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1.
Article in English | WPRIM | ID: wpr-917381

ABSTRACT

With the recent rapid increase in obesity worldwide, metabolic syndrome (MetS) has gained significant importance. MetS is a cluster of obesity-related cardiovascular risk factors including abdominal obesity, atherogenic dyslipidemia, high blood pressure and impaired glucose tolerance. MetS is highly prevalent and strongly associated with an increased risk of developing diabetes and cardiovascular disease, putting a great burden on human society. Therefore, it is very important to reduce MetS risk, which can improve patients’cardiovascular prognosis. The primary and most effective strategy to control each component of MetS is lifestyle change such as losing body weight, keeping regular exercise, adopting a healthy diet, quitting smoking and alcohol drinking in moderation. Many studies have shown that lifestyle modification has improved all components of MetS, and reduces the incidence of diabetes and cardiovascular disease. Here, the Korean Society of CardioMetabolic Syndrome has summarized specific and practical methods of lifestyle modification in the management of MetS in the healthcare field.

2.
Article in English | WPRIM | ID: wpr-915611

ABSTRACT

Objective@#: COVID-19 has spread worldwide since the first case was reported in Wuhan, China, in December 2019. Our institution is a regional trauma and emergency center in the northern Gyeonggi Province. The changing trend of patient care in the emergency room of this hospital likely reflects the overall trend of patients in the area. In the present study, whether changes in the surrounding social environment following the outbreak of COVID-19 changed the incidence of neurosurgical emergency patients and whether differences in practice existed were investigated. @*Methods@#: The overall trend was analyzed from January 2020 which is before the outbreak of COVID-19 to September 2020. To remove bias due to seasonal variation, the previous 2 year's records during the same period were reviewed and compared. Confirmed COVID-19 patients in the northern Gyeonggi Province were identified using data released by the government. And patients who came to the emergency department with head trauma and stroke were identified. @*Results@#: Based on the present study results, the total number of neurosurgery emergency patients decreased over the study period. In the trauma patient group, the number of patients not involved in traffic accidents significantly decreased compared with patients involved in traffic accidents. Among the stroke cases, the rate of ischemic stroke was lower than hemorrhagic stroke, although a statistically significant difference was not observed. Meanwhile, an increase in the risk of mortality associated with trauma or stroke cases was not observed during the COVID-19 outbreak compared with the same time period in the previous year. @*Conclusion@#: Due to the occurrence of COVID-19, non-essential activities have decreased and trauma cases not associated with traffic accidents appeared to decrease. Due to the decrease in overall activity, the number of stroke patients has also decreased. This trend is expected to continue even in the post-COVID-19 era, and accordingly, the results from the present study are relevant especially if the current situation continues.

3.
Article in English | WPRIM | ID: wpr-903683

ABSTRACT

Background/Aims@#Beta-blockers (BBs) have been shown to improve clinical outcomes in heart failure (HF) patients. We evaluated the prescribing status of BBs in patients with HF with reduced ejection fraction (HFrEF) at discharge according to the presence or not of bradycardia, and its effect on prognosis. @*Methods@#Study data were obtained from a multicenter cohort of 3,200 patients hospitalized for HF. Patients were classified into four groups according to the presence of bradycardia and use of BBs at discharge. The primary outcome was the incidence of all-cause death during follow-up. @*Results@#Of 1,584 patients with HFrEF, 281 patients died during follow-up (median 523 days, mean 578.5 ± 429.7 days). In patients with bradycardia, the all-cause death rate did not significantly differ according to the use of BBs, but in those patients without bradycardia, the incidence of all-cause death was significantly lower in the BBs group than the no BBs group. Among these four groups, patients with heart rate (HR) ≥ 60 beats/min with no BBs group had the lowest cumulative death-free survival rate. In addition, HR ≥ 60 beats/min with BBs use was independently associated with a 31% reduced risk of all-cause death in patients with HFrEF. @*Conclusions@#BBs had a beneficial effect on clinical prognosis only in those HFrEF patients without bradycardia. Therefore, BBs should be given by clinicians to HF patients without bradycardia to improve their clinical outcomes.

4.
Article in English | WPRIM | ID: wpr-901915

ABSTRACT

Ginger has been used worldwide in traditional medicine. It has been reported that phenolic compounds such as gingerol and shogaol in ginger have beneficial cellular effect and antibacterial effect. The purpose of this study was to investigate the effect of gingerol and shogaol on the cytocompatibility for the osteoblastic cells and antibacterial activity against oral microorganisms. Chemical structures of gingerol and shogaol were determined by Fourier transform infrared (FT-IR). Thermal and pH stability was analyzed by UPLC assay. Streptococcus mutans, and Porphyromonas gingivalis were used to confirm the antibacterial effect of the ginger compounds and MC3T3-E1 cells were used to identify biocompatibility test. Cell viability and bacterial growth was determined by water-soluble tetrazolium salt (WST-8) colorimetric assay. Cellular morphology was identified with optical microscope after crystal violet staining. Cell differentiation and oxidative stress were evaluated by Alkaline phosphatase (ALP) assay and hydrogen peroxide colorimetric assay. The chemical bonding related with hydroxyl groups, carbonyl groups and aromatic ring was identified in all ginger compounds. Gingerol and shogaol presented good stability at acid and neutral pH at room temperature. All compounds showed better antibacterial effect against Porphyromonas gingivalis than Streptococcus mutans. 10-gingerol and all shogaol groups below 10-6 M presented suitable cytocompatibility for osteoblastic cells compared to control group. All groups showed similar Oxidative stress to control group, and ALP activity in all groups below 10-6 M was not statistically significant compared to control. Hence, this study concludes that shogaol groups presented better antibacterial effect and suitable cytocompatibility than gingerol groups.

5.
Article in English | WPRIM | ID: wpr-901912

ABSTRACT

This study was performed to evaluate the effects of microstructural change of zirconia surface on tensile bond strength with resin cement. The zirconia partially sintered block was cut into a size of 18 × 18 × 7 mm, and then the Zirface slurry (DMAX, Daegu, Korea) containing 15% and 30% zirconia was applied and followed by sintering at 1530 ℃ for 2 hours. Resin cement (PermaCem 2.0, DMG, Hamburg, Germany) was applied on zirconia specimen and polymerized to prepare an 18 × 18 × 14 mm block. In addition, for comparison of bond strength, specimens were prepared for the group that was polished and the group that was blasted at 3 atm using 110 µm alumina. Thereafter, all blocks were cut into a cross-sectional area of 1.0 × 1.0 mm to prepare 12 specimens. The specimens were immersed in distilled water at 37 ℃. for 10 days for aging treatment. A holder for tensile testing was attached to each of the specimens, and then a tensile force was applied at a crosshead speed of 0.5 mm/min to measure the fracture load. The fracture surfaces of each test piece was observed with a high-resolution field emission scanning electron microscope. Through the above tests, the following results were obtained. 1. On the blasted surface, zirconia grains were locally removed but on the Zirface treated surface, a porous microstructure was created on the zirconia surface. 2. Arithmetical mean deviation from the mean line ra was the highest in the blasted group and the lowest in the polished group, and as a result of Tukey analysis, there were statistically significant differences between all test groups (P<0.05). 3. The maximum tensile bond strength was 18.8±5.4 MPa in the Zirface 30% group, and as a result of Tukey analysis, there was a statistically significant difference from the other test groups (P<0.05). 4. As a result of observing the fracture surface after the tensile test with a high-resolution field emission scanning electron microscope, in the Zirface 30% group, cohesive fracture and interfacial fracture in the resin was observed, but the other test groups showed the interfacial fracture pattern. In conclusion, within the limits of this study, treating the zirconia surface with Zirface 30% to form a porous microstructure can contribute to the improvement of the bond strength between zirconia and resin cement.

6.
Article in English | WPRIM | ID: wpr-901911

ABSTRACT

The purpose of this study was to investigate the effect of glazing treatment of multi-colored zirconia disc and lithium disilicate block on the optical properties. From an Ultra Translucent Multi-Layered (UTML) disc containing 50% cubic crystal and a lithium disilicate-based Amber Mill Direct (AMD) block, the 1.2 mm thick specimens of the upper layer (T), the center (M), and the lower layer (B) were prepared. Three types of paste glaze of InSync Glaze Paste, IPS E.max Ceram Glaze Paste, and Amber Ceram G7 Glaze Paste were applied and fired to a uniform thickness on the surface of the specimen. CIE L * , a * , b * values were measured using a spectrophotometer and contrast and translucency were calculated. The bonding interface with the glaze layer was observed using HR FE-SEM. In the glazed groups, L * value increased, but a * value and b * value decreased. The translucency value measured in the untreated group was statically higher in the AMD groups than in UTML groups (P0.05), but significantly decreased compared to the untreated group after glazing treatment in the AMD group (P<0.05). The contrast ratios generally increased after glaze treatment compared to the untreated group. Since the glaze treatment can affect the optical properties of ceramic restorations, the choice of glaze should be considered important for the desired color by the dental technician.

7.
Article in English | WPRIM | ID: wpr-901907

ABSTRACT

The purpose of this study was to evaluate the structural characteristics of the thread length of orthodontic mini-screws and the effects of insertion and removal torques according to the formation of the cutting flute. Two types of mini-screws were made, with a thread length of 6.0 mm and a thread length of 3.3 mm. In order to examine the effect of flute formation, the experiment group was divided into a miniscrew test group with flute formation and an experiment group without flute formation. To evaluate the effect of flute formation, two flutes were formed at 180°on the circumference, and at the tip of the mini screw, up to 4 mm for thread length of 6.0 mm and 2.4 mm for thread length of 3.3 mm. A biomechanical test block formed of 2 mm cortical bone and 10 mm cancellous bone was used to eliminate the influence of the difference in cortical bone thickness and bone density according to the insertion site. 1 mm diameter guide hole was drilled on the test block and the mini-screw was placed vertically. Using a 0.1 N·cm precision digital torque gauge, the maximum torque value was recorded at this time by embedding it to the top of the screw under a static load of 1.2 kg and the value when it was removed in the opposite direction. The insertion torque values for the 6.0 mm and 3.3 mm length mini screws were (29.53±1.84) N·cm and (26.84±2.15) N·cm, and the removal torque values are (14.50±1.37) N·cm and (13.15±2.89) N·cm, respectively.There were no statistically significant differences (P>0.05). The flute of 6.0 mm mini-screws had no statistically significant difference in both insertion and removal torque values and increased to (30.13±1.97) N·cm and (18.65±1.10) N·cm (P>0.05). In experiments with 3.3 mm mini-screws, the insertion and removal torque values decreased to (20.99±3.94) N·cm and (11.32±2.03) N·cm, respectively, showing a statistically significant decrease only in the insertion torque values (P<0.05). The insertion and removal torque values of the mini-screw were not significantly increased even when the screw length was doubled, and the flute formation effect was different with the screw length.

8.
Article in English | WPRIM | ID: wpr-898786

ABSTRACT

Lower urinary tract symptoms (LUTS) are a cluster of voiding symptoms, such as weak stream, hesitancy, intermittency, urinary frequency, urgency, and nocturia. LUTS are frequent in elderly men and it considered the ultimate clinical symptoms of benign prostatic hyperplasia. With aging, male hypogonadism is increased which is defined as decreased ability of the testes to produce sperm and sex steroids because of a pituitary/hypothalamic, or testicular deficiency. In academic andrology associations, the term “male hypogonadism” is commonly used to categorize testosterone deficiency. Testosterone deficiency syndrome (TDS) is defined as a decrease in serum testosterone accompanied by symptoms such as libido decrease, depressive disorder, erectile dysfunction, and fatigue. Although the mechanism about testosterone-replacement therapy (TRT) effects on men with hypogonadism is not yet identified, TRT has been shown to effectively relieve the symptoms of TDS as well as LUTS by several studies. Although the present review demonstrates the effectiveness and safety of TRT in men with TDS by prior studies, future large scale of clinical trials should be conducted to present more high-quality evidence to clinicians and patients.

9.
Article in English | WPRIM | ID: wpr-897407

ABSTRACT

Background@#There have been no guidelines for the management of adult patients with diffuse midline glioma (DMG), H3K27M-mutant in Korea since the 2016 revised WHO classification newly defined this disease entity. Thus, the Korean Society for Neuro-Oncology (KSNO), a multidisciplinary academic society, had begun preparing guidelines for DMG since 2019. @*Methods@#The Working Group was composed of 27 multidisciplinary medical experts in Korea.References were identified through searches of PubMed, MEDLINE, EMBASE, and Cochrane CENTRAL using specific and sensitive keywords as well as combinations of keywords. As ‘diffuse midline glioma’ was recently defined, and there was no international guideline, trials and guidelines of ‘diffuse intrinsic pontine glioma’ or ‘brain stem glioma’ were thoroughly reviewed first. @*Results@#The core contents are as follows. The DMG can be diagnosed when all of the following three criteria are satisfied: the presence of the H3K27M mutation, midline location, and infiltrating feature. Without identification of H3K27M mutation by diagnostic biopsy, DMG cannot be diagnosed. For the primary treatment, maximal safe resection should be considered for tumors when feasible. Radiotherapy is the primary option for tumors in case the total resection is not possible. A total dose of 54 Gy to 60 Gy with conventional fractionation prescribed at 1-2 cm plus gross tumor volume is recommended. Although no chemotherapy has proven to be effective in DMG, concurrent chemoradiotherapy (± maintenance chemotherapy) with temozolomide following WHO grade IV glioblastoma’s protocol is recommended. @*Conclusion@#The detection of H3K27M mutation is the most important diagnostic criteria for DMG. Combination of surgery (if amenable to surgery), radiotherapy, and chemotherapy based on comprehensive multidisciplinary discussion can be considered as the treatment options for DMG.

10.
Article in English | WPRIM | ID: wpr-897406

ABSTRACT

Background@#To date, there has been no practical guidelines for the prescription of antiepileptic drugs (AEDs) in brain tumor patients in Korea. Thus, the Korean Society for Neuro-Oncology (KSNO), a multidisciplinary academic society, had begun preparing guidelines for AED usage in brain tumors since 2019. @*Methods@#The Working Group was composed of 27 multidisciplinary medical experts in Korea.References were identified through searches of PubMed, MEDLINE, EMBASE, and Cochrane CENTRAL using specific and sensitive keywords as well as combinations of the keywords. @*Results@#The core contents are as follows. Prophylactic AED administration is not recommended in newly diagnosed brain tumor patients without previous seizure history. When AEDs are administered during peri/postoperative period, it may be tapered off according to the following recommendations. In seizure-naïve patients with no postoperative seizure, it is recommended to stop or reduce AED 1 week after surgery. In seizure-naïve patients with one early postoperative seizure (<1 week after surgery), it is advisable to maintain AED for at least 3 months before tapering. In seizure-naïve patients with ≥2 postoperative seizures or in patients with preoperative seizure history, it is recommended to maintain AEDs for more than 1 year. The possibility of drug interactions should be considered when selecting AEDs in brain tumor patients. Driving can be allowed in brain tumor patients when proven to be seizure-free for more than 1 year. @*Conclusion@#The KSNO suggests prescribing AEDs in patients with brain tumor based on the current guideline. This guideline will contribute to spreading evidence-based prescription of AEDs in brain tumor patients in Korea.

11.
Article in English | WPRIM | ID: wpr-895979

ABSTRACT

Background/Aims@#Beta-blockers (BBs) have been shown to improve clinical outcomes in heart failure (HF) patients. We evaluated the prescribing status of BBs in patients with HF with reduced ejection fraction (HFrEF) at discharge according to the presence or not of bradycardia, and its effect on prognosis. @*Methods@#Study data were obtained from a multicenter cohort of 3,200 patients hospitalized for HF. Patients were classified into four groups according to the presence of bradycardia and use of BBs at discharge. The primary outcome was the incidence of all-cause death during follow-up. @*Results@#Of 1,584 patients with HFrEF, 281 patients died during follow-up (median 523 days, mean 578.5 ± 429.7 days). In patients with bradycardia, the all-cause death rate did not significantly differ according to the use of BBs, but in those patients without bradycardia, the incidence of all-cause death was significantly lower in the BBs group than the no BBs group. Among these four groups, patients with heart rate (HR) ≥ 60 beats/min with no BBs group had the lowest cumulative death-free survival rate. In addition, HR ≥ 60 beats/min with BBs use was independently associated with a 31% reduced risk of all-cause death in patients with HFrEF. @*Conclusions@#BBs had a beneficial effect on clinical prognosis only in those HFrEF patients without bradycardia. Therefore, BBs should be given by clinicians to HF patients without bradycardia to improve their clinical outcomes.

12.
Article in English | WPRIM | ID: wpr-894211

ABSTRACT

Ginger has been used worldwide in traditional medicine. It has been reported that phenolic compounds such as gingerol and shogaol in ginger have beneficial cellular effect and antibacterial effect. The purpose of this study was to investigate the effect of gingerol and shogaol on the cytocompatibility for the osteoblastic cells and antibacterial activity against oral microorganisms. Chemical structures of gingerol and shogaol were determined by Fourier transform infrared (FT-IR). Thermal and pH stability was analyzed by UPLC assay. Streptococcus mutans, and Porphyromonas gingivalis were used to confirm the antibacterial effect of the ginger compounds and MC3T3-E1 cells were used to identify biocompatibility test. Cell viability and bacterial growth was determined by water-soluble tetrazolium salt (WST-8) colorimetric assay. Cellular morphology was identified with optical microscope after crystal violet staining. Cell differentiation and oxidative stress were evaluated by Alkaline phosphatase (ALP) assay and hydrogen peroxide colorimetric assay. The chemical bonding related with hydroxyl groups, carbonyl groups and aromatic ring was identified in all ginger compounds. Gingerol and shogaol presented good stability at acid and neutral pH at room temperature. All compounds showed better antibacterial effect against Porphyromonas gingivalis than Streptococcus mutans. 10-gingerol and all shogaol groups below 10-6 M presented suitable cytocompatibility for osteoblastic cells compared to control group. All groups showed similar Oxidative stress to control group, and ALP activity in all groups below 10-6 M was not statistically significant compared to control. Hence, this study concludes that shogaol groups presented better antibacterial effect and suitable cytocompatibility than gingerol groups.

13.
Article in English | WPRIM | ID: wpr-894208

ABSTRACT

This study was performed to evaluate the effects of microstructural change of zirconia surface on tensile bond strength with resin cement. The zirconia partially sintered block was cut into a size of 18 × 18 × 7 mm, and then the Zirface slurry (DMAX, Daegu, Korea) containing 15% and 30% zirconia was applied and followed by sintering at 1530 ℃ for 2 hours. Resin cement (PermaCem 2.0, DMG, Hamburg, Germany) was applied on zirconia specimen and polymerized to prepare an 18 × 18 × 14 mm block. In addition, for comparison of bond strength, specimens were prepared for the group that was polished and the group that was blasted at 3 atm using 110 µm alumina. Thereafter, all blocks were cut into a cross-sectional area of 1.0 × 1.0 mm to prepare 12 specimens. The specimens were immersed in distilled water at 37 ℃. for 10 days for aging treatment. A holder for tensile testing was attached to each of the specimens, and then a tensile force was applied at a crosshead speed of 0.5 mm/min to measure the fracture load. The fracture surfaces of each test piece was observed with a high-resolution field emission scanning electron microscope. Through the above tests, the following results were obtained. 1. On the blasted surface, zirconia grains were locally removed but on the Zirface treated surface, a porous microstructure was created on the zirconia surface. 2. Arithmetical mean deviation from the mean line ra was the highest in the blasted group and the lowest in the polished group, and as a result of Tukey analysis, there were statistically significant differences between all test groups (P<0.05). 3. The maximum tensile bond strength was 18.8±5.4 MPa in the Zirface 30% group, and as a result of Tukey analysis, there was a statistically significant difference from the other test groups (P<0.05). 4. As a result of observing the fracture surface after the tensile test with a high-resolution field emission scanning electron microscope, in the Zirface 30% group, cohesive fracture and interfacial fracture in the resin was observed, but the other test groups showed the interfacial fracture pattern. In conclusion, within the limits of this study, treating the zirconia surface with Zirface 30% to form a porous microstructure can contribute to the improvement of the bond strength between zirconia and resin cement.

14.
Article in English | WPRIM | ID: wpr-894207

ABSTRACT

The purpose of this study was to investigate the effect of glazing treatment of multi-colored zirconia disc and lithium disilicate block on the optical properties. From an Ultra Translucent Multi-Layered (UTML) disc containing 50% cubic crystal and a lithium disilicate-based Amber Mill Direct (AMD) block, the 1.2 mm thick specimens of the upper layer (T), the center (M), and the lower layer (B) were prepared. Three types of paste glaze of InSync Glaze Paste, IPS E.max Ceram Glaze Paste, and Amber Ceram G7 Glaze Paste were applied and fired to a uniform thickness on the surface of the specimen. CIE L * , a * , b * values were measured using a spectrophotometer and contrast and translucency were calculated. The bonding interface with the glaze layer was observed using HR FE-SEM. In the glazed groups, L * value increased, but a * value and b * value decreased. The translucency value measured in the untreated group was statically higher in the AMD groups than in UTML groups (P0.05), but significantly decreased compared to the untreated group after glazing treatment in the AMD group (P<0.05). The contrast ratios generally increased after glaze treatment compared to the untreated group. Since the glaze treatment can affect the optical properties of ceramic restorations, the choice of glaze should be considered important for the desired color by the dental technician.

15.
Article in English | WPRIM | ID: wpr-894203

ABSTRACT

The purpose of this study was to evaluate the structural characteristics of the thread length of orthodontic mini-screws and the effects of insertion and removal torques according to the formation of the cutting flute. Two types of mini-screws were made, with a thread length of 6.0 mm and a thread length of 3.3 mm. In order to examine the effect of flute formation, the experiment group was divided into a miniscrew test group with flute formation and an experiment group without flute formation. To evaluate the effect of flute formation, two flutes were formed at 180°on the circumference, and at the tip of the mini screw, up to 4 mm for thread length of 6.0 mm and 2.4 mm for thread length of 3.3 mm. A biomechanical test block formed of 2 mm cortical bone and 10 mm cancellous bone was used to eliminate the influence of the difference in cortical bone thickness and bone density according to the insertion site. 1 mm diameter guide hole was drilled on the test block and the mini-screw was placed vertically. Using a 0.1 N·cm precision digital torque gauge, the maximum torque value was recorded at this time by embedding it to the top of the screw under a static load of 1.2 kg and the value when it was removed in the opposite direction. The insertion torque values for the 6.0 mm and 3.3 mm length mini screws were (29.53±1.84) N·cm and (26.84±2.15) N·cm, and the removal torque values are (14.50±1.37) N·cm and (13.15±2.89) N·cm, respectively.There were no statistically significant differences (P>0.05). The flute of 6.0 mm mini-screws had no statistically significant difference in both insertion and removal torque values and increased to (30.13±1.97) N·cm and (18.65±1.10) N·cm (P>0.05). In experiments with 3.3 mm mini-screws, the insertion and removal torque values decreased to (20.99±3.94) N·cm and (11.32±2.03) N·cm, respectively, showing a statistically significant decrease only in the insertion torque values (P<0.05). The insertion and removal torque values of the mini-screw were not significantly increased even when the screw length was doubled, and the flute formation effect was different with the screw length.

16.
Article in English | WPRIM | ID: wpr-891082

ABSTRACT

Lower urinary tract symptoms (LUTS) are a cluster of voiding symptoms, such as weak stream, hesitancy, intermittency, urinary frequency, urgency, and nocturia. LUTS are frequent in elderly men and it considered the ultimate clinical symptoms of benign prostatic hyperplasia. With aging, male hypogonadism is increased which is defined as decreased ability of the testes to produce sperm and sex steroids because of a pituitary/hypothalamic, or testicular deficiency. In academic andrology associations, the term “male hypogonadism” is commonly used to categorize testosterone deficiency. Testosterone deficiency syndrome (TDS) is defined as a decrease in serum testosterone accompanied by symptoms such as libido decrease, depressive disorder, erectile dysfunction, and fatigue. Although the mechanism about testosterone-replacement therapy (TRT) effects on men with hypogonadism is not yet identified, TRT has been shown to effectively relieve the symptoms of TDS as well as LUTS by several studies. Although the present review demonstrates the effectiveness and safety of TRT in men with TDS by prior studies, future large scale of clinical trials should be conducted to present more high-quality evidence to clinicians and patients.

17.
Article in English | WPRIM | ID: wpr-889703

ABSTRACT

Background@#There have been no guidelines for the management of adult patients with diffuse midline glioma (DMG), H3K27M-mutant in Korea since the 2016 revised WHO classification newly defined this disease entity. Thus, the Korean Society for Neuro-Oncology (KSNO), a multidisciplinary academic society, had begun preparing guidelines for DMG since 2019. @*Methods@#The Working Group was composed of 27 multidisciplinary medical experts in Korea.References were identified through searches of PubMed, MEDLINE, EMBASE, and Cochrane CENTRAL using specific and sensitive keywords as well as combinations of keywords. As ‘diffuse midline glioma’ was recently defined, and there was no international guideline, trials and guidelines of ‘diffuse intrinsic pontine glioma’ or ‘brain stem glioma’ were thoroughly reviewed first. @*Results@#The core contents are as follows. The DMG can be diagnosed when all of the following three criteria are satisfied: the presence of the H3K27M mutation, midline location, and infiltrating feature. Without identification of H3K27M mutation by diagnostic biopsy, DMG cannot be diagnosed. For the primary treatment, maximal safe resection should be considered for tumors when feasible. Radiotherapy is the primary option for tumors in case the total resection is not possible. A total dose of 54 Gy to 60 Gy with conventional fractionation prescribed at 1-2 cm plus gross tumor volume is recommended. Although no chemotherapy has proven to be effective in DMG, concurrent chemoradiotherapy (± maintenance chemotherapy) with temozolomide following WHO grade IV glioblastoma’s protocol is recommended. @*Conclusion@#The detection of H3K27M mutation is the most important diagnostic criteria for DMG. Combination of surgery (if amenable to surgery), radiotherapy, and chemotherapy based on comprehensive multidisciplinary discussion can be considered as the treatment options for DMG.

18.
Article in English | WPRIM | ID: wpr-889702

ABSTRACT

Background@#To date, there has been no practical guidelines for the prescription of antiepileptic drugs (AEDs) in brain tumor patients in Korea. Thus, the Korean Society for Neuro-Oncology (KSNO), a multidisciplinary academic society, had begun preparing guidelines for AED usage in brain tumors since 2019. @*Methods@#The Working Group was composed of 27 multidisciplinary medical experts in Korea.References were identified through searches of PubMed, MEDLINE, EMBASE, and Cochrane CENTRAL using specific and sensitive keywords as well as combinations of the keywords. @*Results@#The core contents are as follows. Prophylactic AED administration is not recommended in newly diagnosed brain tumor patients without previous seizure history. When AEDs are administered during peri/postoperative period, it may be tapered off according to the following recommendations. In seizure-naïve patients with no postoperative seizure, it is recommended to stop or reduce AED 1 week after surgery. In seizure-naïve patients with one early postoperative seizure (<1 week after surgery), it is advisable to maintain AED for at least 3 months before tapering. In seizure-naïve patients with ≥2 postoperative seizures or in patients with preoperative seizure history, it is recommended to maintain AEDs for more than 1 year. The possibility of drug interactions should be considered when selecting AEDs in brain tumor patients. Driving can be allowed in brain tumor patients when proven to be seizure-free for more than 1 year. @*Conclusion@#The KSNO suggests prescribing AEDs in patients with brain tumor based on the current guideline. This guideline will contribute to spreading evidence-based prescription of AEDs in brain tumor patients in Korea.

19.
Article in English | WPRIM | ID: wpr-919700

ABSTRACT

Background@#Dental caries and periodontal disease are bacterial infectious disease, mainly caused by plaque, a bacterial colony deposited on the tooth surface and gum tissue. Dental plaque disclosants easily stain the dental plaque, making them effective for scaling and tooth brushing education. As the erythrosine typically contained in dental plaque disclosants is highly cytotoxic, a low toxicity additive is needed. In this study, we aimed to examine the natural pigments with negligible cytotoxicity but can effectively stain the dental plaques for use in dental plaque disclosants. @*Methods@#The pigmentation of eight types of natural pigments was tested on bovine tongue and teeth, as well as on head and neck tissue sections of experimental ICR mice. The cytotoxicity of gingival epithelial cells was measured via MTT assay. Pigmentation was performed on the bovine tongue and tooth surface. Pigmentation in the oral environment was observed in four mandibular incisors. A 2 Tone was used as a control. @*Results@#Of the eight types of natural pigments, purple and blue pigments were effective in coloring dental plaques on the enamel surface as well as in the head and neck tissue sections. Additionally, purple and blue pigments were visible on the surface of the bovine tongue. Red, pink, orange, green, purple, and yellow pigments showed strong cytotoxicity, whereas brown and blue pigments had relatively low cytotoxicity. Blue pigment was effective in staining the dental plaque of four mandibular incisors. @*Conclusion@#We suggest that the blue pigment derived from Gardenia jasminoides Ellis (Rubiaceae), which is effective for coloring dental plaques and has low cytotoxicity, is useful as a naturally derived dental disclosant.

20.
Article in Korean | WPRIM | ID: wpr-917823

ABSTRACT

Numerous methods for human body fluid identification using microbiological markers specific to different human body parts are well-established in forensic science. However, method for vaginal fluid screening have not been standardized yet. Therefore, in this study, a real-time polymerase chain reaction based assay for vaginal fluid identification was devised using bacteria residing in human vagina. This method employed three markers, namely Lactobacillus iners, Lactobacillus crispatus, and Bacteroides fragilis. L. iners and L. crispatus were chosen due to their high abundance in the vagina, whereas B. fragilis resides in the rectum. To examine the suitability of the new method for forensic microbial applications, a study of the distribution of vaginal flora in 143 Korean women was performed, along with characterization of the specificity, and performance of the new assay. Additionally, a casework study based on 130, 21, 20 and 17 DNA samples collected from the vagina, anus, saliva, blood, respectively, was carried out. L. iners (80.4%) and L. crispatus (55.2%) were detected with high abundance in the vagina of Korean women. The specificity of these markers was verified using microbial DNA from 23 species. This method could detect at least 1,000 copies/µL of microorganisms for all markers, thereby highlighting its robust sensitivity for vaginal fluid identification. The casework study confirmed these findings, with 89.2% (116/130) detection of vaginal fluid-derived DNA samples, and no false positives identified from the other sources studied. In conclusion, the developed method is expected to be efficient for preliminary microbiological analysis of vaginal samples in forensics.

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