The digital workflow of optical impressions by the intraoral scanner and CADCAM manufacture of dental prostheses is actively developing. The complex process of traditional impression taking, definite cast fabrication, wax pattern making, and casting has been shortened, and the number of patient’s visits can also be reduced. Advances in intraoral scanner technology have increased the precision and accuracy of optical impression, and its indication is progressively widened toward the long span fixed dental prosthesis. This case report describes the long span implant case, and the operator fully utilized digital workflow such as computer-guided implant surgical template and CAD-CAM produced restoration after the digital impression. The provisional restoration and customized abutments were prepared with the optical impression taken on the same day of implant surgery. Moreover, the final prosthesis was fabricated with the digital scan while utilizing the same customized abutment from the provisional restoration. During the data acquisition step, stl data of customized abutments, previously scanned at the time of provisional restoration delivery, were imported and automatically aligned with digital impression data using an ‘A.I. abutment matching algorithm’ the intraoral scanner software. By using this algorithm, it was possible to obtain the subgingival margin without the gingival retraction or abutment removal. Using the digital intraoral scanner’s advanced functions, the operator could shorten the total treatment time. So that both the patient and the clinician could experience convenient and effective treatment, and it was possible to manufacture a prosthesis with predictability.

A drug interaction can be defined as an interaction between a drug and other drugs that prevent the drug from performing as expected. These processes may include alterations in the pharmacokinetics of the drug, such as modulations in the absorption, distribution, metabolism, and elimination (ADME) of a drug. Alternatively, drug interactions may be the result of the pharmacodynamic characteristics of the drug: the concomitant medication of a receptor antagonist and an agonist for the same receptor. The following interaction may increase or decrease the effectiveness of the drugs or the adverse drug reactions of the drugs. The possibilities of drug interactions should increase as the number of drugs being taken increases in patients. Therefore, patients taking several drugs simultaneously are at the greatest risk for interactions. Drug interactions can contribute to the increasing cost of healthcare because of the costs of medical care that are required to treat problems caused by changes in effectiveness or adverse drug reactions. The drug utilization review (DUR) system has been defined as a structured, ongoing initiative that interprets patterns of drug usage in relation to predetermined criteria and attempts to prevent or minimize inappropriate prescribing. The primary objectives of DUR are to improve the quality of health care for healthcare members and to assist in containing health care costs. In order to achieve these goals, prescription claims must be reviewed both prospectively and retrospectively. The DUR system supplies information to prohibit co-dispensing of contraindicated drugs which increases the risk of drug interactions properly to all the healthcare professionals participating in the care of the patients. In this article, we suggest the importance of DUR in relation to the contraindication of co-medication drugs.
Absorption ; Delivery of Health Care ; Diphtheria Toxoid ; Drug Interactions ; Drug Toxicity ; Drug Utilization ; Drug Utilization Review ; Equipment and Supplies ; Haemophilus Vaccines ; Health Care Costs ; Humans ; Inappropriate Prescribing ; Prescriptions ; Quality of Health Care

Background: Plastic changes to brain structure and function have been reported in elite athletes of various sports. Interestingly, different regions of the brain were engaged according to the type of sports analyzed. Our laboratory reported no difference in total cerebellar volume of basketball players compared to that in the control group using the manual segmentation method. Further detailed analyses showed that elite basketball players had increased volume of the striatum and vermian lobules VI–VII of the cerebellum. We analyzed the brain magnetic resonance imaging (MRI) of basketball players to understand their cerebral cortical plasticity through automatic analysis tools for MRI. Methods: Brain MRI data were collected from 19 male university basketball players and 20 age-, sex-, and height-matched control groups. In order to understand the changes in the cerebral cortices of basketball players, we employed automated MRI brain analysis techniques, including voxel-based morphometry (VBM) and surface-based morphometry (SBM). Results: VBM showed increased gray and white matter volume in both precentral gyri, paracentral lobules and increased gray matter volume in the right anterior superior temporal gyrus. SBM revealed a left dominant increase in both pericentral gyri. Fractal dimensional analysis showed an increase in the area of both precentral gyri, the left subcallosal gyrus, and the right posterior cingulate gyrus. These results suggest a significant role not only for the primary motor cortex, but also for the cingulate gyrus during basketball. Conclusion Plastic changes of both precentral gyri, the pericentral area, paracentral lobules, and the right superior temporal gyrus were observed in elite basketball players. There was a strong increase of fractal complexity in both precentral gyri and a weak increase in the right posterior cingulate gyrus and left collateral gyrus. In this study, plastic regions linked to functional neuroanatomy were related to the competence required to play basketball.

Duret hemorrhage is characterized by an upper brainstem hemorrhage due to increased intracranial pressure by mass effect such as subdural hematoma or a brain tumor. The anteroposterior elongation and downward displacement of the upper brainstem by transtentorial herniation results in the compression and tearing of the paramedian perforating vessels that feed the upper brainstem tegmentum. The consequent hemorrhage that involves the upper brainstem renders recovery to be almost impossible. Following a tricuspid valve replacement surgery, a 56-year-old woman developed a left fronto-temporo-parietal nontraumatic subdural hematoma resulting in transtentorial herniation of the left mesial temporal lobe. A successful surgical evacuation of the hematoma was done with clinical improvement. Two days later, she was referred to neurology with an aggravated right side weakness, dysarthria, and a newly developed extraocular movement disturbance. A brain CT and MRI showed a pontine hemorrhage. We report a case of pontine hemorrhage, a Duret hemorrhage, after the surgical evacuation of nontraumatic subdural hematoma.
Brain ; Brain Neoplasms ; Brain Stem ; Dysarthria ; Female ; Hematoma ; Hematoma, Subdural* ; Hemorrhage* ; Humans ; Intracranial Pressure ; Magnetic Resonance Imaging ; Middle Aged ; Neurology ; Temporal Lobe ; Tricuspid Valve

No abstract available.
Androgen-Insensitivity Syndrome* ; Male

BACKGROUND: Pilomatricoma(Benign calcifying epithelioma of Malherbe) is a uncommon benign tumor with differentiation toward hair cortex cells. It commonly manifests itself as a firm, deep seated nodule with normal Overlying skin, However, anetodermic cutaneous changes have also been described in the literature since 1943. Although the authors hypothesized this phenomenon as a chronic mechanical irritation or a step of transepidermal elimination of the tumoral mass, distinctive elucidation of pathomechanism of it remained. OBJECTIVE: The purpose of this study was to characterize the clinical and histopathologic features of 25 cases with pilomatricoma and to elucidate pathomechanism of the anetodermic cutaneous changes through the comparison of the anetodermic pattern of overlying skin with the changes of the tumoral mass or collagen and elastic fibers in the dermis. METHODS: Twenty-five cases with pilomatricoa have been collected at Chunganam National University Hospital and Kongju Medical Center during 15 years and 5 years, respectively, And we studied the clinical and histopathological characteristics of patients and tried to reveal the relationship between the cutaneous manifestations and the histologic changes through the test for independence. RESULTS: 1. In the age distribution, the patients lesser than 30 years old was 23 cases(92%). The mean age was 18.9 years old. The ratio of males to females was 1 : 2.6. 2. The duration of lesions was from 2 months to 7 years, with the mean duration of 11 months. The predilection sites were arm(40%), face(28%), neck(12%), shoulder(8%), scalp(4%) and back(4%) in order. All lesions were hard in consistency, and were from bean to walnut sized. Clinically, 10 cases (40%) showed reddish discoloration and/or anetodermic cutaneous changes. 3. Histopathologically, the typical patterns of pilomatricoma were commonly located at the dermis (23 cases) and consisted of the shadow cells predominantly(21 cases). Calcium deposits(21 cases, 84%) were noted within the shadow cells. Eight cases(32%) had the tumoral maese demarcated with fibrous capsules, and the foreign body reaction with giant cells and chronic mononuclear cell infiltrations around the shadow cells ruptured the fibrous capsules in 17 cases(68%). 4. When we compared the relationship between the inflammatory cell infiltrations around the tumoral mass and the changes of dermal collagen and elastic fibers, we observed that the changes of dermal fibers and foreign body reaction and mononuolear cell infiltrations were statistically co-related. When compared the cutaneous changes with the inflammatory cell infiltrations of the tumoral masses, we could also reveal that the anetodermic cutaneous changes of the overlying skin might be influenced by the foreign body reactions with chronic mononulcer cell. Based on the status of foreing body reaction, the average of onset was inversely proportional to the average of age. CONCLUSION: Pilomatricomas are slowly growing, firm, deep seated benign tumor which occurs commonly on the arm, face and neck. However, they often showed the anetodermic changes on the overlying skin. Anetodermic cutaneous changes or discoloration may be correlated with the degree of foreign body reactions without the evidences of transepidermal elimination histopathologically.
Adult ; Age Distribution ; Arm ; Calcium ; Capsules ; Carcinoma ; Chungcheongnam-do ; Collagen ; Dermis ; Elastic Tissue ; Female ; Foreign Bodies ; Foreign-Body Reaction ; Giant Cells ; Hair ; Humans ; Juglans ; Male ; Neck ; Pilomatrixoma* ; Skin

Intestinal metaplasia and dysplasia of the stomach have been stressed as precursors of gastric carcinoma of the intestinal type, although their preneoplastic nature is still debated. In this study, the cytomorphometric and cytokinetic spectra of the suggested preneoplastic and neoplastic lesions of the stomach were investigated. From the resected stomachs of early gastric carcinoma of intestinal type, areas of normal, intestinal metaplasia, dysplasia, and carcinoma were selected. They were immunostained for proliferating cell nuclear antigen, counterstained with propidium iodide, and various nuclear parameters were measured by image analysis. Normal and intestinal metaplastic mucosae differed by the localization of proliferation zone, but not by nuclear profile area, circular shape factor, and proliferation index. In dysplasia, proliferation zone covered large parts of the dysplastic area. Nuclear profile area and proliferation index were larger whereas circular shape factor was smaller than in normal or intestinal metaplasia. Carcinomatous lesion had diffuse proliferation activity, the largest nuclear profile area and proliferating index, and circular shape factor in-between those of normal or intestinal metaplasia and dysplasia. The above results showed a structural spectrum among normal of intestinal metaplasia, dysplasia, and carcinoma of intestinal type in cytomorphometric and cytokinetic terms. The structural spectrum raises the possibility that dysplasia of the stomach is a preneoplastic lesion.

No abstract available.
Abscess* ; Fistula*

Pachydermodactyly is a rare, distinct form of digital fibromatosis characterized by acquired, asymptomatic, bulbous swellings on the back and side of the proximal phalanges or proximal interphalangeal joint areas of fingers. It occurs mostly in men. There have been many cases treated with intralesional injection of corticosteroids, however, only a few by surgical excision. We report a case of pachydermodactyly, involving both fingers, in a young female. She was treated with surgical excision and recovered, with no sign of sequelae, during a follow-up period of 6 months.
Adrenal Cortex Hormones ; Female ; Fibroma ; Fingers ; Follow-Up Studies ; Humans ; Injections, Intralesional ; Joints ; Male

Pachydermodactyly is a rare, distinct form of digital fibromatosis characterized by acquired, asymptomatic, bulbous swellings on the back and side of the proximal phalanges or proximal interphalangeal joint areas of fingers. It occurs mostly in men. There have been many cases treated with intralesional injection of corticosteroids, however, only a few by surgical excision. We report a case of pachydermodactyly, involving both fingers, in a young female. She was treated with surgical excision and recovered, with no sign of sequelae, during a follow-up period of 6 months.
Adrenal Cortex Hormones ; Female ; Fibroma ; Fingers ; Follow-Up Studies ; Humans ; Injections, Intralesional ; Joints ; Male