Background/Aims: It remains unclear which maintenance treatment modality is most appropriate for mild gastroesophageal reflux disease (GERD).We aimed to compare on-demand treatment with continuous treatment using a proton pump inhibitor (PPI) in the maintenance treatment for patients with non-erosive GERD or mild erosive esophagitis. Methods: Patients whose GERD symptoms improved after 4 weeks of standard dose PPI treatment were prospectively enrolled at 25 hospitals.Subsequently, the enrolled patients were randomly assigned to either an on-demand or a continuous maintenance treatment group, and followed in an 8-week interval for up to 24 weeks. Results: A total of 304 patients were randomized to maintenance treatment (continuous, n = 151 vs on-demand, n = 153). The primary outcome, the overall proportion of unwillingness to continue the assigned maintenance treatment modality, failed to confirm the noninferiority of on-demand treatment (45.9%) compared to continuous treatment (36.1%). Compared with the on-demand group, the GERD symptom and health-related quality of life scores significantly more improved and the overall satisfaction score was significantly higher in the continuous treatment group, particularly at week 8 and week 16 of maintenance treatment. Work impairment scores were not different in the 2 groups, but the prescription cost was less in the on-demand group. Serum gastrin levels significantly elevated in the continuous treatment group, but not in the on-demand group. Conclusions Continuous treatment seems to be more appropriate for the initial maintenance treatment of non-erosive GERD or mild erosive esophagitis than on-demand treatment. Stepping down to on-demand treatment needs to be considered after a sufficient period of continuous treatment.

BACKGROUND: We compared the efficacies of vildagliptin (50 mg twice daily) relative to pioglitazone (15 mg once daily) as an add-on treatment to metformin for reducing glycosylated hemoglobin (HbA1c) levels in Korean patients with type 2 diabetes. METHODS: The present study was a multicenter, randomized, active-controlled investigation comparing the effects of vildagliptin and pioglitazone in Korean patients receiving a stable dose of metformin but exhibiting inadequate glycemic control. Each patient underwent a 16-week treatment period with either vildagliptin or pioglitazone as an add-on treatment to metformin. RESULTS: The mean changes in HbA1c levels from baseline were -0.94% in the vildagliptin group and -0.6% in the pioglitazone group and the difference between the treatments was below the non-inferiority margin of 0.3%. The mean changes in postprandial plasma glucose (PPG) levels were -60.2 mg/dL in the vildagliptin group and -38.2 mg/dL in the pioglitazone group and these values significantly differed (P=0.040). There were significant decreases in the levels of total, low density lipoprotein, high density lipoprotein (HDL), and non-HDL cholesterol in the vildagliptin group but increases in the pioglitazone group. The mean change in body weight was -0.07 kg in the vildagliptin group and 0.69 kg in the pioglitazone group, which were also significantly different (P=0.002). CONCLUSION: As an add-on to metformin, the efficacy of vildagliptin for the improvement of glycemic control is not inferior to that of pioglitazone in Korean patients with type 2 diabetes. In addition, add-on treatment with vildagliptin had beneficial effects on PPG levels, lipid profiles, and body weight compared to pioglitazone.
Blood Glucose ; Body Weight ; Cholesterol ; Hemoglobin A, Glycosylated ; Humans ; Lipoproteins ; Metformin* ; Thiazolidinediones

In this article, on page 230, Fig. 2A needs to be corrected.

BACKGROUND AND OBJECTIVES: We compared the efficacy and safety of valsartan and rosuvastatin combination therapy with each treatment alone in hypercholesterolemic hypertensive patients. SUBJECTS AND METHODS: Patients who met inclusion criteria were randomized to receive 1 of the following 2-month drug regimens: valsartan 160 mg plus rosuvastatin 20 mg, valsartan 160 mg plus placebo, or rosuvastatin 20 mg plus placebo. The primary efficacy variables were change in sitting diastolic blood pressure (sitDBP) and sitting systolic blood pressure (sitSBP), and percentage change in low-density lipoprotein-cholesterol (LDL-C) in the combination, valsartan, and rosuvastatin groups. Adverse events (AEs) during the study were analyzed. RESULTS: A total of 354 patients were screened and 123 of them were finally randomized. Changes of sitDBP by least squares mean (LSM) were -11.1, -7.2, and -3.6 mm Hg, respectively, and was greater in the combination, as compared to both valsartan (p=0.02) and rosuvastatin (p<0.001). Changes of sitSBP by LSM were -13.2, -10.8, and -4.9 mm Hg, and was greater in the combination, as compared to rosuvastatin (p=0.006) and not valsartan (p=0.42). Percentage changes of LDL-C by LSM were -52, -4, and -47% in each group, and was greater in the combination, as compared to valsartan (p<0.001), similar to rosuvastatin (p=0.16). Most AEs were mild and resolved by the end of the study. CONCLUSION: Combination treatment with valsartan and rosuvastatin exhibited an additive blood pressure-lowering effect with acceptable tolerability, as compared to valsartan monotherapy. Its lipid lowering effect was similar to rosuvatatin monotherapy.
Blood Pressure ; Drug Therapy, Combination ; Humans ; Least-Squares Analysis ; Rosuvastatin Calcium ; Valsartan

OBJECTIVES: The present study aimed to evaluate the validity of a set of self-reported questionnaires for periodontitis for estimating the prevalence of chronic adult periodontitis in the Korean population. METHODS: The questionnaire is comprised of a total of 14 questions with four summarized concepts including self-diagnosis of oral status, subjective signs related to oral health, smoking and drinking status, and use of auxiliary oral hygiene devices including scaling. The predictiveness of the measures from these self-reported questions was assessed by logistic regression modeling using receiver operating characteristic (ROC) statistics, sensitivity, and specificity. RESULTS: The sensitivity, specificity, and AUC including all questions were 0.571, 0.768, and 0.781, respectively; the sum of sensitivity and specificity was 1.34. To gain robustness, a simplified predictive model was built with six questions. Its results were 0.536, 0.817, and 0.762 for sensitivity, specificity, and AUC, respectively. The sum of sensitivity and specificity was found to be 1.35. CONCLUSIONS: The self-reported questionnaire for periodontitis showed considerable validity, but further study is required to provide optimal validity and predictability.
Area Under Curve ; Chronic Periodontitis ; Drinking ; Logistic Models ; Oral Health ; Oral Hygiene ; Periodontal Diseases ; Periodontitis* ; Prevalence ; Surveys and Questionnaires* ; ROC Curve ; Sensitivity and Specificity ; Smoke ; Smoking

OBJECTIVES: This study aims to compare home care dental devices for their dental plaque removal ability. METHODS: A single blinded randomized crossover clinical study design was used to measure plaque index (Turesky Modification Quigley-Hein Plaque Index). RESULTS: All 3 groups showed a statistically significant decrease in the plaque index after usage (P<0.001). In manual tooth-brushing group, the teeth on the right dental arch showed a greater decrease in the plaque index than on the left arch (P=0.041). All appliances showed greater plaque reduction in the upper right posterior teeth than in the lower right posterior teeth (P=0.009, 0.004, 0.007). CONCLUSIONS: The results of this study support development of more effective oral hygiene appliances and emphasis on oral hygienic education.
Dental Arch ; Dental Devices, Home Care ; Dental Plaque Index ; Dental Plaque* ; Education ; Health Education ; Oral Hygiene* ; Tooth ; Vibration*

OBJECTIVES: The purpose of this study was to develop a self-administered questionnaire survey to determine its validity and reliability as well as to improve the instructions for measurement of periodontal disease during oral examination for reliably calculating the prevalence of periodontal disease. METHODS: The data obtained was analyzed using SPSS 20.0 and the WINSTEPS program that employs the Rasch model to evaluate validity and reliability of the instrument. RESULTS: We developed a self-administered questionnaire survey consisting of 14 questions based on NHANES. We confirmed the reliability by testing and re-testing the questionnaire survey using selfadministered methods. The average Kappa index obtained was 0.73, which indicated a relatively high reliability. CONCLUSIONS: Reliability and validity of the self-administered assessment tool for periodontal disease developed for the local situation/circumstances of Korea is suitable to be applied for oral examination of a large population. Moreover, the questionnaire survey for periodontal disease could be used to acquire data for constructing a database for oral health policy development.
Diagnosis, Oral ; Korea ; Nutrition Surveys ; Oral Health ; Periodontal Diseases* ; Policy Making ; Prevalence ; Surveys and Questionnaires* ; Reproducibility of Results*

OBJECTIVES: In 2002, the Ministry of Health and Welfare initiated a national sealant program (NSP) in public health centers in order to promote oral health among children in rural areas as well as among children with low socio-economic status in urban areas. However, this program was terminated in 2009 and substituted with the national insurance coverage of sealants (NICS). The aim of this study is to evaluate the impact of the change from NSP to NICS on regional inequality. METHODS: Based on data obtained from the 2010 and 2012 Korea National Oral Health surveys conducted, we analyzed the average number of permanent teeth with sealants (mean sealant) on the first molars and the prevalence of active dental caries in permanent teeth (D rate), segregated by region, in 8-year-old children. Analyses were performed using SPSS 21.0 (SPSS Inc., Chicago, IL, USA) after taking into consideration the complex design of the samples. RESULTS: The D rate of rural children was higher than that of those in metropolitan and city areas. Compared to the 2010 data on the mean sealants on the first molars, a 14.4% and 48.1% increase was observed in the mean sealants in children in the metropolis and in cities in 2012, respectively. However, this number decreased by 7.5% only in the rural areas. CONCLUSIONS: Accessibility to dental services was limited in the rural areas as compared than in other areas; this result is based on the fact that the D rate in rural areas was higher than that in other areas. The NSP has decreased this regional inequality with regard to the accessibility to dental services. However, it was suggested that the mean sealant on the first molars was reversed due to a change from NSP to NICS.
Child ; Dental Caries ; Humans ; Insurance Coverage* ; Korea ; Molar ; Oral Health ; Pit and Fissure Sealants ; Prevalence ; Public Health ; Socioeconomic Factors ; Tooth

The National Health Screening program has been implemented in Korea since 1980. First, we had searched recent scientific evidences and verified the accuracy of the data on target oral diseases. In order to determine the validity, we searched scientific bibliographic data and concluded that dental caries and periodontal disease were major oral problems. Second, we developed new improved forms for National Oral Health Screening. To improve these forms, we reviewed previous forms and gathered expert opinions. The new forms were consistent with the examination forms given to all age groups, and information on oral health conditions, dental education needs, and post-treatment care was included in the modified forms. We then designed manuals for dentists, which contained information on the screening criteria as well as consultation and patient education guidelines. The manuals were divided into three parts, including explanation of the screening criteria, standard of the decision, and education and consultation guidelines. By using these new and modified National Oral Health Screening forms, we expect an improvement in the National Oral Health Screening Program and enhancement in the oral health condition of patients.
Adult ; Counseling ; Dental Caries ; Dentists ; Education ; Education, Dental ; Expert Testimony ; Humans ; Infant ; Korea ; Mass Screening* ; Oral Health* ; Patient Education as Topic ; Periodontal Diseases ; Tooth Diseases

PURPOSE: This study was performed to identify correlations between keratocystic odontogenic tumor (KCOT) data from CT sections, and data on the KCOT clinical manifestation and resulting dental expenses. MATERIALS AND METHODS: Following local Institutional Review Board (IRB) approval, a seven-years of retrospective study was performed regarding patients with KCOTs treated at the Seoul National University Dental Hospital. A total of 180 KCOT were included in this study. The following information was collected: age, gender, location and size of the lesion, radiological features, surgical treatment provided and dental expenses. RESULTS: There was no significant association between the size of the KCOT and age, gender, and presenting preoperative symptoms. In both jaws, it was unusual to find KCOTs under 10 mm. The correlation between the number of teeth removed and the size of the KCOT in the tooth bearing area was statistically significant in the mandible, whereas in the maxilla, no significant relationship was found. Dental expenses compared with the size of the KCOT were found to be significant in both jaws. CONCLUSION: The size of KCOT was associated with a significant increase in dental expenses for both jaws and the number of teeth removed from the mandible. These findings emphasize the importance of routine examinations and early detection of lesions, which in turn helps preserving anatomical structures and reducing dental expenses.
Cost of Illness ; Ethics Committees, Research ; Humans ; Jaw ; Mandible ; Maxilla ; Odontogenic Cysts ; Odontogenic Tumors ; Retrospective Studies ; Tooth ; Ursidae