Effects of Oral Health Behavior and Mental Health on Metabolic Syndrome in Korean Adults / 치위생과학회지

Background@#Integrated management of general, mental, and oral health is necessary to improve an individual’s quality of life. This study aimed to identify the effects of mental and oral health behaviors on metabolic syndrome. @*Methods@#A total of 4,227 Korean adults aged 20 years or older were selected as study subjects using raw data from the first year (2019) of the 8th period of the Korea National Health and Nutrition Examination Survey (KNHANES). A complex sample chi-square test and a complex sample logistic regression analysis were performed using the PASW Statistics ver. 18.0 program. @*Results@#The effect on metabolic syndrome was significantly higher in male than in 1.833 times in male, 2.914 times in 30∼49 years old, and 3.855 times in 50∼64 years old, and 3.929 times in people over 65 years old compared to 20∼29 years old, and compared to those with a college degree or higher, those with a middle school degree or lower are 2.116 times, those with lower income levels are 1.507 times higher, those with middle-lower are 1.359 times higher, those with middle-high are 1.401 times. Compared to non-smokers, smokers were 1.570 times higher than non-smokers and compared to those without speech problem and chewing difficulty, they were 1.717 times and 1.397 times higher, respectively and 1.973 times higher in those with 0∼1 brushing times per day. Mental health did not affect prevalence of metabolic syndrome. @*Conclusion@#It is necessary to improve maintain a healthy lifestyle to lower the risk of metabolic syndrome. It is necessary to establish effective dental hygiene customized education and an efficient health management system at the national level that can induce improvement of oral health behavior for the prevention and management of metabolic syndrome.

User-Friendly Vendor-Specific Guideline for Pediatric Cardiothoracic Computed Tomography Provided by the Asian Society of Cardiovascular Imaging Congenital Heart Disease Study Group: Part 1. Imaging Techniques

Optimal performance of pediatric cardiothoracic computed tomography (CT) is technically challenging and may need different approaches for different types of CT scanners. To meet the technical demands and improve clinical standards, a practical, user-friendly, and vendor-specific guideline for pediatric cardiothoracic CT needs to be developed for children with congenital heart disease (CHD). In this article, we have attempted to describe such guideline based on the consensus of experts in the Asian Society of Cardiovascular Imaging CHD Study Group. This first part describes the imaging techniques of pediatric cardiothoracic CT, and it includes recommendations for patient preparation, scan techniques, radiation dose, intravenous injection protocol, post-processing, and vendor-specific protocols.

Pulmonary artery dissection in a patient with Eisenmenger's syndrome and successful conservative medical treatment

No abstract available.

Three-Dimensional Endo-Cardiovascular Volume-Rendered Cine Computed Tomography of Isolated Left Ventricular Apical Hypoplasia: A Case Report and Literature Review

We report multidetector computed tomography (MDCT) and cardiac magnetic resonance (CMR) findings of a 34-year-old female with isolated left ventricular apical hypoplasia. The MDCT and CMR scans displayed a spherical left ventricle (LV) with extensive fatty infiltration within the myocardium at the apex, interventricular septum and inferior wall, anteroapical origin of the papillary muscle, right ventricle wrapping around the deficient LV apex, and impaired systolic function. MDCT visualized morphologic and also functional findings of this unique cardiomyopathy.

Detecting Peripheral Nerves in the Elbow using Three-Dimensional Diffusion-Weighted PSIF Sequences: a Feasibility Pilot Study

PURPOSE: To analyze the feasibility of three-dimensional (3D) diffusion-weighted (DW) PSIF (reversed FISP [fast imaging with steady-state free precession]) sequence in order to evaluate peripheral nerves in the elbow. MATERIALS AND METHODS: Ten normal, asymptomatic volunteers were enrolled (6 men, 4 women, mean age 27.9 years). The following sequences of magnetic resonance images (MRI) of the elbow were obtained using a 3.0-T machine: 3D DW PSIF, 3D T2 SPACE (sampling perfection with application optimized contrasts using different flip angle evolution) with SPAIR (spectral adiabatic inversion recovery) and 2D T2 TSE (turbo spin echo) with modified Dixon (m-Dixon) sequence. Two observers used a 5-point grading system to analyze the image quality of the ulnar, median, and radial nerves. The signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) of each nerve were measured. We compared 3D DW PSIF images with other sequences using the Wilcoxon-signed rank test and Friedman test. Inter-observer agreement was measured using intraclass correlation coefficient (ICC) analysis. RESULTS: The mean 5-point scores of radial, median, and ulnar nerves in 3D DW PSIF (3.9/4.2/4.5, respectively) were higher than those in 3D T2 SPACE SPAIR (1.9/2.8/2.8) and 2D T2 TSE m-Dixon (1.7/2.8/2.9) sequences (P < 0.05). The mean SNR in 3D DW PSIF was lower than 3D T2 SPACE SPAIR, but there was no difference between 3D DW PSIF and 2D T2 TSE m-Dixon in all of the three nerves. The mean CNR in 3D DW PSIF was lower than 3D T2 SPACE SPAIR and 2D T2 TSE m-Dixon in the median and ulnar nerves, but no difference among the three sequences in the radial nerve. CONCLUSION: The three-dimensional DW PSIF sequence may be feasible to evaluate the peripheral nerves around the elbow in MR imaging. However, further optimization of the image quality (SNR, CNR) is required.

Color Doppler Ultrasound of Lower Extremity Varicose Veins: A Simple Grading of Sapheno-Femoral Junction Reflux

PURPOSE: To establish a simple grading method for the severity of an incompetent sapheno-femoral junction (SFJ) using color Doppler ultrasound in patients with lower extremity varicose veins. MATERIALS AND METHODS: 346 legs of 241 consecutive patients with varicose veins were examined (M:F = 96:145, 11-74 years, mean 50 years). The severity of SFJ and sapheno-popliteal (SPJ) incompetence was graded from I to IV according to the patient's position (standing versus supine or prone) and whether the Valsalva's maneuver had been induced. The extent of varicose veins was graded as I to III by the US findings in the SFJ incompetence group. The grading of SFJ incompetence was compared to the extent of varicose vein. RESULTS: SFJ, SPJ, both SFJ and SPJ, and perforator incompetence was observed in 198 (57.2%), 81 (23.4%), 21 (6.1%) and 54 (15.6%), respectively. Among the SFJ incompetence group, severity grade I - IV were observed in 14 (7.1%), 75 (37.9%), 73 (36.9%), and 36 (18.2%), respectively, and the extent grade I - III were noted in 47 (23.7%), 95 (48.0%), and 56 (28.3%), respectively. The SFJ incompetence grade and varicose extent grade showed a positive correlation (p < 0.0001). CONCLUSION: Simple sonographic grading of the severity of SFJ incompetence is possible. The extent of varicose veins in the SFJ incompetence group can be determined using this new grading system.

A Study on Resistance in Type 2 Diabetic Patient Against Commencement of Insulin Treatment / 당뇨병

BACKGROUND: To achieve tight glycemic control in the poorly controlled type 2 diabetic patients with oral hypoglycemic agent, it maybe beneficial to initiate insulin treatment at the early stage. Many patients with type 2 diabetes are often reluctant to begin insulin therapy despite poor glycemic control with oral hypoglycemic agents, this little known phenomenon, often termed 'psychological insulin resistance (PIR)'. This study investigates psychological insulin resistance in Korean patients with type 2 diabetes. METHOD: This study examined a total of 76 type 2 diabetic patients with poor glycemic control during period of April to July 2006. Through questionnaire and telephone survey, total 24 questions were asked about various attitudes on insulin therapy including psychological barriers and patients' acceptance of this treatment. Subjects were asked to allocate points in 5-point scale (from 5 points for 'very true' to 1 point for 'very untrue'). RESULTS: The means of psychological rejection, injection-related anxiety and fear of insulin side effects such as hypoglycemia and weight gain were 3.65 +/- 0.92, 3.17 +/- 0.98 and 2.8 +/- 1.02, respectively. Unwillingness was common in insulin therapy, 67% of patient rejected or was unwilling to take insulin. Main reasons of patients most frequently endorsed beginning insulin indicate that disease is worsening, permanence (once you start insulin you can never quit) and sense of personal failure. Furthermore, study indicates that patients' reasons for avoiding insulin therapy were mainly psychological rejection, which extended far beyond a simple injection related anxiety. CONCLUSION: PIR was psychological reluctance rather than injection related anxiety. To overcome these psychological barriers to insulin treatment, it is necessary to address appropriate diabetes education including training and counseling with excellent interactive communications between patients and clinicians.

A Pulmonary Sarcoidosis Manifesting as a Rare Atypical Pattern and Distribution / 결핵및호흡기질환

A unique case of atypical pulmonary sarcoidosis in a 62-year-old man complaining of dyspnea is presented. Chest CT scan showed an unusual pattern and distribution of pulmonary sarcoidosis manifesting mainly as reticular densities, interlobular septal thickening, and ground-glass opacities, in the subpleural and lower lung predominancy. However, a surgical lung biopsy revealed classical findings of sarcoidosis. Knowledge of this atypical pulmonary involvement may improve understanding sarcoidosis as the great masquerader.

Efffects of Fluoxetine on ATP-induced Calcium Signaling in PC12 Cells

Fluoxetine, a widely used anti-depressant compound, has several additional effects, including blockade of voltage-gated ion channels. We examined whether fluoxetine affects ATP-induced calcium signaling in PC12 cells by using fura-2-based digital calcium imaging and assay for [3H]-inositol phosphates (IPs). Treatment with ATP (100microM) for 2 min induced [Ca2+]i increases. The ATP-induced [Ca2+]i increases were significantly decreased by removal of extracellular Ca2+ and treatment with the inhibitor of endoplasmic reticulum Ca2+ ATPase thapsigargin (1microM). Treatment with fluoxetine for 5 min blocked the ATP-induced [Ca2+]i increase concentration-dependently. Treatment with fluoxetine (30microM) for 5 min blocked the ATP-induced [Ca2+]i increase following removal of extracellular Ca2+ and depletion of intracellular Ca2+ stores. While treatment with the L-type Ca2+ channel antagonist nimodipine for 10 min inhibited the ATP-induced [Ca2+]i increases significantly, treatment with fluoxetine alone blocked the ATP-induced responses. Treatment with fluoxetine also inhibited the 50 mM K+-induced [Ca2+]i increases completely. However, treatment with fluoxetine did not inhibit the ATP-induced [3H]-IPs formation. Collectively, we conclude that fluoxetine inhibits ATP-induced [Ca2+]i increases in PC12 cells by inhibiting both an influx of extracellular Ca2+ and a release of Ca2+ from intracellular stores without affecting IPs formation.

Pharmacological evidence that cromakalim inhibits Ca2+ release from intracellular stores in porcine coronary artery

In the present study, it was aimed to further identify the intracellular action mechanism of cromakalim and levcromakaliin in the porcine coronary artery. In intact porcine coronary arterial strips loaded with fura-2/AM, acetylcholine caused an increase in intracellular free Ca2+ ((Ca2+)-i) in association with a contraction in a concentration-dependent manner. Cromakalim (1 micrometer) caused a reduction in acetylcholine-induced increased (Ca2+)-i not only in the normal physiological salt solution (PSS) but also in Ca2+ -free PSS (containing 1mM EGTA). In the skinned strips prepared by exposure of tissue to 20 micrometer beta-escin, inositol 1,4,5-trisphosphate (IP-3) evoked an increase in (Ca2+)-i but it was without effect on the intact strips. The IP-3-induced increase in (Ca2+)-i was inhibited by cromakalim by 78% and levcromakalim by 59% (1 micrometer, each). Pretreatment with glibenclamide (a blocker of ATP-sensitive K+ channels, 10 micrometer and apamin (a blocker of small conductance Ca2+/-activated K+ channels, 1 micrometer strongly blocked the effect of cromakalim and levcromakalim. However, charybdotoxin (a blocker of large conductance Ca2+ -activated K+ channels, 1-micrometer) was without effect. In addition, cromakalim inhibited the GTP-gamma-S (100 micrometer, nonhydrolysable analogue of GTP)-induced increase in (Ca2+)-i. Based on these results, it is suggested that cromakalim and levcromakalim exert a potent vasorelaxation, in part, by acting on the K+ channels of the intracellular sites (e.g., sarcoplasmic reticulum membrane), thereby, resulting in decrease in release of Ca2+ from the intracellular storage site.