Oral health of older Koreans by region and family status in 2020-2021.

OBJECTIVE: To describe the oral health of older people by region and family status using data from the National Health and Nutrition Survey. BACKGROUND: As the ageing of Korean society intensifies, health inequalities based on region and family status are also deepening. METHODS: Data from the 8th National Health and Nutrition Survey (2020-2021) conducted by the Korea Centers for Disease Control and Prevention were used, and a total of 3437 older people aged 65 or older were selected as study participants. Chewing discomfort and oral health behaviours were assessed by region and family status using multivariable logistic regression analysis with the complex sample survey design. RESULTS: We found an association between living alone and greater chewing discomfort. Residing in rural areas was also associated with a higher prevalence of this. In urban areas, chewing discomfort was 1.27 times higher among older people living alone than in those not living alone, while in rural areas, the discomfort was 1.52 times higher among the older people who lived alone. CONCLUSIONS: Region and family status were associated with greater chewing discomfort in older people. In Korean society, where the number of single-person older people households is increasing, along with the ageing population, attention to resolving the disparities in oral health in older people is needed.

The Encapsulation of Natural Organic Dyes on TiO2 for Photochromism Control.

Titanium dioxide (TiO2) plays a pivotal role in photocatalytic reactions and holds great promise for the cosmetic and paint industries due to its white color and high refractive index. However, the original color of TiO2 changes gradually to blue or yellow with UV irradiation, which affects its color realization. We encapsulated TiO2 with several natural organic dye compounds, including purpurin, curcumin, and safflower, to control its photochromism and realize a range of different colors. The chemical reaction between TiO2 and dyes based on their functional group was investigated, and the light absorption was tested via FTIR and UV-Vis spectroscopy. The changes in morphology and size distribution additionally supported their successful encapsulation. The discoloration after UV irradiation was evaluated by measuring the color difference (ΔE) of control TiO2 and dye encapsulated TiO2. The unique structure utilized natural dyes to preserve photochromism based on the physical barrier and automatically controlled the electronic transition of core TiO2. In particular, the color difference values of purpurin and curcumin were 4.05 and 3.76, which is lower than the 5.36 of the control TiO2. Dye encapsulated TiO2 was manipulated into lipstick to verify its color realization and retention.

Quantitative analysis of pulmonary perfusion with dual-energy CT angiography: comparison of two quantification methods in patients with pulmonary embolism.

The study aimed to evaluate a quantification method of pulmonary perfusion with Dual-Energy CT Angiography (DE-CTA) normalized by lung density in the prediction of outcome in acute pulmonary embolism (PE). In this prospective study with CTA scans acquired with different breathing protocols, two perfusion parameters were calculated: %PBV (relative value of PBV, expressed per unit volume) and PBVm (PBV normalized by lung density, expressed per unit mass). DE-CTA parameters were correlated with simplified pulmonary embolism severity index (sPESI) and with outcome groups, alone and in combinationwith tomographic right-to-left ventricular ratios (RV/LV). PBVm showed significant correlation with sPESI. PBVm presented higher accuracy than %PBV In the prediction of ICU admission or death in patients with PE, with the best performance when combined with RV/LV volumetric ratio.

Association between Dental Caries and Handgrip Strength: In a Population-Based Study in Korea (KNHANES 2016-2018).

This study aimed to verify the relationship between handgrip strength and oral health using data from the Korea National Health and Nutrition Examination Survey, representing Korean adults. Data from the seventh survey (2016−2018) conducted by the Korea Centers for Disease Control and Prevention were utilized, and 10,607 final study participants were recruited according to the selection and exclusion criteria. A complex sample logistic regression analysis was performed to confirm the relationship between handgrip strength and dental caries according to the sex of the study participants. On analyzing the correlation in men, "C1 (DMFT: 11−32)," when compared to "C4 (DMFT: 0−3)," in Model 1 without adjustment for potential confounders, was 2.92 (95% confidence interval [CI]: 2.15−3.97) times more likely to be associated with lower handgrip strength, and a statistically significant result was detected (p < 0.001). Additionally, significant odds ratios (ORs) were confirmed for all adjusted models. In women, the ORs in Model 1 without adjustment for potential confounders were 1.41 times (95% CI: 1.14−1.75) and demonstrated a significant result; however, the results were not significant in all adjusted models 2−4. Resultantly, a significant association was detected between dental caries and handgrip strength in Korean adults.

Nutraceutical potential of polyphenol-rich Sargassum species grown off the Korean coast: a review.

Sargassum, a brown seaweed, has been used traditionally as food and medicine in Korea, China, and Japan. Sargassum spp. contain bioactive substances associated with health benefits, including anti-inflammatory and antioxidant effects. Thirty Sargassum spp. inhabit the Korean coast. However, their health benefits have yet to be systematically summarized. Therefore, the purpose of this article was to review the health benefits of these 30 Sargassum spp. grown off the Korean coast based on their health benefits, underlying mechanisms, and identified bioactive compounds. Supplementary Information: The online version contains supplementary material available at 10.1007/s10068-022-01050-x.

Lobar pulmonary perfusion quantification with dual-energy CT angiography: Interlobar variability and relationship with regional clot burden in pulmonary embolism.

Purpose: Semi-automated lobar segmentation tools enable an anatomical assessment of regional pulmonary perfusion with Dual-Energy CTA (DE-CTA). We aimed to quantify lobar pulmonary perfusion with DE-CTA, analyze the perfusion distribution among the pulmonary lobes in subjects without cardiopulmonary diseases and assess the correlation between lobar perfusion and regional endoluminal clots in patients with acute pulmonary embolism (PE). Methods: We evaluated 151 consecutive subjects with suspected PE and without cardiopulmonary comorbidities. DE-CTA derived perfused blood volume (PBV) of each pulmonary lobe was measured applying a semi-automated lobar segmentation technique. In patients with PE, blood clot location was assessed, and CT-based vascular obstruction index of each lobe (CTOIlobe) was calculated and classified into three groups: CTOIlobe= 0, low CTOIlobe (1-50%) and high CTOIlobe (>50%). Results: Among patients without PE (103/151, 68.2%), median lobar PBV was 13.7% (IQR 10.2-18.0%); the right middle lobe presented lower PBV when compared to all the other lobes (p < .001). In patients with PE (48/151, 31.8%), lobar PBV was 12.6% (IQR 9.6-15.7%), 13.7% (IQR 10.1-16.7%) and 6.5% (IQR 5.1-10.2%) in the lobes with CTOIlobe= 0, low CTOIlobe and high CTOIlobe scores, respectively, with a significantly decreased PBV in the lobes with high CTOIlobe score (p < .001). ROC analysis of lobar PBV for prediction of high CTOIlobe score revealed AUC of 0.847 (95%CI 0.785-0.908). Conclusion: Pulmonary perfusion was heterogeneously distributed along the pulmonary lobes in patients without cardiopulmonary diseases. In patients with PE, the lobes with high vascular obstruction score (CTOIlobe> 50%) presented a decreased lobar perfusion.

Effects of job embeddedness and nursing working environment on turnover intention among trauma centre nurses: A cross-sectional study.

AIM: To investigate the effects of job embeddedness and nursing working environment on trauma centre nurses' turnover intention. BACKGROUND: Trauma centre nurses have higher average turnover intention than hospital nurses. However, factors that increase the turnover intention of trauma centre nurses remain unexplored. METHODS: This cross-sectional study was conducted from August to October 2019, with 120 trauma centre nurses working at three trauma centres in B, D and U cities using measures of demographic characteristics, job embeddedness, nursing working environment and turnover intention. RESULTS: The mean turnover intention score was 3.60/5 points. There were significant correlations among turnover intention and fit, sacrifice, foundation for quality nursing, ability and leadership of nursing managers, cooperation of nurses and doctors, nurse participation in hospital management and sufficient manpower and material support. Turnover intention was predicted by nurse participation in hospital management, gender, clinical experience and fit, which explained 54%. CONCLUSIONS: Factors that influence nurses' turnover intention at trauma centres were gender, clinical experience, job fit and, especially, nurses' participation in hospital management, which had the most effect on the nursing working environment. IMPLICATIONS FOR NURSING MANAGEMENT: To expand participation of trauma centre nurses, hospital management systems and organisational culture need improvement.

Relationship between the Toothbrushing Behavior and Hand Hygiene Practices of Korean Adolescents: A Study Focused on the 15th Korea Youth Risk Behavior Survey Conducted in 2019.

Hand hygiene is one of the most important measures available to prevent infectious diseases such as COVID-19, and it is recommended that individuals wash their hands periodically before and after meals, after using toilets, before preparing food at home, at schools, and in public places. The aim of this study was to investigate the relationship between oral hygiene and hand hygiene in Korean adolescents. Data from 57,303 adolescents who participated in the 2019 Korea Youth Risk Behavior web-based survey were analyzed to determine the relationship between oral hygiene and hand hygiene. A complex sample logistic regression analysis was performed to determine association between toothbrushing behavior and handwashing practices. According to the results of this study, adolescents who brushed their teeth after lunch were 1.48 times more likely to practice handwashing before lunch than were those who did not brush their teeth after lunch (p < 0.001). In addition, the odds ratios adjusted for gender, grade, school type, and residence were found to be 1.87 (p < 0.001). Moreover, these adjusted odds ratios were higher in students who received personal hygiene education (OR: 1.98, p < 0.001). Oral hygiene practices were found to be related to personal hygiene, as assessed by handwashing, in Korean adolescents. Additional studies are needed to develop ways of improving the hygiene and health of adolescents.

The effect of comprehensive oral care program on oral health and quality of life in patients undergoing radiotherapy for head and neck cancer: A quasi-experimental case-control study.

OBJECTIVES: The purpose of this study is to investigate the effect of the comprehensive oral care program on oral health status and symptoms in head and neck cancer (HNC) patients undergoing radiotherapy. METHODS: This was a quasi-experimental study using a non-equivalent control group in non-synchronized design. All participants including control and experimental group were asked for the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire H&N35 (EORTC QLQ-H&N35) and given an oral health education 4 times at baseline, immediate postradiotherapy, 3 months after radiotherapy, and 6 months after radiotherapy. In each visit except for final, the experimental group was given fluoride varnish application and fluoride mouth rinsing solution for daily use. Oral health examination for dental caries, plaque score (PS), bleeding on probing (BOP), and salivary flow rate was performed in baseline and 6 months after radiotherapy. Statistical analyses were done by paired t-tests and mixed ANCOVA repeated-measures analysis. RESULTS: From November 1, 2013 to October 31, 2015, a total 61 patients undergoing radiotherapy for HNC cancer were enrolled (30 in control and 31 in experimental groups). Decrease in salivary flow rate was comparable between 2 groups. Dental caries increased in control group (P = .006); PS and BOP were decreased in experimental group (P < .001 and .004, respectively). Experimental group showed lower swallowing, speech problems, and less sexuality scores in EORTC QLQ-H&N35 than control group. CONCLUSION: We found improvement in oral health and the quality of life in HNC patients with comprehensive oral care intervention by dental professionals. Communicating and cooperating between the healthcare and dental professionals is needed to raise the quality of health care services for HNC patients receiving radiotherapy.

Association between low potassium intake and the number of teeth in Korean adults: based on the national data (2013-2015).

General health and oral health are very closely related. This study aimed to analyze the nutritional factors associated with the number of present teeth in Korean elderly adults. A total of 6,356 individuals were surveyed from the sixth Korean National Health and Nutrition Examination Survey conducted from 2013-2015. The number of existing teeth was divided into three categories: 0-10, 11-20, and over 21, and the nutrition survey covers eating habits, food frequency and food intake using face-to-face interviews. Multiple logistic regression analysis was performed to evaluate the association between nutrient intake and the number of existing teeth after adjusting for socio-demographic factors and general and oral health behaviors and status. As age increases, the number of teeth decreases. Individuals with more teeth had a significantly higher mean daily intake of protein, calcium, phosphorus, potassium and riboflavin (p < 0.05). After adjusting for sociodemographic factors in model 1 and the lower number of teeth in model 2, the strength of the association between the number of teeth and daily calcium intake remained significant. Statistically significant associations were present for dietary potassium intake in models 1 and 2 and in the 11-20 teeth group in model 3 (p < 0.05). We demonstrated a significant association between calcium and potassium intake and the number of teeth.

Etiological profile and main imaging findings in patients with granulomatous diseases who underwent lung biopsy.

BACKGROUND: Granulomatous Lung Diseases (GLD) encompasses a wide range of infectious and non-infectious conditions characterized by chronic inflammatory response. However, different GLD may share similar imaging findings. In this context, the purpose of this study was to outline the etiological profile and their imaging features in patients with GLD who underwent lung biopsy. METHODS: Patients with granulomatous lesions in lung biopsies and previous chest CT performed from 2014 to 2017 at our institution had imaging data reviewed by three blinded radiologists. The imaging features were analyzed according to the Fleischner Society glossary. Categorical data were represented by absolute (n) and relative (%) frequency. The contingency matrices were analyzed by Pearson's Chi-square test. Interreader agreement was assessed by calculating the intraclass correlation coefficient, using kappa (κ) statistic. RESULTS: Thirty-eight of 75 (50.7%) patients were women with a mean age of 59 ± 39 years. Infection was the most common cause of GLD (47/75, 62.7%) and Histoplasma capsulatum (27/75, 36%) was the most prevalent etiology. Nodular pattern was the most common imaging feature in histoplasmosis cases (25/27, 92.6%), whereas it occurred in half of cases (24/48) of GLD of other causes (p < 0.05). Among patients with tuberculosis, the second etiology of GLD in our study population, the most common imaging pattern was centrilobular micronodules (3/7, 42.9%), significantly more frequent than in other causes of GLD (6/68, 8.8%). Interreader agreement in detecting imaging features was almost perfect (κ = 0.88-1.00), except the nodular pattern, which had substantial agreement (κ = 0.73). CONCLUSIONS: In our study population, the main etiologies found in patients with granulomatous disease who underwent lung biopsy were fungal or mycobacterial disease, specially histoplasmosis and tuberculosis, and nodular pattern with focal distribution was the most common imaging finding which was detected with substantial interreader agreement.

COVID-19 pneumonia in the emergency department: correlation of initial chest CT findings with short-term outcome.

PURPOSE: Evaluate chest computed tomography (CT) findings of laboratory-confirmed Coronavirus Disease 2019 (COVID-19) cases and correlate it with clinical and laboratorial signs of severe disease and short-term outcome. METHODS: Chest CTs of 61 consecutive cases of COVID-19 disease that attended in our emergency department (ED) were reviewed. Three groups of patients classified according to the short-term follow-up were compared: (1) early-discharged from ED, (2) hospitalized on regular wards, and (3) admitted to intensive care unit (ICU). CT findings were also correlated with clinical and laboratorial features associated with severe disease. RESULTS: Median age was 52 years (IQR 39-63) with male predominance (60.7%). Most of the patients that did not require hospitalization had parenchymal involvement of less than 25% on CT (84.6%). Among hospitalized patients, interlobular septal thickening and extensive lung disease (> 50% of parenchyma) were significantly more frequent in ICU-admitted patients (P = 0.018 and P = 0.043, respectively). Interlobular septal thickening also correlated with longer ICU stay (P = 0.018). Low oxygen saturation (SpO2 ≤ 93%) was associated with septal thickening (P = 0.004), diffuse distribution (P = 0.016), and pleural effusion (P = 0.037) on CT. All patients with > 50% of parenchymal involvement showed SpO2 ≤ 93%. Elevated C-reactive protein (CRP) levels (> 5.0 mg/dL) correlated with consolidation (P = 0.002), septal thickening (P = 0.018), diffuse distribution (P = 0.020), and more extensive parenchymal involvement (P = 0.017). CONCLUSION: Interlobular septal thickening on CT was associated with ICU admission and longer stay on ICU. Diffuse distribution, septal thickening, and more extensive lung involvement correlated with lower SpO2 and higher CRP levels. Patients that needed hospitalization and ICU admission presented more extensive lung disease on CT.

Interobserver Variability in the Computed Tomography Assessment of Pulmonary Injury and Tumor Recurrence After Stereotactic Body Radiotherapy.

PURPOSE: To evaluate the interobserver agreement of chest computed tomography (CT) findings in the diagnosis of expected changes and local recurrence after stereotactic body radiation therapy (SBRT) in patients with early-stage lung cancer or a single pulmonary metastasis. MATERIALS AND METHODS: A total of 54 patients with early-stage lung cancer or pulmonary metastasis who were treated with SBRT from 2007 to 2015 were included. The exclusion criteria were patients who presented with pulmonary infection during follow-up and patients who underwent a single CT during follow-up. The imaging features on CT were assessed by 3 blinded radiologists at the following 2 time points after SBRT: (a) early follow-up and (b) late follow-up (≥6 mo). The radiologists classified the findings as expected changes after SBRT or recurrence. Interobserver agreement was assessed by kappa and Wilcoxon statistics. RESULTS: A total of 13 women and 41 men with a mean age of 75.3 (±8.9) years were selected. The total and per fraction SBRT doses were 54 Gy (interquartile range: 45 to 54) and 18 Gy (interquartile range: 15 to 18), respectively. All expected changes and findings suggestive of recurrence had an almost perfect agreement (κ>0.85) among readers, except for diffuse consolidation in the early period (κ=0.65). CONCLUSION: CT findings demonstrate high interobserver agreement for expected changes and for findings indicating recurrence after SBRT.

Acquired Pulmonary Arteriovenous Fistula within Metastasis from Choriocarcinoma: A Case Report.

Choriocarcinoma is a highly malignant neoplasm arising from the trophoblast of a human pregnancy, which may have distant spread to multiple organs, particularly to the lung. We report a case of a pulmonary arteriovenous fistula that developed after chemotherapy within a choriocarcinoma metastasis. A 24-year-old female with a history of uterine choriocarcinoma presented with multiple hypervascular pulmonary nodules on the initial chest computed tomography (CT) scan, consistent with lung metastases. Four months after chemotherapy, follow-up chest CT revealed a decrease in the size and vascularity of the lung metastases, except for 1 nodule that persisted with marked contrast enhancement and developed a communication with a pulmonary artery and vein. These findings were consistent with an acquired arteriovenous fistula. Physicians should be aware of the risk of acquired arteriovenous fistula in pulmonary metastases after chemotherapy because it can lead to a right-to-left shunt, pulmonary hemorrhage, and paradoxical emboli. It is also important for the definition of therapeutic planning, in order to avoid it being misdiagnosed as a site of disease progression.

Early-life socioeconomic position and periodontal status in Korean adults.

OBJECTIVES: The aim of this study was to assess the association between different life-course socioeconomic positions (SEPs) and periodontitis in a large representative sample of the Korean population. METHODS: With data from Korean adults aged 30-59, periodontitis was assessed with the community periodontal index. Parental education, own education, and income as indicators of early childhood SEP, adolescence SEP, and adulthood SEP, respectively, were categorized by four groups (1-4). The association between the different life-course SEPs and periodontitis was estimated according to three different life-course models: individual impact of the three SEPs, cumulative impact by the sum of the three SEP values (sum ranges 3-12), and the pathways of the three SEPs through lifetime to the periodontitis. Covariates were demographic factors, health behaviors, and health problems. The prevalence ratios (PRs) and relative index of inequality (RII) for periodontitis were obtained. RESULTS: In an individual impact model, significant associations of each SEP with periodontitis were found after adjusting for all covariates (RII = 1.16 for parental education, 1.19 for own education, and 1.27 for income). For a cumulative impact model, there were higher risks for periodontitis as the sum of the three SEP values increased (RII = 1.51). For the intergenerational social mobility model, prevalence of current periodontal disease was highest in the persistently low group. (RII = 1.54 and PR = 1.51). CONCLUSIONS: These results show that the individual and cumulative SEPs measured by the parental education, own education, and income were independently associated with the periodontal status of Korean adults. The pathway and cumulative hypotheses for the life-course SEP effects on periodontitis could be salient in oral epidemiology.

Association between adult height and tooth loss in a representative sample of Koreans.

OBJECTIVES: Evidence suggests that taller individuals have better health than that of shorter individuals. However, evidence for links to tooth loss is scarce. The aim of this study was to examine the association between adult height and tooth loss and to examine the roles of covariates in explaining the association in different birth cohorts in Korea. METHODS: Using data from the Fourth and Fifth Korea National Health and Nutritional Examination Survey (KNHANES IV and V), the subjects were grouped into two birth cohorts based on their historical context: born from 1920 to 1945 and 1946 to 1962. The dependent variables were loss of 8 or more teeth and total tooth loss (edentulism), while the independent variable was the height quartile. Demographic factors (survey year, age, and gender), early childhood/adult socioeconomic status (SES) (father's education, own education, income, and place of residence), health behaviors (cigarette smoking, binge drinking, frequency of toothbrushing, and regular dental visit), and health problems (diabetes and hypertension) were included in a series of analytical models. RESULTS: The survey year-, age-, and gender-adjusted prevalence ratios (PR) of the loss of 8 or more teeth for the shortest quartile were 1.23 (95% confidence intervals, CI: 1.13-1.35) for the 1920-1945 birth cohorts and 1.39 (95% CI: 1.20-1.62) for the 1946-1962 birth cohorts. The PRs for edentulousness were 1.64 (95% CI: 1.34-2.02) for the 1920-1945 birth cohorts and 2.26 (95% CI: 1.31-3.91) for the 1946-1962 birth cohorts. These associations were moderately attenuated after adjusting for own education but still significant in the fully adjusted models. After full adjustment for the covariates, those in the shortest height quartiles in the relatively young birth cohorts (1946-1962 birth cohorts) had a 1.93 (95% CI: 1.09-3.43) times greater prevalence of edentulism than that of their tallest counterparts. CONCLUSIONS: Given that adult height reflects early-life conditions, independent associations between height and tooth loss support the view that early-life circumstances significantly influence oral health outcomes in later life.

Exploring the determinants of secular decreases in dental caries among Korean children.

OBJECTIVE: The aim of this study was to determine the contributions of sealant and water fluoridation to the time trends in dental caries from 2003 to 2010. MATERIALS AND METHODS: Data were from three waves of the Korean National Oral Health Surveys between 2003 and 2010, including a total of 23 059 children (11 889 boys and 11 170 girls) aged 8, 10, and 12 years. The impacts of sealant and water fluoridation on dental caries were obtained by logistic regression for each age group of children. The contributions of sealant and water fluoridation to the time trends in the prevalence of dental caries were examined by a series of logistic regression models, and changes in the adjusted odds ratios for each survey year were also calculated. RESULTS: Over the past 7 years, the prevalence of dental caries decreased dramatically. Although sealant had a significant impact on dental caries in each survey year, remarkable decreases in dental caries from 2003 to 2010 were not explained by the secular changes in the dental sealant or water fluoridation factor. CONCLUSION: We observed important population declines in dental caries in Korea in children aged 8-12 years; however, the likely causes for these secular trends remain to be determined.

Smoking induced heavy metals and periodontitis: findings from the Korea National Health and Nutrition Examination Surveys 2008-2010.

AIM: Exposure to hazardous heavy metals such as cadmium and lead may contribute to increased oxidative stress and inflammation in the periodontal tissue. We aimed to evaluate the association between serum cadmium and lead levels and periodontitis. MATERIALS & METHODS: Pooled cross-sectional data from the Korea National Health and Nutrition Examination Surveys 2008-2010 were used. Periodontitis was defined as WHO community periodontal index. Active smokers were defined as self-reported current smokers or those with measured urine cotinine ≥164 ng/ml measurements. Serum cadmium and lead levels were measured using graphite furnace atomic absorption spectrometry. Multiple logistic regression analysis was used to estimate the odds ratios (OR) for periodontitis. RESULTS: The mean cadmium and lead levels were significantly higher in the periodontitis group compared with control population. A progressive increase in serum heavy metals were found as the number of sextants with periodontitis. The ORs for periodontitis were significantly associated with serum cadmium (OR = 1.37; 95% CI 1.00-1.87) and lead levels (OR = 1.60; 95% CI 1.15-2.21). The association between periodontitis and smoking was attenuated after adjusting for serum cadmium concentration. CONCLUSIONS: We demonstrated a significant association between periodontitis and serum cadmium and lead concentrations. Cadmium appeared to partially mediate the association between smoking and periodontitis.