell carcinomas of the pleura may occur in association with chronic persistent empyema, with or without pleurocutaneous fistula. We report a case of squamous cell carcinoma associated with chronic empyema caused by a metallic foreign body.
Carcinoma, Squamous Cell* ; Empyema* ; Fistula ; Foreign Bodies ; Pleura

Benign laryngeal injuries have been usually differentiated by the clinical finding. Traditionally the pathologic findings between the polyps and nodules by hematoxylin and eosin(H and E) staining looks alike. So we have used immunohistochemical technique to differentiate the laryngeal response to injury. We have studied 25 paraffin embedded tissues(20 cases: vocal polyps, 5 cases: vocal nodules) to compare their distribution of fibronectin and type IV collagen in vocal fold lamina propria by using their monoclonal antibodies. We have chosen fibronectin, a critical structural glycoprotein in the lamina propria, because of its deposition as a result of tissue injury and type IV collagen because of its location only in the basement membrane zone. The results were as follows: 1) In vocal polyps there were sparse fibronectin(less than normal) staining in superficial layer of lamina propria and the type IV collagen staining in basement membrane zone shows thin, normal thickness band form. These suggests that the injury often seems to be confined to the lamina propria only without basement membrane zone disruption. 2) In voal nodules there were intense fibronectin staining(more than normal) in the superficial layer of the lamina propria and the type IV collagen band in basement membrane shows thick and often coupled with disruption injury. The above results represent only two structural proteins, but it may be possible to suggest that the pathogenesis and the development origin of these laryngeal injuries are different. The deposition of fibronectin may explain why some nodules do not respond to voice therapy and suggest the following better treatment.
Antibodies, Monoclonal ; Basement Membrane* ; Collagen Type IV* ; Fibronectins* ; Glycoproteins ; Hematoxylin ; Mucous Membrane* ; Paraffin ; Polyps ; Vocal Cords ; Voice

Paraneoplastic cancer polyarthritis is a very rare manifestation of musculoskeletal disorders associated with several solid and hematologic malignancies. We describe a 71-year-old woman who presented initially with an abrupt onset of rheumatoid arthritis-like symmetrical polyarthritis. The patient was diagnosed with pancreatic cancer with multiple hepatic metastases approximately six months later. Her symptoms of polyarthritis improved after the introduction of medication including non-steroidal anti-inflammatory drugs and disease modifying anti-rheumatic drugs. This case suggests that a hidden malignancy should always be considered in elderly patients, who present with an abrupt onset of symmetric polyarthritis for the first time in their life.
Aged ; Antirheumatic Agents ; Arthritis ; Arthritis, Rheumatoid ; Female ; Hematologic Neoplasms ; Humans ; Neoplasm Metastasis ; Pancreatic Neoplasms ; Paraneoplastic Syndromes

PURPOSE: Oral squamous carcinoma (OSCC) cells exhibit resistance to chemotherapeutic agent-mediated apoptosis in the late stage of malignancy. Increased levels of heat shock proteins 70 (HSP70) in cancer cells are known to confer resistance to apoptosis. Since recent advances in the understanding of bacterial toxins have produced new strategies for the treatment of cancers, we investigated the effect of Pseudomonas aeruginosa exotoxin A (PEA) on HSP70 expression and induction of apoptosis in chemoresistant OSCC cell line (YD-9). MATERIALS AND METHODS: The apoptotic effect of PEA on chemoresistant YD-9 cells was confirmed by MTT, Hoechst and TUNEL stains, DNA electrophoresis, and Western blot analysis. RESULTS: While YD-9 cells showed high resistance to chemotherapeutic agents such as etoposide and 5-fluorouraci (5-FU), HSP70 antisense oligonucelotides sensitized chemoresistant YD-9 cells to etoposide and 5-FU. On the other hand, PEA significantly decreased the viability of YD-9 cells by deteriorating the HSP70-relating protecting system through inhibition of HSP70 expression and inducing apoptosis in YD-9 cells. Apoptotic manifestations were evidenced by changes in nuclear morphology, generation of DNA fragmentation, and activation of caspases. While p53, p21, and E2F-1 were upregulated, cdk2 and cyclin B were downregulated by PEA treatment, suggesting that PEA caused cell cycle arrest at the G2/M checkpoint. CONCLUSION: Therefore, these results indicate that PEA reduced the chemoresistance through inhibition of HSP70 expression and also induced apoptosis in chemoresistant YD-9 cells.
ADP Ribose Transferases/*pharmacology ; Antineoplastic Agents/*pharmacology ; Apoptosis/drug effects ; Bacterial Toxins/*pharmacology ; Blotting, Western ; Carcinoma, Squamous Cell/drug therapy/*metabolism ; Cell Cycle/drug effects ; Cell Line, Tumor ; Chromatography, Liquid ; Cyclin B/metabolism ; Cyclin-Dependent Kinase 2/metabolism ; Drug Resistance, Neoplasm/*drug effects ; E2F1 Transcription Factor/metabolism ; Electrophoresis ; Exotoxins/*pharmacology ; HSP70 Heat-Shock Proteins/genetics/*metabolism ; Humans ; In Situ Nick-End Labeling ; Mouth Neoplasms/drug therapy/*metabolism ; Tandem Mass Spectrometry ; Tumor Suppressor Protein p53/metabolism ; Virulence Factors/*pharmacology

PURPOSE: This study was designed to evaluate the relationship between obesity and depressive trends in elementary school children. METHODS: In 1999, we surveyed 2,091 elementary school children(1,079 boys and 1,012 girls) whose ages ranged from 10 to 12 years. Obesity was defined as an obesity index over 20 percent. The degree of depression was compared between the obese group and the normal body weight group according to Korean Children's Depression Inventory(CDI) of Kovacs and Beck. RESULTS: Among the subjects, 1,884(88.2%) formed the normal body weight group, 128(6.1%) formed mildly obese group, 98(4.7%) formed the moderately obese group and 21(1.0%) formed the severely obese group. The mean depression score in the obese group was significantly higher than that of the normal body weight group, and the more severely obese the more significantly the depression score increased. The depression score of the obese girls' group was higher than the obese boys' group. The depression score was significantly higher in the obese group who hate exercise and like computer games, than in the group who like exercise and don't play computer games. The depression score was significantly higher in the obese group who hate physical education than the group who like it. CONCLUSION: The depression score of the obese group was significantly higher than normal body weight group in elementary school children. Physicians should provide psychological support in the treatments of obese children.
Child* ; Depression ; Hate ; Humans ; Ideal Body Weight ; Obesity* ; Physical Education and Training ; Video Games

The aims of this study were to determine the short-term effectiveness of an internet-based lifestyle modification (LSM) program in preventing the onset of type 2 diabetes mellitus (T2DM) in prediabetes patients in community settings. A total of 415 subjects who were diagnosed with prediabetes were randomly assigned to the LSM and standard management (SM) groups. After the 6-month intervention, the LSM group had a statistically significant reduction in body weight, body mass index compared to the SM group participants. In the LSM group, blood glucose levels were significantly decreased after intervention and the clinical improvement effect was evident in the group that achieved the target weight loss of 5% or more of the initial weight for 6 months. Internet-based 6-month-intensive LSM programs conducted by public health center personnel are an effective way to provide lifestyle intervention programs and encourage maintenance of healthy behaviors in subjects with a high risk of T2DM in community settings.

To protect patient autonomy when confronting death, the importance of advance directives (ADs) has recently became an issue and gradually accepted in Korea. However, in real practice, ADs were not completed by patients but their families in most cases. To analyze the current situation of performing ADs, we reviewed medical charts of 214 terminal cancer patients admitted to the hospice center from October 2012 to September 2013. Seventy-six (35.5%) patients completed ADs. All ADs were completed by patients themselves. The most common reason for not completing ADs was poor physical and/or mental condition. As a proxy, the majority of patients preferred their spouses (55.3%). Few patients wanted life sustaining treatment (1.3%), however palliative sedation was accepted in 89.5%. The median timing of ADs after admission was three (0-90) days, and duration of survival since ADs was 22 (1-340) days. In conclusion, approximately one third of terminal cancer patients completed ADs by themselves. Considering that patient's poor condition is the main reason for not completing ADs, earlier discussion regarding ADs is necessary to enhance patients' participation.
Adolescent ; Adult ; Advance Directives/psychology/*statistics & numerical data ; Aged ; Aged, 80 and over ; Female ; Hospices/*statistics & numerical data ; Humans ; Male ; Middle Aged ; Neoplasms/*mortality/psychology ; *Palliative Care ; Republic of Korea ; *Terminal Care ; Young Adult

To protect patient autonomy when confronting death, the importance of advance directives (ADs) has recently became an issue and gradually accepted in Korea. However, in real practice, ADs were not completed by patients but their families in most cases. To analyze the current situation of performing ADs, we reviewed medical charts of 214 terminal cancer patients admitted to the hospice center from October 2012 to September 2013. Seventy-six (35.5%) patients completed ADs. All ADs were completed by patients themselves. The most common reason for not completing ADs was poor physical and/or mental condition. As a proxy, the majority of patients preferred their spouses (55.3%). Few patients wanted life sustaining treatment (1.3%), however palliative sedation was accepted in 89.5%. The median timing of ADs after admission was three (0-90) days, and duration of survival since ADs was 22 (1-340) days. In conclusion, approximately one third of terminal cancer patients completed ADs by themselves. Considering that patient's poor condition is the main reason for not completing ADs, earlier discussion regarding ADs is necessary to enhance patients' participation.
Adolescent ; Adult ; Advance Directives/psychology/*statistics & numerical data ; Aged ; Aged, 80 and over ; Female ; Hospices/*statistics & numerical data ; Humans ; Male ; Middle Aged ; Neoplasms/*mortality/psychology ; *Palliative Care ; Republic of Korea ; *Terminal Care ; Young Adult

BACKGROUND: Clean intermittent catheterization is one of the management of the neurogenic bladder caused by such disease as spinal injury. The purpose of this study is to assess the amount of time in a microwave oven required to eliminate seven pathogens isolated from urine of the patients, and to evaluate the effect of repeated use of a microwave oven on the patency and pliability of silicon catheter. METHODS: Seven microorganisms isolated from urine of patients were used as inoculating pathogens. These included Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, Enterococcus faecalis, Enterococcus faecium, Staphylococcus aureus, Candida albicans. The silicon catheter was divided into six pieces (4 cm) and sterilized by ethylene oxide gas, Each piece of catheter was incubated for 60 minutes in a suspension of microorganisms, and placed in a plastic container. The piece was microwaved for 0 (control catheters) to 15 minutes a dose of 1,000 watts. Two methods were used. First method was a water-free method that was microwaved after removing water from the catheter. Second method was a water-added method that was microwaved after adding 5 mL of sterile water around the catheter. Then, that was placed in 15 mL sterile phosphate buffer in a conical tube. The fluid was cultured. Using a new silicon catheter, the microwave procedure was repeated until the catheter was no longer patent or pliable. RESULTS: Using a water-free method, E, coli, C. albicans were eliminated at 5 minutes, P. aeruginosa was at 8 minutes, K. pneumoniae, E. faecalis was at 12 minutes, but S. aureus was remained until 15 minutes, Using a water-added method, all strains were eliminated at 8 minutes. The characteristics of the silicon catheter after repeated procedures were not changed in patency or pliability until 100 times. CONCLUSION: The disinfection of silicon catheters using a microwave oven after adding water around the catheter was able to sterilize the frequent pathogens including C. albicans within 8 minutes. It was clinically useful to sterilize repeatedly the catheter using microwave oven without distorting the characteristics of the silicon catheter.
Candida albicans ; Catheters* ; Disinfection ; Enterococcus faecalis ; Enterococcus faecium ; Escherichia coli ; Ethylene Oxide ; Humans ; Intermittent Urethral Catheterization ; Klebsiella pneumoniae ; Microwaves* ; Plastics ; Pliability ; Pneumonia ; Pseudomonas aeruginosa ; Silicones ; Spinal Injuries ; Staphylococcus aureus ; Sterilization ; Urinary Bladder, Neurogenic ; Water