Preliminary study for the development of a visiting oral health care intervention program for the elderly based on community healthcare / 대한구강보건학회지

Objectives@#We evaluated the level of oral health status and oral health behavior in the elderly prior to their participation in a visiting oral health care intervention program as part of a community healthcare project in Cheonan city, South Korea. @*Methods@#The oral hygiene conditions, oral health behaviors, and oral senility of 64 elderly people subject to community care were measured during the period January 1 to February 15, 2020 using dental health surveys and questionnaire-based interviews conducted in line with World Health Organization standard criteria. @*Results@#The systematic disease retention rate of the elderly in this study was 90.6%, followed by hypertention (70.7%), and diabetes (51.7%). Scores were 1.69 out of 5 for subjective health evaluation, 1.8 out of 5 for subjective awareness of oral health, and the number of natural teeth was 14.9 per person (average mean for elderly people 18.38-19.34). During the day, 94.9% practiced brushing, after dinner 58.9%, and before bedtime 26.8%, which shows a diminished rate of practice. The percentage of participants dissatisfied with dental treatment was high at 67.2%, and the six measures of oral sensitivity, masticatory discomfort, pronunciation discomfort, and tongue pressure, presented less than average scores. @*Conclusions@#The level of oral health and oral health behavior of the elderly prior to the visiting oral health care community intervention program, was very poor. Therefore, the results of this study suggest that there is a need to develop a more systematic and thorough strategy to activate visiting community oral health care intervention programs.

Combined Aerobic and Resistance Exercise Training Reduces Circulating Apolipoprotein J Levels and Improves Insulin Resistance in Postmenopausal Diabetic Women

BACKGROUND: Circulating apolipoprotein J (ApoJ) is closely associated with insulin resistance; however, the effect of exercise on circulating ApoJ levels and the association of ApoJ with metabolic indices remain unknown. Here, we investigated whether a combined exercise can alter the circulating ApoJ level, and whether these changes are associated with metabolic indices in patients with type 2 diabetes mellitus.METHODS: Postmenopausal women with type 2 diabetes mellitus were randomly assigned into either an exercise (EXE, n=30) or control (CON, n=15) group. Participants in the EXE group were enrolled in a 12-week program consisting of a combination of aerobic and resistance exercises. At baseline, 4, 8, and 12 weeks, body composition and metabolic parameters including homeostatic model assessment of insulin resistance (HOMA-IR) and serum ApoJ levels were assessed.RESULTS: In the EXE group, ApoJ levels decreased 26.3% and 19.4%, relative to baseline, at 8 and 12 weeks, respectively. Between-group differences were significant at 8 and 12 weeks (P<0.05 and P<0.001, respectively). In the EXE group, 12 weeks of exercise resulted in significant decreases in body weight, percent body fat, and HOMA-IR indices. Concurrently, weight-adjusted appendicular skeletal muscle mass (ASM/wt) was increased in the EXE group compared with the CON group. Importantly, changes in the ApoJ level were significantly correlated with changes in ASM/wt.CONCLUSION: Exercise training resulted in a significant decrease in the circulating ApoJ level, with changes in ApoJ associated with an improvement in some insulin resistance indices. These data suggest that circulating ApoJ may be a useful metabolic marker for assessing the effects of exercise on insulin resistance.

Research on the Association between Serum Calcium and Elevated Blood Pressure, Overweight, and Obesity in Koreans

BACKGROUND: Calcium plays an important role in the metabolism of essential nutrients in the human body; recently, it became one of the significant causes of various metabolic disorders including hypertension, obesity, diabetes mellitus, and dyslipidemia. However, data regarding the association between calcium and metabolic disorders in Koreans are limited. The present study aimed to assess the association between serum calcium and elevated blood pressure, overweight, and obesity in Koreans.METHODS: A total of 719 Korean adults who visited the outpatient department of a university hospital were included in this study. The association between serum calcium and obesity and elevated blood pressure in men and women was evaluated separately using multiple regression analysis. Odds ratio was calculated to determine the association between serum calcium levels and overweight, obesity, and elevated blood pressure in men and women.RESULTS: Multiple regression analysis showed that body mass index was significantly increased in men with higher serum calcium levels (β=0.156, P=0.043). In men, the odds ratio for obesity and elevated blood pressure by serum calcium level were 2.04 (95% confidence interval [CI]: 1.02–4.06) and 2.26 (95% CI: 1.09–4.69), respectively. In women, the odds ratio for elevated blood pressure by serum calcium level was 1.86 (95% CI: 1.03–3.34).CONCLUSION: In this study, there was a significant positive association between serum calcium level and obesity and elevated blood pressure in men. In women, there was a significant positive association between serum calcium level and elevated blood pressure.

Spontaneous regression of neointimal hyperplasia in a patient who underwent percutaneous coronary intervention with a bare metal stent / 대한내과학회지

Many interventional cardiologists rely upon percutaneous coronary intervention (PCI) with drug-eluting stents (DES), but DES may provoke serious complications, such as stent thrombosis and delayed restenosis. Previous studies of bare metal stent placement showed regression of neointimal proliferation after 6 months. Here, we report the case of a 50-year-old man demonstrating spontaneous regression of neointimal hyperplasia after undergoing PCI with a bare metal stent to treat a middle left anterior descending (LAD) artery lesion. Coronary angiography showed 90% diffuse restenosis at 6 months after stent placement, but the patient refused PCI due to monetary concerns. After 29 months, follow-up angiography revealed spontaneous regression of restenosis in the middle LAD.

A Hospital-based Tabletop Exercise for Pandemic Influenza Preparedness: Design and Evaluation / 감염과화학요법

BACKGROUND: To evaluate the usefulness and compliance of a hospital-based tabletop exercise in setting of pandemic influenza in hospitals. MATERIALS AND METHODS: Tabletop exercise was held in Pusan National University Hospital and forty two hospital employees were invited to participate in the exercise. The scenario for hospital-based tabletop exercise was designed. It consisted of three modules, which simulated the influx and outbreak of H5N1 influenza that was epidemic in Southeast Asia. Pre-, post-exercise surveys were completed by anonymous questions. RESULTS: Thirty-seven (88%) of 42 invited participants attended exercise. All members of the administration group and the ancillary services group participated. But, only 77% members of the clinical services group participated. In pre-exercise survey, priorities of eight goals regarding skills and knowledge during exercise were inquired., The highest priorities pointed out by the respondents were "Increase the knowledge of pandemic influenza" (22%), "Development of strategies for optimal communication among employees within specific department" (19%) and "Development of strategies for improved coordination between facilities within the health system" (19%). Twenty-one (57%) of participants completed the post-exercise surveys. At post-exercise surveys, 81% of the participants stated that the tabletop exercise was extremely or very useful, 86% of the participants also stated that it increased their knowledge of pandemic influenza. CONCLUSION: Tabletop exercise is an effective modality for increasing pandemic influenza preparedness in hospitals, and this method is useful for guiding preparedness activities within the hospital environment. Further studies to determine the appropriate method of discussion, questionnaire, duration of exercise and injection are needed.

A Hospital-based Tabletop Exercise for Pandemic Influenza Preparedness: Design and Evaluation / 감염과화학요법

BACKGROUND: To evaluate the usefulness and compliance of a hospital-based tabletop exercise in setting of pandemic influenza in hospitals. MATERIALS AND METHODS: Tabletop exercise was held in Pusan National University Hospital and forty two hospital employees were invited to participate in the exercise. The scenario for hospital-based tabletop exercise was designed. It consisted of three modules, which simulated the influx and outbreak of H5N1 influenza that was epidemic in Southeast Asia. Pre-, post-exercise surveys were completed by anonymous questions. RESULTS: Thirty-seven (88%) of 42 invited participants attended exercise. All members of the administration group and the ancillary services group participated. But, only 77% members of the clinical services group participated. In pre-exercise survey, priorities of eight goals regarding skills and knowledge during exercise were inquired., The highest priorities pointed out by the respondents were "Increase the knowledge of pandemic influenza" (22%), "Development of strategies for optimal communication among employees within specific department" (19%) and "Development of strategies for improved coordination between facilities within the health system" (19%). Twenty-one (57%) of participants completed the post-exercise surveys. At post-exercise surveys, 81% of the participants stated that the tabletop exercise was extremely or very useful, 86% of the participants also stated that it increased their knowledge of pandemic influenza. CONCLUSION: Tabletop exercise is an effective modality for increasing pandemic influenza preparedness in hospitals, and this method is useful for guiding preparedness activities within the hospital environment. Further studies to determine the appropriate method of discussion, questionnaire, duration of exercise and injection are needed.

Association of Serum Cystatin C with Metabolic Syndrome and Its Related Components in Korean Adults / 당뇨병

BACKGROUND: Serum cystatin C has been reported as a better marker than serum creatinine for estimation of kidney function and may be associated with cardiovascular disease. The aim of this study was to elucidate the association of serum cystatin C with metabolic syndrome (MS), a constellation of cardiovascular risk factors, and its related components and the usefulness of serum cystatin C for the cardiovascular risk assessment. METHODS: 1,468 healthy subjects (814 men and 655 women), who visited health promotion center of Pusan National University Hospital for routine medical checkup were included. MS was defined by modified, revised National Cholesterol Education Program (NCEP) Adult Treatment Panel (ATP) III criteria. RESULTS: Mean serum cystatin C value was 0.87 +/- 0.17 mg/L. In partial correlation analysis adjusted by age, sex and Glomerular Filtration Rate (GFR), cystatin C was associated with most of metabolic parameters and especially had significant positive correlation with waist circumference (r = 0.215), triglyceride (TG) (r = 0.141), diastolic blood pressure (BP) (r = 0.116), and correlated negatively with high density lipoprotein (HDL) cholesterol (r = -0.152) (all P < 0.001). There were increasing trends of prevalence of MS with the increase of quartiles of cystatin C and as the number of MS components increased, cystatin C values significantly increased. Serum cystatin C was also significantly increased in MS (0.90 +/- 0.19 mg/L vs. 0.86 +/- 0.16 mg/L). In stepwise multiple regression analysis including the components of MS, Waist circumference, diastolic BP, triglyceride, and HDL cholesterol were independent determinants of serum cystatin C, but with creatinine, only waist circumference was independent determinant. CONCLUSIONS: Serum cystatin C was closely associated with MS and its related cardiovascular risk factors and might be useful as a tool of cardiovascular risk assessment.

A Case of Aplastic Anemia Associated with Systemic Lupus Erythematosus: Successful Treatement with Cyclosporine / 대한류마티스학회지

Systemic lupus erythematosus(SLE) is autoimmune disease in which involves systemic organs. Hematological manifestations are common in patients with SLE but aplastic anemia is very rare and, although various immunosuppressants have been tried, there is no established treatment in aplastic anemia associated with SLE. Furthermore, disease course and prognosis may be different from other aplastic anemia. A 42-year-old woman presented with fever, chilling, myalgia, general weakness, pancytopenia. Her bone marrow aspirate and biopsy revealed almost acellular bone marrow with rare foci of hematopoietic elements and she was diagnosed with SLE simultaneously. High-dose methyprednisolone, prednisolone and cyclophosphamide therapies had been unsuccessful in controlling pancytopenia. Cyclosproine was started and the aplastic anemia was responded. Now she was free of transfusion with more than 10 g/dL of hemoglobin.