Polymerization Behavior and Mechanical Properties of High-Viscosity Bulk Fill and Low Shrinkage Resin Composites.

The present study determined the mechanical properties and volumetric polymerization shrinkage of different categories of resin composite. Three high viscosity bulk fill resin composites were tested: Tetric EvoCeram Bulk Fill (TB, Ivoclar Vivadent), Filtek Bulk Fill posterior restorative (FB, 3M ESPE), and Sonic Fill (SF, Kerr Corp). Two low-shrinkage resin composites, Kalore (KL, GC Corp) and Filtek LS Posterior (LS, 3M ESPE), were used. Three conventional resin composites, Herculite Ultra (HU, Kerr Corp), Estelite ∑ Quick (EQ, Tokuyama Dental), and Filtek Supreme Ultra (SU, 3M ESPE), were used as comparison materials. Following ISO Specification 4049, six specimens for each resin composite were used to determine flexural strength, elastic modulus, and resilience. Volumetric polymerization shrinkage was determined using a water-filled dilatometer. Data were evaluated using analysis of variance followed by Tukey's honestly significant difference test (α=0.05). The flexural strength of the resin composites ranged from 115.4 to 148.1 MPa, the elastic modulus ranged from 5.6 to 13.4 GPa, and the resilience ranged from 0.70 to 1.0 MJ/m3. There were significant differences in flexural properties between the materials but no clear outliers. Volumetric changes as a function of time over a duration of 180 seconds depended on the type of resin composite. However, for all the resin composites, apart from LS, volumetric shrinkage began soon after the start of light irradiation, and a rapid decrease in volume during light irradiation followed by a slower decrease was observed. The low shrinkage resin composites KL and LS showed significantly lower volumetric shrinkage than the other tested materials at the measuring point of 180 seconds. In contrast, the three bulk fill resin composites showed higher volumetric change than the other resin composites. The findings from this study provide clinicians with valuable information regarding the mechanical properties and polymerization kinetics of these categories of current resin composite.

Effect of Oxygen Inhibition Layer of Universal Adhesives on Enamel Bond Fatigue Durability and Interfacial Characteristics With Different Etching Modes.

OBJECTIVE: The purpose of this study was to evaluate the effect of the oxygen inhibition layer of universal adhesive on enamel bond fatigue durability and interfacial characteristics with different etching modes. METHODS: The three universal adhesives used were Scotchbond Universal Adhesive (3M ESPE, St Paul, MN, USA), Adhese Universal (Ivoclar Vivadent, Schaan, Lichtenstein), and G-Premio Bond (GC, Tokyo, Japan). The initial shear bond strength and shear fatigue strength to enamel was determined in the presence and absence of the oxygen inhibition layer, with and without phosphoric acid pre-etching. The water contact angle was also measured in all groups using the sessile drop method. RESULTS: The enamel bonding specimens with an oxygen inhibition layer showed significantly higher (p<0.05) initial shear bond strengths and shear fatigue strengths than those without, regardless of the adhesive type and etching mode. Moreover, the water contact angles on the specimens with an oxygen inhibition layer were significantly lower (p<0.05) than on those without, regardless of etching mode. CONCLUSION: The results of this study suggest that the oxygen inhibition layer of universal adhesives significantly increases the enamel bond fatigue durability and greatly changes interfacial characteristics, suggesting that the bond fatigue durability and interfacial characteristics of these adhesives strongly rely on its presence.

Influence of Different Curing Modes on Polymerization Behavior and Mechanical Properties of Dual-Cured Provisional Resins.

This study determined the influence of curing mode on polymerization behavior and mechanical properties of dual-cured provisional resins. Three dual-cured bisacryl-based provisional resins were used: Tempsmart (TS; GC Corp), Luxatemp Automix Solar (LX; DMG Chemisch Pharmazeutishe Fabrik GmbH), and Integrity Multi·Cure (IG; Dentsply Caulk). A self-cured bisacryl-based provisional resin, Protemp Plus (PP; 3M ESPE) and a conventional poly(methyl methacrylate) (PMMA) provisional resin, Unifast III (UF; GC Corp) were used as controls. The inorganic filler content and coefficients of linear thermal expansion of the test materials were measured. Six specimens of each material were used to determine the flexural strength, elastic modulus, and resilience. The changes in ultrasound velocity during polymerization were measured. The average inorganic filler contents of the provisional resins, apart from UF, ranged from 24.4 to 39.3 wt%. The highest inorganic filler content was determined for LX, whereas TS showed the lowest value among the tested materials. The average coefficients of thermal expansion of the tested provisional resins ranged from 77.3 to 107.7 (×10-6/°C). TS and IG showed significantly lower thermal expansions than the other tested provisional resins. The mean flexural strengths of the provisional resins ranged from 70.4 to 122.6 MPa, the mean elastic moduli ranged from 1.8 to 3.7 GPa, and the mean resilience of the provisional resins ranged from 1.1 to 2.3 MJ/mm3, respectively. Dual-cured provisional resins showed significantly higher flexural strengths than the PMMA resin. However, in all cases, the light-curing mode showed significantly higher flexural strengths than the self-curing mode. In the initial polymerization phase, dual-cured resins in the light-curing mode showed a rapid increase in the speed of sound (V) during light irradiation, followed by a slower increase. Conversely, the dual-cured resins in the self-curing mode showed a slower initial increase, followed by a rapid increase. Although no significant difference in V was observed between 10 and 15 minutes in the light-curing mode of all tested dual-cured resins, a significantly higher V value was obtained at 15 minutes than at 10 minutes in the self-curing modes for LX and IG. Regardless of the curing mode, tested dual-cured provisional resins showed superior mechanical properties than the conventional PMMA provisional resin. However, dual-cured provisional resin flexural properties and polymerization behavior were affected by the curing mode. This study indicated that the light-curing mode might be recommended for all dual-cured provisional resins because of the enhancement of their mechanical properties and reduction of chair time.

A 60-GHz interferometer with a local oscillator integrated antenna array for divertor simulation experiments on GAMMA 10/PDX.

In conventional multichannel/imaging microwave diagnostics of interferometry, reflectometry, and electron cyclotron emission measurements, a local oscillator (LO) signal is commonly supplied to a receiver array via irradiation using LO optics. In this work, we present a 60-GHz interferometer with a new eight-channel receiver array, called a local oscillator integrated antenna array (LIA). An outstanding feature of LIA is that it incorporates a frequency quadrupler integrated circuit for LO supply to each channel. This enables simple and uniform LO supply to the receiver array using only a 15-GHz LO source and a coaxial cable transmission line instead of using an expensive 60-GHz source, LO optics, and a waveguide transmission line. The new interferometer system is first applied to measure electron line-averaged density inside the divertor simulation experimental module (D-module) on GAMMA 10/PDX tandem mirror device.

Measurement of neutral gas pressure in the D-module of GAMMA 10/PDX by using ASDEX type fast ionization gauge.

In the divertor simulation experiments in the GAMMA 10/PDX tandem mirror, pressure of the neutral gas was investigated by using a fast ionization gauge. The gauge was absolutely calibrated for hydrogen gas by using a capacitance manometer. Change of the gauge sensitivity due to the magnetic field of GAMMA 10/PDX was also evaluated. The typical gas pressure measured in detached plasma experiments was 0.1-10 Pa. The degree of plasma detachment determined from the reduction of heat flux was enhanced as the gas pressure increases. Rapid increase of the gas pressure under the plasma flow was also observed.

Effect of pre-reacted glass-ionomer filler extraction solution on demineralization of bovine enamel.

OBJECTIVE: To determine the effect of pre-reacted glass-ionomer (PRG) filler extraction solution on the demineralization of bovine enamel by measuring changes in the ultrasound transmission velocity. METHODS: The specimens were prepared by cutting bovine teeth into enamel blocks. The specimens were immersed in buffered lactic acid solution for 10 minutes twice a day, and then stored in artificial saliva. Other specimens were stored in PRG filler extraction solution for 10 minutes, followed by 10-minute immersion in the buffered lactic acid solution twice a day. The propagation time of longitudinal ultrasonic waves was measured by a pulser receiver. Six specimens were used for each condition, and analyses of variance followed by Tukey tests (α=0.05) were done. RESULTS: No changes in sonic velocity were found for specimens stored in the PRG filler extraction solution, indicating that the PRG extraction solution had an effect on inhibiting the demineralization of bovine enamel. CONCLUSIONS: The results obtained with the use of an ultrasound measurement technique suggested that PRG filler extraction solution has the ability to prevent demineralization of enamel.

Colorectal cancer pulmonary oligometastases: pooled analysis and construction of a clinical lung metastasectomy prognostic model.

BACKGROUND: Although resecting colorectal cancer (CRC) pulmonary metastasis is associated with long-term survival, identification of prognostic groups is needed for future randomized trials, and construction of a lung metastasectomy prognostic model (LMPM) is warranted. PATIENTS AND METHODS: We searched the PubMed database for retrospective studies evaluating prognostic factors following resecting CRC lung metastasis. Individual patient data were analyzed. Independent prognostic factors were used to construct an LMPM. RESULTS: Between 1983 and 2008, 1112 metastasectomies were carried out on 927 patients included in eight studies. Five-year survival rate was 54.3% following the first lung resection. Multivariate analysis identified three independently poor prognostic factors: pre-thoracotomy carcinoembryonic antigen ≥5 ng/ml, disease-free interval <36 months, and more than one metastatic lesion. Patients with good-, intermediate-, and high-risk groups according to the LMPM had a 5-year survival of 68.2%, 46.4%, and 26.1%, respectively (P < 0.001). Perioperative chemotherapy and previously resected liver metastasis had no influence on survival. CONCLUSIONS: The low- and intermediate-risk groups have a good chance of long-term survival following metastasectomy. However, more studies are needed to investigate whether surgery offers any advantage over systemic therapy for the poor-risk group.

Model for end-stage liver disease and model for end-stage liver disease-Na scores predict both before-listing and wait-list mortality.

BACKGROUND: Due to the organ shortage, many patients die without transplantation, even before completing an evaluation for candidacy. We analyzed outcomes after patient referral and factors associated with mortality both before and after listing for cadaveric donor liver transplantation. METHODS: We analyzed 132 consecutive patients who were evaluated for candidacy for cadaveric donor liver transplantation between 2003 and 2010. RESULTS: The study included 69 men and 63 women of median age 49 years (range, 1-65). Etiologies of diseases were acute hepatic failure (n=19), liver cirrhosis due to hepatitis B or C (n=36), primary biliary cirrhosis (n=19), nonviral cirrhosis (n=14), hepatocellular carcinoma (n=13), or other causes (n=31). After evaluation for candidacy, we listed 68 (52%), subjects whereas 24 (18%) died before listing. Factors affecting death before listing were the levels of albumin (P<.001), bilirubin (P<.001), sodium (P<.001), international normalized ratio (INR; P<.001), Model for End-stage Liver Disease (MELD) score (P<.001), MELD-Na score (P<.001), and Child-Pugh-Turcotte (CPT) score (P<.001). Based on multivariate Cox regression analysis, MELD score (hazard ratio [HR] 1.201, P=.017), MELD-Na score (HR 1.244, P=.014), CPT score (HR 1.468, P=.033), and INR (HR 0.491, P=.027) were independently associated with death before listing. Among 68 listed candidates, 11 (16%) underwent transplantation, whereas 29 (43%) died without transplantation. Based on multivariate Cox regression analysis, MELD score (HR 1.102, P=.001), MELD-Na score (HR 1.128, P=.001), and CPT score (HR 1.282, P=.038) independently predicted wait-list mortality. All 11 patients who underwent cadaveric liver transplantation were alive at 29 months (range, 1-55) after transplantation. CONCLUSIONS: Patients with a higher MELD, higher MELD-Na, and higher CPT score at referral were at greater risk for death without transplantation, especially before listing. Evaluation for transplantation candidacy is a time-consuming process. Therefore, earlier referral is mandatory to achieve successful listing for transplantation.

Primary neuroendocrine carcinoma of the hypopharynx: a case report.

Primary neuroendocrine carcinoma of the hypopharynx is extremely rare. A 59-year-old man complaining of swollen right cervical lymph node was admitted to our hospital. Although computed tomography, upper endoscopy, and positron emission tomography scan were performed, the primary lesion was unknown. Bilateral neck lymph node dissection was performed and diagnosed as metastasis of neuroendocrine carcinoma. Sixteen months after the first operation, computed tomography scan revealed multiple liver metastases. There was no another metastatic lesion, and hepatectomy with negative margin was performed. Three months after the second operation, a small tumor of the hypopharynx was detected by upper endoscopy, and biopsy revealed neuroendocrine carcinoma. Concurrent chemotherapy (cisplatin + docetaxel) and radiotherapy (60 Gy) were carried out. This therapy was highly effective, and primary lesion disappeared. After the chemoradiotherapy, lung metastasis and bone metastasis emerged and treated by radiotherapy and chemotherapy (cisplatin + irinotecan). These therapies were also effective, but multiple liver metastases appeared. The patient died 39 months after the first surgery. Although neuroendocrine carcinoma is a high-grade malignancy which metastasizes easily, combined treatment strategy may be useful for these patients. We have here reported, with bibliographic consideration, a case in which multimodal treatment was employed for primary hypopharyngeal neuroendocrine carcinoma with distant metastases.

R1 resection for aggressive or advanced colorectal liver metastases is justified in combination with effective prehepatectomy chemotherapy.

AIMS: Here we reassess anticipated inability to obtain a microscopically clear surgical margin as an absolute contraindication to surgery for colorectal liver metastases in view of improvements in treatment modalities adjunctive to surgery. METHODS: We retrospectively analysed 310 patients treated at our institution to estimate the survival benefit from R1 hepatectomy performed to remove liver metastases from colorectal cancer. RESULTS: Considering all 310 patients evaluated, the R1 resection group (positive margin; n = 55) showed a lower disease-free rate (P < 0.01) and worse overall survival (P < 0.01) than the R0 resection group (negative margin; n = 255). When patients were divided according to initial resectability, similar differences in disease-free rate and overall survival (P = 0.03) between R1 (n = 19) and R0 (n = 182) were observed in patients whose metastases were resectable. However, superior impact of R0 resection (n = 73) compared to R1 resection (n = 36) on disease-free rate (P = 0.44) and overall survival (P = 0.50) was not confirmed in patients with initially unresectable or marginally resectable metastases, especially those with a favourable response to prehepatectomy chemotherapy. CONCLUSIONS: A predicted positive surgical margin after resection no longer should be an absolute contraindication to surgery for aggressive or advanced liver metastases.

[Evaluation of postoperative pain relief by infiltration of bupivacaine or epidural block after laparoscopic cholecystectomy].

We compared the analgesic effect of bupivacaine infiltration into surgical wounds with that of epidural block after laparoscopic cholecystectomy (LC). Forty-five patients (ASA physical status I-II) for LC were randomized into three groups (n = 15 in each group). Patients received only general anesthesia (Group C), received infiltration of 0.5% bupivacaine into the surgical wound before surgery combined with general anesthesia (Group L), or received epidural anesthesia combined with general anesthesia (Group E). Postoperative pain was assessed using visual analogue scale (scale: 0-10) at 1, 2, 6 and 12 hours after the operation, the need for additional supplemental analgesics, and the cost of anesthesia. Visual analogue scale in Group C at 1, 2, or 6 hours was significantly greater than that of Group L and E. The number of patients who needed supplemental analgesics was 9 in Group C, 5 in Group L, and 2 in Group E. The cost of pharmaceutical and anesthetic practice of Group E was more expensive than Group L and C. In conclusion, infiltration of bupivacaine combined with general anesthesia is an effective and economical method of postoperative pain relief.

Reduction in tick numbers (Haemaphysalis longicornis), mortality and incidence of Theileria sergenti infection in field-grazed calves treated with flumethrin pour-on.

The effectiveness of the pour-on formulation of flumethrin was tested on grazing cattle. Flumethrin was applied once a month from April to October from 1990 to 1995 to cattle grazing in the Aso area of Kumamoto Prefecture in Japan. Both the number of ticks in the field and the number of ticks feeding on cattle decreased remarkably in relation to the number of years flumethrin was applied. Ticks in the field were not detected in 1994 and 1995, and ticks feeding on cattle decreased to 4% in 1995. Mortality due to Theileria sergenti infection also decreased significantly after more than 3 years of flumethrin pour-on application, although overall mortality did not change. At the end of the trial the incidence of T. sergenti had decreased to one-fifth of the pretrial value, although total incidence of disease had not changed. These results indicated that multiple-year seasonal application of flumethrin pour-on to grazing cattle effectively decreased the number of ticks and decreased both mortality and incidence of T. sergenti.

[Chemical evaluation and consideration on the traditional drug "ULUUS" (2)].

Traditional patent medicine named "ULUUS" has been regarded to be the first Dutch precipitation with a western name in Japan. It was found that this drug consists of Rhubarb mainly, and it contained high amounts of effective compounds as for the traditional sample that has been stored for more than 100 years. In fact, a dose of this medicine was supposed to cause a laxative effect.

[ULUUS, the first Japanese medicine with a western name].

"ULUUS" is a patent medicine which was put on sale when the Japanese started to adopt Western Medicine brought in from Holland. It is regarded as the first medicine to have a Western-style name in Japan. In those days, ULUUS was thought be a useful medicine for patients with diseases called Tan, Ryuin and Shakki, causing the excretion of phlegm and bad accumulations in the body through expectoration, urine of feces. We recently obtained an ULUUS medication which was made in around 1870. It contains 15 tablets pressed neatly onto a sheet and has an inner wrapper, middle wrapper and outer wrapper made from 3 kinds of Japanese paper...

[Chemical evaluation and consideration on the traditional drug "ULUUS" (1)].

Traditional medicine named "ULUUS" is regarded to be the first Dutch precipation with a western name in Japan. It was found that this drug consists of Rhubarb (originated from Rheum sp.). Although it is still uncertain whether it was made only of Rhubarb by being kneaded hard into the monotonous square form, we could not find out any other ingredients except Rhubarb, on the bases of our chemical analysis.

Intracranial malignant fibrous histiocytoma: characterization of GFAP-positive cells in the tumor.

A case of malignant fibrous histiocytoma (MFH) arising in the cerebellopontine angle of a 57-year-old woman was reported. The immunohistochemical and electron microscopic findings indicated distinct fibrohistiocytic nature and myofibroblastic differentiation of this peculiar tumor. Immunohistochemistry disclosed that the tumor cells expressed monocyte/macrophage markers including CD-68, MAC 387, and alpha-1-antichymotrypsin. In addition, the neoplasm contained scattered glial fibrillary acidic protein (GFAP)-positive cells which made small nests in some areas. These GFAP-positive cells had bundles of densely packed intermediate filaments and scanty organellae in the cytoplasm, as demonstrated by an immunostained-semithin and serial-ultrathin section method. By immunostaining of MIB-1 and GFAP, and silver nucleolar organizer region (AgNOR) impregnation on serial sections, the GFAP-positive cells were not labeled by MIB-1 and their AgNOR counts averaged 1.13/nucleus. Thus, these GFAP-positive cells seem to have lower proliferating activity than neoplastic astrocytes. It is concluded that they may be nonneoplastic astrocytic cells involved by MFH.

Fournier's gangrene: report of a case associated with paralytic and mechanical ileus throughout the management of the gangrene.

A 65-year-old Japanese male, who was treated for Fournier's gangrene, developed an enlarged erythema over the right thigh and right lower quadrant. The area was surgically debrided, and he was given antibiotics. However, he complained of abdominal swelling with a metallic bowel sound, pain, and vomiting and was then treated for paralytic ileus. Although his symptoms initially improved, he complained again of the same symptoms and underwent surgery for mechanical ileus occurring at the site of a surgical scar from an appendectomy 43 years earlier. This is a very rare case of Fournier's gangrene which caused mechanical ileus of the small intestine and adherence to a peritoneal scare after paralytic ileus due to inflammation of the abdominal fascia following scrotal gangrene.

[Actinomycotic granuloma of the optic chiasma: a case report].

A case of actinomycotic granuloma of the optic chiasma and the optic nerve is reported. A 53-year-old man was admitted to our hospital with headache and vomiting on September 25, 1989. General physical and neurological examination on admission revealed no remarkable findings. CT-scan demonstrated almost normal pictures. On the 17th hospital day, his temperature was 38 degrees C and white blood cell (WBC) count was 12000 cumm. And he presented right abducens palsy. MRI demonstrated no abnormal findings then. After antibiotic therapy of penicillin intravenously for 4 days, his temperature returned to normal and abducens palsy disappeared for two weeks. He was discharged 43 days after admission. But one year after discharge he developed progressive impairment of right visual acuity. He was admitted to our hospital again on January 19, 1991. His neurological examination revealed severe impairment of right visual acuity and bitemporal hemianopsia. WBC count was 5400 and CRP was negative and temperature was 36.2 degrees C. CT-scan and MRI demonstrated a suprasellar enhancing mass lesion. Serum prolactin was 38 ng/ml. A diagnosis of pituitary adenoma was considered and a right frontotemporal craniotomy was performed. At operation, abnormally swelled right optic nerve and chiasma were found and the swelled chiasma only was resected. Histological examination showed an abscess containing necrotic tissues and actinomycotic granules with radiating filaments. The patient was given penicillin intravenously for 37 days and orally for two months. At that time, MRI revealed no abnormal enhancing lesion, and his visual acuity improved gradually. Actinomycosis of the optic nerve and chiasma is very rare.(ABSTRACT TRUNCATED AT 250 WORDS)