We experienced an unusual case of acute encephalopathy in a 4 month-old boy He was admitted to our hospital because of lethargy and seizures after preceding symptoms of upper respiratory tract infection a few days before admission. On admission, he was in semicomatous mental state with decorticated rigidity. Laboratory tests showed normal blood sugar, ammonia, and transaminase levels. CSF was acellular and sterile. Brain MRI in both 71 and 72 weighted-image showed high signal density in both thalami and caudate nucleus head. After recovery, neurologic sequales of developmental delay, mental retardation, right hemiplegia and seizure remained. We report a case of acute encephalopathy that have clinical course similar to Reye syndrome but have specific brain image.
Ammonia ; Blood Glucose ; Brain ; Caudate Nucleus ; Head ; Hemiplegia ; Humans ; Infant ; Intellectual Disability ; Lethargy ; Magnetic Resonance Imaging ; Male ; Respiratory Tract Infections ; Reye Syndrome ; Seizures

PURPOSE: To evaluate the incidence and the site of osteomas and their relation to sinonasal inflammation. MATERIALS AND METHODS: 1578 PNS computed tomography (CT) of patients with symptoms of sinusitis were evaluated and correlation with plain radiographic finding was done. RESULTS: The total incidence of osteomas was 0.82%(13/1578) on plain radiography and 3.29% (52/1578) on CT. Fifty-seven osteomas were found in 1578 PNS CT, including 2 osteomas in 5 cases. The most common site was the ethmoid sinus(54%, 31/57) and the next was the frontal sinus(35%, 20/57) on CT. Forty-five osteomas (78.9%) were associated with the sinonasal inflammatory change. CONCLUSION: The total incidence of osteomas from our results was higher than previous reports. And based on the analysis of CT, the most common site was not the frontal sinus as all the previous reports stated, but the ethmoid sinus, probably by virtue of high resolution of CT and/or higher prevalence of inflammation in the ethmold sinus.
Ethmoid Sinus ; Frontal Sinus ; Humans ; Incidence ; Inflammation ; Osteoma* ; Prevalence ; Radiography ; Sinusitis ; Virtues

An eccrine squamous syringometaplasia (ESS) is defined as a mature squamous metaplasia of the eccrine ducts. The clinical and pathological features of an ESS are presented. Syringometaplasia is a rare lesion, mostly occuring in the extremities, and as far as we know, no report on the ESS has been published in Korean literature. We experienced a case of an ESS occured in a 15 year-old male, who had a tender erythematous plaque in the right knee. The histologic examination revealed some scattered nests of metaplastic squamous epithelium in the deep dermis, associated with acute nonspecific panniculitis. The importance of the ESS is that it histologically simulates the well differentiated squamous cell carcinoma. The histopathologic findings were discussed and a brief review of the literature was made.
Adolescent ; Carcinoma, Squamous Cell ; Dermis ; Epithelium ; Extremities ; Humans ; Knee ; Male ; Metaplasia ; Panniculitis

PURPOSE: Lead toxicity affects every organ system, most importantly, the central and periphral nervous systems, kidney, and blood. Not yet, there are not so many data about blood lead levels of children in Korea. The children residing in Ulsan have some risk exposured to lead because of air pollution resulted from rapid industrialization and some lead-using industries. So we estimated the blood lead levels of children in Ulsan and tried to abtain the predict values of them. METHODS: Venous blood specimens were obtained for lead levels from two groups of 60 primary school children(30 residing in suburb, near-industry, and 30 in inner-city), aged 11-12 years. We also determined serum iron, ferritin, and hemoglobin. We compared blool lead levels between two groups according to nature of housing, age of housing, using the paint, condition of paint, parent's occupation. RESULTS: 1) The mean blood lead levels of 60 chiddren was 6.20+/-2.29 g/dl. 2) The children residing in inner-city had the higher blood lead levels(7.02+/-2.29 g/dl) than near-industry, suburban children (5.38+/-1.99 g/dl) with statistical significance (p<0.01). 3) Four children had the blood lead level over 10 g/dl, but all of them below 15 g/dl, and no intellectual deficit. 4) Air lead in classroom of 2 schools was not detected. 5) The serum iron, ferritin and hemoglobin level were all within the normal range. 6) There were no significant difference of blood lead levels between two groups according to nature of husing, age of housing, using the paint, condition of paint, parent's occupations. CONCLUSIONS: The mean blood lead levels of some primary school children in Ulsan was 6.20+/-2.29 g/dl, within the acceptable ranges. Children residing in inner-city had slightly higher blood lead levels than near-industry, suburban children.
Air Pollution ; Child* ; Ferritins ; Housing ; Humans ; Iron ; Kidney ; Korea ; Nervous System ; Occupations ; Paint ; Reference Values ; Ulsan*

Recently, flexible denture is widely used with some advantages such as esthetics, flexibility and biocompatibility. However, there is an opposite opinion about stability because of the movement of denture by the material's flexibility. As the denture moves to tissue surface during mastication, it irritates the supporting tissue. It can lead to trauma and rapid resorption of residual ridges if this irritation lasts for a long time. In this case, the patient has used flexible denture with insufficient stability, retention and support for several years and thus continuous irritation of the supporting tissue resulted in palate bone exposure. The patient discomfort and palate bone exposure underwent improvements by the new denture with stability and retention. A careful case selection for flexible denture, regular checkup and proper treatment are necessary to prevent the side effects.
Dentures* ; Esthetics ; Humans ; Mastication ; Palate* ; Pliability

No abstract available.
Colon* ; Lymphangioma, Cystic*

PURPOSE: The purpose of this study was to evaluate the proper axial thickness of zirconia abutment applied to implant in the anterior region. MATERIALS AND METHODS: Zirconia abutments were prepared at different axial wall thickness by processing pre-sintered zirconia blocks via CAD/CAM to obtain equal specimens. The abutments were each produced with a thickness of 0.5 mm (Group 1), 0.8 mm (Group 2), 1.2 mm (Group 3), or 1.5 mm (Group 4). The implant used in this study was a external connection type one (US, Osstem, Pussan, Korea) product and the zirconia abutment was prepared via replication of a cemented abutment. The crowns were prepared via CAM/CAM with a thickness of 1.5 mm and were cemented to the abutments using RelyX(TM) UniCem cement. A universal testing machine was used to apply load at 30 degrees and measure fracture strength of the zirconia abutment. RESULTS: Fracture strength of the abutments for Group 1, Group 2, Group 3, and Group 4 were 236.00 +/- 67.55 N, 599.00 +/- 15.80 N, 588.20 +/- 33.18 N, and 97.83 +/- 98.13 N, respectively. Group 1 showed a significantly lower value, as compared to the other groups (independent Mann-Whitney U-test. P<.05). No significant differences were detected among Group 2, Group 3, and Group 4 (independent Mann-Whitney U-test. P>.05). CONCLUSION: Zirconia abutment requires optimal thickness for fracture resistance. Within the limitation of this study, > 0.8 mm thickness is recommended for zirconia abutment in anterior implants.
Crowns

In treating young women for gestational trophoblastic tumor ( G.T.T. ), all efforts are made to preserve fertility and hysterectomy is avoided unless absolutely essential. However, in some cases the operation may be lifesaving. During the last 20 years among the 310 cases of G.T.T. treated at Il Sin Christian Hospital, there were 3 cases in which hysterectomy was avoided by the excision of a localized uterine lesion thus preserving fertility.
Choriocarcinoma* ; Female ; Fertility ; Humans ; Hysterectomy ; Pregnancy ; Trophoblastic Neoplasms

Primary biliary cirrhosis (PBC) is characterized by histological findings of an immunoinflammatory destruction of small- and medium-sized bile ducts with progressive portal fibrosis, and the presence of anti-mitochondrial antibody (AMA) with a laboratory evidence of chronic cholestasis. The term "autoimmune cholangitis" (AIC) is used for a disease with the clinical and pathologic features of primary biliary cirrhosis (PBC) but with negative AMA and positive anti-nuclear antibody (ANA) tests. Eight cases of AIC and ten cases of PBC were reviewed in order to determine whether there was any difference between two diseases in clinico-pathologic aspects. All of the patients were female and the mean ages of AIC and PBC patients were 48 and 47 years, respectively. ANA test was positive in six of ten PBC paients and their mean titer was lower than that of AIC patients. IgM level was significantly higher in PBC group than in AIC group. No significant difference was found between two groups with respect to biochemical and histopathological features. Since the only consistently distinguishing features between these two conditions are the autoantibody profile (AMA vs ANA) and immunoglobulin level (IgM), these two conditions might be part of a spectrum. PBC can be considered to be the same as AMA-positive AIC or alternatively AIC to be the same as AMA-negative PBC.
Bile Ducts ; Cholangitis* ; Cholestasis ; Female ; Fibrosis ; Humans ; Immunoglobulin M ; Immunoglobulins ; Liver Cirrhosis, Biliary*

PURPOSE: To determine the prevalence and characteristics of the hypoechoic halo sign in peripheral cholangiocarcinoma. MATERIALS AND METHODS: Seventeen sonograms of 17 patients with peripheral cholangiocarcinoma histologically proven by either percutaneous needle biopsy (n=16) or surgical biopsy (n=1) were retrospectively reviewed. The size, margin, homogeneity and internal echogenicity of the masses as well as their peritumoral ductal dilatation and intratumoral calcification were ascertained, and the presence of a hypoechoic halo, and if present, its thickness and type, were also determined. We arbitrarily defined a 'thin' and 'thick' halo respectively, as one with a thickness less than of less than 3 mm, and 3 mm or more, and classified halos as 'intratumoral', 'extratumoral', or 'mixed'. RESULTS: Tumor diameter ranged from 4 to 13.5 (mean, 7.3) cm, and the margin was well-defined in 15 cases (smooth: n=2; lobulated: n=13) and irregular in two. Echogenicity was slightly heterogeneous in 11 cases, severely heterogeneous in three, and homogeneous in three, while the central portion was hyperechoic in eight cases, isoechoic in seven, and hypoechoic in only two. A hypoechoic halo was detected in 10 of 15 tumors(67%) with isoechoic centers. In evaluating the halo, two cases in which the mass was hypoechoic were excluded. All ten hypoechoic halos were at least 3 (range, 4-13; mean, 8.3) mm thick; in two cases the presence of a halo was equivocal, and in three there was no halo. Eight of ten halos were the mixed type, two were intratumoral, and none were extratumoral. Peritumoral ductal dilatation was seen in four cases (24%), but no internal calcification was observed. CONCLUSION: US showed that the margins of peripheral cholangiocarcinomas were mostly well-defined and smooth (12%) or lobulated (76%), and that masses were mainly heterogeneous (64%). A hypoechoic halo, which in all cases was thick and in 80% of cases was mixed, was noted in 67% of tumors with a hyper (47%) or isoechoic (41%) center. A halo of this kind may be useful in isoechoic mass detection and also in the differentiation of hyperechoic peripheral cholangiocarcinoma from hepatic hemangioma, the most common hyperechoic benign tumor.
Biopsy ; Biopsy, Needle ; Cholangiocarcinoma* ; Dilatation ; Hemangioma ; Humans ; Prevalence ; Retrospective Studies