Traditionally, it has been emphasized that hemolytic disease was the primary cause of gallstones (cholelithiasis) in most young patients. In recent years, gallstones and common bile duct calculi have been increasingly diagnosed in infants and children, unrelated to hemolytic diseases. On the matter, the World Health Organization (WHO) classified intraepithelial neoplasia (dysplasia) of gall bladder as one of the precursor lesions of invasive cancer. The following article describes the case of a 2-year-old girl who had a laparoscopic cholecystectomy due to cholelithiasis and the pathologic diagnosis was chronic cholecystitis with diffuse, mild mucosal dysplasia.
Child ; Cholecystectomy, Laparoscopic ; Cholecystitis ; Cholelithiasis ; Gallbladder ; Gallstones ; Humans ; Infant ; Preschool Child ; Urinary Bladder ; World Health Organization

No abstract available.
Postoperative Complications*

A pulmonary thromboembolism usually results from deep vein thrombosis as a serious and fatal complication. It is well known that several risk factors are predisposed to these thrombotic events, causing sudden death. Recently, new variant forms of pulmonary thromboembolism, termed as "economy class syndrome or e-thrombosis" were reported in association with sitting for long time in aircraft seat or at computer. The authors experienced a case of death developed after prolonged gambling at casino in 46-year-old man and concluded that the cause of death was fatal pulmonary thromboembolism due to deep vein thrombosis, associated with prolonged sitting. Therefore, the author thought that this case may be contribute to another possible risk factor of life-threatening pulmonary thromboembolism and highlights the importance of predicting deep vein thrombosis after prolonged gambling in sitting position at casino in the similar mechanism of aforementioned reported cases.
Aircraft ; Autopsy* ; Cause of Death ; Death, Sudden ; Gambling* ; Humans ; Middle Aged ; Pulmonary Embolism* ; Risk Factors ; Venous Thrombosis

Purpose: To confirm that the phaco chop method using an illuminated chopper (iChopper; Oculight, Seongnam, Korea) can reduce cataract surgery complications, and that even beginners can safely and effectively perform phaco chop. Methods: We retrospectively analyzed the medical records of the first 30 phaco chop cases using illuminated chopper of four cataract surgeons. Four ophthalmologists had a variety of empirical backgrounds, from those who have experienced more than 10,000 cataract surgery, to beginners who have experienced 20 cataract surgery. Results: Of the total 120 eyes, two eyes (1.67%) had posterior capsule rupture. The chopping method was changed from phaco chop to stop and chop in three eyes (2.5%) including one eye with brown cataract with pseudoexofoliation syndrome and two eyes with nuclear opacity grade ≥5. Conclusions The rates of posterior capsule rupture of phaco chop using an illuminated chopper were very low in four surgeons with various experiences and who became proficient shortly in phaco chop.

Purpose: To minimize ultrasound power use and surgical phaco time in illuminated chop cataract surgery. Methods: The charts of patients who underwent senile cataract surgery by a single surgeon were reviewed retrospectively. A conventional intracameral endoilluminator was used in a Stop & Chop group (n = 45), while an illuminated chopper was used in an illuminated chop (I-Chop) group (n = 71). EFX, a unitless value that roughly correlates with ultrasound energy during phacoemulsification, surgical phaco time, and changes in endothelial cell count were compared between the two groups and the ratio of zero phacoemulsification in the I-Chop group was evaluated. Results: EFX of the Stop & Chop and I-Chop groups was 18.08 ± 16.15 and 0.82 ± 3.53, respectively (p = 0.001), while the surgical phaco time was 185.08 ± 41.42 and 162.04 ± 49.65 seconds (p = 0.01). However, the endothelial loss did not differ in the two groups (7.03 ± 7.89 vs. 7.13 ± 9.47%, p = 0.76). In the I-Chop group, 56 (86%) eyes had zero phaco energy and patients with EFX >1 (n = 6) had more severe nuclear sclerosis grading (2.90 ± 0.71 vs. 4.5 ± 1.0; p = 0.001). Conclusions The I-Chop group had lower EFX and shorter surgical phaco time than the Stop & Chop group. Illuminated chop using an illuminated chopper is one way to attain minimal phacoemulsification.

In the past, computer-aided design/computer-aided manufacturing (CAD/CAM) technology was the closed system that users had to use the components of only one manufacturer. At present, it has changed to the open system with the flexibility to select and use the components of various manufacturers' components according to their needs. Despite the development of dental materials and prostheses manufacturing methods, denture manufacturing has followed conventional manufacturing methods for nearly 100 years. However, studies on CAD/CAM fabricated denture have been recently carried out to overcome the disadvantages of conventional denture manufacturing. Some commercialized products using milling or 3D printing have already been applied clinically. This case report confirms the possibility of CAD/CAM dentures using 3D face scan and compared them to conventionally fabricated dentures.
Dental Materials ; Denture, Complete* ; Dentures ; Pliability ; Printing, Three-Dimensional ; Prostheses and Implants

A case of traumatic carotico-cavernous fistula was managed by intravascular occlusion using detachable balloon catheter. The great advantage of this technique is that the cerebral blood flow can usually be preserved after the occlusion of the fistula. The fistula was obliterated by this procedure. The radiological feature, symptomatology and management were discussed with brief review of the literature.
Catheters* ; Fistula*

There is too many pathological test compared to the number of pathology doctor in Korea. To solve this problem, there is a solution that establish more department of pathology, but it's not easy because of the amount of costs and other environmental constraints. In this circumstance, when special doctors whose fields are not pathology need external consulting, they go to pathology doctor and ask them personally. It wastes unexpectable time and cost. The improved system of these inefficient procedure in pathological consulting is "The Web Based Consultation System in Pathology". In this system, when a pathological consulting is needed, the doctors can send and receive the informations with web based platform. It's digitalized procedure of existing pathological consulting and made it possible to accomplish efficient consulting. Moreover the Pathology Database which generated in this system makes more systematic and continuous information administrate and practical use of that information.
Humans ; Korea ; Pathology*

Primary Sjogren's syndrome is a chronic autoimmune disorder characterized by xerostomia and keratoconjunctivitis sicca result from lymphocytic infiltrations of salivary and lacrimal glands.It may accompany by the wide spectrums of extraglandular symptoms,such as musculoskeletal,pulmonary,renal,intestinal,hematologic,and nervous system.However,overt cardiac manifestations are very rare and are documented only a few cases sporadically. We report a patient with primary Sjogren's syndrome who developed reversible congestive heart failure as part of a myocarditis.A 39-year-old woman with primary Sjogren's syndrome developed fatigue,dyspnea,and abdominal discomfort.An echocardiography revealed global hypokinetic left ventricle with markedly decreased ejection fraction (EF=39%),abnormal restrictive filling pattern,secondary tricuspid valve insufficiency and no pericardial effusion or thickening.A myocardial biopsy disclosed myocardial degeneration with lymphocyte infiltration.Following treatment with digitalis,diuretics,ACE inhibitor and corticosteroid,the symptoms of congestive heart failure improved.A repeat echocardiography showed an improved ventricular contractility and recovered both diastolic (normalized E/A ratio)and systolic (EF=50%)functions.
Adult ; Biopsy ; Echocardiography ; Female ; Heart Failure ; Heart Ventricles ; Humans ; Keratoconjunctivitis Sicca ; Lymphocytes ; Myocarditis* ; Pericardial Effusion ; Sjogren's Syndrome* ; Tricuspid Valve Insufficiency ; Xerostomia

PURPOSE: To find the applicability of adjuvant radiotherapy for extrahepatic bile duct cancer (EBDC), we analyzed the pattern of failure and evaluate prognostic factors of locoregional failure after curative resection without adjuvant treatment. MATERIALS AND METHODS: In 97 patients with resected EBDC, the location of tumor was classified as proximal (n = 26) and distal (n = 71), using the junction of the cystic duct and common hepatic duct as the dividing point. Locoregional failure sites were categorized as follows: the hepatoduodenal ligament and tumor bed, the celiac artery and superior mesenteric artery, and other sites. RESULTS: The median follow-up time was 29 months for surviving patients. Three-year locoregional progression-free survival, progression-free survival, and overall survival rates were 50%, 42%, and 52%, respectively. Regarding initial failures, 79% and 81% were locoregional failures in proximal and distal EBDC patients, respectively. The most common site was the hepatoduodenal ligament and tumor bed. In the multivariate analysis, perineural invasion was associated with poor locoregional progression-free survival (p = 0.023) and progression-free survival (p = 0.012); and elevated postoperative CA19-9 (> or =37 U/mL) did with poor locoregional progression-free survival (p = 0.002), progression-free survival (p < 0.001) and overall survival (p < 0.001). CONCLUSION: Both proximal and distal EBDC showed remarkable proportion of locoregional failure. Perineural invasion and elevated postoperative CA19-9 were risk factors of locoregional failure. In these patients with high risk of locoregional failure, adjuvant radiotherapy could be considered to improve locoregional control.
Bile Duct Neoplasms ; Bile Ducts, Extrahepatic* ; Celiac Artery ; Cystic Duct ; Disease-Free Survival ; Follow-Up Studies ; Hepatic Duct, Common ; Humans ; Ligaments ; Mesenteric Artery, Superior ; Multivariate Analysis ; Prognosis ; Radiotherapy, Adjuvant* ; Recurrence ; Risk Factors ; Survival Analysis ; Survival Rate