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Effects of drilling process in stability of micro-implants used for the orthodontic anchorage (고정원을 위한 micro-implant 매식시 drilling 유무에 따른 안정성에 관한 연구)

  • Chang, Young-Il;Kim, Jong-Wan
    • The korean journal of orthodontics
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    • v.32 no.2 s.91
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    • pp.107-115
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    • 2002
  • The aim of this study was to investigate experimentally the mechanical and histological effect of drilling process on the stability of micro-implant used for the orthodontic anchorage. For this purpose, 32 micro-implants(Osas$^{(R)}$, Epoch medical, ${\phi}$1.6 mm) were inserted into maxilla, mandible and palate in two beagle dogs. 16 micro-implants(8 per dog) were inserted after drilling with pilot drilling bur (drill method group). 16 micro-implants(8 per dog) were inserted without drilling (drill-free method group). After 1 week, micro-implants were loaded by means of Ni-Ti coil spring (Ni-Ti springs-extension$^{(R)}$, Ormco) with 200-300 gm force. Following 12 weeks, the micro-implants and the surrounding bone were removed. Before sacrifice, the mobilities were tested with Periotest$^{(R)}$(Siemens). Undecalcified serial sections with the long axis were made and the histologic evaluations were done. The results of this study were as follow ; 1. The osseointegration was found in both of drill-free method group and drill method group 2. Two of drill method group and one of drill-free method group in 32 micro-implants were lost after loading. 3. The mobilities of drill-free method group were less than drill method group 4. The bone contact on surface of micro-implants in drill-free method group was more than drill method group but there was no significant difference between groups. 5. The bone density in threads of micro-implants in drill-free method group was more than drill method group and there was significant difference between groups. These results suggest that drill-free method in insertion of micro-implants is superior to drill method on the stabilities, bone remodeling and osseointegrations under early loading.

The experimental study of early loading on the Miniplate in the beagle dog (성견의 하악골에 식립된 Miniplate에 가한 조기 부하의 영향에 관한 실험적 연구)

  • Chung, Yong-Koo;Lee, Young-Jun;Chung, Kyu-Rhim
    • The korean journal of orthodontics
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    • v.33 no.4 s.99
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    • pp.307-317
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    • 2003
  • Conventional osseointegrated titanium implants have many limitations; large size, limited location for placement of the implant, severity of the surgery, discomfort of initial healing, difficulty of oral hygiene and uncontrollable force direction. Recently titanium miniscrew and miniplate have been used for an alternative to conventional dental implant. But in relation to miniplate, miniscrew has disadvantages in that more potential inflammation, light orthodontic force application and limited orthodontic application. This study was conducted to evaluate the effectiveness of miniplate by observing the reactions of peri-implant tissues to early orthodontic and orthopedic loading of titanium miniplate. In four adult beagle dogs 10 miniplates were inserted into the alveolar bone using 20 osseointegrated titanium screws. 4 miniplates were placed in two dogs(dogA, B) and 6 miniplates in two dogs(dogC, D). In dogA, B miniplates were loaded with 200gm of force immediately after placement for 15 weeks. In dogc, D, miniplates were loaded with 400gm of force immediately after placement for 8 weeks. Miniplates of dogA were removed, dogA was healed for 4 weeks, and the area which was removed of miniscrew was examined. Following an observation period, the miniplates including miniscrews and the surrounding bone of dogB and dogC, D were removed, respectively. Undecalcified section along the long axis of miniscrews were made and the degree of osseointegration was examined under the light microscope. The results were as follows. 1. In the histologic features there was direct contact between bone and miniscrew in all groups except one, dogC control group. The loaded miniscrew demonstrated only a slight increase of the osseous proximaty when compared with unloaded miniscrew 2. There was no significant difference of the osseointegration of Peri-miniscrew surface between dogB and dogC, D. But dogB showed slightly more increased bone apposition than dogC, D 3. The gingiva overlapping the miniplate and miniscrew showed no inflammatory sign in clinical and histological aspects. 4. The impaled hard and soft tissues at the area which was removed of miniscrews showed good healing without inflammatory reaction. 5. The mobility showed slight increase in un-loaded miniplate but that was insignificant. Based on the results of this study, miniplate(C-tube) can be used as a firm osseous orthodontic and orthopedic anchorage unit immediately after insertion.

Neurovascular Morphometric Aspect in the Region of Cranio-Cervical Junction (두개와 경추의 이행부에서 뇌신경계와 혈관계에 대한 형태학적 계측)

  • Lee, Kyu;Bae, Hack-Gun;Choi, Soon-Kwan;Yun, Seok-Mann;Doh, Jae-Won;Lee, Kyeong-Seok;Yun, Il-Gyu;Byun, Bark-Jang
    • Journal of Korean Neurosurgical Society
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    • v.30 no.9
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    • pp.1094-1102
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    • 2001
  • Objective : During the trans-condylar or trans-jugular approach for the lesion of cranio-cervical junction(CCJ), its necessary to identify the accurate locations of vertebral artery(VA), internal jugular vein(IJV) and its related lower cranial nerves. These neurovascular structures can also be damaged during the operation for vascular tumor or traumatic aneurysm around extra-jugular foramen, because of their changed locations. To reduce the neurovascular injury at the operation for CCJ, morphometric relationship of its surrounding neurovascular structures based on the tip of the transverse process of atlas(C1 TP), were studied. Materials & Methods : Using 10 adult formalin fixed cadavers, tip of mastoid process(MT) and TPs of atlas and axis were exposed bilaterally after removal of occipital and posterior neck muscles. Using standard caliper, the distances were measured from the C1 TP to the following structures : 1) exit point of VA from C1 transverse foramen, 2) branching point of muscular artery from VA, 3) entry point of VA into posterior atlanto-occipital membrane(AOM), 4) branching point of C-1 nerve. In addition, the distances were measured from the mid-portion of the posterior arch of atlas to the entry point of the VA into AOM and to the exit point of the VA from C1 transverse foramen. After removal of the ventrolateral neck muscles, neurovascular structures were exposed in the extra-jugular foraminal region. Distances were then measured from the C1 TP to the following structures : 1) just extra-jugular foraminal IJV and lower cranial nerves, 2) MT and branching point of facial nerve in parotid gland. In addition, distance between MT and branching point of facial nerve was measured. Results : The VA was located at the mean distance of 12mm(range, 10.5-14mm) from the C1 transverse foramen and entered into the AOM at the mean distance of 24mm(range, 22.8-24.4mm) from the C1 TP. The mean distance from the mid portion of the C1 posterior arch was 20.6mm(range, 19.1-22.3mm) to the entry point of the VA into AOM and 38.4mm(range, 34-42.4mm) to the exit point of the VA from C1 transverse foramen. Muscular artery branched away from the posterior aspect of the transverse portion of VA below the occipital condyle at the mean distance of 22.3mm(range, 15.3-27.5mm) from the C1 TP. The C-1 nerve was identified in all specimens and ran downward through the ventroinferior surface of the transverse segment of VA and branched at the mean distance of 20mm(range, 17.7-20.3mm) from the C1 TP. The IJV was located at the mean distance of 6.7mm(range, 1-13.4mm) ventromedially from the lateral surface of the C1 TP. The XI cranial nerve ran downward on the lateral surface of the IJV at the mean distance of 5mm(range, 3-7.5mm) from the C1 TP. Both IX and X cranial nerves were located in the soft tissue between the medial aspect of the internal carotid artery(ICA) and the medial aspect of the IJV at the mean distance of 15.3mm(range, 13-24mm) and 13.7mm(range, 11-15.4mm) from the C1 TP, respectively. The IX cranial nerve ran downward ventroinferiorly crossing the lateral aspect of the ICA. The X cranial nerve ran downward posteroinferior to the IX cranial nerve and descended posterior to the ICA. The XII cranial nerve was located between the posteroinferior aspect of the IX cranial nerve and the posterior aspect of the ICA at the mean distance of 13.3mm(range, 9-15mm) ventromedially from the C1 TP. The distance between MT and C1 TP was 17.4mm(range, 12.5-23.9mm). The VII cranial nerve branched at the mean distance of 10.2mm(range, 6.8-15.3mm) ventromedially from the MT and at the mean distance of 17.3mm(range, 13-21mm) anterosuperiorly from the C1 TP. Conclusion : This study facilitates an understanding of the microsurgical anatomy of CCJ and may help to reduce the neurovascular injury at the surgery around CCJ.

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Improved Device Performance Due to AlxGa1-xAs Barrier in Sub-monolayer Quantum Dot Infrared Photodetector

  • Han, Im Sik;Byun, Young-Jin;Lee, Yong Seok;Noh, Sam Kyu;Kang, Sangwoo;Kim, Jong Su;Kim, Jun Oh;Krishna, Sanjay;Ku, Zahyun;Urbas, Augustine;Lee, Sang Jun
    • Proceedings of the Korean Vacuum Society Conference
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    • 2014.02a
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    • pp.298-298
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    • 2014
  • Quantum dot infrared photodetectors (QDIPs) based on Stranski-Krastanov (SK) quantum dots (QDs) have been widely explored for improved device performance using various designs of heterostructures. However, one of the biggest limitations of this approach is the "pancake" shape of the dot, with a base of 20-30 nm and a height of 4-6 nm. This limits the 3D confinement in the quantum dot and reduces the ratio of normal incidence absorption to the off-axis absorption. One of the alternative growth modes to the formation of SK QDs is a sub-monolayer (SML) deposition technique, which can achieve a much higher density, smaller size, better uniformity, and has no wetting layer as compared to the SK growth mode. Due to the advantages of SML-QDs, the SML-QDIP design has attractive features such as increased normal incidence absorption, strong in-plane quantum confinement, and narrow spectral wavelength detection as compared with SK-DWELL. In this study, we report on the improved device performance of InAs/InGaAs SML-QDIP with different composition of $Al_xGa1-_xAs$ barrier. Two SML-QDIPs (x=0.07 for sample A and x=0.20 for sample B) are grown with the 4 stacks 0.3 ML InAs. It is investigated that sample A with a confinement-enhanced (CE) $Al_{0.22}Ga_{0.78}As$ barrier had a single peak at $7.8{\mu}m$ at 77 K. However, sample B with an $Al_{0.20}Ga_{0.80}As$ barrier had three peaks at (${\sim}3.5{\mu}m$, ${\sim}5{\mu}m$, ${\sim}7{\mu}m$) due to various quantum confined transitions. The measured peak responsivities (see Fig) are ~0.45 A/W (sample A, at $7.8{\mu}m$, $V_b=-0.4V$ bias) and ~1.3 A/W (sample B, at $7{\mu}m$, $V_b=-1.5V$ bias). At 77 K, sample A and B had a detectivity of $1.2{\times}10^{11}cm.Hz^{1/2}/W$ ($V_b=-0.4V$ bias) and $5.4{\times}10^{11}cm.Hz^{1/2}/W$ ($V_b=-1.5V$ bias), respectively. It is obvious that the higher $D^*$ of sample B (than sample A) is mainly due to the low dark current and high responsivity.

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Analysis of Mistakes in Photosynthesis Unit in Biology II Textbooks and Survey of Biology Teachers' Recognition on them (생물 II 교과서 광합성 단원의 오류 분석 및 생물 교사의 오류 인지 조사)

  • Park, Hae-Kyung;Yoon, Ki-Soon;Kwon, Duck-Kee
    • Journal of Science Education
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    • v.32 no.1
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    • pp.33-46
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    • 2008
  • The purpose of this study was to know whether or not any wrongful description or simple errors were in photosynthesis unit of Biology II textbook under 7th national curriculum and if so, to know whether or not high school teachers recognized and corrected properly the mistakes. The mistakes in photosynthesis unit of text books were determined by the comparison with several reference books and through examination by three plant physiologists in 8 different Biology II textbooks. After the mistakes were analysed, the survey using contents of textbook containing the mistakes was conducted on high school teachers teaching Biology II. As a result, 48 mistakes were determined in 13 subjects. As many as four mistakes were found even in one subject in a certain textbook and a same mistake was found repeatedly in several textbooks. The survey result showed that the teachers who pointed exactly the mistakes out corrected properly, however, the percentage of these ones out of 35 teachers replied to survey was less than 50%. The ratios of correction out of total number of responses were high in question #6 (43%), #4-3 (40%), and #1-2 (32%) which were containing a simple mistake in graph, a wrong word and a wrong picture, respectively. But, no one pointed out and made correction in question #5-1 and #5-2 which were containing Z scheme of light reaction without the legend of vertical axis that should be explained as electron energy or standard reduction potential. The result indicates the possibility that the mistakes in photosynthesis unit of Biology II textbook can be corrected and teached properly by teachers may be low. In order to reduce the possibility that students may have misconceptions about photosynthesis, the list of print's errors should be provided to the teachers and/or the training program and/or workshop for in-service high school biology teachers was recommended.

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토양 및 지하수 Investigation 과 Remediation에 대한 현장적용

  • Wallner, Heinz
    • Proceedings of the Korean Society of Soil and Groundwater Environment Conference
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    • 2000.11a
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    • pp.44-63
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    • 2000
  • Situated close to Heathrow Airport, and adjacent to the M4 and M25 Motorways, the site at Axis Park is considered a prime location for business in the UK. In consequnce two of the UK's major property development companies, MEPC and Redrew Homes sought the expertise of Intergeo to remediate the contaminated former industrial site prior to its development. Industrial use of the twenty-six hectare site, started in 1936, when Hawker Aircraft commence aircraft manufacture. In 1963 the Firestone Tyre and Rubber Company purchased part of the site. Ford commenced vehicle production at the site in the mid-1970's and production was continued by Iveco Ford from 1986 to the plant's decommissioning in 1997. Geologically the site is underlain by sand and gravel, deposited in prehistory by the River Thames, with London Clay at around 6m depth. The level of groundwater fluctuates seasonally at around 2.5m depth, moving slowly southwest towards local streams and watercourses. A phased investigation of the site was undertaken, which culminated in the extensive site investigation undertaken by Intergeo in 1998. In total 50 boreholes, 90 probeholes and 60 trial pits were used to investigate the site and around 4000 solid and 1300 liquid samples were tested in the laboratory for chemical substances. The investigations identified total petroleum hydrocarbons in the soil up to 25, 000mg/kg. Diesel oil, with some lubricating oil were the main components. Volatile organic compounds were identified in the groundwater in excess of 10mg/l. Specific substances included trichloromethane, trichloromethane and tetrachloroethene. Both the oil and volatile compounds were widely spread across the site, The specific substances identified could be traced back to industrial processes used at one or other dates in the sites history Slightly elevated levels of toxic metals and polycyclic aromatic hydrocarbons were also identified locally. Prior to remediation of the site and throughout its progress, extensive liaison with the regulatory authorities and the client's professional representatives was required. In addition to meetings, numerous technical documents detailing methods and health and safety issues were required in order to comply with UK environmental and safety legislation. After initially considering a range of options to undertake remediation, the following three main techniques were selected: ex-situ bioremediation of hydrocarbon contaminated soils, skimming of free floating hydrocarbon product from the water surface at wells and excavations and air stripping of volatile organic compounds from groundwater recovered from wells. The achievements were as follows: 1) 350, 000m3 of soil was excavated and 112, 000m3 of sand and gravel was processed to remove gravel and cobble sized particles; 2) 53, 000m3 of hydrocarbon contaminated soil was bioremediated in windrows ; 3) 7000m3 of groundwater was processed by skimming to remove free floating Product; 4) 196, 000m3 of groundwater was Processed by air stripping to remove volatile organic compounds. Only 1000m3 of soil left the site for disposal in licensed waste facilities Given the costs of disposal in the UK, the selected methods represented a considerable cost saving to the Clients. All other soil was engineered back into the ground to a precise geotechnical specification. The following objective levels were achieved across the site 1) By a Risk Based Corrective Action (RBCA) methodology it was demonstrated that soil with less that 1000mg/kg total petroleum hydrocarbons did not pose a hazard to health or water resources and therefore, could remain insitu; 2) Soils destined for the residential areas of the site were remediated to 250mg/kg total petroleum hydrocarbons; in the industrial areas 500mg/kg was proven acceptable. 3) Hydrocarbons in groundwater were remediated to below the Dutch Intervegtion Level of 0.6mg/1; 4) Volatile organic compounds/BTEX group substances were reduced to below the Dutch Intervention Levels; 5) Polycyclic aromatic hydrocarbons and metals were below Inter-departmental Committee for the Redevelopment of Contaminated Land guideline levels for intended enduse. In order to verify the qualify of the work 1500 chemical test results were submitted for the purpose of validation. Quality assurance checks were undertaken by independent consultants and at an independent laboratory selected by Intergeo. Long term monitoring of water quality was undertaken for a period of one year after remediation work had been completed. Both the regulatory authorities and Clients representatives endorsed the quality of remediation now completed at the site. Subsequent to completion of the remediation work Redrew Homes constructed a prestige housing development. The properties at "Belvedere Place" retailed at premium prices. On the MEPC site the Post Office, amongst others, has located a major sorting office for the London area. Exceptionally high standards of remediation, control and documentation were a requirement for the work undertaken here.aken here.

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Finite element analysis of peri-implant bone stress influenced by cervical module configuration of endosseous implant (임플란트 경부형상이 주위골 응력에 미치는 영향에 관한 유한요소법적 분석)

  • Chung, Jae-Min;Jo, Kwang-Heon;Lee, Cheong-Hee;Yu, Won-Jae;Lee, Kyu-Bok
    • The Journal of Korean Academy of Prosthodontics
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    • v.47 no.4
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    • pp.394-405
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    • 2009
  • Statement of problem: Crestal bone loss, a common problem associated with dental implant, has been attributed to excessive bone stresses. Design of implant's transgingival (TG) part may affect the crestal bone stresses. Purpose: To investigate if concavely designed geometry at a dental implant's TG part reduces peri-implant bone stresses. Material and methods: A total of five differently configured TG parts were compared. Base model was the ITI one piece implant (Straumann, Waldenburg, Switzerland) characterized by straight TG part. Other 4 experimental models, i.e. Model-1 to Model-4, were designed to have concave TG part. Finite element analyses were carried out using an axisymmetric assumption. A vertical load of 50 N or an oblique load of 50 N acting at $30^{\circ}$ with the implant's long axis was applied. For a systematic stress comparison, a total of 19 reference points were defined on nodal points around the implant. The peak crestal bone stress acting at the intersection of implant and crestal bone was estimated using regression analysis from the stress results obtained at 5 reference points defined along the mid plane of the crestal bone. Results: Base Model with straight configuration at the transgingival part created highest stresses on the crestal bone. Stress level was reduced when concavity was imposed. The greater the concavity and the closer the concavity to the crestal bone level, the less the crestal stresses. Conclusion: The transgingival part of dental implant affect the crestal bone stress. And that concavely designed one may be used to reduce bone stress.

A comparative study on the fracture behavior of zironia, glass infiltrated alumina and PFM full crown system (지르코니아, 유리침투알루미나 및 PFM 전부관 시스템의 파절 경향에 관한 비교연구)

  • Lee, Sang-Hyeok;Ahn, Jin-Soo;Kim, Myung-Ho;Lim, Bum-Soon
    • The Journal of Korean Academy of Prosthodontics
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    • v.50 no.4
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    • pp.235-242
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    • 2012
  • Purpose: The purpose of this study was to compare the fracture behavior of Zironia, glass infiltrated Alumina and PFM full crown system. Materials and methods: Fifteen crowns for each of 3 experimental groups (Zironia, glass infiltrated Alumina and PFM full crown) were made by the conventional method. The crowns mounted on the testing jig were inclined in 30 degrees to the long axis of the tooth and the universal testing machine was used to measure the fracture strength. Results: 1. The mean fracture strengths were $588.3{\pm}49.6MPa$ for zirconia system, $569.1{\pm}61.8MPa$ for PFM system and $551.0{\pm}76.5MPa$ for glass-infiltrated alumina system (P>.05). 2. The mean shear bond strengths were $25.5{\pm}5.6MPa$ for zirconia system, $38.9{\pm}5.0MPa$ for Ni-Cr alloy system and $39.4{\pm}5.1MPa$ for glass-infiltrated alumina system. 3. The chemical bonding was observed at interfaces between PFM or glass-infiltrated alumina and veneering porcelain, however, no chemical bonding was observed at interface between zirconia and veneering porcelain. Conclusion: With the study, the fracture strengths of PFM crown system had a higher fracture strength than conventional zirconia system crown and glass-infiltrated alumina crowns. and than the shear bond strengths glass-infiltrated alumina system had a higher shear bond strength than conventional PFM system and zirconia system.

Effect of an Acrylic Plate and SSD on Dose Profile and Depth Dose Distribution of 9 MeV Electron Beams (에너지 저하체로서 아크릴과 SSD 가 9MeV 전자선의 측방 및 깊이선량분포에 미치는 효과)

  • 강위생
    • Progress in Medical Physics
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    • v.9 no.2
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    • pp.65-71
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    • 1998
  • The aims are to evaluate the effects of an 1.0 cm acrylic plate and SSD on the dose profile and depth dose distribution of 9 MeV electron beam and to analyse adequacy for using an acrylic plate to reduce energy of electron beams. An acrylic plate of 1.0 cm thickness was used to reduce energy of 9 MeV electron beam to 7 MeV. The plate was put on an electron applicator at 65.4 cm distance from x-ray target. The size of the applicator was 10${\times}$l0cm at 100 cm SSD. For 100cm, l05cm and 110cm SSD, depth dose on beam axis and dose profiles at d$\_$max/ on two principal axes were measured using a 3D water phantom. From depth dose distributions, d$\_$max/, d$\_$85/, d$\_$50/ and R$\_$p/, surface dose, and mean energy and peak energy at surface were compared. From dose profiles flatness, penumbra width and actual field size were compared. For comparison, 9 MeV electron beams were measured. Surface dose of 7 MeV electron beams was changed from 85.5% to 82.2% increasing SSD from 100 cm to 110 cm, and except for dose buildup region, depth dose distributions were independent of SSD. Flatness of 7 MeV ranged from 4.7% to 10.4% increasing SSD, comparing 1.4% to 3.5% for 9 MeV. Penumbra width of 7 MeV ranged from 1.52 cm to 3.03 cm, comparing 1.14 cm to 1.63 cm for 9 MeV. Actual field size increased from 10.75 cm to 12.85 cm with SSD, comparing 10.32 cm to 11.46 cm for 9 MeV. Virtual SSD's of 7 and 9 MeV were respectively 49.8 cm and 88.5cm. In using energy reducer in electron therapy, depth dose distribution were independent of SSD except for buildup region as well as open field. In case of using energy reducer, increasing SSD made flatness to deteriorate more severely, penumbra width more wide, field size to increase more rapidly and virtual SSD more short comparing with original electron beam. In conclusion, it is desirable to use no energy reducer for electron beam, especially for long SSD.

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Effect of Inhaled Steroids on the Cortisol Concentration by Different Dosage or Delivery Method (흡입성 스테로이드 제제의 투여용량 및 방법이 기저 코르티솔농도에 미치는 영향)

  • Lee, Yong-Chul;Rhee, Yang-Keun
    • Tuberculosis and Respiratory Diseases
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    • v.42 no.6
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    • pp.888-899
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    • 1995
  • Background: Topical inhaled steroids, budesonide(Bu) and beclomethasone dipropionate (BOP), are now established as effective drugs in the management of chronic asthma. These drugs have high topical anti-inflammatory effect with low systemic activity. This study was performed to determine the effects of two inhaled corticosteroids, Bu and BOP, on the adrenocortical supression in 44 patients with bronchial asthma or chronic obstructive pulmonary disease. Methods: The adrenocortical function was assessed by measurement of serum cortisol concentration at 8 o'clock in morning and free cortisol in 24-hour urine collection at interval in 44 patients. No steroid was administered during the pretreatment period of 10 days and the final 6 days of the study. Each subject inhaled BOP or Bu, in daily doses of 800 or 1,600 micrograms for 12 days. The dose was delivered by metered dose inhaler (MDI) or diskhaler or large spacing device attached to MDI. Results: The levels of serum cortisol and 24-hour urinary free cortisol were decreased during the treatment period in patients inhaled Bu delivered by MDI in daily doses of 800 and 1,600 micrograms. In contrast, serum cortisol level was decreased on 6 and 12th day of treatment period in patients with BDP diskhaler in daily doses of 800 micrograms. In daily doses of 1,600 micrograms, the serum cortisol and 24hour urine free cortisol levels were decreased on 6, 9 and 12th day of treatment period in patients with BDP disk haler. The serum cortisol and 24-hour urinary free cortisol levels were not significantly decreased during the treatment period in patients inhaled Bu delivered by large spacing device attached to a MDI. Conclusion: These results showed that 1) the endogenous cortisol secretion was suppressed after inhalation of BDP and Bu in daily doses of 800 and 1,600micrograms, 2) Bu with MDI suppressed the adrenocortical function more than BDP with diskhaler, in daily doses of 1600 micrograms. and 3)large spacing device attached to a MDI might decrease the risk of suppression in the hypothalamic -pituitary- adrenal axis.

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