Purpose: . This study aimed to evaluate the effect of shell thickness on the fracture strength of provisional crowns fabricated by indirect-direct technique. Materials and methods. The study simulated the application of a provisional crown on a maxillary first molar implant abutment. A titanium metal die was milled by replicating a ready-made implant abutment. Using CAD software, shells for provisional crown was designed with varying thicknesses of 0.5 mm, 1.0 mm and 1.5 mm with different internal spaces for relining. These shells were 3D printed using photosensitive liquid resin and relined with PMMA resin to fabricate provisional crown specimens using indirect-direct technique. Ten specimens per each group were prepared. Fracture strength was measured by applying compressive loads vertically to the occlusal center of the specimens at a crosshead speed of 1.0 mm/min using a universal testing machine, and the maximum load value (N) at fracture was recorded. To compare the fracture strength between experimental groups, a one-way ANOVA followed by Tukey’s post hoc test was conducted (α=.05). Results . The fracture strength was observed in the following order: Group 1.5(1504.5 ± 141.30 N), Group 1.0 (1420.2 ± 182.05 N), and Group 0.5 (1083.1 ± 178.90 N). Group 1.5 was not significantly different from group 1.0, but was significantly different from group 0.5, and group 1.0 was also significantly different from group 0.5. Conclusion. The fracture strength of provisional crowns fabricated by the indirect-direct techniques were significantly different depending on the thickness of the shell. The fracture strength of the indirect-direct method was significantly lower when the shell thickness was 0.5 mm compared to 1.0 mm and 1.5mm. This finding indicates that the shell should not be too thin when fabricating provisional crowns using the indirect-direct technique.

Purpose: . This study aimed to evaluate the effect of shell thickness on the fracture strength of provisional crowns fabricated by indirect-direct technique. Materials and methods. The study simulated the application of a provisional crown on a maxillary first molar implant abutment. A titanium metal die was milled by replicating a ready-made implant abutment. Using CAD software, shells for provisional crown was designed with varying thicknesses of 0.5 mm, 1.0 mm and 1.5 mm with different internal spaces for relining. These shells were 3D printed using photosensitive liquid resin and relined with PMMA resin to fabricate provisional crown specimens using indirect-direct technique. Ten specimens per each group were prepared. Fracture strength was measured by applying compressive loads vertically to the occlusal center of the specimens at a crosshead speed of 1.0 mm/min using a universal testing machine, and the maximum load value (N) at fracture was recorded. To compare the fracture strength between experimental groups, a one-way ANOVA followed by Tukey’s post hoc test was conducted (α=.05). Results . The fracture strength was observed in the following order: Group 1.5(1504.5 ± 141.30 N), Group 1.0 (1420.2 ± 182.05 N), and Group 0.5 (1083.1 ± 178.90 N). Group 1.5 was not significantly different from group 1.0, but was significantly different from group 0.5, and group 1.0 was also significantly different from group 0.5. Conclusion. The fracture strength of provisional crowns fabricated by the indirect-direct techniques were significantly different depending on the thickness of the shell. The fracture strength of the indirect-direct method was significantly lower when the shell thickness was 0.5 mm compared to 1.0 mm and 1.5mm. This finding indicates that the shell should not be too thin when fabricating provisional crowns using the indirect-direct technique.

Purpose: . This study aimed to evaluate the effect of shell thickness on the fracture strength of provisional crowns fabricated by indirect-direct technique. Materials and methods. The study simulated the application of a provisional crown on a maxillary first molar implant abutment. A titanium metal die was milled by replicating a ready-made implant abutment. Using CAD software, shells for provisional crown was designed with varying thicknesses of 0.5 mm, 1.0 mm and 1.5 mm with different internal spaces for relining. These shells were 3D printed using photosensitive liquid resin and relined with PMMA resin to fabricate provisional crown specimens using indirect-direct technique. Ten specimens per each group were prepared. Fracture strength was measured by applying compressive loads vertically to the occlusal center of the specimens at a crosshead speed of 1.0 mm/min using a universal testing machine, and the maximum load value (N) at fracture was recorded. To compare the fracture strength between experimental groups, a one-way ANOVA followed by Tukey’s post hoc test was conducted (α=.05). Results . The fracture strength was observed in the following order: Group 1.5(1504.5 ± 141.30 N), Group 1.0 (1420.2 ± 182.05 N), and Group 0.5 (1083.1 ± 178.90 N). Group 1.5 was not significantly different from group 1.0, but was significantly different from group 0.5, and group 1.0 was also significantly different from group 0.5. Conclusion. The fracture strength of provisional crowns fabricated by the indirect-direct techniques were significantly different depending on the thickness of the shell. The fracture strength of the indirect-direct method was significantly lower when the shell thickness was 0.5 mm compared to 1.0 mm and 1.5mm. This finding indicates that the shell should not be too thin when fabricating provisional crowns using the indirect-direct technique.

Purpose: . This study aimed to evaluate the effect of shell thickness on the fracture strength of provisional crowns fabricated by indirect-direct technique. Materials and methods. The study simulated the application of a provisional crown on a maxillary first molar implant abutment. A titanium metal die was milled by replicating a ready-made implant abutment. Using CAD software, shells for provisional crown was designed with varying thicknesses of 0.5 mm, 1.0 mm and 1.5 mm with different internal spaces for relining. These shells were 3D printed using photosensitive liquid resin and relined with PMMA resin to fabricate provisional crown specimens using indirect-direct technique. Ten specimens per each group were prepared. Fracture strength was measured by applying compressive loads vertically to the occlusal center of the specimens at a crosshead speed of 1.0 mm/min using a universal testing machine, and the maximum load value (N) at fracture was recorded. To compare the fracture strength between experimental groups, a one-way ANOVA followed by Tukey’s post hoc test was conducted (α=.05). Results . The fracture strength was observed in the following order: Group 1.5(1504.5 ± 141.30 N), Group 1.0 (1420.2 ± 182.05 N), and Group 0.5 (1083.1 ± 178.90 N). Group 1.5 was not significantly different from group 1.0, but was significantly different from group 0.5, and group 1.0 was also significantly different from group 0.5. Conclusion. The fracture strength of provisional crowns fabricated by the indirect-direct techniques were significantly different depending on the thickness of the shell. The fracture strength of the indirect-direct method was significantly lower when the shell thickness was 0.5 mm compared to 1.0 mm and 1.5mm. This finding indicates that the shell should not be too thin when fabricating provisional crowns using the indirect-direct technique.

Purpose: . This study aimed to evaluate the effect of shell thickness on the fracture strength of provisional crowns fabricated by indirect-direct technique. Materials and methods. The study simulated the application of a provisional crown on a maxillary first molar implant abutment. A titanium metal die was milled by replicating a ready-made implant abutment. Using CAD software, shells for provisional crown was designed with varying thicknesses of 0.5 mm, 1.0 mm and 1.5 mm with different internal spaces for relining. These shells were 3D printed using photosensitive liquid resin and relined with PMMA resin to fabricate provisional crown specimens using indirect-direct technique. Ten specimens per each group were prepared. Fracture strength was measured by applying compressive loads vertically to the occlusal center of the specimens at a crosshead speed of 1.0 mm/min using a universal testing machine, and the maximum load value (N) at fracture was recorded. To compare the fracture strength between experimental groups, a one-way ANOVA followed by Tukey’s post hoc test was conducted (α=.05). Results . The fracture strength was observed in the following order: Group 1.5(1504.5 ± 141.30 N), Group 1.0 (1420.2 ± 182.05 N), and Group 0.5 (1083.1 ± 178.90 N). Group 1.5 was not significantly different from group 1.0, but was significantly different from group 0.5, and group 1.0 was also significantly different from group 0.5. Conclusion. The fracture strength of provisional crowns fabricated by the indirect-direct techniques were significantly different depending on the thickness of the shell. The fracture strength of the indirect-direct method was significantly lower when the shell thickness was 0.5 mm compared to 1.0 mm and 1.5mm. This finding indicates that the shell should not be too thin when fabricating provisional crowns using the indirect-direct technique.

This is a case report of pernicious anemia with neurologic deficits. The patient is a 69 years old male with generalized tingling sense. On examination, slight pale conjunctiva and beefy red tongue are noted. Laboratory stud show megaloblastic anemia with low serum vitamin B12 level, positive Schilling test, gastric achlorhydria and mild gastric atrophy. Neurologic examination reveals cerebral, spinal and peripheral involovement and EEG and EMG study support those things. On parenteral vitamin B12, the hematologic and neurological abnormalities are improved dramatically.
Achlorhydria ; Aged ; Anemia, Megaloblastic ; Anemia, Pernicious* ; Atrophy ; Conjunctiva ; Electroencephalography ; Humans ; Male ; Neurologic Examination ; Neurologic Manifestations ; Schilling Test ; Tongue ; Vitamin B 12

OBJECTIVE: This study compares the efficacy of the cholinesterase inhibitor (ChEI) galantamine on cognition in patients with mild-to-moderate Alzheimer's dementia (AD) who were either naïve to ChEI drugs or who had failed a trial of the ChEI donepezil. METHODS: Outpatients with AD were sequentially referred for screening and enrollment. Current outpatients who had taken donepezil for at least 6 months without demonstrated efficacy on cognition were switched to galantamine (switched group). New outpatients with no ChEI prescription history were classified as the naïve group and were given galantamine. The primary outcome measures for the between-group comparison were response rate on cognition at 26 and 52 weeks (categorical) and change on the Korean version of the Alzheimer's Disease Assessment Scale-cognitive subscale (dimensional). Secondary cognitive outcomes were measured using the subset of frontal executive function and the Korean Mini-Mental State Examination. RESULTS: Seventy outpatients were enrolled and 66 were analyzed by Intent-to-treat (ITT). There were 42 cases in the naïve group and 24 in the switched group. Response rates did not differ at 26 weeks (71.4% naïve vs. 58.3% switched; p=0.277) or at 52 weeks (59.5% naïve vs. 41.6% switched; p=0.162). No significant differences were observed in the pattern of change over the 52 weeks on the primary and secondary cognitive scales. CONCLUSION: As the efficacy of galantamine on cognition was not inferior in the switched group compared to that in the naïve group, switching ChEI drugs is clinically feasible for non-responding patients with mild-to-moderate AD.
Alzheimer Disease ; Cholinesterases ; Cognition* ; Dementia* ; Executive Function ; Galantamine* ; Humans ; Mass Screening ; Outcome Assessment (Health Care) ; Outpatients ; Prescriptions ; Weights and Measures

BACKGROUND AND OBJECTIVE: The aging process affects the responsiveness and other functions of endothelium and vascular smooth muscle cells, predisposing the old vessels to the development of atherosclerotic lesions. Endothelial nitric oxide synthase (ecNOS) gene polymorphism was shown to affect the occurrence of acute myocardial infarction (AMI). We hypothesized that aging may affect the association between the ecNOS gene polymorphism and AMI. METHODS: We investigated the age-related distribution of the ecNOS gene a/b polymorphism in 121 male AMI patients and 206 age-matched healthy male controls. As a control, we also genotyped b-fibrinogen gene H1/H2 polymorphism in the same population. RESULTS: The aa, ab, and bb genotypes were found in 1, 49 and 156 cases among the control subjects and 5, 23 and 93 cases among the AMI patients, respectively. There was a significant association between the ecNOS polymorphism and AMI (p=0.045). When the correlation was analyzed by age, the significance remained only in the group below the age of 51 (p=0.009). The distribution of the b-fibrinogen gene H1/H2 alleles, however, was not found to be associated with development of AMI in both young (p=0.7400) and old (p=0.2160) population. CONCLUSION: Our results provide the first evidence that links ecNOS polymorphism to the risk of AMI in relation to age. Young persons who smoke or have ecNOS aa genotype may have an increased risk of developing AMI. The functional as well as structural changes associated with aging in the vascular endothelium may mask the effect of the ecNOS polymorphism in the development of AMI in old people.
Aging ; Alleles ; Endothelium ; Endothelium, Vascular ; Genotype ; Humans ; Male ; Masks ; Muscle, Smooth, Vascular ; Myocardial Infarction* ; Nitric Oxide Synthase ; Nitric Oxide Synthase Type III* ; Smoke ; Smoking

OBJECTIVE: This study examined the efficacy and safety of memantine-an uncompetitive N-methyl-D-aspartate (NMDA) receptor antagonist-in the treatment of moderate-to-severe dementia. METHODS: Forty-four patients with moderate-to-severe dementia received 20 mg of memantine daily for 24 weeks. The primary efficacy variable was measured by the Korean version of Severe Impairment Battery(K-SIB), and the secondary efficacy variables were measured using the Seoul-Activites of Daily Living(S-ADL) and Neuropsychiatric Inventory-Questionnaire(NPI-Q). Neuropsychological assessments were administrated at baseline, 12 weeks, and 24 weeks. Safety parameters were monitored. RESULTS: Of 44 patients recruited, 30 completed the study and 14 dropped out. Memantine-treated patients showed a therapeutic benefit in all efficacy variables ; the K-SIB, S-ADL, and NPI-Q total scores were not significantly different from baseline either at the endpoint(in the analysis of intention-to-treat, with the last observation carried forward, ITT-LOCF) or at week 24(in the analysis of observed cases, OC). The response rates, when "response" was defined as improved or unchanged in the K-SIB or the S-ADL scores, were 43.3 and 50%, respectively(in the analysis of OC). The responders showed significant improvement in the cognitive subdomain of memory function, praxis, visuospatial ability, and orienting to name. Memantine was shown to be tolerable and safe. CONCLUSIONS: Memantine treatment reduced or delayed clinical deterioration in cognition, function, and behavior in patients with moderate-to-severe dementia.
Cognition ; Dementia* ; Humans ; Memantine* ; Memory ; N-Methylaspartate

OBJECTIVES: The aging process affects responsiveness and other functions of endothelium and vascular smooth muscle cells, predisposing the old vessels to the development of atherosclerotic lesions. Endothelial nitric oxide synthase (ecNOS) gene polymorphisms were shown to affect the occurrence of acute myocardial infarction (AMI). We hypothesized that aging may affect the association between the ecNOS gene polymorphism and AMI. METHODS: We investigated the age-related distribution of the ecNOS gene a/b polymorphism in 121 male AMI patients and 206 age-matched healthy male controls. RESULTS: The aa, ab and bb genotypes were found in 1, 49 and 156 cases among the control subjects and 5, 23 and 93 cases among the AMI patients, respectively. There was a significant correlation between the ecNOS polymorphism and AMI (p +AD0- 0.045). When the correlation was analyzed by age, the significance remained only in the group below the age of 51 (p +AD0- 0.009). The proportion of smokers was increased in the young patients when compared to the old patients (p +AD0- 0.033), indicating that smoking also has greater effect on the younger population. The incidences of hypertension and diabetes mellitus, however, were similar in both populations. CONCLUSION: Our work provides the first evidence that links ecNOS polymorphism to the risk of AMI in relation to age. Young persons who smoke or have ecNOSaa genotype may have an increased risk of developing AMI. The functional as well as structural changes associated with aging in the vascular endothelium may mask the effect of the ecNOS polymorphism in the development of AMI in old persons.
Adult ; Age Distribution ; Aged ; Aged, 80 and over ; Aging/physiology+ACo- ; Chi-Square Distribution ; Comorbidity ; Diabetes Mellitus/epidemiology ; Endothelium, Vascular/enzymology+ACo- ; Genotype ; Human ; Hypertension/epidemiology ; Korea/epidemiology ; Male ; Middle Age ; Myocardial Infarction/physiopathology+ACo- ; Myocardial Infarction/epidemiology ; Nitric-Oxide Synthase/metabolism+ACo- ; Nitric-Oxide Synthase/genetics+ACo- ; Polymerase Chain Reaction ; Polymorphism (Genetics)+ACo- ; Risk Assessment ; Statistics, Nonparametric