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Stable posterior occlusal support is crucial for adequate masticatory function and facial aesthetics. In elderly patients over the age of 65, masticatory ability has a significant impact on nutritional intake and overall health. This case report presents a prosthetic treatment of an elderly patient with edentulous maxilla and bilateral posterior edentulous mandible. The upper jaw was restored with a complete denture to establish an ideal occlusal plane, and the three-dimensional positions of the mandibular implants were determined accordingly. The implants were placed through computer-guided implant surgery and were immediately loaded with fixed provisional restorations. The implant-fixed zirconia final restorations were inserted in the lower posterior region, and the occlusal surface of posterior artificial teeth in the upper denture was substituted with cobalt-chrome alloy to resist occlusal wear. The patient’s posterior occlusal support and masticatory function were promptly restored through this treatment process, and long-term stability against wear was also obtained.
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PURPOSE@#. This study evaluated the reliability of the chair-side CAD-CAM surgical guide (CSG) in the anterior maxilla by comparing its accuracy with the laboratory 3D-printed surgical guide (3DSG) and manual surgical guide (MSG) concerning different levels of dentists' surgical experience. @*MATERIALS AND METHODS@#. Ten surgical guides of each type (MSG, 3DSG, and CSG) were fabricated on a control study model with missing right and left central incisors. Sixty implants were placed in 30 study models by two dentists (one inexperienced and one experienced) using three different types of surgical guides. Horizontal deviations at shoulder and at apex, vertical, and angular deviations were measured after superimposing the planned and placed implant positions in the software. Kruskal-Wallis and Mann-Whitney U tests were used to compare the accuracy of three types of surgical guides in each dentist group and the accuracy of each surgical guide between two dentists (α = .05). @*RESULTS@#. There were no significant differences in any deviations between CSG and 3DSG, apart from angular deviation, for both dentists’ groups. Moreover, both CSG and 3DSG showed no significant differences in accuracy between the two dentists (P > .05). In contrast, MSG demonstrated significant differences from CSG and 3DSG and a significant difference in accuracy between the two dentists (P < .05). @*CONCLUSION@#. CSG provides superior accuracy to MSG in implant placement in the maxillary anterior region and is comparable to 3DSG at different levels of surgical experience, while offering the benefits of shorter manufacturing time and reduced patient visits.
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Background@#In workers with moderate to severe work-related traumatic brain injury (wrTBI), this study aimed to investigate the effect of the timing of rehabilitation therapy initiation on the length of hospital stay and the factors that can influence this timing. @*Methods@#We used data obtained from the Republic of Korea's nationwide Workers' Compensation Insurance. In the Republic of Korea, between the years 2010 and 2019, a total of 26,324 workers filed a claim for compensation for moderate to severe wrTBI. Multiple regression modeling was performed to compare the length of hospital stay according to the timing of rehabilitation therapy initiation following wrTBI. According to the timing of the initiation of rehabilitation therapy following TBI, the proportions of healthcare institutions that provided medical care during each admission step were compared. @*Results@#The length of hospital stay for workers who started rehabilitation therapy within 90 days was significantly shorter than that for workers who started rehabilitationment were first admitted to tertiary hospitals. Approximately 39% of patients who received delayed rehabilitation treatment were first admitted to general hospitals, and 28.5% were first admitted to primary hospitals. @*Conclusions@#Our findings demonstrate the importance of early rehabilitation initiation and that the type of healthcare institution that the patient is first admitted to after wrTBI may influence the timing of rehabilitation initiation. The results of this study also emphasize the need to establish a Worker’s Compensation Insurance–specialized rehabilitation healthcare delivery system.
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Purpose@#In our previous studies, application of trichloroacetic acid (TCA) to gingival fibroblasts or to canine palatal soft tissue was verified to alter the expression of several genes responsible for cell cycle progression. In order to confirm this effect in a system allowing sequential release of TCA and epidermal growth factor (EGF), expression of various cell cycle genes following the application of the agents, using hydrophobically modified glycol chitosan (HGC)-based nano-controlled release system, was explored in this study. @*Materials and methods@#HGCbased nano-controlled release system was developed followed by loading TCA and EGF. The groups were defined as the control (CON); TCA-loaded nano-controlled release system (EXP1); TCA- and EGF- individually loaded nano-controlled release system (EXP2). At 24- and 48 hr culture, expression of 37 cell cycle genes was analyzed in human gingival fibroblasts. Correlations and the influential genes were also analyzed. @*Results@#Numerous genes such as cyclins (CCNDs), cell division cycles (CDCs), cyclin-dependent kinases (CDKs), E2F transcription factors (E2Fs), extracellular signal-regulated kinases (ERKs) and other cell cycle genes were significantly up-regulated in EXP1 and EXP2. Also, cell cycle arrest genes of E2F4, E2F5, and GADD45G were up-regulated but another cell cycle arrest gene SMAD4 was down-regulated. From the multiple regression analysis, CCNA2, CDK4, and ANAPC4 were determined as the most influential factors on the expression of ERK genes. @*Conclusion@#Application of TCA and EGF, using the HGC-based nano-controlled sequential release system significantly up-regulated various cell cycle progression genes, leading to the possibility of regenerating oral soft tissue via application of the proposed system.
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This report demonstrates a method of generating a chair-side and computer-aided template for implant surgery based on the Top-Down and restoration-driven concept. Compared to the traditional CAD-CAM process which requires multiple steps to be taken between dental clinic and laboratory, this alternative procedure, VARO guide system (VARO Guide, CAD, Pre-Guide, VARO-mill, NeoBiotech, Seoul, South Korea) enables accurate and patient-friendly implant surgery as well as immediate provisional restoration in a single visit. First, bite-registration at centric jaw relation and CBCT were taken using the Pre-Guide. The CBCT data was then reorganized directly through the chair-side CAD, and we could determine the most appropriate 3-dimensional position of implant. The STL file was extracted and put into the chair-side CAM (VARO-mill) to fabricate a VARO. This surgical guide allowed the implants to be accurately positioned into the planned sites within an hour.
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Purpose@#This study was performed to compare the efficacies of newly developed needle grasper-assisted (Endo Relief) single-incision laparoscopic appendectomy (NASILA) and single-incision laparoscopic appendectomy (SILA). @*Methods@#This study enrolled 110 patients with acute appendicitis without periappendiceal abscess, diagnosed using computed tomography, who were randomized to the SILA (n = 54) and NASILA groups (n = 56) between December 2017 and August 2018 (6 patients withdrawn). The NASILA technique entailed a small umbilical incision for the glove port (equivalent to that for a 12-mm trocar), and a 2.5-mm suprapubic incision for the needle grasper. @*Results@#The SILA and NASILA groups included 49 (male, 61.2%) and 55 (male, 54.5%) patients, respectively. Age, body mass index, abdominal surgical history, symptom duration, and use of patient-controlled analgesia did not differ significantly between the 2 groups. The main wound size was significantly smaller in the NASILA group than in the SILA group (1.8 ± 0.4 cm vs. 2.2 ± 0.4 cm, P < 0.001). The operative time and estimated blood loss did not differ significantly between both groups. The immediate postoperative pain score, i.e., the primary endpoint, was significantly lower in the NASILA group than in the SILA group (2.33 ± 0.98 vs. 2.82 ± 1.29, P = 0.031). The complaints for scar status 1 month postoperatively did not differ significantly between the groups. @*Conclusion@#NASILA could attenuate postoperative pain by minimizing the size of the surgical wound; further, NASILA may not be inferior to SILA in terms of cosmetic results.
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Objective@#To examine the features of powered mobility device-related injuries and identify the predictors of injury severity in such settings. @*Methods@#Emergency Department-based Injury In-depth Surveillance data from 2011 to 2018 were used in this retrospective study. Participants were assigned to the mild/moderate and severe groups based on their excess mortality ratio–adjusted injury severity score and their general injury-related factors and injury outcome-related factors were compared. @*Results@#Of 407 patients, 298 (79.2%) were assigned to the mild/moderate group and 109 (26.8%) to the severe group. The severe group included a higher percentage of patients aged 70 years or older (43.0% vs. 59.6%, P=0.003), injuries incurred in the daytime (72.6% vs. 82.4%, P=0.044), injuries from traffic accidents and falls (P=0.042), head injuries (38.6% vs. 80.7%, P<0.001), torso injuries (16.8% vs. 32.1%, P=0.001), overall hospital admission (28.5% vs. 82.6%, P<0.001), intensive care unit admission (1.7% vs. 37.6%, P<0.001), death after admission (1.4% vs. 10.3%, P=0.034), and total mortality (0.7% vs. 9.2%, P<0.001). The odds ratios (ORs) for injury severity were as follows: age 70 years or older (OR, 2.124; 95% confidence interval [CI], 1.239–3.642), head injury (OR, 10.441; 95% CI, 5.465–19.950), and torso injury (OR, 4.858; 95% CI, 2.495–9.458). @*Conclusion@#The proportions of patients aged 70 years or older, head and torso injuries, injuries from traffic accidents and falls, and injuries in the daytime were higher in the severe group. Our results highlight the need for measures to address these factors to lower the incidence of severe injuries.
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Dyslipidemia related diseases such as hyperlipidemia and atherosclerosis are the leading cause of death in humans. While cellular and molecular basis on the pathophysiology of dyslipidemia has been extensively investigated over decades, we still lack comprehensive understanding on the etiology of dyslipidemia due to the complexity and the innate multimodality of the diseases. While mouse has been the model organism of choice to investigate the pathophysiology of human dyslipidemia, zebrafish, a small freshwater fish which has traditionally used to study vertebrate development, has recently emerged as an alternative model organism. In this review, we will provide comprehensive perspective on zebrafish as a model organism for human dyslipidemia; we will discuss the attributes of zebrafish as a model, and compare the lipid metabolism in zebrafish and humans. In addition, we will summarize current landscape of zebrafish-based dyslipidemia research.
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Objective@#To examine the features of powered mobility device-related injuries and identify the predictors of injury severity in such settings. @*Methods@#Emergency Department-based Injury In-depth Surveillance data from 2011 to 2018 were used in this retrospective study. Participants were assigned to the mild/moderate and severe groups based on their excess mortality ratio–adjusted injury severity score and their general injury-related factors and injury outcome-related factors were compared. @*Results@#Of 407 patients, 298 (79.2%) were assigned to the mild/moderate group and 109 (26.8%) to the severe group. The severe group included a higher percentage of patients aged 70 years or older (43.0% vs. 59.6%, P=0.003), injuries incurred in the daytime (72.6% vs. 82.4%, P=0.044), injuries from traffic accidents and falls (P=0.042), head injuries (38.6% vs. 80.7%, P<0.001), torso injuries (16.8% vs. 32.1%, P=0.001), overall hospital admission (28.5% vs. 82.6%, P<0.001), intensive care unit admission (1.7% vs. 37.6%, P<0.001), death after admission (1.4% vs. 10.3%, P=0.034), and total mortality (0.7% vs. 9.2%, P<0.001). The odds ratios (ORs) for injury severity were as follows: age 70 years or older (OR, 2.124; 95% confidence interval [CI], 1.239–3.642), head injury (OR, 10.441; 95% CI, 5.465–19.950), and torso injury (OR, 4.858; 95% CI, 2.495–9.458). @*Conclusion@#The proportions of patients aged 70 years or older, head and torso injuries, injuries from traffic accidents and falls, and injuries in the daytime were higher in the severe group. Our results highlight the need for measures to address these factors to lower the incidence of severe injuries.
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BACKGROUND@#One effective way to improve return-to-work (RTW) performance may be to convince the employer that the worker has the necessary skills. The aim of this paper is to investigate the effect of having a professional certification among workers injured in occupational injuries on their return to work.@*METHODS@#The Panel Study of Workers' Compensation Insurance (PSWCI) targets workers who completed medical care in 2012 after an occupational injury. The study population (n = 2000) was stratified by gender, age, region, disability grade, and rehabilitation service use. A total of 1458 workers were finally selected for this study. The effect of having a certification on RTW status was calculated with an odds ratio and 95% confidence intervals using binomial and multinomial logistic regression analyses. In the binomial logistic regression analysis, the RTW group was made up as a combination of the return to original work and the reemployment groups.@*RESULTS@#The ORs of RTW among those with a certification compared to those without certification were 1.38 (1.16-1.65) in Model 1, 1.25 (1.05-1.50) in Model 2, and 1.22 (1.01-1.47) in Model 3. Among female workers with a certification, the OR of RTW was 4.60 (2.68-7.91), that of return to original work was 3.21 (1.74-5.91), and that of reemployment was 5.85 (3.34-10.27). Among daily workers with a certification, the OR of RTW was 1.32 (1.03-1.69) and that of reemployment was 1.37 (1.07-1.76).@*CONCLUSION@#In conclusion, injured workers with a certification generally had a higher RTW rate. In particular, the RTW rate was higher among female workers and daily workers with a certification than among those without.
Asunto(s)
Adulto , Anciano , Anciano de 80 o más Años , Humanos , Persona de Mediana Edad , Adulto Joven , Certificación/estadística & datos numéricos , Traumatismos Ocupacionales/estadística & datos numéricos , República de Corea , Reinserción al Trabajo/estadística & datos numéricos , Poblaciones Vulnerables/estadística & datos numéricos , Lugar de Trabajo/estadística & datos numéricosRESUMEN
Purpose@#To explore the scope and method of applying standardized nursing terminologies to nursing diagnosis and problems used in nursing practice. @*Methods@#A descriptive study was done with a retrospective analysis of the nursing records of 141,420 patients that were hospitalized in 4 tertiary hospitals. The nursing diagnosis and problems collected from the records were standardized, and the standardized nursing diagnosis and problems cross mapped with NANDA-I, confirmed in a nursing focus group. @*Results@#65 (67.7%) of the 96 standardized nursing diagnosis and problems were equal with NANDA-I and included in the 10 domains of NANDA-I. Among 86 nursing diagnosis and problems excluded from the cross mapping with NANDA-I, the 63 terms (73.3%) related to surgery/procedure were the most common. @*Conclusion@#It is meaningful that multi-tertiary hospital nursing diagnosis and problems were standardized and cross mapping with standard nursing terminologies was performed. As for the method of applying standardized nursing terminologies in nursing practice, it is appropriate to use several standardized nursing terminologies complementarily.
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Purpose@#This study was to determine the possible effects of trichloroacetic acid (TCA) and epidermal growth factor (EGF) through cell survival genes of the PI3K-AKT signaling pathway when applying an hydrophobically modified glycol chitosan (HGC)-based nanocontrolled release system to human gingival fibroblasts in oral soft tissue regeneration. @*Materials and Methods@#An HGC-based nano-controlled release system was produced, followed by the loading of TCA and EGF. The group was divided into control (CON), TCA-loaded nano-controlled release system (EXP1), and the TCA- and EGF- individually loaded nano-controlled release system (EXP2).A total for 29 genes related to the PI3K-AKT signaling pathway were analyzed after 48h of culture in human gingival fibroblasts.Real-time PCR, 1- way ANOVA and multiple regression analysis were performed. @*Results@#Cell survival genes were significantly upregulated in EXP1 and EXP2. From multiple regression analysis, ITGB1 was determined to be the most influential factor for AKT1 expression. @*Conclusion@#The application of TCA and EGF through the HGC-based nano-controlled release system can up-regulate the cell survival pathway.
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Purpose@#Here, we verified that the actin cytoskeletal gene expression of human gingival fibroblasts was altered by the administration of trichloroacetic acid (TCA) and epidermal growth factor (EGF) using the nano-controlled releasing system. @*Materials and methods@#The control and experimental groups were divided into 3 groups: the group with the TCA-only nano-controlled releasing system (EXP1), the group with the TCA- and EGF nano-controlled releasing system (EXP2), and the control group (CON) with 48-h incubation. Expression of 26 genes involved in the regulation of actin cytoskeleton were analyzed by real-time PCR followed by the determination of correlations and influential factors using the Pearson correlation analysis and multiple regression analysis. @*Results@#Among 23 genes upregulated in EXP1 and EXP2, expression of 14 genes were significantly increased in EXP2 compared to EXP1. On the other hand, LPAR1 was downregulated only in EXP1, GNA13 was upregulated only in EXP2, and F2R was downregulated only in EXP2. Three Rac1-related genes and CDC42 were identified as the influential factors of the actin gene upregulation. @*Conclusion@#The actin cytoskeleton genes in human gingival fibroblast were upregulated by the administration of TCA and EGF using HGC-based nano-controlled releasing system.
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All the faculties at the prosthodontic department in Kyung Hee University Dental Hospital at Gangdong, have been implementing the Top-Down concept of treatment approach since 2006 in which the outcomes of the last prosthetic treatment are predicted in advance during the treatment planning stage of patients with dental tissue defects. Based on the Top-Down concept, this report is also an example of how the final prosthetic treatment was performed in advance before going into implant surgery for the missing teeth. Among the various methods of connecting implant fixture and restoration, the cement-retained method is relatively simple to manufacture restoration without being constrained by the angle of the implants placed, but difficult to remove remaining subgingival excess cement completely, and to detach it being when necessary. In the report, SB-locking method will be introduced which enables an aesthetic implant restoration without either a screw hole or residual excess cement.
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Background@#The effect of nano controlled sequential release of trichloroacetic acid (TCA) and epidermal growth factor (EGF) on the oral soft tissue regeneration was determined. @*Methods@#Hydrophobically modified glycol chitosan (HGC) nano controlled system was developed for the sequential release of TCA and EGF, and the release pattern was identified. The HGC-based nano controlled release system was injected into the critical-sized defects created in beagles’ palatal soft tissues. The palatal impression and its scanned body was obtained on various time points post-injection, and the volumetric amount of soft tissue regeneration was compared among the three groups: CON (natural regeneration control group), EXP1 (TCA-loaded nano controlled release system group), EXP2 (TCA and EGF individually loaded nano controlled release system). DNA microarray analysis was performed and various soft tissue regeneration parameters in histopathological specimens were measured. @*Results@#TCA release was highest at Day 1 whereas EGF release was highest at Day 2 and remained high until Day 3. In the volumetric measurements of impression body scans, no significant difference in soft tissue regeneration between the three groups was shown in two-way ANOVA. However, in the one-way ANOVA at Day 14, EXP2 showed a significant increase in soft tissue regeneration compared to CON. High correlation was determined between the histopathological results of each group. DNA microarray showed up-regulation of various genes and related cell signaling pathways in EXP2 compared to CON. @*Conclusion@#HGC-based nano controlled release system for sequential release of TCA and EGF can promote regeneration of oral soft tissue defects.
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Purpose@#To explore the scope and method of applying standardized nursing terminologies to nursing diagnosis and problems used in nursing practice. @*Methods@#A descriptive study was done with a retrospective analysis of the nursing records of 141,420 patients that were hospitalized in 4 tertiary hospitals. The nursing diagnosis and problems collected from the records were standardized, and the standardized nursing diagnosis and problems cross mapped with NANDA-I, confirmed in a nursing focus group. @*Results@#65 (67.7%) of the 96 standardized nursing diagnosis and problems were equal with NANDA-I and included in the 10 domains of NANDA-I. Among 86 nursing diagnosis and problems excluded from the cross mapping with NANDA-I, the 63 terms (73.3%) related to surgery/procedure were the most common. @*Conclusion@#It is meaningful that multi-tertiary hospital nursing diagnosis and problems were standardized and cross mapping with standard nursing terminologies was performed. As for the method of applying standardized nursing terminologies in nursing practice, it is appropriate to use several standardized nursing terminologies complementarily.
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Purpose@#This study was to determine the possible effects of trichloroacetic acid (TCA) and epidermal growth factor (EGF) through cell survival genes of the PI3K-AKT signaling pathway when applying an hydrophobically modified glycol chitosan (HGC)-based nanocontrolled release system to human gingival fibroblasts in oral soft tissue regeneration. @*Materials and Methods@#An HGC-based nano-controlled release system was produced, followed by the loading of TCA and EGF. The group was divided into control (CON), TCA-loaded nano-controlled release system (EXP1), and the TCA- and EGF- individually loaded nano-controlled release system (EXP2).A total for 29 genes related to the PI3K-AKT signaling pathway were analyzed after 48h of culture in human gingival fibroblasts.Real-time PCR, 1- way ANOVA and multiple regression analysis were performed. @*Results@#Cell survival genes were significantly upregulated in EXP1 and EXP2. From multiple regression analysis, ITGB1 was determined to be the most influential factor for AKT1 expression. @*Conclusion@#The application of TCA and EGF through the HGC-based nano-controlled release system can up-regulate the cell survival pathway.
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Background@#The effect of nano controlled sequential release of trichloroacetic acid (TCA) and epidermal growth factor (EGF) on the oral soft tissue regeneration was determined. @*Methods@#Hydrophobically modified glycol chitosan (HGC) nano controlled system was developed for the sequential release of TCA and EGF, and the release pattern was identified. The HGC-based nano controlled release system was injected into the critical-sized defects created in beagles’ palatal soft tissues. The palatal impression and its scanned body was obtained on various time points post-injection, and the volumetric amount of soft tissue regeneration was compared among the three groups: CON (natural regeneration control group), EXP1 (TCA-loaded nano controlled release system group), EXP2 (TCA and EGF individually loaded nano controlled release system). DNA microarray analysis was performed and various soft tissue regeneration parameters in histopathological specimens were measured. @*Results@#TCA release was highest at Day 1 whereas EGF release was highest at Day 2 and remained high until Day 3. In the volumetric measurements of impression body scans, no significant difference in soft tissue regeneration between the three groups was shown in two-way ANOVA. However, in the one-way ANOVA at Day 14, EXP2 showed a significant increase in soft tissue regeneration compared to CON. High correlation was determined between the histopathological results of each group. DNA microarray showed up-regulation of various genes and related cell signaling pathways in EXP2 compared to CON. @*Conclusion@#HGC-based nano controlled release system for sequential release of TCA and EGF can promote regeneration of oral soft tissue defects.
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Purpose@#The aim of this study was to evaluate the diagnostic image quality of low dose abdominal digital radiography processed with a new post-processing technique. @*Materials and Methods@#Abdominal radiographs from phantom pilot studies were post-processed by the novel and conventional post-processing methods of our institution; the proper dose for the subsequent patient study of 49 subjects was determined by comparing image quality of the two preceding studies. Two radiographs of each patient were taken using the conventional and derived dose protocols with the proposed post-processing method. The image details and quality were evaluated by two radiologists. @*Results@#The radiation dose for the patient study was derived to be half of the conventional method. Overall half-dose image quality with the proposed method was significantly higher than that of the conventional method (p < 0.05) with moderate inter-rater agreement (κ = 0.60, 0.47). @*Conclusion@#By applying the new post-processing technique, half-dose abdominal digital radiography can demonstrate feasible image quality compared to the full-dose images.
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At the department of prosthodontics, the elderly patients with severely atrophied alveolar ridge who have been wearing complete dentures for a long period frequently visit the clinic. In general, the open-mouth impression technique for manufacturing a mandibular complete denture to secure primary support on buccal shelf area has been prevalent. In addition, for securing retention and stability of mandibular denture, we should consider diagnosis, oral function, denture border, occlusal plane, teeth arrangement, and patient training, etc.. But in edentulous patients with severe alveolar bone atrophy, it may hardly secure retention and stability of mandibular complete denture. To promote these, some of clinicians are making an attempt manufacturing the mandibular complete dentures using closed-mouth impression technique based on several reports that compare various impression techniques including open-mouth and closed-mouth impression technique. This case report suggests closed-mouth impression technique may promote retention and stability of mandibular complete denture and compares between the two impression techniques clinically.