This study investigated reduction of the bandgap of silica by applying nano-silver doping technique and possible application of such silica as a filler in dental resin. Due to reduce band gap, newly fabricated nano-silver doped silica was able to release ROS in accordance with exposure of visible light. Nano-silver doped silica was composed of below 20 nm size crystal silver nanoparticle and 100~500 nm size amorphous silica. These two components were chemically attached to each other (Si-O-Ag). The reduced bandgap was 2.10 eV, which the value could be interpreted as occurrence of surface plasmon resonance generating ROS in visible light exposure conditions. When such nano-silver doped silica was used as a filler in dental resin, increased antibacterial property of nano-silver ion was observed which was related to releasing of ROS when exposed in visible light. The antibacterial properties were statistically significant following exposure to visible light when 0.7 to 1.5 wt% of nano-silver doped silica were incorporated into resin. When the contents of nano-silver doped silica were below 0.7 wt%, minimal ROS release resulted in no significant increase in antibacterial properties as there would be less exposed nano-silver doped silica on the resin surface by visible light. Meanwhile, more than 1.5 wt% of nano-silver doped silica also resulted no significant increase in antibacterial properties following exposure to visible light as the antibacterial effects from nano-silver ion itself were greater than effects from released ROS. Hence, it was concluded that dental resin containing 0.7 to 1.5 wt% of nano-silver doped silica would provide antibacterial properties when exposed to visible light, significantly greater than in dark conditions.

Background and Objectives: Smoking is well-established as a risk factor for coronary artery disease. However, recent studies demonstrated favorable results, including reduced mortality, among smokers, which are referred to as the “smoker's paradox”. This study examined the impact of smoking on clinical outcomes in patients with acute myocardial infarction (AMI) undergoing percutaneous coronary intervention (PCI). Methods: Patients with AMI undergoing PCI between 2004 and 2014 were enrolled and classified according to smoking status. The primary endpoint was a composite of major adverse cardiovascular events (MACE) including cardiac death, myocardial infarction, stroke, and revascularization. Results: Among the 10,683 patients, 4,352 (40.7%) were current smokers. Smokers were 10.7 years younger and less likely to have comorbidities such as hypertension, diabetes mellitus, chronic kidney disease, stroke, and prior PCI. Smokers had less MACE (hazard ratio [HR], 0.644; 95% confidence interval [CI], 0.594–0.698; p<0.001) and cardiac death (HR, 0.494; 95% CI, 0.443–0.551; p<0.001) compared to nonsmokers during the 5 years in an unadjusted model. However, after propensity-score matching, smokers showed higher risk of MACE (HR, 1.125; 95% CI, 1.009–1.254; p=0.034) and cardiac death (HR, 1.190; 95% CI, 1.026–1.381; p=0.022). Smoking was a strong independent predictor of lung cancer (propensityscore matched HR, 2.749; 95% CI, 1.416–5.338; p=0.003). Conclusions In contrast to the unadjusted model, smoking is associated with worse cardiovascular outcome and higher incidence of lung cancer after adjustment of various confounding factors. This result can be explained by the characteristics of smokers, which were young and had fewer comorbidities.

Background and Objectives: Smoking is well-established as a risk factor for coronary artery disease. However, recent studies demonstrated favorable results, including reduced mortality, among smokers, which are referred to as the “smoker's paradox”. This study examined the impact of smoking on clinical outcomes in patients with acute myocardial infarction (AMI) undergoing percutaneous coronary intervention (PCI). Methods: Patients with AMI undergoing PCI between 2004 and 2014 were enrolled and classified according to smoking status. The primary endpoint was a composite of major adverse cardiovascular events (MACE) including cardiac death, myocardial infarction, stroke, and revascularization. Results: Among the 10,683 patients, 4,352 (40.7%) were current smokers. Smokers were 10.7 years younger and less likely to have comorbidities such as hypertension, diabetes mellitus, chronic kidney disease, stroke, and prior PCI. Smokers had less MACE (hazard ratio [HR], 0.644; 95% confidence interval [CI], 0.594–0.698; p<0.001) and cardiac death (HR, 0.494; 95% CI, 0.443–0.551; p<0.001) compared to nonsmokers during the 5 years in an unadjusted model. However, after propensity-score matching, smokers showed higher risk of MACE (HR, 1.125; 95% CI, 1.009–1.254; p=0.034) and cardiac death (HR, 1.190; 95% CI, 1.026–1.381; p=0.022). Smoking was a strong independent predictor of lung cancer (propensityscore matched HR, 2.749; 95% CI, 1.416–5.338; p=0.003). Conclusions In contrast to the unadjusted model, smoking is associated with worse cardiovascular outcome and higher incidence of lung cancer after adjustment of various confounding factors. This result can be explained by the characteristics of smokers, which were young and had fewer comorbidities.

Conventional dental resins for crown and bridge fulfill ISO 10477 and ISO 10993 before clinical application. Although 3D printing or rapid prototyping (RP) for the fabrication of temporary crown and bridge have been proposed, a little studies were reported for 3D printing resin for temporary crown and bridge. The purpose of this study was to evaluate the physical properties (such as water sorption and solubility, color stability and flexural strength) of the various 3D printing temporary crown and bridge resin following the ISO 10477:2018 and estimate the effect of chemical composition of resin on the physical properties. Four resins approved by KFDA and 4 experimental resins developed by different manufacturer were tested in this study. Samples were prepared with DLP typed 3D Printer (G-Printer) and post-cured using UV-light Cure Unit (Cure M). Proper 3D printing and post-curing conditions were selected for different 3D printing resins. Each test was performed according to the ISO 10477 and results were statistically analyzed using Tukey-multiple comparison test (p=0.05). Only group-B did not satisfied the ISO requirement (< 40 µg/ mm³) in water sorption test, but 3 groups (C, E and F) showed high solubility which exceeds the ISO requirement (< 7.5 µg/mm³). For color stability, the color difference were detected at 5 groups (A, E, F, G and H). Group-D and F showed the low flexural strength and some building direction did not satisfied the ISO requirement (> 60 MPa). Resin components may affect the flexural strength, then user should check the components of 3D printing resin. Deficient degree of polymerization may lead to large water sorption, water solubility and color changes. Further study should be done comparison between specimens printed with specific 3D printer recommended by manufacturer and specimens used in this study.
Crowns ; Polymerization ; Polymers ; Printing, Three-Dimensional ; Resins, Synthetic ; Solubility ; Water

BACKGROUND AND OBJECTIVES: We sought to evaluate nationwide trends, characteristics, and clinical outcomes in patients undergoing percutaneous coronary intervention (PCI) in Korea. METHODS: From National Health Insurance claims data in Korea, 81,115 patients, who underwent PCI for the first episode of coronary artery disease between 2011 and 2015, were enrolled. Patients were categorized into angina (n=49,288) or acute myocardial infarction (AMI, n=31,887) groups and analyzed. RESULTS: The mean age of patients was 64.4±12.2 years and 56,576 (69.7%) were men. Diabetes, hyperlipidemia, and hypertension were observed in 27,086 (33.4%), 30,675 (37.8%), and 45,389 (56.0%) patients, respectively. There was a 10% increase in the number of patients undergoing PCI for angina between 2011–2012 and 2014–2015 (11,105 vs. 13,261; p=0.021). However, the number of patients undergoing PCI for AMI marginally decreased between 2011–2012 and 2014–2015 (8,068 vs. 7,823; p=0.052). In procedures, drug-eluting stent was the most frequently used device (93.2%), followed by balloon angioplasty (5.5%) and bare metal stents (1.3%). The mean number of stents per patient was 1.39±0.64. At discharge, dual-anti platelet therapy, statin, beta-blockers, and angiotensin converting enzyme inhibitor or angiotensin receptor blocker were provided to 76,292 (94.1%), 71,411 (88.0%), 57,429 (70.8%), and 54,418 (67.1%) patients, respectively. The mean in-hospital and 1-year total medical costs were 8,628,768±4,832,075 and 13,128,158±9,758,753 Korean Won, respectively. In-hospital mortality occurred in 2,094 patients (2.6%). CONCLUSIONS: Appropriate healthcare strategies reflecting trends, characteristics, and clinical outcomes of PCI are needed in Korea.
Angina Pectoris ; Angioplasty, Balloon ; Angiotensins ; Blood Platelets ; Coronary Artery Disease ; Delivery of Health Care ; Drug-Eluting Stents ; Hospital Mortality ; Humans ; Hydroxymethylglutaryl-CoA Reductase Inhibitors ; Hyperlipidemias ; Hypertension ; Korea ; Male ; Myocardial Infarction ; National Health Programs ; Peptidyl-Dipeptidase A ; Percutaneous Coronary Intervention ; Stents

BACKGROUND AND OBJECTIVES: We sought to evaluate nationwide trends, characteristics, and clinical outcomes in patients undergoing percutaneous coronary intervention (PCI) in Korea. METHODS: From National Health Insurance claims data in Korea, 81,115 patients, who underwent PCI for the first episode of coronary artery disease between 2011 and 2015, were enrolled. Patients were categorized into angina (n=49,288) or acute myocardial infarction (AMI, n=31,887) groups and analyzed. RESULTS: The mean age of patients was 64.4±12.2 years and 56,576 (69.7%) were men. Diabetes, hyperlipidemia, and hypertension were observed in 27,086 (33.4%), 30,675 (37.8%), and 45,389 (56.0%) patients, respectively. There was a 10% increase in the number of patients undergoing PCI for angina between 2011–2012 and 2014–2015 (11,105 vs. 13,261; p=0.021). However, the number of patients undergoing PCI for AMI marginally decreased between 2011–2012 and 2014–2015 (8,068 vs. 7,823; p=0.052). In procedures, drug-eluting stent was the most frequently used device (93.2%), followed by balloon angioplasty (5.5%) and bare metal stents (1.3%). The mean number of stents per patient was 1.39±0.64. At discharge, dual-anti platelet therapy, statin, beta-blockers, and angiotensin converting enzyme inhibitor or angiotensin receptor blocker were provided to 76,292 (94.1%), 71,411 (88.0%), 57,429 (70.8%), and 54,418 (67.1%) patients, respectively. The mean in-hospital and 1-year total medical costs were 8,628,768±4,832,075 and 13,128,158±9,758,753 Korean Won, respectively. In-hospital mortality occurred in 2,094 patients (2.6%). CONCLUSIONS Appropriate healthcare strategies reflecting trends, characteristics, and clinical outcomes of PCI are needed in Korea.

Hemobilia is a rare gastrointestinal bleeding, usually caused by injury to the bile duct. Hemobilia after endoscopic retrograde cholangiopancreatography (ERCP) is generally self-limiting and patients will spontaneously recover, but some severe and fatal hemorrhages have been reported. ERCP-related bowel or bile duct perforation should be managed promptly, according to the type of injury and the status of the patient. We recently experienced a case of late-onset severe hemobilia in which the patient recovered after endoscopic biliary stent insertion. The problem was attributable to ERCP-related bile duct perforation during stone removal, approximately 5 weeks prior to the hemorrhagic episode. The removal of the stent was performed 10 days before the onset of hemobilia. The bleeding was successfully treated by two sessions of transarterial coil embolization.
Bile Ducts ; Cholangiopancreatography, Endoscopic Retrograde ; Embolization, Therapeutic ; Hemobilia* ; Hemorrhage ; Humans ; Plastics* ; Stents*

BACKGROUND: Aortic banding and debanding models have provided useful information on the development and regression of left ventricular hypertrophy (LVH). In this animal study, we aimed to evaluate left ventricular (LV) deformation related to the development and regression of LVH. METHODS: Minimally invasive ascending aorta banding was performed in rats (10 Sprague Dawley rats, 7 weeks). Ten rats underwent a sham operation. Thirty-five days later, the band was removed. Echocardiographic and histopathologic analysis was assessed at pre-banding, 35 days of banding and 14 days of debanding. RESULTS: Banding of the ascending aorta created an expected increase in the aortic velocity and gradient, which normalized with the debanding procedure. Pressure overload resulted in a robust hypertrophic response as assessed by gross and microscopic histology, transthoracic echocardiography [heart weight/tibia length (g/m); 21.0 +/- 0.8 vs. 33.2 +/- 2.0 vs. 26.6 +/- 2.8, p < 0.001]. The circumferential (CS) and radial strains were not different between the groups. However, there were significant differences in the degree of fibrosis according to the banding status (fibrosis; 0.10 +/- 0.20% vs. 5.26 +/- 3.12% vs. 4.03 +/- 3.93%, p = 0.003), and global CS showed a significant correlation with the degree of myocardial fibrosis in this animal model (r = 0.688, p = 0.028). CONCLUSION: In this animal study, simulating a severe LV pressure overload state, a significant increase in the LV mass index did not result in a significant reduction in the LV mechanical parameters. The degree of LV fibrosis, which developed with pressure overload, was significantly related to the magnitude of left ventricular mechanics.
Animals ; Aorta* ; Echocardiography ; Fibrosis ; Hypertrophy, Left Ventricular ; Mechanics* ; Models, Animal* ; Rats ; Rats, Sprague-Dawley

BACKGROUND: This study was to investigate the feasibility of real-time 3-dimensional echocardiography (RT3DE) for the analysis of biventricular ejection fractions and volume measurements in patients with cor pulmonale and the correlations of RT3DE results with 64-slice multi-detector cardiac computed tomography (64-MDCT) results. METHODS: This study included a total of 22 patients (59.3 +/- 16.6 years of age; 10 males and 12 females) who showed flattening or reverse curvature of the interventricular septum and severe pulmonary hypertension [mean right ventricular (RV) systolic pressure = 66.8 +/- 19.7 mmHg] on 2-dimensional transthoracic echocardiography due to cor pulmonale. Biventricular end-diastolic and end-systolic volumes were measured by RT3DE and 64-MDCT. The severity of D-shaped deformation was evaluated by using left ventricular (LV) eccentricity index (ratio of diameters parallel/perpendicular to the interventricular septum on parasternal short axis images of the papillary muscle level). RESULTS: There were moderate correlations between biventricular volumes measured by RT3DE and 64-MDCT except for LV end-systolic volume (59.8 +/- 17.1 vs. 73.2 +/- 20.2 mL, r = 0.652, p = 0.001 for LV end-diastolic volume; 30.6 +/- 9.1 vs. 30.8 +/- 12.5 mL, r = 0.361, p = 0.099 for LV end-systolic volume; 110.1 +/- 42.9 vs. 171.1 +/- 55.3 mL, r = 0.545, p = 0.009 for RV end-diastolic volume; and 80.9 +/- 35.0 vs. 128.7 +/- 45.1 mL, r = 0.549, p = 0.005 for RV end-systolic volume respectively). CONCLUSION: This study suggests that RT3DE may be a modest method for measuring distorted biventricular end-systolic and end-diastolic volumes in patients with cor pulmonale.
Axis, Cervical Vertebra ; Blood Pressure ; Echocardiography ; Echocardiography, Three-Dimensional ; Humans ; Hypertension, Pulmonary ; Male ; Papillary Muscles ; Pulmonary Heart Disease

Patent ductus arteriosus (PDA) is a rare clinical finding in adult patients. Considering the increase in cases of PDA discovered incidentally on echocardiograms at young ages, and the life-shortening effect of PDA, it is rare to diagnose PDA in old patients. We report a case of an 80-year-old patient who experienced symptoms of congestive heart failure showed findings suggestive of PDA in echocardiogram and confirmed the diagnosis through a cardiac catheterization and a coronary angiography. After percutaneous occlusion of PDA with an Amplatzer duct occlusion device, symptoms related to congestive heart failure improved.
Adult ; Aged ; Cardiac Catheterization ; Cardiac Catheters ; Coronary Angiography ; Ductus Arteriosus, Patent ; Estrogens, Conjugated (USP) ; Heart Failure ; Humans