Purpose: This retrospective study aimed to assess the long-term cumulative survival rate of titanium, sandblasted, large-grit, acid-etched implants over a 10-year follow-up period and investigate the factors affecting the survival rate and change in marginal bone loss (MBL). Methods: The study included 400 patients who underwent dental implant placement at the Department of Periodontology of Seoul National University Dental Hospital (SNUDH) between 2005 and 2015. Panoramic radiographic images and dental records of patients were collected and examined using Kaplan-Meier analysis, Cox proportional hazards regression analysis, and multiple regression analysis to determine the survival rates and identify any factors related to implant failure and MBL. Results: A total of 782 implants were placed with a follow-up period ranging from 0 to 16 years (mean: 8.21±3.75 years). Overall, 25 implants were lost, resulting in a cumulative survival rate of 96.8%. Comparisons of the research variables regarding cumulative survival rate mostly yielded insignificant results. The mean mesial and distal MBLs were 1.85±2.31 mm and 1.59±2.03 mm, respectively. Factors influencing these values included age, diabetes mellitus (DM), jaw location, implant diameter, bone augmentation surgery, and prosthetic unit. Conclusions This study found that the implant survival rates at SNUDH fell within the acceptable published criteria. The patients’ sex, age, DM status, implant location, implant design, implant size, surgical type, bone augmentation, and prosthetic unit had no discernible influence on long-term implant survival. Sandblasted, large-grit, acid-etched implants might offer advantages in terms of implant longevity and consistent clinical outcomes.

OBJECTIVES: The escalating burden of cardiovascular disease (CVD) is a critical public health issue worldwide. CVD, especially acute myocardial infarction (AMI) and stroke, is the leading contributor to morbidity and mortality in Korea. We aimed to develop algorithms for identifying AMI and stroke events from the National Health Insurance Service (NHIS) database and validate these algorithms through medical record review. METHODS: We first established a concept and definition of “hospitalization episode,” taking into account the unique features of health claims-based NHIS database. We then developed first and recurrent event identification algorithms, separately for AMI and stroke, to determine whether each hospitalization episode represents a true incident case of AMI or stroke. Finally, we assessed our algorithms’ accuracy by calculating their positive predictive values (PPVs) based on medical records of algorithm- identified events. RESULTS: We developed identification algorithms for both AMI and stroke. To validate them, we conducted retrospective review of medical records for 3,140 algorithm-identified events (1,399 AMI and 1,741 stroke events) across 24 hospitals throughout Korea. The overall PPVs for the first and recurrent AMI events were around 92% and 78%, respectively, while those for the first and recurrent stroke events were around 88% and 81%, respectively. CONCLUSIONS We successfully developed algorithms for identifying AMI and stroke events. The algorithms demonstrated high accuracy, with PPVs of approximately 90% for first events and 80% for recurrent events. These findings indicate that our algorithms hold promise as an instrumental tool for the consistent and reliable production of national CVD statistics in Korea.

This study compared levels of whole grain consumption-related predisposing, reinforcing, and enabling factors according to socio-demographic variables, and examined how these factors are associated with whole grain consumption frequency among Korean adults. A survey questionnaire was administered to a convenience sample of adult males and females aged 20~59 years (n=300). The questionnaire included questions on predisposing, reinforcing, and enabling factors in relation to whole grain consumption as well as a brief whole grain food frequency questionnaire. Female subjects showed a significantly higher level of negative beliefs on health.nutrition.taste.texture while showing a significantly lower level of social support compared to that of males. The age group of 40~59 years showed a significantly higher social support level than the age group of 20~39 years. Results from multivariate regression analyses showed that different combinations of predisposing, reinforcing, and enabling variables were significant in predicting whole grain consumption frequency according to sex and age. The study findings can be used for developing specific target-oriented nutrition intervention programs for promotion of whole grain intake among Korean adults.
Adult* ; Causality* ; Edible Grain* ; Female ; Humans ; Male ; Surveys and Questionnaires

PURPOSE: Myotonic dystrophy 1 (DM1, OMIM 160900) is an autosomal-dominant muscular disorder caused by an expansion of CTG repeats in the 3' UTR of the DMPK gene. Variable expansions of CTG repeats preclude the accurate determination of repeat size. We tried to show the clinical and analytical validity of the application of Southern blotting after long-range PCR was demonstrated in Korean DM1 patients. MATERIALS AND METHODS: The Southern blotting of long-range PCR was applied to 1,231 cases with clinical suspicion of DM1, between 2000 and 2011. PCR was performed using genomic DNA with forward 5'-CAGTTCACAACCGCTCCGAGC-3' and reverse 5'-CGTGGAGGATGGAACACGGAC-3' primers. Subsequently, the PCR fragments were subjected to gel electrophoresis, capillary transfer to a nylon membrane, hybridization with a labeled (CAG)10 probe. The correlation between clinical manifestations and the CTG repeat expansions were analyzed. RESULTS: Among a total of 1,231 tested cases, 642 individuals were diagnosed with DM1 and the range of the detected expansion was 50 to 2,500 repeats; fourteen cases with mild DM1 (75+/-14 repeats), 602 cases with classical DM1 (314+/-143 repeats), and 26 cases with congenital DM1 (1,219+/-402 repeats). The positive and negative predictive values were 100%. The age at test requested and the CTG repeat numbers were inversely correlated (R=-0.444, P<0.01). CONCLUSION: This study indicates that Southern blotting after long-range PCR is a reliable diagnostic method DM1.
3' Untranslated Regions ; Blotting, Southern ; Chimera ; Databases, Genetic ; DNA ; Electrophoresis, Capillary ; Genetic Testing ; Humans ; Membranes ; Myotonic Dystrophy ; Nylons ; Polymerase Chain Reaction

PURPOSE: We aimed to determine whether a preoperative urodynamic parameter is a valuable predictor for the persistence of OAB symptoms after the AVP repair. MATERIALS AND METHODS: 65 OAB patients with concomitant POP-Q stage III, IV anterior vaginal wall prolapse underwent a surgical repair were involved. All the patients were subjected to a preoperative urodynamic study, for whom the OABSS on questionnaire were preoperatively recorded. We firstly analyzed the correlation between the BOOI and the OABSS, then randomly divided patients into two groups: the group A (high PdetQmax, BOOI> or =20) and the group B (low PdetQmax, BOOI<20). In each group, the OABSS was repeatedly measured post-operatively and the change were analyzed. RESULTS: 31 patients were classified as the group A and 34 patients were classified as the group B. The group B showed significant decrease of symptom score in daytime frequency (p<0.01), urgency (p=0.04), urge incontinence (p=0.03), nocturnal frequency (p=0.01) and total score (p=0.01). The group A showed no significant decrease of symptom score in daytime frequency (p=0.42), urgency (p=0.61), urge incontinence (p=0.3), total score (p=0.15) except nocturnal frequency (p=0.01). CONCLUSIONS: A preoperative pressure-flow study can be a valuable tool in predicting the OAB symptoms change after the combined AVP repair. While the AVP repair leads to the improvement of OAB symptoms generally, some patients with a higher preoperative PdetQmax are still in need of the additional medical treatment.
Humans ; Pelvic Organ Prolapse ; Pilot Projects ; Prolapse ; Urinary Bladder, Overactive ; Urinary Incontinence, Urge ; Urodynamics

BACKGROUND: Uncomplicated acute cystitis (CA-UAC) is one of the most common infections treated with antibiotics in the community. However, few data on etiology of CA-UAC and its susceptibility to antibiotics are available, primarily because, in Korea, insurance does not allow reimbursement for microbiological evaluation of CA-UAC. However, microbiologic data on community-acquired uncomplicated acute pyelonephritis (CA-UAPN) are available. The objective of the study was to evaluate the question of whether microbiologic data on CA-UAPN can be used for treatment of CA-UAC; therefore, etiology and antimicrobial susceptibility were compared between pathogens of CA-UAC and those of CA-UAPN. MATERIALS AND METHODS: During 2008, 538 CA-UACs and 1,265 CA-UAPNs were recruited retrospectively from 14 hospitals (UTI research group). Microbiologic data on etiology and susceptibility to antibiotics were collected retrospectively. RESULTS: Urine culture was positive in 131 CA-UACs (131/469, 27.9%) and 719 CA-UAPNs (719/1249, 57.6%). Escherichia coli was the most common pathogen in both groups [83.2% (109/131) in CA-UAC vs. 91.9% (661/719) in CA-UAPN]. Susceptibility to common UTI regimens, such as ciprofloxacin, extended-spectrum cephalosporins, and trimethoprim/sulfamethoxazole did not differ between urinary pathogens of CA-UACs and CA-UAPNs, however, a significant difference was observed in rates of resistance to ampicillin/sulbactam (16.5% vs. 42.9%, P<0.001, respectively). CONCLUSIONS: Rates of resistance of E. coli from CA-UAC and CA-UAPN to most antibiotics did not differ. For proper treatment, further microbiological evaluation for CA-UAC is mandatory.
Anti-Bacterial Agents ; Cephalosporins ; Ciprofloxacin ; Cystitis ; Escherichia coli ; Insurance ; Korea ; Pyelonephritis ; Retrospective Studies

PURPOSE: This study was conducted to perform a comparative analysis of the efficacy and safety of conventional transurethral resection of the prostate (TUR-P), transurethral resection in saline (TURIS), and TURIS-plasma vaporization (TURIS-V) when performed by a single surgeon for benign prostatic hyperplasia (BPH). MATERIALS AND METHODS: The clinical data of 73 consecutive men who underwent conventional TUR-P (39), TURIS (19), or TURIS-V (15) for BPH were retrospectively analyzed. All procedures were carried out by a single surgeon between October 2007 and April 2010. The patients were assessed preoperatively and perioperatively and were followed at 1, 3, and 6 months postoperatively. Patient baseline characteristics, perioperative data, and postoperative outcomes were compared, and major complications were recorded. RESULTS: In all groups, significant improvements in subjective and objective voiding parameters were achieved and were sustained throughout follow-up. TURIS-V had the shortest operation time compared with conventional TUR-P and TURIS (p=0.211). TURIS-V significantly decreased procedural irrigation fluid volume, postoperative irrigation duration, catheter duration, and hospital stay compared with conventional TUR-P and TURIS. There were no significant differences between the groups in hemoglobin levels or serum sodium levels before and after the operations. There were three transfusions and four clot retentions in the TUR-P group, and one transfusion and one clot retention in the TURIS group. The TURIS-V group had no complications. CONCLUSIONS: TURIS and TURIS-V were effective for the surgical treatment of BPH in addition to conventional TUR-P. TURIS-V was not inferior to conventional TUR-P or TURIS in terms of safety.
Catheters ; Follow-Up Studies ; Hemoglobins ; Humans ; Length of Stay ; Male ; Pilot Projects ; Prostate ; Prostatectomy ; Prostatic Hyperplasia ; Retention (Psychology) ; Retrospective Studies ; Sodium ; Transurethral Resection of Prostate ; Urologic Surgical Procedures ; Volatilization

PURPOSE: The aim of this study is to analyze the patterns of presentation and progress of tuberous sclerosis complex (TSC) and the prevelance of items in diagrnostic criteria of TSC in the pediatric population group. METHODS: We reviewed 74 patients diagnosed with TSC by clinical diagnostic criteria, who visited Asan Medical Center from April, 1991 to August, 2008. RESULTS: Forty-four males and 30 females were enrolled with 2.3 years(0 days-15.4 years) of mean age at the diagnosis. Mean follow-up period was 3.2(0-12.6) years. Remarkable initial symptoms or signs at the first hospital visit were seizure(n=48, 64.9%), cardiac rhabdomyoma(n=15, 20.2%) and skin lesions(n=7, 9.5%). Seven of 74 patients(9.5%) had familial history of TSC. Seventy-one patients(95.9%) showed one or more brain lesions on the neuroimaging studies, including cortical tubers(n=69, 93.2%), subependymal nodules(n=71, 95.9%), subependymal giant cell astrocytomas(SEGA, n=5, 6.8%). Retinal astrocytic hamartomas were confirmed in 14 patients and suspicious in 4 patients. Skin lesions were detected in 58 patients(78%). Sixty-one patients(82%) had experienced one or more seizures and 58 were confirmed as epilepsy. Twenty-eight patients(38%) had experienced infantile spasm. Thirty-two of 52 patients evaluated(61.5%) had mental retardation. Gene studies were done in 13 patients and revealed two TSC1 gene mutations and seven TSC2 gene mutations. CONCLUSION: Seizure attacks and skin lesions were two most common causes to visit hospital in pediatric TSC patients. Considering the high incidence of epilepsy and its correlation with poor neurodevelopemental outcome, early diagnosis and adequate treatment will lead to the better quality of life.
Brain ; Early Diagnosis ; Epilepsy ; Female ; Follow-Up Studies ; Giant Cells ; Hamartoma ; Humans ; Incidence ; Infant ; Infant, Newborn ; Intellectual Disability ; Male ; Neuroimaging ; Population Groups ; Quality of Life ; Retinaldehyde ; Seizures ; Skin ; Spasms, Infantile ; Tuberous Sclerosis

Sedation is often necessary to optimize care for critically ill children requiring mechanical ventilation. If too light or too deep, however, sedation can cause significant adverse reactions, making it important to assess the degree of sedation and maintain its optimal level. We evaluated the efficacy of the COMFORT scale in assessing optimal sedation in critically ill children requiring mechanical ventilation. We compared 12 month data in 21 patients (intervention group), for whom we used the pediatric intensive care unit (PICU) sedation protocol of Asan Medical Center (Seoul, Korea) and the COMFORT scale to maintain optimal sedation, with the data in 20 patients (control group) assessed before using the sedation protocol and the COMPORT scale. Compared with the control group, the intervention group showed significant decreases in the total usage of sedatives and analgesics, the duration of mechanical ventilation (11.0 days vs. 12.5 days) and PICU stay (15.0 days vs. 19.5 days), and the development of withdrawal symptoms (1 case vs. 7 cases). The total duration of sedation (8.0 days vs. 11.5 days) also tended to decrease. These findings suggest that application of protocol-based sedation with the COMPORT scale may benefit children requiring mechanical ventilation.
Anesthetics, Intravenous/administration & dosage/therapeutic use ; Child, Preschool ; Conscious Sedation/methods/standards ; Critical Care/*methods/standards ; *Critical Illness ; Female ; Fentanyl/administration & dosage/therapeutic use ; Humans ; Hypnotics and Sedatives/administration & dosage/*therapeutic use ; Infant ; Infusions, Intravenous ; Intensive Care Units/statistics & numerical data ; Length of Stay ; Male ; Midazolam/administration & dosage/therapeutic use ; *Respiration, Artificial ; Treatment Outcome

BACKGROUND: Pediatric epilepsy can result in a heavy burden of illness for the family and the role of family caregivers is becoming more important for the management of the disease. However, there are only few studies about care-giver burden of pediatric epilepsy. This study examined the factors which may influence care-giver burden of pediatric epilepsy patients METHODS: We surveyed 87 care-givers of pediatric epilepsy patients. The demographic and social data of the care-givers, along with the social and clinical data of the patients were obtained. The Korean version of the Burden Interview (KBI) and the Korean version of the Beck Depression Inventory (KBDI) were used. The relationship between the demographic and social data of care-givers, the clinical factors of the patients and KBI score were evaluated. RESULTS: Of the 87 participants, sixty-nine (79.3%) were the mothers. The mean age of caregivers was 41.3 years and the mean score on the KBI was 20.2 (+/-16.8) points. The mean age of the patients was 11.1 years and 48 patients (55.8%) were male. The number of antiepileptic drugs prescribed, severity of the disease and school record had a significant correlation with KBI in a multivariate linear regression analysis. CONCLUSIONS: We suggest that in addition to the strict control of the seizure, that the consideration for the academic functions of pediatric patients is also important for reducing care-giver burden in the treatment of pediatric epilepsy.
Anticonvulsants ; Caregivers ; Cost of Illness ; Depression ; Epilepsy* ; Humans ; Linear Models ; Male ; Mothers ; Seizures