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In vitro study of the fracture resistance of monolithic lithium disilicate, monolithic zirconia, and lithium disilicate pressed on zirconia for three-unit fixed dental prostheses

  • Choi, Jae-Won;Kim, So-Yeun;Bae, Ji-Hyeon;Bae, Eun-Bin;Huh, Jung-Bo
    • The Journal of Advanced Prosthodontics
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    • v.9 no.4
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    • pp.244-251
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    • 2017
  • PURPOSE. The purpose of this study was to determine fracture resistance and failure modes of three-unit fixed dental prostheses (FDPs) made of lithium disilicate pressed on zirconia (LZ), monolithic lithium disilicate (ML), and monolithic zirconia (MZ). MATERIALS AND METHODS. Co-Cr alloy three-unit metal FDPs model with maxillary first premolar and first molar abutments was fabricated. Three different FDPs groups, LZ, ML, and MZ, were prepared (n = 5 per group). The three-unit FDPs designs were identical for all specimens and cemented with resin cement on the prepared metal model. The region of pontic in FDPs was given 50,000 times of cyclic preloading at 2 Hz via dental chewing simulator and received a static load until fracture with universal testing machine fixed at $10^{\circ}$. The fracture resistance and mode of failure were recorded. Statistical analyses were performed using the Kruskal-Wallis test and Mann-Whitney U test with Bonferroni's correction (${\alpha}=0.05/3=0.017$). RESULTS. A significant difference in fracture resistance was found between LZ ($4943.87{\pm}1243.70N$) and ML ($2872.61{\pm}658.78N$) groups, as well as between ML and MZ ($4948.02{\pm}974.51N$) groups (P<.05), but no significant difference was found between LZ and MZ groups (P>.05). With regard to fracture pattern, there were three cases of veneer chipping and two interfacial fractures in LZ group, and complete fracture was observed in all the specimens of ML and MZ groups. CONCLUSION. Compared to monolithic lithium disilicate FDPs, monolithic zirconia FDPs and lithium disilicate glass ceramics pressed on zirconia-based FDPs showed superior fracture resistance while they manifested comparable fracture resistances.

Modification of Cutoff Values for HE4, CA125, the Risk of Malignancy Index, and the Risk of Malignancy Algorithm for Ovarian Cancer Detection in Jakarta, Indonesia

  • Winarto, Hariyono;Laihad, Bismarck Joel;Nuranna, Laila
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.5
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    • pp.1949-1953
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    • 2014
  • Background: CA125 and HE4 are used in calculating Risk of Malignancy Algorithm (ROMA); and Risk of Malignancy Index (RMI). However, studies showed that normal levels of CA125, and HE4 differ among ethnicities such as between Asians and Caucasians, thus affecting the accuracy of the RMI score and ROMA in predicting ovarian malignancy. This study aimed to determine whether new or modified cutoff values for Ca125, HE4, the RMI score, and ROMA resulted in a better prediction of malignancy compared with the previous or standard ones. Materials and Methods: Serum level of CA125 and HE4 from 128 patients with diagnosis of ovarian tumor that had been collected before surgery at Cipto Mangunkusumo General Hospital (CMH) in Jakarta from November 2010 until May 2011 were reviewed and analysed. The standard cutoff values of these biomarkers, RMI, and ROMA were modified by using logistic regression model. The modified cutoff values were compared to the standard cutoff values in terms of sensitivity, specificity, and accuracy. Results: The modified cutoff value of CA125, HE4, RMI score and ROMA were 165.2 U/mL, 103.4 pM, 368.7, 28/54. The sensitivity and specificity of the modified cutoff values CA125, HE 4, RMI score and ROMA in differentiating benign from malignant and borderline were 67% and 75,4%; 73.1% and 85.2%; 73.1% and 80.3%; and 77.6% and 86.9%. While the sensitivity and specificity of the standard cutoff value of CA125; HE4; RMI score; and ROMA were 91% and 24.6%; 83.6% and 65%; 80.6% and 65.6%; and 91.0% and 42.6%. The accuracy of modified cutoff values compared with standard cutoff values were: 71.2% vs 59.3%, 78.9% vs 75% vs, 76.5% vs 73.4%, and 82% vs 67.9%. Conclusions: The new or modified cutoff values of Ca125, HE4, RMI score and ROMA resulted in higher accuracy compared to the previous or standard ones, at the cost of reduced sensitivity.

A Review of the Medical Nutrition Therapy (MNT) of the U.S. Medicare System (미국 임상영양치료(MNT)의 법제화 과정 및 수가 체계)

  • 박은철;김현아;이해영;이영은;양일선
    • Korean Journal of Community Nutrition
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    • v.7 no.6
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    • pp.852-862
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    • 2002
  • The purposes of this study were 1) to review the Medical Nutrition Therapy (MNT) Act of the United States, 2) to introduce the efforts of the American Dietetic Association (ADA) to expand the Medicare coverage for MNT and 3) to provide information about the reimbursement under Medicare Part B for the cost of MNT. The MNT Act defined MNT services as “the nutritional diagnostic, therapeutic, and counseling services provided by a Registered Dietitian or nutritional professional for the purpose of managing diabetes or renal diseases”. Also, the MNT Act defined “conditions for coverage of MNT”, “limitations on coverage of MNT”, and “qualifications of MNT service provider”. To expand the coverage of Medicare to include MNT, the ADA realized the need for development of a protocol for MNT, as well as studies to evaluate the effectiveness and cost-effectiveness of the MNT protocol developed. Therefore, the ADA supported the studies to develop a strong database of scientific investigations of nutritional services. Furthermore, the ADA needed credible data that could be used by Policy makers, so the ADA contracted with the Lewin Group to if out the study to gather the additional data needed to strengthen the ADA's position. In the report of the Lewin Group, which was entitled, “The Cost of Covering Medical Nutrition Therapy under Medicare : 1998 through 2004”, it was concluded, that if coverage for MNT in the Part B portion of Medicare had begun in 1998, by 2004, approximately $ 2.3 billion would have been saved through reduced hospital spending under Part A of Medicare ($ 1.2 billion) and reduced physician visits under Part B ($ 1.1 billion) Effective January 1 2002, the US Congress extended Medicare coverage to include MNT to beneficiaries with diabetes or renal diseases. The Centers for Medicare and Medicaid Services (CMS) established the duration and frequency for the MNT based on published reports or generally accepted protocols (for example, protocols suggested by the ADA). The number of hours covered by Medicare is 3 hours for the initial MNT and 2 hours for a follow-up MM. In 2002, a Medicare coverage policy was made to define the Physician's Current Procedural Terminology (CPT) codes 97802, 97803, and 97804 for MNT.

Can Reproductive Characteristics Predict Bladder Cancer in Women with Haematuria?

  • Yavuzcan, Ali;Caglar, Mete;Kayikci, Muhammet Ali;Basaran, Ekrem;Tekin, Ali;Ozdemir, Enver;Dilbaz, Serdar;Ustun, Yusuf;Cam, Haydar Kamil
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.9
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    • pp.5107-5110
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    • 2013
  • Background: Among women with haematuria, defining individuals under high risk for bladder cancer based on reproductive factors prior to cystoscopy would be of great benefit in the management of this condition. The aim of this study was to compare age and reproductive factors such as menopausal status, parity, age at first delivery and age at the last delivery between women who have haematuria with or without bladder cancer. Materials and Methods: A total of 463 patients underwent diagnostic cystoscopy in D$\ddot{u}$zce University Faculty of Medicine between 1 June 2008 and 1 June 2013. Female patients who presented with persistent microscopic or macroscopic haematuria and underwent standard evaluation for haematuria including urinalysis, urine culture, urine cytology, urinary tract imaging with excretory urography or computerized tomography with contrast enhancement and endoscopic evaluation of the urethra and bladder were included in this study. Exclusion criteria were tobacco use and high risk occupations for bladder cancer such as textile, dry cleaning, painting and etc. Forteen women had hematuria due to benign conditions, and 18 due to bladder cancer. Data were retrospectively retrieved from the medical records of Duzce University Hospital. Results: Patients with haematuria due to benign reasons did not significantly differ from patients who were found to have bladder cancer in terms of age (p=0.28), menopausal status (p=0.29), mean parity (p=0.38), being nulliparous (p=0.57), parity ${\geq}3$ (p=0.22), age ${\leq}18$ years at first delivery (p=1.00), age ${\geq}30$ years at last delivery (p=0.26), age ${\geq}35$ years at last delivery (p=0.23) and percentage of the patients with advanced age (${\geq}65$ years) (p=0.18). Conclusions: It is difficult to predict a high risk for developing bladder cancer in women with haematuria based solely on reproductive factors.

A Comparative Study of Improvement of Neck Pain According to Hospitalization Period in Patients of Neck pain Caused by Traffic Accident (교통사고로 인한 경항통 환자의 입원 기간에 따른 통증 호전도 비교 연구)

  • Kim, Tae Gyu;Seo, Young Woo;Kim, Yoo Jong;Lee, Jeong Ryol;Choi, Jae Young;Kim, Ji Su;Kim, Seh Young;Park, Han Sol;Jeon, Eun Jeong;Kim, Ki Ok;Lee, Min Ho
    • Journal of Acupuncture Research
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    • v.33 no.3
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    • pp.189-195
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    • 2016
  • Objectives : The aim of this study was to compare improvement according to the hospitalization period of patients with neck pain as a result of traffic accidents. Methods : Patients of 59 cases with neck pain induced by traffic accidents were investigated. Based on their hospitalization period, 59 subjects were divided into two groups: A group with a shorter hospitalization period and B group with a longer hospitalization period. Each group was treated by the same therapies including acupuncture, pharmacopuncture, and herbal medicine. To compare the treatment effects of the two groups, the Visual Analog Scale(VAS) was used. Statistical analysis between two groups was assessed using the chi-square test, Mann-Whitney U Test and paired t-test through the SPSS 12.0 Windows program. Results : After admission treatment, both A and B group showed a significant decrease in their VAS scores. In addition, B group, of which the hospitalization period was longer than A group, showed a significant improvement in comparison to A group in its VAS score. Conclusion : This study suggests that pain control is more effectively achieved in patients that received more than 8 days of admission treatment compared to those who received less than 7 days of admission treatment.

Cephalometric Predisposing Factors of the Snoring and Obstructive Sleep Apnea (코골이 및 폐쇄성 수면 무호흡증의 두부 규격 방사선 계측학적 기여 인자)

  • Seo, Eun-Woo;Lee, Ho-Kyung;Han, Min-Woo;Seo, Mi-Hyun;Kim, Hyun-Jun;Song, Seung-Il
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.35 no.3
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    • pp.161-166
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    • 2013
  • Purpose: This study was intended to perform a cephalometric comparison between the patients with and without obstructive sleep apnea (OSA). The factors influencing the OSA in the lateral cephalogram were also investigated. Methods: Fifty patients who had visited the Sleep Disorder Clinic at the Ajou University Hospital and evaluated with the polysomnograph (PSG) and cephalogram, were included in the study. The patients had the apnea-hypopnea episode over 5 times per hour (apnea-hypopnea index $[AHI]{\geq}5$) were diagnosed as OSA after the overnight PSG. To evaluate the hard and soft tissue profiles, the cephalometric radiograms were taken at the maximal intercuspation. The correlation between the patient's age, height, weight, body mass index (BMI) and AHI was inspected in the OSA and control group. The difference between the OSA and control group was evaluated (Mann-Whitney U Test). The cephalometric influencing factors to OSA were analyzed (Pearson's correlation coefficient) statistically using SPSS statistics. Results: The OSA Group had a significantly higher BMI than the control group. The mean lower facial height (ANS-Me) was longer in the OSA group; however, statistically significant difference was not detected in the anteroposterior craniofacial measurements. The distance between mandibular plane and hyoid bone of the OSA group was significantly longer than that of the control group. The hyoid position (MP-Hyoid) had a positive correlation between AHI (P<0.001). However, the measurements of oropharyngeal airway were not different between the two groups. The hypothesis, that the antero-posteriorly narrow oropharyngeal airway may aggravate the airway resistance and give rise to a higher AHI, was rejected in the study. Conclusion: We suggest that the lateral cephalogram may be utilized as a useful method to evaluate OSA. The patients with a lower hyoid position can be expected to have higher risks of OSA. However, a comprehensive intraoral inspection, including the soft palate and tonsilar hypertrophy, is emphasized, as the lateral cepahlogram cannot visualize the oropharyngeal status completely.

The Evaluation of Usefulness of the Manufactured DTAB (Double Tilt Angle Board) System (Double Tilt Angle Board (DTAB)의 자체 제작에 관한 유용성 평가)

  • Lee, Joung-Jin;Jang, In-Gi;Kim, Wan-Sun
    • The Journal of Korean Society for Radiation Therapy
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    • v.18 no.1
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    • pp.43-51
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    • 2006
  • Purpose: To resolution of A hospital-handmade modification double tilt angle immobilization system (DTAB immobilization system) and to report the clinical results of it. Material and Methods: It was developed in conjunction with the breast board for patients unable to achieve and maintain the desired uncomfortable respiration and position of set-up needed in the treatment of RT (This custom design provides an alternative to accomplishing this desired head angle needed to relax position treatment area, realizing that the lenses totally protected eye-ball out) By using the angled breast board and SBDD(small bowel device), reproducibility of set-up and patient comfort were addressed throughout the simulation, computed tomography planning and treatment process. Results: Usually patients the error range-within 5 mm. When use of Aqua patients error range-within 3 mm. Conclusion: It was constructed in tandem with a unique custom-built double tilt angle board (DTAB). It was designed to eliminate clinical set-up problems with head immobilization and instability during treatment, thus providing for a more comfortable head rest for the patient.

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Prognostic Factors in Patients Who Performed Angiographic Embolization for the Bleeding from Injury of the Intraabdominal Organ and Pelvic Area (외상성 복부 장기 손상 및 골반 손상에 의한 혈복강으로 동맥 색전술을 시행 받은 환자에서 예후 인자)

  • Lee, Jin Ho;Jang, Ji Young;Shim, Hong jin;Lee, Jae Gil
    • Journal of Trauma and Injury
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    • v.25 no.4
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    • pp.166-171
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    • 2012
  • Purpose: In patients with traumatic hemoperitoneum or pelvic bone fracture who underwent angiography and embolization, we want to find the prognostic factors related with mortality. Methods: Patients(333 patients) who visited our hospital with traumatic injury from March 2008 to April 2012 were included in this study. Only 37 patients with traumatic hemoperitoneum or pelvic bone fracture underwent angiography and embolization. A retrospective review was conducted, and Glasgow coma scale (GCS), Revised trauma score (RTS), Injury severity score (ISS), initial laboratory finding and time interval, the amount of transfusion from the arrival at the ER to the start of embolization, and the vital signs before and after procedure were checked. Stastical analysis was conducted using the Chi square and Mann-Whitney U test. Results: In univariate analysis, the amount of transfusion, the base deficit before procedure, the systolic blood pressure before and after the procedure, the GCS, the RTS and the ISS were significantly associated with prognosis. In the multivariate analysis, the ISS and the base deficit had significant association with prognosis. Of the 37 patients who underwent angiography and embolization, 31 patients needed not additional procedure (Group A) while the other 6 patients needed an additional procedure (Group B). After procedure, a statistically significant higher blood pressure was observed in Group A than in Group B. As to the difference in blood pressure before and after the procedure, a statistically significant decrease in systolic blood pressure was observed in Group B, but an increase was observed in Group A. Conclusion: In traumatic hemoperitoneum or pelvic bone fracture patients who underwent angiography and embolization, GCS, ISS, RTS, transfusion amount before the procedure, initial base deficit and systolic blood pressure were factors related to mortality. When patients who underwent angiography and embolization only were compared with patients who underwent re-embolization or additional procedure after the first embolization, an increase in systolic blood pressure after embolization was a prognostic factor for successful control of bleeding.

Closure of Patent Ductus Arteriosus with a Method of Double Ligation in a Dog (개에서 이중 결찰법을 통한 동맥관 개존증의 완치 예)

  • Yoon, Heo-Young;Jung, Soon-Wook;Park, Hee-Myung;Park, Chul;Jung, Man-Bok;Kim, Jun-Young;Han, Hyun-Jung;Hwang, Min;No, Byung-Guk;Park, Sang-Hyuk;Jang, Ha-Young;Park, Jung-Yoon
    • Journal of Veterinary Clinics
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    • v.21 no.1
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    • pp.72-75
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    • 2004
  • A ten months old, female Yorkshire terrier weighing 2.88 kg referred to veterinary leaching hospital of college of veterinary medicine, Konkuk University because of syncope, cough and dyspnea. First hematological and serum chemical test revealed thrombocytopenia, mild anemia, and increase of concentration of ALP (195 U/L). On 57 days later, second hematological and serum chemical test revealed polycythemia, increase of concentration of ALP (211 UR.), and Tchol (387 mg/dl). Right atrium enlargement, main pulmonary artery bulge and cardiomegaly (VHS = 11.5) were observed in radiographic findings. Ultrasohographic images showed both right and left ventricular dilation and turbulent flow between the descending aorta and the main pulmonary artery in color Doppler imaging. ECG showed left ventricular enlargement, SA block, and electrical alternant. Thoracotomy was performed through left fourth intercostal incision under isoflurane anesthesia. Patent ductus arteriosus was double ligated with 1-0 silk. Cough and dyspnea disappeared on 5 days after operation. Turbulent flow was not found in color doppler imaging of ultrasonography on 10 days after operation. Ten months later after the operation, syncope could not exist any more.

The Effects of Gamisachi-tang on the Serotonin Contents in Separate Brain Region of Mice Immobilized by Stress (가미사칠탕(加味四七湯)이 구속 Stress 생쥐의 뇌 부위별 Serotonin 함량에 미치는 영향)

  • Jun, Chan-Yong;Park, Jong-Hyung;Han, Yang-Hi;Kim, Dong-U;Park, Se-Gi;Choi, You-Kyung;Baek, Eun-Gi;Han, Ji-Wan;Ha, Kyung-Sik;Hong, Ui-Sil
    • The Journal of Internal Korean Medicine
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    • v.23 no.1
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    • pp.41-46
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    • 2002
  • Background and Objectives ; This experimental study was conducted to evaluate an anti-stress effect of Gamisachi-tang(加味四七湯) on mice immobilized by stress. Methods : The experimental animals were immobilized by stress for 15 minutes, and administered 9mg/20g or 18mg/20g of Gamisachi-tang(加味四七湯) extract for seven days before they got stressed. The serotonin contents in the frontal cortex, hypothalamus, corpus striatum, hippocampus were measured by HPLC method in rat brain. Results : In frontal cortex, serotonin contents significantly decreased in both sample A and B group compared to the controlled group. In the hypothalamus, serotonin contents increased in both sample A and B group compared to the controlled group. In the corpus striatum, serotonin contents significantly increased in both sample A and B group compared to the controlled group. In the hippocamous, serotonin contents significantly increased in both sample A and B group compared to the controlled group. Conclusions : According to the above results, Gamisachi-tang(加味四七湯) had a significant impact on the changes in serotonin contents, which occurred in a separated part of mouse brain caused by stress.

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