Association between Candidiasis and Early Childhood Caries : Analysis Using Healthcare Big Data / 대한소아치과학회지

The aim of this study was to identify the association between candidiasis and early childhood caries and to investigate whether the experience of candidiasis or oral candidiasis before age 1 can be considered as a risk factor for early childhood caries.The database used in this study was provided by Health Insurance Review and Assessment Service. Medical records of children born from January 2010 to December 2012 were obtained, and those without dental records were excluded. Subjects were divided into several groups based on the experience of candidiasis or oral candidiasis before age 6: candidiasis group and non-candidiasis group; oral candidiasis group and non-oral candidiasis group. Another categorization was done according to the experience of candidiasis or oral candidiasis before age 1. The incidence rate of early childhood caries in each group were compared.The prevalence of dental caries in children who have been diagnosed with candidiasis or oral candidiasis before age 6 was significantly different from those who have not experienced candidiasis. Similarly, children who have suffered from candidiasis or oral candidiasis before age 1 had significantly different incidence of caries from the children without candidiasis experience.

Color Stability of Bulk-Fill Resin Composites after Immersion in Different Media / 대한소아치과학회지

The aim of this study was to evaluate the color stability of bulk-fill and conventional resin composites with respect to different storage media and thickness of composites.Filtek™ Z250 and Filtek™ Z350XT were evaluated as conventional resin composites. Filtek™ Bulk-fill Posterior Restorative and Tetric® N-Ceram Bulk Fill were evaluated as bulk-fill resin composites.CIE L*a*b* values of baseline were measured after 24 hours of storage in distilled water, and each resin composite group was divided into three subgroups and stored in distilled water, red wine, and coffee media respectively. Again after 1, 7 and 28 days of immersion, color changes (ΔE*) were calculated using the CIE L*a*b* values.The greatest ΔE* was observed in red wine for all resin composites, and the mean color changes were ranked in the increasing order of distilled water, coffee, red wine. Filtek™ Z350XT exhibited the greatest color change in all media, followed by Filtek™ Bulk-fill Posterior Restorative. Filtek™ Z250 and Tetric® N-Ceram Bulk Fill followed with similar mean color change values. According to the 2 different thicknesses of 2 mm and 4 mm of bulk-fill resin composites, there was no thickness-related difference on color changes.

Evaluation of Total and Soluble Fluoride Concentrations in Ten Toothpastes for Children / 대한소아치과학회지

In this study, total fluoride (TF) in commercial toothpastes for children in Korea was evaluated and compared with the fluoride concentration declared by the manufacturer (Declared F). Additionally, total soluble fluoride (TSF) was evaluated and compared with TF.Ten toothpastes were coded with letters to allow blind analysis. For evaluation of TF, each toothpaste was homogenized in deionized water. For evaluation of TSF, each toothpaste was centrifuged and then, the supernatant of the sample was evaluated. Fluoride concentrations were assessed using a fluoride electrode coupled to an ion analyzer.Only one toothpaste showed lower TF concentration than Declared F. In all toothpastes, TSF was similar to the TF.

Outcome of Regenerative Endodontic Treatment for an Avulsed Immature Permanent Tooth: A Case Report / 대한소아치과학회지

Dental avulsion, defined as the complete displacement of a tooth from the alveolar bone with consequent loss of the blood and nerve supply, was reported as one of the most severe dental injuries. Avulsion can cause tissue ischemia, which leads to pulp necrosis.Apexification is a conventional treatment method that induces an apical calcified barrier in immature roots with pulp necrosis. However, root development characterized by an increase in the root thickness and length cannot be achieved by apexification.The purpose of this case report was to describe the radiographic and clinical outcomes of regenerative endodontic treatment for the avulsed and necrosed permanent tooth with an immature root after replantation in a 5-year-old girl; the treatment was performed using a mixture of ciprofloxacin, metronidazole and cefaclor, CollaTape and Biodentine.

Reversible Heart Failure after Bortezomib Treatment in a Patient with Multiple Myeloma / 대한내과학회지

Bortezomib (Velcade(R)) came into the spotlight as a target therapy for multiple myeloma. It acts through reversible inhibition of intracellular proteasomes, which triggers apoptosis, with relative selectivity for malignant cells. It has been hypothesized that the accumulation of damaged proteins in myocytes impairs cardiac function. Cardiotoxicity is a rare side effect of bortezomib treatment. We report a case of reversible systolic heart failure that probably occurred after bortezomib treatment in a patient with multiple myeloma. Patients being treated with bortezomib who have previously had cardiac comorbidities should undergo routine cardiac monitoring.

Genome-Wide Association Study of Liver Enzymes in Korean Children

Liver enzyme elevations, as an indicator of liver function, are widely associated with metabolic diseases. Genome-wide population-based association studies have identified a genetic susceptibility to liver enzyme elevations and their related traits; however, the genetic architecture in childhood remains largely unknown. We performed a genome-wide association study to identify new genetic loci for liver enzyme levels in a Korean childhood cohort (n = 484). We observed three novel loci (rs4949718, rs80311637, and rs596406) that were multiply associated with elevated levels of alanine transaminase and aspartate transaminase. Although there are some limitations, including genetic power, additional replication and functional characterization will support the clarity on the genetic contribution that the ST6GALNAC3, ADAMTS9, and CELF2 genes have in childhood liver function.

Effect of Genetic Predisposition on Blood Lipid Traits Using Cumulative Risk Assessment in the Korean Population

Dyslipidemia, mainly characterized by high triglyceride (TG) and low high-density lipoprotein cholesterol (HDL-C) levels, is an important etiological factor in the development of cardiovascular disease (CVD). Considering the relationship between childhood obesity and CVD risk, it would be worthwhile to evaluate whether previously identified lipid-related variants in adult subjects are associated with lipid variations in a childhood obesity study (n = 482). In an association analysis for 16 genome-wide association study (GWAS)-based candidate loci, we confirmed significant associations of a genetic predisposition to lipoprotein concentrations in a childhood obesity study. Having two loci (rs10503669 at LPL and rs16940212 at LIPC) that showed the strongest association with blood levels of TG and HDL-C, we calculated a genetic risk score (GRS), representing the sum of the risk alleles. It has been observed that increasing GRS is significantly associated with decreased HDL-C (effect size, -1.13 +/- 0.07) compared to single nucleotide polymorphism combinations without two risk variants. In addition, a positive correlation was observed between allelic dosage score and risk allele (rs10503669 at LPL) on high TG levels (effect size, 10.89 +/- 0.84). These two loci yielded consistent associations in our previous meta-analysis. Taken together, our findings demonstrate that the genetic architecture of circulating lipid levels (TG and HDL-C) overlap to a large extent in childhood as well as in adulthood. Post-GWAS functional characterization of these variants is further required to elucidate their pathophysiological roles and biological mechanisms.

Effect of Genetic Predisposition on Blood Lipid Traits Using Cumulative Risk Assessment in the Korean Population

Dyslipidemia, mainly characterized by high triglyceride (TG) and low high-density lipoprotein cholesterol (HDL-C) levels, is an important etiological factor in the development of cardiovascular disease (CVD). Considering the relationship between childhood obesity and CVD risk, it would be worthwhile to evaluate whether previously identified lipid-related variants in adult subjects are associated with lipid variations in a childhood obesity study (n = 482). In an association analysis for 16 genome-wide association study (GWAS)-based candidate loci, we confirmed significant associations of a genetic predisposition to lipoprotein concentrations in a childhood obesity study. Having two loci (rs10503669 at LPL and rs16940212 at LIPC) that showed the strongest association with blood levels of TG and HDL-C, we calculated a genetic risk score (GRS), representing the sum of the risk alleles. It has been observed that increasing GRS is significantly associated with decreased HDL-C (effect size, -1.13 +/- 0.07) compared to single nucleotide polymorphism combinations without two risk variants. In addition, a positive correlation was observed between allelic dosage score and risk allele (rs10503669 at LPL) on high TG levels (effect size, 10.89 +/- 0.84). These two loci yielded consistent associations in our previous meta-analysis. Taken together, our findings demonstrate that the genetic architecture of circulating lipid levels (TG and HDL-C) overlap to a large extent in childhood as well as in adulthood. Post-GWAS functional characterization of these variants is further required to elucidate their pathophysiological roles and biological mechanisms.

Association Between Parental Socioeconomic Level, Overweight, and Eating Habits with Diet Quality in Korean Sixth Grade School Children

This study investigated the association among parental socioeconomic level, overweight, and eating habits with diet quality in Korean sixth grade school children. A 3-day dietary survey was conducted, and a questionnaire and anthropometric data were collected from the Korean child obesity cohort (320 boys and 345 girls). The children were classified into two groups (low or high level) based on monthly household income and paternal and maternal education status. Lower maternal education status was associated with a higher risk for overweight in girls (odd ratio, 1.91; 95% confidence interval 1.07-3.44), whereas belonging to a higher socioeconomic group in terms of parental income or parental education level resulted in the consumption of significantly more fruit. Boys did not show significant differences in the intake of most nutrients or diet quality regardless of socioeconomic status. However, girls in the lower socioeconomic group had a lower food habit score (higher frequency of breakfast skipping and ramen noodle consumption), diet quality, and intake of nutrients (carbohydrate, vitamin C, potassium, and fiber) than those in the higher socioeconomic group. Therefore future nutrition policies and interventions should support parents and children with lower socioeconomic status to develop health-related behaviors that may prevent childhood overweight.

Serum Leptin Levels and Changes in Body Weight and Obesity Index in Gwacheon Elementary School Children

Leptin, as an adipocyte-derived hormone, is an important regulator of food intake and energy expenditure. In the cross-sectional study, leptin was shown to be positively related to body adiposity and metabolic disorders in adults. However, there were very few studies which reported the leptin as a predictor of weight gain over time. We examined whether serum leptin can be used as an indicator of the present and 1-year past weight status in very young children. First grade students from elementary schools in Gwacheon City were enrolled in the study since 2005. The study subjects (total 375 students; 195 boys and 180 girls) participated in the investigation of both 2005 and 2006. Physical examinations including height, weight, waist circumference were done. To examine the prevalence of obesity, obesity index was used. Serum leptin was measured, and their nutritional status was also evaluated based on 3-Day dietary records. Serum leptin levels were strongly positively related with the value of the present BMI and with the value of the BMI one year before. We found no association with leptin levels and amount of energy intake and macronutrient intake in this children population. Children were divided into three groups according to leptin tertiles. The highest leptin tertile group showed highest prevalence of obesity in year 2006 as well as in year 2005. Serum leptin levels can reflect the weight status now and as well as 1-year before. Possibly serum leptin levels can predict the weight gain of year later. Without an action against the obesity on children with high leptin level, those children would maintain the excess adiposity growth and progress into the obesity-related metabolic disorders. Further studies are needed to predict the obesity as early as possible and preventive system then after.

Effect of Genistein and Soy Protein on Lipids Metabolism in Ovariectomized Rats

Postmenopausal women or ovariectomized rats are associated with increased cholesterol levels, which are risk factors of metabolic syndrome and cardiovascular diseases. Increased prevalence of metabolic syndrome after menopause might be associated with estradiol deficiency. Harmful effect of estradiol hampers the casual usage of hormone to prevent the metabolic syndrome. Soy protein has been reported to show several beneficial effects on health, however it is unclear which components of soy protein is responsible for anti-obesity and hypocholesterolemic effects. Soy isoflavones, genistein and daizein, are suggested to have anti-obesity and hypocholesterolemic effects but with inconsistency. The present study investigated the effect of supplementation of genistein (experiment I) and soy protein containing isoflavones (experiment II) to high fat diet on body weight gain, food intake, liver and fat tissue weight and the lipid levels in ovariectomized rats. Plasma and hepatic lipid contents and the mRNA levels of genes encoding lipid metabolism related proteins, such as CPT1 and HMGR were measured. Ovariectomy increased body weight, fat tissue weight and plasma and hepatic lipid levels which increase the risk of metabolic syndrome. Soy protein could improve plasma and hepatic lipids levels. Soy protein also increased hepatic CPT1 and HMGR mRNA levels. Plasma and hepatic lipids levels could not be decreased by dietary genistein alone. In contrast, lipids levels could be decreased by isoflavone-fortified soy protein, suggesting that the ingestion of soy protein enriched with isoflavone gives more benefit for protecting postmenopausal women from metabolic syndrome.

Effect of Ovariectomy and Genistein on Hepatic Mitochondrial Function

Women with menopause or rats with ovariectomy is associated with increased body weight, body fat and insulin resistance, which are components of metabolic syndrome. Increased prevalence of metabolic syndrome after menopause might be associated with mitochondrial dysfunction, since mitochondrial oxidative and phosphorylation activity is strongly correlated with insulin sensitivity. Although estradiol replacement prevents the metabolic syndrome, harmful effect of estradiol hampers the casual usage to prevent the metabolic syndrome. It has been reported that genistein has a mild estrogenic activity, decreases fat mass in mice and has an antidiabetic role in diabetic rats. Although insulin resistance is closely related to mitochondrial functions, there has not been yet any study in regard to the effect of dietary genistein on mitochondrial function in the insulin resistant female subjects induced by ovariectomy or similar situation. The present study investigated whether the supplementation of genistein in the high fat diet affected the mitochondrial function of high fat fed ovariectomized rats. Female Sprague Dawley rats (8 weeks old) were assigned to the following groups: sham-operated + high fat diet (S, n = 6); sham-operated + high fat diet with 0.1% genistein (S + G, n = 7); ovariectomized + high fat diet (OVX, n = 8); ovariectomized + high fat diet with 0.1% genistein (OVX + G, n = 8). Ovariectomy significantly increased body weight compared with S group. Genistein consumption in ovariectomized (OVX + G) rats decreased body weight gain compared with OVX rats. Liver weights were increased by ovariectomy. The hepatic mitochondrial protein density expressed as mg per g liver was lower in the OVX group than in the S group. However, OVX + G group showed the increased mitochondrial protein density similar to the level of S group. When mRNA levels of genes related to mitochondria such as peroxisome proliferator-activated receptor gamma coactivator 1 (PGC-1) and cytochrome c oxidase subunit III (COX III) were measured, there were decreases in the mRNA levels of PGC-1 and COX III in S + G, OVX and OVX + G group. The activity of cytochrome c oxidase was not different between groups. We could observe the decrease in succinate dehydrogenase (SDH) activity per g liver in OVX rats. Genistein supplement increased SDH activity. In conclusion, genistein supplementation to the OVX rats enhanced mitochondrial function by increasing mitochondrial protein density and SDH activity. The improvement in mitochondrial function by genistein can contribute to the improvement in metabolic syndrome.

CT Coronary Angiography Using Multidetector Computed Tomography in Coronary Artery Disease : A Comparative Study to Quantitative Coronary Angiography

BACKGROUND AND OBJECTIVES: The purpose of the present study was to investigate the diagnostic accuracy of coronary stenoses in patients with ischemic heart disease using multidetector CT coronary angiography (MDCT) in the assessment of coronary artery disease. SUBJECTS AND METHODS: Forty-three patients (49-72yrs) undergoing conventional coronary angiography (CCA) were included in this study. All patients were premedicated with oral propranolol, 40-80 mg, to achieve an acceptable heart rate of less than 65 bpm, 1hr before the MDCT. All coronary arteries, including the distal segments and side branches, were assessed with respect to assessability and the presence of significant stenosis (>50%) and the results compared with those of CCA. RESULTS: Of the 645 coronary artery segments scanned, 540 were assessable (84%). A total 44 significant stenoses were detected by CCA and 49 lesions by MDCT. The overall sensitivity and specificity were 77 and 97%, respectively. The overall accuracy for the LAD, RCA and LCX was 94, 98 and 95%, respectively, and there were no differences in the accuracies in each vessel. The sensitivity in the proximal segments was much higher than in the distal segments. A total 15 segments were overestimated by the MDCT due to calcification and the small vessel size. CONCLUSION: MDCT, with improved spatial and temporal resolutions, and pre-treated with oral beta-blocker, permits the detection of coronary artery stenoses with a high degree of accuracy.