Conclusion: GPB reduced

HE events as well as ammonia in patients with cirrhosis and HE and its safety profile was similar to placebo. The findings implicate ammonia in the pathogenesis of HE and suggest that GPB has therapeutic potential in this population. (Clinicaltrials.gov, NCT00999167). (Hepatology 2014;59:1073-1083) “
“SURGERY IS THE most reliable local control treatment for tumor removal; however, MK0683 the assurance that its safety is not inferior to other treatments is required. Lately, the safety of hepatectomy has improved to a level comparable to that of general gastroenterological surgery. According to the 17th Nationwide Follow-up Survey of Primary Liver Cancer (2002–2003) by the Liver Cancer Study Group of Japan, operative mortality is reported to be 0.8%, and the 5-year survival rate is 53.4% (LF120891). These rates were achieved by integration of preoperative evaluation, surgical techniques and management in the perioperative period. For determining whether surgery is indicated, evaluations of the extent of the hepatocellular carcinoma and liver function are essential. The stage

of hepatocellular carcinoma is defined by tumor size and tumor number, and the Anti-infection Compound Library presence or absence of vascular invasion, lymph node metastasis and distant metastasis. For assessing the appropriateness of the indications of surgery based on liver function, easier and more highly accurate criteria have been proposed and have come into widespread use. For surgical techniques, various procedures found to be appropriate from both the perspective of radical tumor treatment and that of preservation of liver function have been developed in Japan. In the future, evidence of the improvement of long-term prognosis such as recurrence-free survival and cumulative survival, and evidence of adjuvant therapy need to be accumulated. In this revision, we examined items reflecting the current condition and comprised sections concerning indication for surgery/surgical procedures/treatment for recurrence (three clinical Fossariinae questions [CQ]: one CQ reduced), prognostic factors (three CQ), management of the perioperative period

(two CQ) and adjuvant therapy (two CQ). In addition, liver transplantation (from a living donor) was covered by the National Health Insurance in 2004 and has since become common as a new surgical therapy for hepatocellular carcinoma. Japan is the world leader in living donor liver transplantation, and results for hepatocellular carcinoma have been pooled as evidence. In this revised version, the four CQ on transplantation are newly added. We searched articles from the MEDLINE database (Dialog system) using four key words including “hepatocellular carcinoma”, “surgery”, “English original articles” and “1980 to 2007” and selected 1481 articles. Then, 121 (8.2%) highly reliable articles were selected after primary to tertiary selection.

Leon Williams, working together between 1910 and MAPK inhibitor 1914, presented to

the profession the “Trubyte Artificial Tooth System” that embodied both a typal system for selecting anterior teeth and new posterior occlusal carvings that made possible, for the first time, the articulation of artificial teeth. This incited many of prosthetic dentistry’s elite to introduce their own theories of mandibular movement and the articulators that they designed to reflect those theories. The intense debates that ensued, both in the meeting halls and in the literature, were numerous and lasted for decades. At the time, the “Articulator Wars” had both positive and negative consequences. Today, with many of the “Articulator Wars” issues remaining as part of the practice of dentistry, the “Articulator Wars” can be considered BAY 80-6946 cell line a phenomenon of enlightenment.

“
“Purpose: The objective of this review was to systematically screen the literature for data related to the survival and complication rates observed with dental or implant double crown abutments and removable prostheses under functional loading for at least 3 years. Materials and Methods: A systematic review of the dental literature from January 1966 to December 2009 was performed in electronic databases (PubMed and Embase) as well as by an extensive hand search to investigate the clinical outcomes of double crown reconstructions. Results: From the total of 2412 titles retrieved

from the search, 65 were selected for full-text review. Subsequently, 17 papers were included for data extraction. An estimation of the cumulative survival and complication rates was not feasible due to the lack of detailed information. Tooth survival rates for telescopic abutment teeth ranged from 82.5% to 96.5% after an observation period of 3.4 to 6 years, and for tooth-supported double Astemizole crown retained dentures from 66.7% to 98.6% after an observation period of 6 to 10 years. The survival rates of implants were between 97.9% and 100% and for telescopic-retained removable dental prostheses with two mandibular implants, 100% after 3.0 and 10.4 years. The major biological complications affecting the tooth abutments were gingival inflammation, periodontal disease, and caries. The most frequent technical complications were loss of cementation and loss of facings. Conclusions: The main findings of this review are: (I) double crown tooth abutments and dentures demonstrated a wide range of survival rates. (II) Implant-supported mandibular overdentures demonstrated a favorable long-term prognosis. (III) A greater need for prosthetic maintenance is required for both tooth-supported and implant-supported reconstructions.

The deduced L protein sequence of BYSMV showed similarities with the L proteins of other plant rhabdoviruses and contained polymerase module motifs characteristic GSI-IX datasheet of RNA-dependent RNA polymerases of negative-strand RNA viruses. Pairwise and multiple alignments and phylogenetic analysis of BYSMV L protein revealed that it was more closely related to cytorhabdoviruses. These results revealed that, on the basis of polymerase gene, the Iranian isolate of BYSMV and Northern cereal mosaic virus (NCMV) appeared to be the most closely related

plant rhabdoviruses sequenced to date. Interestingly, the amino acid sequence identity of BYSMV/NCMV (61.3%), shared more than twice the amino acid sequence identity compared with the next two most similar cytorabdoviruses, Lettuce necrotic yellows virus (28.8%) and Lettuce yellow mottle virus (28.2%). In this

paper, we discuss the similarities and differences of BYSMV with other rhabdoviruses which support the classification of BYSMV as a distinct Cytorhabdovirus. This is the first report of BYSMV genome sequences. “
“Hydroponic experiments were conducted to compare the effects of Pythium irregulare and root pruning on wheat (Triticum drug discovery aestivum cv. Janz) transpiration, water-use efficiency (WUE) and plant growth in the presence and absence of polyethylene glycol–induced drought (PEG). Pythium, PEG and root pruning reduced transpiration to a similar extent, but the mechanism that affects transpiration differed between the treatments. Reduced hydraulic conductivity of roots caused by disease in the Pythium treatment and reduced size of the root system in the root pruning treatment were responsible

for decreased transpiration while reduction of stomatal conductance was the main cause for reduced transpiration in the PEG treatment. Pythium reduced shoot dry weight and increased root/shoot ratio but had no effect on whole-plant or instantaneous WUE. There was a small additive effect of Pythium on whole-plant transpiration of plants exposed to PEG-induced drought, but there was no evidence of an interaction between Pythium and very PEG-induced drought on WUE or growth. This suggests that moderate root damage by pathogens is likely to have only a modest effect on the water relations of wheat plants. “
“The Japanese government legally restricts entry of the bacterial fruit blotch disease of cucurbits caused by Acidovorax citrulli. However, the disease has occurred several times in Japan caused by infestations of melon, watermelon and wax gourd seeds with the pathogen. We prepared seeds infested with this pathogen for melon, cucumber, squash, wax gourd and bottle gourd and treated the seeds with dry heat for disinfection from the pathogen, varying the temperature and duration. Percentages of seed infested with the pathogen were determined after the dry heat treatments.

The aim of this study was to evaluate the short-term efficacy and duration of response to combined medical and surgical therapy. Methods: This was a retrospective review of CD patients with complex perianal fistula treated with

infliximab and (or) immunomodulator after primary seton drainage between September 2012 and April 2013. Complex perianal fistula was identified by examination under anaesthetic (EUA) and pelvic MRI. Results: Fourteen CD patients with complex perianal fistula (9 male; and median age 24 years) received seton drainage and two of them received additional surgery of enterostomy. Infliximab (IFX) and (or) azathioprine (AZA) was started 7 to 34 days (median 15 days) later after drainage. Nine of 14 patients (64%) had find more a complete response (median follow-up 23 weeks, range 13–30 weeks). One patient (7%) had a partial response (follow-up 6 weeks), defined by decreased drainage but not removed seton. Four patients (29%) had no response because of relapsed (median 20 weeks, range 8–31 weeks), but one had a complete

(follow-up 14 weeks) and three had a partial response (median 22 www.selleckchem.com/products/Gefitinib.html weeks, range 8–31 weeks) to retreatment (received seton drainage again). Among the 9 patients with complete response, two received AZA, five received IFX and two received IFX+AZA initially. But 3 of these changed the initial therapy protocol, including 2 were added AZA to initial IFX therapy and 1 stopped IFX+AZA treatment for acute appendicitis. Both of the 2 patients with enterostomy had a complete response. Conclusion: Surgery-based combined therapy is effective for complex perianal fistula in CD patients. IFX with or without AZA may help over two thirds of patients to get complete remission. Short tern relapse could be effectively dealt with repeat seton drainage. Whether IFX+AZA is better than mono therapy need further investigation. Key Word(s): 1. perianal fistula; 2. Crohn’s disease; 3. therapy; Presenting Author: CHENG CHENG JI Additional Authors: L-gulonolactone oxidase XIANG GAO, MIN ZHI, MIN ZHANG, JIAN TANG, HUANG WEI CHEN, PIN JIN HU Corresponding Author:

XIANG GAO Affiliations: The sixth affiliated hospital of Sun Yat-sen University Objective: Anemia is a common complication of patients with Crohn’s disease (CD). The aim of this study is to estimate the characteristics of anemia in CD. Methods: We performed an observational, descriptive, retrospective study in patients with CD followed-up between 2011 and 2013 in outpatient clinc in the Sixth Affiliated Hospital of Sun Yat-sen University. The study group with proved CD underwent the analysis according to age, signs, clinical course and activity of the disease. Complications, treatment option and/or surgery were recorded. The routine blood test (RBC, Hb, PLT, MBC, MCH, MCHC), erythrocyte sedimentation rate (ESR), high sensitive C-reactive protein (hs-CRP) were tested for each patient at first visit and subsequent visits at 3 month, 6 month, 9 month and 12 month.

Results: A total of 2275 participants A-769662 purchase were included in this study (629 patients with adenomatous polyps and 1,646 polyp-free

controls). Old age (p < 0.01), male gender (p < 0.01), current cigarette smoker (p < 0.01), or current alcohol drinker (p = 0.01), and high BMI (>25 kg/m2), Family history of colorectal cancer (p = 0.022) were associated with the development of sporadic colorectal neoplasm of 40s patients. In the point of view of a family history of malignant neoplasm, colorectal cancer (OR:1.50, CI:1.05–2.14), kidney cancer (OR:2.55, CI:1.00–6.50) were associated with adenomas development especially more than 3 adenomas. Family history of colorectal cancer is associated with advanced adenoma development (OR:3.02, CI:1.42–6.40) at the multivariate analysis adjusted for sex, age, BMI, smoking and alcohol AP24534 purchase consumption. Especially, colon adenoma is more affected than rectal adenoma by family history of colorectal cancer. Conclusion: This study shows family history of colon cancer, family history of kidney cancer were a risk factor for the colorectal adenoma in persons aged 40–49 years. Therefore, earlier screening

colonoscopic surveillance might be needed for individual 40–49 years aged relatives than none of family history. Key Word(s): 1. colorectal neoplasm; 2. aged 40–49 years; 3. colon cancer; 4. kidney cancer; Table 2 The association between family history of cancer and risk for colorectal adenomas according to the location of adenomas   Colon Rectum (n = 564) (n = 98) N (%) OR* (95% CI) N (%) OR* (95% CI) *Adjusted for sex, age, BMI, smoking status, alcohol consumption Presenting Author: RASOUL SOTOUDEHMANESH Additional Authors: NAIMEH NEJATI, MARYAM FARSINEJAD,, SHADI KOLAHDOOZAN, ROYA RAHIMI, JAVAD MIKAELI, MORTEZA KHATIBIAN Corresponding Author: RASOUL SOTOUDEHMANESH Affiliations: digestive DiseaseResearchCenter; Digestive Disease Research Center Objective: Not infrequently, the usual imaging modalities fail to identify the cause of CBD dilation and

endoscopic ultrasonography (EUS) becomes necessary. The aim of this study was to assess the value of EUS in identifying the cause of CBD dilatation undiagnosed by transabdominal ultrasonography Methods: During 18 months, 152 consecutive patients who were referred for evaluation all of dilated CBD (diameter ≥7 mm) discovered incidentally during transabdominal ultrasonography were included. Final diagnoses were confirmed by ERCP, EUS-guided FNA, surgical exploration, or clinical follow up of at least 10 months. Patients with choledocholithiasis were referred for ERCP and sphincterotomy, and patients with operable tumors were referred for surgery. Patients with inoperable tumors underwent biliary stenting with or without chemoradiotherapy. Results: One hundred and fifty (54% female) with dilated CBD were included. Mean age of patients was 60 ± 17 years. The final diagnoses was choledocholithiasis in 32 (21.

Minimal HE (MHE), the mildest form of HE, is characterized by subtle motor and cognitive deficits and impairs health-related quality of life. The Indian National Association for Study of the Liver (INASL) set up a Working Party on MHE in 2008 with a mandate to develop consensus guidelines on various aspects of MHE relevant to clinical practice. Questions related to the definition of MHE, its prevalence, diagnosis, clinical characteristics, pathogenesis, natural history and treatment were addressed by the members of the Working Party. Hepatic encephalopathy (HE) is a major complication that develops in some form and

at some stage in a majority of patients with liver cirrhosis. Overt HE occurs in approximately 30–45% of cirrhotic patients2,3 and in 10–50% of patients with transjugular intrahepatic portosystemic

shunt (TIPS).1 Minimal HE (MHE), the mildest form of HE, is learn more characterized by subtle motor and cognitive deficits, and impairs health-related quality of life (HRQOL).2–4 The Indian National Association for Study of the Liver (INASL) set up a Working Party on MHE in 2008 with a mandate to develop consensus guidelines on various aspects of MHE relevant to clinical practice; its final report was presented at the annual meeting of the INASL on 28 March 2009. This is the Selumetinib mw first-ever Consensus Statement developed on this subject. The following questions were addressed by the Working Party. Definition: What is the most appropriate definition of MHE? Is there a need to broaden the definition to include liver diseases and causes of portal hypertension PRKACG other than cirrhosis? (Discussion led by Dr Deepak Amarapurkar.) Prevalence: What is the overall prevalence of MHE? What are the risk factors

that influence its prevalence? Does it interfere with patients’ HRQOL? What is the associated economic burden of MHE? (Discussion led by Dr Avnish K. Seth and Dr Ramesh R. Rai.) Diagnosis: How can we differentiate grade 0 from grade 1 HE? What are the roles for neuropsychological and neurophysiological testing and current neuroimaging techniques in the diagnosis of MHE? (Discussion led by Dr Vivek A. Saraswat, Dr Barjesh K. Sharma and Dr Rakesh K. Gupta.) Clinical characteristics: Is MHE a ‘symptomatic’ condition? If so, what are the cognitive symptoms? Should all cirrhotic patients be subjected to testing for the diagnosis of MHE or should it be restricted to patients with cognitive symptoms? (Discussion led by Dr Vivek A. Saraswat and Dr Samir Shah.) Pathogenesis: What is the role of ammonia, intestinal flora and inflammation in the pathogenesis of MHE? (Discussion led by Dr Yogesh K. Chawla, Dr Praveen Sharma and Dr Kaushal Madan.) Natural history: Does MHE predict overt HE and poor outcome? (Discussion led by Dr Rakesh Aggarwal.) Treatment: What is the role of non-absorbable disaccharides, pre and/or probiotic, L-ornithine–L-aspartate (LOLA), or antibiotics in the treatment of MHE? Does treatment improve HRQOL? (Discussion led by Dr Radha K.

“
“The small intestine cannot be completely evaluated via traditional endoscopic techniques due to its length and location. Video capsule endoscopy is a safe and well-tolerated procedure to visualize the small intestine. Capsule endoscopy can evaluate numerous gastrointestinal disorders, including obscure gastrointestinal bleeding, celiac disease, inflammatory bowel disease, and polyposis syndromes. Capsule endoscopy technology has also been used to examine the esophagus and most recently the colon. Limitations of capsule endoscopy include the inability to take biopsies, missed lesions, difficulty in localization, incomplete examinations, and variability in interpretation. “
“Aim:  The

present study aimed to

Small molecule library concentration conduct a nationwide investigation on the relationship between hospital volume and outcomes following liver resection in Japan. We also discuss health policy Everolimus implications of the results. Methods:  Using the Japanese Diagnosis Procedure Combination database, we identified 18 046 patients who underwent hepatic resection between July and December 2007–2009. Patients were subdivided into hospital-volume quartiles: very low- (<18/year), low- (18–35), high- (36–70) and very high-volume groups (>70). Multivariate logistic regression analysis for in-hospital mortality within 30 days of surgery was performed to analyze adjusted effects of various factors. Results:  Patients in the very high-volume group had a higher Charlson Comorbidity Index (P < 0.001) than those in the very low-volume group. Very low-volume hospitals were significantly less likely to perform extended lobectomy than very high-volume hospitals (5.4% vs 17.6%, P < 0.001). Crude in-hospital mortality within 30 days of surgery was 1.1% (0.6%, 0.8%, 1.9% and 3.0% for limited resection, segmentectomy, lobectomy and extended lobectomy, respectively). With

reference to the very low-volume group, risk-adjusted odds ratios ADAMTS5 (95% confidence intervals) of low-, high- and very high-volume groups for overall mortality were 0.70 (0.48–1.02; P = 0.060), 0.52 (0.34–0.81; P = 0.004) and 0.16 (0.09–0.30; P < 0.001), respectively. Conclusion:  There is a linear trend between higher hospital volume and lower in-hospital mortality of liver resection in Japan, particularly for lobectomy and extended lobectomy. Based on these results, regionalization of lobectomy and extended lobectomy in high-volume centers could be effective for reducing postoperative mortality. "
“Non-alcoholic fatty liver disease (NAFLD) is linked to metabolic syndrome, and is known to be associated with impaired fasting glycemia and diabetes mellitus. This prospective community-based study was conducted to determine the association between NAFLD and incidence of diabetes mellitus in an urban adult population in Sri Lanka. Participants of the Ragama Health Study cohort were assessed for NAFLD using established ultrasound criteria in 2007.

The miR-361–3p regulates RelA and CDX2 mRNA expression; and miR-212–3p regulates COX-2 mRNA expression. miRNAs may contribute to the inflammation of lower esophagus with H. pylori infection, and may be involved in the development of Barrett’s Esophagus and esophageal adenocarcinoma. Key Word(s): 1. MicroRNAs; 2. COX-2; 3. CDX2; 4. Helicobacter pylori; Presenting Author: GUI-GEN TENG Additional Authors: WEI-HONG WANG, YUN DAI, SHU-JUN WANG, YUN-XIANG CHU, JIANG LI Corresponding Author: WEI-HONG WANG Affiliations: Peking University First Hospital Objective: Barrett’s esophagus (BE) is recognized as a complication of chronic gastroesophageal acid

and bile reflux, and also considered to be a precancerous state in the esophagus and may progress to esophageal adenocarcinoma (EA). H. pylori has been found to colonize the Barrett epithelium of lower esophagus. However, its role in the development of Barrett’s esophagus and esophageal adenocarcinoma is unclear. Here, we explored the effects of acidic deoxycholic acid and H. pylori on esophageal cell lines in vitro, with a particular focus on whether NF-kB is involved in this event. Methods: H. pylori 26695 and its cagA mutant strain were cocultured

with two esophageal cell lines (HET-1A, OE33) with or without acidic deoxycholic acid (DCA) in vitro. Cell proliferation was tested by CCK-8 assay. Apoptosis was determined by Flow Cytometry. COX-2 and CDX2 were assessed by real-time PCR and Western blot. MUC2 was determined by qPCR and immunocytochemistry. clonidine NF-kB phosphorylation and

DNA-binding activity were determined by Western blot and EMSA. NF-kB transcriptional activity was identified by luciferase reporter assay. The downstream genes of NF-kB, such as IL-8 were assessed by ELISA and qPCR. Results: DCA, live H. pylori and HPE (H. pylori extract) reduced proliferation and promoted apoptosis of esophageal cells. DCA, live H. pylori and HPE up-regulate the expression of COX-2, CDX2 and MUC2 in both esophageal cell lines. However, cagA mutant strain and its extract did not induce the expression of CDX2 and MUC2. NF-kB activity was induced by DCA, live H. pylori and HPE. Treatment with DCA in the presence of either live H. pylori or HPE further augmented the NF-kB phosphorylation, its DNA-binding and the transcriptional activity; and PF-562271 subsequently increased the expression of COX-2, CDX2, MUC2 and IL-8 as compared to DCA treatment alone. The results suggested a synergistic effect between DCA and H. pylori in esophageal cells. Both siRNA P65 and PDTC significantly inhibited NF-kB activity, and influenced the downstream genes expression in esophageal cell lines with H. pylori infection. Conclusion: The present study reveals that both H. pylori and DCA up-regulate the expression of COX-2, CDX2, MUC2 and IL-8 in esophageal cells by inducing the activation of NF-kB. These results indicate that H.

[8] Essential for the normal function and development of most multicellular organisms, integrins play important roles in various pathological conditions, such as chronic liver diseases and tumor development.[9-13] Indeed, integrins are important at every stage of cancer, including tumor cell migration, invasion, proliferation and survival, and they learn more contribute to tumor progression and metastasis.[14, 15] The αvβ6 integrin is a receptor

for the extracellular matrix proteins fibronectin, vitronectin and tanascin, and is expressed exclusively on epithelial cells, typically only during tissue remodeling, which occurs in inflammation and cancer; however, αvβ6 is not expressed in normal adult epithelia.[16-18] It has been reported that αvβ6 is upregulated in various cancers, modulates tumor cell invasion and click here apoptosis, and possibly promotes cancer progression and metastasis.[19, 20] Recently, the αvβ6 integrin was shown to be strongly expressed in human CCC but not in hepatocellular carcinoma (HCC).[21] The α6β4 and α3β1 integrins are biliary type integrins that are expressed on normal and proliferating biliary epithelium and CCC but not on normal hepatocytes and differentiated HCC.[10-13, 22] The α6β4 and α3β1 integrins,

which are receptors for laminin, have also been suggested to play key roles in tumor cell invasion and tumor development.[23-25] Recently, it has been reported that the enhanced expression of integrin α6β4 is associated with a migratory and invasive phenotype and the progression of CCC, whereas almost no expression was detected in most HCC cell lines.[26] However, the expression of integrins and the extracellular matrix in CoCC has not been examined to date. Therefore, the aim

of this study was to evaluate the expression of integrins αvβ6, α6β4 and α3β1, and their ligands, fibronectin and laminin, see more in CoCC. The results of the present study reveal the downregulation of β6, β4 and α3 integrins in CoCC in contrast to high expression in CCC and the distinct immunolocalization of fibronectin and laminin in CoCC. These results suggest that integrin expression may be of diagnostic value and a useful tool for defining the clinical and pathological entity of CoCC. TISSUE SAMPLES OF 23 tumors of CoCC from 21 patients obtained by surgical resection (17 cases) and autopsy (four cases) were collected at the Department of Pathology, Teikyo University School of Medicine, Teikyo University Hospital and Toranomon Hospital during 1991–2013. Samples of CCC (28 cases), HCC (42 cases), and classical type CHC (classical CHC) (11 cases) were obtained by resection and autopsy at Teikyo University Hospital during 1991–2013. The clinical and pathological characteristics of the patients are shown in Table 1.

5–7,11–13 Hardness is one of the most frequently measured properties of a ceramic. Its value helps to characterize resistance to deformation, densification, www.selleckchem.com/products/ABT-263.html and fracture.14 One of the main concerns over the use of porcelains is their abrasive potential or wear of the opposing tooth structure. Two major determinants of enamel wear are surface finish and microstructure.15,29 Layering high-strength ceramics in a restoration provides improved esthetics but affects the overall performance of a restoration, as each ceramic has different

chemical and physical properties and a different coefficient of thermal expansion (CTE). As all-ceramic technology is relatively young, less development has taken place regarding veneering materials for these ceramic coping systems. Thus some early core/porcelain systems were even less esthetic than what was available at

the time in metal–ceramic technologies, and many problems with those materials have only been dealt with recently. Problems include poor color stability, abrasiveness, devitrification Cisplatin mw with multiple firings, and poor core/veneer bonding. In-Ceram is an all-ceramic system consisting of a high-volume fraction alumina core material veneered with feldspathic porcelain.5–7 Three veneering materials have been developed for In-Ceram cores, and no authors have compared them. This study was designed to evaluate three core/veneer combinations in terms of bond strength, microhardness, and interface quality, as the veneering material can greatly influence the longevity, wear, click here and esthetics of all-ceramic systems. A stainless steel die was machined to approximate dimensions for a prepared molar (6 mm high, 9 mm diameter). The die had a standard recommended preparation for an all-ceramic crown, including an 8° occlusal convergence and a rounded 90° shoulder of 1 mm width to accommodate an In-Ceram crown. The materials used in this study were In-Ceram core

material with its three veneering materials: Vitadur N, Vitadur Alpha, and the recently developed VM7 powder (Vita Zahnfabrik Bad Sackingen, Germany). A total of 15 In-Ceram cores were constructed for this study. These cores were divided into three groups of five. The specimens of each group were layered with one veneering ceramic disc (2-mm thick, 2 mm diameter): Vitadur N, Vitadur Alpha, or VM7 for shear bond and microhardness testing. The stainless steel die was duplicated 15 times in special plaster (Vita Zahnfabrik) using a special tray and addition silicon impression material (Imprint II, 3M ESPE, Seefeld, Germany). A split counter die was designed to allow the production of a wax coping of 0.7 mm thickness for standardization of the core dimensions. The wax coping was invested and cast to produce a metal coping of standard dimension.