No abstract available.
Anesthesia* ; Korea*

With the goal of providing optimal care to patients, student-centered active learning and the development of clinical competency have become vital components of the education of future physicians capable of sustainably coping with future challenges. However, the shape of future medicine is dramatically changing based on advances in information and communication technology, and the current classroom model seems to have difficulties in fully preparing students for the future of medicine. New trends in teaching and assessment methods include computer-aided instruction, virtual patients, augmented reality, human patient simulations, and virtual reality for the assessment of students’ competency. The digital technologies introduced in medical and dental education include Google Forms to collect students’ answers, YouTube livestreaming, Google Art & Culture (an online art museum), and choose-your-own-adventure as a story-telling technique. Innovations in digital technology will lead the way toward a revolution in medical and dental education, allowing learning to be individualized, interactive, and efficient.

With the goal of providing optimal care to patients, student-centered active learning and the development of clinical competency have become vital components of the education of future physicians capable of sustainably coping with future challenges. However, the shape of future medicine is dramatically changing based on advances in information and communication technology, and the current classroom model seems to have difficulties in fully preparing students for the future of medicine. New trends in teaching and assessment methods include computer-aided instruction, virtual patients, augmented reality, human patient simulations, and virtual reality for the assessment of students’ competency. The digital technologies introduced in medical and dental education include Google Forms to collect students’ answers, YouTube livestreaming, Google Art & Culture (an online art museum), and choose-your-own-adventure as a story-telling technique. Innovations in digital technology will lead the way toward a revolution in medical and dental education, allowing learning to be individualized, interactive, and efficient.

No abstract available.
Bile Ducts, Extrahepatic* ; Carcinoma, Hepatocellular*

The purpose of this study was to compare the sealing ability of root canal obturation with or without the treatment of smear layer. Eighty extracted human teeth with one canal were selected. Instrumentation was performed with crown-down technique. After instrumentation, root canals of the NaOCl group and NaOCl-6 group were irrigated with 3% NaOCl. EDTA group and EDTA-6 group were irrigated with 17% EDTA. Then all teeth were obturated using continuous wave obturation technique. NaOCl group and EDTA group were immersed in methylene blue solution for 84hours. NaOCl-6 group and EDTA-6 group were immersed in methylene blue solution for 6months. The teeth were sectioned at 1.5 mm (Level 1), 3.0 mm (Level 2) and 4.5 mm (Level 3) from the root apex. The length of dye-penetrated interface and the circumferential length of canal at each level were measured using Sigma-Scan Pro 5.0. 1. The mean leakage ratio was decreased cervically. 2. NaOCl group showed higher mean leakage ratio than EDTA group at each level. But there was significant difference at level 1 only (p < 0.05). 3. NaOCl-6 group showed higher mean leakage ratio than EDTA-6 group at each level. But there was significant difference at level 1 only (p < 0.05). 4. NaOCl-6 group showed higher mean leakage ratio than NaOCl group at each level. But there was significant difference at level 1 only (p < 0.05). 5. EDTA-6 group showed higher mean leakage ratio than EDTA group at each level. But there was no significant difference. 6. In NaOCl group and NaOCl-6 group, scanning electron micrographs of tooth sections generally covered with smear layer. In EDTA group and EDTA-6 group, tooth sections showing the penetration of sealers to opened dentinal tubules. The results suggest that removal of smear layer was effective to reduce the apical microleakage of the root canal.
Dental Pulp Cavity ; Dentin ; Edetic Acid ; Humans ; Methylene Blue ; Root Canal Obturation ; Smear Layer* ; Tooth

The purpose of this study was to assess the incidence of flare-ups among patients who received endodontic treatment and to examine the correlation with pre-operative and operative variables. Analysis was in two aspects (a) overall incidence of flare-ups as expressed by a percentage of all patients visits and (b) percentage of flare-ups that occurred as related to various factors such as patient demographics, diagnosis, and treatment procedures. 1. From the 840 teeth which were examined in this study, the total number of flare-ups was 13. 2. As to gender of patients, there was no significant difference in flare-ups. 3. As to tooth groups, there was no significant difference in flare-ups. 4. In the teeth with pre-operative symptom, there was a statistically significant higher incidence of flare-ups than the teeth without it. 5. In the teeth with apical periodontitis, there was a statistically significant higher incidence of flare-ups. 6. As to pulp and periapical status, non-vital teeth had a higher incidence as compared with vital teeth, irreversible pulpitis. 7. Multi-visit treatment resulted in the higher incidence of flare-ups than one visit treatment. 8. Re-treatment procedures had a statistically significant higher incidence of flare-ups than root canal treatment. In this study, overall percentages of flare-ups was 1.55%. It showed a statistically significant higher incidence related to pre-operative symptom, apical periodontitis, and re-treatment. There was no significant difference in flare-ups related to gender, tooth groups, and fistula.
Demography ; Dental Pulp Cavity ; Diagnosis ; Fistula ; Humans ; Incidence* ; Periapical Periodontitis ; Pulpitis ; Tooth

The purpose of this study was to evaluate the effect of different etching times on microtensile bond strength (microTBS) to dentin both initial and after thermocycling with 3 different types of total-etching adhesives. Fifty four teeth were divided into 18 groups by etching times (5, 15, 25 sec), adhesives types (Scotchbond Multipurpose (SM), Single Bond (SB), One-Step (OS)), and number of thermocycling (0, 2,000 cycles). Flat dentin surfaces were prepared on mid-coronal dentin of extracted third molars. After exposed fresh dentin surfaces were polished with 600-grit SiC papers, each specimen was acid-etched with 35% phosphoric acid (5, 15, 25 sec) and bonded with 3 different types of total etching adhesives respectively. Then, hybrid composite Z-250 was built up. Half of them were not thermocycled (control group) and the others were subjected to 2,000 thermocycle (experimental group). They were sectioned occluso-gingivally into 1.0 x 1.0 mm2 composite-dentin beams and tested with universal testing machine at a crosshead speed of 1.0 mm/min. Within limited data of this study, the results were as follows 1. There was no statistically significant difference in microTBS between the thermocycled and non-thermocycled groups, except for both SM and SB etched for 25 sec. 2. In thermocycled SM and SB groups, bond strength decreased by extended etching time. In total etching systems, adhesive durability for dentin could be affected by type of solvents in adhesive and etching time. Especially, extended etching time may cause deteriorate effects on bond strength when ethanol-based adhesive was used.
Adhesives* ; Dentin* ; Molar, Third ; Solvents ; Tooth

Pancreatic collision tumors are rare neoplasm, and cases consisting of ductal adenocarcinoma with a neuroendocrine tumor, intraductal papillary mucinous neoplasm with a neuroendocrine tumor, and solid pseudopapillary neoplasm with a neuroendocrine tumor have been reported. We report a case of a rapidly growing pancreatic collision tumor consisting of desmoidtype fibromatosis and mucinous cystic neoplasm in a 30-year-old pregnant female. To the best of our knowledge, this is the first reported case of a pancreatic collision tumor consisting of desmoid-type fibromatosis and mucinous cystic neoplasm.

Pancreatic collision tumors are rare neoplasm, and cases consisting of ductal adenocarcinoma with a neuroendocrine tumor, intraductal papillary mucinous neoplasm with a neuroendocrine tumor, and solid pseudopapillary neoplasm with a neuroendocrine tumor have been reported. We report a case of a rapidly growing pancreatic collision tumor consisting of desmoidtype fibromatosis and mucinous cystic neoplasm in a 30-year-old pregnant female. To the best of our knowledge, this is the first reported case of a pancreatic collision tumor consisting of desmoid-type fibromatosis and mucinous cystic neoplasm.

OBJECTIVE: Gestational diabetes mellitus (GDM) is one of the most common metabolic disorders complicating pregnancy. It is associated with adverse outcomes of pregnancy including obstetrical complications such as increased rate of cesarean section, preeclampsia, and birth trauma, and perinatal morbidities, such as macrosomia, hypoglycemia, hypocalcemia, and hyperbilirubinemia. Therefore, screening for gestational diabetes mellitus and early diagnosis of this condition allows intervention to be carried out, thereby, the reduction of the untoward effects mentioned above can be minimized. But selective screening based on clinical or historic risk factors has been reported ineffective to identify the women with GDM. BACKGROUND: Circulating sex hormones have a role in the development of insulin resistance associated with certain physiological states including hyperandrogenism and polycystic ovary syndrome. Throughout pregnancy, normal human pregnancy is a hyperestrogenic state of major proportions. To evaluate the clinical correlation between Gestational diabetes mellitus and unconjugated estriol, we used it to screening protocol using three biochemical markers for unconjugated estriol levels. METHODS: In our retrospective between January 2002 and December 2003 at Korea university medical center, 137 women were screened for three biochemical tests and 50 gm Glucose challenge test at second trimester of pregnancy. The 50 gm GCT positive (n=56) women were performed 100 gm oral glucose tolerance test and by NDDG diagnosic criteria, women were diagnosed as Gestational diabetes mellitus (n=42). RESULTS: With logistic regression analysis, the significant risk factors were family history of DM (odd ration 16.59 95% CI 2.66-103.52), previous macrosomia birth (odd ratio 9.02 95% CI 1.98-41.6), maternal BMI (odd ratio 1.29 95% CI 1.09-1.49), parity (odd ratio 0.31 95% CI 0.11-0.83), glucosuria (odd ratio 0.68 95% CI 0.26-1.76) and among three biochemical test, estriol (odd ratio 1.60 95% CI 0.49-5.27), AFP (odd ratio 1.35 95% CI 0.35-5.28), hCG (odd ratio 0.59 95% CI 0.27-1.28). CONCLUSION: The screening test of GDM would be preferable and intensified management approach needed for patients with obesity, previous macrosomia birth. In three biochemical test, estriol and AFP levels were elevated in GDM but these odd ratio were not statistically significant.
Academic Medical Centers ; Biomarkers ; Cesarean Section ; Diabetes, Gestational* ; Early Diagnosis ; Estriol* ; Female ; Glucose ; Glucose Tolerance Test ; Gonadal Steroid Hormones ; Humans ; Hyperandrogenism ; Hyperbilirubinemia ; Hypocalcemia ; Hypoglycemia ; Insulin Resistance ; Korea ; Logistic Models ; Mass Screening ; Obesity ; Parity ; Parturition ; Polycystic Ovary Syndrome ; Pre-Eclampsia ; Pregnancy ; Pregnancy Trimester, Second ; Retrospective Studies ; Risk Factors