PURPOSE: This in vitro study aimed to analyze and compare the reproducibility of zirconia and lithium disilicate crowns manufactured by digital workflow. MATERIALS AND METHODS: A typodont model with a prepped upper first molar was set in a phantom head, and a digital impression was obtained with a video intraoral scanner (CEREC Omnicam; Sirona GmbH), from which a single crown was designed and manufactured with CAD/CAM into a zirconia crown and lithium disilicate crown (n=12). Reproducibility of each crown was quantitatively retrieved by superimposing the digitized data of the crown in 3D inspection software, and differences were graphically mapped in color. Areas with large differences were analyzed with digital microscopy. Mean quadratic deviations (RMS) quantitatively obtained from each ceramic group were statistically analyzed with Student's t-test (α=.05). RESULTS: The RMS value of lithium disilicate crown was 29.2 (4.1) µm and 17.6 (5.5) µm on the outer and inner surfaces, respectively, whereas these values were 18.6 (2.0) µm and 20.6 (5.1) µm for the zirconia crown. Reproducibility of zirconia and lithium disilicate crowns had a statistically significant difference only on the outer surface (P<.001). The outer surface of lithium disilicate crown showed over-contouring on the buccal surface and under-contouring on the inner occlusal surface. The outer surface of zirconia crown showed both over- and under-contouring on the buccal surface, and the inner surface showed under-contouring in the marginal areas. CONCLUSION: Restoration manufacturing by digital workflow will enhance the reproducibility of zirconia single crowns more than that of lithium disilicate single crowns.
Ceramics* ; Crowns* ; Head ; In Vitro Techniques* ; Lithium ; Microscopy ; Molar*

PURPOSE: This study aimed to demonstrate reduction in stroke symptoms by analyzing the changes in respiratory function and activities of daily living (ADL) after respiratory muscle strengthening exercise in patients who had a stroke and thereby, propose an efficient exercise method. METHODS: Twenty patients with hemiplegic stroke were divided into two groups, with 10 patients in each. The control group (CG) received the traditional exercise therapy, and the experimental group (EG) received the traditional exercise therapy combined with expiratory muscle strengthening training. The training continued for 6 weeks, 5 days a week. Forced vital capacity (FVC) and forced expiratory volume at 1 second (FEV1) were measured with a spirometer, SpO₂ was measured with a pulse oximeter, and ADL were assessed by using the modified Barthel index (MBI). A paired t test was applied to compare the differences before and after the intervention, and an independent t test was used to compare the differences between the groups. The level of statistical significance was set as α=0.05. RESULTS: The changes in the FVC and FEV1 values within the group showed significant differences only in the EG (p<0.01). The between-group difference was statistically significant only for FVC and FEV1 in the EG (p<0.01). The changes in SpO₂ and MBI within the group showed significant differences only in the EG and CG (p<0.01). Between-group differences were statistically significant only for SpO₂ and MBI in the EG (p<0.05). CONCLUSION: The interventions with active patient involvement and combined breathing exercises had a positive impact on all the functions investigated in this study.
Activities of Daily Living* ; Breathing Exercises ; Exercise Therapy ; Forced Expiratory Volume ; Humans ; Methods ; Patient Participation ; Respiratory Muscles* ; Stroke* ; Vital Capacity

OBJECTIVES: The aim of this study was to investigate the gender differences of direct aggression and relational aggression in Korean elementary and middle school students. METHODS: Parents of 946 elementary school students(age 9.54±1.72 years, 485 boys, 461 girls) completed the Child Behavior Checklist(CBCL). Six-hundred-and-three middle school students(age 13.98±0.93 years, 301 boys, 302 girls) completed the Youth Self-Report(YSR). Independent t-test, chi-square test, and Fisher's exact test were used. RESULTS: Boys had significantly higher direct aggression scores than girls in elementary school students(p<0.001). There was no significance gender difference of relational aggression in elementary school students(p=0.235). In middle school students, boys had significantly higher direct aggression than girls(p=0.017), and girls had significantly higher relational aggression compared to the boys(p<0.001). CONCLUSION: Our results suggest the presence of gender differences in manifestation of aggression subtypes in Korean elementary and middle school students. These gender differences should be taken into account in prevention and intervention approaches of aggression in children and adolescents.
Adolescent* ; Aggression* ; Child Behavior ; Child* ; Female ; Humans ; Parents

Post-traumatic fat embolism was first reported by Zenker in 1862, Von Bergmann reported the first clinical diagnosis of the fat embolism syndrome in 1873. Fat embolism has been associated with traumatic or non-traumatic disorders. Fat embolization after long bone trauma is probably common as a subclinical event. The diagnosis of fat embolism syndrome is based on the patient's history, is supported by clinical signs of pulmonary, cerebral, and cutaneous dysfunction, and is confirmed by the demonstration of arterial hypoxemia in the abscence of other disorders. Two different mechanisms cause fat to embolize: direct entry of deposit fat into the blood stream and agglutination of endogenous or exogenous plasma fat. MRI can detect a cerebral fat embolism with a higher sensitivity than cerebral CT. We report a case of post-traumatic cerebral fat embolism without pulmonary involvement, and we present a review of the literature. A 16-year girl had a traffic accident and pelvic bone fracture. Forty eight hours later severe trauma become stuporous without a focal neurological deficit. The patient received supportive therapy, and her condition improved throughout her hospital course. She was discharged with good condition after a 30-day hospital stay.
Accidents, Traffic ; Agglutination ; Anoxia ; Diagnosis ; Embolism, Fat* ; Female ; Humans ; Length of Stay ; Magnetic Resonance Imaging ; Pelvic Bones ; Plasma ; Rivers ; Stupor

PURPOSE: Effective hemodialysis for a patient with end-stage renal disease (ERDS) is dependent upon a durable, low-morbidity vascular access. Although It is generally agreed that the distal radiocephalic fistula originally discribed by Brescia and Cimino is the most effective primary access constrruction, no consensus exists regarding primary and secondary alternatives for patients with inadequate of failed rediocephalic prodedures. Many options are available, but the relative value of these alternative operations is unclear. Therefore the place of the basilic vein in secondary acccess construction needs to be assessed. We evaluated if the basilic vein can be used to construct a durable, low-morbidity access. METHODS: A native brachio-basilic arterio-venous fistula with superficial transposition has been performed, for lack of usuable vein on 54 forearm in 47 patients from August 1995 to October 1999 (Male: 15, female: 32) with mean age 51 years (26 to 70 years). RESULTS: The main cause of renal insufficiency were: diabetes 27 (57.4%), hypertensive 19 (40.4%), renal tuberculosis 2 (4.3%) and renal cyst 1 (2.1%). The waiting period before vascular access puncture has been 28 6 days. Eight (17.0%) stenosis has been detected and, forearm and/or hand edema occured in three (6.4%); thrombosis in two (4.3%); bleeding in two (4.3%); pseudoaneurysm in one. Through the follow-up periods of 50 months, the primary patency was 80.9% at 12 months and 78.7% at 24 months. CONCLUSION: The brachio-basilic fistula with superficial transposition of basilic vein is a valuable vascular access for diabetes, female old patients, and can remain an alternative method for even younger patients by avoiding the installation of artificial graft after failed forearm arteriovenous fistula.
Aneurysm, False ; Arteriovenous Fistula* ; Consensus ; Constriction, Pathologic ; Edema ; Female ; Fistula ; Follow-Up Studies ; Forearm ; Hand ; Hemorrhage ; Humans ; Kidney Failure, Chronic ; Ocimum basilicum* ; Punctures ; Renal Dialysis* ; Renal Insufficiency ; Thrombosis ; Transplants ; Tuberculosis, Renal ; Veins*

BACKGROUND: An important metabolic feature of acromegaly is a reduced action of insulin on hepatic gluconeogenesis and peripheral glucose disposal which mediated by growth hormone hypersecretion. Octreotide, a synthetic octapeptide somatostatin analogue exerts complex effects on hormonal and metabolic regulations affecting glucose homeostasis. This study was designed to ascertain the shorterm effect of octreotide on glucose tolerance in acromegaly. METHODS: 10 patients (five men and five women, age 47.9+/-11.8) were injected subcutaneously with octreotide, 100 micrograms for 24 hours. Patients were assessed with respect to growth hormone, glucose, and insulin response to a standard 100 g oral glucose tolerance test (OGTT) before and during the last 2 hour of octreotide infusion. RESULTS: During the therapy, there was significant decrease in mean blood glucose response to OGTT (678.4+/-51.9 vs 581.9+/-47.3 mg/dL/2hr: mean areas under the glucose curve, p=0.01) and mean serum insulin response to oral glucose load was significantly reduced in all patients (339.2+/-106.2 vs 256.7+/-111.3 U/mL/2hr: mean areas under the insulin curve, p=0.01). Using glucose tolerance test criteria three patients of 10 had normal glucose tolerance, four and three had impaired glucose tolerance and diabetes, respectively, at base line. While on octreotide these composition was changed to six patients of NGT, three of IGT and one diabetes. CONCLUSION: We conclude that insulin resistance mediated by GH hypersecretion was improved by shorterm octreotide treatment.
Acromegaly* ; Blood Glucose ; Female ; Gluconeogenesis ; Glucose Tolerance Test ; Glucose* ; Growth Hormone ; Homeostasis ; Humans ; Infusions, Subcutaneous* ; Insulin ; Insulin Resistance ; Male ; Octreotide* ; Social Control, Formal ; Somatostatin

The present study was undertaken to find out the role of NO on cataractogenesis in the experimenally-induced uveitis(EIU) model. Nitrite and nitrate, stable oxidative products of nitric oxide(NO), were measured in the aqueous humor and the progression of inflammations and lens opacities were evaluated with slit lamp biomicroscope. Immunoperoxidase staining and immunofluorescent staining for inducible NO synthase(iNOS) and peroxynitrite were performed to confirm the site of production of NO and peroxynitrite. The grades of inflammation were peaked at 24 hours inflammation was gradually decreased after 48 hours and lens opacity after 72 hours. These changes returned to the baseline level by one week after LPS injection. Similarly, NO concentration in aqueous humor was peaked at 24 hours. And it was then decreased after 48 hours and returned to the baseline level by one week. These inflammatory signs and lens opacities were significantly decreased in NG-nitro-L-arginine methyl ester(L-NAME) administrated group. Inflammatory cells in anterior chamber, iris, and ciliary body expressed highly iNOS which was coincide with peroxynitrite immunolocalization. Therefore, these results suggest that cataract formation in EIU is related to the NO production in aqueous humor. Furthermore, lipid peroxidation by peroxynitrite is possibly related with cataractogenesis in EIU. But, we need a further evaluation to seek the relationship between cataractogenesis and increased nitric oxide concentration, combined with studies of other biochemical changes in anterior chamber and lens.
Anterior Chamber ; Aqueous Humor ; Cataract* ; Ciliary Body ; Inflammation ; Iris ; Lipid Peroxidation ; Nitric Oxide ; Nitroarginine ; Peroxynitrous Acid ; Uveitis*

Amyloidosis results from the deposition of insoluble, fibrous amyloid proteins, nearly always in the extracellular spaces of organs and tissues. There are several varieties of amyloidosis, each of which is identified by the immunochemical nature of amyloid protein fibrils. Amyloid goiter is a very rare clinical entity and can be confused with a neoplasm. We have experienced a case of amyloid goiter with hypothyroidism secondary to tuberculosis. A 20 years old women with 5 months history of pulmonary tuberculosis was admitted with complaints of diarrhea, abdominal pain, weight loss at one year ago. She had a non-tender, diffuse and firm goiter. Also she had normal thyroid function at the first admission but was found to be hypothyroid at the second admission, 10 months later. Histologic examination revealed amyloid deposition in thyroid gland, stomach, colon and rectum.
Abdominal Pain ; Amyloid* ; Amyloidogenic Proteins ; Amyloidosis ; Colon ; Diarrhea ; Extracellular Space ; Female ; Goiter* ; Humans ; Hypothyroidism* ; Plaque, Amyloid ; Rectum ; Stomach ; Thyroid Gland ; Tuberculosis ; Tuberculosis, Pulmonary ; Weight Loss ; Young Adult

We report computed tomography (CT) and magnetic resonance (MR) findings of a patient with polyostotic Paget disease and multicentric giant cell tumor (GCT). Brain CT scan showed widening of diploic space, cortical thickening and enhancing soft tissue mass in occiput with underlying calvarial destruction. Ill-defined soft tissue masses were also detected in maxillary sinus and buttock with underlying bony destruction on CT. MR image showed multifocal nodules in wide diploic space with low signal intensity on T1 -weighted image and bright signal intensity on T2-weighted image. Mass in occiput showed homogeneous hypointensity to bone marrow on T1-weighted image and homogeneous iso- intensity on T2-weighted image. Multiple nodules in diploic space and occipital mass showed contrast enhancement following administration of Gd-DTPA. Biopsy was performed at scal p, maxillary sinus and buttock, and histologic analysis revealed GCT.
Biopsy ; Bone Marrow ; Brain ; Buttocks ; Gadolinium DTPA ; Giant Cell Tumors* ; Giant Cells* ; Humans ; Maxillary Sinus ; Tomography, X-Ray Computed

The aim of this study was to evaluate the histopathologic changes of the pigmented rabbit ratina after endocryopexy. We investigated the differences or similarity among endocryopexy, transscleral cryopexy and laser phocoagulation. Their ultrastructural changes were observed with light and electron microscope. The results were as follows; 1. The first day after endocryopexy, we observed rupture of the internal limiting membrane, breakdown the inner and outer retina, separation of intercellular gap junction of pigment epithelial cells, and accumulation of exudation within subretinal space. 2. In the 8th days, there are mull iplication of retinal pigment epithelial cell layer and development of basal infolding. 3. The present study suggested that effects of endocryopexy on the retina to cause chorioretinal adhesion was similar to transscleral cryopexy or laser photocoagulation However it should be operated on the premise that in requires technical skill for the purpose of clinical application.
Epithelial Cells ; Gap Junctions ; Light Coagulation ; Membranes ; Retina* ; Retinaldehyde ; Rupture