Laboratorio de función tiroidea en pediatría. Ventajas y limitaciones de los métodos indirectos para la obtención de intervalos de referencia / Thyroid function laboratory in pediatrics. Advantages and limitations of indirect methods to obtain reference intervals

Obtener intervalos de referencia (IRs) confiables para pruebas de laboratorio en pediatría es particularmente complejo y costoso. Una alternativa a este problema es el uso de métodos indirectos, donde se usan grandes bases de datos preexistentes de pacientes. Nuestros objetivos fueron: calcular IR para TSH y hormonas tiroideas (Perfil tiroideo, PT) en población pediátrica que asiste al Hospital de Pediatría Juan P. Garrahan, por método indirecto y verificar la confiabilidad de los mismos para su aplicación. Se recolectaron datos de 19.842 pacientes entre enero de 2020 y diciembre de 2021. Se aplicaron filtros para eliminar los pacientes que pudieran tener afectado el PT. Los 4.861 pacientes incorporados al análisis fueron divididos en 3 grupos: G1: 0-12 meses (n: 551), G2:13 meses- 7 años (n: 1347) y G3: 8 -18 años (n: 2963). Los IR fueron calculados por 2 métodos: el de Hoffman adaptado y el de CLSI EP28A3, para cada grupo de edad. TSH, TT3 y T4L se analizaron con Architect i4000-Abbott y TT4 con Immulite 2000XPi-Siemens. Para la primera etapa de verificación se utilizaron 20 sueros de pacientes provenientes de análisis prequirúrgicos. Los outliers se detectaron aplicando el método de Tukey. Los datos fueron procesados según CLSI EP28A3c. Los IR obtenidos fueron similares a los previamente publicados obtenidos por método directo. Los resultados de la verificación fueron en su mayoría aceptados. Por lo tanto, los métodos indirectos son una buena alternativa de cálculo de IR en pediatría (AU)

Obtaining reliable reference ranges (RRs) for laboratory tests in pediatrics is particularly complex and costly. An alternative to this problem is to use of indirect methods, where large pre-existing patient databases are used. Our aims were to calculate RRs for TSH and thyroid hormones (thyroid profile, PT) in children seen at Hospital de Pediatría Juan P. Garrahan by indirect methods and to verify their reliability for their application. Data were collected from 19,842 patients seen between January 2020 and December 2021. Filters were applied to eliminate patients in whom the PT was potentially affected. The remaining 4,861 patients included in the analysis were divided into 3 groups: G1: 0-12 months (n: 551), G2: 13 months-7 years (n: 1347) and G3: 8-18 years (n: 2963). RRs were calculated by 2 methods: the adapted Hoffman method and the CLSI EP28A3 method, for each age group. TSH, TT3, and FT4 were analyzed with Architect i4000-Abbott and TT4 with Immulite 2000XPi-Siemens. For the first stage of verification, 20 patient sera from pre-surgical analysis were used. Outliers were detected by applying the Tukey method. The data were processed according to CLSI EP28A3c. The RRs obtained were similar to those previously published using the direct method. The verification results were mostly acceptable. Therefore, indirect methods are a good option for calculating RRs in children (AU)

Investigation and analysis of concentrations of radium-226 and uranium in agricultural products around uranium tailings pond / 中国辐射卫生

@#<b>Objective</b> To investigate the radionuclide radium-226 and natural uranium content in the main agricultural products around a decommissioned uranium tailings pondand to determine the radioactivity level in the food around the tailings pond. <b>Methods</b> From 2017 to 2021, several samples of rice and beans were collected in the surrounding area of the tailings pond for five consecutive years, and the concentrations of radium-226 and natural uranium were measured by a high-purity germanium gamma spectrometer. The annual accumulated effective dose of internal exposure caused by radium-226 ingested through local standard human diet was estimated by the indirect method. <b>Results</b> The detection rate of natural uranium in rice was 96.0%, and the detection rate of radium-226 was 74.0%; the detection rate of natural uranium in beans was 96.7%, and the detection rate of radium-226 was 73.3%. The annual accumulated effective dose caused by radium-226 ingested through diet was about 170.22 μSv/a in surrounding residents. <b>Conclusion</b> The concentrations of radium-226 and natural uranium in the main agricultural products around the tailings pond are within the limit of the national standard. By comparing with the research results in related fields in China, the radiation effects caused by radium-226 ingested through dieton the residents around the tailings pond are acceptable.

Establishment of reference intervals for thyroid stimulating hormone measurement by big data and indirect method in adults / 中华检验医学杂志

Objective:To establish the sex-, age-and season-specific (month) reference intervals (RI) for thyroid stimulating hormone (TSH) measurement by big data and indirect method in adults.Methods:TSH data of anonymous patients were collected from Beijing Chaoyang Hospital Affiliated to Capital Medical University in 2016, the data were selected and outliers were removed. Indirect methods (Hoffmann method and Bhattacharya method) were used to calculate TSH reference intervals of whole population, different genders, ages and seasons (months). TSH RI from two indirect methods of total population, selected population, physical examination population was compared with RI from reagent instruction according to reference change value ( RCV) based on biological variability. Results:A total of 61 599 records were obtained from 90 699 records including 18 776 males and 42 823 females. The TSH RI were obtained by Hoffmann method: the whole population, 0.59-5.59 μIU/ml (1 μIU/ml=1 mIU/L), male, 0.53-5.16 μIU/ml, female, 0.59-6.11 μIU/ml. The upper limits of TSH RI were higher with age and in winter (January): 18-30 years old, 0.62-5.57 μIU/ml, 71-80 years old, 0.49-6.45 μIU/ml; January, 0.59-6.40 μIU/ml, August, 0.60-5.56 μIU/ml; The RI of TSH by Bhattacharya method: the whole population, 0.58-5.80 μIU/ml, male, 0.55-5.02 μIU/ml, female, 0.62-6.21 μIU/ml. The upper limits of TSH RI were also higher with age and in winter (January): 18-30 years old, 0.65-5.67 μIU/ml, 71-80 years old, 0.46-5.99 μIU/ml, January: 0.61-6.52 μIU/ml, August: 0.61-5.69 μIU/ml. Compared to RI from reagent instruction, the differences of TSH RI from two indirect methods of total population, selected population, physical examination population were acceptable.Conclusions:TSH RI was established by indirect method. With the increase of age and winter, the upper limit of TSH reference interval tends to increase.

Establishing reference intervals of thyroid hormone based on a laboratory information system / 中华内科杂志

Objective@#To establish reference intervals (RIs) of thyroid hormone based on data from healthy subjects in laboratory information system (LIS) by indirect methods.@*Methods@#Data were selected from the physical examination center in LIS of the First Hospital of Jilin University from May 2014 to December 2018. The normal distribution of the original data was checked by the Kolmogorov-Smirnov test. Skewed data were transformed into normal distribution using BOX-COX techniques, and outliers were identified by the Turkey method. The continuous percentile curve was established by coefficient of skewness-median-coefficient of variation(LMS) methods. Cut-off value of age was determined by decision trees, and the differences between groups were verified by Z-tests. P2.5 and P97.5 in the RIs were analyzed by non-parametric methods.@*Results@#A total of 45 742 subjects were included in the study. There were no differences in the RI for thyroid stimulating hormone (TSH) among age groups or between men and women (Z<Z*), and the RI was 0.60-4.41mIU/L (20-79 years old). However, the levels of free triiodothyronine(FT3) decreased with age in males and females under 35-year-old. The RIs for FT3 were 4.47-6.44pmol/L (20-44 years old), 4.19-6.21pmol/L (45-64 years old) and 3.90-5.85pmol/L (65-79 years old) in males, and 4.04-6.13pmol/L (20-34 years old) and 3.87-5.76pmol/L (35-79 years old) in females, respectively. The levels of free thyroxine(FT4) in men were higher than those in women from 20 to 49 years old, and no gender and age differences could be viewed in subjects after 50 years old (Z<Z*). The RIs for FT4 were 13.69-21.76pmol/L (male, 20-49 years old), 12.99-20.83pmol/L (female, 20-49 years old) and 12.98-21.21pmol/L (50~79 years old).@*Conclusion@#Establishment of RIs of thyroid hormone based on the data from LIS is simple and reliable, which is suitable for clinical laboratory application.

Analysis on the results and establish the reference range of trace element in whole blood of pregnant women / 国际检验医学杂志

Objective The levels of multi-trace elements in whole blood of pregnant women in Zhejiang province were analyzed to establish the reference range for this population.Methods Routine physical exami-nation data of 21 151 pregnant women during January 2015 to September 2016 from Hangzhou Dian Medical Center were analyzed retrospectively.Three groups including early pregnancy group,middle pregnancy group and late pregnancy group were divided according to the pregnancy period.A total of 1 859 women range from 20 to 40 years old healthy without pregnant were selected as control group.The levels of copper(Cu),zinc (Zn),calcium(Ca),magnesium(Mg)and iron(Fe)in different pregnancy groups were analyzed statistically. The reference interval of each element in the early,middle and late pregnancy group should be established re-spectively if necessary.Results There were significant differences existed in the levels of Cu between early, middle,late pregnancy group and the control group(P<0.05).The levels of whole blood Cu increased gradu-ally with the time of pregnancy.Compared with the control group,the levels of Zn in other group were differ-ent,and the deficiency rates in early,middle,late pregnancy group were 5.6%,9.3% and 5.0% respectively. There was no significant difference in the level of Fe between the control group and the early pregnancy group (P=0.083).But the levels of Fe in middle and late pregnancy group showed significant difference with control group(P< 0.05).The reference ranges published in manufactures′ package inserts could not meet clinical needs.Conclusion The lack of trace elements existed in different stages of pregnancy.It′s important to moni-tor and analyze the levels of trace elements during each stages of pregnancy,and intervention measures should be done as necessary.T he taken of Cu supplement should based on its reference interval in each stage of preg-nancy respectively.T he taken of Fe supplement should based on the reference interval of healthy,reproductive-age w omen.

Avaliação da pressão arterial sistêmica em cães obesos: comparação entre os métodos oscilométrico e doppler ultrassônico / Systemic blood pressure evaluation by oscillometric versus doppler ultrasonographic methods in obese dogs

A obesidade é o problema nutricional que mais acomete os cães e pode causar vários efeitos deletérios a saúde animal. No entanto, o efeito desta condição sobre a pressão arterial sistólica (PAS) em cães obesos é controverso. Os métodos indiretos de mensuração da PAS são os mais comumente utilizados na medicina veterinária para o diagnóstico da hipertensão sistêmica, por serem mais práticos e de fácil acesso. Não foram localizados na literatura estudos que tenham comparado os dois métodos para esta avaliação em cães obesos. Diante do exposto, o objetivo desse estudo foi avaliar a PAS em cães obesos, comparando os métodos indiretos de mensuração da pressão arterial, oscilométrico e doppler ultrassônico, a fim de verificar as diferenças nos valores obtidos, como também o método mais indicado para aferir a PAS em cães nesta condição. Foram avaliados 50 cães, incluindo 25 obesos com escore de condição corporal (ECC) médio de 8,42±0,50 e 25 cães com peso corporal ideal com ECC médio de 4,56±0,51. Os resultados revelaram valores superiores da PAS obtidos pelo método doppler (152±16mmHg) comparados ao oscilométrico (136±11mmHg). A análise de correspondência determinada por análise estatística multivariada demonstrou maior correspondência entre a condição corporal e o método de avaliação da PAS. Esses achados sugerem que o método indireto doppler pode aferir com mais precisão os valores de PAS em cães obesos.(AU)

Obesity is the most common nutritional problem in dogs and it can cause various harmful effects on animal health. However, the effect of this condition on systolic blood pressure (SBP) in obese dogs is controversial. The indirect method of measuring PAS is the most commonly used in veterinary medicine for the diagnosis of systemic hypertension, because it is more practical and easy to access. There is little scientific information about the comparison of the two non-invasive methods of measurement of blood pressure in obese dogs. Therefore, the objective of this study was to evaluate the SBP in obese dogs by comparing both indirect methods of measuring blood pressure, with oscillometric and doppler vascular in order to verify the differences in blood pressure values, but also the best method to assess the SBP dogs in this body score condition. The study complain blood pressure measurement of 50 dogs, with were divided in obese dogs with mean body condition score (BCS) of 8.42±0.50 (n=25) and dogs with ideal BCS of 4.56±0.51 (n=25). At comparison of blood pressure values, SBP values obtained by doppler method (152±16mmHg) were higher than the oscillometric (136±11mmHg). Correspondence analysis determined by multivariate statistical analysis showed correlation between body condition and the procedure of the SBP. These findings suggest that the indirect method doppler can better reflect the SBP in obese dogs.(AU)

Uso de indicadores indigestíveis obtidos in situ e in vivo para determinar a digestibilidade de nutrientes em equinos / The use of indigestible markers obtained in situ and in vivo to determine digestibility of nutrients in equine

Objetivou-se estudar a viabilização dos indicadores internos, celulose (CELi) e lignina (LIGi) indigestíveis, obtidos pelas técnicas in situ e in vivo, para predizer a digestibilidade de nutrientes em equinos. Foram utilizados quatro cavalos castrados, por meio de delineamento em blocos ao acaso. Os tratamentos consistiram de metodologias de avaliação de digestibilidade, como a coleta total de fezes (CT) e o uso de indicadores internos, CELi e LIGi, obtidos pelas técnicas in situ (IS) na cavidade ruminal de bovinos e in vivo (IV) nos equinos, por meio da técnica do saco de náilon móvel (TSNM), totalizando cinco tratamentos. A ingestão diária de MS foi de 2,0 por cento do peso vivo de feno de coast-cross. A CELi-IV promoveu a melhor taxa de recuperação do indicador, igualando-se à CT, em 100,31 por cento, enquanto a LIGi resultou nas piores taxas, na média 76,45 por cento, para ambas as técnicas (P<0,05). As estimativas dos coeficientes de digestibilidade dos nutrientes foram adequadamente preditas pela CELi, obtidos IS e IV em que os valores observados foram de 46,41, 48,16, 46,90, 47,92 e 45,51 por cento para MS, MO, PB, FDN e EB, respectivamente. Concluiu-se que a CELi pode ser obtida in vivo por meio da TSNM em equinos, para predizer a digestibilidade de nutrientes...

The objective of this paper was to study the use of the internal indigestible cellulose (CELi) and lignin (LIGi) markers, obtained in situ or in vivo, to predict the apparent digestibility of nutrients in horses. Four castrated horses were utilized in a randomized blocks experimental design. Treatments consisted of different digestibility determination methodologies: total feces collection (TC) and use of CELi and LIGi internal markers obtained by the in situ (IS) incubation in bovine rumen and in vivo (IV) by the mobile nylon bag technique (MNBT) with horses, resulting in five treatments. The diet consisted exclusively of coast-cross hay and the average daily dry matter intake corresponded to 2.0 percent of the BW of the horses. The CELi-IV resulted in the best marker recuperation rate (100.31 percent), being similar to the control method; while the LIGi resulted in low recuperation rates (76.45 percent) for both techniques (P<0.05). The nutrients' digestibility coefficients were effectively predicted by CELi, obtained in situ or in vivo, with average values of 46.41, 48.16, 46.90, 47.92 and 45.51 percent for DM, organic matter, crude protein, neutral detergent fiber and crude energy, respectively. It can be concluded that CELi may be obtained in vivo by MNBT in horses to predict the nutrients' digestibility coefficients...

Zygomatic Arch Fracture Reduction via Gillie's (Temporal) Approach—Report of 3 Cases

In mid-face, the zygomatic bone and arch represents the bridge between the maxilla, orbital cavity and temporal bone anterosuperior and posterior, respectively. Zygomatic arch plays a potential relation with the maxilla, petrous part of temporal bone, orbits and the multitude of structures contained within and posterior to it make the temporomandibular joint functionally. Fracture of the zygomatic arch of the bone is potentially disturb the function of the mandibular jaw while opening and closing as well as disfigure by forming depression on face even in case of undisplaced. In time and reduction of arch fracture provides the best chance to avoid facial deformity, jaw dysfunction and prevents unfavorable sequelae. We conclude that, Gillies approach for undisplaced arch fracture reduction will be considerable due to simple and effective method and cosmetically more acceptable.

Analysis on results of hepatitis C antibody detection by three kinds of ELISA reagents / 国际检验医学杂志

Objective To analyze and evaluate the performance of the double antigen sandwich method reagents by comparing the detection results of three kinds of domestic hepatitis C virus(HCV)antibody detection kits with indirect method and sandwich method.Methods The different test methods were designed.The HCV antibody detection by using three kinds of reagents was performed on the collected positive and negative specimens and those specimens with positive reaction by the single and dual rea-gents were simultaneously performed the recombinant immunoblot assay(RIBA)and the nucleic acid detection;in addition,after the multiple proportion dilution,the quality control material with known content was parallelly detected with three kinds of reagents. All the detection results were conducted the comparison and the comprehensive analysis.Results Compared with the confirmation reagent,the false positive rates of two kinds of indirect method reagent and one kind of sandwich method reagent were 40.9%, 59.1% and 2.2% respectively.Their positive rates were 100%,but the analytical sensitivity of the sandwich method was higher than that of the indirect method by 1 ~4 times.Conclusion The sandwich ELISA reagent is significantly superior to the indirect EllSA reagent in the aspects of sensitivity and specificity.

Evaluation of value of indirect method in establishing reference intervals of CA72-4 / 中华检验医学杂志

Objective To establish the reference interval for CA 72-4 in indirect method.Methods All results for CA72-4 that were stored in our laboratory information system of Zhongshan hospital between Jan.2010 and Dec.2012 were included in this study.Outliers were identified and omitted using Stem-and-Leaf&Box Plots in SPSS statistical software.The treated data was divided into several groups according to gender and age.Nonparametric rank sum test was used to observe the difference between male and female participants and Spearman correlation analysis was used to examine the correlation between CA 72-4 and age.Nonparametric reference intervals for CA 72-4 were estimated statistically in two gender sub-groups.Results After 139 cases excluded, there were 1 548 cases of male (Median 1.7, 0.4 to 18.9) and 773 cases of female ( Median 1.8, 0.2 to 18.9 ).There was a significant difference in serum CA 72-4 between male and female participants.No significant difference was found in serum CA 72-4 among age sub-groups.Indirect reference values for CA 72-4 of male and female were respectively 0 to 8.9 U/ml and 0 to 11.6 U/ml.Conclusion Indirect method to establish biological reference interval is a relatively simple and less expensive method under the high rapid development of the hospital information network .It can be used in the periodical review and establishing the reference intervals where the direct method can not be used.

Predição da potência aeróbia (VO2máx) de crianças e adolescentes em teste incremental na esteira rolante / Prediction of aerobic power (VO2max) of children and adolescents during an incremental treadmill test

O consumo máximo de oxigênio (VO2máx) é a quantidade máxima de energia que pode ser produzida pelo metabolismo aeróbio em determinada unidade de tempo, podendo ser determinado direta ou indiretamente através de equações preditivas. O objetivo deste trabalho foi elaborar uma equação preditiva específica para determinar o VO2máx de meninos de 10 a 16 anos. Quarenta e dois meninos realizaram teste ergoespirométrico de corrida em esteira rolante com velocidade inicial de 9 km/h até exaustão voluntária. Através da regressão linear múltipla foi possível desenvolver a seguinte equação para a determinação indireta do VO2máx: VO2máx (ml/min) = -1574,06 + (141,38 x Vpico) + (48,34 * Massa corporal), com erro padrão de estimativa = 191,5 ml/min (4,10 ml/kg/min) e o coeficiente de determinação = 0,934. Sugerimos que esta é uma fórmula adequada para predizer o VO2máx para esta população.

The maximal oxygen uptake (VO2max) is the maximal quantity of energy that can be produced by the aerobic metabolism in certain time unity. It can be determined direct or indirectly by predictive equations. The objective of this study was to make a specific predictive equation to determine the VO2max from boys aged 10-16 years-old. Forty-two boys underwent a treadmill running ergospirometric test, with the initial velocity set at 9 km/h, until voluntary exhaustion. By the multiple linear regression was possible to develop the following equation for the indirect determination of the VO2max: VO2max (ml/min) = -1574.06 + (141.38 x Vpeak) + (48.34 * Body mass), with standard error of estimate = 191.5 ml/min (4.10 ml/kg/min) and coefficient of determination = 0.934. We suggest that this formula is appropriate to predict VO2max for this population.

In vitro study on the influence of the light polymerization technique and appliance on the bond strength of intra-radicular posts / Estudo in vitro da influência da técnica e do aparelho de fotopolimerização sobre a resistência de união de pinos intra-radiculares

The purpose of this study is to verify the influence of light curing type on retention force of direct technique and direct-indirect technique.Forty bovine single root teeth with 12mm length were used in this study. Roots were endodontically treated and randomly divided into four groups according to the light curing unit and the technique used: group HD (direct technique, halogen lamp), group LD (direct technique, LED), group HI (direct-indirect technique, halogen lamp), group LI (direct-indirect technique, LED). Retention force was determined using a Universal Testing Machine (Instron). All data were analyzed using one-way analysis of variance (ANOVA) and Tukey’s test. After the test, failure was examined and classified according to the fracture place: post/ resin; resin/dentin; mix. Group HI (246.05N ± 29.51) and LI (241.60N ± 28.95) did not show difference statistically but presented higher retention force than group HD (142.30N ± 25.60) and LD (178.56N ± 25.67). Most of fracture occurred in interface between dentin/resin. Based on the obtained results, it was concluded that adhesive cementation technique influenced in the retention of glass fiber post

O objetivo deste estudo foi avaliar a influência do tipo de luz sobre força de adesão de pinos feitos pela técnica direta ou indireta. Quarenta dentes bovinos unirradiculares com 12 milímetros de comprimento foram utilizadas neste estudo. As raízes foram tratadas endodonticamente e divididas aleatoriamente em quatro grupos de acordo com a unidade de fotoativação e técnica utilizada: grupo 1 (técnica direta, lâmpada halógena), grupo 2 (técnica direta, LED), grupo 3 (técnica direta indireta, lâmpada halógena ), grupo 4 (técnica direta indireta, LED). A força de retenção foi determinada utilizando-se uma máquina universal de ensaios (Instron). Todos os dados foram analisados pela análise de variância (ANOVA) e teste de Tukey. Após o teste, as falhas foram analisadas e classificadas de acordo com o local de fratura: pino / resina; resina / dentina ou mista. Os Grupos 3 (246,05 N ± 29,51) e 4 (241,60 N ± 28,95) não apresentaram diferenças estatísticas entre si, mas apresentou maior força de retenção que os grupos 1 (142,30 N ± 25, 60) e 2 (178,56 ± 25,67 N). A maioria das fraturas ocorreu na interface entre a dentina / resina. Com base nos resultados obtidos, concluiu-se que a técnica de cimentação adesiva influenciou na retenção dos pinos de fibra de vidro

Resíduos de construção e demolição: avaliação de métodos de quantificação / Construction and demolition waste: evaluation of quantification methods

Neste trabalho, estimou-se a gerão dos resíduos de construção e demolição por dois métodos de quantificação, um indireto e outro direto, considerando-se a produção advinda dos agentes informais e formais. O método indireto considerou a área construída das edificações (construção) e transformação dos pontos de ligação de água e luz instalados (reforma). O método direto identificou a geração advinda de agentes informais e formais nos pontos de disposição finais em diferentes regiões do município, empregando-se o conceito de balanço de massa. Não é possível quantificar a geração de resíduos de construção e demolição dos agentes informais (reformas) por meio de dados indiretos relacionados Às transformações dos pontos de água no município. Há indícios de que as transformações dos pontos de energia elétrica sejam um indicador indireto mais preciso, podendo evitar a dispendiosa quantificação direta.

In this paper, construction and demolition waste generation was estimated by two quantification methods, one direct and other indirect, regarding informal and formal generators. Construction area and transformation of the points of water and energy were applied for indirect quantification method. For the direct one, volume of dumping areas associated with informal and formal generators in different regions of municipality were quantified and the mass balance was applied. Indirect quantification of informal generators by transformation points of water is not precise. There are evidences that transformation points of energy can be more precise, avoiding costly direct construction and demolition waste quantification method.

A Study on Reference Values from Health Checkup Data of Korea Association of Health Promotion by Indirect Method: A Study on Standardization of Reference Values among Laboratories of Korea Association of Health Promotion II / 임상검사와정도관리

BACKGROUND: The reference values of laboratory should review regularly to maintain good quality of practice. This is the second report of studies on reference values of Korea Association of Health Promotion (KAHP). The first one was reported in 2002 in Journal of Laboratory Medicine and Quality Assurance in Korea. The aim of this study is to know the changes of reference values for the past five years. METHODS: The way to analyze the data this time was essentially the same as the previous one (Indirect Method). The data from January to December, 2007 were collected. They totalled 5,133,327 test results from approximately 140 thousands individuals who visited for health checkup. The data were statistically analyzed with Minitab version 15.1.20.0 for Gaussian distribution using Anderson-Darling test. The trimming process repeated for the outliers, the results lying outside of +/-3SD, and as much as four times in certain test items, though, none of the tests showed Gaussian distribution. Subsequently, the reference values of most tests were defined in the ranges from the point of lowest 2.5% to the point of highest 97.5% and others were those, below 95 percentiles according to CLSI C28-A3 guideline. RESULTS: The reference ranges of 56 test items were either set as before or adjusted with new values, and compared. CONCLUSIONS: Comparing to the previous reference values (2002), the tests for liver function showed the lower upper values and the tests for diabetes and lipids showed higher upper values. Others were changed minimally with no significance.

Effect of impression technique on the accuracy of master cast for implant prosthesis / 대한치과보철학회지

STATEMENT OF PROBLEM: Major objective in making on implant-supported prosthesis is the production of superstructure that exhibits a passive fit when connected to multiple abutments. One requirement to ensure passive fit is to make an accurate impression. PURPOSE: The purpose of this study was to compare the accuracy of master cast fabricated by using different impression methods at the different impression levels. MATERIAL AND METHOD: The master model used in this study was resin block having four implant analogs. Impression method studied were 1) direct method on fixture level (Group FIX-D), 2) indirect method on fixture level(Group FIX-I), 3) modified indirect method on fixture level(Group FIXM) 4) direct method on abutment level(Group AB-D) and 5) indirect method on abutment level(Group AB-I). Each of the five groups took 10 impressions. Fifty impressions were made for master cast by using Impregum F. impression material loaded on individual tray. Three dimensional measuring microscope was used to measure the inter-implant distance. Error rate of each inter-implant distance were calculated and evaluated. RESULTS: The results were as follows. 1. Group FIX exhibited higher accuracy than group AB. 2. In group FIX, modified indirect method showed the highest accuracy, while indirect method showed the lowest accuracy. In group Ab, indirect method showed the higher accuracy than direct method. 3. Group FIX showed larger horizontal error than group AB. But, group AB showed the larger vertical error than group FIX. 4. Group Fix-M showed smallest vertical and horizontal error. CONCLUSION: An impression method have more effect on accuracy of master model than an impression level. A modified indirect method showed smallest vertical and horizontal error.