A melanotic neuroectodermal tumor of infancy (MNTI) is a uncommon osteolytic pigmented neoplasm that primarily affects the jaws of newborn infants. Most patients (> 90%) present with the tumor in the first year of life. Approximately 65% form in the maxilla, 11% in the mandible, 5% in the brain and elsewhere. MNTI is normally benign, but up to 15% may recur and a few have metastasized. Approximately 200 cases of MNTI have been reported but only 2 of them presented as multifocal. A case of MNTI in a 7 month old boy was encountered. The chief complaint was maxillary anterior ridge swelling. The incisional biopsy findings were MNTI. Two months after the first operation, mild swelling of another site was observed. The infant was examined periodically since undergoing two procedures with no recurrence. This case demonstrates the possibility of a multicentric MNTI. We report a multicentric MNTI with a review of the relevant literature.
Biopsy ; Brain ; Humans ; Infant ; Infant, Newborn ; Jaw ; Mandible ; Maxilla ; Neuroectodermal Tumor, Melanotic ; Polyenes ; Recurrence

INTRODUCTION: To evaluate the skeletal stability after a bilateral sagittal split osteotomy (BSSO) setback of the mandible fixed with a biodegradable internal fixation device or metal internal fixation device. MATERIALS AND METHODS: Thirty consecutive patients underwent mandibular setback via BSSO. Fifteen patients were fixed with a biodegradable internal fixation device or metal internal fixation device respectively. Posteroanterior (PA) and lateral cephalograms were taken preoperatively and at two days, 5.5 months and 14.5 months postoperatively. The relevant skeletal points were traced and digitized to evaluate the skeletal changes postoperatively. The relapse rates were analyzed and compared statistically. RESULTS: There was no statistically significant differences in postoperative stability between the two groups.(P<0.05) CONCLUSION: The biodegradable internal fixation device may make an effective device alternative to a metal internal fixation device for setback BSSO.
Humans ; Internal Fixators ; Mandible ; Osteotomy ; Osteotomy, Sagittal Split Ramus ; Recurrence ; Sitosterols

Duodenal varix is a rare cause of hemorrhage in patients with portal hypertension, however their rupture is serious and often life threatening. Treatments for duodenal variceal bleeding include endoscopic procedures, surgery, or interventional radiologic procedures. We report a case of duodenal varices rupture in a 45-year-old man with alcoholic liver cirrhosis who presented with melena and dizziness. Emergent upper endoscopy revealed large nodular varices with a ruptured erosion on the top in the distal second portion of duodenum. Two consecutive injections with 1.0 mL of n-butyl-2-cyanoacrylate (Histoacryl; Braun-Melsungen, Germany) mixed with 1.0 mL of lipiodol (Laboratoire-Guerbet, France) were performed intravariceally and achieved successful hemostasis. This suggests that endoscopic injection sclerotherapy with histoacryl may be an effective therapeutic option for the control of ruptured duodenal variceal bleeding.
Duodenal Diseases/etiology/*therapy ; Duodenoscopy ; Duodenum/*blood supply ; Enbucrilate/*analogs & derivatives/chemistry/therapeutic use ; Gastrointestinal Hemorrhage/etiology/*therapy ; Humans ; Liver Cirrhosis, Alcoholic/complications ; Male ; Middle Aged ; Rupture ; Sclerosing Solutions/*therapeutic use ; *Sclerotherapy ; Tissue Adhesives/therapeutic use ; Tomography, X-Ray Computed ; Varicose Veins/complications/*therapy

BACKGROUND/AIMS: The aim of this study was to identify non-endoscopic predictors for the presence of large esophageal varices in Korean patients with liver cirrhosis. METHODS: Among 736 patients with liver cirrhosis newly diagnosed between the year 2001 and 2005, 245 patients (171 men and 74 women, mean age of 51.9 years) fulfilled the inclusion criteria and underwent EGD as screening tests for esophageal varices. Fifteen variables were analysed to identify the presence of large esophageal varices. RESULTS: Esophageal varices were noted in 186 patients (75.9%) and large varices in 55 patients (22.4%), while 59 patients (24.1%) had no varices at the time of initial diagnosis of cirrhosis. The causes of liver cirrhosis were viral hepatitis (41.2%), chronic alcoholism (42.4%), viral hepatitis/alcoholism (9.8%), and others (6.6%). Fifty-one percent, 35.1% and 13.9% of the patients belonged to Child-Pugh class A, B, and C, respectively. Variables associated with the presence of large esophageal varices on univariate analysis were the presence of ascites, splenomegaly (long-axis > or =12 cm by ultrasound measure), alcoholism, Child-Pugh class, platelet count, prothrombin time, and albumin. On multivariate analysis, alcohol, splenomegaly, and ascites were significantly associated with the presence of large esophageal varices. If the patients have two of them, sensitivity and negative predictive value were 80% and 91.7%, respectively. Patients without all three factors had no large esophageal varices. CONCLUSIONS: These results suggest that patients who have at least two among ascites, splenomegaly, and alcoholism would have an increased risk of having large esophageal varices.
Adult ; Aged ; Ascites/diagnosis ; Esophageal and Gastric Varices/diagnosis/epidemiology/*etiology ; Female ; Humans ; Liver Cirrhosis/*complications/epidemiology ; Liver Cirrhosis, Alcoholic/*complications/epidemiology ; Male ; Middle Aged ; Multivariate Analysis ; Odds Ratio ; Predictive Value of Tests ; Prevalence ; ROC Curve ; Risk Factors ; Sensitivity and Specificity ; Severity of Illness Index ; Splenomegaly/complications

BACKGROUND/AIMS: Recently, the incidence of acute hepatitis A has increased nationwide and is related to the low rate of IgG anti-HAV. This study compared the prevalence of IgG anti-HAV in two university hospitals located in a large city and in a small city including a rural region according to age, gender, and the year of diagnosis. METHODS: IgG anti-HAV was measured in a total of 4299 patients, who visited Seoul or Guri Hanyang University Hospital between January 2002 and December 2006. RESULTS: The positive rates of the antibody in Seoul and Guri hospitals were 52.7% vs 57.1% in under the age of 1, 40.7% vs 42.2% in age of 1 to 4, 31.8% vs 30.3% in age of 5 to 9, 24.8% vs 27.1% in age of 10 to 14, 11.6% vs 18.2% in age of 15 to 19, 23.0% vs 20.3% in age of 20 to 24, 40.5% vs 42.9% in age of 25 to 29, 67.5% vs 75.0% in age of 30 to 34, 86.5% vs 88.1% in age of 35 to 39, 95.3% vs 93.6% in age of 40 to 44, 97.0% vs 98.7% in age of 45 to 49, and 98.5% vs 98.6% in patients who were more than 50, respectively. The positive rates of the antibody were not significantly different between two sites according to each age group and gender. CONCLUSIONS: The results confirmed the low rates of IgG anti-HAV, particularly in the ages of 10-24 that match the age group of recently increased incidence of acute hepatitis A nationwide. Therefore, measurement of the antibody and vaccination should be considered in this age group.
Adolescent ; Adult ; Aged ; Child ; Child, Preschool ; Female ; Hepatitis A/*epidemiology ; Hepatitis A Antibodies/*blood ; Hepatitis A Virus, Human/immunology ; Hospitals ; Humans ; Immunoglobulin G/*blood ; Infant ; Korea/epidemiology ; Male ; Middle Aged ; Rural Population ; Seroepidemiologic Studies ; Urban Population

Hemangioblastoma is uncommon, accounting for 1 to 2.5% of all primary neoplasms of the central nervous system. Ten to 20% of hemangioblastomas occur as part of Von Hippel-Lindau disease(VHL). Multiple hemangioblastomas are seen only with VHL and these are seen in up to half of VHL-associated hemangioblastomas. We have treated two cases of multiple hemangioblastomas associated with VHL disease in a family, sister(case I, 48/female) and her brother(case II, 41/male). Both patients had renal and pancreatic cysts in addition to CNS hemangioblastomas. Their hemangioblastomas were removed totally, and then their neurological symptoms had Improved. With a review of the literature, the authors present a family of VHL-associated multiple hemangioblastomas.
Central Nervous System ; Hemangioblastoma* ; Humans ; Pancreatic Cyst

Autoimmune Diseases ; B-Lymphocytes ; Biopsy ; Bone Marrow ; Breast ; Female ; Humans ; Lip ; Lung ; Lymphoid Tissue ; Lymphoma ; Lymphoma, B-Cell, Marginal Zone ; Lymphoma, Non-Hodgkin ; Mouth ; Recurrence ; Skin ; Stomach ; Surgery, Oral ; Thyroid Gland

INTRODUCTION: Bone density is one of the important factors for the long term success of endosseous implants. The bone density varies from site to site and from patient to patient. A preoperative evaluation of the bone density is quite useful to oral surgeons for planning dental implantation. More accurate information on the bone density will help surgeons identify suitable implant sites, thereby increase the success rate of dental implantation. This study examined the correlation between the bone density measured preoperatively by computed tomography (CT) and the implant primary stability measured by resonance frequency analysis. Furthermore, the effects of the implant sites, gender, age and generalized systemic disorder patients on the bone density and primary implant stability were examined. MATERIALS AND METHODS: One hundred and fourteen patients were selected. None of the patients had undergone a tooth extraction or bone graft history in the previous year. Preoperatively, the patients underwent CT scanning to evaluate the Hounsfield unit (HU), and resonance frequency analysis (RFA) was used to evaluate the implant primary stability at the time of implant installation. All implants were 4.0 mm diameter and 11.5 mm length US II. All patients were recorded and the HU and implant stability quotient (ISQ) value were evaluated according to the sites, gender and age. RESULTS: The highest HU values were found in the mandibular anterior site (827.6+/-151.4), followed by the mandibular molar site (797+/-135.1), mandibular premolar site (753.8+/-171.2), maxillary anterior site (726.3+/-154.4), maxillary premolar site (656.7+/-173.8) and maxillary molar site (621.5+/-164.9). The ISQ value was the highest in the mandibular premolar site (81.5+/-2.4) followed by the mandibular molar site (80.0+/-5.7), maxillary anterior site (77.4+/-4.1), mandibular anterior site (76.4+/-11.9), maxillary premolar site (74.2+/-14.3) and maxillary molar site (73.7+/-7.4). The mean HU and ISQ value were similar in females and males. (HU: P=0.331, ISQ: P=0.595) No significant difference was also found in the age group respectively. However, the correlation coefficients between the variables showed a closed correlation between the HU and ISQ value. CONCLUSION: These results showed close correlation between the bone density (HU) and primary stability value (ISQ) at the time of implant installation (Correlation coefficients=0.497, P<0.01). These results strengthen the hypothesis that it might be possible to predict and quantify the initial implant stability and bone density from a presurgical CT diagnosis. These results strengthen the hypothesis that it might be possible to predict and quantify the initial implant stability and bone density from a presurgical CT diagnosis.
Bicuspid ; Bone Density ; Dental Implantation ; Dental Implants ; Female ; Humans ; Male ; Molar ; Osseointegration ; Tooth Extraction ; Transplants

OBJECTIVE: Lexical fluency tests are frequently used to assess language and executive function in clinical practice. We investigated the influences of age, gender, and education on lexical verbal fluency in an educationally-diverse, elderly Korean population and provided its' normative information. METHODS: We administered the lexical verbal fluency test (LVFT) to 1676 community-dwelling, cognitively normal subjects aged 60 years or over. RESULTS: In a stepwise linear regression analysis, education (B=0.40, SE=0.02, standardized B=0.506) and age (B=-0.10, SE=0.01, standardized B=-0.15) had significant effects on LVFT scores (p<0.001), but gender did not (B=0.40, SE=0.02, standardized B=0.506, p>0.05). Education explained 28.5% of the total variance in LVFT scores, which was much larger than the variance explained by age (5.42%). Accordingly, we presented normative data of the LVFT stratified by age (60-69, 70-74, 75-79, and > or =80 years) and education (0-3, 4-6, 7-9, 10-12, and > or =13 years). CONCLUSION: The LVFT norms should provide clinically useful data for evaluating elderly people and help improve the interpretation of verbal fluency tasks and allow for greater diagnostic accuracy.
Aged* ; Education ; Executive Function ; Humans ; Linear Models

Colonic pseudolipomatosis is a benign condition that is caused by mechanical trauma during an endoscopic procedure or by disinfectant colitis. It is characterized by empty vacuoles that are similar to the adipocyte in the lamina propria on histology and whitish plaques that are seen endoscopy. The prevalence of pseudolipomatosis is relatively low due to the lack of clinical experience and there have been no Korean reports about colonic pseudolipomatosis with the typical endoscopic findings. We report here on three cases of colonic pseudolipomatosis that was caused by endoscope disinfectant (paracetic acid). Typical whitish plaques were observed during the colonoscopic procedures in all 3 cases. In one case, whitish plaques appeared before our eyes immediately after the sudden appearance of whitish foamy fluid when the water button was depressed. H&E stain revealed empty vacuoles in the lamina propria and immunohistochemical staining showed no expression of CD31, CD34 and s-100. There were no symptoms related to these lesions in our cases.
Adipocytes ; Colitis ; Colon ; Endoscopes ; Endoscopy ; Eye ; Mucous Membrane ; Prevalence ; Vacuoles