STATEMENT OF PROBLEM: There has been a great interest in the use of titanium for fixed and removable prostheses in recent because of its excellent biocompatibility. However, the melting temperature and chemical reactivity of titanium necessities casting system different from those used in conventional casting. The current titanium casting systems are based on an electric-arc design for melting the metal in an argon atmosphere and its exclusive investment. Despite the new development in Ti casting system, inadequate mold filling and internal porosity are frequently observed casting defects. PURPOSE: The purposes of this study were to compare the castibility and reaction layer of the casting titanium under the two casting machines and their investment condition. MATERIAL AND METHOD: coping and machine-milled titanium coping according to the casting methods and the marginal configurations. The total 28 specimens were used, and these are divided into 4 groups according to 2 casting machines and 2 investments. The castings were analyzed using x-ray microanalysis and microhardness testing. The reaction layer between margin of titanium casting and the investments was observed and analyzed with scanning electron microscope. RESULT: 1. Castabiliy of casting titanium specimen was best in the group of centrifugal casting machine and Selevest CB(R) and good that of Selevest CB and pressure differential casting machine, Rematitan plus and centrifugal casting machine, Rematitan plus and pressure differential casting machine in order. 2. There was no significanct correlation in titanium castability in respect of casting machine. However ANOVA indicated that Selevest CB(R) groups had significantly better castability than Rematitan plus(R) groups.(p<0.05) 3. There was a significant microhardness difference between cetrifugal casting machine groups and pressure differential groups.(p<0.05) Titanium castings in centifugal groups had significantly harder than those in pressure differential groups. 4. The addition of zirconia decreased interfacial reactivity. CONCLUSION: above result revealed that of the castability of titanium casting specimens had little correlation in casting machines and was better in magnesia-based investment contained ZrO2 groups. However in order to practice casting titanium in clininic, its castability should be improved, also there should be more research on factor of castability so that long-span prothesis and removable partial denture metla frame may be casted completly.
Alloys* ; Argon ; Atmosphere ; Denture, Partial, Removable ; Electron Probe Microanalysis ; Freezing ; Fungi ; Investments* ; Porosity ; Prostheses and Implants ; Titanium*

An 18 year old female with oligodontia and maxillary hypoplasia was treated using an interdisciplinary team approach involving orthodontists, maxillofacial surgeons and prosthodontists. Full mouth one-piece fixed partial dentures were the final restoration. The fixed partial dentures fabricated for the maxilla and mandible using the concept of a shortened dental arch resulted in improved esthetics and the masticatory function. This paper describes the treatment procedures for an oligodontia patient with alveolar bone hypoplasia.
Dental Arch ; Denture, Partial, Fixed ; Esthetics ; Female ; Humans ; Mandible ; Maxilla ; Mouth

Background: Postmenopausal status increases the risk of cardiovascular disease, and C-reactive protein (CRP) constitutes an independent cardiovascular risk factor. This study aimed to investigate the factors associated with increased high-sensitivity CRP (hs-CRP) level in postmenopausal women. Methods: We included postmenopausal women without laboratory test results that suggested acute inflammation who participated in the Korea National Health and Nutrition Examination Survey between 2016 and 2017. The participants were divided into high and low hs-CRP groups (cutoff value, 3.0 mg/L). We investigated factors that influenced the hs-CRP level with logistic regression analysis. Results: The total number of subjects was 2,739, of whom 76.4% had low hs-CRP levels and 23.6% had high hs-CRP levels. The mean age and body mass index were higher in the high than in the low hs-CRP group. In the simple logistic regression analysis, high hs-CRP level was associated with smoking, whereas low hs-CRP level was associated with aerobic exercise, use of oral contraceptives, and history of pregnancy in postmenopausal women. When the analysis was adjusted for confounding variables, histories of smoking and pregnancy had a statistically significant association with high hs-CRP level. Conclusion This study showed that the important modifiable risk factors of elevated hs-CRP level in postmenopausal women of Korea include obesity, smoking, and lack of aerobic exercise, but well-controlled prospective investigations should be considered.

BACKGROUND: With the increasing demand for general anesthesia for endoscopic esophageal procedures, anesthesiologists should understand the clinical characteristics of post-procedural complications (PPCs). METHODS: We retrospectively investigated the incidence of and risk factors associated with PPCs of endoscopic esophageal procedures performed under general anesthesia from July 2013 to November 2016. The final analysis included 129 patients; 114 who underwent esophageal endoscopic dissection for esophageal tumors and 15 cases of peroral endoscopic myotomy for achalasia. Frank perforation during the procedure was defined as an endoscopically recognizable or clinically detected perforation during the procedures. A multivariable logistic regression analysis was conducted to identify independent risk factors for PPCs. RESULTS: The overall incidence of PPCs was 19.4% (25/129). All of the PPCs were managed successfully with conservative measures. The most common PPC was symptomatic, radiologically documented atelectasis (11/25, 44.0%), followed by esophageal perforation-related PPCs (symptomatic pneumomediastinum or pneumoperitoneum; 9/25, 36.0%). In the multivariable analysis, frank perforation during the procedure was the only independent risk factor for PPCs (odds ratio, 8.470, 95% CI, 2.051–34.974, P = 0.003). Although frank perforation during the procedure occurred in 13 patients, 38.5% (5/13) of them did not develop any clinical sequelae after their procedures. Compared with patients without PPCs, patients who developed PPCs took longer to their first oral intake and had prolonged hospital stays (P = 0.047 and 0.026, respectively). CONCLUSIONS: Iatrogenic perforation during endoscopic esophageal procedures under general anesthesia was the only independent risk factor for PPCs; therefore, proactive measures and close follow-up are necessary.
Anesthesia, General* ; Endoscopy, Gastrointestinal ; Esophageal Achalasia ; Esophagus ; Follow-Up Studies ; Humans ; Incidence ; Length of Stay ; Logistic Models ; Mediastinal Emphysema ; Pneumoperitoneum ; Pulmonary Atelectasis ; Retrospective Studies ; Risk Factors

BACKGROUND/AIMS: Although eosinophilic liver infiltration (ELI) is not rare, few data exist regarding its clinical characteristics and etiology. Therefore, we evaluated these aspects to better understand the clinical implications of this lesion type, which is reasonably common in Korea. METHODS: Patients suspected of having ELI, based on abdominal computed tomography results obtained between January 2010 and September 2017, were enrolled in this retrospective study. The presumptive etiologies of ELI were categorized as parasite infections, hypereosinophilic syndrome (HES), eosinophilic granulomatosis with polyangiitis (EGPA), malignancies, and unidentified. Clinical courses and treatment responses were also evaluated. RESULTS: The mean age of the enrolled patients (male, 237/328) was 62 years. Most patients (63%) were diagnosed incidentally and had peripheral eosinophilia (90%). Only 38% of the enrolled patients (n=126) underwent further evaluations to elucidate the etiology of the suspected ELI; 82 (25%) had parasite infections, 31 (9%) had HES, five (2%) had EGPA, and five (2%) had drug reactions in conjunction with eosinophilia and systemic symptoms. Almost half of the other enrolled patients had cancer. Radiologic resolution was achieved in 191 patients (61%; median time to radiologic resolution, 185 days). Resolution of peripheral eosinophilia was achieved in 220 patients (79%). In most cases, the course of ELI was benign. CONCLUSIONS: This large ELI study is unique in that the incidence rate, underlying diseases, and clinical courses were comprehensively evaluated. Clinicians should investigate the etiology of ELI, as several of the underlying diseases require intervention rather than observation.
Eosinophilia ; Eosinophils ; Granulomatosis with Polyangiitis ; Humans ; Hypereosinophilic Syndrome ; Incidence ; Korea ; Liver ; Parasites ; Retrospective Studies

PURPOSE: To evaluate the risk factors of hepatocellular carcinoma (HCC) extension into the right atrium (RA) and determine poor prognostic factors for HCC extension to the heart. MATERIALS AND METHODS: A total of 665 patients who were newly diagnosed with HCC were analyzed retrospectively from January 2004 to July 2012. The patients were divided into two groups: 33 patients with HCC extending into the RA and 632 HCC patients during the same period. The patients with HCC extending into the RA were subdivided into shorter survival group (<2 months) and longer survival group (> or =2 months). RESULTS: The prevalence of HCC extending to the RA was 4.96%. In multivariate analysis, a modified Union Internationale Contre le Cancer (UICC) stage higher than IVA, hepatic vein invasion, concomitant inferior vena cava and portal vein invasion, and multinodular tumor type were risk factors for HCC extending to the RA. In multivariate analysis, Cancer of the Liver Italian Program (CLIP) score >3 (p=0.016, OR: 13.89) and active treatment (p=0.024, OR: 0.054) were associated with prognostic factors in patients HCC extending into the RA. Active treatment such as radiation (n=1), transcatheter arterial chemoembolization (TACE) (n=11), Sorafenib (n=1), and combined modalities (n=2) were performed. CONCLUSION: Modified UICC stage higher than IVA, vascular invasion and multinodular tumor type are independent risk factors for HCC extending to the RA. Active treatment may prolong survival in patients HCC extending into the RA.
Carcinoma, Hepatocellular* ; Heart Atria ; Heart* ; Hepatic Veins ; Humans ; Liver Neoplasms ; Methods ; Multivariate Analysis ; Neoplasm Metastasis ; Portal Vein ; Prevalence ; Prognosis ; Retrospective Studies ; Risk Factors* ; Vena Cava, Inferior

A metastatic melanoma to the gastrointestinal tract is observed in 1.5~4.4% of all melanoma patients. However, colonic and rectal involvement is less common. A 72-year-old woman was admitted due to abdominal pain and poor oral intake for 20 days. She had a 3 x 4 cm-sized mass on her right inguinal area 4 month ago, which was diagnosed as a malignant melanoma of the inguinal lymph node on excision biopsy. A large exophytic mass with an irregular ulcerlated, whitish patch, erythematous surface was observed in the hepatic flexure during colonoscopy. A histology diagnosis of a metastatic melanoma was made by an optical microscopy examination of the biopsies obtained during the colonscopy, and palliative right hemicolectomy was performed on account of a potential intestinal obstruction. We report a case of a metastatic melanoma of the colon with a review of the relevant literature.
Abdominal Pain ; Aged ; Biopsy ; Colon* ; Colonoscopy ; Diagnosis ; Female ; Gastrointestinal Tract ; Humans ; Intestinal Obstruction ; Lymph Nodes ; Melanoma* ; Microscopy