Whole-Exome Sequencing in Papillary Microcarcinoma: Potential Early Biomarkers of Lateral Lymph Node Metastasis

Background@#Early identification of patients with high-risk papillary thyroid microcarcinoma (PTMC) that is likely to progress has become a critical challenge. We aimed to identify somatic mutations associated with lateral neck lymph node (LN) metastasis (N1b) in patients with PTMC. @*Methods@#Whole-exome sequencing (WES) of 14 PTMCs with no LN metastasis (N0) and 13 N1b PTMCs was performed using primary tumors and matched normal thyroid tissues. @*Results@#The mutational burden was comparable in N0 and N1b tumors, as the median number of mutations was 23 (range, 12 to 46) in N0 and 24 (range, 12 to 50) in N1b PTMC (P=0.918). The most frequent mutations were detected in PGS1, SLC4A8, DAAM2, and HELZ in N1b PTMCs alone, and the K158Q mutation in PGS1 (four patients, Fisher’s exact test P=0.041) was significantly enriched in N1b PTMCs. Based on pathway analysis, somatic mutations belonging to the receptor tyrosine kinase-RAS and NOTCH pathways were most frequently affected in N1b PTMCs. We identified four mutations that are predicted to be pathogenic in four genes based on Clinvar and Combined Annotation-Dependent Depletion score: BRAF, USH2A, CFTR, and PHIP. A missense mutation in CFTR and a nonsense mutation in PHIP were detected in N1b PTMCs only, although in one case each. BRAF mutation was detected in both N0 and N1b PTMCs. @*Conclusion@#This first comprehensive WES analysis of the mutational landscape of N0 and N1b PTMCs identified pathogenic genes that affect biological functions associated with the aggressive phenotype of PTMC.

Efficacy and Safety of Treatment with Quadruple Oral Hypoglycemic Agents in Uncontrolled Type 2 Diabetes Mellitus: A Multi-Center, Retrospective, Observational Study

BackgroundOnly few studies have shown the efficacy and safety of glucose-control strategies using the quadruple drug combination. Therefore, the aim of the present study was to investigate the usefulness of the quadruple combination therapy with oral hypoglycemic agents (OHAs) in patients with uncontrolled type 2 diabetes mellitus (T2DM).MethodsFrom March 2014 to December 2018, data of patients with T2DM, who were treated with quadruple hypoglycemic medications for over 12 months in 11 hospitals in South Korea, were reviewed retrospectively. We compared glycosylated hemoglobin (HbA1c) levels before and 12 months after quadruple treatment with OHAs. The safety, maintenance rate, and therapeutic patterns after failure of the quadruple therapy were also evaluated.ResultsIn total, 357 patients were enrolled for quadruple OHA therapy, and the baseline HbA1c level was 9.0%±1.3% (74.9±14.1 mmol/mol). After 12 months, 270 patients (75.6%) adhered to the quadruple therapy and HbA1c was significantly reduced from 8.9%±1.2% to 7.8%±1.3% (mean change, −1.1%±1.2%; PPConclusionThis study shows the therapeutic efficacy of the quadruple OHA regimen T2DM and demonstrates that it can be an option for the management of T2DM patients who cannot use insulin or reject injectable therapy.

Novel Animal Model of Oral Dysphagia Following Hemiglossectomy / 대한연하장애학회지

Objective@#This study aimed to establish an animal model of oral dysphagia for translational research purposes. @*Methods@#Four week old C57BL/6 mice were randomized to a surgical partial glossectomy group (horizontal resection, n=13 vs. vertical resection, n=15) and a nonsurgical group (control, n=7). The survival rate, mouse weight, amount of food, and water consumption were compared. Comparisons were made using a Kruskall Wallis test, and survival was analyzed using Kaplan-Meier method. @*Results@#Eleven of the 13 (84.6%) horizontal resection animals and 11 of the 15 (73.3%) vertical resection animals survived to the study endpoint. Compared to the non-surgical control mice, the mice that had undergone a horizontal and vertical resection had a significantly lower mean body weight (P＜0.05) during experimental day (ED) 5, with the greatest dysphagia observed in ED 2. The horizontal resection-type mice showed greater mean body weight loss and food consumption in the early stages of the experiment than the vertical resection-type mice. In contrast, the horizontal resection-type mice showed greater body weight gain and food consumption in the late stages of the experiment. @*Conclusion@#This study provides novel evidence that the proper timing for an animal model of oral dysphagia was within ED 5; severe dysphagia was observed in ED 2. The horizontal-type partial glossectomy had a better survival rate than the vertical-type model. Furthermore, the prolonged dysphagia model mimics the vertical resection-type mice.

Efficacy and Safety of Treatment with Quadruple Oral Hypoglycemic Agents in Uncontrolled Type 2 Diabetes Mellitus: A Multi-Center, Retrospective, Observational Study

BackgroundOnly few studies have shown the efficacy and safety of glucose-control strategies using the quadruple drug combination. Therefore, the aim of the present study was to investigate the usefulness of the quadruple combination therapy with oral hypoglycemic agents (OHAs) in patients with uncontrolled type 2 diabetes mellitus (T2DM).MethodsFrom March 2014 to December 2018, data of patients with T2DM, who were treated with quadruple hypoglycemic medications for over 12 months in 11 hospitals in South Korea, were reviewed retrospectively. We compared glycosylated hemoglobin (HbA1c) levels before and 12 months after quadruple treatment with OHAs. The safety, maintenance rate, and therapeutic patterns after failure of the quadruple therapy were also evaluated.ResultsIn total, 357 patients were enrolled for quadruple OHA therapy, and the baseline HbA1c level was 9.0%±1.3% (74.9±14.1 mmol/mol). After 12 months, 270 patients (75.6%) adhered to the quadruple therapy and HbA1c was significantly reduced from 8.9%±1.2% to 7.8%±1.3% (mean change, −1.1%±1.2%; PPConclusionThis study shows the therapeutic efficacy of the quadruple OHA regimen T2DM and demonstrates that it can be an option for the management of T2DM patients who cannot use insulin or reject injectable therapy.

Management of Hyperglycemia in Diabetic Kidney Disease / 임상당뇨병

Diabetes has reached epidemic proportions in Korea and worldwide, and is associated with increased risk for chronic kidney disease (CKD) and end-stage kidney disease (ESKD). Given the increasing prevalence of diabetes and its high morbidity and mortality, diabetic kidney disease (DKD) represents a serious concern in individual patients and a considerable socioeconomic burden. The kidneys contribute to glucose homeostasis through processes of gluconeogenesis, glucose filtration, glucose reabsorption, and glucose consumption. Decreased nephron mass and kidney dysfunction due to DKD progression lead to the complicated state that causes both hypoglycemia and hyperglycemia. Appropriate management tailored for DKD patients is required to improve their morbidity and mortality. This review focuses on special issues related to the management of DKD, including clinical kidney outcomes in DKD progression, glycemic control indices and targets for diabetes mellitus (DM) CKD, glucose management of advanced DM CKD or ESKD and tailored medications for DKD based on clinical evidence.

Tensile bond strength of chairside reline resin to denture bases fabricated by subtractive and additive manufacturing / 대한치과보철학회지

Purpose@#The purpose of this study was to compare and evaluate the tensile bond strength of chairside reline resin to denture base resin fabricated by different methods (subtractive manufacturing, additive manufacturing, and conventional heat-curing). @*Materials and methods@#Denture base specimens were fabricated as cuboid specimens with a width of 25 mm × length 25 mm × height 3 mm by subtractive manufacturing (VITA VIONIC BASE), additive manufacturing (NextDent Base) and conventional heat-curing (Lucitone 199). After storing the specimens in distilled water at 37°C for 30 days and drying them, they were relined with polyethyl methacrylate (PEMA) chairside reline resin (REBASE II Normal). The subtractive and additive manufacturing groups were set as the experimental group, and the heat-curing group was set as the control group. Ten specimens were prepared for each group. After storing all bound specimens in distilled water at 37°C for 24 hours, the tensile bond strength between denture bases and chairside reline resin was measured by a universal testing machine at a crosshead speed of 10 mm/min. The fracture pattern of each specimen was analyzed and classified into adhesive failure, cohesive failure, and mixed failure. Tensile bond strength, according to the fabrication method, was analyzed by 1-way ANOVA and Bonferroni’s method (α =.05). @*Results@#Mean tensile bond strength of the heat-curing group (2.45 ± 0.39 MPa) and subtractive manufacturing group (2.33 ± 0.39 MPa) had no significant difference (P>.999). The additive manufacturing group showed significantly lower tensile bond strength (1.23 ± 0.36 MPa) compared to the other groups (P<.001). Most specimens of heat-curing and subtractive manufacturing groups had mixed failure, but mixed failure and adhesive failure showed the same frequency in additive manufacturing group. @*Conclusion@#The mean tensile bond strength of the subtractive manufacturing group was not significantly different from the heat-curing group. The additive manufacturing group showed significantly lower mean tensile bond strength than the other two groups.

Efficacy and Safety of Treatment with Quadruple Oral Hypoglycemic Agents in Uncontrolled Type 2 Diabetes Mellitus: A Multi-Center, Retrospective, Observational Study

Background@#Only few studies have shown the efficacy and safety of glucose-control strategies using the quadruple drug combination. Therefore, the aim of the present study was to investigate the usefulness of the quadruple combination therapy with oral hypoglycemic agents (OHAs) in patients with uncontrolled type 2 diabetes mellitus (T2DM). @*Methods@#From March 2014 to December 2018, data of patients with T2DM, who were treated with quadruple hypoglycemic medications for over 12 months in 11 hospitals in South Korea, were reviewed retrospectively. We compared glycosylated hemoglobin (HbA1c) levels before and 12 months after quadruple treatment with OHAs. The safety, maintenance rate, and therapeutic patterns after failure of the quadruple therapy were also evaluated. @*Results@#In total, 357 patients were enrolled for quadruple OHA therapy, and the baseline HbA1c level was 9.0%±1.3% (74.9± 14.1 mmol/mol). After 12 months, 270 patients (75.6%) adhered to the quadruple therapy and HbA1c was significantly reduced from 8.9%±1.2% to 7.8%±1.3% (mean change, –1.1%±1.2%; P<0.001). The number of patients with HbA1c <7% increased significantly from 5 to 68 (P<0.005). In addition, lipid profiles and liver enzyme levels were also improved whereas no changes in body weight. There was no significant safety issue in patients treated with quadruple OHA therapy. @*Conclusion@#This study shows the therapeutic efficacy of the quadruple OHA regimen T2DM and demonstrates that it can be an option for the management of T2DM patients who cannot use insulin or reject injectable therapy.

Efficacy and Safety of Pioglitazone versus Glimepiride after Metformin and Alogliptin Combination Therapy: A Randomized, Open-Label, Multicenter, Parallel-Controlled Study

BACKGROUND: There is limited information regarding the optimal third-line therapy for managing type 2 diabetes mellitus (T2DM) that is inadequately controlled using dual combination therapy. This study assessed the efficacy and safety of pioglitazone or glimepiride when added to metformin plus alogliptin treatment for T2DM.METHODS: This multicenter, randomized, active-controlled trial (ClinicalTrials.gov: NCT02426294) recruited 135 Korean patients with T2DM that was inadequately controlled using metformin plus alogliptin. The patients were then randomized to also receive pioglitazone (15 mg/day) or glimepiride (2 mg/day) for a 26-week period, with dose titration was permitted based on the investigator's judgement.RESULTS: Glycosylated hemoglobin levels exhibited similar significant decreases in both groups during the treatment period (pioglitazone: −0.81%, P<0.001; glimepiride: −1.05%, P<0.001). However, the pioglitazone-treated group exhibited significantly higher high density lipoprotein cholesterol levels (P<0.001) and significantly lower homeostatic model assessment of insulin resistance values (P<0.001). Relative to pioglitazone, adding glimepiride to metformin plus alogliptin markedly increased the risk of hypoglycemia (pioglitazone: 1/69 cases [1.45%], glimepiride: 14/66 cases [21.21%]; P<0.001).CONCLUSION: Among patients with T2DM inadequately controlled using metformin plus alogliptin, the addition of pioglitazone provided comparable glycemic control and various benefits (improvements in lipid profiles, insulin resistance, and hypoglycemia risk) relative to the addition of glimepiride.

Association between Serum Free Thyroxine and Anemia in Euthyroid Adults: A Nationwide Study

BACKGROUND: Studies on the relationship between thyroid function and anemia in the euthyroid range are scarce. We aimed to evaluate the association between anemia and serum free thyroxine (fT4) and thyrotropin (TSH) in euthyroid adults.METHODS: Data on 5,352 participants aged ≥19 years were obtained from the Korea National Health and Nutrition Examination Survey VI (2013 to 2015). Anemia was defined as hemoglobin (Hb) <13 and <12 g/dL for men and women, respectively.RESULTS: Overall, 6.1% of participants had anemia, and more women (9.9%) had anemia than men (2.8%, P<0.001). In multivariate analysis, serum fT4 levels, but not TSH, were positively associated with serum Hb levels in both sexes (P<0.001, each). Serum Hb levels linearly reduced across decreasing serum fT4 quartile groups in both sexes (P<0.001, each). After adjusting for potential confounding factors, participants with low-normal fT4 had 4.4 (P=0.003) and 2.8 times (P<0.001) higher risk for anemia than those with high-normal fT4 among men and women, respectively. When participants were divided into two groups at 50 years of age, in younger participants, men and women with the first quartile were at higher risk of anemia than men with the second quartile (odds ratio [OR], 3.3; P=0.029) and women with the forth quartile (OR, 3.2; P<0.001), respectively. This association was not observed in older participants.CONCLUSION: These results suggest that a low-normal level of serum fT4 was associated with a lower serum Hb level and a higher risk of anemia in euthyroid adults, especially in younger participants.

Effect of accelerated aging on long-term accuracy of full arches manufactured using various 3-dimensional printers / 대한치과재료학회지

Full arch models play an important role in clear aligner orthodontic therapy and the preparation of prosthodontic appliances. Three dimensional (3D) printed full arches are very popular with the benefit of easy production and good mechanical properties for fabricating clear aligner. However, the accuracy of 3D printed full arches after long storage have not been proved yet. The objective of this study was to estimate the long-term accuracy of 3D full arches produced by the four types of 3D printers (stereo-lithography apparatus (SLA), digital light projector (DLP), Polyjet™ (POL), and fused deposition modeling (FDM)) following an accelerated aging treatment. The highest accuracy was produced by POL (before treatment) and SLA (after treatment) group, respectively. Comparisons between absolute mean trueness for the 3D printed full arches before and after treatment indicated that the deviation of the trueness values of FDM group were significantly higher than those of other experimental groups (p<0.05). In addition, all trueness relative errors for FDM group were greater than 0.04 after treatment, which was high compared to those of other experimental groups. Therefore, the long-term storage of full arches fabricated by FDM type 3D printer is not recommended and the 3D printed full arches should be used immediately whenever possible.

The Relationship between Thyroid Function and Different Obesity Phenotypes in Korean Euthyroid Adults

BACKGROUND: Thyroid disease and metabolic syndrome are both associated with cardiovascular disease. The aim of this study was to investigate the correlation between thyroid hormones and obesity sub-phenotypes using nationwide data from Korea, a country known to be iodine replete.METHODS: This study was based on data obtained from the sixth Korea National Health and Nutrition Examination Survey, administered from 2013 to 2015. A total of 13,873 participants aged ≥19 years were included, and classified into four groups: metabolically healthy non-obesity (MHNO), metabolically healthy obesity (MHO), metabolically unhealthy non-obesity (MUNO), and metabolically unhealthy obesity (MUO) by body fat on the basis of body mass index and metabolic health.RESULTS: At baseline, serum free thyroxine (fT4) values were significantly higher in the MHNO phenotype (MHNO, 1.27±0.01 ng/dL; MHO, 1.25±0.01 ng/dL; MUNO, 1.24±0.01 ng/dL; MUO, 1.24±0.01 ng/dL, P<0.001) in total study population. However, this significant association no longer remained after adjustment for age, urine iodine concentration, and smoking (P=0.085). After adjustment for confounders, statistically significant association was observed between lower thyroid stimulating hormone (TSH) and MHNO phenotype (P=0.044). In men participants (not women), higher fT4 values were significantly associated with MHNO phenotype (P<0.001). However, no significant association was observed between thyroid function (TSH or fT4) and obesity phenotypes in groups classified by age (cutoff age of 55 years).CONCLUSION: Although there was a difference by age and sex, we found that the decrease of TSH and the increase of fT4 values were associated with MHNO.

Comparison of marginal and internal discrepancies of zirconia crowns fabricated by various digital scan methods / 대한치과재료학회지

In this study, marginal and internal discrepancies of zirconia crowns fabricated with the CAD/CAM (computer aided design

Management of Hyperglycemia in Type 2 Diabetes: A Summary of New Consensus Report from the American Diabetes Association and the European Association for the Study of Diabetes in 2018 / 임상당뇨병

In 2018, the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD) published a consensus recommendation on management of hyperglycemia. This consensus report emphasized the need for patient-centered management considering multimorbidity and individual patient preferences and barriers. Patients with type 2 diabetes with established atherosclerotic cardiovascular disease who fail to control blood glucose with the initial glucose-lowering medication are recommended a sodium-glucose cotransporter 2 (SGLT2) inhibitor or a glucagon-like peptide 1 (GLP-1) receptor agonist. For patients with chronic kidney disease and heart failure, SGLT2 inhibitors are recommended. In patients who need an injectable medication, GLP-1 receptor agonists are the preferred choice over insulin. In this section, we summarize “Management of Hyperglycemia in Type 2 Diabetes, 2018. A Consensus Report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD).”

Comparative evaluation of marginal and internal fit of metal copings fabricated by various CAD/CAM methods / 대한치과보철학회지

PURPOSE: The purpose of the present study was to compare the accuracy of four different metal copings fabricated by CAD/CAM technology and to evaluate clinical effectiveness. MATERIALS AND METHODS: Composite resin tooth of the maxillary central incisor was prepared for a metal ceramic crown and duplicated metal die was fabricated. Then scan the metal die for 12 times to obtain STL files using a confocal microscopy type oral scanner. Metal copings with a thickness of 0.5 mm and a cement space of 50 µm were designed on a CAD program. The Co-Cr metal copings were fabricated by the following four methods: Wax pattern milling & Casting (WM), Resin pattern 3D Printing & casting (RP), Milling & Sintering (MS), Selective laser melting (SLM). Silicone replica technique was used to measure marginal and internal discrepancies. The data was statistically analyzed with One-way analysis of variance and appropriate post hoc test (Scheffe test) (α=.05). RESULTS: Mean marginal discrepancy was significantly smaller in the Group WM (27.66 ± 9.85 µm) and Group MS (28.88 ± 10.13 µm) than in the Group RP (38.09 ± 11.14 µm). Mean cervical discrepancy was significantly smaller in the Group MS than in the Group RP. Mean axial discrepancy was significantly smaller in the Group WM and Group MS then in the Group RP and Group SLM. Mean incisal discrepancies was significantly smaller in the Group RP than in all other groups. CONCLUSION: The marginal and axial discrepancies of the Co-Cr coping fabricated by the Wax pattern milling and Milling/Sintering method were better than those of the other groups. The marginal, cervical and axial fit of Co-Cr copings in all groups are within a clinically acceptable range.

Influence of CYP2D6 Polymorphism on the Pharmacokinetic/Pharmacodynamic Characteristics of Carvedilol in Healthy Korean Volunteers

BACKGROUND: Carvedilol is commonly used to treat hypertension as a β- and α1-adrenoreceptor blocker, but it is metabolized by CYP2D6, and CYP2D6*10 allele is dominant in Asian population. The objective of this study was to assess the influence of CYP2D6 polymorphisms on the pharmacokinetic (PK) and pharmacodynamic (PD) characteristics of carvedilol in healthy Korean volunteers. METHODS: A PK/PD study for a single and multiple dosing of carvedilol were conducted. All volunteers in 3 genotypic groups received single oral dose of carvedilol 12.5 mg for 3 days, then 25 mg QD for 5 days, and 12.5 mg QD for another 3 days. PK parameters for carvedilol and its three metabolites were determined using non-compartmental analysis. For PD properties, blood pressure, heart rate, and the chronotropic dose 25 (CD25) value were obtained. RESULTS: The IM_2 group with two *10 alleles (intermediate metabolizers) exhibited lower clearance of carvedilol as well as higher area under the curve (AUC) for O-desmethyl carvedilol. The ratio of CD25 to baseline at multiple dosing was significantly higher in the combined IM group (IM_1 and IM_2) than in the EM group, however, the ratio of CD25 after single and multiple dosing and the other PD markers were not significantly different between the 3 genotypic groups compared with the baseline. CONCLUSION: These findings showed that CYP2D6 genotype influenced the PK characteristics of carvedilol and no differences in PD response were observed in Korean healthy volunteers. Registered at the ClinicalTrials.gov, NCT02286934.

Prevalence of BRAF(V600E) Mutation in Follicular Variant of Papillary Thyroid Carcinoma and Non-Invasive Follicular Tumor with Papillary-Like Nuclear Features (NIFTP) in a BRAF(V600E) Prevalent Area

BACKGROUND: BRAF V600E mutation status and prevalence of non-invasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP) has not yet been reported in Korea. The aim of this study was to investigate the significance of the BRAF V600E mutation in the follicular variant of papillary thyroid carcinoma (FVPTC) and to determine the prevalence of NIFTP in BRAF V600E mutation-prevalent Korean patients. METHODS: This study retrospectively analyzed 1,417 consecutive patients who underwent total thyroidectomy with routine prophylactic central lymph node dissection for papillary thyroid carcinoma (PTC). BRAF V600E mutation analysis was performed routinely using multiplex polymerase chain reaction by applying dual priming oligonucleotide. Clinicopathological characteristics and ultrasonographic findings were compared between BRAF V600E mutation-positive and -negative groups for FVPTC. Pathologists reviewed the pathology slides according to consensus diagnostic criteria for the encapsulated FVPTC and NIFTP. RESULTS: The prevalence of the BRAF V600E mutation in all subtypes of PTC was 61.0% (861/1,411). FVPTC presented a BRAF V600E mutation rate of 27.3%. The FVPTC patients with BRAF V600E mutation were older than those with no BRAF V600E mutation (P = 0.021). The prevalence of NIFTP was 0.18% among all PTC patients (2/1,411) and the proportion of NIFTP among FVPTC was 9.1% (2/22). CONCLUSION: The BRAF V600E mutation is prevalent in Korean patients with FVPTC in a region with high frequency of the BRAF V600E mutation and very low prevalence of NIFTP compared with that reported in western studies.

Development of the Three-Dimensional Perfusion Culture Technology for the Salivary Ductal Cells

BACKGROUND AND OBJECTIVES: Salivary hypofunction is one of the common side effects after radioiodine therapy, and its pathophysiology is salivary ductal stenosis resulting from ductal cell injury. This study aimed to develop the functional culture environment of human parotid gland ductal cells in in vitro three-dimensional perfusion culture system. MATERIALS AND METHODS: We compared plastic dish culture method and three-dimensional culture system containing Matrigel and nanofiber. Morphogenesis of reconstituted salivary structures was assessed by histomorphometry. Functional characteristics were assessed by immunohistochemistry and reverse transcription polymerase chain reaction (aquaporin 5, CK7, CK18, connexin 43, and p21). In addition, we designed the media perfusion culture system and identified higher rate of cell proliferation and expression of connexin 43 in perfusion system comparing to dish. RESULTS: Human parotid ductal cells were well proliferated with the ductal cell characters under environment with Matrigel. In the presence of Matrigel, aquaporin 5, CK18 and connexin 43 were more expressed than 2D dish and 3D nanofiber setting. In the media perfusion culture system, ductal cells in 3D culture media showed higher cells count and connexin 43 expression compared to 2D dish. CONCLUSION: This in vitro ductal cell perfusion culture system using Matrigel could be used to study for radioiodine induced sialadenitis model in vivo.

Comparison of Three-Dimensional Accuracy between Digital Models Obtained from Impression Scan and Model Scan / 대한치과재료학회지

The purpose of the study is to compare and analyze the accuracy of digital images obtained from impression and stone model with model scanner and to find out clinical effectiveness. A mandibular left first molar composite resin tooth was made for abutment. Digital models were obtained with a same model scanner(Ceramill Map 400, Amann Girrbach, Austria); (1) Fabricated resin model was scanned(Group C). (2) 10 impressions were taken with putty and polyvinyl siloxane, then were scanned (Group I). (3) Type IV stone was poured in each impressions made in step(2) and 10 stone models were scanned(Group S). 3 dimensional super-impositional program (Geomagic control X, 3D Systems, USA) was used to analyze the STL files. Stone model scan(Group S) showed lower deviation than impression scan(Group I) compared to the control group(P < 0.001). Both Group I and Group S showed signs of expansion in the occlusion surface and margin surface while showing contraction in the axial surface. The deviations were smaller in order of occlusal plane, horizontal plane of margin and axial plane. Within the limited boundary of this study, the digital model obtained from stone model scan showed smaller deviation than the digital model obtained from impression scan.

The evaluation of the shear bond strength between various Hybrid CAD/CAM restorative materials and repairing composite resins / 대한치과재료학회지

The purpose of this study was to evaluate the shear bond strengths between various hybrid computer-aided design (CAD)/computer-aided manufacturing (CAM) restorative materials and repairing resin. Two resin network-based hybrid (Lava Ultimate and Polyglass), one ceramic framework-based hybrid (Enamic), and one zirconia (Zenotec Zr bridge) CAD/CAM restorative materials were used in this study. The shear bond strength test and failure modes of four experimental groups designated LUS (Lava Ultimate), ENA (Enamic), PGB (Polyglass), and ZBR (zirconia control group) were characterized in this study. The hybrid CAD/CAM restorative materials showed stronger shear bond strengths in the sequence of PGB, LUS, and ENA (P < 0.05). The shear bond strengths of PGB and LUS groups showed significantly higher than those of ZBR (P < 0.05), while ENA did not show any significant difference from ZBR (P < 0.05). The PEG and LUS groups mostly exhibited cohesive failure, but the ENA and ZBR groups predominantly showed adhesive failure. Therefore, resin network-based hybrid CAD/CAM restorative materials such as Lava Ultimate and Polyglass should be more useful for intra-oral repairs.

Effects of CYP2C19 Genetic Polymorphisms on PK/PD Responses of Omeprazole in Korean Healthy Volunteers

The aim of this study was to examine the effects of CYP2C19*2 and *3 genetic polymorphisms on omeprazole pharmacokinetic (PK) and pharmacodynamic (PD) responses. Twenty-four healthy Korean volunteers were enrolled and given 20 mg omeprazole orally once daily for 8 days. The genotypes of CYP2C19 single nucleotide polymorphisms (SNPs) (*2, *3, and *17) were screened. The plasma concentrations of omeprazole, omeprazole sulfone, and 5-hydroxy (5-OH) omeprazole were determined by liquid chromatography with tandem mass spectrometry (LC-MS/MS). The noncompartmental method was used for the determination of PK parameters. Change of mean pH and proportion (%) of time of gastric pH above 4.0 were estimated. The poor metabolizer (PM) group had the lowest metabolic ratio and exhibited the highest area under the curve (AUC) for omeprazole among the CYP2C19 phenotype groups. The PM group showed the greatest change of mean pH and the highest % time of gastric pH above 4.0. The relationship between AUC of omeprazole and % time of gastric pH above 4.0 was confirmed. The study demonstrates that CYP2C19*2 and *3 influence the PKs and PDs of omeprazole in Korean healthy volunteers. Clinical trial registry at the U.S. National Institutes of Health (https://clinicaltrials.gov), number NCT02299687.