Detecting T-cell receptor clonality in patients with severe atopic dermatitis refractory to dupilumab.

BACKGROUND: Trials and real-life studies demonstrated clinically meaningful improvements of disease activity in the majority of patients with moderate to severe atopic dermatitis (AD) treated with the anti-IL-4RA-antibody dupilumab. However, misdiagnosis or confounding skin diseases in particular cutaneous T-cell lymphoma (CTCL) may lead to inadequate response. OBJECTIVE: To investigate the clinical and pathological features of patients with AD who showed insufficient response to dupilumab. METHODS: We reviewed the medical records of 371 patients treated with dupilumab for severe AD. Insufficient response was defined as failure to achieve an improvement of the eczema area severity index (EASI) of at least 50% (EASI-50) at Week 16 and of 75% (EASI-75) at Week 52. Among 46 patients with insufficient response, 35 patients consented to a re-evaluation including a full physical exam, biopsies and laboratory assessments including immunohistochemistry and T-cell receptor gene rearrangement analysis to differentiate CTCL. RESULTS: Of the 371 patients treated with dupilumab, 46 (12.3%) patients showed insufficient response to dupilumab. Of these, 35 underwent further evaluation, and 19 (54.2% of inadequate responders) were finally diagnosed with mycosis fungoides (MF). In these patients, transition to or addition of conventional MF treatment led to clinical improvements. CONCLUSION: Insufficient response to dupilumab treatment may help uncover early MF on an existing AD background.

Implant stability changes over time following implant placement in elderly patients: A prospective study.

OBJECTIVES: This study aimed to evaluate the effect of aging on the changes in implant stability over time following implant placement. MATERIALS AND METHODS: A total of 104 patients in four age ranges (group 1: <60 years, group 2: 61-70 years, group 3: 71-80 years, and group 4: >80 years) were included. Bone-level tapered implants were placed without implementing any bone augmentation procedure. The final torque value displayed on the implant engine during implant insertion was recorded. Cone-beam computed tomography (CBCT) was performed immediately after surgery to analyze the bone quality around the implant. Implant stability was measured immediately after surgery and 2, 4, and 8 weeks after surgery. RESULTS: In the CBCT image, higher grayscale values were observed in the order of group 1, group 2, and groups 3/4, with statistical significance (p < .05). There was no significant difference in the insertion torque values between age groups (p ≥ .05). Groups 1 and 2 showed lower implant stability values after 2 and 4 weeks compared to immediately and 8 weeks after surgery (p < .05); however, groups 3 and 4 showed no significant difference between the results measured at different timepoints (p ≥ .05). CONCLUSIONS: Implant treatment in elderly patients is successful showing a settled implant stability over time following implant placement when the implant is appropriately engaged in the alveolar bone in the absence of bone augmentation.

Effects of thermal and mechanical cycling on the mechanical strength and surface properties of dental CAD-CAM restorative materials.

STATEMENT OF PROBLEM: The properties of dental computer-aided design and computer-aided manufacturing (CAD-CAM) materials vary. Studies regarding the effects of aging on the properties of these materials are lacking. PURPOSE: The purpose of this in vitro study was to evaluate the changes in the mechanical and surface properties of different CAD-CAM materials after thermocycling and mechanical loading. MATERIAL AND METHODS: In total, 150 bar-shaped specimens (17.0×4.0×2.0 mm) were prepared from feldspathic glass-ceramic (VM; Vitablocs Mark II), lithium disilicate glass-ceramic (EX; IPS e.max CAD), zirconia-reinforced lithium silicate glass-ceramic (CD; Celtra Duo), polymer-infiltrated ceramic network (VE; Vita Enamic), and resin-nanoceramic (CS; Cerasmart). Each type was divided into 2 groups (n=15; each). One group was subjected to thermocycling in distilled water at 5 °C to 55 °C for 6000 cycles and 50 N mechanical loading for 1.2×106 cycles. The other group was stored in 37 °C water for 24 hours. Nanoindentation hardness, Young modulus, and 3-point flexural strength were measured for the analyses of the mechanical properties. Surface roughness, surface microstructure, and elemental composition were measured to analyze the surface characteristics. Statistical analyses were performed with 1-way ANOVA with the Tukey HSD post hoc test, independent samples t test, Kruskal-Wallis test with Bonferroni post hoc test, Mann-Whitney U test, and 2-way ANOVA (α=.05). RESULTS: Before and after aging, CS exhibited the lowest hardness (1.20 to 1.04 GPa) and Young modulus (13.76 to 13.48 GPa) values (P<.05). EX exhibited the highest flexural strengths (393.43 to 391.86 MPa), and VM exhibited the lowest (109.98 to 112.73 MPa) values (P<.05). CS exhibited the highest surface roughness (Sa and Sq; 10.60 to 28.82, 14.21 to 38.27 nm) values (P<.05). After aging, the hardness and Young modulus of VM, EX, and VE decreased significantly (P<.001). No significant difference was observed in the flexural strengths of the CAD-CAM materials (P>.05). Significant increases were observed in the surface roughness of all the materials (P<.05), with altered microstructures. Except for the flexural strength, the mechanical properties and surface characteristics of the CAD-CAM materials were significantly affected by the material type after aging. CONCLUSIONS: Before and after aging, resin-nanoceramic exhibited the lowest hardness and Young modulus, and the highest surface roughness. Lithium disilicate glass-ceramic exhibited the highest flexural strength and feldspathic glass-ceramic exhibited the lowest value. After aging, increased surface roughness and microstructure alterations were observed. Significant interactions between aging process and material type were found for the mechanical properties and surface characteristics except for the flexural strength.

Evaluation of the response of esthetic restorative materials to ultraviolet aging.

STATEMENT OF PROBLEM: The optical properties of esthetic computer-aided design and computer-aided manufacturing (CAD-CAM) materials can change depending on the clinical situation. Studies that compare esthetic CAD-CAM materials based on their optical properties are lacking. PURPOSE: The purpose of this in vitro study was to evaluate the optical properties of esthetic CAD-CAM specimens after ultraviolet (UV) aging based on the type and thickness of the material. MATERIAL AND METHODS: In total, 240 plate-shaped specimens (14×12×1 mm and 14×12×2 mm) of a nanohybrid composite resin (Tetric CAD), a fine-structure feldspathic ceramic (Vitablocs Mark II), 2 different glass-ceramics (IPS Empress CAD and IPS e.max CAD), a zirconia-reinforced lithium silicate glass-ceramic (Celtra Duo), a polymer-infiltrated ceramic network (Vita Enamic), and 2 different resin nanoceramics (Cerasmart and Lava Ultimate) were fabricated (n=15). The optical parameters were analyzed by spectrophotometry before and after UV aging. The brightness (L∗), red green (a∗), yellow-blue (b∗), chroma (Ch), and hue (h) were measured, and the color difference (ΔE00) values were calculated. The translucency parameter (TP), total transmittance (Tt), and contrast ratio (CR) were also determined. Statistical analyses were performed with 1-way ANOVA, the Tukey honestly significant difference post hoc test, independent- and paired-samples t tests, and 2-way ANOVA (α=.05). RESULTS: Significant interactions were observed for the aging process, material type, and thickness for all optical parameters (P<.05). L∗, TP, and Tt had lower values, while CR had higher values for the aging group than that of the control group (P<.05). The h, TP, and Tt values were higher, whereas the b∗ and CR values were lower for the 1-mm group than those of the 2-mm group (P<.05). The highest ΔE00 value was found in the Lava Ultimate 1-mm group (ΔE00=3.21) and 2-mm group (ΔE00=2.42). The lowest ΔE00 value was found in the Vitablocs Mark II 1-mm group (ΔE00=0.31). The highest TP and Tt and the lowest CR values were observed for Tetric CAD; the lowest TP and Tt, and the highest CR values were noted in Celtra Duo (P<.05). CONCLUSIONS: The optical properties of the CAD-CAM specimens were affected by the aging process, material type, and thickness, and the color stability was clinically applicable in all CAD-CAM materials except groups Lava Ultimate and Cerasmart(ΔE00<2.25). Resin nanoceramics exhibited the greatest color changes after UV aging, and a 2-mm thickness is recommended to ensure acceptable color stability. The zirconia-reinforced lithium silicate glass-ceramic was the most opaque, with a 1-mm thickness providing increased translucency.

Facial flushing and erythema of rosacea improved by carvedilol.

Flushing and erythema are the most common symptoms of rosacea; however, management of these symptoms remains challenging. Recent case studies suggest that treatment with carvedilol may reduce facial flushing and persistent erythema in the pathogenesis of rosacea. To find the effect of carvedilol in the treatment of facial flushing and erythema in rosacea. Twenty-four rosacea patients treated with carvedilol for facial flushing and erythema were retrospectively reviewed. All patients were prescribed carvedilol 6.25 mg either once or twice per day, and the daily dose was gradually titrated up to 12.5 mg. Clinical erythema severity was assessed by the Clinician's Erythema Assessment (CEA) and Patient's Self-Assessment (PSA) scales. Improvement of CEA and PSA scores compared to the baseline were assessed. The proportion of patients with improvement of two or more points from baseline in CEA score was analyzed by sex, previous treatment exposure, disease duration, and subtypes. The mean change of -1.6 in the CEA score and of -1.8 in the PSA score showed significant improvement from baseline. Erythematotelangiectatic rosacea (ETR) patients achieved more than 2-points improvement in the CEA score, compared with non-ETR patients (53.8% vs 16.7% [P = .035]). No statistically significant differences were observed by sex, disease duration, or previous treatment exposure. No serious adverse event was observed. Carvedilol can be an effective and safe treatment option for rosacea patients suffering from facial flushing and erythema.

Benefits of extracorporeal shock waves for keloid treatment: A pilot study.

Keloids are fibroproliferative skin disorders characterized by the progressive deposition of collagen. Recently, extracorporeal shock wave therapy (ESWT) has been used to treat pathologic scars. Herein, we conducted a study to compare the efficacy of intralesional injections (ILIs) of triamcinolone acetonide (TA) used alone, or in combination with ESWT for keloids. Forty patients were randomized equally into two groups in this 12-week comparative clinical trial. Group A was treated with TA ILIs and ESWT, and group B was treated with TA ILIs alone. At week 12, both groups showed acceptable improvements in nearly all dimensions evaluated, and these improvements were statistically more significant in group A. Group A showed a higher mean percentage reduction in lesion length, width, and height and in the Vancouver Scar Scale score than group B (all P < .05). More patients in group A than in group B had scores of ≥4, which indicated improvements that were good or excellent, on the patient global assessment and investigator global assessment. No serious adverse events occurred. This study suggests that ESWT could be a new, effective and acceptable adjuvant treatment option for keloids.

Optimal Timing for Surgical Excision of Nevus Sebaceus on the Scalp: A Single-Center Experience.

BACKGROUND: Treatment of nevus sebaceus (NS) on the scalp is usually surgical excision, but the optimal timing is debatable. The scalp presents significant challenges to the reconstructive surgeon because the lack of elasticity of the scalp makes the repair of defects difficult. OBJECTIVE: The aim of this study was to investigate the optimal timing for surgical excision of NS on the scalp through postoperative outcomes. METHODS: The authors retrospectively reviewed the postoperative cosmetic results of patients with a follow-up period of 12 to 15 months. The variables analyzed were patient demographics, preoperative tumor size, location, operative time, cosmetic results, and complications. RESULTS: This study enrolled 62 patients, including 30 adults and 32 children. The main complications were hair loss, hypertrophic scar, and widening of the scar. The overall complication rate was 17.7%, and the complication rate in children (9/32, 28.1%) was higher than that in adults (2/30, 6.7%) (p < .05). Tumor location, shape, and size showed no association with complications. CONCLUSION: Complications after surgical excision of NS on the scalp are more likely to occur in children than in adults. On the basis of these findings, surgical excision of NS on the scalp can be delayed until after childhood.

Effects of Initiation Time of Glycemic Control on Skin Collagen Recovery in Streptozotocin-Induced Diabetic Rats.

BACKGROUND: Diabetes damages the collagen in the skin. No study has investigated the relationship between the treatment initiation time and the degree of collagen recovery. This study aimed to evaluate the effects of the initiation time of glycemic control on collagen recovery and to determine the basic molecules mediating the process. METHODS: Streptozotocin-induced diabetic rats were divided into five groups: normal controls (C), those with untreated diabetes (DM), and those with diabetes treated with daily insulin injections from 7 weeks (7W), 10 weeks (10W), and 13 weeks (13W) after diabetes induction. The levels of collagen and several molecules were compared among skin tissues collected at 14 weeks. RESULTS: The amounts of total collagen, collagen 1, and collagen 3 were significantly lower in DM than in C. Among the treated groups, recovery reaching normal levels was only observed in 7W and 10W. The earlier the treatment began, the greater was the collagen recovery. Similar to that of collagen, the expression of transforming growth factor-ß1 (TGF-ß1), vascular endothelial growth factor (VEGF), and insulin-like growth factor 1 receptor (IGF-1R) significantly decreased in DM compared with that in C. Higher recovery of TGF-ß1 and VEGF was detected in groups with earlier treatment, whereas the IGF-1R level was identically elevated in all treated groups. The results suggest that these molecules affect collagen recovery at different time points during glycemic control. CONCLUSION: The initiation time of glycemic control is expected to have a considerable effect on collagen recovery in the diabetic skin through modulation of TGF-ß1, VEGF, and IGF-1R.

Effect of ceramic material and resin cement systems on the color stability of laminate veneers after accelerated aging.

STATEMENT OF PROBLEM: Laminate veneers are susceptible to color change during clinical service. Studies that compare the effects of different ceramic and resin cement systems on color stability are lacking. PURPOSE: The purpose of this in vitro study was to evaluate the color stability of laminate veneers after accelerated aging using different ceramic and resin cement systems. MATERIAL AND METHODS: Ceramic specimens (N=168; shade A1; thickness, 0.50 ±0.05 mm; diameter, 10.00 ±0.10 mm) were prepared using nanofluorapatite and lithium disilicate (high translucency [HT] to low translucency [LT]) ceramics. Light-polymerizing (LP) cements were classified by brightness (high or low). Dual-polymerizing cements were classified by composition (base-only [DB] or base-catalyst [DC]) for comparison of color stability on the basis of polymerization type. DB cement was light-polymerizing, whereas DC cement was dual-polymerizing. They were further classified by shade (transparent, white, or yellow [n=7, each]). Color difference (ΔE) values were obtained by spectrophotometric quantification of L* (lightness), a* (green-red), and b* (blue-yellow) values before and after aging. The Kruskal-Wallis, Mann-Whitney U, Wilcoxon signed rank, and Bonferroni post hoc tests were used for statistical analysis. RESULTS: After specimens were subjected to accelerated aging, HT ceramic specimens luted with yellow-shade DC cement exhibited the greatest color change (ΔE=2.11), whereas HT and LT ceramic specimens luted with low-brightness LP cement exhibited the least color change (ΔE=1.37). In HT ceramic specimens, which exhibited the greatest color change of the 3 ceramic types, transparent shade cement exhibited significantly lower ΔE values than the other shades with DB (P<.001) and DC cements (P=.010). High-brightness cement exhibited significantly higher ΔE values than low-brightness cement when used with NF (P=.017), HT (P<.001), and LT (P<.001) ceramics. The ΔE values of DB cement were not always lower than those of DC cement. For all specimens, the aging of laminate veneers decreased the L* values and increased the a* and b* values. CONCLUSIONS: Ceramic and resin-cement systems affected the color stability of laminate veneers. Relative to other ceramics, HT lithium disilicate ceramics exhibited greater color changes upon aging. For HT ceramics, the use of transparent shade resin cement is recommended. The lower the brightness of resin cement, the higher the color stability of veneers. For luting of 0.5-mm-thick laminate veneers with dual-polymerizing cement, light polymerization did not yield better color stability than dual polymerization over time.

A comparative study of low-fluence 1,064 nm Q-Switched Nd:YAG laser with or without chemical peeling using Jessner's solution in melasma patients.

BACKGROUND: Although low-fluence 1,064-nm Q-switched Nd:YAG laser (QSNYL) is widely used for the treatment of melasma, multiple treatments are necessary for clinical improvement. Superficial chemical peeling using Jessner's solution has been used for treatment of melasma conventionally. OBJECTIVES: To evaluate the additional therapeutic effect and adverse effects of Jessner's peel when combined with 1,064 nm QSNYL for melasma patients in a double-blind, placebo-controlled design. METHODS: Total of 52 patients were included. Patients who received 10 sessions of 1,064 nm QSNYL plus chemical peeling with placebo (Group A) in a two-week intervals and those who received 10 sessions of 1,064 nm QSNYL plus chemical peeling with Jessner's solution (Group B) in a 2-week intervals were analyzed. Responses were evaluated using the Melasma Area and Severity Index (MASI) score, physician's global assessment (PGA) and subjective self-assessment. RESULTS: At 8 weeks, the mean MASI score decreased from 8.68 ± 4.06 to 8.60 ± 3.88 in Group A and from 8.98 ± 3.72 to 7.13 ± 2.57 in Group B, showing a significant difference (p < 0.001). But at 20 weeks, there was no significant difference on reduction of MASI, self-assessment, and PGA between the two groups. No serious adverse effects were reported with the additional Jessner's peeling. CONCLUSION: This study suggests Jessner's peel is a safe and effective method in the early course of treatment for melasma, when combined with low-fluence 1,064-nm QSNYL.

Compact coherent perfect absorbers using topological guided-mode resonances.

We propose a topological coherent perfect absorber that enables almost ideal performance with remarkably compact device footprint and tight incident beams. The proposed structure is based on a topological junction of two guided-mode-resonance gratings. The structure provides robust systematic ways of remarkably tight lateral confinement of the absorbing resonance mode and near-perfect mode-match to arbitrary incident beams, which are unavailable with the conventional approaches. We demonstrate an exemplary amorphous Si thin-film structure that enables near-perfect absorptance modulation between 1.7 and 99% with device footprint width of 30-µm and 10-µm-wide incident Gaussian beams. Therefore, our proposed approach greatly improves practicality of guided-mode-resonance coherent perfect absorbers.

Facial Dermatoses Associated With Mask-Wearing in the COVID-19 Era: A Nationwide, Cross-Sectional, Multicenter, Questionnaire-based Study.

BACKGROUND: Daily usage of facial masks during coronavirus disease 2019 pandemic influenced on facial dermatoses. OBJECTIVE: This study investigated the impact of mask-wearing habits on facial dermatoses. METHODS: A nationwide, observational, questionnaire-based survey was conducted from July through August 2021, involving 20 hospitals in Korea. RESULTS: Among 1,958 facial dermatoses, 75.9% of patients experienced aggravation or development of new-onset facial dermatoses after wearing masks. In aggravated or newly developed acne patients (543 out of 743), associated factors were healthcare provider, female gender, and a long duration of mask-wearing. Irritating symptoms, xerosis, and hyperpigmentation were more frequently observed in this group. Aggravated or newly developed rosacea patients (515 out of 660) were likely to be female, young, and have a long duration of mask-wearing per day. Seborrheic dermatitis patients who experienced aggravation or de novo development (132 out of 184) were younger, and they more frequently involved the chin and jaw in addition to the nasolabial folds and both cheeks. Contact dermatitis patients (132 out of 147) with aggravation or de novo development tended to be female, involve both cheeks, and complain of pruritus. Aggravated or newly developed atopic dermatitis patients (165 out of 224) were more likely to be female, and had a higher baseline investigator global assessment score before mask-wearing. CONCLUSION: Clinical features and factors related to aggravation were different according to the types of facial dermatoses.

Consensus Report on Truncal Acne: The Korean Acne and Rosacea Society Experts Panel.

BACKGROUND: More than half of acne patients have truncal acne on their chest, back, and shoulders. However, since most studies on acne have focused on the face, data on clinical characteristics and proper management for truncal acne are insufficient. OBJECTIVE: To establish a Korean Acne Rosacea Society (KARS) consensus for experts' perception and treatment patterns of truncal acne. METHODS: We conducted two rounds of the Dephi technique to gather expert opinion and reach a consensus on truncal acne. The first round comprised 48 questionnaires focusing on various aspects such as epidemiology, clinical features, diagnosis, treatment, prognosis and more, while second rounds consisted of 26 questionnaires. RESULTS: A total of 36 dermatologists (36/38 KARS members, 94.7%) completed this survey. In the first-round survey, consensus was reached on 20 out of the 48 questions (41.7%). In the second-round questionnaire, consensus was achieved on 9 of the 26 questions (34.6%). The most unresponsive lesion to truncal acne treatment was scars (atrophic/hypertrophic). The most commonly used treatments for each non-inflammatory and inflammatory truncal acne lesions were selected to use topical retinoids (78.1% of the responders) and oral antibiotics (93.8% of the responders). CONCLUSION: Our study has yielded valuable insights into the epidemiology, clinical manifestations, diagnosis, treatment, and quality of life of patients with truncal acne. We anticipate that this study will inspire further comprehensive research for individuals with truncal acne.

Implementation of CAD/CAM program in a nonface-to-face classroom environment due to the COVID-19 pandemic.

PURPOSE/OBJECTIVES: This study aimed to evaluate a nonface-to-face crown designing module in a preclinical dental course. METHODS: Free dental planning software (Blue Sky Plan) was installed on the personal computers of dental college students, and a #46 full veneer crown designing practice was performed individually. An online survey was conducted on the computers' specification and main usage of the students, the practice process, and results. Statistical analysis was conducted to analyze the association between variables, such as "operating system," "central processing unit ," "number of cores," "random-access memory (RAM)," "graphic card," and task performance. RESULTS: Of the D2 students, 75.4% (52 of 69) responded to the survey. Overall, 96% of the respondents used their computers, and all respondents had no problem running the program. Most of the students marked their level of computer literacy as intermediate and had purchased the computers for the purpose of performing light work. The most common specifications of the computer were Intel i5, quad core, 8 GB RAM, and Windows 10. Students had little experience with computer-aided design/computer-aided manufacturing before the class. The relationship between computer specifications and task performance was not statistically significant. CONCLUSIONS: Overall, students with intermediate-level computer literacy used computers with less than the recommended specifications of the program; however, they were able to run the program and individually proceed with modules to submit results. Using an individually available crown designing program can provide an opportunity to diversify curricula and broaden students' perspectives even under circumstances like the COVID-19 pandemic that limits intimate face-to face classes.

Evaluation of Implant Stability According to Implant Placement Site and Duration in Elderly Patients: A Prospective Multi-Center Cohort Study.

The aim of this prospective study is to investigate implant stability and the reliability of different measuring devices according to implant placement site and duration in patients aged over 65 years. The study evaluated 60 implants (diameter: 3.5/4.0/4.5/5.0 mm and length: 8.5/10.0/11.5 mm) in 60 patients aged ≥ 65 years. The implant placement sites were divided into six evenly distributed sections (n = 10), i.e., maxillary right-posterior, A; maxillary anterior, B; maxillary left-posterior, C; mandibular right-posterior, D; mandibular anterior, E; mandibular left-posterior, F. Participants visited the hospital six times: implant surgery, 1V; stitch removal, 2V; 1-month follow-up, 3V; 2-month follow-up, 4V; before final restoration delivery, 5V; and after final restoration delivery, 6V. The implant stability was evaluated with the Osstell Mentor (ISQ), Periotest M (PTV), and Anycheck (IST). The mean values of ISQ, PTV, and IST were analyzed (α = 0.05). ISQ, PTV, and IST results of 4V and 5V were significantly higher than those of 1V (p < 0.05). The lowest ISQ results occurred in the E location at 4V and 5V (p < 0.05). In all mandibular locations, IST results of 6V were significantly higher than those of 1V, 2V, 3V, and 4V (p < 0.05). ISQ results were negatively correlated with PTV and positively correlated with IST, and PTV was negatively correlated with IST. By considering various factors affecting the stability of the implant, it is necessary to determine the appropriate implant load application time. This could help increase the implant success rate in elderly patients. And as a diagnostic device for implant stability and the evaluation of osseointegration in elderly patients, Anycheck was also able to prove its relative reliability compared to Osstell ISQ Mentor and Periotest M.

Influence of thermo-mechanical aging on fracture resistance and wear of digitally standardized chairside computer-aided-designed/computer-assisted-manufactured restorations.

OBJECTIVES: To investigate the influence of thermal cycling and mechanical loading (TCML) aging on fracture resistance and wear behavior of various chairside computer-aided-designed/computer-assisted-manufactured (CAD/CAM) premolar crowns cemented on standardized tooth abutments. METHODS: Eighty chairside CAD/CAM crowns were prepared using lithium disilicate (IPS e.max CAD; EM), zirconia-infiltrated lithium silicate (Celtra Duo; CD), polymer-infiltrated ceramic network (Vita Enamic; VE), and resin nanoceramics (Cerasmart; CS) (n = 20). The specimens were divided into two groups (n = 10). In one group, they were subjected to TCML: thermocycling (6000 cycles in distilled water at 5-55 °C) and mechanical loading (50 N for 1.2 × 106 cycles), while in control group they were stored in distilled water (37 °C for 24 h). The fracture load, height loss, and volume wear of the crowns were measured after TCML. Fractography was performed on fractured specimens. Data were analyzed using analysis of variance and multiple comparison tests (α=0.05). RESULTS: The mean fracture loads of EM and CD were significantly higher than those of EC and CS (p<0.05). There was no significant change in the fracture load of any CAD/CAM crowns after TCML (p>0.05). CS exhibited a significantly higher volume wear than the other materials investigated. The wear tracts of all TCML crowns acted as failure origins during the fracture test. CONCLUSIONS: The fracture resistance of glass-ceramic CAD/CAM crowns was significantly higher than that of resin composite crowns. A 5-year TCML aging did not affect the fracture resistance of CAD/CAM crowns investigated. However, TCML treatment produces a larger wear track in CS than in other materials. CLINICAL SIGNIFICANCE: Appropriate chairside CAD/CAM restorative material should be selected for successful clinical practice after considering the fracture and wear resistance of the crowns.

The Effects of Thermocycling on the Physical Properties and Biocompatibilities of Various CAD/CAM Restorative Materials.

The purpose of this study is to evaluate the changes in physical properties and biocompatibilities caused by thermocycling of CAD/CAM restorative materials (lithium disilicate, zirconia reinforced lithium silicate, polymer-infiltrated ceramic network, resin nanoceramic, highly translucent zirconia). A total of 225 specimens were prepared (12.0 × 10.0 × 1.5 mm) and divided into three groups subjected to water storage at 37 °C for 24 h (control group), 10,000 cycles in distilled water at 5-55 °C (first aged group), and 22,000 cycles in distilled water at 5-55 °C (second aged group) [(n= 15, each]). The nanoindentation hardness and Young's modulus (nanoindenter), surface roughness (atomic force microscopy (AFM)), surface texture (scanning electron microscopy (FE-SEM)), elemental concentration (energy dispersive spectroscopy (EDS)) and contact angle were evaluated. The morphology, proliferation and adhesion of cultured human gingival fibroblasts (HGFs) were analyzed. The data were analyzed using one-way ANOVA and Tukey's test (p < 0.05). The results showed that the nanoindentation hardness and Young's modulus were decreased after thermocycling aging. Cell viability and proliferation of the material decreased with aging except for the highly translucent zirconia. Zirconia-reinforced lithium silicate exhibited significantly lower cell viability compared to other materials. The surface roughnesses of all groups increased with aging. Cell viability and Cell adhesion were influenced by various factors, including the surface chemical composition, hydrophilicity, surface roughness, and topography.

Curcumin Enhances the Anticancer Effects of Binimetinib on Melanoma Cells by Inducing Mitochondrial Dysfunction and Cell Apoptosis with Necroptosis.

BACKGROUND: Recent studies suggest that MEK1/2 inhibitors, including binimetinib, significantly improve malignant melanoma (MM) patient survival. Growing evidence suggests that phytochemicals, especially curcumin, can overcome drug resistance in cancer cells through a variety of mechanisms. OBJECTIVE: This study aims to examine curcumin's efficacy in vitro combined with binimetinib in human MM cells. METHODS: We used 2D monolayer and 3D spheroid human epidermal melanocyte culture models, HEMn-MP (human epidermal melanocytes, neonatal, moderately pigmented), and two human MM cell lines, G361 and SK-MEL-2, to evaluate cell viability, proliferation, migration, death, and reactive oxygen species (ROS) production following single therapy treatment, with either curcumin or binimetinib, or a combination of both. RESULTS: Compared to MM cells treated with single therapy, those with combination therapy showed significantly decreased cell viability and increased ROS production. We observed apoptosis following both single and combination therapies. However only those who had had combination therapy had necroptosis. CONCLUSION: Collectively, our data demonstrates that curcumin exerts significant synergistic anticancer effects on MM cells by inducing ROS and necroptosis when combined with binimetinib. Therefore, a strategy of adding curcumin to conventional anticancer agents holds promise for treating MM.

Effects of ultraviolet weathering aging on the color stability and biocompatibility of various computer-aided design and computer-aided manufacturing glass-ceramic materials.

OBJECTIVES: This study assessed the changes in color stability and biocompatibility of computer-aided design and computer-aided manufacturing (CAD-CAM) glass-ceramics after ultraviolet weathering (UW) aging. METHODS: A total of 300 plate-shaped specimens (12.0 × 14.0 × 1.5 mm3) were prepared using a leucite-reinforced glass-ceramic (IPS Empress CAD; E), a lithium disilicate (IPS e.max CAD; M), and two zirconia-reinforced lithium silicate (Celtra Duo; C, Vita Suprinity; V) glass-ceramics. Specimens were divided into three groups (n = 25, each), subjected to water storage at 37 °C for 24 h (control group), or UW aging at 150 kJ/m2 (first-aged group) or 300 kJ/m2 (second-aged group). The color stability, mechanical and surface properties, and biocompatibility of the CAD-CAM glass-ceramics were investigated experimentally, followed by statistical analysis. RESULTS: The brightness and redness or greenness were reduced in all groups after aging. After the first aging, V exhibited the largest color change and E exhibited the smallest color change. After the second aging, E exhibited the highest nanoindentation hardness and Young's modulus. The surface roughness was the highest for V after the first aging. Furthermore, the hydrophilicity of the materials increased after aging process. The cell proliferation/viability of human gingival fibroblasts was the highest in E before and after aging. Almost all cells survived for all groups based on a live/dead assay. CONCLUSIONS: Leucite-reinforced glass-ceramic exhibit the highest color stability and biocompatibility after aging. The color stability and biocompatibility of CAD-CAM glass-ceramics depend on the aging process and material type. CLINICAL SIGNIFICANCE: Various CAD-CAM glass-ceramics exhibit adequate color stability after UW aging. The leucite-reinforced glass-ceramics exhibit the highest color stability, cell proliferation, and viability after aging. The color stability, mechanical and surface properties, and biocompatibility of the glass-ceramics depend on the aging process and material type.

Basic Therapeutic Approach for Patients with Plaque Psoriasis: Korean Expert Consensus Using the Modified Delphi Method.

BACKGROUND: Currently, there is no consensus on the treatment of psoriasis in Korean patients. OBJECTIVE: This study aimed to establish a consensus on the basic therapeutic principles for Korean patients with plaque psoriasis. METHODS: Using the modified Delphi method, a steering committee proposed 53 statements for the first Delphi round, which covered five subjects: (1) the goal of treatment and evaluation of disease severity, (2) topical therapy, (3) phototherapy, (4) conventional systemic therapy, and (5) biologic therapy. The panel of dermatologists scored the level of agreement for each statement on a ten-point scale with scores ranging from 1 (strongly disagree) to 10 (strongly agree). After discussing the results of the first round, the committee reformulated 41 statements. Finally, consensus was defined as more than 70% of the second round scores being ≥7. RESULTS: The panel participants strongly agreed that the ideal treatment goals for Korean patients with plaque psoriasis should include complete skin clearance and high dermatological quality of life. A strong consensus was also reached on the use of topical agents for psoriasis of any severity, the consideration of phototherapy before biologics therapy, the conventional systemic agents for moderate-to-severe psoriasis, and the recommendation of biologic for retractable psoriasis to conventional systemic therapy and phototherapy. CONCLUSION: This modified Delphi panel established an expert consensus on the therapeutic approach for Korean patients with plaque psoriasis. This consensus may improve the treatment outcomes for psoriasis in Korea.