Purpose: The aim of this study was to compare the accuracy of dies fabricated using 3D printing system to conventional method and to evaluate overall volumetric changes by arranging the superimposed surfaces. Materials and Methods: A mandibular right first molar from a dental model was prepared, scanned and fabricated with composites of polyetherketoneketone (PEKK). Master dies were classified into 4 groups. For the conventional method, the impression was taken with polyvinylsiloxane and the impression was poured with Type IV dental stone. For the 3D printing, the standard die was scanned and converted into models using three different 3D printers. Each of four methods was used to make 10 specimens. Scanned files were superimposed with the standard die by using 3D surface matching software. For statistical analysis, Kruskal-Wallis test and Mann-Whitney U test were done (P < 0.05). Results: Compared to the standard model, the volumetric changes of dies fabricated by each method were significantly different except the models fabricated by conventional method and 3D printer of Stereolithography (P < 0.05). The conventional dies showed the lowest volumetric change than 3D printed dies (P < 0.05). 3D printed dies fabricated by Stereolithography showed the lowest volumetric change among the different 3D printers (P < 0.05). Conclusion The conventional dies were more accurate than 3D printed dies, though 3D printed dies were within clinically acceptable range. Thus, 3D printed dies can be used for fabricating restorations.

Nowadays, 3 dimentional (3D) printing, especially Direct Metal Laser Sintering (DMLS) system is used in dentistry. DMLS system has recently been introduced for fabrication metal framework for metal ceramic crowns to overcome the disadvantages of the casting method and computer aided design/computer aided manufacturing (CAD/CAM) milling system. DMLS system uses a high-temperature laser beam to selectively heat a substructure metal powder based on the CAD data with the framework design. A thin layer of the beamed area becomes fused, and the metal framework is completed by laminating these thin layers. Utilizing DMLS system to fabricate fixed prostheses is expected to achieve free-from shaping without mold and limitations from cutting tools, fabricate prostheses with complex geometry, prevent distortion and fabrication defects that inherent to conventional fabrication methods. The purpose of this case report is to demonstrate various fixed prostheses such as long span fixed prostheses, post to achieve satisfactory results in functional and esthetic aspects.
Ceramics ; Crowns ; Dentistry ; Fungi ; Hot Temperature ; Methods ; Printing, Three-Dimensional ; Prostheses and Implants*

Synchronous tumor of the fallopian tube and endometrium is an unusual co-occurrence of gynecologic malignancies. To the best of our knowledge, there have been no reports on synchronous papillary tumor of the fallopian tube and endometrium. In this report, we present the case of a patient who synchronously suffered with papillary serous adenocarcinoma of the fallopian tube and endometrium and the tumor showed characteristic frondlike projections on magnetic resonance imaging.
Adenocarcinoma ; Endometrium* ; Fallopian Tubes* ; Female ; Humans ; Magnetic Resonance Imaging ; Neoplasms, Multiple Primary

Epithelioid angiomyolipoma (EAML) of liver is a rare neoplasm. Hepatic EAML is often misdiagnosed as other neoplasms such as hepatocellular carcinoma due to non-specific clinical and radiologic features. The morphologic features under microscope and immunohistochemistry staining profile are important in the diagnosis EAML. Here, we report a case of 52-year-old man who found 1.2 cm mass in liver by routine checkup. On the impression of hepatocellular carcinoma, lateral sectionectomy of the liver was done. Microscopically, the tumor is composed of predominant epithelioid cells with vascular component and foamy cells. These cells were positive for HMB45, MelanA, and smooth muscle actin and negative for epithelial membrane antigen. The final diagnosis was hepatic EAML.
Actins ; Angiomyolipoma* ; Carcinoma, Hepatocellular ; Diagnosis ; Epithelioid Cells ; Humans ; Immunohistochemistry ; Liver* ; MART-1 Antigen ; Middle Aged ; Mucin-1 ; Muscle, Smooth ; Perivascular Epithelioid Cell Neoplasms

PURPOSE: The purpose of this study was to evaluate the efficacy of focused ultrasound (US) to characterize small indeterminate hepatic lesions on contrast-enhanced CT in cancer patients. MATERIALS AND METHODS: Forty-three consecutive patients with proven cancers developed 70 indeterminate hepatic lesions that were less than 1.5 cm in size, as detected on contrast-enhanced CT. Two radiologists performed ultrasound focusing on the targeted area after referencing the location of the hepatic lesions on a previous CT image. When the hepatic lesions were visualized by focused US, the lesions were characterized as cysts, hemangiomas, or solid/metastases. Verification of the hepatic lesions was assessed by a histopathological examination or by follow-up imaging. RESULTS: Focused US detected 51 (73%) of 70 indeterminate hepatic nodules on CT and all of the nodules visualized on focused US could be characterized as cysts (n = 40), hemangiomas (n = 7), or solid/metastases (n = 4). All of the cysts and six hemangiomas were verified as benign lesions. One hemangioma was subsequently identified as a metastasis. Nineteen (27%) indeterminate hepatic nodules were not visible on focused US and 18 nodules were verified as benign lesions. The sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of focused US for differentiating metastases among indeterminate hepatic nodules less than 1.5 cm in size on CT were 66.7%, 100%, 97.1%, 100%, and 97%, respectively. CONCLUSION: Focused US may be the next appropriate examination to perform for cancer patients with indeterminate hepatic nodules detected on CT, Focused US may be a pivotal modality for defining prognosis and treatment.
Abdomen ; Follow-Up Studies ; Hemangioma ; Humans ; Liver ; Liver Neoplasms ; Neoplasm Metastasis ; Prognosis ; Sensitivity and Specificity

BACKGROUND: Cytoplasmic stainings in antinuclear antibody tests using HEp-2 cells are usually undetermined and the significance has not been fully understood until now. Hence, we evaluated their clinical characteristics and also the coexistence of other autoantibodies in the sera with cytoplasmic stainings in antinuclear antibody tests. METHODS: We reviewed clinical records retrospectively in 53 sera showing cytoplasmic stainings among 3, 610 sera that were tested antinuclear antibodies from January to September, 2002 and performed antimitochondrial antibodies (AMA) tests using indirect immunofluorescence (IIF) and antibodies to antiribosomal P and extractable nuclear antigens (ENA) tests using enzyme immunoassay (EIA). RESULTS: Among 53 sera with cytoplasmic stainings, 31 sera showed an AMA pattern and 15 sera showed an antibody to ribosomal P pattern. Three cytoskeletal and one golgi complex patterns were also observed. The most common diagnosis was autoimmune disorders (32, 60.4%) and hepatic disorders (excluding autoimmune hepatitis) (6, 11.3%). Hepatic disorders including autoimmune, drug-induced, and alcoholic hepatitis were most commonly observed (32.3%) in sera with an AMA pattern. On the other hand, various autoimmune disorders such as SLE, systemic sclerosis, dermatomyositis, and polymyositis were observed (86.7%) in sera with a ribosomal P pattern. Of 31 sera with the AMA pattern, the corresponding antibodies were confirmed in three by IIF and of 15 sera with a ribosomal P pattern, only one was confirmed to have this antibody by EIA. All the confirmed sera showed high titered (>1: 320) cytoplasmic stainings. Antibodies to ENA were positive in sixteen (RnP, 5; Sm, 4; Ro, 5; La, 2) and anti-DNA in three of the sera. CONCLUSIONS: Although cytoplasmic staining patterns are not disease specific, it is suggested that continuous high titer stainings be followed up since they could provide diagnostic help.
Antibodies ; Antibodies, Antinuclear* ; Antigens, Nuclear ; Autoantibodies ; Cytoplasm* ; Dermatomyositis ; Diagnosis ; Fluorescent Antibody Technique, Indirect ; Golgi Apparatus ; Hand ; Hepatitis, Alcoholic ; Immunoenzyme Techniques ; Polymyositis ; Retrospective Studies ; Scleroderma, Systemic

PURPOSE: This study analyzed the correlation between grade point average (GPA) of medical school and the score of Korean Medical Licensing Examination (KMLE). METHODS: This study based on the results of 67th KMLE applicants who graduated from a college of medicine in 2003. We also gathered data of these applicants from the college of medicine: gender, age, type of entrance, GPA of basic medicine, clinical medicine, clinical clerkships and final test scores. We analyzed whether there was discrimination between achievement of KMLE passed and that of KMLE failed, which of variables affected the results of KMLE. RESULTS: 173 applicants passed KMLE among 189. There were significant correlations between basic medicine, clinical medicine, final test score and the score of KMLE (respective p-value; < 0.0001). There were also significant differences of GPA between KMLE passed applicants and failed. Final test scores were the most correlated with those of KMLE. If the GPA of 2nd grade was below 2.5 and the GPA of 3rd year grade was below 2.3, they was a high-risk group for failing KMLE (sensitivity 100%, specificity 90%). CONCLUSION: There were significant correlations between the GPA of medical school and the score of KMLE, and significant differences between KMLE passed applicants and failed. A high-risk group of failing KMLE was the students that the GPA of 2nd grade was below 2.5 and the GPA of 3rd grade was below 2.3.
Clinical Medicine ; Discrimination (Psychology) ; Humans ; Licensure* ; Schools, Medical* ; Sensitivity and Specificity

OBJECTIVE: To evaluate the short-term changes in masticatory muscle activity and mandibular movement patterns after orthognathic surgery in skeletal Class III patients with facial asymmetry. METHODS: Twenty-seven skeletal Class III adult patients were divided into two groups based on the degree of facial asymmetry: the experimental group (n = 17 [11 male and 6 female]; menton deviation ≥ 4 mm) and control group (n = 10 [4 male and 6 female]; menton deviation < 1.6 mm). Cephalography, electromyography (EMG) for the anterior temporalis (TA) and masseter muscles (MM), and mandibular movement (range of motion [ROM] and average chewing pattern [ACP]) were evaluated before (T0) and 7 to 8 months (T1) after the surgery. RESULTS: There were no significant postoperative changes in the EMG potentials of the TA and MM in both groups, except in the anterior cotton roll biting test, in which the masticatory muscle activity had changed into an MM-dominant pattern postoperatively in both groups. In the experimental group, the amount of maximum opening, protrusion, and lateral excursion to the non-deviated side were significantly decreased. The turning point tended to be shorter and significantly moved medially during chewing in the non-deviated side in the experimental group. CONCLUSIONS In skeletal Class III patients with facial asymmetry, the EMG activity characteristics recovered to presurgical levels within 7 to 8 months after the surgery. Correction of the asymmetry caused limitation in jaw movement in terms of both ROM and ACP on the non-deviated side.

Purpose: This study examined the effects of the application of Schroth exercise-based instrument Pilates exercise on the Cobb’s angle, angle of trunk rotation, and low back pain of female patients with idiopathic scoliosis. Methods: Three patients with idiopathic scoliosis at a Cobb’s angle of 20° or more participated in this study. Among the single-subject experimental research designs, a reversal (ABA) design was performed. In particular, Schroth exercise-based instrument, Pilates exercise, was performed for 10 weeks, consisting of five weeks between the baseline and intervention one period and five weeks between the intervention 1 and intervention 2 periods, and then followed up for five weeks. Results: After the Schroth exercise-based instrument, Pilates exercise, was applied, the Cobb’s angle and the angle of trunk rotation decreased compared to the baseline in all subjects, and the follow-up period also showed a continuous decline. After Pilates exercise was performed, low back pain in subjects 1 and 2 was decreased in the intervention 1 period compared to the baseline. The level of low back pain in the intervention 2 period increased compared to the intervention 1 period, but a reduction was noted in the follow-up period. The low back pain in the subject was decreased in all intervention periods and the follow-up period. Conclusion Schroth exercise-based Pilates exercise improves the Cobb’s angle and the angle of trunk rotation for female patients with idiopathic scoliosis in their teens and 20s, and an effective intervention method is proposed for low back pain.

Background: The Harris-Galante (HG) prosthesis is a first-generation, cementless total hip arthroplasty (THA) prosthesis. Considering the recent increase in the demand for THA in young patients and their life expectancy, a study with a follow-up duration of longer than 20 years in a young population is needed. Therefore, we evaluated the long-term clinical and radiographic results after cementless THA using the HG prosthesis in patients younger than 50 years. Methods: A total of 61 THAs performed using the HG with a minimum follow-up of 10 years were included. There were 38 men and 11 women with an average age of 46 years and the mean follow-up duration was 22 years. Clinical evaluation included modified Harris Hip Score (HHS) and radiographic analysis consisted of cup inclination, anteversion angle, component stability, osteolysis, liner wear rate, wear-through, liner dissociation, and heterotopic ossification. Complications included recurrent dislocation, periprosthetic femoral fracture, and periprosthetic joint infection. Survivorship analysis included cup and stem revision for aseptic loosening, as well as any revision. Results: The HHS improved from 46.5 preoperatively to 81.8 postoperatively (p < 0.001). The average linear wear rate was 0.36 mm/yr. A total of 34 hips (56%) were revised: stem revision in 10 (16.4%), cup revision in 9 (14.8%), exchange limited to bearing surface in 8 (13.1%), and revision of all components in 7 (11.5%). Estimated survivorship at 34 years postoperatively was 90.9% for cup revision for aseptic loosening, 80.5% for stem revision for aseptic loosening, and 22.1% for any revision. Conclusions THA using the HG prosthesis showed satisfactory estimated survivorship of the acetabular and femoral components at 34 years postoperatively with good clinical outcomes. Bearing-related problems, such as osteolysis and liner dissociation, accounted for 56% of revision operations and were concerns in patients younger than 50 years.