Development and Validation of a Symptom-Focused Quality of Life Questionnaire (KOQUSS-40) for Gastric Cancer Patients after Gastrectomy.

PURPOSE: Patients who have undergone gastrectomy have unique symptoms that are not appropriately assessed using currently available tools. This study developed and validated a symptom-focused quality of life (QoL) questionnaire for patients who have received gastrectomy for gastric cancer. MATERIALS AND METHODS: Based on a literature review, patient interviews, and expert consultation by the KOrean QUality of life in Stomach cancer patients Study group (KOQUSS), the initial item pool was developed. Two large-scale developmental studies were then sequentially conducted for exploratory factor analyses for content validity and item reduction. The final item pool was validated in a separate cohort of patients and assessed for internal consistency, test-retest reliability, construct validity, and clinical validity. RESULTS: The initial questionnaire consisted of 46-items in 12 domains. Data from 465 patients at 11 institutions, followed by 499 patients at 13 institutions, were used to conduct item reduction and exploratory factor analyses. The final questionnaire (KOQUSS-40) comprised 40 items within 11 domains. Validation of KOQUSS-40 was conducted on 413 patients from 12 hospitals. KOQUSS-40 was found to have good model fit. The mean summary score of the KOQUSS-40 was correlated with the EORTC QLQ-C30 and STO22 (correlation coefficients, 0.821 and 0.778, respectively). The KOQUSS-40 score was also correlated with clinical factors, and had acceptable internal consistency (> 0.7). Test-retest reliability was greater than 0.8. CONCLUSION: The KOQUSS-40 can be used to assess QoL of gastric cancer patients after gastrectomy and allows for a robust comparison of surgical techniques in clinical trials.

The pattern of postoperative quality of life following minimally invasive gastrectomy for gastric cancer: a prospective cohort from Korean multicenter robotic gastrectomy trial.

PURPOSE: Quality of life (QOL) has become important in the trend of emphasizing patient satisfaction. This study aimed to evaluate the QOL in patients who underwent laparoscopic or robotic gastrectomy for gastric cancer. METHODS: A prospective trial was performed involving patients who underwent laparoscopic or robotic gastrectomy for primary gastric cancer at 11 hospitals in Korea. Within this comparative trial, QOL, postoperative pain, and long-term complications were exanimated. The quality-of-life questionnaire (QLQ)-C30 and QLQ-STO22 developed by the European Organization for Research and Treatment of Cancer were used for the QOL survey. We compared the data after dividing it into several types of characteristics as follows; device (robotic or laparoscopic), operation type, pathological stage, and sex. Biased components were extracted by logistic regression analysis. Propensity score matching was applied to the data set with the biased components. RESULTS: In total, 434 patients (211 for laparoscopic surgery and 223 for robotic surgery) were enrolled, out of which 321 patients who responded to both preoperative and postoperative surveys were selected for analysis. Robotic gastrectomy was not different from laparoscopic gastrectomy with respect to postoperative QOL. Distal gastrectomy showed better scores than total gastrectomy in terms of role functioning, social functioning, fatigue, nausea/vomiting, pain, dyspnea, constipation, financial difficulties, dysphagia, eating restrictions, anxiety, taste, and body image. Male patients showed better scores on the 19 scales compared to female patients. CONCLUSION: Robotic and laparoscopic approaches for gastric cancer surgery did not differ from each other with respect to QOL. Distal gastrectomy resulted in better QOL than total gastrectomy.

Antibacterial dental restorative materials: A review.

PURPOSE: To provide updated summary information about antibacterial dental materials, primarily covering the literature from 2012 through 2017. METHODS: A key-worded search was conducted of peer-reviewed literature (Titles/Abstracts) indexed by PubMed databases, constrained to "English" and " dental" publications between the years 2012 and 2017. Key words applied to the search included: antimicrobial, antibacterial, primer, bonding agent, adhesive, cement, composite, liner, sealant, etchant, and core-build-up. Titles and abstracts of the articles returned by the search were reviewed and evaluated for appropriateness for inclusion in this review. RESULTS: A variety of antibacterial agents have been incorporated into experimental and commercial dental restorative materials to provide antibacterial activity in dental applications. No new antibacterial compounds were introduced in this review period (2012-2017), since the last review of period of 1980-2012. Antibacterial agents include leachable compounds (e.g. benzalkonium chloride, chlorhexidine), polymerizable monomers (e.g. quaternary ammonium methacrylates), and filler particles (e.g. silver nanoparticle). During the 2012-2017 review period, many antibacterial agents were tested in experimental formulations, but only four agents (benzalkonium chloride, chlorhexidine, glutaraldehyde, and MDPB) were used in commercial products. CLINICAL SIGNIFICANCE: Leachable antibacterial agents are the most frequently used type of antibacterial dental materials, but their efficacy may be short-lived due to their characteristic burst effect. Solid filler particles appear to be effective antibacterial agents, especially given their ability to reduce biofilm formation, but the color stability of their component metal particles is unfavorable for use in a commercial product. Polymerizable antibacterial agents (MDPB) are theoretically a good choice of material because they are very effective at killing any residual bacteria in a cavity preparation prior to polymerization, however, apart from their proven effect on reduction of biofilm formation, their long-term clinical performance is still questionable.

Long-Term Survival of a Patient with Adenocarcinoma of the Esophagogastric Junction with a Portal Vein Tumor Thrombosis Who Underwent Palliative Total Gastrectomy: A Case Report.

Portal vein tumor thrombosis (PVTT) with advanced gastric cancer is very rare; when it occurs, it exhibits aggressive growth and carries a poor prognosis. In addition, definitive treatment has not been established due to insufficient data. Herein, we report a case of PVTT associated with an adenocarcinoma of the esophagogastric junction that was successfully controlled by means of a palliative total gastrectomy without surgical resection of the PVTT and administration of palliative continuous doxifluridine.

The association between skeletal maturation and adrenal androgen levels in obese children and adolescents.

PURPOSE: This study aimed to investigate the association between skeletal maturation and adrenal androgen levels in obese children and adolescents. METHODS: Fifty-three children and adolescents (aged 7-15 years) diagnosed as obese or overweight were investigated. Anthropometric measurements, bone age (BA) determination, serum biochemical analyses, and hormonal measurements were performed. The difference between BA and chronological age (BA-CA, dBACA) was calculated and used to represent the degree of advanced skeletal maturation. RESULTS: Thirty-one subjects were classified into the obese group and 22 subjects into the overweight group. Insulin resistance as calculated by the homeostasis model assessment of insulin resistance (HOMA-IR) was significantly higher in the obese group than in the overweight group (4.03±2.20 vs. 2.86±1.11, P=0.026). The skeletal maturation of the obese group was advanced, but the dBACA did not differ between the obese and overweight groups statistically (1.43±1.35 vs. 0.91±1.15, P=0.141). Serum dehydroepiandrosterone sulfate (DHEA-S) levels were significantly higher in subjects with dBACA>1 compared to those with dBACA≤1 (104.3±62.2 vs. 59.6±61.0, P=0.014). Correlation analyses demonstrated that dBACA was positively correlated with body mass index standard deviation scores (r=0.35, P=0.010), fasting insulin (r=0.36, P=0.009), HOMA-IR (r=0.30, P=0.031), and insulin-like growth factor-binding protein-3 (r=0.331, P=0.028). In multivariate linear regression analysis, HOMA-IR (P=0.026) and serum DHEA-S (P=0.032) were positively correlated with the degree of advanced skeletal maturation. CONCLUSION: Advanced skeletal maturation is associated with increased insulin resistance and elevated DHEA-S levels in obese children and adolescents.

A Case of Noncuratively Resected Gastric Cancer and Postoperative Chemotherapy with S-1 Monotherapy Resulting in Long-Term Survival for Over 8 Years.

We report the case of a noncuratively resected gastric cancer patient who was successfully treated with S-1 monotherapy, resulting in long-term survival of 96 months. A 72-year-old woman underwent noncurative resection of subtotal gastrectomy for advanced gastric cancer with conglomerated lymph node metastasis and pancreatic invasion. She received chemotherapy with S-1 monotherapy postoperatively. S-1 (100 mg/day) was administered orally after breakfast and dinner for 28 days followed by a 14-day break for a total of 52 months. Regular checkups with esophagogastroduodenoscopy, abdominopelvic computed tomography, and fluorine-18-fluorodeoxyglucose positron emission tomography revealed no evidence of cancer 96 months after the operation. The patient was effectively treated with long-term administration of S-1 after noncurative gastrectomy for advanced gastric cancer.

Alcohol Consumption, High-Density Lipoprotein Cholesterol, Antithrombin III, and Body Mass Index Are Associated with Great Saphenous Vein Reflux in the Thigh.

BACKGROUND: Venous valvular reflux is the main cause of chronic venous dysfunction. However, the etiology of valvular reflux is not completely understood. We conducted this study to investigate new risk factors for venous reflux of the great saphenous vein (GSV) in the thigh. METHODS: We studied 139 consecutive patients (278 legs) who underwent Doppler ultrasonography at our hospital between March 2015 and February 2016 for leg discomfort with visible varicosities, edema, skin changes, or venous ulcer in the legs. Continuous variables included age, body mass index (BMI), hematological and blood chemistry parameters, smoking (pack-years), and alcohol consumption (days). Nominal variables included sex, comorbidities, smoking status, alcohol drinking status, and specific antibodies. The relationship of GSV reflux with pregnancy and number of children was investigated in 184 legs of 92 patients among 96 female patients. RESULTS: On logistic regression analysis, independent factors determining GSV reflux were BMI (B = 0.126, P = 0.012), high-density lipoprotein (HDL) cholesterol level (B = 0.029, P = 0.025), duration of alcohol consumption (B = 1.237 E-4, P = 0.016), and antithrombin III level (B = -0.036, P = 0.011). CONCLUSIONS: In this study, the factors determining GSV reflux were higher HDL cholesterol level, longer duration of alcohol consumption, lower antithrombin III level, and higher BMI.

[The Short-term Outcome and Safety of Laparoscopic Colorectal Cancer Resection in Very Elderly Patients].

BACKGROUND/AIMS: Due to the recent increase in elderly population, laparoscopic surgery is more frequently performed in the elderly. This study aimed to compare the short-term outcomes of laparoscopic colorectal cancer surgery between the very elderly group (VEG), categorized as those with age over 80 years and the elderly group (EG), categorized as those with age 65 to 79 years. METHODS: We retrospectively compared 48 very elderly patients with 96 elderly patients (1:2 matched) who underwent laparoscopic resection for colorectal cancers at our institution between March 2010 and December 2014. The clinicopathologic parameters, surgical characteristics and short term outcomes were compared. RESULTS: There was no statistically significant difference in clinicopathologic characteristics between VEG and EG. Postoperative pain score (7 points vs. 6 points, p=0.264), time to first flatus (3 days vs. 3 days, p=0.335), hospital stay (15 days vs. 16.5 days, p=0.361), complication rates (47.9% vs. 26.0%, p=0.147) and major complication rate (25% vs. 20.8%, p=0.681) were not statistically different between the two groups. Before surgery, VEG had higher rate of neurologic underlying disease, such as dementia or cerebrovascular disease, than EG (25.0% vs. 7.3%, p=0.007). CONCLUSIONS: There was no significant difference in the clinicopathologic characteristics, short-term outcomes, and complication rates for laparoscopic colorectal resection between VEG and EG, except delirium. Age over 80 years may be relevant for the application of laparoscopic colorectal cancer resection.

A Case of Advanced Gastric Cancer with Para-Aortic Lymph Node Metastasis Treated with Preoperative FOLFOX Chemotherapy Followed by Radical Subtotal Gastrectomy and D2 Lymph Node Dissection.

We report the case of a 73-year-old female who was diagnosed with advanced gastric cancer. Esophagogastroduodenoscopy was used to diagnose Borrmann type 3 advanced gastric cancer located at the gastric antrum. A biopsy revealed poorly differentiated adenocarcinoma. Abdominopelvic computed tomography (CT) and 18F-fluorodeoxyglucose positron emission tomography-CT (FDG-PET-CT) scans demonstrated multiple lymph node metastases, including the para-aortic lymph nodes. Systemic chemotherapy with 5-fluoruracil (5-FU), oxaliplatin, and leucovorin (FOLFOX) was initiated. An abdominopelvic CT scan taken after 4 cycles of chemotherapy showed improvement in the ulceroinfiltrative gastric lesion and marked regression of several enlarged lymph nodes. Consequently, we performed a subtotal gastrectomy with D2 lymphadenectomy. The postoperative histopathological report was early gastric carcinoma with no lymph node metastasis in the 48 resected lymph nodes. Another 4 cycles of FOLFOX chemotherapy were performed after surgery. A FDG-PET-CT scan taken 12 months postoperatively showed no definite evidence of local recurrence or distant metastasis, and the previously noted retroperitoneal lymph nodes had disappeared. A FDG-PET-CT taken 16 months postoperatively showed multiple lymph node metastases, including the left supraclavicular lymph node. Despite 8 cycles of secondary chemotherapy with 5-FU, irinotecan, and leucovorin (FOLFIRI) and radiotherapy, the patient died 38 months after the operation.

Epidemiologic Study of Human Epidermal Growth Factor Receptor 2 Expression in Advanced/Metastatic Gastric Cancer: an Assessment of Human Epidermal Growth Factor Receptor 2 Status in Tumor Tissue Samples of Gastric and Gastro-Esophageal Junction Cancer.

PURPOSE: The Trastuzumab for gastric cancer (GC) trial identified human epidermal growth factor receptor 2 (HER2) as a predictor of successful treatment with trastuzumab (HER2 receptor targeting agent) among patients with advanced/metastatic GC. To date, the prevalence of HER2 overexpression in the Korean population is unknown. The present study aimed to assess the incidence of HER2 positivity among GC and gastroesophageal (GE) junction cancer samples and the relationship between HER2 overexpression and clinicopathological characteristics in Korean patients. MATERIALS AND METHODS: Tumor samples collected from 1,695 patients with histologically proven GC or GE junction enrolled at 14 different hospitals in Korea were examined. After gathering clinicopathological data of all patients, HER2 status was assessed by immunohistochemistry (IHC) at each hospital, and IHC 2+ cases were subjected to silver-enhanced in situ hybridization at 3 central laboratories. RESULTS: A total of 182 specimens tested positive for HER2, whereas 1,505 tested negative. Therefore, the overall HER2-positive rate in this study was 10.8% (95% confidence interval=9.3%-12.3%). The HER2-positive rate was higher among intestinal-type cases (17.6%) than among other types, and was higher among patients older than 70 years and 50 years of age, compared to other age groups. CONCLUSIONS: Our evaluation of the HER2 positivity rate (10.8%) among Korean patients with GC and GE junction indicated the necessity of epidemiological data when conducting studies related to HER2 expression in GC and GE junction.

Prognostic Discrepancy of the 6th and 7th UICC N Classification for Lymph Node Staging in Gastric Cancer Patients after Curative Resection.

BACKGROUND: The validity of N classification of the 7th edition of the American Joint Committee on Cancer/Union Internationale contre le Cancer (AJCC/UICC) tumor-node-metastasis (TNM) staging system is still under debate. The purpose of this study was to evaluate the prognostic efficacy of the 7th edition of the AJCC/UICC TNM staging system (focusing on N stage), in comparison with the 6th edition, at a single Eastern institution. METHODS: We analyzed 1,435 patients with gastric cancer who underwent curative resection performed from September 1998 to August 2003 at the Memorial Jin-Pok Kim Korea Gastric Cancer Center. We analyzed the survival rate of the patients according to the AJCC/UICC 6th and 7th editions, and compared each stage, focusing on N stage. RESULTS: Significant differences in the 5-year survival rates were observed between the 6th and the 7th AJCC/UICC staging system. In the 6th edition staging system, the Kaplan-Meier curves discriminated each N stage significantly. In contrast, there was no difference in terms of survival curves for N stage according to the 7th edition, especially between N1 and N2: the Kaplan-Meier plots of survival curves between N1 (77.0%) and N2 (78.1%) stages overlapped significantly (p < 0.05). CONCLUSION: Although the 7th UICC staging system is a more detailed and sophisticated system in the T category, there was no prognostic significance between the pN1 and pN2 stages according to our data. Therefore, we suggest establishing a new UICC staging system taking into consideration the application of the N stage.

A Case of Gastric Cancer with Situs Inversus Totalis.

Situs inversus totalis (SIT) is a rare congenital anomaly that refers to a completely reversed location of the abdominal and thoracic organs. We report the case of 50-year-old man with gastric cancer and SIT who was diagnosed during a screening esophagogastroduodenoscopy. A chest X-ray, abdominopelvic computed tomography, and 18F-fluoro2-deoxyglucose-D-glucose-positron emission tomography scans revealed SIT. We performed a radical subtotal gastrectomy with D2 lymph node dissection. Advanced surgical skill is required to perform a precise lymphadenectomy in a patient with SIT by visualizing the exact mirror image of the anatomy during the operation. The patient had an uneventful intra- and postoperative course and was followed up at the outpatient department without any evidence of recurrence. In conclusion, surgery in a patient with gastric cancer and SIT can be safely performed by paying attention to the inverted anatomic structures during the operation.

Simultaneous robotic subtotal gastrectomy and right hemicolectomy for synchronous adenocarcinoma of stomach and colon.

Simultaneous laparoscopy-assisted resection for synchronous stomach and colon cancers has been reported frequently; however, robot-assisted gastrectomy and colectomy for these conditions are rarely reported. We report the successful use of robotic surgery for synchronous cancers of the stomach and colon. A 71-year-old woman with no specific medical history was diagnosed with early gastric cancer at the gastric angle and right colon cancer after undergoing esophagogastroduodenoscopy and colonofiberoscopy. Abdomino-pelvic computed tomography revealed that the stomach and colon lesions were limited to the mucosa without any lymph nodes or distant metastasis, which suggested the clinical stage for both cancers as T1N0M0. We performed robot-assisted radical subtotal gastrectomy and simultaneous right hemicolectomy through six ports. All procedures were successful without any perioperative complications. A 36-month postoperative follow-up of the patient at the outpatient department revealed no evidence of recurrence. We consider that concurrent robot-assisted subtotal gastrectomy and colectomy are technically feasible and safe.

Cytotoxicity and biocompatibility of resin-free and resin-modified direct pulp capping materials: A state-of-the-art review.

Direct pulp capping is the placement of a dental material directly over exposed pulp to prevent dental pulp from dying and avoid the need for root canal treatments. Calcium hydroxide and calcium silicates/mineral trioxide aggregates (MTA) have been commonly used for direct pulp capping with great success clinically. In recent years, resin-modified calcium hydroxide and calcium silicates have been developed with the advantages of precise placement, command set, and superior physical strength. As pulp capping materials would be in direct contact with the pulp, the cytotoxicity and biocompatibility is of particular importance in order to avoid pulp irritation and maintain pulp vitality. Therefore, this review article will summarize the cytotoxicity and biocompatibility of direct pulp capping materials, particularly resin-modified materials.

Effect of silane contamination on dentin bond strength.

STATEMENT OF PROBLEM: Intraoral repair of porcelain or other silica-based ceramics typically requires the use of silane in the repair protocol. Some porcelain intraoral repairs also involve bonding to exposed or involved tooth tissues including dentin. A study is needed to evaluate whether the cross-contamination of dentin with silane affects bond strength to this tissue. PURPOSE: The purpose of this in vitro study was to investigate the effect of silane cross-contamination on dentin bond strength. MATERIAL AND METHODS: Flat surfaces of human dentin specimens were created, followed by wet polishing with 320-grit silicon carbide paper. The dentin specimens were divided into 4 groups: group SE (All-Bond Universal Adhesive used in self-etching mode); group SiSE (silane applied to dentin followed by All-Bond Universal Adhesive used in self-etching mode); group ER (All-Bond Universal Adhesive used in total-etch (etch-and-rinse) mode); and group ERSi (Etch and rinse and silane applied to dentin followed by All-Bond Universal Adhesive). The dentin specimens were treated with a universal adhesive (All-Bond Universal) and bonded with a composite resin, using an Ultradent jig mold. Shear bond strength (n=10) was measured after 24 hours of water storage at 37°C. After the shear bond strength test, the dentin sides of fractured specimens in each group were examined with a stereomicroscope at ×15 magnification to determine failure modes. Data were statistically analyzed by 2-way and a 1-way ANOVA followed by post hoc Tukey honest significant difference test (α=.05). Scanning electron microscopy examination was used to evaluate the dentin surface morphology before and after bonding. RESULTS: The shear bond strength of composite resin to dentin was not affected adversely when the dentin was contaminated with silane prior to using All-Bond Universal in the self-etch or total- etch (phosphoric acid) mode. SE, 30.3 ±3.8 MPa; SiSE, 32.9 ±3.9 MPa; ER, 34.9 ±3.1 MPa; ERSi: 35.2 ±4.9 MPa (P>.05) CONCLUSIONS: Under the conditions of this study, cross-contamination of dentin with silane before the use of All-Bond Universal in the self-etch or total-etch with phosphoric acid mode did not adversely affect composite resin bond strength to dentin.

Synchronous and Metachronous Colon Cancers in Patients with Gastric Cancer: Report of 2 Cases.

Colorectal cancer is the most common synchronous or metachronous cancer in patients with gastric cancer. I report two cases of synchronous and metachronous colon cancer with gastric cancer. Case 1: A 70-year-old man was admitted to our hospital for the treatment of gastric cancer, which had been diagnosed during esophagogastroduodenoscopy (EGD) screening. The recommended preoperative testing was colonofiberscopy (CFS). The CFS revealed a 3-cm ulcerofungating mass, located 20 cm from the anal verge. The pathological report showed a well-differentiated adenocarcinoma. Consequently, we performed radical total gastrectomy and low anterior resection simultaneously. There was no recurrence during the 40-month follow-up of this individual on an out-patient basis. Case 2: A 71-year-old man who was treated with laparoscopically assisted distal gastrectomy (LADG) due to early gastric cancer underwent regular follow-up examination with EGD and abdominopelvic computed tomography. A CFS performed 5 years after the LADG revealed a polypoid mass in the sigmoid colon. The pathological report showed a villous adenoma with adenocarcinoma in situ. The patient underwent a colonofiberscopic mucosectomy. At 36 months after the endoscopic mucosectomy, the patient remained free of recurrence.

A Case of Malignant Gastrointestinal Stromal Tumor Initially Misdiagnosed as Malignant B-Cell Lymphoma.

Errors that occur in anatomic pathology influence the treatment strategy of patients with malignancy. There are four general types of error with three subtypes in the category of defective interpretation. The first subtype is a false-negative diagnosis or undercall of the extent or severity of the lesion, the second is a false-positive diagnosis, and the third is misclassification. We herein report a 65-year-old female patient with malignant gastrointestinal stromal tumor that was diagnosed after reevaluation of the lesion at our hospital - and treated with proximal gastrectomy - after initial diagnosis as malignant B-cell lymphoma on esophagogastroduodenoscopy biopsy of a small gastric fundic mass and subsequent treatment with six cycles of CHOP chemotherapy with aggravation of the mass at another hospital.

A Giant Retroperitoneal Liposarcoma Encasing the Entire Left Kidney and Adherent to Adjacent Structures: A Case Report.

Retroperitoneal liposarcoma is a rare tumor. The dimension and weight of liposarcoma are variable; those over 20 kg are called 'giant liposarcoma'. Herein, we report giant retroperitoneal liposarcoma measuring 45 cm in diameter and 25 kg in weight encasing the entire left kidney and adherent to adjacent structures. A 71-year-old woman presented for a regular checkup. Image study revealed a huge mass probably indicative of retroperitoneal liposarcoma encasing the entire left kidney and adherent to adjacent structures. We performed an organ-preserving surgical removal. The pathologic report was liposarcoma. At postoperative month 16, a follow-up CT revealed a locally recurrent tumor. The patient underwent surgical removal of the newly discovered mass. After the second surgery, the patient underwent regular follow-up CT for approximately 12 months, and to date, there has been no evidence of tumor recurrence. High-grade liposarcoma shows sensitivity to radiation therapy. However, the toxic effect of radiation therapy limits this option by treatment modality. The use of chemotherapy is also controversial. As a result, complete resection is the gold standard treatment. Here, we report a giant retroperitoneal liposarcoma encasing the entire left kidney and adherent to adjacent structures, describe successful organ-preserving surgical removal and discuss prognosis.

Effects of light-, self-, and tack-curing on degree of conversion and physical strength of dual-cure resin cements.

PURPOSE: To evaluate the polymerization degree of conversion (DC) and physical strength of dual-cure cements with tack-curing, and compare them to those with light-curing and self-curing resins. METHODS: Four dual-cure resin cements were evaluated by DC and diametral tensile strength (DTS) tests with three different polymerization methods: Light-cure (photo-polymerization 40 seconds, self-curing 30 minutes); Self-cure (self-curing 30 minutes); and Tack-cure (photo-polymerization 3 seconds, self-curing 30 minutes). Polymerization degree of conversion was determined using Fourier transform infrared spectroscopy, and calculated based on the ratio changes of aliphatic-to-aromatic C=C IR absorption peaks before and after polymerized. Specimens for DTS (n = 10) were prepared using circular molds (6.0 mm in diameter and 3.0 mm in height) and tested after 24-hour water storage. Data were analyzed by two-way ANOVA. Multiple post-hoc pairwise comparisons were performed by t-test when significant effects were found across the factors (α = 0.05). Results: The Self-cure groups had slow initial curing rate, resulting in the lower DC than both the Light-cure and Tack-cure groups. After 30 minutes of polymerization, only in the RelyX Ultimate group, light-curing resulted in higher DC than tack-curing, which resulted in higher DC than self-curing (P < 0.05). The self-cure of resin cements resulted in a significantly lower DTS only for RelyX Ultimate cement (P < 0.05). There was no significantly different DTS between the Tack-cure and Light-cure groups for all of the resin cements. For all of the three curing modes, RelyX Ultimate cements had the lowest DTS among the four cements tested in this study.

Gastric Schwannoma Mimicking Malignant Gastrointestinal Stromal Tumor Exhibiting Increased Fluorodeoxyglucose Uptake.

A schwannoma is a kind of neurogenic tumor that rarely occurs in the gastrointestinal tract. Gastric schwannomas make up 0.2% of all gastric neoplasms. Gastrointestinal stromal tumors (GIST) are the most common mesenchymal tumors and up to 60-70% of GIST occur in the stomach. Schwannoma and GIST are similar in clinical features, so they are difficult to differentiate preoperatively. Differential diagnosis of these two submucosal tumors is important because of the malignant potential of GIST and the relatively benign course of gastric schwannomas. We report a 49-year-old woman who was diagnosed after operation with a gastric schwannoma, which was suspected a malignant GIST by fluorine-18-fluorodeoxyglucose positron emission computed tomography imaging.