Effects of smart-care services program for breast cancer survivors / 한국간호교육학회지

Purpose@#The purpose of this study was to examine the effects of a smart-care services program for breast cancer survivors on cognitive function and physical health. @*Methods@#A quasi-experimental control group pretest posttest design was used. Subjects were recruited in D city, and data were collected from July 2017 to February 2018. The experimental group (n=24) participated in the smart-care services program, whereas the control group (n=26) received conventional management. The smart-care services program consisted of addressing cognitive function problems arising from chemotherapy, diet, exercise, headeck massage and self-monitoring using smartphone applications and smart bands. All participants underwent assessments at baseline, at 6 weeks, and at 12 weeks. Data were analyzed using descriptive statistics (frequency, percentage, mean and standard deviation), a chi-squared test, t-test, and repeated measures ANOVA. @*Results@#After the smart-care services program, significant differences were found between the groups in cognitive function (F=18.91, p<.001) and sleep time (F=9.25, p<.001). No significant differences were found between the groups in caloric consumption after the program. @*Conclusion@#The smart-care services program significantly improved the level of cognitive function and sleep time for breast cancer survivors. The use of this smart-care services program for breast cancer survivors might be an effective nursing intervention tool for improving cognitive function and health behaviors.

Effects of smart-care services program for breast cancer survivors / 한국간호교육학회지

Purpose@#The purpose of this study was to examine the effects of a smart-care services program for breast cancer survivors on cognitive function and physical health. @*Methods@#A quasi-experimental control group pretest posttest design was used. Subjects were recruited in D city, and data were collected from July 2017 to February 2018. The experimental group (n=24) participated in the smart-care services program, whereas the control group (n=26) received conventional management. The smart-care services program consisted of addressing cognitive function problems arising from chemotherapy, diet, exercise, headeck massage and self-monitoring using smartphone applications and smart bands. All participants underwent assessments at baseline, at 6 weeks, and at 12 weeks. Data were analyzed using descriptive statistics (frequency, percentage, mean and standard deviation), a chi-squared test, t-test, and repeated measures ANOVA. @*Results@#After the smart-care services program, significant differences were found between the groups in cognitive function (F=18.91, p<.001) and sleep time (F=9.25, p<.001). No significant differences were found between the groups in caloric consumption after the program. @*Conclusion@#The smart-care services program significantly improved the level of cognitive function and sleep time for breast cancer survivors. The use of this smart-care services program for breast cancer survivors might be an effective nursing intervention tool for improving cognitive function and health behaviors.

Grounded Theoretical Approach on Illness Experience Process in Middle Aged Women with Brain Tumor / 재활간호학회지

Purpose@#The purpose of this study was to develop a substantive theory that can understand the process of illness experience in brain tumor patients and explain their experiences. @*Methods@#Data were analyzed by Corbin & Strauss's grounded theory method. @*Results@#As a result of this study, the core category of brain tumor patients was the reintegration process to adapt to the changed me. This reintegration process has experience of illness through the stages of shock, ambivalent recognizer, relief, re-anxiety and readaptation. During the process of this illness experience, causal conditions were the testimony of the body, the threat of death, the contextual condition were the vulnerability of the woman, the search for the alternative, and the central phenomenon appeared to be the ambivalence toward escape versus acceptance. The interventional conditions were hopes of discovery, common patient wishes. The positive aspects of action/interaction were bright vision of the illness, prevention of recurrence, facing the illness, and the negative aspect was mental sequela. As a result, the paradoxical gift growth of the disease and recovery of normalization were derived. @*Conclusion@#The disease experience of these brain tumor patients was found to be through the stages of shock stage, ambivalent stage, relief stage, re-anxiety stage, re-adaptation stage. This reintegrated into the changed body and reality, and the transition of life was made by the illness event of brain tumor.

A Case of Squamous Cell Carcinoma in Situ Occurredin the External Auditory Canal / 대한이비인후과학회지

Primary malignant lesions in the external auditory canal are rare. While squamous cell carcinoma is the most common of these lesions, there are also basal cell carcinoma, malignant melanoma and adenocarcinoma, etc. However, squamous cell carcinoma in situ of the external auditory canal is extremely rare since its first report in the English literature in 1953 and has not been reported in Korea. Its clinical manifestations are very similar to chronic ear disease. For treatment, local wide resection of the lesions is preferred. We recently encountered a 54-year-old female, who presented with intermittent irritating sensation in the external auditory canal. Otoscopic examination showed a scaly plaque with the irregular surface on the anteroinferior portion of the left external auditory canal. Excisional biopsy revealed a squamous cell carcinoma in situ. We report this very rare and unique case with a literature review.

The Role of Growth Differentiation Factor 15 in Energy Metabolism

Growth differentiation factor 15 (GDF15) is receiving great interest beyond its role as an aging and disease-related biomarker. Recent discovery of its receptor, glial cell line-derived neurotrophic factor (GDNF) family receptor α-like (GFRAL), suggests a central role in appetite regulation. However, there is also considerable evidence that GDF15 may have peripheral activity through an as-of-yet undiscovered mode of action. This raises the question as to whether increased GDF15 induction during pathophysiologic conditions also suppresses appetite. The present review will briefly introduce the discovery of GDF15 and describe the different contexts under which GDF15 is induced, focusing on its induction during mitochondrial dysfunction. We will further discuss the metabolic role of GDF15 under various pathophysiological conditions and conclude with possible therapeutic applications.

Are Vitamin Beverages Good for Dental Health? / 치위생과학회지

Background@#Although the consumption of vitamin beverages has increased because of the recent interest in health and beauty, guidelines addressing appropriate consumption habits are lacking. Thus, the aim of this study was to investigate the erosive potential of several vitamin beverages and to propose guidelines for the appropriate intake of these drinks. @*Methods@#Five vitamin beverages were selected after a pre-investigation of the current beverage market. Coca-Cola and mineral water were selected as the control beverages. The pH of the beverages was measured with a calibrated pH meter, and the titratable acidity (TA) was determined by using 1 M sodium hydroxide to reach pH 5.5 (TA5.5) and 7.0 (TA7.0). The screening method suggested by the International Organization for Standardization was used to measure pH variation (pH) by using an under-saturated hydroxyapatite solution to determine the difference between the initial and final pH of the screening solution. All measurements were performed in triplicate. @*Results@#All vitamin beverages tested in this study exhibited a low pH (2.53∼2.99), similar to Coca-Cola, which is known to be a highly acidic beverage. The highest TA5.5 and TA7.0 values of the vitamin beverages were 7.03 ml and 8.81 ml, respectively. The largest change in pH determined by using the screening solution was found in Bacchus D (pH 1.44±0.05). The mean pH of the vitamin beverages was 1.12±0.29, which was higher than that of Coca-Cola (positive control, pH 0.58±0.05). @*Conclusion@#Vitamin beverages exhibited an erosive potential capable of damaging enamel surfaces. Therefore, the frequency of vitamin beverage intake should be limited, and individuals consuming these drinks should try to restore normal oral pH as quickly as possible.

Implications of specific gene expression patterns in enamel knot in tooth development

Enamel knot (EK)—a signaling center—refers to a transient morphological structure comprising epithelial tissue. EK is believed to regulate tooth development in early organogenesis without its own cellular alterations, including proliferation and differentiation. EKs show a very simple but conserved structure and share functions with teeth of recently evolved vertebrates, suggesting conserved signaling in certain organs, such as functional teeth, through the course of evolution. In this study, we examined the expression patterns of key EK-specific genes including Dusp26 , Fat4, Meis2, Sln , and Zpld1 during mice embryogenesis. Expression patterns of these genes may reveal putative differentiation mechanisms underlying tooth morphogenesis.

Bilateral Rhegmatogenous Retinal Detachments after Systemic Pazopanib Treatment

PURPOSE: A case of bilateral rhegmatogenous retinal detachment is reported after pazopanib treatment of a patient with breast angiosarcoma. CASE SUMMARY: A 53-year-old female presented with bleeding in a right breast mass prior to an emergency room visit. She was diagnosed with metastatic breast angiosarcoma after a breast mass biopsy. She was treated with paclitaxel and radiation therapy. Systemic pazopanib treatment was added to treat lung metastasis. After 3 weeks, she felt sudden floaters in her right eye. In her fundus examination, there was vitreous hemorrhage, but no retinal detachment was noted. Five weeks later, she visited the clinic for a bilateral temporal visual field defect. A fundus examination showed bilateral retinal detachments with superonasal retinal tears. Both the patient and her family did not want surgery for her systemic condition because of her terminal cancer. CONCLUSIONS: Retinal detachment has been reported as a rare complication after systemic pazopanib treatment, but there has been no previous report in the Republic of Korea, therefore this is the first case of bilateral retinal detachments after systemic pazopanib treatment.

A Case of Angioimmunoblastic T-cell Lymphoma Involving the Ipsilateral Parotid and Lateral Neck / 대한두경부종양학회지

Angioimmunoblastic T-cell lymphoma (AITL) is a rare subtype of malignant lymphoma (ML), accounting for only 1 to 2% of all non-Hodgkin's lymphoma (NHL). Although ML of the parotid gland is rare, the majority are B-cell types. The AITL occurring synchronously in the parotid gland and lateral neck has not been reported earlier. It is classified as a high-grade malignancy with aggressive clinical features, and the prognosis is worse than any other type of NHL. We recently encountered a 72-year-old man with multiple mass on the ipsilateral parotid tail and lateral neck, and he was finally diagnosed as AITL. We report the unique and rare disease entity with a brief literature review.

Cytomegalovirus-Associated Severe Direct Antiglobulin Test Negative Hemolytic Anemia: A Case Report / 임상소아혈액종양

Cytomegalovirus is a common virus that is mostly asymptomatic when infected, but rarely causes life-threatening hemolysis especially in immunocompromised children. We report a case of antiglobulin test negative severe hemolytic anemia caused by cytomegalovirus infection developed in an immune competent 9-year-old girl. The patient's hemoglobin level was 4.8 g/dL on the day of admission. The diagnosis was achieved by exclusion of other causes of hemolytic anemia and serological evidence of recent CMV infection. The patient was successfully treated with anti-viral agents and steroids resulting in recovery from anemia. Clinicians should consider cytomegalovirus infection in the differential diagnosis of hemolytic anemia in pediatric patients.

A Case of Soft Tissue Metastasis in Contralateral Submandibular Space by Regional Recurrence of Lower Lip Cancer / 대한이비인후과학회지

The most common cause of treatment failure in oral cavity cancer is when it is found to have local recurrence, usually occurring in the ipsilateral cervical lymph node. On the contrary, it is extremely rare to find local recurrence in soft tissue metastasis (STM) in the contralateral neck. Furthermore, lung cancer and malignant lymphoma are most commonly confined to their primary sites. The poor general condition increases the likelihood of STM, which indicates bad prognosis. A 72-year-old man with a hard and fixed mass on the right submandibular space visited our clinic. He had received a wide excision with local flapreconstruction for squamous cell carcinoma in the left corner of lower lip 18 months ago. We performed the wide excision with bilateral selective neck dissection (I–III), and he was finally diagnosed as STM from contralateral lip cancer. We report this unique and rare disease entity with a literature review.

The incidence of the abutment screw loosening and its affecting factors in posterior implant restorations / 대한치과보철학회지

PURPOSE: This study was to assess clinically the incidence of abutment screw loosening of posterior implant-supported fixed prosthesis and its affecting factors. MATERIALS AND METHODS: 391 implant-supported crowns restored from January 2013 to January 2016 were included in this study. All restorations were fabricated with either a single crowns or a splinted crown, and cemented with temporary cement. The incidence of abutment screw loosening is investigated and gender, restoration position, opposing teeth, restoration type, abutment connection type were assessed as possible factors affecting abutment screw loosening. RESULTS: During the observation period (2 – 5 years), abutment screw loosening was found in 29 restorations (7.4%). It took 3 to 48 months (means 19.5 months) to loose the screw, and three of these implants were fractured. Among the factors considered, there were statistically significant differences at abutment screw loosening rate between molar group (9.4%) and premolar group (2.6%) (P<.019). According to the type of opposing teeth, there were statistically significant differences between nature teeth (74.7%) and implant (25.0%), removable denture (3%) (P<.019). The other possible factors did not have a significant effect on loosening of the abutment. CONCLUSION: The incidence of abutment screw loosening in posterior restoration was 7.4%. Abutment screw loosening were more likely to occur in molars group than premolar group, and according to the opposing teeth, there were the greatest frequency in nature teeth than implant and removal denture. There was a statistically significant difference.

Ultrastructure of Substance P Immunopositive Axons in the Human Dental Pulp

There exists very little information on the ultrastructure of substance P immunopositive (+) fibers in the human dental pulp, which may help in understanding the mechanism for substance P associated pulpal inflammatory pain. To address this issue, we investigated the presence of substance P+ fibers in the human dental pulp by light- and electron-microscopic immunohistochemistry. Light microscopy revealed that substance P+ fibers ran within neurovascular bundles in the radicular pulp and in the core of coronal pulp. They were also frequently present in the peripheral pulp. Substance P+ fibers showed beads like swellings interconnected by thin axonal strand, in a manner similar to bouton en passants and interconnecting axonal strand in the spinal cord. Electron microscopy revealed that almost all the substance P+ axons were unmyelinated. The axonal swellings of the substance P+ contained numerous clear round vesicles (40–50 nm in diameter) and many large dense-cored vesicles (80–110 nm in diameter) as well as many mitochondria. The vesicles and mitochondria were rarely observed in the thin axonal strand interconnecting the swellings. Intimate interrelationship or synaptic structure between the swellings of substance P+ axon and nearby pulpal cells or axons was not found. These findings suggest co-release of substance P and glutamate from the substance P+ pulpal axons and its action on nearby structures in a paracrine manner.

Radiologic Comparison of Humeral Position according to the Implant Designs Following Reverse Shoulder Arthroplasty: Analysis between Medial Glenoid/Medial Humerus, Lateral Glenoid/Medial Humerus, and Medial Glenoid/Lateral Humerus Designs

BACKGROUND: The currently available reverse shoulder arthroplasty (RSA) designs can be classified into medial glenoid/medial humerus (MGMH), lateral glenoid/medial humerus (LGMH), and medial glenoid/lateral humerus (MGLH) prosthesis designs. The purpose of this study was to radiologically analyze the effect of different RSA designs on humeral position following RSA. METHODS: A total of 50 patients who underwent primary RSA were retrospectively analyzed. Among 50 patients, 33 patients (group A: MGMH) underwent RSA with Aequalis system (Wright, Inc, Bloomington, MN, USA), 6 (group B: LGMH) with Aequalis system using bony increased offset, and 11 (group C: MGLH) with Aequalis Ascend Flex system. The acromiohumeral distance, acromioepiphyseal distance (AED), lateral humeral offset (LHO), LHO from the center of rotation (LHO(COR)), and deltoid length were radiologically measured to quantify the distalization and lateralization of the humerus. RESULTS: The increment in postoperative AED was 19.92 ± 3.93 mm in group A, 24.52 ± 5.25 mm in group B, and 25.97 ± 5.29 mm in group C, respectively (p=0.001). The increment in postoperative LHO was 0.13 ± 6.30 mm, 8.00 ± 12.14 mm, and 7.42 ± 6.88 mm, respectively (p=0.005). The increment in postoperative LHOCOR was 20.76 ± 6.06 mm, 22.04 ± 5.15 mm, and 28.11 ± 4.14 mm, respectively (p=0.002). CONCLUSIONS: The radiologic analysis of the effect of different RSA designs on humeral position following RSA showed significant differences in the increment in postoperative AED, LHO, and LHO(COR) between the 3 groups. Therefore, MGLH design seems to be more effective for humeral distalization and lateralization compared to original Grammont design.

A Case of Glottic Mucoepidermoid Carcinoma Presenting as Submucosal Mass / 대한이비인후과학회지

Mucoepidermoid carcinoma (MEC) is the most common malignant tumor originated from salivary gland. However, it rarely occurs in the larynx, which is approximately less than 0.35% of all laryngeal neoplasm. In the literature, the laryngeal MEC often appears as submucosal mass with intact mucosa. As a result, most patients are diagnosed in the advanced stage due to difficulty of early detection. There is no standard treatment option because of the rarity of the disease and the prognosis varies by histological features. We recently encountered a 85-yearold male with progressive hoarseness, and he was finally diagnosed as high grade glottic MEC. We report this rare and unique case with a literature review.

Screw-in forces during instrumentation by various file systems

OBJECTIVES: The purpose of this study was to compare the maximum screw-in forces generated during the movement of various Nickel-Titanium (NiTi) file systems. MATERIALS AND METHODS: Forty simulated canals in resin blocks were randomly divided into 4 groups for the following instruments: Mtwo size 25/0.07 (MTW, VDW GmbH), Reciproc R25 (RPR, VDW GmbH), ProTaper Universal F2 (PTU, Dentsply Maillefer), and ProTaper Next X2 (PTN, Dentsply Maillefer, n = 10). All the artificial canals were prepared to obtain a standardized lumen by using ProTaper Universal F1. Screw-in forces were measured using a custom-made experimental device (AEndoS-k, DMJ system) during instrumentation with each NiTi file system using the designated movement. The rotation speed was set at 350 rpm with an automatic 4 mm pecking motion at a speed of 1 mm/sec. The pecking depth was increased by 1 mm for each pecking motion until the file reach the working length. Forces were recorded during file movement, and the maximum force was extracted from the data. Maximum screw-in forces were analyzed by one-way ANOVA and Tukey's post hoc comparison at a significance level of 95%. RESULTS: Reciproc and ProTaper Universal files generated the highest maximum screw-in forces among all the instruments while M-two and ProTaper Next showed the lowest (p < 0.05). CONCLUSIONS: Geometrical differences rather than shaping motion and alloys may affect the screw-in force during canal instrumentation. To reduce screw-in forces, the use of NiTi files with smaller cross-sectional area for higher flexibility is recommended.

Esthetic enhancement of a traumatized anterior tooth with a combination of forced eruption and tooth alignment: a case report

Exposing sound structure of a subgingivally fractured tooth using orthodontic extrusion is considered to be a conservative way to re-establish biologic width without sacrificing esthetics or jeopardizing periodontal support of neighboring teeth. When a misaligned tooth is traumatically involved, a more comprehensive approach combining tooth extrusion and re-alignment may be necessary for a successful restorative outcome. This case report describes a successful esthetic management of a patient with complicated crown-root fracture on the maxillary right central incisor and pre-existing malocclusion in the maxillary anterior region. Forced eruption along with re-alignment of teeth by orthodontic movement seems to allow re-positioning of the fracture line to a favorable position and correction of crowding, providing a better esthetic result.

Preference of undergraduate students after first experience on nickel-titanium endodontic instruments

OBJECTIVES: This study aimed to compare two nickel-titanium systems (rotary vs. reciprocating) for their acceptance by undergraduate students who experienced nickel-titanium (NiTi) instruments for the first time. MATERIALS AND METHODS: Eighty-one sophomore dental students were first taught on manual root canal preparation with stainless-steel files. After that, they were instructed on the use of ProTaper Universal system (PTU, Dentsply Maillefer), then the WaveOne (WO, Dentsply Maillefer). They practiced with each system on 2 extracted molars, before using those files to shape the buccal or mesial canals of additional first molars. A questionnaire was completed after using each file system, seeking students' perception about 'Ease of use', 'Flexibility', 'Cutting-efficiency', 'Screwing-effect', 'Feeling-safety', and 'Instrumentation-time' of the NiTi files, relative to stainless-steel instrumentation, on a 5-point Likert-type scale. They were also requested to indicate their preference between the two systems. Data was compared between groups using t-test, and with Chi-square test for correlation of each perception value with the preferred choice (p = 0.05). RESULTS: Among the 81 students, 55 indicated their preferred file system as WO and 22 as PTU. All scores were greater than 4 (better) for both systems, compared with stainless-steel files, except for 'Screwing-effect' for PTU. The scores for WO in the categories of 'Flexibility', 'Screwing-effect', and 'Feeling-safety' were significantly higher scores than those of PTU. A significant association between the 'Screwing-effect' and students' preference for WO was observed. CONCLUSIONS: Novice operators preferred nickel-titanium instruments to stainless-steel, and majority of them opted for reciprocating file instead of continuous rotating system.

Proximity of the mandibular molar root apex from the buccal bone surface: a cone-beam computed tomographic study

OBJECTIVES: The purpose of this study was to evaluate the proximity of the mandibular molar apex to the buccal bone surface in order to provide anatomic information for apical surgery. MATERIALS AND METHODS: Cone-beam computed tomography (CBCT) images of 127 mandibular first molars and 153 mandibular second molars were analyzed from 160 patients' records. The distance was measured from the buccal bone surface to the root apex and the apical 3.0 mm on the cross-sectional view of CBCT. RESULTS: The second molar apex and apical 3 mm were located significantly deeper relative to the buccal bone surface compared with the first molar (p < 0.01). For the mandibular second molars, the distance from the buccal bone surface to the root apex was significantly shorter in patients over 70 years of age (p < 0.05). Furthermore, this distance was significantly shorter when the first molar was missing compared to nonmissing cases (p < 0.05). For the mandibular first molars, the distance to the distal root apex of one distal-rooted tooth was significantly greater than the distance to the disto-buccal root apex (p < 0.01). In mandibular second molar, the distance to the apex of C-shaped roots was significantly greater than the distance to the mesial root apex of non-C-shaped roots (p < 0.01). CONCLUSIONS: For apical surgery in mandibular molars, the distance from the buccal bone surface to the apex and apical 3 mm is significantly affected by the location, patient age, an adjacent missing anterior tooth, and root configuration.

A Case of Thyroid Insular Carcinoma with Multiple Bone Metastases Presenting as Pyriform Sinus Mass / 대한이비인후과학회지

Thyroid insular carcinoma (TIC, poorly differentiated thyroid carcinoma) is derived from thyroid follicular cells and known to show pathophysiologic behaviors intermediate between well-differentiated and undifferentiated types of thyroid carcinoma. The estimated incidence of TIC is from 0.4% to 5% of all thyroid cancers and is rare in Asians. Moreover, the multiple bone metastases in TIC have been rarely reported so far. Clinically, there are two pathways that thyroid cancer is presented, either as a parapharyngeal or retropharyngeal mass. For the first pathway, the mass is located on the thyroid upper pole and it grows toward the anatomical defect of posterior aspect of inferior pharyngeal constrictor. The second pathway involves a pharynx directly compressed by the mass from outside to inside of inferior pharyngeal constrictor. A 66-year-old man who had a thyroid mass revealed important clinical findings: a right pyriform sinus mass from laryngoscopy and multiple bone metastases from radiology. We performed subtotal thyroidectomy with central neck dissection. The mass was confirmed as TIC from follicular thyroid carcinoma. The patient received radiation and radioactive iodine therapy, and bcause of a remnant thyroid mass, he was observed closely. We herein report a rare, unique case of TIC with a review of literatures.