Marginal and internal fit of 3D printed provisional crowns according to build directions

PURPOSE@#. This study aimed to fabricate provisional crowns at varying build directions using the digital light processing (DLP)-based 3D printing and evaluate the marginal and internal fit of the provisional crowns using the silicone replica technique (SRT). MATERIALS AND METHODS. The prepared resin tooth was scanned and a single crown was designed using computer-aided design (CAD) software. Provisional crowns were printed usinga DLP-based 3D printer at 6 directions (120°, 135°, 150°, 180°, 210°, 225°) with 10 crowns in each direction. In total, sixty crowns were printed. To measure the marginal and internal fit, a silicone replica was fabricated and the thickness of the silicone impression material was measured using a digital microscope. Sixteen reference points were set and divided into the following 4 groups: marginal gap (MG), cervical gap (CG), axial gap (AG),and occlusal gap (OG). The measurements were statistically analyzed using one-way ANOVA and Dunnett T3. @*RESULTS@#MG, CG, and OG were significantly different by build angle groups (P<.05). The MG and CG were significantly larger in the 120° group than in other groups. OG was the smallest in the 150° and 180° and the largest in the 120° and 135° groups. @*CONCLUSION@#The marginal and internal fit of the 3D-printed provisional crowns can vary depending on the build angle and the best fit was achieved with build angles of 150°and 180°

Brain Stimulation and Modulation for Autism Spectrum Disorder / 한양의대학술지

Autism spectrum disorder (ASD) is characterized by a range of conditions including impairments in social interaction, communication, and restricted and repetitive behaviors. Pharmacological treatments can improve some symptoms of ASD, but the effect is limited and there is a huge unmet demand for successful interventions of ASD. Brain stimulation and modulation are emerging treatment options for ASD: electroconvulsive therapy for catatonia in ASD, vagal nerve stimulation for comorbid epilepsy and ASD, and deep brain stimulation for serious self-injurious behavior. Therapeutic tools are evolving to mechanism-driven treatment. Excitation/Inhibition (E/I) imbalance alters the brain mechanism of information processing and behavioral regulation. Repetitive transcranial magnetic stimulation can stabilize aberrant neuroplasticity by improving E/I balance. These brain stimulation and modulation methods are expected to be used for exploration of the pathophysiology and etiology of ASD and might facilitate the development of a mechanism-driven solution of core domains of ASD in the future.

Immune tolerance induction in patients with severe hemophilia A with inhibitors

BACKGROUND: Inhibitory antibodies to factor VIII (FVIII) are an important complication when managing patients with hemophilia A. Immune tolerance induction (ITI) has been regarded as a useful method for eradicating inhibitors. We report the results of a retrospective study in Korean patients with hemophilia A who underwent ITI. METHODS: We reviewed the records of patients with hemophilia A with inhibitors who underwent ITI from March 2004 to December 2014. ITI was started with FVIII concentrates at 100 IU/kg, 3 times per week. The dose of FVIII was reduced according to the inhibitor titer and recovery of FVIII. Inhibitor elimination was defined as the time taken to achieve a negative inhibitor assay with no anamnestic response and normal FVIII recovery and/or normal half-life. RESULTS: In total, 17 patients with severe hemophilia A were evaluated. Complete tolerance was achieved in 14 of 17 patients (83%). The mean peak inhibitor titer before ITI was 38.4 BU/mL. The mean treatment duration was 26.2 months. The mean duration between inhibitor detection and ITI was 5.1 years in the complete tolerance group and 10.8 years in the partial tolerance and failed group. CONCLUSION: This study shows that ITI can be an effective and well-tolerated method for eradicating inhibitors. Possible influencing factors for ITI success were age at the start of ITI treatment and duration after inhibitor detection. More research to provide further insight about other factors and conditions is needed.

Recurrent Gastric Perforation in a Neonate Recovered after Primary Surgical Repair and Percutaneous Peritoneal Drainage / 대한주산의학회잡지

Neonatal gastric perforation is a rare but fatal disease, occurred mainly in preterm infants. In general, primary surgical repair is the main treatment. To the best of our knowledge, there has been only one report of improvement of gastric perforation in neonates after percutaneous peritoneal drainage alone. We describe a case of gastric perforation in a premature extremely low-birth-weight infant girl of 25(+4) weeks gestational age. We present this case to emphasize that gastric perforation may improve with percutaneous peritoneal drainage.

The Pre-stroke Bone Mineral Density in First Stroke Patients

OBJECTIVE: To evaluate pre-stroke bone mineral density (BMD) of the patients with first stroke events. We previously reported that pre-stroke BMD of first stroke patients with severe immobility were relatively lower than those of normal population. In current study, we evaluated pre-stroke BMD of patients in first stroke patients regardless of severity or type of stroke. METHOD: The 121 patients with first stroke events were included. To reflect pre-stroke BMD, patients who had bone densitometry scans within the first thirty days from onset were chosen. The BMDs of the lumbar spine and both femurs (total hip and femoral neck) were examined. RESULTS: Among the 121 stroke patients, 56.2% were osteoporotic and 28.1% were osteopenic. In the female patients, 78.1% were osteoporotic and 20.5% were osteopenic. In the male patients, 22.9% were osteoporotic and 39.6% were osteopenic. CONCLUSION: Patients with first stroke events showed a high prevalence of pre-stroke low BMD. In the acute stages of stroke, bone loss progression is rapid. Therefore, such a high prevalence of pre-stroke low BMD can bring on a greater risk of fractures and additional functional loss. Early screening and active intervention of osteoporosis including patient education from the acute stages of stroke is crucial.

Refractures after Operative Fixation in Severe Spastic Cerebral Palsy: A case report

Patients with severe cerebral palsy (CP) are susceptible to bone fractures due to low bone mineral density, deformity from contracture and developmental disability. We experienced a 12-year-old spastic CP female who sustained recurrent fracture of the right femur. The first episode occurred when she had been moved passively by another child in residential care. She underwent operative treatment with plate fixation, but seventeen days after operation, spasticity of legs aggravated and refracture happened at the fixation site. She underwent re-operative fixation, but at three days after the second operation, she sustained another fracture at the top of the plate, for which she underwent the third operation. She was then referred to our department for scissoring patterns of the lower extremities. We performed bilateral obturator nerve block which relieved patient's spasticity. We think that her recurrent fracture may be related with ignored risk factor of refracture such as uncontrolled spasticity.