STATEMENT OF PROBLEM: Glass fiber post is one of recent developments to accommodate esthetic restoration for endodontically treated teeth. This has many advantages over conventional post system in physical properties, esthetic factor, risk of root and restoration fracture, adhesion to core, radiopacity, removal and retrievabilty, biocompatibility and chemical stability. PURPOSE: This in vitro study was to evaluate the most suitable type of resin core for the glass fiber post through surveying the fracture modes and the maximum load that fractures the tooth. MATERIAL AND METHODS: 50 sound maxillary premolars restored with glass fiber posts(ParaPost(R) Fiber White) and different types of resin cores(ParaCore, Z100(TM), Rebilda(R) and Admira(R)) were prepared and loaded to faiure in a universal test machine. The maximum fracture load and fracture mode were investigated in the specimens that were restored with resin and those of metal cast and core. With the data, Wilcoxon rank sum test was used to validate the significance between the test groups, and Tukey's studentized range test was used to check if there is any significant statistical difference between each test group. Every analysis was approved with 95% reliance. RESULTS: On measuring the maximum fracture load of teeth specimens, there was a significant difference between the maximum fracture loads of the tooth specimens. ParaCore showed the highest mean maximum fracture load followed by Z100(TM). And, the distribution of fracture mode of tooth specimens showed generally Type D, the three parted fracture of the core around the post was mostly seen(62.5%), and specifically, ParaCore showed 90% and Z100(TM) showed 100% Type D fracture. CONCLUSION. Referring to the values of maximum fracture load and mean compressive fracture load, ParaCore and Z100(TM) had high values and are recommended as tooth colored resin core material for glass fiber post. CLINICAL IMPLICATIONS: This study was carried out intending to be of aid in selecting the appropriate resin core for the glass fiber post. The dual cure type composite resin ParaCore and light cure type composite resin Z100(TM) have good properties and are recommended as tooth colored resin core material for glass fiber post.
Bicuspid ; Glass* ; Humans ; Risk Factors ; Tooth

BACKGROUND: Management of massive rotator cuff tears can be challenging because of the less satisfactory results and a higher retear rate regardless of the use of open or arthroscopic repair technique. METHODS: We retrospectively analyzed 102 cases of massive rotator cuff tear treated with either open or arthroscopic repair. Open repair was performed in 38 patients; and arthroscopic repair, in 64 patients. The mean age at the time of surgery was 59.7 years in the open group and 57.6 years in the arthroscopic group. RESULTS: The Constant score increased from the preoperative mean of 55.9 to 73.2 at the last follow-up in the open repair group and from 53.8 to 67.6 in the arthroscopic repair group (p<0.001 and <0.001, respectively). The University of California at Los Angeles (UCLA) score increased from a preoperative mean of 17.7 to 30.8 at the last follow-up in the open group and from 17.5 to 28.7 in the arthroscopic group (p<0.001 and <0.001, respectively). No statistically significant difference in the Constant and UCLA scores was observed between the two groups at the last follow-up (p=0.128 and 0.087, respectively). Retear was found in 14 patients (36.8%) in the open group and 39 patients (60.9%) in the arthroscopic group (p=0.024). CONCLUSIONS: Open and arthroscopic repairs of massive rotator cuff tears may provide satisfactory clinical results with no significant difference. However, a significantly lower retear rate was observed for the open repair group compared with the arthroscopic repair group.
Arthroscopy ; California ; Follow-Up Studies ; Humans ; Retrospective Studies ; Rotator Cuff* ; Shoulder ; Tears* ; Tendon Injuries

No abstract available.
Lung Neoplasms* ; Lung*

No abstract available.
Mesothelioma* ; Pleura*

Progressive multifocal leukoencephalopathy (PML) is a demyelinating disease resulting from infection of oligodendrocytes with JC virus. PML was a rare disease, but nowadays not uncommon as AIDS prevailed. Histopathologic features of the affected lesion shows infiltrations of foamy macrophages and hyperchromatic, pleomorphic, reactive astrocytes that may raise the suspicion of a brain tumor. We recently met with 3 cases of PML. Two of the patients had AIDS and the other had been treated for lymphoma. All cases were diagnosed by histopathologic examination in stereotactic brain biopsies.
Acquired Immunodeficiency Syndrome ; Astrocytes ; Biopsy ; Brain ; Brain Neoplasms ; Demyelinating Diseases ; Humans ; Immunocompromised Host* ; JC Virus ; Leukoencephalopathy, Progressive Multifocal* ; Lymphoma ; Macrophages ; Oligodendroglia ; Rare Diseases

BACKGROUND: Vitamin D3 up-regulated protein 1 (VDUP1) gene is known to be a novel member of the early response genes and an oxidative stress mediator. This study was designed to elucidate VDUP1 expression and its involvement in central sensitization after spinal cord injury (SCI). METHODS: Contusion injury was produced at spinal segment T10 (20 mm drop, 10 g rod) in adult male Sprague-Dawley rats (250 300 g). Withdrawal responses were measured using von Frey filaments and acetone on the 1st, 3rd and 7th days after SCI. The expressions of VDUP1 gene in the brain and in the cervical and lumbar spine were examined by immunohistochemistry on the 1st, 3rd and 7th day after SCI. RESULTS: VDUP1 gene was detected in a few oligodendrocytes in the spinal cord and in the brain of control rats. VDUP1 gene expression increased in most of the neurons and ependymal cells in the central canal of the injured (lumbar) spinal cord 1 day after SCI. This expression gradually decreased in majority of cells from day 1 to day 7 after SCI. VDUP1 gene expression was also observed to be increased 1 day after SCI, and gradually to decrease from 1 day to 7 days after SCI. The neurons in the intact (cervical) spinal cord VDUP1 gene expression increases maximally 3 days after SCI in the cerebral cortex and the thalamus. Neuropathic pain behavior was triggered by the plantar surface of the fore foot after SCI. CONCLUSIONS: These results show that the VDUP1 gene may be an early modulator of transneuronal stress response after SCI, and to be related to the central sensitization of neuropathic pain behavior after SCI.
Acetone ; Adult ; Animals ; Brain ; Central Nervous System Sensitization ; Cerebral Cortex ; Cholecalciferol* ; Contusions ; Foot ; Gene Expression* ; Humans ; Immunohistochemistry ; Male ; Neuralgia ; Neurons ; Oligodendroglia ; Oxidative Stress ; Rats ; Rats, Sprague-Dawley ; Spinal Cord Injuries* ; Spinal Cord* ; Spine ; Thalamus ; Vitamins*

BACKGROUND: It is well known that when macrophages are stimulated with endotoxin, they produce a wide variety of cytokine mediators, including TNF-α and IL-1β. However, there is an alterationnin the macrophages responsiveness when they are challenged with repeated bouts of endotoxin, termed 'endotoxin tolerance' which is regarded as a self-protective phenomenon from continuous stimulation. In this study, endotoxin tolerance in the peripheral blood monocytes of sepsis patients was evaluated. METHODS: Fourteen patients with organism-documented sepsis were included. The severity of illness was evaluated by APACHE IIscore. Peripheral blood monocytes were isolated from the patients and diluted to 1×105/well. After stimulation with endotoxin(LPS of E. coli O114:B4, 100 ng/ml), they were incubated at 37℃ in 5% CO2 incubator for 24 hours. Supernatant was collected for the measurement of TNF-αand IL-1β with ELISA method. Peripheral blood monocytes of seven healthy volunteers were used as control. RESULTS: The APACHE IIscore(mean±SD) of the patients at the time of blood sampling was 12.2±5.7. The primary infection foci were urinary tract infection, pneumonia, subacute bacterial endocarditis, and catheter related infection, etc. The causative organisms were gram negative rods(10 cases), gram positive cocci(6 cases) with two cases of mixed infection. Serum TNF-α could be measured in 4 cases with 29.9±27.7 pg/ml. Serum IL-1β was measureable in only one patient. The TNF-α level of supernatant of cultured peripheral blood monocytes was 2,703±2,066 pg/ml in patients and 2,102±1,914 pg/ml in controls. The IL-1β level of supernatant was 884±1,050 pg/ml in patients and 575±558 pg/ml in controls. There was no difference of TNF-α and IL-1β level between patients and controls. CONCLUSION: We cannot prove the phenomenon of endotoxin tolerance in this study. Future study needs to be focused on the more severe sepsis patients who were taken for sampling earlier. Addition of serum to the culture medium could be an another valuable option for the success of this study.
APACHE ; Catheters ; Coinfection ; Endocarditis, Subacute Bacterial ; Enzyme-Linked Immunosorbent Assay ; Healthy Volunteers ; Humans ; Incubators ; Macrophages ; Monocytes ; Pneumonia ; Sepsis* ; Tumor Necrosis Factor-alpha* ; Urinary Tract Infections

BACKGROUND/AIMS: Epidemiological data indicate that emotional stress and depression might influence the development of gastrointestianl disorders and cancers, but the relationship between the two is still unclear. The aim was to investigate the effect of stress/depression on the prevalence of digestive diseases. In addition, we tried to identify whether stress and depression are risk factors for these diseases. METHODS: A total of 23 698 subjects who underwent a medical check-up including upper and lower endoscopy were enrolled. By review -ing the subject's self-reporting questionnaire and endoscopic findings, we investigated the digestive diseases, including functional dyspepsia (FD), irritable bowel syndrome (IBS), reflux esophagitis, peptic ulcer disease, and adenoma and carcinoma of the stomach and colon. Stress and depression scores were measured by the Brief Encounter Psychosocial Instrument and Beck's Depression Inventory, respectively (Korean version). RESULTS: Stress and depression were related to FD, IBS, and reflux esophagitis. Depression was also linked to peptic ulcer disease and adenoma/carcinoma of the colon and stomach. Multivariate analysis revealed that stress and depression were independent risk factors for FD (OR, 1.713 and 1.984; P < 0.001) and IBS (OR, 1.730 and 3.508; P < 0.001). In addition, depression was an independent risk factor for gastric adenoma/carcinoma (OR, 4.543; P < 0.001). CONCLUSIONS: Stress and depression are related to various digestive diseases, and they may be predisposing factors for FD and IBS. Depression may also be a cause of gastric cancer. Psychological evaluation of gastroenterology patients may be necessary, but more study is needed.
Adenoma ; Causality ; Colon ; Depression* ; Dyspepsia ; Endoscopy ; Esophagitis, Peptic ; Gastroenterology ; Humans ; Irritable Bowel Syndrome ; Multivariate Analysis ; Peptic Ulcer ; Prevalence* ; Surveys and Questionnaires ; Risk Factors ; Stomach ; Stomach Neoplasms ; Stress, Psychological*

BACKGROUND/AIMS: Some people have difficulty tolerating upper endoscopy. The cause of and risk factors for this are not well known. The aim of this study was to investigate the factors involved in poor cooperation during screening upper endoscopy. METHODS: A total of 4,422 subjects who underwent a health inspection with upper endoscopy carried out by a single experienced endoscopist were included. We retrospectively investigated subjects' self-reporting questionnaires and medical records, including endoscopic and histologic findings. The examinees' cooperation and the completeness of endoscopic examination were evaluated based on the operator's subjective judgment. RESULTS: Examinee cooperation during the endoscopic procedure was poor in 358 out of 4,422 subjects (8.1%). Of the subjects with poor cooperation, the endoscopic examination was incomplete in 36 subjects (10.1%). Multivariate analysis revealed that young age (< 40 years), female sex, high body mass index (≥ 25), hiatal hernia, and procedural sedation using midazolam were independent risk factors for poor cooperation. CONCLUSIONS: Cooperation during screening upper endoscopy was poor in a considerable number of examinees. Endoscopists must keep in mind that examinee cooperation is more likely to be poor in the young, obese people, women, patients with hiatal hernias, and those who receive procedural sedation.
Body Mass Index ; Endoscopy ; Female ; Gastroscopy* ; Hernia, Hiatal ; Humans ; Judgment ; Mass Screening ; Medical Records ; Midazolam ; Multivariate Analysis ; Patient Compliance* ; Retrospective Studies ; Risk Factors

BACKGROUND/AIMS: Colonoscopic polypectomy is highly efficient in preventing colorectal cancer, but polyps may not always be completely removed. Improved knowledge of the risk factors for incomplete polyp resection after polypectomy may decrease the cancer risk and additional costs. The aim of this study was to investigate the conditions that can cause incomplete polyp resection (IPR) after colonoscopic polypectomy. METHODS: A total of 12,970 polyps that were removed by colonoscopic polypectomy were investigated. Among them, we identified 228 cases with a positive resection margin and 228 controls with a clear resection margin that were matched for age, gender, and polyp size. We investigated the location, morphology, and histological type of the polyps and evaluated the skills of the endoscopist and assisting nurse. RESULTS: Multivariate analysis revealed that the polyps, which were located in the proximal part of the colon and rectum, were at significant risk of IPR. Histologically, an advanced polyp and an inexperienced assistant were also independent risk factors for IPR. CONCLUSIONS: Polypectomy should be performed more carefully for polyps suspected to be cancerous and polyps located in the proximal part of the colon or rectum. A systematic training program for inexperienced assistants may be needed to decrease the risk of IPR.
Adult ; Aged ; Aged, 80 and over ; Case-Control Studies ; Clinical Competence ; Colon/pathology/surgery ; Colonic Polyps/pathology/*surgery ; *Colonoscopy ; Female ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Risk Factors ; Treatment Failure