Multiple symmetric lipomatosis is a rare disease and affects almost exclusively middle aged man, usually with a background of excessive a alcohol intake. The disease is characterized by progressive growth of subcutaneous fat masses which are located symmetrically at neck, shoulders, chest, abdomen and groin, and which subsequently penetrate deeply into the surrounding spaces and structures with symptomatic compression of deep organs, such as trachea. A recent survey revealed a high incidence of sometic and autonomic neuropathy. The exact cause of the disease is not known, but a hyperplastic mechanism has been postulated, with in vitro studies demonstrating a defect in adrenergic-stimulated lipolysis of lipomatous tissue. We have experienced two cases of multiple symmetric lipomatosis. Case 1 was a 59-year-old male, complaining of slowly enlarging doughunt ring-shaped mass at his neck. He had a habit of excessive alcohol intake for many years. The subcutaneous mass at the neck was excised. The pathology report described the specimen as "normal adipose tissue". Case 2 was a 49-year-old male, complanining of slowly enlarging multiple symmetric masses at the neck, shoulders, chest, abdomen, flank and groin over a period of 6 years. He also complained of mild muscular weakness. He had a habit of excessive alcohol intake for many years. The subcutaneous mass in the neck was excised. The specimen had a tendency to form globular masses and microscopically indistinguishable from mature adipose tissue.
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STATEMENT OF PROBLEM: Higher incidence of prosthetic complications such as screw loosening, screw fracture has been reported for posterior single tooth implant. So, there is ongoing research regarding stability of implant-abutment interface. One of those research is increasing the implant diameter and prosthetic table width to improve joint stability. In another part of this research, internal conical type implant-abutment interface was developed and reported joint strength is higher than traditional external hex interface. Purpose. The purpose of this study is to compare stress distribution in single molar implant between external hex butt joint implant and internal conical joint implant when increasing the implant diameter and prosthetic table width : 4mm diameter, 5mm diameter, 5mm diameter/6mm prosthetic table width. MATERIAL AND METHOD: Non-linear finite element models were created and the 3-dimensional finite element analysis was performed to see the distribution of stress when 300N static loading was applied to model at 0., 15., 30.off-axis angle. RESULTS: The following results were obtained: 1. Internal conical joint showed lower tensile stress value than that of external hex butt joint. 2. When off-axis loading was applied, internal conical joint showed more effective stress distribution than external hex butt joint. 3. External hex butt joint showed lower tensile stress value when the implant diameter was increased. 4. Internal conical joint showed lower tensile stress value than external hex butt joint when the implant diameter was increased. 5. Both of these joint mechanism showed lower tensile stress value when the prosthetic table width was increased. CONCLUSION: Internal conical joint showed more effective stress distribution than external hex joint. Increasing implant diameter showed more effective stress distribution than increasing prosthetic table width.
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History, incidence and associated anormalies of the anorectal malformations were reviewed.
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Though basal cell carcinoma is the most frequent and increasing malignant tumor of the skin in Korea, its pathological analysis has been done only on the small numbers. So, we did a comprehensive pathologic study on the 283 patients with basal cell carcinoma diagnosed in the Department of Pathology, Seoul National(233cases) and Chung-Ang(50cases) University Hospital during 1975-1992. The age distribution was ranged from 15 to 84 years with highest incidence rate in the age group of 5th-8th decades and 83.7% of all patients were over 40 years of age. Sex difference was not noted. The most common site was face occuring in 235 out of 283cases(83.0%) especially in the eyelid(25.5%), nose(17.9%) and cheek(16.6%). The most frequent histopathologic type was solid type(54.0%) followed by mixed(23.9%), adenoid(7.5%), and metatypical(4.7%). Among 51 mixed type, all showed solid components with adenoid(51.0%) followed by morphea(25.5%) and metatypical type(13.7%). And among 14 recurrent cases, solid type is found in 50% of cases. The characteristic clinicopathological findings are solid arrangement of tumor cells with various histological pattern and predominant occurence on the face.
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An increasing use of complementary and alternative medicine(CAM) is apparent both in Asian and in Western countries for the management of numerous diseases to improve symptoms and to improve general health and well being. Many patients with benign prostatitc hyperplasia(BPH) and lower urinary tract symptoms(LUTS), erectile dysfunction(ED), urinary tract infection(UTI) are using CAM. Complementary and alternative medicines for urologic malignancies such as renal cell carcinoma, bladder cancer, and prostate cancer are also one of the important issues in the management of patients. Dietary supplements and nutraceuticals are commonly used modality for the patients with BPH/LUTS or ED. Vegetables and cruciferous fruits showed significant preventive effect on urologic malignancies in many studies. Phytotherapy for BPH including beta-sitosterols, saw palmetto, pygeum, and nettles etc, is under vigorous research for their therapeutic effect. No solid evidence showing better effective treatment modality for ED than placebo was found yet in CAM area. Recently, a potent NO donor, L-arginine is under research with promising results. Cranberry juice has been used for the patients with recurrent UTI but safety was a limit for its use. Various antioxidants have been studied for prevention of urological malignancies. Lycopene, isoflavone, vitamin A, C, and E, and polyphenols showed the possibility of decreasing cancer incidence in many studies but their effect is still controversial. Vitamin D is known to be associated with cancer progression and the effect of combination treatment with other chemotherapeutic agents for advanced cancer is under trial. CAM is used by a number of patients with urological diseases and urologists need to have both accurate knowledge and apprehension of CAM. The possible effects and side effects should be defined and offered to the urologic patients by urologists.
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Malignant hyperthermia is a dramatic syndrome that rarely arises during anesthesia and which is still fatal in the majority of cases. It is a hypermetabolic muscle condition characterized by hyperpyrexia and skeletal muscle rigidity. Any potent inhalation anesthetic agent or any skeletal muscle relaxant can trigger this acute catast rophic reaction. A case is presented of a 28 year old femal with a family history of malignant hyperthermia in herrelatives. She sunderwent repair of a retinal detachment under N2O-O2-halothane withcinduction by thiopenthal and succinylcholine. One and half hours after induction, arrhythmia developed and was followed by unstable blood pressure, hyperpyrexia, muscular rigidity. Anesthesia was ended and vigorous emergency treatment was attempted. But she died postoperatively on the 4th day after anesthesia. The etiologic factors, incidence, clinical feature, prevention, treatment and prognosis of malignant hyperthermia are discussed.
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Cervical plexus block has been evaluated clinically for surgery of the anterior neck in 13 patients during the 10 months(from July 1981 to April 1982) at the Department of Anesthesiology in Capital Armed Forces General Hospital. We have assessed CPB for technique, onset, anesthetized area, duration, complication and supplimentary agents, and reviewed the anatomical aspects of cervical plexus. The distribution of injected local anesthetics was demonstrated under radiography using Urographin. We experienced incomplete block in 9 cases which needed substitution with Thalamonal. The incidence of complications was few and most significant complication seen in this study was respiratory difficulty. However, There was no evidence for phrenic nerve paralysis. Cervical plexus block was performed safely and effectively for surgery of the anterior neck.
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The incidence of glomerulonephritis associated with malignancy is not common. Membranous glomerulonephritis associated with carcinomas and minimal change nephrotic syndrome with Hodgkin's disease has been occasionally reported. The pathogenesis of glomerular injury associated with malignancy is not well known. The IgA nephropathy associated with malignancy, though rare, has been reported. IgA nephropathy associated with acute myeloid leukemia, however, is yet to be reported. We hereby report a case of IgA nephropathy associated with acute myeloid leukemia (AML M2).
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The incidence of glomerulonephritis associated with malignancy is not common. Membranous glomerulonephritis associated with carcinomas and minimal change nephrotic syndrome with Hodgkin's disease has been occasionally reported. The pathogenesis of glomerular injury associated with malignancy is not well known. The IgA nephropathy associated with malignancy, though rare, has been reported. IgA nephropathy associated with acute myeloid leukemia, however, is yet to be reported. We hereby report a case of IgA nephropathy associated with acute myeloid leukemia (AML M2).
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Bronchial artery embolization (BAE) is a well accepted and effective treatment for massive and recurrent hemoptysis. However, several complications of BAE have been reported. Cortical blindness is defined as a loss of vision caused by bilateral occipital lobe lesions with normal pupillary light reflexes and a normal fundus. The reported incidence of transient cortical blindness (TCB) after cerebrovertebral angiography is approximately 1%. Two cases of TCB after BAE were found from a Medline search. Here, we report another case of TCB who was treated with BAE for a massive hemoptysis.
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