Background: Although excessive physical activity (PA) does not always confer additional health benefits, there is a paucity of studies that have quantitatively examined the doseresponse relationship between PA and type 2 diabetes. Therefore, this study investigated the relationship between the type 2 diabetes prevalence and intensity, frequency, and metabolic equivalent of task (MET) score of PA in a large population sample. Methods: We conducted a nationwide cross-sectional analysis examining sociodemographic variables, PA habits, and type 2 diabetes prevalence in 2,428,448 participants included in the Korea Community Health Survey. The non-linear association between MET score and odds ratios (ORs) for type 2 diabetes prevalence was plotted using a weighted generalized additive model. Categorical analysis was used to examine the joint association of moderate-intensity PA (MPA) and vigorous-intensity PA (VPA), and the influence of PA frequency. Results: MET score and diabetes prevalence revealed a non-linear association with the nadir at 1,028 MET-min/week, beyond which ORs increased with additional PA. Joint analysis of MPA and VPA showed the lowest OR of 0.79 (95% confidence interval, 0.75–0.84) for those engaging in 300–600 MET-min/week of MPA and > 600 MET-min/week of VPA concurrently, corresponding with World Health Organization recommendations. Additionally, both “weekend warriors” and “regularly active” individuals showed lower ORs compared to the inactive, although no significant difference was noted between the active groups. Conclusion In a large South Korean sample, higher PA is not always associated with a lower prevalence of type 2 diabetes, as the association follows a non-linear pattern; differences existed across sociodemographic variables. Considering the joint association, an adequate combination of MPA and VPA is recommended. The frequency of PA does not significantly influence the type 2 diabetes prevalence.

Obstructive sleep apnea (OSA), characterized by nocturnal airway obstruction, hypoxia, and arousal, is a significant risk factor for cardiovascular diseases, including arrhythmia. This case report describes the association between OSA and nocturnal sinus tachycardia in a 58-year-old woman who presented with sleep maintenance difficulties and recurrent nocturnal tachycardia. Polysomnography confirmed a direct correlation among the apnea/hypopnea episodes, tachycardia, and sleep maintenance difficulties. Continuous positive airway pressure therapy effectively resolved tachycardia and sleep maintenance difficulties, reducing the number of medications required to alleviate the symptoms. This report highlights the importance of considering OSA as a possible cause of unexplained nocturnal tachycardia.

The study aimed to evaluate the skeletal, dentoalveolar, and soft-tissue effects of prefabricated myofunctional appliances in pediatric patients with Class II malocclusion. Twenty-three patients (12 boys and 11 girls; mean chronological age 9.03 ± 1.90 years) with Class Ⅱ malocclusion who were treated with Éducation Fonctionnelle (EF line®) (Orthoplus, Igny, France) were assessed. Radiographic analysis using lateral cephalograms was conducted at treatment initiation and following a 12-month intervention period, with an average monitoring duration of 14.13 ± 2.82 months. Cephalometric evaluation was performed using V-ceph™ (Osstem, Seoul, Korea), and the Wilcoxon signed-rank test was employed for data analysis. The results demonstrated significant improvements in sagittal relationships, including decreased ANB angle and Wits appraisal, as well as increased SNB angle. Mandibular growth was evident through increases in mandibular length measurements (Co-Go, Co-Gn, and Go-Gn). Vertically, backward and downward rotation of the mandible was observed, as evidenced by increases in FMA, SN-MP, and Y-axis angles, resulting in significant increases in facial height. Dentoalveolar changes were characterized by lingual inclination of the maxillary incisors and labial tipping of the mandibular incisors, with significant reductions in both overjet and overbite. Soft tissue analysis revealed enhanced facial esthetics through increases in the nasolabial and mentolabial angles, accompanied by reduced upper lip protrusion. In conclusion, this study validated the clinical efficacy of prefabricated myofunctional appliances in managing Class II malocclusions.

Silver diamine fluoride (SDF) is recognized as a reliable option for inhibiting caries progression without tooth removal and for preventing new lesions. However, most studies have focused on the management of dentin caries, and few studies have explored the use of SDF in conjunction with light curing for enamel caries. This study evaluated the effects of SDF and potassium iodide (KI) with additional light curing on the remineralization of artificially induced enamel caries. Sixty-four specimens were prepared from 32 primary molars. Of these, two were used to observe polished sound enamel surfaces, whereas the remaining 62 were demineralized to artificially induce caries. After excluding two specimens to observe the carious enamel surface, 60 specimens were randomly divided into four groups: Group I (SDF for 60 s), Group II (SDF for 10 s), Group III (SDF for 10 s + light curing for 3 s), and Group IV (SDF for 10 s + KI + light curing for 3 s). After the allocated interventions, all specimens were subjected to pH cycling for 8 days. The Vickers microhardness, surface morphology, and chemical composition of enamel were analyzed using a microhardness tester, field-emission scanning electron microscopy (FE-SEM), and energy dispersive X-ray spectroscopy (EDS), respectively. Group IV exhibited the greatest increase in microhardness, followed by Group III, with significant differences between the groups. Groups I and II showed smaller increases, without significant differences between the groups. SEM-EDS analysis revealed higher silver deposition in the lightcured groups, and iodine peaks were observed in Group IV, confirming the formation of silver iodide. The combination of SDF, KI, and light curing could enhance enamel remineralization and shorten the application time compared with that for SDF alone.

Background: Although excessive physical activity (PA) does not always confer additional health benefits, there is a paucity of studies that have quantitatively examined the doseresponse relationship between PA and type 2 diabetes. Therefore, this study investigated the relationship between the type 2 diabetes prevalence and intensity, frequency, and metabolic equivalent of task (MET) score of PA in a large population sample. Methods: We conducted a nationwide cross-sectional analysis examining sociodemographic variables, PA habits, and type 2 diabetes prevalence in 2,428,448 participants included in the Korea Community Health Survey. The non-linear association between MET score and odds ratios (ORs) for type 2 diabetes prevalence was plotted using a weighted generalized additive model. Categorical analysis was used to examine the joint association of moderate-intensity PA (MPA) and vigorous-intensity PA (VPA), and the influence of PA frequency. Results: MET score and diabetes prevalence revealed a non-linear association with the nadir at 1,028 MET-min/week, beyond which ORs increased with additional PA. Joint analysis of MPA and VPA showed the lowest OR of 0.79 (95% confidence interval, 0.75–0.84) for those engaging in 300–600 MET-min/week of MPA and > 600 MET-min/week of VPA concurrently, corresponding with World Health Organization recommendations. Additionally, both “weekend warriors” and “regularly active” individuals showed lower ORs compared to the inactive, although no significant difference was noted between the active groups. Conclusion In a large South Korean sample, higher PA is not always associated with a lower prevalence of type 2 diabetes, as the association follows a non-linear pattern; differences existed across sociodemographic variables. Considering the joint association, an adequate combination of MPA and VPA is recommended. The frequency of PA does not significantly influence the type 2 diabetes prevalence.

Obstructive sleep apnea (OSA), characterized by nocturnal airway obstruction, hypoxia, and arousal, is a significant risk factor for cardiovascular diseases, including arrhythmia. This case report describes the association between OSA and nocturnal sinus tachycardia in a 58-year-old woman who presented with sleep maintenance difficulties and recurrent nocturnal tachycardia. Polysomnography confirmed a direct correlation among the apnea/hypopnea episodes, tachycardia, and sleep maintenance difficulties. Continuous positive airway pressure therapy effectively resolved tachycardia and sleep maintenance difficulties, reducing the number of medications required to alleviate the symptoms. This report highlights the importance of considering OSA as a possible cause of unexplained nocturnal tachycardia.

The study aimed to evaluate the skeletal, dentoalveolar, and soft-tissue effects of prefabricated myofunctional appliances in pediatric patients with Class II malocclusion. Twenty-three patients (12 boys and 11 girls; mean chronological age 9.03 ± 1.90 years) with Class Ⅱ malocclusion who were treated with Éducation Fonctionnelle (EF line®) (Orthoplus, Igny, France) were assessed. Radiographic analysis using lateral cephalograms was conducted at treatment initiation and following a 12-month intervention period, with an average monitoring duration of 14.13 ± 2.82 months. Cephalometric evaluation was performed using V-ceph™ (Osstem, Seoul, Korea), and the Wilcoxon signed-rank test was employed for data analysis. The results demonstrated significant improvements in sagittal relationships, including decreased ANB angle and Wits appraisal, as well as increased SNB angle. Mandibular growth was evident through increases in mandibular length measurements (Co-Go, Co-Gn, and Go-Gn). Vertically, backward and downward rotation of the mandible was observed, as evidenced by increases in FMA, SN-MP, and Y-axis angles, resulting in significant increases in facial height. Dentoalveolar changes were characterized by lingual inclination of the maxillary incisors and labial tipping of the mandibular incisors, with significant reductions in both overjet and overbite. Soft tissue analysis revealed enhanced facial esthetics through increases in the nasolabial and mentolabial angles, accompanied by reduced upper lip protrusion. In conclusion, this study validated the clinical efficacy of prefabricated myofunctional appliances in managing Class II malocclusions.

Silver diamine fluoride (SDF) is recognized as a reliable option for inhibiting caries progression without tooth removal and for preventing new lesions. However, most studies have focused on the management of dentin caries, and few studies have explored the use of SDF in conjunction with light curing for enamel caries. This study evaluated the effects of SDF and potassium iodide (KI) with additional light curing on the remineralization of artificially induced enamel caries. Sixty-four specimens were prepared from 32 primary molars. Of these, two were used to observe polished sound enamel surfaces, whereas the remaining 62 were demineralized to artificially induce caries. After excluding two specimens to observe the carious enamel surface, 60 specimens were randomly divided into four groups: Group I (SDF for 60 s), Group II (SDF for 10 s), Group III (SDF for 10 s + light curing for 3 s), and Group IV (SDF for 10 s + KI + light curing for 3 s). After the allocated interventions, all specimens were subjected to pH cycling for 8 days. The Vickers microhardness, surface morphology, and chemical composition of enamel were analyzed using a microhardness tester, field-emission scanning electron microscopy (FE-SEM), and energy dispersive X-ray spectroscopy (EDS), respectively. Group IV exhibited the greatest increase in microhardness, followed by Group III, with significant differences between the groups. Groups I and II showed smaller increases, without significant differences between the groups. SEM-EDS analysis revealed higher silver deposition in the lightcured groups, and iodine peaks were observed in Group IV, confirming the formation of silver iodide. The combination of SDF, KI, and light curing could enhance enamel remineralization and shorten the application time compared with that for SDF alone.

Purpose: This study assessed the reproducibility and clinical value of the vascular index (VI), derived from superb microvascular imaging (SMI) using Doppler ultrasonography, for evaluating renal function in transplanted kidneys. Methods: This retrospective study included 63 renal transplant patients who underwent grayscale and Doppler ultrasonography with SMI from January 2022 to February 2023. The VI of the transplanted kidneys was measured using three methods (VI_box, VI_F1, VI_F2). The VI was compared across chronic kidney disease (CKD) groups categorized by estimated glomerular filtration rate (eGFR) and Kidney Disease: Improving Global Outcomes (KDIGO) CKD risk groups based on eGFR and albuminuria. The correlation between VI and renal function was evaluated. Univariate and multivariate linear regression analyses were used to identify predictors of eGFR. Results: Significant differences in VI were observed among CKD groups based on eGFR (VI_box, P=0.001; VI_F1, P<0.001; VI_F2, P<0.001) and KDIGO CKD groups based on eGFR and albuminuria (VI_box, P=0.039; VI_F1, P=0.001; VI_F2, P<0.001). VI_F1 and VI_F2 demonstrated moderate/high correlations with eGFR (r=0.627, P<0.001 and r=0.657, P<0.001, respectively) and serum creatinine (r=-0.626, P<0.001 and r=-0.649, P<0.001, respectively). VI_box moderately correlated with eGFR (r=0.445, P<0.001). Multivariate regression identified the urine albumincreatinine ratio (ACR) (adjusted odds ratio [aOR], 1.122; 95% confidence interval [CI], -0.007 to, 0.000; P=0.030) and VI_F2 (aOR, 1.114; 95% CI, 0.466 to 1.235; P<0.001) were independently associated with eGFR. Conclusion The VI measured by drawing a region of interest along the border of the transplanted kidney in SMI (VI_F2) is highly reproducible and correlates well with eGFR. Both VI_F2 and ACR independently predict eGFR.

Purpose: To investigate the association between soluble suppressor of tumorigenicity 2 (sST2) levels and cardiovascular disease predictors in patients with gout. Materials and Methods: We retrospectively reviewed the medical records of patients with gout who were tested for sST2 but did not receive uric acid-lowering therapy. These patients were classified into elevated and normal sST2 groups using a cut-off of >49.6 ng/mL and >35.4 ng/mL in males and females, respectively. Correlations between clinical and laboratory variables, sST2 levels, and elevated sST2 level predictors were assessed using linear and logistic regression analyses. Results: Notably, 27 (11.3%) and 211 (88.7%) of the 238 identified patients had elevated and normal sST2 levels, respectively. Linear regression analysis revealed that male sex (β=-0.190, p=0.002), body mass index (BMI) (β=-0.184, p=0.002), white blood cell count (β=0.231, p<0.001), C-reactive protein (β=0.135, p=0.031), and fasting blood glucose (β=0.210, p<0.001) were independently associated with sST2 levels. In multivariate logistic regression analysis, male sex [odds ratio (OR) 0.112, p=0.001], BMI (OR 0.836, p=0.008), creatinine (OR 5.730, p=0.024), and fasting blood glucose (OR 1.042, p=0.002) predicted elevated sST2 levels. Patients with increased sST2 levels had a significantly higher atherosclerotic cardiovascular disease risk score and a greater proportion of high-risk Framingham Risk Score compared to the normal sST2 group (p=0.002 and p<0.001). Conclusion Patients with gout and elevated sST2 levels have a higher risk of future cardiovascular disorders, which may provide insights into risk stratification and the implementation of intervention strategies.