This report presents the case of severe tooth wear and vertical dimension loss in a 71-year-old male patient. A combined conventional and digital approach was employed for full-mouth rehabilitation. After determining an increase in the vertical dimension of 5.5 mm using an anterior jig and diagnostic wax-up, provisional restorations were fabricated and adjusted throughout the adaptation period.For the fabrication of the final prosthesis, digital methodologies such as oral scanning and occlusal acquisition were performed. To obtain precise margin data, a die model was fabricated using the traditional impression method, followed by model scanning, which was then combined with intraoral scan data. The final prosthesis was made of zirconia to enhance esthetics and strength. Consequently, the treatment enhanced both function and esthetics, leading to high patient satisfaction with the outcomes.

Purpose: Cuscuta australis R. Brown (CA) is a parasitic plant that attaches to host plants and disrupts the growth, nutrient absorption, and overall development of leguminous plants.However, CA is known to contain various bioactive components, including vitamin A, β-carotene, lutein, and kaempferol, which have demonstrated pharmacological effects in immune responses. This study aims to investigate the potential benefits of CA extracts obtained using different extraction methods to explore its potential as a novel natural resource for applications in the food and pharmaceutical industries. Methods: In this study, water (CAW), ethanol (CAE), and hot water (CAHW) extracts of CA were prepared to investigate their antioxidant and anti-inflammatory effects in RAW264.7 cells. Results: The CAHW group exhibited the highest levels of antioxidant compounds, such as total polyphenols and flavonoids, resulting in a significantly higher ferric reducing antioxidant power compared to the other groups. The 1,1-diphenyl-2-picrylhydrazyl and 2,2-azino-bis-3-ethylen-benzothiazoline-6-sulfonate radical scavenging activities were also high in the CAHW and CAE groups but were lower compared to the positive control, ascorbic acid. In RAW264.7 cells, CA extracts at concentrations of 50, 100, and 200 μg/mL showed no cytotoxicity, and nitric oxide (NO) production was reduced in a dose-dependent manner.At a concentration of 200 μg/mL, all the CA extracts exhibited significant anti-inflammatory activity by modulating the nuclear factor kappa B signaling pathway, effectively resulting in the down-regulation of inflammation-related genes such as cyclooxygenase-2, inducible NO synthase, tumor necrosis factor-alpha, and interleukin-6 in RAW264.7 cells, with the CAHW extract demonstrating the most potent inhibitory effect among all the CA extract groups. Conclusion Overall, CA extraction is effective for both antioxidant and anti-inflammatory activities, with the hot water extraction method proving to be the most effective.

Purpose: Cuscuta australis R. Brown (CA) is a parasitic plant that attaches to host plants and disrupts the growth, nutrient absorption, and overall development of leguminous plants.However, CA is known to contain various bioactive components, including vitamin A, β-carotene, lutein, and kaempferol, which have demonstrated pharmacological effects in immune responses. This study aims to investigate the potential benefits of CA extracts obtained using different extraction methods to explore its potential as a novel natural resource for applications in the food and pharmaceutical industries. Methods: In this study, water (CAW), ethanol (CAE), and hot water (CAHW) extracts of CA were prepared to investigate their antioxidant and anti-inflammatory effects in RAW264.7 cells. Results: The CAHW group exhibited the highest levels of antioxidant compounds, such as total polyphenols and flavonoids, resulting in a significantly higher ferric reducing antioxidant power compared to the other groups. The 1,1-diphenyl-2-picrylhydrazyl and 2,2-azino-bis-3-ethylen-benzothiazoline-6-sulfonate radical scavenging activities were also high in the CAHW and CAE groups but were lower compared to the positive control, ascorbic acid. In RAW264.7 cells, CA extracts at concentrations of 50, 100, and 200 μg/mL showed no cytotoxicity, and nitric oxide (NO) production was reduced in a dose-dependent manner.At a concentration of 200 μg/mL, all the CA extracts exhibited significant anti-inflammatory activity by modulating the nuclear factor kappa B signaling pathway, effectively resulting in the down-regulation of inflammation-related genes such as cyclooxygenase-2, inducible NO synthase, tumor necrosis factor-alpha, and interleukin-6 in RAW264.7 cells, with the CAHW extract demonstrating the most potent inhibitory effect among all the CA extract groups. Conclusion Overall, CA extraction is effective for both antioxidant and anti-inflammatory activities, with the hot water extraction method proving to be the most effective.

Purpose: Cuscuta australis R. Brown (CA) is a parasitic plant that attaches to host plants and disrupts the growth, nutrient absorption, and overall development of leguminous plants.However, CA is known to contain various bioactive components, including vitamin A, β-carotene, lutein, and kaempferol, which have demonstrated pharmacological effects in immune responses. This study aims to investigate the potential benefits of CA extracts obtained using different extraction methods to explore its potential as a novel natural resource for applications in the food and pharmaceutical industries. Methods: In this study, water (CAW), ethanol (CAE), and hot water (CAHW) extracts of CA were prepared to investigate their antioxidant and anti-inflammatory effects in RAW264.7 cells. Results: The CAHW group exhibited the highest levels of antioxidant compounds, such as total polyphenols and flavonoids, resulting in a significantly higher ferric reducing antioxidant power compared to the other groups. The 1,1-diphenyl-2-picrylhydrazyl and 2,2-azino-bis-3-ethylen-benzothiazoline-6-sulfonate radical scavenging activities were also high in the CAHW and CAE groups but were lower compared to the positive control, ascorbic acid. In RAW264.7 cells, CA extracts at concentrations of 50, 100, and 200 μg/mL showed no cytotoxicity, and nitric oxide (NO) production was reduced in a dose-dependent manner.At a concentration of 200 μg/mL, all the CA extracts exhibited significant anti-inflammatory activity by modulating the nuclear factor kappa B signaling pathway, effectively resulting in the down-regulation of inflammation-related genes such as cyclooxygenase-2, inducible NO synthase, tumor necrosis factor-alpha, and interleukin-6 in RAW264.7 cells, with the CAHW extract demonstrating the most potent inhibitory effect among all the CA extract groups. Conclusion Overall, CA extraction is effective for both antioxidant and anti-inflammatory activities, with the hot water extraction method proving to be the most effective.

Background: A healthcare system’s collapse due to a pandemic, such as the coronavirus disease 2019 (COVID-19), can expose healthcare workers (HCWs) to various mental health problems. This study aimed to investigate the impact of the COVID-19 pandemic on the depression and anxiety of HCWs. Methods: A nationwide questionnaire-based survey was conducted on HCWs who worked in healthcare facilities and public health centers in Korea in December 2020. Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder-7 (GAD-7) were used to measure depression and anxiety. To investigate factors associated with depression and anxiety, stepwise multiple logistic regression analysis was performed. Results: A total of 1,425 participating HCWs were included. The mean depression score (PHQ-9) of HCWs before and after COVID-19 increased from 2.37 to 5.39, and the mean anxiety score (GAD-7) increased from 1.41 to 3.41. The proportion of HCWs with moderate to severe depression (PHQ-9 ≥ 10) increased from 3.8% before COVID-19 to 19.5% after COVID-19, whereas that of HCWs with moderate to severe anxiety (GAD-7 ≥ 10) increased from 2.0% to 10.1%. In our study, insomnia, chronic fatigue symptoms and physical symptoms after COVID-19, anxiety score (GAD-7) after COVID-19, living alone, and exhaustion were positively correlated with depression. Furthermore, post-traumatic stress symptoms, stress score (Global Assessment of Recent Stress), depression score (PHQ-9) after COVID-19, and exhaustion were positively correlated with anxiety. Conclusion In Korea, during the COVID-19 pandemic, HCWs commonly suffered from mental health problems, including depression and anxiety. Regularly checking the physical and mental health problems of HCWs during the COVID-19 pandemic is crucial, and social support and strategy are needed to reduce the heavy workload and psychological distress of HCWs.

This study aimed to evaluate the differences in the baseline characteristics and patterns of antibiotic usage among hospitals based on their participation in the Korea National Antimicrobial Use Analysis System (KONAS). We obtained claims data from the National Health Insurance for inpatients admitted to all secondary- and tertiary-care hospitals between January 2020 and December 2021 in Korea. 15.9% (58/395) of hospitals were KONAS participants, among which the proportion of hospitals with > 900 beds (31.0% vs.2.6%, P < 0.001) and tertiary care (50.0% vs. 5.2%, P < 0.001) was higher than that among non-participants. The consumption of antibiotics targeting antimicrobial-resistant gram positive bacteria (33.7 vs. 27.1 days of therapy [DOT]/1,000 patient-days, P = 0.019) and antibiotics predominantly used for resistant gram-negative bacteria (4.8 vs. 3.7 DOT/1,000 patient-days, P = 0.034) was higher in KONAS-participating versus -non-participating hospitals. The current KONAS data do not fully represent all secondary- and tertiary-care hospitals in Korea; thus, the KONAS results should be interpreted with caution.

Background: As the coronavirus disease 2019 (COVID-19) pandemic is ongoing, heavy workload of healthcare workers (HCWs) is a concern. This study investigated the workload of HCWs responding to the COVID-19 outbreak in South Korea. Methods: A nationwide cross-sectional survey was conducted from September 16 to October 15, 2020, involving 16 healthcare facilities (4 public medical centers, 12 tertiary-care hospitals) that provide treatment for COVID-19 patients. Results: Public medical centers provided the majority (69.4%) of total hospital beds for COVID-19 patients (n = 611), on the other hand, tertiary care hospitals provided the majority (78.9%) of critical care beds (n = 57). The number of beds per doctor (median [IQR]) in public medical centers was higher than in tertiary care hospitals (20.2 [13.0, 29.4] versus 3.0 [1.3, 6.6], P = 0.006). Infectious Diseases physicians are mostly (80%) involved among attending physicians. The number of nurses per patient (median [interquartile range, IQR]) in tertiarycare hospitals was higher than in public medical centers (4.6 [3.4–5] vs. 1.1 [0.8–2.1], P =0.089). The median number of nurses per patient for COVID-19 patients was higher than the highest national standard in South Korea (3.8 vs. 2 for critical care). All participating healthcare facilities were also operating screening centers, for which a median of 2 doctors, 5 nurses, and 2 administrating staff were necessary. Conclusion As the severity of COVID-19 patients increases, the number of HCWs required increases. Because the workload of HCWs responding to the COVID-19 outbreak is much greater than other situations, a workforce management plan regarding this perspective is required to prevent burnout of HCWs.

Background/Aims: Steatohepatitis related to metabolic syndrome is a chronic liver disease prevalent in patients not only with non-alcoholic steatohepatitis but also with alcoholic liver disease and chronic viral hepatitis. On the other hand, there is limited data on the effects of hepatotonic agents in these patients. Therefore, this study evaluated the efficacy of a combined hepatotonic agent in this population. Methods: Thirty-three adults with chronic hepatitis and one or more components of metabolic syndrome were assigned randomly to receive biphenyl dimethyl dicarboxylate/ursodeoxycholic acid or a placebo for 24 weeks. The primary outcome was the normalization of ALT (≤40 U/L). The secondary outcomes were the change in controlled attenuation parameter, transient elastography, and Chronic Liver Disease Questionnaire score. Results: The 33 patients were assigned randomly to two groups. Eight (50%) of 16 patients who received the intervention drug showed the normalization of ALT, whereas only one (6%) of 17 patients in the placebo group did so. In contrast, the change in controlled attenuation, transient elastography, and Chronic Liver Disease Questionnaire were similar in the two groups. ALT was changed significantly during the four assessment periods, and this change was affected by the group. The interaction between the group and time was also significant. AST was changed significantly during the same period. This change was not affected by the group. Conclusions Biphenyl dimethyl dicarboxylate/ursodeoxycholic acid combination reduced ALT in chronic liver disease related to metabolic syndrome. On the other hand, there is no evidence that this leads to improved hepatic steatosis and fibrosis within 6 months.

Background/Aims: Steatohepatitis related to metabolic syndrome is a chronic liver disease prevalent in patients not only with non-alcoholic steatohepatitis but also with alcoholic liver disease and chronic viral hepatitis. On the other hand, there is limited data on the effects of hepatotonic agents in these patients. Therefore, this study evaluated the efficacy of a combined hepatotonic agent in this population. Methods: Thirty-three adults with chronic hepatitis and one or more components of metabolic syndrome were assigned randomly to receive biphenyl dimethyl dicarboxylate/ursodeoxycholic acid or a placebo for 24 weeks. The primary outcome was the normalization of ALT (≤40 U/L). The secondary outcomes were the change in controlled attenuation parameter, transient elastography, and Chronic Liver Disease Questionnaire score. Results: The 33 patients were assigned randomly to two groups. Eight (50%) of 16 patients who received the intervention drug showed the normalization of ALT, whereas only one (6%) of 17 patients in the placebo group did so. In contrast, the change in controlled attenuation, transient elastography, and Chronic Liver Disease Questionnaire were similar in the two groups. ALT was changed significantly during the four assessment periods, and this change was affected by the group. The interaction between the group and time was also significant. AST was changed significantly during the same period. This change was not affected by the group. Conclusions Biphenyl dimethyl dicarboxylate/ursodeoxycholic acid combination reduced ALT in chronic liver disease related to metabolic syndrome. On the other hand, there is no evidence that this leads to improved hepatic steatosis and fibrosis within 6 months.

To develop a clinical practice guideline for vaccination in patients with autoimmune inflammatory rheumatic disease (AIIRD), the Korean College of Rheumatology and theKorean Society of Infectious Diseases developed a clinical practice guideline according to the clinical practice guideline development manual. Since vaccination is unlikely to cause AIIRD or worsen disease activities, required vaccinations are recommended. Once patients are diagnosed with AIIRD, treatment strategies should be established and, at the same time, monitor their vaccination history. It is recommended to administer vaccines when the disease enters the stabilized stage. Administering live attenuated vaccines in patients with AIIRD who are taking immunosuppressants should be avoided. Vaccination should be considered in patients with AIIRD, prior to initiating immunosuppressants. It is recommended to administer influenza, Streptococcus pneumoniae, hepatitis A, hepatitis B, herpes zoster, measlesmumps- rubella virus, human papillomavirus, and tetanus-diphtheria-pertussis vaccines in patients with AIIRD; such patients who planned to travel are generally recommended to be vaccinated at the recommended vaccine level of healthy adults. Those who live in a household with patients with AIIRD and their caregivers should also be vaccinated at levels that are generally recommended for healthy adults.