Implant overdentures are widely used as a treatment method to restore oral function in completely edentulous or partially edentulous patients with severe bone resorption. Using a milled bar, it is mechanically advantageous as the implant fixtures are splinted. Applying additional attachments to the bar has the advantage of dispersing the stress applied to the implant. In this case, a patient who used implant overdentures using 4 implants wanted to fabricate a new prosthesis due to repeated fractures of the denture and weakened retention. Milled bar with ADDTOC attachment and zirconia prosthesis were fabricated by CAD-CAM method and mechanically and aesthetically satisfactory results were obtained.

We present a case of a colonic involvement associated with necrotizing pancreatitis, with a review of the literature. A 10 year old boy had an appendectomy at the local clinic ten days ago. On admission, he complained nausea, vomiting and severe constipation. His abdomen was distended and he had tenderness on the left abdomen. Laboratory and radiologic studies revealed findings consistent with acute pancreatitis with colonic complication. He was treated conservatively for 30 days but did not improve. On hospital 30th day, abdominal pain developed and his vital sign changed. Abdominal CT suggested ischemic change of the transverse colon. At laparotomy, the left colon showed stenosis. The greatly distended transverse colon was resected and a transverse end colostomy was done. He was discharged at postoperative 45th day with improvement and colostomy closure was performed 8 months later.
Abdomen ; Abdominal Pain ; Appendectomy ; Child ; Colon* ; Colon, Transverse ; Colostomy ; Constipation ; Constriction, Pathologic ; Humans ; Laparotomy ; Male ; Nausea ; Pancreatitis ; Pancreatitis, Acute Necrotizing* ; Tomography, X-Ray Computed ; Vital Signs ; Vomiting

Infantile digital fibromatosis is a rare benign tumor on the fingers and toes of infants and childhood which is characterized by fibroblastic proliferation. Usually the lesions occur singly or severally on the dorsal or lateral aspects of the distal phalanges of the toes and fingers. The thumb and great toe are usually spared. These asymptomatic, firm, red, smooth nodules, some lcm diameter, occur during the first year of life. Forty-seven percent occur in the first month of life. This disease can occur after trauma. The lesions do not metastasize. Occasionally, spontaneous regression has been reported. After excision, recurrence can be possible. A 2 years old female infant had three large bean sized erythematous masses on the left 2,3,4th fingers. The erythematous aacule was developed at 6 months old and grew slowly. We could find inclusion body stained bright red with Massons trichrome and purple with PTAH in cytoplasm of fibroblast. The patient was treated with a simple excision followed by a skin graft. During 5 rnonths after operation, recurrence was not occurred.
Child, Preschool ; Cytoplasm ; Female ; Fibroblasts ; Fibroma* ; Fingers ; Humans ; Inclusion Bodies ; Infant ; Recurrence ; Skin* ; Thumb ; Toes ; Transplants*

Many different myelographic contrast media have been employed for the radiographic visualization of the spinal cord. Unfortunately, none has fulfilled all the requirements of an ideal contrast medium-no toxicity, complete and rapid absorption, good radiographic contrast, and miscibility with the cerebrospinal fluid. Toxic reactions have been reported from the water soluble contrast media, which require the administration of a spinal anesthesia and have thus been employed clinically only in examination of the lumbosacral area. Some authors have advocated the use of new contrast media, Conray(Meglumine iothalamate), Dimer-X, for the lumbar myelography without a spinal anesthesia and obtained good results. The present work is an attempt to provoke and emphasize the toxicologic response and the pathologic changes by variation in amount of Conray and rate of injection. Each dog was prepared with a catheter in lumbar subarachnoid space under the light anest hesia. After recovery from the anesthesia, myelography was performed by lumbar subarachnoid injection of Conray by variations in amount of Conray and rate of injection under the control of a fluoroscope. The experimental conditions were varied as follows. 1. Conray was injected in variable amounts from the lumbosacral subarachnoid space to the high cervical and intracranial subarachnoid space. 2. Conray was injected in variable rate of injection. 3. Decadron was added to Conray in another group. 4. The brain and the spinal cord including the dura and the nerve roots were taken for the pathologic study in variable durations after myelography. The results were summarized as follows. 1. A large amount of Conray injection to the high cervical and intracranial subarachnoid space produced wevere toxic reactions followed by death. 2. Rapid injection of Conray was considered to elicit more toxic reactions. 3. The toxic reactions included changes in behavior and respiration, neck muscle spasms, paresis of forelegs and hindlegs, urination, defecation and epileptiform convulsions. 4. There was no difference in toxic reactions in adding Decardon. 5. Radiographic contrast densities were somewhat less than that of Pantopaque. Conray was freely miscible with the cerebrospinal fluid, thus providing total myeloraphy. 6. No recognizable reaction was noted in gross and histopathological examination.
Absorption ; Anesthesia ; Anesthesia, Spinal ; Animals ; Brain ; Catheters ; Cerebrospinal Fluid ; Contrast Media ; Defecation ; Dogs ; Iophendylate ; Myelography* ; Neck Muscles ; Paresis ; Respiration ; Seizures ; Spasm ; Spinal Cord ; Subarachnoid Space ; Urination

BACKGROUND: The purpose of this study is to investigate the incidence and associated factors of postoperative delirium in elderly patients with hip fracture. METHODS: We interviewed 90 patients with hip fracture with the aim of identifying underlying diseases and laboratory data. Cognitive function was measured with Mini Mental Status Exam-K (MMSE-K) before surgery. RESULTS: Delirium developed in 20 patients (22.2%). History of dementia (p=0.041) and mean score of MMSE-K (p<0.001) were significantly related to the incidence of delirium. An MMSE-K score less than 20 was an independent risk factor for postoperative delirium in patients with hip fracture. CONCLUSION: Cognitive impairment was a risk factor of postoperative delirium. MMSE-K is expected to be a simple indicator for predicting postoperative delirium in older patients with hip fracture.
Aged ; Delirium ; Dementia ; Hip ; Humans ; Incidence ; Risk Factors

After acute interruption of cerebral blood flow, various hemodynamic, morphologic and metabolic changes ensue in the occluded area. Such changes and subsequent brain damage are of great concern in the course of temporary arterial occlusion during aneurysmal surgery. Many experimental studies investigating the processes of cerebral infarction have been done through selective occlusion of intracranial vessels, and it has been known that 4 to 8 minutes interruption of cerebral blood flow results in irreversible brain damage. Cerebral resistance following vascular occlusion may be influenced by collateral circulation, hypothermia and hyperventilation. Recently we experienced two patients with right middle cerebral artery aneurysms, who were operated upon under normothermia, slight hypotension, and hyperventilation using microsurgical technique. The technique of temporary occlusion of middle cerebral artery was applied as an adjunctive method.
Aneurysm ; Brain ; Cerebral Infarction ; Collateral Circulation ; Hemodynamics ; Humans ; Hyperventilation ; Hypotension ; Hypothermia ; Intracranial Aneurysm* ; Middle Cerebral Artery*

Recently interleukin-4 (IL-4) has been suggested to be a promising therapeutic agent for the malignant tumors of both murine and human origin. The effect of IL-4 is mediated by IL-4 receptor (IL-4R), which has been shown to be expressed in many normal and tumor cell lines. We herein tested two cell lines of human renal cell carcinoma (RCC), Caki-1 and CURC-II, for the expression of IL-1R gene. On the reverse transcription-polymerase chain reaction study, both cell lines expressed IL-4R mRNA. The present study suggests that it would be worthwhile to investigate the anti-tumor effect of IL-4 on Caki-l and CIJRC-II, which may help to develop new therapeutic strategies for RCC using IL-4.
Carcinoma, Renal Cell* ; Cell Line* ; Cell Line, Tumor ; Gene Expression ; Humans* ; Interleukin-4* ; Receptors, Interleukin-4 ; RNA, Messenger

The purpose of this report is to present the results of clinical observation upon 21 surgical cases with tic douloureux (female 13, male 8) during the period from January, 1960 to August, 1972 at the Department of Neurosurgery, Seoul National University Hospital, Seoul, Korea. The average age at onset was 48 years of age ranging from 22 to 66 years. The average duration from onset to operation was 5 years. The frequency of involvement was the highest in the maxillary division, next was maxillary and mandibular division, and none in the ophthalmic division. Whole division was involved in one case. Right-sided involvement predominated by a ratio of 2 to 1 and bilateral involvement was found in only one case. Extraction of innocent teeth, ungratifying operation upon paranasal sinus had been carried out in 11 cases as consequence of misdiagnosis. Alcohol injection of peripheral branches of trigeminal nerve and medical treatment produced short-lived or none-effectiveness. Trauma to ipsilateral mandible and epidermoid cyst at cerebellopontine angle seemed to be the cause of tic doulourex in 2 cases, respectively. Major complications observed in Frazier's method group, were paresthesia, facial nerve palsy, partial paralysis of motor root, and recurrence of neuralgia. All of the peripheral nerve avulsion group developed recurrence of pin within three years. Mild decrease of cornea reflex was noted in two cases of Dandy's method group. Posterior fossa operation stands in superiority, when it is considered that some pathologic lesions are frequently found in the posterior fossa, that motor root is less frequently injured, and that the light touch is so fairly preserved in all three divisions that the least damage to the cornea is expected.
Cerebellopontine Angle ; Cornea ; Diagnostic Errors ; Epidermal Cyst ; Facial Nerve ; Humans ; Korea ; Male ; Mandible ; Neuralgia ; Neurosurgery ; Paralysis ; Paresthesia ; Peripheral Nerves ; Recurrence ; Reflex ; Seoul ; Tics ; Tooth ; Trigeminal Nerve ; Trigeminal Neuralgia

The purpose of this report is to present the results of clinical observations on the surgical treatment of 26 patients (16 male, 10 female) with intractable pain during the period from May, 1960 to April, 1972 at the Department of Neurosurgery, Seoul National University Hospital. Age at the time of operation raged from 27 to 69 years. Duration of the pain from the onset to surgery was less than one year in most of the cases. The most common causes of the pain were the pelvic malignancies, lung cancer, and metastatic spine tumors in the order. In 20 cases of anterolateral cordotomies, the main complications were urinary retention, ipsilateral motor weakness, and decubitus. The high cervical cordotomy produced high analgesic level and less dropping of established analgesic level postoperatively. Posterior rhizotomy for intercostal neuralgia and a case of thoracic commissurotomy for intramedullary tumor were of gratifying result. The higher the pain located, the longer the pain existed, the operation was less likely to relieve the pain. High cervical cordotomy seems to be superior to high thoracic cordotomy even in the pain of leg, when it is considered in the respect of the high analgesic level, the lack of "island" of pain, and technical easiness.
Cordotomy ; Humans ; Leg ; Lung Neoplasms ; Male ; Neuralgia ; Neurosurgery ; Pain, Intractable* ; Rage ; Rhizotomy ; Seoul ; Spine ; Urinary Retention

The von Hippel-Lindau (VHL) disease is an autosomal dominant disorder by germline mutation of VHL tumor suppressor gene. The affected patients mainly develop cancers of the central nervous system, renal cell carcinoma, pheochromocytoma, and pancreatic cysts. Pancreatic involvement was observed 12~77% in VHL patients and included true cysts, serous cystadenomas, and neuroendocrine tumors. We experienced two cases of pancreatic cyst of the von Hippel-Lindau disease and reviewed associated literatures.
Carcinoma, Renal Cell ; Central Nervous System ; Cystadenoma, Serous ; Genes, Tumor Suppressor ; Germ-Line Mutation ; Humans ; Neuroendocrine Tumors ; Pancreatic Cyst ; Pheochromocytoma ; von Hippel-Lindau Disease