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Mucosa-associated lymphoid tissue (MALT) lymphoma, also known as extranodal marginal zone lymphoma, is a low-grade B-cell lymphoma that can develop in the mucosal layer of various organs, including the gastrointestinal tract, salivary glands, lungs, and skin. The most common site is the gastrointestinal tract, particularly the stomach. On the other hand, primary esophageal lymphomas are extremely rare. MALT lymphomas can undergo histological transformation into more aggressive B-cell lymphomas, such as diffuse large B-cell lymphoma, resulting in a poor prognosis. This paper reports a rare case of primary esophageal MALT lymphoma mimicking a subepithelial tumor located in the lower esophagus that was treated successfully with radiotherapy. MALT lymphoma should be included in a differential diagnosis when subepithelial tumors are found in the esophagus, particularly if endoscopic ultrasonography reveals the tumor to be located in the deep mucosal and submucosal layers. Following the precise diagnosis, accurate staging and appropriate treatment are crucial. Regular follow-up is necessary to assess the possibility of recurrence or transformation to high-grade lymphoma.
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Chronic nonbacterial osteomyelitis (CNO) is histologically characterized by nonspecific osteitis. This inflammatory disorder, which lacks an infectious origin, typically presents with chronic pain and swelling at the affected site that can persist for months or even years. However, it is rare for CNO to affect the mandible. A 10-year-old girl presented with a primary complaint of pain in her left mandible. She had no significant medical or dental history. On examination, swelling was visible on the left buccal side, and imaging revealed radiolucent bone deterioration within the left mandible. This case report presents the radiological changes observed over a 12-year follow-up period. Variations in radiopacity, radiolucency, and periosteal reactions were noted periodically. This case highlights the radiological characteristics and findings that are crucial for the diagnosis of CNO, a condition for which no clear diagnostic criteria are currently available.
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This study assessed the beauty care behavior and the dietary attitudes, eating behaviors, and dietary quality related to beauty care in accordance with the level of interest in beauty care by examining 558 female high school subjects in the Incheon area. The study aimed to identify the interest in beauty care on the part of adolescent girls that impacts their dietary life and provide basic data for nutrition education forming desirable dietary habits. The interest in beauty care on the part of female high school students is relevant to dietary life and dietary attitude, with the high-level interest group attempting to use diet foods more frequently and attempting weight control because of their low satisfaction with their body type. On the other hand, a high level of interest in appearance failed to lead to the practice of a varied and balanced dietary life. Therefore, nutritional education is necessary to avoid a high level of interest in beauty care, leading to an incorrect perception of body shape and excessive weight control. Furthermore, nutrition education is necessary to link interest in appearance to the beauty of a healthy body based on nutritional balance by connecting the interest in appearance to a varied and balanced dietary life that goes beyond the category of practice.
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Background@#As the medical knowledge base grows at an accelerating rate, evidence-based clinical performance becomesincreasingly important for providing quality care. Previous studies have highlighted the need to promote job crafting to actualize evidence-based practical skills in the medical field. This study aimed to investigate the degree of evidence-based practice among dental hygienists and assess the impact of job crafting on the evidence-based practical skills of dental hygienists. @*Methods@#Dental hygienists working at dental hospitals and clinics in Seoul and Gyeonggi Province were surveyed betweenFebruary 28 and April 6, 2023. The sample was comprised of 267 participants. The hypotheses were tested independent t-tests, one-way analysis of variance, Pearson’s correlation coefficients, and multiple regression analyses using SPSS 29.0. @*Results@#The degree of job crafting by dental hygienists demonstrated significant differences based on educational attainment,workplace size, and workplace type. Evidence-based practical skills exhibited significant variations based on educational attainment and job position. All job crafting subfactors demonstrated positive correlations with evidence-based practical skills. The job crafting subfactors affecting the evidence-based practical skills of dental hygienists were ‘increasing structural job resources’ and ‘increasing challenging job demands,’ which together explained 38.7% of the variance in evidence-based practical skills. @*Conclusion@#This study demonstrates that job crafting was positively and significantly correlated with evidence-based practicalskills. To strengthen the job crafting ability of dental hygienists, improving environmental conditions and fostering an organizational culture that motivates continued participation in education is necessary. The development and promotion of programs that enable learning of the latest evidence should be actively pursued. Additionally, regular attendance at workshops and participation in organizational evidence-based practice education programs are necessary.
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Purpose@#This study was conducted to assess the antidepressant effects of capsaicin in chronic depressive rats and elucidate the mechanism underlying its effects. @*Methods@#Male Wistar rats (280~320 g, 8 weeks of age) were subjected to depression induced by chronic unpredictable mild stresses. The rats were exposed to 8 kinds of stresses for 8 weeks. In the last 2 weeks, fluoxetine or capsaicin was injected subcutaneously. The dose of fluoxetine was 10 mg/kg (body weight), while the doses of capsaicin consisted of low (1 mg/kg), middle (5 mg/kg), and high (10 mg/kg). The forced swim test (FST) was conducted to evaluate the immobility time of rats. The immobility time indicates despair, one of symptoms of depression. The change of tryptophan hydroxylase (TPH) in the dorsal raphe was investigated using immunohistochemistry. In the hippocampus cornu ammonis (CA) 1 and 3, glucocorticoid receptor (GR) expression was measured. @*Results@#The immobility time in the FST was significantly lower (p < .05) in the low-dose (M = 32.40 ± 13.41 seconds) and middle-dose (M = 28.48 ± 19.57 seconds) groups than in the non-treated depressive rats (M = 90.19 ± 45.34 seconds). The amount of TPH in the dorsal raphe was significantly higher (p < .05) in the middle-dose (M = 249.17 ± 35.02) and high-dose (M = 251.0 ± 56.85) groups than in the non-treated depressive rats (M = 159.78 ± 41.16). However, GR expression in the hippocampus CA1 and CA3 did not show significant differences between the non-treated depressive rats and the capsaicin-injected rats. @*Conclusion@#This study suggests that capsaicin produces an antidepressant-like effect on chronic unpredictable mild stress-induced depression in rats via the serotonin biosynthesis pathway.
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Sarcopenia, defined as a progressive loss of muscle mass and function, is typified by mitochondrial dysfunction and loss of mitochondrial resilience. Sarcopenia is associated not only with aging, but also with various metabolic diseases characterized by mitochondrial dyshomeostasis. Pyruvate dehydrogenase kinases (PDKs) are mitochondrial enzymes that inhibit the pyruvate dehydrogenase complex, which controls pyruvate entry into the tricarboxylic acid cycle and the subsequent adenosine triphosphate production required for normal cellular activities. PDK4 is upregulated in mitochondrial dysfunction-related metabolic diseases, especially pathologic muscle conditions associated with enhanced muscle proteolysis and aberrant myogenesis. Increases in PDK4 are associated with perturbation of mitochondria-associated membranes and mitochondrial quality control, which are emerging as a central mechanism in the pathogenesis of metabolic disease-associated muscle atrophy. Here, we review how mitochondrial dysfunction affects sarcopenia, focusing on the role of PDK4 in mitochondrial homeostasis. We discuss the molecular mechanisms underlying the effects of PDK4 on mitochondrial dysfunction in sarcopenia and show that targeting mitochondria could be a therapeutic target for treating sarcopenia.
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Background/Aims@#The prevalence of nonalcoholic fatty liver disease (NAFLD) has increased rapidly as a consequence of more sedentary lifestyles and a Westernized diet. Fracture is a major clinical problem in older people, but few large-scale cohort studies have evaluated the relationship between NAFLD and fracture. Therefore, we aimed to determine whether the fatty liver index (FLI), which represents the severity of NAFLD, can predict fracture risk. @*Methods@#We analyzed the relationship between the FLI and incident fracture using multivariate Cox proportional hazards models and data for 180,519 individuals who underwent National Health check-ups in the Republic of Korea between 2009 and 2014. @*Results@#A total of 2,720 participants (1.5%) were newly diagnosed with fracture during the study period (median 4.6 years). The participants were grouped according to FLI quartiles (Q1, 0 to <5.653; Q2, 5.653 to <15.245; Q3, 15.245 to <37.199; and Q4 ≥37.199). The cumulative fracture incidence was significantly higher in the highest FLI group than in the lowest FLI group (Q4, 986 [2.2%] and Q1, 323 [0.7%]; p<0.001). The adjusted hazard ratio indicated that the highest FLI group was independently associated with a higher incidence of fracture (hazard ratio for Q4 vs Q1, 2.956; 95% confidence interval, 2.606 to 3.351; p<0.001). FLI was significantly associated with a higher incidence of fracture, independent of the baseline characteristics of the participants. @*Conclusions@#Our data imply that the higher the FLI of a Korean patient is, the higher their risk of osteoporotic fracture, independent of key confounding factors.
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Purpose@#The aim of this study was to evaluate the diagnostic value of shear-wave elastography (SWE) combined with Doppler ultrasonography (US) in selecting equivocal breast fibroepithelial lesions (FELs) for follow-up without further excision. @*Methods@#A retrospective analysis was conducted of 88 patients with equivocal breast FELs (FELs with the possibility of both fibroadenoma [FA] and phyllodes tumor [PT]) diagnosed by core needle biopsy (CNB). For post-CNB treatment, surgical or vacuum-assisted excision was performed on 88 equivocal FELs, of which 56 were diagnosed as FAs and 32 as PTs on histopathology. Mean elasticity (Emean) and vascularity were determined using SWE and Doppler US. The diagnostic performances of B-mode US, SWE, and Doppler US were calculated to differentiate FAs and PTs in the excised equivocal FELs. @*Results@#In the excised equivocal FELs diagnosed by CNB, FAs showed significantly lower median Emean values (36.4 vs. 66.7 kPa, P=0.005) and more frequent low vascularity (0–1 vessel flow signal) (P60.9 kPa and high vascularity (≥2 vessel flows) showed a sensitivity and negative predictive value of 100%, as well as better performance in other diagnostic values than B-mode US alone (Breast Imaging Reporting and Data System ≥4A) (all P<0.05). @*Conclusion@#Equivocal breast FELs showing both low elasticity and low vascularity were not upgraded to PTs upon further excision. Therefore, the combination of SWE and color Doppler US mode might help select patients with equivocal FELs for whom further excision is unnecessary.
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Background@#CycloZ, a combination of cyclo-His-Pro and zinc, has anti-diabetic activity. However, its exact mode of action remains to be elucidated. @*Methods@#KK-Ay mice, a type 2 diabetes mellitus (T2DM) model, were administered CycloZ either as a preventive intervention, or as a therapy. Glycemic control was evaluated using the oral glucose tolerance test (OGTT), and glycosylated hemoglobin (HbA1c) levels. Liver and visceral adipose tissues (VATs) were used for histological evaluation, gene expression analysis, and protein expression analysis. @*Results@#CycloZ administration improved glycemic control in KK-Ay mice in both prophylactic and therapeutic studies. Lysine acetylation of peroxisome proliferator-activated receptor gamma coactivator 1-alpha, liver kinase B1, and nuclear factor-κB p65 was decreased in the liver and VATs in CycloZ-treated mice. In addition, CycloZ treatment improved mitochondrial function, lipid oxidation, and inflammation in the liver and VATs of mice. CycloZ treatment also increased the level of β-nicotinamide adenine dinucleotide (NAD+), which affected the activity of deacetylases, such as sirtuin 1 (Sirt1). @*Conclusion@#Our findings suggest that the beneficial effects of CycloZ on diabetes and obesity occur through increased NAD+ synthesis, which modulates Sirt1 deacetylase activity in the liver and VATs. Given that the mode of action of an NAD+ booster or Sirt1 deacetylase activator is different from that of traditional T2DM drugs, CycloZ would be considered a novel therapeutic option for the treatment of T2DM.
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Background/Aims@#Dual priming oligonucleotide-based multiplex polymerase chain reaction (DPO-PCR) has recently been used for both the detection of Helicobacter pylori and the identification of H. pylori 23S ribosomal RNA point mutations that cause clarithromycin resistance.The aim of this study was to investigate the duration of effective standard triple therapy in a clarithromycin susceptible group and of bismuth-based quadruple therapy in a resistant group based on DPO-PCR. @*Methods@#We retrospectively analyzed the electronic medical records of 184 patients who, between September 2019 and December 2020, received eradication therapy following detection of H. pylori, and the subsequent identification of the clarithromycin susceptibility of their H. pylori using DPO-PCR. Patients were treated with 7- or 14-day standard triple therapy in the clarithromycin susceptible group, whereas 7- or 14-day bismuth-based quadruple therapy in the clarithromycin resistance group. @*Results@#In the clarithromycin susceptible group, per-protocol analyses showed eradication rates of 87.5% (42/48; 95% confidence interval [CI], 77.1% to 95.8%) for 7-day therapy and 87.2% (41/47; 95% CI, 78.7% to 95.7%) for 14-day therapy (p=0.969). The eradication rates in the clarithromycin resistance group were 91.4% (32/35; 95% CI, 80.0% to 100.0%) for 7-day therapy and 90.3% (28/31; 95% CI, 77.4% to 100.0%) for 14-day therapy (p=0.876). There was no significant difference in the eradication rates, patient compliance, or rate of adverse events between the 7-and 14-day therapies for both groups. @*Conclusions@#Compared to the 14-day therapy, 7-day eradication therapy is sufficient after DPO-PCR-based clarithromycin susceptibility testing.
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The challenges of successful nasal reconstruction, which are related to the anatomical complexity of the region, have been extensively studied. Revisional operations are often required to achieve proper nasal reconstruction, with results resembling the premorbid nasal status. This is necessary to ensure the quality of life of skin cancer patients. Fundamental nasal reconstruction requires both proper soft tissue coverage and proper function. However, earlier studies in the field primarily focused on the functional aspect of nose reconstruction, although the cosmetic aspect is also an important factor to consider. In response to this need, many recent studies on nose reconstruction have proposed various refinement strategies to improve aesthetic satisfaction. Most plastic surgeons accept the nasal aesthetic subunit principle as a standard for nasal reconstruction. This review outlines the commonly used surgical refinement options and management strategies for postoperative complications based on the subunit principle. In patients with nasal defects, a proper technical strategy might help minimize revision operations and optimize the long-term results.
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Intraosseous xanthoma of the mandible is a rare benign disorder. A 17-year-old male patient presented with a suspected abscess in the right mandibular third molar, detected on a panoramic radiograph. The patient had no history of systemic or lipid-related metabolic diseases and complained of no specific symptoms or pain. A radiographic examination revealed a heterogeneous radiolucency extending from the apical to the distal aspect of the right mandibular third molar tooth germ. The lesion measured 9×16×24 mm (antero-posterior×mediolateral×supero-inferior) and showed a relatively well-defined, multilocular, foamy appearance with hyperostotic borders spreading to the inferior alveolar nerve canal. After excisional biopsy, a diagnosis of central xanthoma was made. The lesion recurred, and intraoral vertical ramus osteotomy was done near the lesion. For the treatment of xanthoma of the mandible, extensive and delicate surgical treatment under general anesthesia should be considered.
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Background@#This study compared the neutralizing antibody kit using the Enzyme-Linked Immunosorbent Assay (ELISA) method with the rapid antibody diagnostic kit using the Lateral Flow Immunoassay (LFIA) method to evaluate the clinical effectiveness of the COVID-19 Biokit IgG/IgM regarding evaluation of antibody formation after COVID-19 vaccination. @*Methods@#The neutralizing antibody test was performed with antibody detection kit of diagnostic medical devices for the qualitative method using the standard ELISA method. The rapid antibody diagnostic kit was measured with the COVID-19 Biokit IgG/IgM using the LFIA method. Based on the results of the neutralizing antibody measurement test of the standard test method, the test results of the rapid antibody diagnostic kit are compared and analyzed to confirm its the sensitivity and specificity. @*Results@#When the consistency was determined as positive and negative for the two test results, 118 cases were matched and two cases were inconsistent, showing a 98.3% consistency rate. That is, sensitivity 98%, specificity 100% and correctly classified proportion 98%. @*Conclusions@#Although the positive results of antibody formation of this kit would mean that individual has immunity to COVID-19, the result cannot be used to confirm or evaluate for re-infection. But the strong agreement between rapid antibody diagnostic kit results and ELISA results suggests that the kit used in this study is available as a screening test for antibody and neutralizing antibody responses, which could help evaluate the need for additional vaccinations, collect data quickly and cheaply and monitor individual immune responses.
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Objective@#Suicide is a complex phenomenon; therefore, it should be approached in light of sociocultural perspectives and the general attitude toward suicide. This study aimed to extract factors from the Attitude Toward Suicide Scale (ATTS) and investigate the relationship between attitudes toward suicide and suicidal behavior (i.e., suicidal idea, plan, and attempt) by using a representative sample of Korean adults. @*Methods@#Three thousand Koreans aged 19 to 75 years were surveyed cross-sectionally in 2013 and 2018. The data collected were subjected to exploratory factor analysis. Extracted attitude factors were compared using a suicidal behavior continuum. Univariate and multivariate logistic models were constructed to compare the association between attitude factors and suicidal behaviors. @*Results@#Among the participants, 477 (15.9%) experienced suicidal idea only, 85 (2.8%) had a suicidal plan without attempt, and 58 (1.9%) attempted suicide. Four meaningful factors were extracted from the factor analysis: “permissiveness,” “unjustified behavior,” “preventability/readiness to help,” and “loneliness.” “Permissiveness,” “unjustified behavior,” and “loneliness” factors showed significant trends across the suicidal behavior continuum. Permissive attitude toward suicide increased the odds of suicidal idea, suicidal plan, and suicide attempt (adjusted odds ratio [aOR]=1.49, 95% confidence interval [CI]=1.25–1.79; aOR=2.79, 95% CI=1.84–4.25; aOR=2.67, 95% CI=1.65–4.33), while attitude toward suicide as unjustified behavior decreased the odds of suicidal ideation and attempt (aOR=0.79, 95% CI=0.67–0.94; aOR=0.64, 95% CI=0.42–0.99). @*Conclusion@#A significant association was found between attitude toward suicide and suicidal behaviors. Attitude toward suicide is a modifiable factor that can be used to develop prevention policies.
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Background and Objectives@#Coronavirus disease 2019 (COVID-19) is a worldwide pandemic, and some patients require mechanical ventilation and tracheostomy. Owing to the risks of aerosol spreading to health care workers, the protocols and guidelines related to the novel timing and technique for tracheostomy are rapidly changing. We investigated the characteristics of tracheostomy with patients with COVID-19 over a year.Subjects and Method We measured the mean time from intubation to the tracheostomy, survival rate, the incidence of infection to medical staff, and operation time, complications for tracheostomy, and the time of decannulation. All patients underwent a novel percutaneous tracheostomy without bronchoscope (hybrid modified percutaneous dilatational tracheostomy, hybrid MPDT) in the negative pressure intensive care unit. @*Results@#Of the 448 patients with COVID-19 patients, 34 required invasive mechanical ventilation at a tertiary hospital from February 2020 to April 2021. Of those, 15 patients underwent tracheostomy. Of the tracheostomy patients, survival rate was 93.33%. The mean time from intubation to the tracheostomy was 18.27±14.74 days (range, 8-36 days). The incidence of infection to medical staff was zero percent whereas racheostomy-related bleeding was the most common complication (2 patients). Operation time for hybrid MPDT was 5.45±1.12 min. @*Conclusion@#The optimal timing of tracheostomy procedure for COVID-19 patients is still unknown, but it is believed that the treatment of COVID-19 can be achieved better if the hybrid MPDT is used at the right time.
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Background@#Selecting effective products among the various types of silicone gel sheets can be challenging for surgeons. Therefore, we assessed the effect of silicone gel sheet thickness on surgical scars in pediatric and adolescent patients. @*Methods@#From December 2017 to May 2018, we identified patients aged 1–19 years who underwent excision. Among these patients, those who were prescribed 0.3-mm or 1.0-mm-thick silicone sheets were selected. Scars were subjectively evaluated using a questionnaire consisting of seven items. Objective evaluation was performed by two plastic surgeons using the Vancouver Scar Scale (VSS). @*Results@#The mean age of the 49 selected patients was 9.78 years. The patients were divided into two groups according to the thickness of the silicone gel sheet used (0.3 mm vs. 1.0 mm). Objective evaluation of the patients’ scars revealed more favorable results in the 0.3 mm group than in the 1.0 mm group (P=0.010). Multivariate analysis of VSS scores indicated that the resulting scars in cases involving the trunk were of poorer quality than those involving facial areas (P=0.015). Additionally, favorable (i.e., below-average) VSS scores were significantly less likely in patients with longer scars (odds ratio, 0.896; 95% confidence interval, 0.834–0.963; P=0.003) or thicker silicone sheets (odds ratio, 0.085; 95% confidence interval, 0.011–0.699; P=0.019). @*Conclusions@#The use of thinner silicone gel sheets in children and adolescents resulted in better scars according to subjective evaluations, underscoring the importance of compliance in pediatric patients. The type of operation and surgical lesion should also be considered when planning the management of surgical scars.
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Esophageal abscess caused by acute phlegmonous esophagitis is rare but life-threatening. Rapid abscess drainage is an important part of the treatment, and endoscope-assisted intra-luminal abscess drainage is frequently performed. Although endoscopic drainage is less invasive than surgery, it has the potential to cause esophageal stricture as a complication. We present a rare case of esophageal stricture as a complication of intra-luminal drainage and evaluate a method to minimize the incidence of esophageal stricture complications.
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Objective@#To analyze the overall treatment effects in terms of the amount of uprighting with changes in the three-dimensional positions of the mandibular posterior teeth after applying the biocreative reverse curve (BRC) system. @*Methods@#Thirty-four patients (mean age, 20.5 ± 8.56 years) were treated using the BRC system (mean period, 8.17 ± 2.19 months). Cone-beam computed tomography was performed before treatment and after treatment with the BRC system. The three-dimensional movement of each tooth was analyzed in the coordinate system at points on the crown and root apex. A paired t-test was used to analyze the treatment effects of the BRC system. @*Results@#The application of the BRC system spanning from the first premolar to the second molar resulted not only in buccal and distal uprighting, but also in increased buccal and distal tipping of the teeth. The premolars and the first molar were extruded, and the second molar was intruded. @*Conclusions@#When the BRC system is applied, simultaneous distal and buccal uprighting of the premolars and molars can be achieved bilaterally using a temporary skeletal anchorage device without unnecessary movement of the anterior teeth.
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Background@#This study aimed to investigate the changes in facial width according to the ostectomy level of the proximal segment after orthognathic surgery using intraoral vertical ramus osteotomy (IVRO) in patients with mandibular prognathism. @*Methods@#The participants included 32 individuals who were diagnosed with class III malocclusion prior to surgery. All participants underwent orthognathic surgery using either version of IVRO. The surgery patients were categorized into two groups depending on the type of proximal bone-segment ostectomy technique used: patients whose osteotomy height was at the level of the mandibular tooth occlusal surface (the mandibular tooth surface–level group) and patients whose osteotomy height was at the level of the mandibular inferior border (the mandibular inferior border–level group). The distances between the mandibular width and soft tissue width at the height of the sigmoid notch, mandibular foramen, and alveolar bone and at the anterior-posterior location of the mandibular condyle, mandibular foramen, and coronoid process were compared between the groups. All data were compared to identify differences between preoperative and postoperative measurements. @*Results@#The postoperative change in facial soft tissue width at the intersection of the coronal plane with the coronoid process and the horizontal plane at the height of the mandibular alveolar bone in the group with osteotomy at the level of the mandibular occlusal surface differed significantly from that in the group with osteotomy at the level of the mandibular inferior border, with respective increases (mean ± SD) of 1.3 ± 3.5% and 4.7 ± 5.6%, compared to preoperative measurements (p = 0.050). @*Conclusions@#Proximal segment ostectomy at the level of the mandibular occlusal surface must be considered with regard to postoperative facial soft tissue width in vertical ramus osteotomy. Additionally, it is necessary to study the visual effect of the width of the mandible appearing small because of the posterior position of the mandible, even when the mandibular facial width is maintained.
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Recently, the prevalence of diabetic mellitus patients in Korea has been increasing, and it increasing with age. The treatment goal of diabetes is to prevent complications through blood sugar management, for which it is important to maintain an appropriate nutritional state. Unbalanced diet refers to excessive or insufficient nutrition, which can be generally confirmed through weight conditions. Therefore, medical nutrition therapy in diabetic patients with unbalanced diet aims to maintain a moderate body mass index. Older people with diabetes have a higher risk of unbalanced diet than those without diabetes. Clinical nutritional intervention in diabetic patients should shift from strict dietary restrictions for treatment of metabolic syndrome/obesity to diet for prevention of frailty and sarcopenia with age. Therefore, clinical nutrition therapy for diabetic patients with unbalanced diet should be individualized in consideration of age, gender, and medical condition. Medical nutrition therapy tailored for each patient can contribute to improving the nutritional status of diabetic patients, prolonging healthy life expectancy and improving quality of life.