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The clinical application of 3D-printed provisional restorations is increasing due to expansion of intraoral scanners, easy dental computer-aided design (CAD) software, and improved 3D printing speed. This study compared flexural strength of 3D-printed three-unit fixed dental prostheses with that of conventionally fabricated and milled restorations. A metal jig of two abutments and pontic space and an indenter for flexural strength measurement were fabricated. A three-unit fixed dental prosthesis was designed and manufactured using three additive manufacturing technologies, with subtractive manufacturing and a conventional method as controls. Digital light processing (DLP) group specimens were prepared from a polymethyl methacrylate (PMMA)-based resin and printed with a DLP printer. Stereolithography (SLA) group specimens were prepared from PMMA-based resin and printed with an SLA printer, and fused deposition modeling (FDM) group specimens were from a polylactic acid-based resin and printed with an FDM printer. Flexural strength was investigated using a universal testing machine, and the results were statistically analyzed. DLP and SLA groups had significantly higher flexural strength than the conventional group (p &lt, 0.001). No significant difference was observed in flexural strength between DLP and SLA groups. The FDM group showed only dents but no fracture. The results of this study suggest that provisional restorations fabricated by DLP and SLA technologies provide adequate flexural strength for dental use.

Supplemental Digital Content is available in the text, Endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) has become one of the most useful diagnostic modalities for the diagnosis of pancreatic mass. The aim of this study was to investigate the role of analyzing the minimal specimens obtained by EUS-FNA for the diagnosis of solid masses of pancreas. This study consisted of retrospective and prospective analyses. The retrospective study was performed on 116 patients who underwent EUS-FNA of solid masses for cytological smear, histological analysis, and combined analysis including immunohistochemical (IHC) staining. In the prospective study, 79 patients were enrolled to evaluate the quality and accuracy of EUS-FNA histological analysis and feasibility of IHC staining. The final diagnoses of all patients included pancreatic cancer (n = 126), nonpancreatic cancer (n = 21), other neoplasm (n = 27), and benign lesions (n = 21). In our retrospective study, the combined analysis was more sensitive than cytological analysis alone (P

Background and aim: Aurora kinase A (AURKA) is a member of the protein serine/threonine kinase family that plays critical roles in cell mitosis and in tumorigenesis. The aim of this study was to investigate the expression of AURKA in non-small cell lung cancer (NSCLC) and analyze the correlation between AURKA expression and clinicopathological factors. Methods: One hundred and twenty patients with NSCLC, including 56 with squamous cell carcinoma and 64 patients with adenocarcinoma who underwent operations, were analyzed. Immunostaining for AURKA was performed in a tissue microarray block. The clinicopathologic parameters of these patients were reviewed and analyzed for correlations with AURKA expression. Results: AURKA expression was positive in 66 patients (55.0%) and negative in 54 patients (45.0%). The correlation between AURKA expression and histologic grade was statistically significant (P= 0.013). Subset analysis revealed that AURKA expression was significantly associated with histologic grade in squamous cell carcinoma (P= 0.007), not in adenocarcinoma (P= 0.499). No association was found between AURKA expression and other clinicopathological parameters. Analysis of survival failed to reveal statistically significant differences between positive and negative groups in both squamous cell carcinoma and adenocarcinoma of lung. Conclusions: AURKA expression was associated with the histologic grade of squamous cell carcinoma of lung, but no significant effect on overall survival.

Background and Aim: In patients with hilar cholangiocarcinoma (HC), longitudinal tumor extent is important for curative resection. The purpose of this study was to evaluate the longitudinal extents of HC using transpapillary intraductal ultrasonography (IDUS) for optimal surgical planning. Methods: From July 2006 to April 2010, a total of 42 patients with borderline resectable HC were enrolled at Samsung Medical Center, a tertiary referral hospital in Seoul, Korea. All patients were evaluated using multi-detector computed tomography (MDCT), endoscopic retrograde cholangiopancreatography (ERCP) and IDUS. The new modified Bismuth Type (MBT) classification, in which the traditional Bismuth type IV stage is divided into stages IVa and IVb, was used to determine whether the tumor invaded the left lateral section. Among the subtypes of HC, the periductal infiltrative type (PDI) and intraductal papillary neoplasm of the bile duct (IPN-B) were compared. The accuracies of CT, ERCP, and IDUS were assessed through comparison with the postoperative histology findings. Results: A total of 42 patients were prospectively enrolled, and the tumor extent could be assessed histologically in 30 patients. The accuracies of CT, ERCP, and IDUS were 66.6%, 60%, and 90%, respectively. The accuracy of IDUS was 85.7% in 21 patients with PDI and 100% in nine patients with IPN-B. Conclusions: Hilar cholangiocarcinoma staging based on IDUS findings was highly accurate. We therefore highly recommend using IDUS for optimal surgical planning in patients with borderline resectable HC.

Neuroblastoma (NB) is one of the most common malignant pediatric tumors that show aggressive behavior. Most advanced-stage NBs have proven refractory to many treatment modalities, and a fundamental alternative therapy, such as inhibition of biological pathways, is now being explored. Anaplastic lymphoma kinase (ALK) has recently been identified as an activation mutation in familial or high-risk sporadic NBs. We examined the prevalence of the ALK mutation in 54 NB cases (23 pre-treatment cases and 31 cases for which specimens were available before and after treatment) and the presence of the ALK mutation in various pediatric tumors. We detected the ALK mutation (F1174C and R1275Q) in 2 (3.7%) of the 54 NB specimens. Both cases showed poorly differentiated and advanced-stage NBs. No ALK mutations were detected in other pediatric tumors. The frequency of the ALK mutation was somewhat lower than that expected in Korean patients with NBs. The mutation detected in the present study was one of the hotspot mutations, including positions of F1174 and R1275 reported previously. The results of the present study suggest the possibility of potential roles of ALK inhibitors in the therapeutics of a small population of neuroblastoma carrying mutated ALK kinases.

Intraductal papillary mucinous neoplasms (IPMNs) of the pancreas are classified into the following four histopathologic subtypes: gastric, intestinal, pancreatobiliary, and oncocytic. However, the clinicopatholgic characteristics of IPMN subtypes have not been fully clarified. Recently, a subgroup classification of minimally invasive intraductal papillary mucinous carcinomas (MI-IPMCs) was suggested in contrast to overt invasive carcinoma from IPMCs (IC-IPMCs). The purpose of this study was to determine whether or not the pathologic subtype classification can predict prognosis and to validate the usefulness of the newly proposed diagnostic criteria of MI-IPMCs. We reviewed the clinicopathologic characteristics of 142 surgically resected cases of IPMNs. There were 54, 56, 30, and two cases of the gastric, intestinal, pancreatobiliary, and oncocytic types of IPMNs, respectively. The intestinal and pancreatobiliary types were more likely to have a main duct type. All gastric type tumors were adenomas or moderate dysplasia, whereas greater than one half of the intestinal and pancreatobiliary types were carcinomas in situ or invasive carcinomas. A significant difference in recurrence and death rate was noted for invasive carcinoma between the intestinal and pancreatobiliary types. The majority of MI-IPMCs were the intestinal type, whereas the majority of IC-IPMCs were the pancreatobiliary type. The IC-IPMC group showed a decreased recurrence-free and overall survival with statistically significance (p < 0.001 and p = 0.001, respectively). Our results suggest that the pathologic subtype classification and the newly proposed diagnostic criteria for minimal invasion may also be useful to predict prognosis of IPMNs of the pancreas.

The genetic library of α-helical amphipathic peptides, 20 amino acid long, was designed and expressed under the T7 promoter in the E. coli JM109(DE3) and BL21 (DE3). Clones that inhibited the growth of the host cell were screened by the relative size of colonies on the plates. Clones which strongly inhibited growth of Escherichia coli JM109(DE3) were further selected. The method developed in this study is useful for the structure activity relationship study of antimicrobial peptides.

Ataxia telangiectasia mutated kinase (ATM) and cyclin B1 are involved in cell cycle control. The prognostic significance of both molecules has not yet been investigated in pancreatic neuroendocrine tumors. The aim of this study was to evaluate the clinical and prognostic significance of ATM and cyclin B1 in patients with pancreatic neuroendocrine tumors. A total of 107 pancreatic neuroendocrine tumor specimens that were surgically resected were immunohistochemically investigated using the tissue microarray technique. Clinicopathologic results and survival were evaluated retrospectively. High expression of ATM and cyclin B1 was related to well-differentiated endocrine tumors of the World Health Organization (WHO) classification, but not related to TNM stages. The high ATM expression group (ATM ≥ 4) had a significantly smaller tumor size, lower recurrence rate, more number of functioning tumor, and well differentiation of WHO classification. The high cyclin B1 expression group (cyclin B1 ≥ 5) was related to smaller tumor size, less vascular invasion, less recurrence rate, and less death rate. However, cyclin B1 was the only significant factor for survival following multivariate analysis (p = 0.008; OR, 0.54; 95 % CI, 0.35-0.85). The current results suggested that expression of ATM and cyclin B1 may be useful markers to identify patients with poor prognosis who may benefit from close follow-up and aggressive therapy in pancreatic neuroendocrine tumors.

Objective: To compare results of liquid-based cytology (LBC) and the conventional smear method (SMEAR) when performing endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) for lesions of suspected pancreatic malignancy without an on-site cytopathologist. Study Design: Fifty-eight patients were prospectively enrolled between July and December 2009. Aspirates obtained from the first needle pass were randomized either to SMEAR or LBC. Another sample from the second needle pass was allocated to the other method. The rest of the aspirates from the third or later needle passes were used for SMEAR. Diagnostic accuracy was compared and related factors were pursued. Results: Although both methods were 100% specific, LBC was inferior to SMEAR in terms of sensitivity, negative predictive value, and accuracy. However, LBC provided correct diagnoses in 2 out of 3 cases of false negatives for malignancy by SMEAR in which blood was highly contaminated. Although no factor was identified for LBC, low blood contamination and more than 3 needle passes were related with accurate diagnosis in SMEAR. Conclusion: LBC was less accurate than SMEAR when performing pancreatic EUS-FNA without an on-site cytopathologist. However, LBC might serve as a good complement to SMEAR if blood contamination is profound.

In patients with hilar cholangiocarcinoma (HC), longitudinal tumor extent is important for curative resection. The purpose of this study was to evaluate the longitudinal extents of HC using transpapillary intraductal ultrasonography (IDUS) for optimal surgical planning.From July 2006 to April 2010, a total of 42 patients with borderline resectable HC were enrolled at Samsung Medical Center, a tertiary referral hospital in Seoul, Korea. All patients were evaluated using multi-detector computed tomography (MDCT), endoscopic retrograde cholangiopancreatography (ERCP) and IDUS. The new modified Bismuth Type (MBT) classification, in which the traditional Bismuth type IV stage is divided into stages IVa and IVb, was used to determine whether the tumor invaded the left lateral section. Among the subtypes of HC, the periductal infiltrative type (PDI) and intraductal papillary neoplasm of the bile duct (IPN-B) were compared. The accuracies of CT, ERCP, and IDUS were assessed through comparison with the postoperative histology findings.A total of 42 patients were prospectively enrolled, and the tumor extent could be assessed histologically in 30 patients. The accuracies of CT, ERCP, and IDUS were 66.6%, 60%, and 90%, respectively. The accuracy of IDUS was 85.7% in 21 patients with PDI and 100% in nine patients with IPN-B.Hilar cholangiocarcinoma staging based on IDUS findings was highly accurate. We therefore highly recommend using IDUS for optimal surgical planning in patients with borderline resectable HC.

Sold bump mold fabrication using Excimer laser (KrF, 248 nm) source for patterning method is presented. The mold is designed to make reflowed solder bump with diameter of 115 ?m for 8 inch wafer. We have developed CrOx / Cr binary metal masks which allow for obtaining circular cavities with diameter of 160 ?m, depth of 50 ?m and pitch of 300 ?m. We have obtained the characteristics of patterned etch mask with diameter of 60 ± 3 ?m, pitch of 300± 2 ?m by laser method. Cavities are performed with a dilute hydrofluoric acid (HF) solution, having the diameter of 160 ± 3 ?m, depths of 50 ±1 ?m. These results indicate that solder bump mold fabrication using laser method enables cavity formation with good uniformity.

s / Pancreatology 13 (2013) S1–S80 S45 Background/aim: Distinguishing pancreatic adenocarcinomas from other pancreatic masses remains challenging in clinical practice. Contrastenhanced harmonic endoscopic ultrasound (CEH-EUS) is a promising method for characterizing pancreatic lesions due to its noninvasiveness. The clinical significance according to the change of enhancement pattern from arterial to venous phaseswas not established. The purpose of this study is to investigate the accuracy of CEH-EUS in the differentiation of pancreatic solid lesions by visualizing enhancement pattern during contrast infusion time. Methods: Between July, 2011 and March, 2013, 116 patients who referred for EUS examination of pancreatic lesions were consecutively enrolled. CEH-EUS was performed with a conventional radial echoendoscope after intravenous bolus injection of contrast agent (SonoVue). Enhancement pattern of target lesion was classified into three groups (hypo-, isoor hyper-enhancement) and also described as contrast injection time; early (10w 30 seconds), late (30w 60 seconds) and delay phase (60 w 90 seconds). The enhancement pattern of pancreatic adenocarcinoma was compared with that of other pancreatic lesions. Results: A total of 83 patients (51 male, median age 68, range 25–91) were evaluated for pancreatic solid lesions. The final diagnoses were pancreatic adenocarcinoma in 63 (75.9%), neuroendocrine tumor in 8 (9.6%), chronic pancreatitis in 3 (3.6%), autoimmune pancreatitis in 3 (3.6%), pancreatic metastasis in 2 (2.4%), malignant lymphoma in 2 (2.4%) and each cases of pancreatic abscess and solid pseudopapillary neoplasm (2.4%). In 63 pancreatic lesions with adenocarcinoma, hypoenhancement during arterial, late and delay phase was observed in 52 (82.5%), 59 (93.7%), and 62 (98.4%), respectively. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy for adenocarcinoma as hypoenhancement at CEH-EUS showed at table 1. Conclusions: CEH-EUS could characterize pancreatic mass lesions with relatively high accuracy during late phase and may be useful for distinguishing adenocarcinomas from other pancreatic masses.

Su1376 Preoperative Evaluation of Longitudinal Tumor Extent by Intraductal Ultrasonography in Borderline Resectable Hilar Cholangiocarcinoma Da Min Kim, E Ryoung Choi, Jong Kyun Lee, Kyu Taek Lee, Kwang Hyuck Lee, Dong-Wook Choi, Sung Ho Choi, Jin-Seok Heo, Kee Taek Jang, Sang-Mo Park, Jae Hoon Lim Samsung medical center, Seoul, Republic of Korea Objective: In hilar cholangiocarcinoma (HC), longitudinal tumor extent is important issue for curative resection. The purpose of this study was to evaluate longitudinal tumor extent of HC with intraductal ultrasonography (IDUS) for optimal surgical plan. Materials and Methods: Patients with borderline resectable HC were prospectively enrolled. All patients were evaluated by multi-detector computed tomography (MDCT), endoscopic retrograde cholangiopancreatography (ERCP), IDUS, and/or magnetic resonance imaging (MRI). We used new modified Bismuth type (MBT) which divided traditional Bismuth type IV into IVa and IVb whether tumor invaded left lateral section. Accuracies of CT, ERCP, and IDUS for the longitudinal tumor extent were compared with postoperative histologic tumor extent. We also sub-analyzed the tumor extent as periductal infiltrative type (PDI) and intraductal papillary neoplasm of the bile duct (IPN-B). Results: A total of 42 patients were prospectively enrolled. Among 42 patients, 31 patients underwent surgery for curative intension. Tumor extent could be assessed histologically in 30 patients. When comparing preoperative and postoperative MBT, the accuracies of CT, ERCP and IDUS were 66.6%, 60%, and 90%, respectively. Overestimation was in one patient and underestimation was in two patients by IDUS. Accuracy of IDUS was 85.7% in 21 patients with PDI and 100% in 9 patients with IPN-B. Conclusion: The IDUS for assessing longitudinal tumor extent was highly accurate than other conventional images. IDUS can give advantage for optimal surgical plan in HC.

=Abstract= Cervical endometriosis is defined as the presence of endometrial glands and stroma at the cervix. This is rare and sometimes asymptomatic. Most of these are diagnosed by incidental findings within histopathology. As the presence of cytological features do not guarantee the presence of cervical endometriosis, it is difficult to diagnose this disorder prior to surgery. We recently encountered a case of cervical endometriosis in a post-menopausal woman who was not receiving hormone therapy. As a reminder to clinicians about this neglected issue, we report a case of cervical endometriosis with a literature review. (J Korean Soc Menopause 2011;17:174-177)

Neurilemmomas are benign nerve sheath tumors derived from Schwann cells that rarely occur in the chest wall. Neurilemmomas of the chest wall are usually solitary lesions th at bulge toward the pleural cavity. Neurilemmomas are confirmed histologically based on the presence of Verocay bodies, Antoni A and Antoni B tissue patterns and S-100 protein. Bilateral neurilemmomas in the chest wall are extremely rare, as are those that grow in the subcutaneous tissue but not the pleural area. We report here a case of bilateral chest wall neurilemmomas in which the tumors bulged out to the skin and were palpable. (Tuberc Respir Dis 2008;65:318-322)Key Words: Bilateral neurilemmomas, Chest wall

Background : Cervicovaginal cytology is a screening test of uterine cervical cancer. The sensitivity of cervicovaginal cytology is less than 50%, but studies of cytologic/histologic correlation are limited. We analyzed the diagnostic accuracy of cervicovaginal cytology in the detection of the squamous epithelial lesions of the uterine cervix and investigate the cause of diagnostic discordance. Materials and Methods : We collected a total of 481 sets of cervicovaginal cytology and biopsies over 5 years. The cytologic diagnoses were categorized based on The Bethesda System and the histologic diagnoses were classified as negative, flat condyloma, cervical intraepithelial neoplasia (CIN) I, CIN II, CIN III, or squamous cell carcinoma. Cytohistologic discrepancies were reviewed. Results: The concordance rate between the cytological and the histological diagnosis was 79.0%. The sensitivity and specificity of cervicovaginal cytology were 80.6% and 92.6%, respectively. Its positive predictive value and negative predictive value were 93.7% and 77.7%, respectively. The false negative rate was 19.4%. Among 54 false negative cytology cases, they were confirmed by histology as 50 flat condylomas, 2 CIN I, 1 CIN III, and 1 squamous cell carcinoma. The causes of false negative cytology were sampling errors in 75.6% and interpretation errors in 24.4%. The false positive rate was 7.4%. Among 15 false positive cytology cases, they were confirmed by histology as 12 atypical squamous cells of undetermined significance (ASCUS) and 3 low grade squamous intraepithelial lesions (LSIL). The cause of error was interpretation error in all cases. The overall diagnostic accuracy of cervicovaginal cytology was 85.7%. Conclusions : Cervicovaginal cytology shows high overall diagnostic accuracy and is a useful primary screen of uterine cervical cancer.

Tae Sung Jung, Kyu Hyoung Cho, Won Jae Yang, Yun Seob Song, Young Ho Park, Sang Mo Park, Dong Won Kim From the Departments of Urology, Pathology, Soonchunhyang University College of Medicine, Seoul, Korea Fistula formation between the upper urinary tract and cutaneous tissue is an uncommon complication in urogenital disease. Xanthogranulomatous pyelonephritis (XGP) is a severe, chronic infection of the renal parenchyma that is often associated with calculi and obstruction. We present a rare case of XGP with a nephrocutaneous fistula. (Korean J Urol 2008;49:11581160) 󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏