Recently the 2nd generation laboratory composite resins were introduced. Although the mechanical properties of these composite resins have been improved, there were some disadvantages such as discoloration, low abrasion resistance and debonding between metal and resin. The purpose of this study was to evaluate the tensile bond strength between non-pecious dental alloy(verabond) and four veneering reinforced composite resins: Targis(Ivoclar Co.,U.S.A.), Artglass(Kulzer CO., Gemany). Sculpture(Jeneric Pentron Co., U.S.A.), and Estenia(Kurary Co., Japan). All test metal specimens were polished with #1,000 SiC paper, and sandblasted with 250micrometer aluminum oxide. After then, according to manufacturer's instructions metal adhesive primer and veneering resins were applied. All test specimens were divided into two groups. One group was dried in a desiccator at 25degrees C for 3 days, the other group was subjected to thermal cycling(2,000x) in water(5/55degrees C). Tensile bond strength was measured using Instron Universal Testing machine and the fractured surface was examined under the naked eyes and scanning microscope. Within the limitations imposed in this study, the following conclusions can be drawn: 1. in no-thermal cycling groups, there were no significant differences between Estenia and VMK68 but there were significant differences between Targis, Artglass, Sculpture and VMK68(p<0.05). 2. in no-thermal cycling resin groups, the highest tensile bond strength was observed in Estenis and there were significant differences between Estenia and the other resins(p<0.05). 3. Before and after thermal cycling, there were significant differences in tensile bond strength of Targis and Artglass(p<0.05). The tensile bond strength of Artglass was decreased and that of Targis was increased. 4. in no-thermal cycling groups, Artglass showed mixed fracture modes(95%), but after thermal cycling, Artglass showed adhesive fracture modes(75%).
Adhesives ; Aluminum Oxide ; Composite Resins* ; Dental Alloys* ; Sculpture

Objectives: We descriptively reviewed a coronavirus disease 2019 (COVID-19) outbreak at a nursing hospital in Gyeonggi Province (South Korea) and assessed the effectiveness of the first dose of the Oxford-AstraZeneca vaccine in a real-world population. Methods: The general process of the epidemiological investigation included a public health intervention. The relative risk (RR) of vaccinated and unvaccinated groups was calculated and compared to confirm the risk of severe acute respiratory syndrome coronavirus-2 (SARSCoV-2) infection, and vaccine effectiveness was evaluated based on the calculated RR. Results: The population at risk was confined to ward E among 8 wards of Hospital X, where the outbreak occurred. This population comprised 55 people, including 39 patients, 12 nurses, and 4 caregivers, and 19 cases were identified. The RR between the vaccinated and unvaccinated groups was 0.04, resulting in a vaccine effectiveness of 95.3%. The vaccination rate of the nonpatients in ward E was the lowest in the entire hospital, whereas the overall vaccination rate of the combined patient and non-patient groups in ward E was the third lowest. Conclusion The first dose of the Oxford-AstraZeneca vaccine (ChAdOx1-S) was effective in preventing SARS-CoV-2 infection. To prevent COVID-19 outbreaks in medical facilities, it is important to prioritize the vaccination of healthcare providers

Urinary stones are rarely seen in the urethra and are usually encountered in men with urethral stricture or diverticulum. The case of a 52-year-old woman presented, who consulted for weak stream associated with repeated urinary infections. The diverticulum was approached via vaginal route and the extraction was successful. The patient has been well, with no dysuria, dyspareunia, incontinence for 3-month follow-ups.
Calculi ; Diverticulum ; Dyspareunia ; Dysuria ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Rivers ; Urethra ; Urethral Stricture ; Urinary Calculi

PURPOSE: To evaluate the efficacy and safety of laparoscopic renal cryoablation (LRC) of small endophytic renal cell carcinoma, for which surgical treatment is technically difficult. MATERIALS AND METHODS: We enrolled patients with endophytic tumors from a prospectively collected database of 45 renal tumors in 39 patients who had undergone LRC from June 2005 to May 2009. An endophytic tumor was defined as less than 40% of the lesion extending off the surface of the kidney. We evaluated surgical and oncological outcomes. RESULTS: Among the treated tumors, 17 tumors (37.8%) were defined as endophytic tumors and 15 tumors from 14 patients were confirmed as renal cell carcinoma (RCC) in the pathologic examination of the tissue biopsy that was conducted at the time of LRC. The mean American Society of Anesthesiologists (ASA) score of the whole patient group was 2.9 (range, 1-4), and 85.7% (12/14) of the patients had an ASA physical status score over 3. The mean tumor size was 2.8 cm (range, 1.7-3.7 cm). The layout of the cryoprobe was carefully planned preoperatively on the basis of radiologic evaluation in all tumors. Multiple cryoprobes (mean, 3.2; range, 2-5) were used. No major complications, including open surgical conversion and nephrectomy due to bleeding, occurred. No patient experienced clinical symptoms of collecting system injuries. During the mean follow-up of 32.6 months (range, 12-51 months), radiologic evidence of tumor recurrence was found in one patient (6.7% for RCC). With the exception of this patient, all other patients have remained free of recurrence or metastasis, as determined by periodic radiologic workups. CONCLUSIONS: In this series of patients with intermediate-term follow-up, LRC for endophytic renal cell carcinoma showed acceptable oncological and surgical outcomes without sequelae in the collecting system.
Biopsy ; Carcinoma, Renal Cell ; Cryosurgery ; Follow-Up Studies ; Hemorrhage ; Humans ; Kidney ; Neoplasm Metastasis ; Nephrectomy ; Prospective Studies ; Recurrence

We report a case of tuberous sclerosis associated with two histologically different renal cell carcinomas (RCCs) and multiple angiomyolipomas (AMLs) in the same kidney. A 43-year-old female was admitted to our hospital with left flank pain and a huge palpable mass in the left flank area. Abdominal computed tomography revealed two concurrent RCCs and multiple AMLs in the left kidney. Because of the clinical suspicion of RCC, the patient underwent left radical nephrectomy. On gross examination, the total size of the resected left kidney was 30.5x17x8 cm. Microscopically, the upper pole tumor features were consistent with chromophobe RCC and the midpole tumor was a clear-cell RCC. The multifocal masses in the remaining remnant parenchyma were AMLs. Six months after surgery, the patient is healthy without signs of tumor recurrence.
Adult ; Angiomyolipoma ; Carcinoma, Renal Cell ; Female ; Flank Pain ; Humans ; Kidney ; Nephrectomy ; Recurrence ; Tuberous Sclerosis

PURPOSE: Antagonists of alpha1-adrenergic receptors (alpha1ARs) relax prostate smooth muscle and relieve voiding and storage symptoms. Recently, increased expression of alpha1ARs with change of its subtype expression has been proved in bladder outlet obstruction (BOO). To search for the evidence of changes in alpha1ARs subtype expression and activity in the peripheral and spinal routes, the effects of spinal and peripheral administration of tamsulosin (an alpha1A/D-selective AR), naftopidil (an alpha1A/D-selective AR), and doxazosin (non-selective AR) on bladder activity were investigated in a rat model with or without BOO. METHODS: A total of 65 female Sprague-Dawley rats were divided into the BOO surgery group (n=47) and the sham surgery group (n=18). After 6 weeks, cystometry was assessed before and after intrathecal and intra-arterial administrations of tamsulosin, naftopidil, and doxazosin. RESULTS: After intra-arterial administrations of all three drugs, bladder capacity (BC) was increased and maximal intravesical pressure (Pmax) was decreased in both BOO and the sham rat models (P<0.05). After intrathecal administration of all three drugs, BC was increased and Pmax was decreased in only the BOO group. The episodes of involuntary contraction in the BOO rat models were decreased by intra-arterial administration (P=0.031). The increase of BC after intrathercal and intra-arterial administrations of alpha1ARs was significantly greater in the BOO group than in the sham group (P=0.023, P=0.041). In the BOO group, the increase of BC and decrease in Pmax were greater by intra-arterial administration than by intrathecal administration (P=0.035). There were no significant differences of the degrees of changes in the cystometric parameters among the three different alpha1ARs. CONCLUSIONS: Up-regulations of the alpha1ARs in BOO were observed by the greater increases of BC after alpha1AR antagonist administrations in the BOO group than in the sham group. However, there were no subtype differences of the alpha1ARs in functional parameters of bladder activity. In addition, alpha1ARs also act on the lumbosacral cord which implies that the sensitivity of alpha1ARs is increased in pathologic models such as BOO. Further evaluation including differential expression of alpha1ARs in BOO models are need.
Adrenergic alpha-Antagonists ; Animals ; Contracts ; Doxazosin ; Female ; Humans ; Muscle, Smooth ; Naphthalenes ; Piperazines ; Prostate ; Rats ; Rats, Sprague-Dawley ; Salicylamides ; Sulfonamides ; Urinary Bladder ; Urinary Bladder Neck Obstruction

PURPOSE: To investigate the frequency of symptoms of late onset hypogonadism(LOH) and the intention for testosterone replacement therapy in Korean males in their 40s and above. MATERIALS AND METHODS: Korean males over age 40 were given a detailed explanation of LOH and the Korean version of Androgen Deficiency in Aging Male(ADAM) questionnaire(Saint Louis University) by e-mail. Positive for ADAM was defined as answering 'yes' to Q3 or Q7 which estimate the decline of sexual desire and erectile dysfunction or answering 'yes' to more than 3 other questions. The men's intention to take testosterone replacement therapy when recommended for symptoms of LOH was also queried. RESULTS: Among 38,502 people who opened the e-mail, 15.1%(5,795) of men responded to the survey. The largest fraction of respondents was males in their 40s(60%). The ADAM questionnaire revealed 64.6% of respondents as positive for LOH. More than 50% of respondents complained of decline in erection, endurance, or sexual desire. When asked about their intention to take testosterone replacement therapy, 96% of those positive for LOH answered that they would accept the treatment. CONCLUSIONS: Although the response ratio was low, 96% of screened LOH men showed high interest in LOH and a positive attitude toward testosterone replacement therapy. Urologists should thoroughly investigate the symptoms of LOH in men in their 40s and above and conduct testosterone replacement therapy as indicated, in order to improve the quality of life for Korean men.
Aging ; Surveys and Questionnaires ; Electronic Mail ; Erectile Dysfunction ; Humans ; Hypogonadism* ; Intention ; Male* ; Quality of Life ; Testosterone

PURPOSE: To evaluate the feasibility and efficacy of performing laparoscopic renal cryoablation (LRC) for the treatment of RCC, as compared with open partial nephrectomy (OPN), which is the established NSS. MATERIALS AND METHODS: From April 2004, among the patients who underwent LRC with a 1.47 mm cryoprobe, we enrolled 20 patients who were pathologically confirmed as having RCC with a tumor size smaller than 4 cm. These patients were matched with a group of 20 patients, who were selected based on the pre-operative characteristics of the tumor and those of the patients, from a pre-existing database of the patients who underwent OPN during the same period. RESULTS: The mean age and tumor size were 56.3+/-11.5 years and 2.4+/-1.7 cm in the LRC group, and 57.6+/-10.9 years and 2.2+/-1.1 cm in the OPN group. The two groups were similar for their age, gender, BMI, ASA, the tumor characteristics and the indications for operation. While the pathologic results and the operation time showed similarity, the EBL (98+/-87 ml vs 351+/-147 ml, respectively, p=0.001), the transfusion rate (10% vs 40%, respectively, p=0.03) and the hospital stay (4.2+/-1.5 days vs 8.2+/-2.4 days, respectively, p=0.005) were significantly less in the LRC group. Major complications did not occur in the LRC group, but in the OPN group, one patient experienced urine leakage and one patient had a perirenal hematoma. During the mean follow up of 27.3+/-10.8 months and 28.7+/-14.9 months for each group, respectively, all the patients remained disease- free with no evidence of local recurrence or metastases. CONCLUSIONS: LRC using ultra-thin cryoprobes for the treatment of small RCC showed similar effective oncologic results with the merits of minimal invasiveness, as compared with OPN, during the intermediate term follow up.
Carcinoma, Renal Cell ; Cryosurgery ; Follow-Up Studies ; Hematoma ; Humans ; Length of Stay ; Nephrectomy ; Recurrence

PURPOSE: This study is to assess the pharmacologic effects of ethanol and its metabolite, acetaldehyde on potassium channels of the corpus cavernosal smooth muscle of the rabbit. MATERIALS AND METHODS: Cavernosal strips from New Zealand white rabbits were harvested and pharmacophysiologic organ bath studies were executed. In equilibrium state after incubation, zaprinast (PDE5 inhibitor) induced relaxations were monitored in strips precontracted with phenylephrine (PE, 10(-4)M). The inhibitory effects of ethanol and acetaldehyde (2, 20, 40, 80 mmol) on zaprinast-induced relaxations were recorded. Pinacidil (K(ATP) channel opener) and phloretin (BK channel opener) were tested to reverse the inhibitory effects of ethanol and acetaldehyde on zaprinast-induced relaxations. RESULTS: Both ethanol and acetaldehyde inhibited the zaprinast-induced relaxations in a dosedependent manner (p<0.05). Both pinacidil and phloretin abolished the inhibition by both ethanol and acetaldehyde (p<0.05). Ethanol and acetaldehyde inhibits cavernosal relaxation, possibly through BK channels and K(ATP) channels. CONCLUSIONS: These results suggest that ethanol and its metabolite may affect the corpus cavernosal smooth muscle directly and lead to consequent erectile dysfunction. Furthermolecular and electrophysiological studies will help reveal the underlying mechanisms to which this process occurs.
Acetaldehyde ; Baths ; Erectile Dysfunction ; Ethanol ; Large-Conductance Calcium-Activated Potassium Channels ; Male ; Muscle, Smooth ; Penis ; Phenylephrine ; Phloretin ; Pinacidil ; Potassium Channels ; Purinones ; Rabbits ; Relaxation

PURPOSE: Oral testosterone undecanoate and transdermal testosterone gel are the testosterone formulas widely prescribed as hormonal replacement for tesosterone deficiency syndrome (TDS) in male patients. We evaluated the changes in serum testosterone level and the effects of these medicines. MATERIALS AND METHODS: The medical records of 162 patients who were diagnosed with TDS based on serum testosterone (<2.55 ng/ml) and prescribed testosterone formula were analyzed retrospectively. In the 111 patients of group I, tablets of oral testosterone undecanoate were initially given. If the follow up serum testosterone level had not increased enough, the dosages were increased up to 6 tablets. In the 51 patients of group II, one pack of transdermal testosterone gel (5 gm) daily without dosage adjustment was prescribed. Statistical analysis was done to identify any correlations among age, initial and final aging male's symptoms scale (AMS) score, initial, peak and final testosterone level, and duration of therapy. RESULTS: The mean ages of group I and II were 53.4+/-14.5 and 55.2+/-11.9, respectively (p>0.05). The initial and final testosterone levels of the two groups were not significantly different. However, the peak level during treatment was significantly higher in group II (p<0.05). The maximal increment of testosterone level was also significantly higher in group II. Initially, group II reached its peak testosterone level earlier than group I. The final serum levels were not significantly different after adjustment of dosages in group I. Testosterone replacement significantly decreased the AMS scales in both groups. CONCLUSIONS: Both oral testosterone undecanoate and transdermal testosterone gel improved the serum testosterone level and symptom score for those with TDS. Transdermal testosterone gel may reach the peak serum testosterone level faster than oral testosterone undecanoate. Large prospective studies are required to assess the precise role of testosterone replacement therapy.
Aging ; Follow-Up Studies ; Humans ; Hypogonadism ; Male ; Medical Records ; Retrospective Studies ; Sorbitol ; Tablets ; Testosterone ; Tyramine ; Weights and Measures