Full mouth rehabilitation of patient with severe dental caries with implant fixed prosthesis fabricated with milling and 3D printing method: A case report / 대한치과보철학회지

Passive fit of prosthesis is an essential property of implant supported prosthesis for long term success and minimization of complications. And the property is determined mostly by fabrication procedure. There were limitations of extensive implant prosthesis because conventional casting method generate contraction error of long span prosthesis. However, Computer-aided design/Computer-aided manufacturing (CAD/CAM) technology of 3D printing and milling metal framework can overcome those limitations. This case is a full mouth rehabilitation using extensive implant fixed prosthesis. Removable interim prosthesis was made for esthetic, functional evaluation and a guide for implant insertion. After the insertion, implant fixed interim prosthesis was delivered. After additional evaluation and adjustment, final prosthesis was designed with CAD, the fabricated with CAM. Milling technique was used for anterior screw type implant superstructure and 3D printing technique was used for the anterior and posterior implant copings. Fit of the final restoration was favorable. The practitioner and patient were both esthetically and functionally satisfied with the final result.

Prevalence of Respiratory Viral Infections in Korean Adult Asthmatics With Acute Exacerbations: Comparison With Those With Stable State

PURPOSE: Viral infections are involved in ~50% of exacerbations among Caucasian adult asthmatics. However, there have been few reports on the causative virus of exacerbations in Korean adult asthmatics. Thus, we compared frequencies and types of viruses between lower respiratory tract illnesses (LRTIs) with exacerbations (exacerbated LRTIs) and those without exacerbations (stable LRTIs) to evaluate contribution of respiratory viruses to exacerbations. METHODS: Viral RNA was extracted from sputum using the Viral Gene-spin™ Kit. Reverse transcription-polymerase chain reaction (RT-PCR) was performed to detect adenovirus (ADV), metapneumovirus (MPV), parainfluenza virus (PIV) 1/2/3, influenza virus (IFV) A, IFV B, respiratory syncytial virus (RSV) A/B, and rhinovirus (RV) A. RESULTS: Among the 259 patients, 210 underwent a single sputum examination, and the remaining 49 underwent 2 to 4 sputum examinations. Virus was detected in 68 of the 259 exacerbated episodes and in 11 of the 64 stable episodes. Among the exacerbated episodes, RV was the most frequently detected virus, followed by influenza A, parainfluenza, RSV A/B, and ADV. Among the 11 stable episodes, RV was most frequently detected. Detection rates of these viruses did not differ between the 2 groups (P>0.05). Thirty-five patients underwent the virus examination at 2 episodes of exacerbation, while 14 patients underwent at each time of exacerbated and stable episodes. Virus detection rate at the second examination was significantly higher in cases with 2 exacerbation episodes than in those with initial exacerbation and sequential stable episodes (P=0.003). A seasonal pattern was noted in the detection rates of RV (September to December), IFV (January to April), PIV (May to September), and RSV A/B (September to April). CONCLUSIONS: Respiratory viruses were identified in approximately 20% of LRTI irrespective of the presence of asthma exacerbation. RV and IFV A/B were most frequently detected. A group of patients experienced frequent viral infections followed by asthma exacerbations.

Naltrexone influences protein kinase C epsilon and integrin alpha7 activity in SH-SY5Y neuroblastoma cells

Alcohol influences the neuroadaptation of brain cells where receptors and enzymes like protein kinase C (PKC) exist. Naltrexone acts on opioid receptors. However, other mechanisms of action remain unknown. We prepared SH-SY5Y neuroblastoma cells, and fed them with 150 mM ethanol for 72 h followed by treatment with naltrexone for 24 h. We performed microarray analysis and reverse transcriptase-polymerase chain reaction. Our results showed that PKC epsilon increased 1.90 times and showed an overall decreasing pattern as time increased. Phosphorylated ERK also increased 2.0 times according to the change of PKC epsilon. Integrin alpha7 increased 2.32 times and showed an increasing pattern as time increased. In conclusion, naltrexone influences PKC epsilon neuronal signaling system and endothelial adhesion molecule integrin alpha7 in addition to the well-known opioid system.

An Association of Serum Cholesterol, Triglycerides, and Impulsiveness in Adolescents / 신경정신의학

OBJECTIVES: Many studies have shown an association between low serum cholesterol concentration and impulsive aggressive behaviors. Recent studies reported that serum triglycerides concentration has been independently associated with impulsive aggressive behaviors regardless of serum cholesterol concentration. However, conflicting results have also been reported. This study was designed to find the relationship between serum lipid levels (cholesterol and triglycerides) and impulsiveness in adolescents. METHODS: Serum cholesterol concentration, serum triglycerides concentration, complete blood count, electrolytes, liver function test, and blood sugar level were measured by overnight fasting blood sampling and urinalysis was also conducted in 450 high school students. Impulsiveness level was measured by Barratt impulsiveness scale(BIS). Serum cholesterol was measured by standard enzymatic assay and serum triglycerides was measured by Boehringer Mannheim method. RESULTS: 1) The cholesterol concentration in high impulsiveness group was found to be significantly lower compared with low impulsiveness group both in male and female separately. Especially, the lower cholesterol concentration was associated with motor impulsiveness, a subscale of BIS. 2) The triglycerides concentration in high impulsiveness group was found to be higher compared with the triglycerides concentration in low impulsiveness group. Above results were still valid even after exclu-ding the factor of sex and of body mass index. CONCLUSION: These results suggest that low cholesterol concentration is associated with an increased impulsiveness, and there is a relationship between serum triglycerides concentration and impulsiveness. These results support the previous hypothesis that serum lipid levels(cholesterol and triglycerides) affect brain serotonin level and human psychologic characteristics.

The Effect of 30 Min Pre-treatment with Continuous Lidocaine Infusion on Propofol-induced Pain / 대한마취과학회지

BACKGROUND: Pain on injection is one of the major disadvantages of propofol. To solve this problem, many investigations have been done. We postulated that the duration of pre-treatment of local anesthetics might affect the incidence and nature of injection pain. METHODS: Seventy seven patients were involved in our study. They were divided into control group (group C, n = 25); pre-treatment with normal saline and study group (n = 52); pre-treatment with 0.1% lidocaine 1 ml/kg/h for 30 min before propofol injection. The study group was subdivided into 2 groups, one receiving maintenance fluid (group LF, n = 28) and one not (group LS, n = 24). A vein on the dorsum of the hand was used for the intravenous line in all patients. Pain assessment was made twice, immediately after injection of first half dose of propofol and after injection of the remaining half dose. The speed of propofol injection was 0.5 ml/sec. After measuring pain with the visual analogue scale (VAS) and pain scoring (PS) during propofol injection, the highest score in each case was used for comparison. RESULTS: The values of VAS and PS of group LF were not different from group C. However the corresponding values of group LS were lower than those of group C (P<0.05). CONCLUSIONS: From our results, it can be suggested that the duration of 30 min pre-treatment of lidocaine without maintenance fluid is one method for reducing the incidence and nature of pain induced by propofol.

Religious Orientation and Persecutors in Delusions of Schizophrenic Patients / 신경정신의학

OBJECTIVES: The purpose of this study was to evaluate the characteristics of relationship between the frequency of various persecutors in schizophrenic delusion and religious orientation with other religious variables. METHODS: The subjects were 105 schizophrenic patients. Diagnostic criteria used in this study was DSM-III-R. Religious orientation was assessed with the Intrinsic and Extrinsic Religious Orientation Scale. Demographic data, religious data, and contents of persecutory delusion were also analyzed. RESULTS: 1) The group obsessed with religious delusion regarded God, ghosts, and supernatural beings as persecutors. Predominantly, they used to have religious affiliation with protestantism before schizophrenic onset while being "intrinsic" in religious attitude. They also participated in religious activities more than 2 times every week. 2) The group who regarded religious leaders and shamans as persecutors predominantly had a religious affiliation after schizophrenic onset with "proreligious" and "intrinsic" religious attitude while some of them never participated in religious activity. 3) The group who regarded predominantly family and relatives as persecutors have a religious affiliation with buddhism and others(shamanism and etc) after schizophrenic onset with "extrinsic" religious attitude. CONCLUSION: These results suggest that religious orientation and other religious factors seem to affect persecutory delusion formation in schizophrenic patients.

G-CSF Treatment of Clozapine-Induced Agranulocytosis: A Case Report / 신경정신의학

The authors present a successful treatment case of clozapine-induced agranulocytosis with granulocyte colony-stimulating factor(G-CSF). It is the first case in Korea that occurred despite proper monitoring by the Clozaril patient Monitoring System(CPMS) and lull clinical vigliance. The mechanism of clozapine-induced agranulocytosis is unknown. Various studies are attempting to identity the pathogenic mechanism involved, and whether it is immunologic like human leukocyte antigen(HLA)-associated or toxic like desmethylclozapine-associated. However, it is clear that the final common pathway is suppression of myeloid proliferation in the bone marrow. The theory that clozapine-induced agranulocytosis Is caused by suppression of colony forming units of granulocytes and macrophages(CFU-GM) forms the rationale far the use of G-CSF or GM-CSF. The management of clozapine-induced agranulocytosis should include accurate diagnosis of agranulocytosis through bone marrow examinations, prompt discontinuation of clozapine, consultation with a hematologist, infectious disease specialist. Reverse isolation and administration of prophylactic antibiotics are need for prevention of secondary infection. A potential decrease of recovery time achieved by G-CSF obviously lowers the risk of secondary infectious disease.

Religious Orientation and Delusion in Schizophrenic Patients / 신경정신의학

OBJECTIVES: The purpose of this study was to evaluate the characteristics of religious orientation and religious life pattern in schizophrenic patients and their relationships to the types and themes of delusion. METHODS: Subjects were 120 schizophrenic patients. Diagnostic criteria used in this study was DSM-III-R. Religious orientations were assessed with the Intrinsic and Extrinsic Religious Orientation Scale. Demographic data, religious data and contents of delusion were also analyzed. RESULTS: 1) Distribution and prevalence of religious affiliations were similar to those of general population in Korea. 2) Religious orientations of the schizophrenic patients changed from the "extrinsic" attitude to the "proreligious" attitude as time passed. 3) Prominent religious orientations were different according to religious affiliation. The "proreligious" orientation and the "intrinsic" orientation were dominant in the religious group, whereas the "extrinsic" orientation and "antireligious" orientation were dominant in the nonreligious group. 4) Religious orientations were different according to the types of religions. The "intrinsic" orientation was dominant in Protestantism and Catholicism, the "extrinsic" orientation was dominant in Buddhism and the "proreligious" orientation was dominant in other type of religious group. 5) Schizophrenic delusion and religious factors showed several characteristic relations First, it was suggested that religion facilitated the psychological maturation and served as a ventilating pathway of guilty feeling. Second, schizophrenic delusion seemed to be affected by the types of the religions. Buddhism group dominantly presented delusion of reference and of guilt, whereas Protestant and Catholic groups dominantly presented delusion of being controlled. Other groups of religion dominantly presented somatic delusion. Third, delusion of guilt was most prevalent in the "extrinsic" attitude and 1311owe4 by the "proreligious" and "intrinsic" attitudes. It was similar to the previous study that guilty feeling was most prevalent in the "extrinsic" attitude in the orders of the "antireligious" , the "proreligious" , and the "intrinsic" attitude. Fourth, religious and supernatural themes of delusion were most dominant in the "intrinsic" attitude, whereas realistic themes of delusion were most dominant in the "extrinsic" attitude. CONCLUSION: These results suggest that religious orientation and other religious factors seem to affect delusion formation and mental health in schizophrenic patients.