3-D finite element analysis of the effects of post location and loading location on stress distribution in root canals of the mandibular 1st molar

Objective The purpose of this study was to evaluate, by using finite element analysis, the influence of post location and occlusal loading location on the stress distribution pattern inside the root canals of the mandibular 1st molar. Material and Methods Three different 3-D models of the mandibular 1st molar were established: no post (NP) – a model of endodontic and prosthodontic treatments; mesiobuccal post (MP) – a model of endodontic and prosthodontic treatments with a post in the mesiobuccal canal; and distal post (DP) – a model of endodontic and prosthodontic treatments with a post in the distal canal. A vertical force of 300 N, perpendicular to the occlusal plane, was applied to one of five 1 mm2 areas on the occlusal surface; mesial marginal ridge, distal marginal ridge, mesiobuccal cusp, distobuccal cusp, and central fossa. Finite element analysis was used to calculate the equivalent von Mises stresses on each root canal. Results The DP model showed similar maximum stress values to the NP model, while the MP model showed markedly greater maximum stress values. The post procedure increased stress concentration inside the canals, although this was significantly affected by the site of the force. Conclusions In the mandibular 1st molar, the distal canal is the better place to insert the post than the mesiobuccal canal. However, if insertion into the mesiobuccal canal is unavoidable, there should be consideration on the occlusal contact, making central fossa and distal marginal ridge the main functioning areas

Variability of Response Time as a Predictor of Methylphenidate Treatment Response in Korean Children with Attention Deficit Hyperactivity Disorder

PURPOSE: Methylphenidate (MPH) is an effective medication for the treatment of attention deficit hyperactivity disorder (ADHD). However, about 30% of patients do not respond to or are unable to tolerate MPH. Based on previous findings, we hypothesized that great variability in response time (RT) among Korean children with ADHD on a computerized continuous performance attention test would be related to poor MPH treatment response. MATERIALS AND METHODS: Children (ages 6-18 years) with ADHD were recruited for a prospective 12-week, open-labeled, multicenter study to examine optimal dosage of OROS methylphenidate. Of the 144 subjects selected, 28 dropped out due to adverse events, medication noncompliance, or follow-up loss, and an additional 26 subjects with comorbid disorders were excluded from statistical analyses. We defined 'responders' as subjects who received a score of less than 18 on the attention deficit hyperactivity disorder rating scale (ARS; Korean version, K-ARS) and a score of 1 or 2 on the Clinical Global Impression-Improvement scale (CGI-I). RT variability was assessed with the ADHD diagnostic system (ADS). RESULTS: Fifty-nine (67%) subjects responded to MPH treatment. The non-responders showed greater RT variability at baseline (Mann Whitney U = 577.0, p < 0.01). Baseline RT variability was a significant predictor of MPH response (Nagelkerke R(2) = 0.136, p < 0.01). It predicted 94.9% of responder, 17.2% of non-responder and 69.3% of overall group. CONCLUSION: High RT variability may predict poor response to MPH treatment in children with ADHDope

Mid-term results in patients having tricuspidization of the quadricuspid aortic valve

BACKGROUND: Quadricuspid aortic valve (QAV) is a rare congenital anomaly. We investigate the mid-term results of aortic valve reconstruction by tricuspidization in patients with QAV. METHODS: We analyzed the outcome of eight consecutive patients who underwent aortic valve reconstruction surgery (AVRS) with pericardial leaflets with symptomatic quadricuspid aortic valve (QAV) disease between December 2007 and May 2012. AVRS consists of leaflet reconstruction and fixation of the sino-tubular junction in order to maintain coaptation of the new valve. RESULTS: Six males and two females were included; ages ranged from 19 to 63 years (mean age, 51 years). According to Hurwitz and Roberts’s classification, three patients had type A, three patients had type B, one patient had type C, and one patient had type E. All patients had significant aortic regurgitation (AR): moderate in three patients, moderate to severe in one patient, and severe in four patients. Concomitant ascending aorta wrapping with an artificial vascular graft was performed in one case. There was no occurrence of mortality during the follow-up period (42.4 ± 18.0 months). No redo-operation was required. The NYHA functional class showed improvement from 2.1 ± 0.2 to 1.1 ± 0.2 (p = 0.008). The latest echocardiograms showed AR absent or trivial in seven patients, and mild in one patient. The aortic valve orifice area index (AVAI) was 1.03 ± 0.49 cm(2)/m(2). Compared with preoperative echocardiograms, the left ventricular (LV) ejection fraction showed improvement from 57.6 ± 17.0 to 63.7 ± 13.2% (p = 0.036); the end-diastolic and end-systolic LV dimensions showed a significant decrease, from 63.5 ± 9.6 to 49.5 ± 3.1 mm (p = 0.012) and 43.6 ± 11.8 to 32.1 ± 5.4 mm (p = 0.012), respectively. CONCLUSION: In patients with QAV, AVRS with tricuspidization showed satisfactory early and mid-term results. Long-term follow-up will be necessary in order to study the durability of AVRS; however, it can be considered as a potential standard procedure

Ecologic correlation Study on Nutrients/Foods Intake and Mortal ity for Female Breast Cancer in Korea

In order to investigate the possible role of dieta-ry factors on the recent increase in mortality for female breast cancer in Korea, an ecologic correlation study between per capita intakes of nutrients and foods and the mortality for female breast cancer during the last 10 years was conducted. In spite of the possibility of an ecologic fallacy, the age-adjusted mortality rates for female breast cancer were positively correlated with protein from animal source, total lipid, total animal foods, animal foods to total intake, fresh fish and shellfish, milk and milk products, and meat and meat products. The rates were inversely associated with energy from cereal, total carbohydrate, vegetable foods to total intake, total vegetable foods, daily intake of cereals and grain products, and starch and starch roots. These results suggest that an increased intake of protein- and fat-rich foods rather than carbohydrate-rich foods or vegetables might be associated with the increase in mortality for breast cancer during the last 10 years in Korea

Determinants of gastric cancer screening attendance in Korea: a multi-level analysis

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited.Abstract Background We aimed to assess individual and area-level determinants of gastric cancer screening participation. Method Data on gastric cancer screening and individual-level characteristics were obtained from the 2007–2009 Fourth Korea National Health and Nutrition Examination Survey. The area-level variables were collected from the 2005 National Population Census, 2008 Korea Medical Association, and 2010 National Health Insurance Corporation. The data were analyzed using multilevel logistic regression models. Results The estimated participation rate in gastric cancer screening adhered to the Korea National Cancer Screening Program guidelines was 44.0% among 10,658 individuals aged over 40 years who were included in the analysis. Among the individual-level variables, the highest income quartile, a college or higher education level, living with spouse, having a private health insurance, limited general activity, previous history of gastric or duodenal ulcer, and not currently smoking were associated with a higher participation rate in gastric cancer screening. Urbanization showed a significant negative association with gastric cancer screening attendance among the area-level factors (odds ratio (OR) = 0.73; 95% confidence interval (CI) = 0.57-0.93 for the most urbanized quartile vs. least urbanized quartile). Conclusion There are differences in gastric cancer screening attendance according to both individual and regional area characteristics

The complete chloroplast genome sequence of Abies nephrolepis (Pinaceae: Abietoideae)

AbstractThe plant chloroplast (cp) genome has maintained a relatively conserved structure and gene content throughout evolution. Cp genome sequences have been used widely for resolving evolutionary and phylogenetic issues at various taxonomic levels of plants. Here, we report the complete cp genome of Abies nephrolepis. The A. nephrolepis cp genome is 121,336 base pairs (bp) in length including a pair of short inverted repeat regions (IRa and IRb) of 139 bp each separated by a small single copy (SSC) region of 54,323 bp (SSC) and a large single copy region of 66,735 bp (LSC). It contains 114 genes, 68 of which are protein coding genes, 35 tRNA and four rRNA genes, six open reading frames, and one pseudogene. Seventeen repeat units and 64 simple sequence repeats (SSR) have been detected in A. nephrolepis cp genome. Large IR sequences locate in 42-kb inversion points (1186 bp). The A. nephrolepis cp genome is identical to Abies koreana’s which is closely related to taxa. Pairwise comparison between two cp genomes revealed 140 polymorphic sites in each. Complete cp genome sequence of A. nephrolepis has a significant potential to provide information on the evolutionary pattern of Abietoideae and valuable data for development of DNA markers for easy identification and classification

Associations of reproductive factors with incidence of myocardial infarction and ischemic stroke in postmenopausal women: a cohort study

Background To assess the association between the reproductive factors of age at menarche, age at menopause, and reproductive span and the incidence of myocardial infarction (MI) and ischemic stroke (IS). Methods We used a population-based retrospective cohort study from the National Health Insurance Service database of Korea including a total of 1,224,547 postmenopausal women. Associations between age at menarche (≤ 12, 13–14 [reference], 15, 16, and ≥ 17years), age at menopause (< 40, 40–45, 46–50, 51–54 [reference], and ≥ 55years), and reproductive span (< 30, 30–33, 34–36, 37–40 [reference], and ≥ 41years) and the incidence of MI and IS were assessed by Cox proportional hazard models with adjustment for traditional cardiovascular risk factors and various reproductive factors. Results During a median follow-up of 8.4years, 25,181 MI and 38,996 IS cases were identified. Late menarche (≥ 16years), early menopause (≤ 50years), and short reproductive span (≤ 36years) were linearly associated with a 6%, 12–40%, and 12–32% higher risk of MI, respectively. Meanwhile, a U-shaped association between age at menarche and risk of IS was found, with a 16% higher risk in early menarche (≤ 12years) and a 7–9% higher risk in late menarche (≥ 16years). Short reproductive span was linearly associated with an increased risk of MI, whereas both shorter and longer reproductive spans were associated with an increased risk of IS. Conclusions This study demonstrated different patterns of association between age at menarche and incidence of MI and IS: a linear association for MI versus a U-shaped association for IS. Female reproductive factors in addition to traditional cardiovascular risk factors should be considered when assessing overall cardiovascular risk in postmenopausal women