Making of the “Pristine Vegetables”: Soil-Transmitted Parasites and U.S. Military Procurement in Korea / 의사학

In the twenty-first century Korea, “Pristine Vegetables(청정채소, 淸淨菜蔬)” refers to organic products grown without the use of pesticides and chemical fertilizers. However, the meaning of “Pristine” was radically different until 1970s. After the Korean War, the infection rate of intestinal parasite reached almost 100 percent in Korean population. Disruption in chemical fertilizers manufacturing pressured farmers to use night-soil, which was contaminated with parasite eggs, causing the vicious cycle of infection. At the same time, rapid urbanization increased the demands of fresh vegetables in the city, leading to a large amount of semi-urban agricultural practices. This was closely linked with the national economy; as most of Korean vegetable products were contaminated with parasites, they were deemed unsuitable for export. In 1957, US Army stationed in Seoul issued a guideline for producing local vegetables acceptable for US troop consumption. This gave rise to the concept of “Pristine Vegetables” that were free of any infectious materials. These practices continued well into the 1970s. Due to the lack of sewage treatment system, the waste of urban population provided necessary fertilizer for these farmers without much cost. In order to secure public health, the Korean government actively encouraged the use of chemical fertilizers, naming the vegetables “Pristine.” This effort included the ban of night-soil in urban and semi-urban farms and the establishment of Pristine Vegetable Shops. However, the rapid decline of parasitic diseases in the population and the rising concerns of environmental pollutions reshaped Pristine Vegetables from chemical to organic in the 1980s. Thus, Pristine Vegetable in Korea during late twentieth century exemplifies rapid transformation of the urban environment, showing shifted concept of cleanness and contaminants among the public and policymakers, as well as acceptable risk of the urban environment in Korea.

A comparison study of vessel twisting by different microsurgical suture techniques in a chicken wing artery side to side bypass training model

Objective@#Microvascular anastomosis, particularly side-to-side (STS) bypass, is a complex surgical procedure. While several suture techniques exist, none of them is superior to the others. We assessed the association between various STS bypass techniques and vessel twisting using chicken wing training models. @*Methods@#Three suture techniques were compared over an anterior wall suture procedure. The unidirectional continuous suture (UCS) group used a downward “right-to-left” continuous suture. The reverse continuous suture (RCS) group used a downward “left-to-right” continuous suture. The interrupted suture (IS) group used the standard interrupted suture. The number of samples in each of the three groups was 30 (n=90). We compared the incidence of vessel twisting and rotation angles across groups. @*Results@#Vessel twisting occurred in 96.7%, 56.7%, and 0% of the cases in the UCS, IS, and RCS groups, respectively. The incidence of vessel twisting differed significantly in all 3 groups (p<0.001), with an apparent trend (p=0.002). The mean rotation angles were 201˚±90.6˚, 102˚±107.6˚, and 0˚ in the UCS, IS, and RCS groups, respectively, which were significantly different (p<0.001). On excluding cases without twisting, the rotation angles of twisted vessels in the UCS and IS groups were 207.9˚±83.7˚ and 180˚±77.9˚, respectively, which yielded a significant difference between these groups (p<0.001). @*Conclusions@#We found that the incidence and trend of vessel twisting differed significantly across suture techniques. The RCS technique may aid in preventing vessel twisting in the STS bypass procedure.

Survey of Public Attitudes toward the Secondary Use of Public Healthcare Data in Korea / 대한의료정보학회지

Objectives@#Public healthcare data have become crucial to the advancement of medicine, and recent changes in legal structure on privacy protection have expanded access to these data with pseudonymization. Recent debates on public healthcare data use by private insurance companies have shown large discrepancies in perceptions among the general public, healthcare professionals, private companies, and lawmakers. This study examined public attitudes toward the secondary use of public data, focusing on differences between public and private entities. @*Methods@#An online survey was conducted from January 11 to 24, 2022, involving a random sample of adults between 19 and 65 of age in 17 provinces, guided by the August 2021 census. @*Results@#The final survey analysis included 1,370 participants. Most participants were aware of health data collection (72.5%) and recent changes in legal structures (61.4%) but were reluctant to share their pseudonymized raw data (51.8%). Overall, they were favorable toward data use by public agencies but disfavored use by private entities, notably marketing and private insurance companies. Concerns were frequently noted regarding commercial use of data and data breaches. Among the respondents, 50.9% were negative about the use of public healthcare data by private insurance companies, 22.9% favored this use, and 1.9% were “very positive.” @*Conclusions@#This survey revealed a low understanding among key stakeholders regarding digital health data use, which is hindering the realization of the full potential of public healthcare data. This survey provides a basis for future policy developments and advocacy for the secondary use of health data.

A Rare Case of Nontuberculous Mycobacterial Abscess Mimicking Brain Tumor in an Immunocompetent Patient

Nontuberculous mycobacteria (NTM) is a type of bacteria that typically infects the pulmonary system, and NTM–central nervous system (CNS) infection, which occurs in the brain, is a very rare disease. A 64-year-old female patient presented with seizures as the main symptom and was found to have a mass of less than 1 cm in the right temporal lobe with accompanying edema. Although diseases such as tumor metastasis and parasitic cyst were suspected, the patient underwent a surgical resection, and NTM-CNS infection with abscess was diagnosed through biopsy. Antibiotic treatment was initiated after surgery, and the patient has been followed up without any significant symptoms. In this report, we review a rare case of NTM-CNS infection and discuss the understanding and treatment of this disease.

Retrospective clinical study of mandible fractures / 대한악안면성형재건외과학회지

Background@#As society becomes more complex, the incidence of mandibular fractures is increasing. This study aimed to analyze the incidence and type and identify etiological factors of mandibular fractures to use them in future treatments.Material and methodsData were collected from 224 patients who visited the department of oral and maxillofacial surgery at the Kyung Hee Medical Center dental hospital during a 6-year period (2016 to 2021). A logistic regression model was used for data analysis. @*Results@#In a total of 224 patients, 362 fractures were appeared. The average age of the patients was 34.1 years, with the highest incidence in the 20s. And the ratio between male and female was 4.09:1. Symphysis fractures were the most prevalent of all patients (52.7%), followed by unilateral condyle (37.1%), angle (36.2%), bilateral condyle (9.4%), body (8%), and coronoid (2.2%). The most common cause of fracture was daily-life activity (57.6%), followed by violence (30.4%), traffic accidents (8.5%), and syncope (3.6%). Patients with symphysis fracture were at low risk (OR 1) of coronoid fractures. And younger patients were high risk of mandibular angle fractures. @*Conclusion@#Through this study, it was confirmed that etiological factors of mandibular fractures were like those of previous studies.

DDT Resistance Korean Body Lice and Development of Insecticide Resistance Knowledge during Korean War / 의사학

DDT exemplifies success and failure of modern science and technology. Once it was heralded as technological wonder that will deliver human from misery of insect-borne infectious disease. However DDT took dramatic downturn after failure in global malaria eradication program initiated by World Health Organization, with advent of DDT-resistant strain of mosquitoes. Although insecticide resistance has been know since late 19th century, the definitions and mythologies for finding resistance has not been settled until 1950s. This paper argues that discovery of DDT-resistant strain of body lice in prisoners of war camp in Korea during the Korean War provided essential knowledge and opportunity for advancing insecticide resistance studies.Since 1945 to the end of Korean War, US Army sprayed thousands of tonnes of DDT on Korean body and soil. DDT was only went into wide field application since 1943, was still a very new technology. The ways to deliver and utilize DDT was still under the investigation. And Korea, especially during the War, was ideal place to construct such knowledge and place it in the application. The main focus was to control public health threats, such as louse-borne typhus fever. Korean soldiers and prisoners of war exposed to regular dose of DDT, which soon gave rise to DDT-resistant strain of body lice. It was the first major outbreak of insecticide-resistance appeared in insect that has major public health importance. Until early 1950s, mechanisms of resistance, or even definition of insecticide resistance was unclear. Researchers in US Army and Department of Agriculture rushed to find the ways to quantify insecticide resistance. Network of laboratories, connecting Korea-Japan-US, had to devise new laboratory methods to rear, and test body lice. These body lice later migrate to laboratories in US, providing valuable asset for future insecticide resistance research in US. At the same time, laboratory methods of testing resistance in body louse became a standard across the globe, setting new research agenda through World Health Organization. This shows flow of knowledge, along with migration of body louse, during the Korean War. At the same time, this case show who new knowledge is constructed through the expense of involvement of minority populations, such as natives, soldiers, and prisoners of war.

Medication Related Osteonecrosis of the Jaw: 2021 Position Statement of the Korean Society for Bone and Mineral Research and the Korean Association of Oral and Maxillofacial Surgeons

Antiresorptives are the most widely prescribed drugs for the treatment of osteoporosis. They are also used in malignant bone metastases, multiple myeloma, and Paget's disease, and provide therapeutic efficacy on those diseases. However, it was reported that the occurrence of osteonecrosis of the jaw (ONJ) could be related to antiresorptive exposures, and there have been many cases regarding this issue. Therefore, a clearer definition and treatment guidelines were needed for this disease. The American Society for Bone and Mineral Research and the Amnerican Association of Oral and Maxillofacial Surgeons reported statements on bisphosphonate-related ONJ (BRONJ), and a revised version was recently presented. In the revised edition, the diagnosis BRONJ was changed to medication-related ONJ (MRONJ), which reflects consideration of the fact that ONJ also occurs for denosumab, a bone resorption inhibitor of the receptor activator of the nuclear factor-κB ligand antibody family, and bevacizumab, an anti-angiogenesis inhibitor. The Korean Society for Bone and Mineral Research and the Korean Association of Oral and Maxillofacial Surgeons had collectively formed a task force for the preparation of an official statement on MRONJ based on a previous position paper in 2015. The task force reviewed current knowledge and coordinated dental and medical opinions to propose the guideline customized for the local Korean situation.

Localization of Praziquantel Production and Clonorchiasis Control Program in Korea, 1970s~1980s / 의사학

The Korean parasite control program is regarded as one of the most successful examples of health care movement in Korea. This ‘Parasite Eradication Program’ which was conducted from 1969 to 1995, involved testing and treating of 300 million people. In cooperation with Japan, parasitologists and activists who participated in the parasite control program formed a common system called the ‘Mass Testing, Mass Treatment.’ This study focuses on the localization process of Praziquantel, Clonorchiasis treatment production and its application in Clonorchiasis control program. Parasitologists rapidly introduced newly developed Praziquantel, and Korean chemists quickly reverse engineered the compound to evade patent issues. This allowed for the mass production of Praziquantel at a lower price, which in turn enabled a nationwide Clonorchiasis control program. At the same time, low price and stable supply opened the private market for Praziquantel. However, acceptance and understanding of the Praziquantel differed significantly among the stakeholders. For the government, it was a means for policy propaganda, and for the health agencies, it was a means for mass scale control program, while for the public, it was a means for maintaining conventional eating habits without risk of infection. This study reveals how the material end of a disease control policy is accepted and interpreted by different actors.

Removal of a suture needle: a case report / 대한악안면성형재건외과학회지

Background@#Foreign bodies may be embedded or left behind in the oral cavity during oral surgical procedure. The loss of instruments such as impression material, surgical gauze, and broken injection needles are commonly reported in the dental field. These complications are generally symptomatic and show signs of inflammation, pain, and purulent discharge. Accidental breakage of suture needles is a rare but potentially dangerous event.Case presentation: In this report, we present one case of lost suture needle during the procedure of flap operation at local dental clinic and its successful removal under local/general anesthesia administration via CBCT with a help of two reference needles to localize the 6-0 nylon needle and consulting with the clinician. @*Conclusion@#CT scanning taken while mouth-closing may not be accurate with regard to real location measurement performed while mouth-opening. If so, other up-to-date radiographic devices and methods to retrieve a needle are recommended.

Correlation between Unfavorable Split in the Distal Segment during the Bilateral Sagittal Ramus Osteotomy and Skeletal Relapse:Cone-Beam Computed Tomography Study

Purpose@#The purpose of this article is to study the relationship of unintentionally extended split in the distal segment during the bilateral sagittal split ramus osteotomy (BSSRO) and skeletal relapse. @*Materials and Methods@#Twenty patients with mandibular prognathism were divided into two groups according to whether or not unintentionally extended split had occurred. Cone-beam computed tomography images were taken before surgery (T0), immediately after surgery (T1), and postoperatively at 6 months (T2). The stability was evaluated by measuring the change of Nasion perpendicular-Pogonion (N-Pog) distance.Result: Both groups showed mild advancement of Pog during follow-up. In both groups, the condyle head rotated inward and moved posterioinferiorly after surgery, but tended to return to their original position during follow-up. @*Conclusion@#There was no statistically significant difference between the two groups in mandible position. Moreover, the condylar position was stable. If it is difficult to proceed reduction of the unintentionally extended split, careful inspection should be performed to prevent subsequent complications during follow-up.

Localization of Praziquantel Production and Clonorchiasis Control Program in Korea, 1970s~1980s / 의사학

The Korean parasite control program is regarded as one of the most successful examples of health care movement in Korea. This ‘Parasite Eradication Program’ which was conducted from 1969 to 1995, involved testing and treating of 300 million people. In cooperation with Japan, parasitologists and activists who participated in the parasite control program formed a common system called the ‘Mass Testing, Mass Treatment.’ This study focuses on the localization process of Praziquantel, Clonorchiasis treatment production and its application in Clonorchiasis control program. Parasitologists rapidly introduced newly developed Praziquantel, and Korean chemists quickly reverse engineered the compound to evade patent issues. This allowed for the mass production of Praziquantel at a lower price, which in turn enabled a nationwide Clonorchiasis control program. At the same time, low price and stable supply opened the private market for Praziquantel. However, acceptance and understanding of the Praziquantel differed significantly among the stakeholders. For the government, it was a means for policy propaganda, and for the health agencies, it was a means for mass scale control program, while for the public, it was a means for maintaining conventional eating habits without risk of infection. This study reveals how the material end of a disease control policy is accepted and interpreted by different actors.

Office-based 2-stage Posterior Maxillary Segmental Osteotomy for Mandibular Implant Placement: Clinical Study

Purpose@#This clinical study presented the effectiveness of 2-stage posterior maxillary segmental osteotomy (PMSO) under local anesthesia in gaining interarch space to restore the posterior mandibular segment with dental implants. @*Materials and Methods@#Nine patients who received two-stage PMSO for mandibular implant placement from 2003 to 2011 were included in the study. Of the 9 patients, 7 were female and 2 were male. Ages ranged form 28 to 72 (mean 46.6). Potential complications were investigated such as sinus infection, survival of bone segment, inflammatory root resorption of adjacent teeth, relapse of bone segment and timing of implant placement, delivery of implant prosthesis and stability of bone segment.Result: None of the patients showed relapse or complication. Bone segments were stabilized by opposed implant prosthesis. @*Conclusion@#Office-based 2-stage PMSO under local anesthesia can be considered a stable and predictable procedure. Also pedicle damage can be avoided by allowing favor of blood supply to the bone segments. From these advantages, it can be concluded that this surgical procedure can decrease post-operative complications.

Office-based 2-stage Posterior Maxillary Segmental Osteotomy for Mandibular Implant Placement: Clinical Study

Purpose@#This clinical study presented the effectiveness of 2-stage posterior maxillary segmental osteotomy (PMSO) under local anesthesia in gaining interarch space to restore the posterior mandibular segment with dental implants. @*Materials and Methods@#Nine patients who received two-stage PMSO for mandibular implant placement from 2003 to 2011 were included in the study. Of the 9 patients, 7 were female and 2 were male. Ages ranged form 28 to 72 (mean 46.6). Potential complications were investigated such as sinus infection, survival of bone segment, inflammatory root resorption of adjacent teeth, relapse of bone segment and timing of implant placement, delivery of implant prosthesis and stability of bone segment.Result: None of the patients showed relapse or complication. Bone segments were stabilized by opposed implant prosthesis. @*Conclusion@#Office-based 2-stage PMSO under local anesthesia can be considered a stable and predictable procedure. Also pedicle damage can be avoided by allowing favor of blood supply to the bone segments. From these advantages, it can be concluded that this surgical procedure can decrease post-operative complications.

Current status of surgery-first approach (part III): the use of 3D technology and the implication in obstructive sleep apnea / 대한악안면성형재건외과학회지

Considering psychosocial needs of patients, it is not surprising that surgery-first approach (SFA) is becoming more popular than ever. Although the concept of SFA was introduced a few decades ago, the limitation of analysis method based on two-dimensional images makes surgeons reluctant to choose SFA. Recently, the advancement of three-dimensional technology allows us to perform SFA even without minimal pre-surgical orthodontic treatment, and the prediction of surgical outcome became more accurate, especially in obstructive sleep apnea (OSA) patients to whom the advantages of SFA should be more significant. Here, we describe the current trend of SFA and its implication in OSA patients.

Positional change in mandibular condyle in facial asymmetric patients after orthognathic surgery: cone-beam computed tomography study / 대한악안면성형재건외과학회지

BACKGROUND: We evaluated change in the mandibular condyle after orthognathic surgery using cone-beam computed tomography (CBCT) in patients with facial asymmetry. METHODS: Thirty patients with skeletal class III malocclusion and mandibular prognathism or facial asymmetry were classified into two groups according to the amount of menton deviation (MD) from the facial midline on anteroposterior (AP) cephalogram: group A (asymmetry, MD ≥ 4 mm; n = 15) and group B (symmetry, MD < 4 mm; n = 15). Position and angle of condylar heads on the axial, sagittal, and coronal views were measured within 1 month preoperatively (T0) and postoperatively (T1) and 6 months (T2) postoperatively. RESULTS: On axial view, both groups showed inward rotation of condylar heads at T1, but at T2, the change was gradually removed and the condylar head returned to its original position. At T1, both groups showed no AP condylar head changes on sagittal view, although downward movement of the condylar heads occurred. Then, at T2, the condylar heads tended to return to their original position. The change in distance between the two condylar heads showed that they had moved outward in both groups, causing an increase in the width between the two heads postoperatively. Analysis of all three-dimensional changes of the condylar head positions demonstrated statistically significant changes in the three different CBCT views in group B and no statistically significant changes in group A. CONCLUSIONS: There was no significant difference between the two groups in condylar head position. Because sagittal split ramus osteotomy can be performed without significant change in symmetrical and asymmetrical cases, it can be regarded as an effective method to stabilize the condylar head position in patients with skeletal class III malocclusion and mandibular prognathism or facial asymmetry.

Genial tubercle position and genioglossus advancement in obstructive sleep apnea (OSA) treatment: a systematic review / 대한악안면성형재건외과학회지

BACKGROUND@#To systematically review the literature for methods to localize the genial tubercle as a means for performing an advancement of the genioglossus muscle.@*METHODS@#PubMed, Google Scholar, CRISP, EMBASE, CINAHL, and Scopus were searched from inception through June 16, 2015.@*RESULTS@#One hundred fifty-two articles were screened, and the full text versions of 12 articles were reviewed in their entirety and 7 publications reporting their methodology for localizing the genial tubercle. Based upon these measurements and the results published from radiographic imaging and cadaveric dissections of all the papers included in this study, we identified the genial tubercle as being positioned within the mandible at a point 10 mm from the incisor apex and 10 mm from the lower mandibular border.@*CONCLUSION@#Based upon the results of this review, the genial tubercles were positioned within the mandible at a point 10 mm from the incisor apex and 10 mm from the lower mandible border. It may serve as an additional reference for localizing the genial tubercle and the attachment of the genioglossus muscle to the mandible, although the preoperative radiological evaluation and the palpation of the GT are recommended to accurately isolate.

Floating septum technique: easy and safe method maxillary sinus septa in sinus lifting procedure / 대한악안면성형재건외과학회지

BACKGROUND@#The presence of septa increases the risk of Schneiderian membrane perforation during sinus lift procedure, and therefore, the chance of graft failure increases. We present a safe method of managing septa and, in particular, overcoming small and palatally located septa.@*METHODS@#After the elevation of the flap and the creation of a small bony window positioned anterior to the septum, the Schneiderian membrane is lifted carefully. A thin and narrow osteotome is then placed at the indentation created at the base of the septum, and mobilization of the septum is achieved by gentle malleting. The membrane is again carefully lifted up behind the septum.@*RESULTS@#There was one small membrane perforation case in all 16 cases, and none of these patients showed postoperative complications such as implant failure, infection, or maxillary sinusitis.@*CONCLUSIONS@#This technique is useful for overcoming the problem of maxillary sinus septa hindering the sinus floor elevation procedure, leading to fewer complications.

“It All Started from Worms”: Korea-Japan Parasite Control Cooperation and Asian Network, 1960s – 1980s / 의사학

The Korea Association of Health Promotion and Japanese Organization for International Cooperation in Family Planning (JOICFP), and Taiwan's Chinese Foundation of Health all originated from parasite control organizations. Currently these organizations hold no apparent relations to parasite control activities. However, many of the senior leaderships of these organizations including presidents, have parasitology as their background. Kunii Chojiro (the founder of Japan Association of Parasite Control (JAPC) and JOICFP) explained it as “it all started from worms.” In 1949, Kunii Chojiro established JAPC after personally experienced intestinal parasite infection. The JAPC people conducted mass examination and mass chemotherapy focusing on school children, which allowed them to have sustainable income. In 1965, the Korea Association of Parasite Eradication (KAPE) requested JAPC to assist Korea's parasite control activity. In 1968, when Korea-Japan cooperation for parasite control activity established, Japan's operating procedures were directly absorbed by KAPE. With support from JAPC and official development aid through Overseas Technical Cooperation Agency in Japan (now Japan International Cooperation Agency), Korea successfully controlled parasite infection. Post-war and cold-war geopolitics had a significant impact on Korea-Japan cooperation. In 1960s the president of KAPE, Chong-Chin Lee and Kunii Chojiro were well known figures in population control network. They did understand the importance of population control, but did not agree with the approaches taken by western population control experts. From their point of view, it had to be self-initiated, economically self sustainable grass-root activities rather than top-down activities, as experienced in their parasite control in Japan and Korea. This lead to a new Asian model named “Integrated Program”. Together with their influence in population control network, Kunii and Lee manage to secure the fund from IPPF. Emergence of Integrated Program showed how collective experience of Asia, as well as overlap of networking formed ‘Asian Model’ of public health activities. Kunii and Lee shared the same agenda to enable people to have better life through public health measures. While they funneled money from global population control network, they were more interested in securing sustainability of the parasite control activities. This paper focuses on activities and experiences of Kunii Chojiro and Chong-Chin Lee to show interplay of Cold War geopolitics in Asia led to emergence of Asian network.

Polydeoxyribonucleotide, as a Novel Approach for the Management of Medication-Related Osteonecrosis of the Jaw: A Preliminary Observational Study

PURPOSE: Polydeoxyribonucleotide (PDRN), consisting of a mixture of deoxyribonucleotide polymers, has been suggested to have anti-inflammatory effects and enhance angiogenesis as an adenosine A(2A) receptor agonist. The aim of this study was to report the effectiveness of PDRN as an adjuvant therapy after surgical debridement in MRONJ (medication-related osteonecrosis of the jaw) patients. MATERIALS AND METHODS: Five patients (1 male, 4 females, age 65~79 years) who were diagnosed with MRONJ stage 2 or 3 underwent surgical debridement and PDRN mucosal injection. After surgical debridement, patients were subject to daily injection with 1 ml of PDRN around the surgical wound for 14 days. RESULT: The patients' symptoms gradually disappeared. The surgical wound uneventfully healed, and no recurrence was observed during the follow-up period. CONCLUSION: Although further studies are required, the present study first describes the possibility of PDRN as a useful option for MRONJ treatment.

Hypoglossal nerve stimulation for treatment of obstructive sleep apnea (OSA): a primer for oral and maxillofacial surgeons / 대한악안면성형재건외과학회지

The prevalence of obstructive sleep apnea (OSA) is estimated to be 1–5% of the adult population world-wide, and in Korea, it is reported at 4.5% of men and 3.2% of women (Age 40 to 69 years old). Active treatment of OSA is associated with decrease in insulin resistance, cardiovascular disease, psychosocial problems, and mortality. Surgical treatment of OSA has evolved in the era of neuromodulation with the advent of hypoglossal nerve stimulation (HGNS). We share this review of HGNS with our maxillofacial surgical colleagues to expand the scope of surgical care for OSA.