PURPOSE: To evaluate the accuracy of a model made using the computer-aided design/computer-aided manufacture (CAD/CAM) milling method and 3D printing method and to confirm its applicability as a work model for dental prosthesis production. MATERIALS AND METHODS: First, a natural tooth model (ANA-4, Frasaco, Germany) was scanned using an oral scanner. The obtained scan data were then used as a CAD reference model (CRM), to produce a total of 10 models each, either using the milling method or the 3D printing method. The 20 models were then scanned using a desktop scanner and the CAD test model was formed. The accuracy of the two groups was compared using dedicated software to calculate the root mean square (RMS) value after superimposing CRM and CAD test model (CTM). RESULTS: The RMS value (152±52 µm) of the model manufactured by the milling method was significantly higher than the RMS value (52±9 µm) of the model produced by the 3D printing method. CONCLUSION: The accuracy of the 3D printing method is superior to that of the milling method, but at present, both methods are limited in their application as a work model for prosthesis manufacture.
Dental Models ; Dental Prosthesis ; Methods ; Printing, Three-Dimensional ; Prostheses and Implants ; Tooth

Parathyroid carcinoma is very rare malignant neoplasm, accounting for less than 0.005% of all cancers. Most parathyroid carcinoma is a functioning tumor that causes hyperparathyroidism, leading to hypercalcemia. We report a parathyroid carcinoma case that was suspicious for spontaneous infarction of cancer, leading to resolution of hypercalcemia. A 29-year-old male visited our hospital presenting with right neck swelling and pain. He has been experiencing frequent urolithiasis for four years but laboratory tests showed normal serum calcium level. Right vocal cord paresis was identified with laryngoscopy. Ultrasonography revealed a 3.7 × 3.5 cm mass in the right thyroid containing a focal cystic portion. Computed tomography confirmed the presence of a low-density right thyroid mass. Right thyroid lobectomy was performed and pathological evaluation revealed parathyroid carcinoma with central necrosis. We report this very rare case with a literature review.

OBJECTIVE: Adiponectin is an adipocyte-derived hormone with profound insulin sensitizing, anti-inflammatory, and antiatherogenic effects. Apart from its obvious potential as a mediator of adult metabolic syndrome, in pregnancy, adiponectin could have a significant role in regulating energy homeostasis. However, correlations between umbilical cord and maternal serum adiponectin levels and neonatal birthweights are far from understood. The purpose of the present study was to clarify correlations between umbilical cord and maternal serum adiponectin levels and neonatal birthweights. METHODS: The study included 30 healthy mothers who had given birth to healthy neonates. Adiponectin levels in maternal serum and umbilical cord serum were determined by ELISA and analysed. RESULTS: The ranges of adiponectin levels for umbilical cord and maternal serum were 7.12-24.93 microgram/mL and 1.76-8.20 microgram/mL, respectively. Umbilical cord adiponectin levels (14.82+/-3.66 microgram/mL) were significantly higher than maternal serum levels (4.73+/-1.87)(p<0.001). Umbilical cord adiponectin levels were correlated positively with neonatal birthweights (r=0.459, p=0.011). No significant differences in adiponectin levels were found between female and male neonates. In addition, there was no correlation between umbilical cord adiponectin levels and maternal serum adiponectin levels, maternal body mass index, umbilical leptin, or insulin levels. CONCLUSION: The levels of adiponectin were higher in umbilical cord than in maternal serum. The adiponectin levels in umbilical cord were found to correlate positively with neonatal birthweights. Therefore, adiponectin may be involved in fetal energy metabolism in pregnancy.
Adiponectin* ; Adult ; Body Mass Index ; Energy Metabolism ; Enzyme-Linked Immunosorbent Assay ; Female ; Homeostasis ; Humans ; Infant, Newborn ; Insulin ; Leptin ; Male ; Mothers ; Parturition ; Pregnancy ; Umbilical Cord

We report one case of renal PV infection after renal allograft transplantation leading to graft dysfunction. According to prior reports, PV induced interstitial nephritis might be a cause of graft loss. Pathologic findings show varying degrees of interstitial infiltration and tubular degenerative changes, which resemble acute cellular rejection. Therapeutic strategies have not yet been developed. Case ; A 23 years old male underwent renal transplantation from his HLA haploidentical 25 year old sister. His renal function had been good with cyclosporin, steroid and azathioprine until 9 months after transplantation, when his serum creatinine level rose to 2.2mg/dl. The renal biopsy revealed diffuse lymphocyte infiltration in the interstitium and feature of the tubulitis. Also, giant tubular epithelial cells with large, hyperchromic nuclei were present. Despite steroid pulsing and OKT3, renal function progressively de- teriorated. After 10 days of OKT3 therapy, the patient suffered from high fever, dyspnea and general aches. A chest X-ray revealed interstitial infiltration in both lung fields and the cytomegalovirus PCR (polymerase chain reaction) test of serum and blood was positive. Intravenous ganciclorvir was administered and immunosuppressants were tapered. 4 months after admission, he lost his graft function and underwent hemodialysis. The aforementioned renal biopsy was retested immunohistochemically. Nuclear inclusions in renal tubular epithelial cells were shown and these inclusions were reacted positively with PV monoclonal antibodies.
Adult ; Allografts* ; Antibodies, Monoclonal ; Azathioprine ; Biopsy ; Creatinine ; Cyclosporine ; Cytomegalovirus ; Dyspnea ; Epithelial Cells ; Fever ; Humans ; Immunosuppressive Agents ; Intranuclear Inclusion Bodies ; Kidney Transplantation ; Lung ; Lymphocytes ; Male ; Muromonab-CD3 ; Nephritis, Interstitial ; Polymerase Chain Reaction ; Renal Dialysis ; Siblings ; Thorax ; Transplants ; Young Adult

BACKGROUND AND OBJECTIVES: Ergonovine stress echocardiography (ErgECHO) has been proposed as a noninvasive tool for the diagnosis of coronary vasospasm. However, concern over the safety of ErgECHO remains. This study was undertaken to investigate the safety and prognostic value of ErgECHO in a large population. METHODS: We studied 3,094 consecutive patients from a single-center registry who underwent ErgECHO from November 2002 to June 2009. Medical records, echocardiographic data, and laboratory findings obtained from follow-up periods were analyzed. RESULTS: The overall positive rate of ErgECHO was 8.6%. No procedure-related mortality or myocardial infarction (MI) occurred. Nineteen patients (0.6%) had transient symptomatic complications during ErgECHO including one who was successfully resuscitated. Cumulative major adverse cardiac events (MACEs) occurred in 14.0% and 5.1% of the patients with positive and negative ErgECHO results, respectively (p < 0.001) at a median follow-up of 10.5 years. Cox regression survival analyses revealed that male sex, age, presence of diabetes, total cholesterol level of >220 mg/dL, and positive ErgECHO result itself were independent factors associated with MACEs. CONCLUSIONS ErgECHO can be performed safely by experienced physicians and its positive result may be an independent risk factor for long-term adverse outcomes. It may also be an alternative tool to invasive ergonovine-provoked coronary angiography for the diagnosis of vasospastic angina.

OBJECTIVE: This study aimed to determine the association between preeclampsia and the postpartum development of metabolic syndrome based on the pre-pregnancy status. METHODS: Korean women who delivered their first child between January 1, 2011, and December 31, 2012, were enrolled. All subjects underwent a national health screening examination conducted by the National Health Insurance Corporation 1 or 2 years prior to their first delivery and within 2 years after their first delivery. RESULTS: Among the 49,065 participants, preeclampsia developed in 3,391 participants (6.9%). The prevalence of metabolic syndrome was higher postpartum in women with preeclampsia than in those without preeclampsia (4.9% vs. 2.7%, respectively, P<0.001). Through the pre-pregnancy to postpartum period, women with preeclampsia had a greater increase in gestational weight retention, body mass index, waist circumference, systolic blood pressure, and triglyceride levels and a greater decrease in high-density lipoprotein cholesterol levels than women without preeclampsia. Preeclampsia was associated with an increased risk of the postpartum development of metabolic syndrome in women without pre-pregnancy metabolic syndrome (odds ratio, 1.28; 95% confidence interval, 1.05–1.56). However, preeclampsia was not associated with postpartum metabolic syndrome in women with pre-pregnancy metabolic syndrome or 2 components of metabolic syndrome. CONCLUSION: In this study, preeclampsia was associated with the postpartum development of metabolic syndrome in women without pre-pregnancy metabolic syndrome. However, the effects were attenuated by predisposing risk factors in the pre-pregnancy period.
Blood Pressure ; Body Mass Index ; Cardiovascular Diseases ; Child ; Cholesterol ; Diabetes Mellitus ; Female ; Humans ; Hypertension ; Lipoproteins ; Mass Screening ; National Health Programs ; Postpartum Period ; Pre-Eclampsia ; Prevalence ; Risk Factors ; Triglycerides ; Waist Circumference

BACKGROUND AND OBJECTIVES: Ergonovine stress echocardiography (ErgECHO) has been proposed as a noninvasive tool for the diagnosis of coronary vasospasm. However, concern over the safety of ErgECHO remains. This study was undertaken to investigate the safety and prognostic value of ErgECHO in a large population. METHODS: We studied 3,094 consecutive patients from a single-center registry who underwent ErgECHO from November 2002 to June 2009. Medical records, echocardiographic data, and laboratory findings obtained from follow-up periods were analyzed. RESULTS: The overall positive rate of ErgECHO was 8.6%. No procedure-related mortality or myocardial infarction (MI) occurred. Nineteen patients (0.6%) had transient symptomatic complications during ErgECHO including one who was successfully resuscitated. Cumulative major adverse cardiac events (MACEs) occurred in 14.0% and 5.1% of the patients with positive and negative ErgECHO results, respectively (p < 0.001) at a median follow-up of 10.5 years. Cox regression survival analyses revealed that male sex, age, presence of diabetes, total cholesterol level of >220 mg/dL, and positive ErgECHO result itself were independent factors associated with MACEs. CONCLUSIONS: ErgECHO can be performed safely by experienced physicians and its positive result may be an independent risk factor for long-term adverse outcomes. It may also be an alternative tool to invasive ergonovine-provoked coronary angiography for the diagnosis of vasospastic angina.
Cholesterol ; Coronary Angiography ; Coronary Vasospasm ; Diagnosis ; Echocardiography ; Echocardiography, Stress ; Ergonovine ; Follow-Up Studies ; Humans ; Male ; Medical Records ; Mortality ; Myocardial Infarction ; Prognosis ; Risk Factors

Background: The detrimental effects of excessive thyroid hormone on glucose metabolism have been widely investigated. However, the risk of diabetes in patients with long-standing hyperthyroidism, especially according to treatment modality, remains uncertain, with few longitudinal studies. Methods: The risk of diabetes in patients with Graves’ disease treated with antithyroid drugs (ATDs) for longer than the conventional duration (≥2 years) was compared with that in age-and sex-matched controls. The risk was further compared according to subsequent treatment modalities after a 24-month course of ATD: continuation of ATD (ATD group) vs. radioactive iodine ablation (RIA) group. Results: A total of 4,593 patients were included. Diabetes was diagnosed in 751 (16.3%) patients over a follow-up of 7.3 years. The hazard ratio (HR) for diabetes, after adjusting for various known risk factors, was 1.18 (95% confidence interval [CI], 1.10 to 1.28) in patients with hyperthyroidism. Among the treatment modality groups, the RIA group (n=102) had a higher risk of diabetes than the ATD group (n=4,491) with HR of 1.56 (95% CI, 1.01 to 2.42). Further, the risk of diabetes increased with an increase in the ATD treatment duration (P for trend=0.019). Conclusion The risk of diabetes was significantly higher in patients with long-standing Graves’ disease than in the general population, especially in patients who underwent RIA and prolonged ATD treatment. Special attention to hyperglycemia during follow-up along with effective control of hyperthyroidism may be necessary to reduce the risk of diabetes in these patients.

PURPOSE: The aim of our study is to investigate the current status of metabolic and bariatric surgery in Daejeon and Chungcheong province and examine the role and necessity of the community research society. MATERIALS AND METHODS: In this retrospective study, 58 patients who underwent bariatric and metabolic surgery from January 2010 to June 2018 were included. Patients' demographics and comorbidities, operation type and early complications were analyzed. RESULTS: Mean age was 36.9±11.4 (range, 18–64) years, and mean preoperative body mass index was 39.2±6.9 (range, 24.6–56.1) kg/m². The most frequently performed operation was sleeve gastrectomy (48 cases, 82.8%), followed by adjustable gastric banding (8 cases, 13.8%) and Roux-en-Y gastric bypass (2 cases, 3.4%). Postoperative complications were reported in two patients; however, no mortality was reported. CONCLUSION: We investigated the patients who underwent metabolic and bariatric surgery in Daejeon Chungcheong province. Our research society will continue to ensure safe operation and proper management of morbidly obese patients in our community.
Bariatric Surgery ; Body Mass Index ; Comorbidity ; Demography ; Gastrectomy ; Gastric Bypass ; Humans ; Mortality ; Obesity ; Postoperative Complications ; Retrospective Studies

PURPOSE: This study aimed to evaluate the initial outcomes of proton beam therapy (PBT) for hepatocellular carcinoma (HCC) in terms of tumor response and safety. MATERIALS AND METHODS: HCC patients who were not indicated for standard curative local modalities and who were treated with PBT at Samsung Medical Center from January 2016 to February 2017 were enrolled. Toxicity was scored using the Common Terminology Criteria for Adverse Events (CTCAE) version 4.0. Tumor response was evaluated using modified Response Evaluation Criteria in Solid Tumors (mRECIST). RESULTS: A total of 101 HCC patients treated with PBT were included. Patients were treated with an equivalent dose of 62–92 GyE10. Liver function status was not significantly affected after PBT. Greater than 80% of patients had Child-Pugh class A and albumin-bilirubin (ALBI) grade 1 up to 3-months after PBT. Of 78 patients followed for three months after PBT, infield complete and partial responses were achieved in 54 (69.2%) and 14 (17.9%) patients, respectively. CONCLUSION: PBT treatment of HCC patients showed a favorable infield complete response rate of 69.2% with acceptable acute toxicity. An additional follow-up study of these patients will be conducted.
Carcinoma, Hepatocellular ; Follow-Up Studies ; Humans ; Liver ; Proton Therapy ; Protons ; Radiotherapy ; Response Evaluation Criteria in Solid Tumors