Association of Periodontitis with Serum Vitamin D Level among Korean Adults / 치위생과학회지

Periodontal disease is a chronic inflammatory disease that affects quality of life and nutrition. Several studies have demonstrated a link between periodontal disease and low bone density, and vitamin D is expected to have a beneficial effect on periodontal disease as well as on bone mineral density and anti-inflammatory effects. The purpose of this study was to identify the association between periodontal disease and vitamin D because the results are different in some studies and there is a lack of research in Korea. In this study, we conducted a multiple linear regression analysis of 8,783 subjects among 23,626 subjects who were older than 20 years of age, who had serum vitamin D levels and periodontal disease, who had three years of the National Health and Nutrition Survey that was conducted in Korea from 2012 to 2014. We examined the relationship between serum vitamin D levels and periodontal disease. Tooth loss and vitamin D levels were negatively correlated (β=−0.028, p=0.008). In addition, the prevalence of periodontal disease was found to be higher in men younger than 50 years of age with lower vitamin D levels (Q1: 1.769 [1.125~2.782], Q2: 1.182 [0.743~1.881], Q3: 0.676 [0.400~1.881]; p=0.001). Low vitamin D levels and periodontal disease are common diseases in primary care. Vitamin D supplementation is expected to have favorable effect on periodontal disease and falls, osteoporosis, osteoarthritis, and cancer. Therefore, patients with periodontal disease may benefit from periodic vitamin D management to improve quality of life as well as to manage periodontal disease. In addition, as shown in this study, not only elderly individuals, but also men younger than 50 years of age are related to periodontal disease, so there should be interest in controlling the levels of vitamin D in adults.

A Twenty-Minute Nap Boosts the Planning Domain of Executive Function in Sleep Deprived Late Adolescents

OBJECTIVES: The positive effects of nap on cognitive function and memory have been researched intensively among children and adults. However, the relationship between afternoon nap and executive function among sleep deprived late adolescents has not been studied as much. METHODS: Ten sleep deprived, otherwise healthy Korean high school students were recruited, and asked to fill out Pittsburgh Sleep Quality Index questionnaire. They were put to nap for 5 min on three days during the first week, then for 10, 20, and 30 min in the same protocol during the consecutive weeks. After a 1-h class, both the students themselves and their corresponding teachers evaluated the participation level of the participants. They were then divided into two groups, and were instructed to play iPad game ‘Free Flow’. One group took a nap while the other group was prohibited from taking a nap. Both groups were instructed to play the game again. This was repeated once every afternoon for three days. RESULTS: The experiment showed that 20-min nap was superior in subjective evaluations to the other nap duration, and the mean game score differences before and after were significantly higher in the nap taking group after the 20-min nap when analyzed using non-parametric statistical method (p-value 0.04). CONCLUSIONS: Therefore, 20-min nap is likely to boost planning domain of executive function on sleep deprived late adolescents.

Mental Health of the People with Hearing Impairment in Korea: A Population-Based Cross-Sectional Study / 가정의학회지

BACKGROUND: The prevalence of hearing impairment is increasing and an association between hearing impairment and mental health has been reported. Our study aimed to determine the association between hearing impairment and mental health in Korea. METHODS: This was a cross-sectional study of data from the Korean National Health and Nutrition Examination Survey 2010–2013, with a sample size of 18,563 individuals (6,395 with hearing impairment and 12,168 without hearing impairment), aged ≥20 years. RESULTS: The female group with hearing impairment tended to have a higher rate of stress (odds ratio [OR], 1.32; 95% confidence interval [CI], 1.11 to 1.56). The association between hearing impairment and depressive symptoms was higher in elderly males (OR, 1.60; 95% CI, 1.10 to 2.32), while the association of hearing impairment with suicide ideation was higher in elderly females (OR, 1.32; 95% CI, 1.00 to 1.75). CONCLUSION: Elderly individuals with hearing impairment are easily susceptible to poor mental health status. Early targeted intervention to address mental health problems is recommended for people with hearing impairment.

Prospective Study for Evaluating Therapeutic Efficacy of Obese Patients of Low Socioeconomic Status in Korea

BACKGROUND: Recently, the prevalence of obesity and socioeconomic costs stemming from obesity are increasing steeply. Obesity, in particular, has a highly polarization caused by income levels. Obesity in low-income patients is expected to become a serious social problem in the future. This study aims to observe the effects of consistent consultation and drug therapy during a six months period, and to develop the treatment process of obesity for low-income people. METHODS: The body weight, waist circumference, body mass index (BMI), and blood pressure (BP) was measured every 2 weeks, and laboratory blood tests with a survey including Beck Depression Inventory (BDI) and eating behavior index was checked at 0, 3, and 6 months. Paired t-test and linear mixed model was done to evaluate the difference between pre-treatment data and post-treatment data. RESULTS: Twenty-one patients (2 males, median age [interquartile range] of 39 years [29-46]) were analyzed. There were statistically significant reductions of body weight (P<0.01), BMI (P<0.01), waist circumference (P<0.01), low-density lipoprotein (P=0.01), BDI-I (P<0.01), eating behavior index (P<0.01). There was no statistically significant difference of safety outcome of the BP and blood tests. CONCLUSIONS: Proper obesity treatment of obese patients of low socioeconomic status was meaningful enough to affect depression and eating patterns as well as reducing body weight and decreased waist circumference.

The Impact of a Spouse's Depression on Family Functioning and Communication

BACKGROUND: Depression is known to affect family function and communication. However, the distress experienced by those who have spouse with depression has not been properly assessed to date. This study attempted to examine the effect of depression on family function and communication as reported by the spouses of the depressed patients. METHODS: The participants of this study were 445 couples who visited 28 family doctors from April 2009 to June 2011. The Family Adaptability and Cohesion Evaluation Scale III (FACES-III) was used to evaluate the family function, and the family communication scale in FACES-IV was used to evaluate communication among family members. A score of more than 21 points on the CES-D scale was used to indicate depression. The relationships between family type, family communication, and the depression of one's spouse were analyzed using the chi-square test and logistic regression. RESULTS: The odds ratios, indicating how the family is heading towards an extreme level, were statistically significant in all male and female respondents (male: odds ratio [OR] 3.08, 95% confidence interval [CI] 1.73-5.48; female: OR 2.09, 95% CI 1.02-4.27). On the other hand, only female respondents with depressed spouses reported their family communication not to be good (male: OR 1.65, 95% CI 0.88-3.07; female: OR 2.48, 95% CI, 1.25-4.93). CONCLUSIONS: This study revealed people perceive their family function and communication not good when they have spouses with depression. There was no gender difference in the evaluation of their family function, but the perception on their family communication were different by gender.

Facility characteristics as independent prognostic factors of nursing home-acquired pneumonia

BACKGROUND/AIMS: Recently, the incidence of nursing home-acquired pneumonia (NHAP) has been increasing and is now the leading cause of death among nursing home residents. This study was performed to identify risk factors associated with NHAP mortality, focusing on facility characteristics. METHODS: Data on all patients > or = 70 years of age admitted with newly diagnosed pneumonia were reviewed. To compare the quality of care in nursing facilities, the following three groups were defined: patients who acquired pneumonia in the community, care homes, and care hospitals. In these patients, 90-day mortality was compared. RESULTS: Survival analyses were performed in 282 patients with pneumonia. In the analyses, 90-day mortality was higher in patients in care homes (12.2%, 40.3%, and 19.6% in community, care homes, and care hospitals, respectively). Among the 118 NHAP patients, residence in a care home, structural lung diseases, treatment with inappropriate antimicrobial agents for accompanying infections, and a high pneumonia severity index score were risk factors associated with higher 90-day mortality. However, infection by potentially drug-resistant pathogens was not important. CONCLUSIONS: Unfavorable institutional factors in care homes are important prognostic factors for NHAP.

Effect of 1-palmitoyl-2-linoleoyl-3-acetyl-rac-glycerol on Immune Functions in Healthy Adults in a Randomized Controlled Trial

We previously reported that 1-palmitoyl-2-linoleoyl-3-acetyl-rac-glycerol (PLAG) accelerates hematopoiesis and has an improving effect on animal disease models such as sepsis and asthma. The effects of PLAG supplementation on immune modulation were assessed in healthy men and women. The objective was to evaluate the effects of PLAG supplementation on immune regulatory functions such as activities of immune cells and cytokine production. A randomized double blind placebo-controlled trial was conducted. Seventy-five participants were assigned to one of two groups; all participants had an appropriate number of white blood cells on the testing day. The PLAG group (n=27) received oral PLAG supplements and the control group (n=22) received oral soybean oil supplements. IL-4 and IL-6 production by peripheral blood mononuclear cells (PBMC) were lower (p<0.001 and p<0.001, respectively) with PLAG than with soybean oil. However, the production of IL-2 and IFN-gamma by PBMC was unaltered with PLAG supplementation. The B cell proliferation decreased significantly in the PLAG group compared to the soybean oil control (p<0.05). The intake of PLAG in healthy adults for 4 weeks was deemed safe. These data suggest that PLAG has an immunomodulatory function that inhibits the excessive immune activity of immunological disorders such as atopic and autoimmune diseases. PLAG could improve the condition of these diseases safely as a health food supplement.

Physical and Emotional Status of Nursing Home Residents: Long-term Care of Older People via Incheon Nursing Home Network (LOVE) Study

BACKGROUND: The aim of the Long-term Care of Older People via Incheon Nursing Home Network (LOVE) study was to evaluate disease status and its association with physical activity and emotional status among the elderly in nursing homes. METHODS: This retrospective study included 1,379 nursing home residents aged 65 years and older, of which 260 were excluded due to lack of baseline information. Data regarding major diseases from 1,119 people were analyzed to compare prevalence according to age. Data about physical function and emotional status on admission from 497 residents were analyzed looking for contributing factors to limited function and unstable emotion. RESULTS: Hypertension was the most common ailment at 58.6% of the total followed by dementia (50.6%), stroke (28.7%), and diabetes (24.2%). Prevalence of diabetes (p<0.001) and stroke (p<0.001) were relatively low in the older age groups but that of osteoarthritis (p<0.001) and dementia (p=0.001) were relatively high. After adjusting for age and sex, limited physical activity was more frequent in those with strokes (odds ratio [OR], 3.7 [2.1-6.2], p<0.001) and fractures (OR, 2.1 [1.1-4.1], p=0.023). Unstable emotion was more frequent in residents with dementia (OR, 1.9 [1.3-2.8], p=0.001). CONCLUSION: The most common diseases among nursing home residents, in decreasing order, were hypertension, dementia, stroke, and diabetes. Diseases related to the need for physical aids were strokes and fractures. Effective strategies for the management of unstable emotional status in the elderly with dementia are needed.

Effect of a Needle Aspiration in Patients with Lymphedema / 한국호스피스완화의료학회지

PURPOSE: Lymphedemas are tissue fluid swellings, usually on the arms or legs, and occur as a result of impaired lymphatic drainage. Presently, the most effective treatment available is complete decongestive physiotherapy (CDP). However, this therapy is ineffective in some patients and surgery may be indicated. Herein, we examined the efficacy of minimally invasive needle aspiration of the most enlarged areas in hypodermic adipose tissues, of patients who had failed CDP. METHODS: We included 21 patients who were diagnosed with lymphedema stage II-III in the upper or lower extremities and visited the lymphedema clinic at a university hospital from September 1, 2003 to February 28, 2004. All patients had been treated with CDP at least once, but had failed to respond to the therapy for more than one year. Nine patients had breast cancer and 12 had cervical cancer. We identified the area with the most severe edema by using MRI and performed a 16-gauge angio-needle aspiration on the area. The patients were followed up for 3 months. Effectiveness of the treatment was evaluated by comparing the volume of edema before and after the treatment using Wilcoxon signed rank-test. RESULTS: The mean reduction ratio of the volume of edema comparison normal volume was 41.1+/-35.3% (P=0.001). There were no major or minor operative complications except localized hemorrhage. CONCLUSION: We conclude that a needle aspiration prior to other surgical treatments is relatively safe and effective for those patients who are unresponsive to CDP.

The Relationship between Heart Rate Variability and Illness Severity

BACKGROUND: In severity of illness index, there is an acute physiologic and chronic health evaluation (APACHE) scoring system which was modified to APACHE III in 1990. Heart rate variability (HRV) studies for the intensive care unit (ICU) patients provides an indirect but noninvasive probe of autonomic cardiovascular control. Therefore, we intended to find out the relationship between the APACHE III score and the HRV variables in ICU patients. METHODS: We examined 22 patients in medical ICU of one college hospital from April to May of 2003, excluding patients with cardiac disorders, neurologic disorders or surgical diseases. We also examined 22 patients in general wards of family medicine. We checked the APACHE III during the 24 hours of admission, and examined the HRV on the second day of admission and then the total power (TP), normalized low frequency (LFnorm), low frequency/ high frequency ratio (LF/HF ratio) and approximate entropy (ApEn). RESULTS: The average of TP (msec2) were 538.9+/-896.7 in ICU patients and 1605.3+/-3091.8 in patients of general ward. The average APACHE III score was 35.9+/-18.5 and by Pearson correlation analysis, the correlation coefficient between the APACHE III score and the log (TP) was -0.58 (P=0.005). CONCLUSION: We found that the medical ICU patients had more decreased autonomic function than the patients of general ward, and there was a negative correlation with the APACHE III score and the disease severity.