Background and Objectives: This study aimed to investigate the association between cardiovascular events and 2 different levels of elevated on-treatment diastolic blood pressures (DBP) in the presence of achieved systolic blood pressure targets (SBP). Methods: A nation-wide population-based cohort study comprised 237,592 patients with hypertension treated. The primary endpoint was a composite of cardiovascular death, myocardial infarction, and stroke. Elevated DBP was defined according to the Seventh Report of Joint National Committee (JNC7; SBP <140 mmHg, DBP ≥90 mmHg) or to the 2017 American College of Cardiology/American Heart Association (ACC/AHA) definitions (SBP <130 mmHg, DBP ≥80 mmHg). Results: During a median follow-up of 9 years, elevated on-treatment DBP by the JNC7 definition was associated with an increased risk of the occurrence of primary endpoint compared with achieved both SBP and DBP (adjusted hazard ratio [aHR], 1.14; 95% confidence interval [CI], 1.05–1.24) but not in those by the 2017 ACC/AHA definition. Elevated ontreatment DBP by the JNC7 definition was associated with a higher risk of cardiovascular mortality (aHR, 1.42; 95% CI, 1.18–1.70) and stroke (aHR, 1.19; 95% CI, 1.08–1.30). Elevated on-treatment DBP by the 2017 ACC/AHA definition was only associated with stroke (aHR, 1.10;95% CI, 1.04–1.16). Similar results were seen in the propensity-score-matched cohort. Conclusion Elevated on-treatment DBP by the JNC7 definition was associated a high risk of major cardiovascular events, while elevated DBP by the 2017 ACC/AHA definition was only associated with a higher risk of stroke. The result of study can provide evidence of DBP targets in subjects who achieved SBP targets.

Background: Danshen has been widely used in oriental medicine to improve body function. The purpose of this study is to investigate the effect of water-soluble Danshen extract (DE) on weight loss and on activation proteins involved in mitochondrial biogenesis in brown adipose tissue (BAT) in obese mice. Methods: BAT was isolated from 7-week-old male Sprague-Dawley rats, and expression of proteins related to mitochondrial biogenesis was confirmed in both brown preadipocytes and mature brown adipocytes treated with DE. For the in vivo study, low-density lipoprotein receptor knock out mice were divided into three groups and treated for 17 weeks with: standard diet; high fat diet (HFD); HFD+DE. Body weight was measured every week, and oral glucose tolerance test was performed after DE treatment in streptozotocin-induced diabetic mice. To observe the changes in markers related to thermogenesis and adipogenesis in the BAT, white adipose tissue (WAT) and liver of experimental animals, tissues were removed and immediately frozen in liquid nitrogen. Results: DE increased the expression of uncoupling protein 1 and peroxisome proliferator-activated receptor gamma coactivator 1-alpha in brown preadipocytes, and also promoted the brown adipocyte differentiation and mitochondrial function in the mature brown adipocytes. Reactive oxygen species production in brown preadipocytes was increased depending on the concentration of DE. DE activates thermogenesis in BAT and normalizes increased body weight and adipogenesis in the liver due to HFD. Browning of WAT was increased in WAT of DE treatment group. Conclusion DE protects against obesity and activates mitochondrial function in BAT.

PURPOSE: The objective of this study was to investigate the relationships between primary implant stability as measured by impact response frequency and the structural parameters of trabecular bone using cone-beam computed tomography(CBCT), excluding the effect of cortical bone thickness. METHODS: We measured the impact response of a dental implant placed into swine bone specimens composed of only trabecular bone without the cortical bone layer using an inductive sensor. The peak frequency of the impact response spectrum was determined as an implant stability criterion (SPF). The 3D microstructural parameters were calculated from CT images of the bone specimens obtained using both micro-CT and CBCT. RESULTS: SPF had significant positive correlations with trabecular bone structural parameters (BV/TV, BV, BS, BSD, Tb.Th, Tb.N, FD, and BS/BV) (P<0.01) while SPF demonstrated significant negative correlations with other microstructural parameters (Tb.Sp, Tb.Pf, and SMI) using micro-CT and CBCT (P<0.01). CONCLUSIONS: There was an increase in implant stability prediction by combining BV/TV and SMI in the stepwise forward regression analysis. Bone with high volume density and low surface density shows high implant stability. Well-connected thick bone with small marrow spaces also shows high implant stability. The combination of bone density and architectural parameters measured using CBCT can predict the implant stability more accurately than the density alone in clinical diagnoses.
Bone and Bones ; Bone Density ; Bone Marrow ; Cone-Beam Computed Tomography* ; Dental Implants* ; Diagnosis ; Swine ; X-Ray Microtomography

PURPOSE: This study investigated the effect of amount of thickness reduction on color and translucency of dental monolithic zirconia ceramics. MATERIALS AND METHODS: One-hundred sixty-five monolithic zirconia specimens (16.3 mm x 16.3 mm x 2.0 mm) were divided into 5 groups (Group I to V) according to the number of A2-coloring liquid applications. Each group was then divided into 11 subgroups by reducing the thickness up to 1.0 mm in 0.1-mm increments (Subgroup 0 to 10, n=3). Colors and spectral distributions were measured according to CIELAB on a reflection spectrophotometer. All measurements were performed on five different areas of each specimen. Color difference (DeltaE*(ab)) and translucency parameter (TP) were calculated. Data were analyzed using one-way ANOVA and multiple comparison Scheffe test (alpha=.05). RESULTS: There were significant differences in CIE L* between Subgroup 0 and other subgroups in all groups. CIE a* increased (0.523.7) were obtained between Subgroup 0 and other subgroups. TP values generally increased as the thickness reduction increased in all groups (R2>0.89, P<.001). CONCLUSION: Increasing thickness reduction reduces lightness and increases a reddish, bluish appearance, and translucency of monolithic zirconia ceramics.
Ceramics* ; Prosthesis Coloring

PURPOSE: The aim of this study was to compare the film thicknesses of several resin cements as a function of time after mixing and to examine the effect of working time on the film thicknesses. MATERIALS AND METHODS: The film thickness (microm) of 4 resin cements (n=10), 1 composite resin (Panavia F 2.0), 3 self-adhesive resin (Clearfil SA luting, Zirconite, RelyX U200) cements was measured at 20-second intervals after mixing of the cements up to 200 seconds under a load of 50 N. Linear regression was fitted to verify the effect of working time on the film thickness of each cement. Data were compared to the working time recommended by manufacturers using Wilcoxon test (alpha=.05). RESULTS: All of the materials showed a positive linear correlation between the film thickness and working time. There was no statistically significant difference between the working time based on our results and the values recommended by the manufacturers even though there was a discrepancy between those two values. CONCLUSION: The film thickness of resin cements could increase with the increase of working time. Working time to meet the ISO standard of 50-microm maximum film thickness could be different from the manufacturer's recommended value.
Linear Models ; Resin Cements ; Resins, Synthetic*

PURPOSE: The aim of this study was to determine whether there are monthly and seasonal variations of incidence of subarachnoid hemorrhage (SAH) in Seoul. METHODS: We conducted a cross-sectional, retrospective study on the incidence of SAH using the National Emergency Department Information System (NEDIS) of Korea, a nationwide electronic emergency medical care database. Meteorological data (daily and monthly mean sea level air pressure, daily and monthly mean air temperature, daily temperature range) between January 2010 and December 2010 in Seoul were acquired from the Korea Meteorological Administration. The incidence of SAH in patients visiting the ED was defined as those assigned the following codes of the Korea Standard Classification of Disease, 6th Revision (KCD-6codes): I600-I609. RESULTS: The diurnal variation of the onset of SAH showed two broad peak times from 10 a.m. to 2 p.m. and from 4 p.m. to 7 p.m. There was a clear seasonal variation in the occurrence rate of SAH, which was higher in winter than in any other season. Daily temperature (mean, maximum, and minimum) and mean sea-level barometric pressure were not associated with the occurrence rates of SAH. Univariate analysis showed no significant difference between bleeding days and non-bleeding days for the number of SAH patients. In multivariate analysis, the monthly mean temperature showed significant correlation with the occurrence of SAH. CONCLUSION: This study showed seasonal variation in the onset of SAH. Conduct of further population-based study would be required in order to obtain more precise and valuable information.
Air Pressure ; Classification ; Climate* ; Emergencies ; Emergency Service, Hospital ; Epidemiology ; Hemorrhage ; Humans ; Incidence ; Information Systems ; Korea ; Multivariate Analysis ; Retrospective Studies ; Seasons* ; Seoul ; Subarachnoid Hemorrhage*

PURPOSE: The purpose of this study was to observe the change of viscoelastic properties of dental resin cements during polymerization. MATERIALS AND METHODS: Six commercially available resin cement materials (Clearfil SA luting, Panavia F 2.0, Zirconite, Variolink N, RelyX Unicem clicker, RelyX U200) were investigated in this study. A dynamic oscillation-time sweep test was performed with AR1500 stress controlled rheometer at 32degrees C. The changes in shear storage modulus (G'), shear loss modulus (G"), loss tangent (tan delta) and displacement were measured for twenty minutes and repeated three times for each material. The data were analyzed using one-way ANOVA and Tukey's post hoc test (alpha=0.05). RESULTS: After mixing, all materials demonstrated an increase in G' with time, reaching the plateau in the end. RelyX U200 demonstrated the highest G' value, while RelyX Unicem (clicker type) and Variolink N demonstrated the lowest G' value at the end of experimental time. Tan delta was maintained at some level and reached the zero at the starting point where G' began to increase. The tan delta and displacement of the tested materials showed similar pattern in the graph within change of time. The displacement of all 6 materials approached to zero within 6 minutes. CONCLUSION: Compared to other resin cements used in this study, RelyX U200 maintained plastic property for a longer period of time. When it completed the curing process, RelyX U200 had the highest stiffness. It is convenient for clinicians to cement multiple units of dental prostheses simultaneously.
Dental Prosthesis ; Plastics ; Polymerization* ; Polymers* ; Resin Cements ; Resins, Synthetic* ; Triacetoneamine-N-Oxyl

Dentinogenesis Imperfecta, with a high incidence rate of 1 : 6 - 8000, is inherited by autosomal dominant genetic transmission. This dental disorder causes discoloration of the teeth and the enamel and dentin show hypoplastic or hypocalcified defects which lead to frequent fractures and rapid attrition. Therefore, timely treatment is necessary for the preservation of the remaining teeth. In this particular case, a 19-year-old patient suffering from Type 1 dentinogenesis imperfecta showed signs of brownish hued teeth with multiple fractures, a loss of vertical dimension, excessive interdental space in the maxillary anterior teeth, and a lack of 5 posterior teeth. To improve the esthetic appearance of the anterior teeth, the vertical dimension was increased. Resin caps were used to alleviate the difficulty of taking an impression of multiple teeth at once. Monolithic zirconia materials used in this case showed high fracture strength and the ability to mask the discoloration of the teeth and therefore, functionally and esthetically favorable results were achieved.
Dental Enamel ; Dentin ; Dentinogenesis Imperfecta* ; Humans ; Incidence ; Masks ; Rehabilitation* ; Tooth ; Vertical Dimension ; Young Adult

PURPOSE: The aim of this study was to compare the fracture toughness of currently available resin cements for zirconia restorations and evaluate the effect of water storage on fracture toughness of those resin cements. MATERIALS AND METHODS: Single-edge notched specimens (3 mm x 6 mm x 25 mm) were prepared from three currently available dual cure resin cements for zirconia restorations (Panavia F 2.0, Clearfil SA luting and Zirconite). Each resin cement was divided into four groups: immersed in distilled water at 37degrees C for 1 (Control group), 30, 90, or 180 days (n=5). Specimens were loaded in three point bending at a cross-head speed of 0.1 mm/s. The maximum load at specimen failure was recorded and the fracture toughness (K(IC)) was calculated. Data were analyzed using one-way ANOVA and multiple comparison Scheffe test (alpha=.05). RESULTS: In control group, the mean KIC was 3.41 +/- 0.64 MN.m(-1.5) for Panavia F, 2.0, 3.07 +/- 0.41 MN.m(-1.5) for Zirconite, 2.58 +/- 0.30 MN.m(-1.5) for Clearfil SA luting respectively, but statistical analysis revealed no significant difference between them. Although a gradual decrease of K(IC) in Panavia F 2.0 and gradual increases of KIC in Clearfil SA luting and Zirconite were observed with storage time, there were no significant differences between immersion time for each cement. CONCLUSION: The resin cements for zirconia restorations exhibit much higher K(IC) values than conventional resin cements. The fracture toughness of resin cement for zirconia restoration would not be affected by water storage.
Immersion ; Resin Cements ; Resins, Synthetic* ; Water*

PURPOSE: The purpose of this study was to evaluate various core designs on stress distribution within zirconia crowns. MATERIALS AND METHODS: Three-dimensional finite element models, representing mandibular molars, comprising a prepared tooth, cement layer, zirconia core, and veneer porcelain were designed by computer software. The shoulder (1 mm in width) variations in core were incremental increases of 1 mm, 2 mm and 3 mm in proximal and lingual height, and buccal height respectively. To simulate masticatory force, loads of 280 N were applied from three directions (vertical, at a 45degrees angle, and horizontal). To simulate maximum bite force, a load of 700 N was applied vertically to the crowns. Maximum principal stress (MPS) was determined for each model, loading condition, and position. RESULTS: In the maximum bite force simulation test, the MPSs on all crowns observed around the shoulder region and loading points. The compressive stresses were located in the shoulder region of the veneer-zirconia interface and at the occlusal region. In the test simulating masticatory force, the MPS was concentrated around the loading points, and the compressive stresses were located at the 3 mm height lingual shoulder region, when the load was applied horizontally. MPS increased in the shoulder region as the shoulder height increased. CONCLUSION: This study suggested that reinforced shoulder play an essential role in the success of the zirconia restoration, and veneer fracture due to occlusal loading can be prevented by proper core design, such as shoulder.
Bite Force ; Crowns ; Dental Porcelain ; Dental Prosthesis Design ; Dental Stress Analysis ; Finite Element Analysis ; Molar ; Shoulder ; Software ; Tooth ; Zirconium