In cases of partially edentulous patients with insufficient remaining teeth, rotational movement of the denture occurs and prognosis of the remaining teeth is uncertain when restoring with a removable partial denture. Recently, implant-assisted removable partial dentures, where a small number of implants are placed and surveyed crowns are fabricated on the implants to be used as abutments, have been suggested. In this case, the patient had only one remaining tooth in the mandible and implants were placed in both posterior regions to be used as surveyed crowns to restore the patient with an implant-assisted removable partial denture. This approach improved the support, retention, and stability of the denture, resulting in functionally and aesthetically satisfactory outcomes.

In cases of partially edentulous patients with insufficient remaining teeth, rotational movement of the denture occurs and prognosis of the remaining teeth is uncertain when restoring with a removable partial denture. Recently, implant-assisted removable partial dentures, where a small number of implants are placed and surveyed crowns are fabricated on the implants to be used as abutments, have been suggested. In this case, the patient had only one remaining tooth in the mandible and implants were placed in both posterior regions to be used as surveyed crowns to restore the patient with an implant-assisted removable partial denture. This approach improved the support, retention, and stability of the denture, resulting in functionally and aesthetically satisfactory outcomes.

In cases of partially edentulous patients with insufficient remaining teeth, rotational movement of the denture occurs and prognosis of the remaining teeth is uncertain when restoring with a removable partial denture. Recently, implant-assisted removable partial dentures, where a small number of implants are placed and surveyed crowns are fabricated on the implants to be used as abutments, have been suggested. In this case, the patient had only one remaining tooth in the mandible and implants were placed in both posterior regions to be used as surveyed crowns to restore the patient with an implant-assisted removable partial denture. This approach improved the support, retention, and stability of the denture, resulting in functionally and aesthetically satisfactory outcomes.

In cases of partially edentulous patients with insufficient remaining teeth, rotational movement of the denture occurs and prognosis of the remaining teeth is uncertain when restoring with a removable partial denture. Recently, implant-assisted removable partial dentures, where a small number of implants are placed and surveyed crowns are fabricated on the implants to be used as abutments, have been suggested. In this case, the patient had only one remaining tooth in the mandible and implants were placed in both posterior regions to be used as surveyed crowns to restore the patient with an implant-assisted removable partial denture. This approach improved the support, retention, and stability of the denture, resulting in functionally and aesthetically satisfactory outcomes.

In cases of partially edentulous patients with insufficient remaining teeth, rotational movement of the denture occurs and prognosis of the remaining teeth is uncertain when restoring with a removable partial denture. Recently, implant-assisted removable partial dentures, where a small number of implants are placed and surveyed crowns are fabricated on the implants to be used as abutments, have been suggested. In this case, the patient had only one remaining tooth in the mandible and implants were placed in both posterior regions to be used as surveyed crowns to restore the patient with an implant-assisted removable partial denture. This approach improved the support, retention, and stability of the denture, resulting in functionally and aesthetically satisfactory outcomes.

Patients with dementia and concomitant parkinsonism are frequently encountered in the elderly population. When it comes to young adults, however, coexistence of Alzheimer's disease (AD) and Parkinson's disease (PD) is rare. We described a case of 47-year old man with presenile onset dementia associated with hemiparkinsonism involving the right extremities. Brain biopsy showed neurofibrillary tangles and neuritic plaques, compatible with Alzheimer's disease. Iodine-123 labelled N-(3-iodopropen-2-yl)-2beta-carbomethoxy-3beta-(4-chlorophenyl) tropane ([(123)I]IPT) SPECT, dopamine transporter imaging, revealed a decreased uptake in both basal ganglia, more severe on the left side, particularly the caudal putamen, which is consistent with the finding of idiopathic Parkinson's disease. This case is unique in that damage on the nigrostriatal dopaminergic system in a patient with Alzheimer's disease was demonstrated by a functional neuroimaging study and that early-onset AD and early-onset PD, two rare conditions, coexist in the same individual.
Aged ; Alzheimer Disease* ; Basal Ganglia ; Biopsy ; Brain ; Dementia ; Dopamine Plasma Membrane Transport Proteins ; Extremities ; Functional Neuroimaging ; Humans ; Middle Aged ; Neurofibrillary Tangles ; Parkinson Disease ; Parkinsonian Disorders ; Plaque, Amyloid ; Putamen ; Tomography, Emission-Computed, Single-Photon ; Young Adult

Continuous venovenous hemodiafiltration (CVVHDF) was used to eliminate pentobarbital from the blood of a 30-year-old potentially brain dead male patient with traumatic intracranial hemorrhage after a motorcycle accident. The Acute Physiology and Chronic Health Evaluation (APACHE) II score of hospital day 1 was 24, but by day 8 it was 36, when the patient was considered to be brain dead. To control seizures and reduce intracranial pressure, pentobarbital had been administered in a continuous flow (2,880 mg/day for 5 days). Coma can be induced by pentobarbital at a serum level of 1~5 mg/dL. However, drug intoxication should be excluded from a brain death evaluation; therefore, the patient was not given any drug for approximately 88 hrs after ceasing pentobarbital in order for serum level to dip below 0.5 mg/dL (which is the hypnotic level). At 48 hours from CVVHDF, the pentobarbital level was close to the hypnotic level (0.1~0.5 mg/dL). Before stopping, the serum level of pentobarbital was 3.89 mg/dL and between 48 and 72 hours from CVVHDF, 4 cycles of pentobarbital half-life elimination (0.24 mg/dL) could be measured. Therefore, we suggest that in case of potential brain dead patients who have been administered pentobarbital, CVVHDF can enhance the elimination of pentobarbital from the circulatory system and shorten the waiting time for a brain death evaluation.
Adult ; APACHE ; Brain ; Brain Death ; Coma ; Half-Life ; Hemodiafiltration ; Humans ; Intracranial Hemorrhage, Traumatic ; Intracranial Pressure ; Male ; Motorcycles ; Pentobarbital ; Seizures

BACKGROUND: It is well known that a lacunar infarction has characteristic clinical features and a relatively good prognosis. However, the significance of lesions in the parent artery of patients with lacunar syndrome as regard to the prognosis remains unsettled. METHODS: Using the data of consecutive patients with their first ischemic stroke and were followed longer than 1 year, were divided the patients by their clinical features and the results of the work-up was as follows; (1) mismatching [MM] group; lacunar syndrome and the presence of parent arterial lesion, (2) large artery artherosclerosis [LAD]; non-lacunar syndrome and the presence of parent arterial lesion, (3) no determined etiology [NE]; non-lacunar syndrome without parent arterial lesion, and (4) small artery disease [SAD]; lacunar syndrome without parent arterial lesion. Patients with a potential source of embolism were excluded from this study. The prognosis and recurrence rate of patients with the MM group were compared with those of other groups. RESULTS: A total of 176 patients were included; 56 LAD, 62 SAD, 22 MM and 36 NE groups. An unstable hospital course was more frequently found in LAD than in the other groups. The recurrence rate of the MM group (23%) was significantly higher than that of SAD (2%), but was similar to that of patients with non-lacunar syndrome (LAD 16%, NE 28%). CONCLUSIONS: Among patients with lacunar syndrome, the prognosis of those with parent arterial lesions was different from those without lesions. Therefore, a systematic work up of the stroke mechanism may be important in patients with lacunar syndrome.
Arteries ; Embolism ; Humans ; Parents* ; Prognosis ; Recurrence ; Stroke ; Stroke, Lacunar*

We report a patient diagnosed with neuro-Behcet's disease showing multiple enhancing lesions on a brain MRI that were confined to the cerebral cortex without any involvement of other brain regions. The patient, a 30-year-old man, was admitted because of seizure attacks. He had the symptom triad of recurrent oral ulcer, genital ulcer, and uveitis. Neurologic symptoms included ataxia, dysarthria, and dementia which had progressed over several years. During the hospital course, he underwent a right hemicolectomy due to bowel perforation. A pathological examination showed multiple discrete ulcerations from the cecum to the mid-transverse colon, consistent with Behcet's colitis. A brain MRI revealed multiple small enhancing lesions distributed over wide areas of the cerebral cortex. To our knowledge, this pattern of lesion distribution has not yet been reported in neuro-Behcet's disease.
Adult ; Ataxia ; Brain ; Cecum ; Cerebral Cortex ; Colitis ; Colon ; Dementia ; Dysarthria ; Humans ; Magnetic Resonance Imaging ; Neurologic Manifestations ; Oral Ulcer ; Seizures ; Ulcer ; Uveitis

No abstract available.
Postural Orthostatic Tachycardia Syndrome* ; Syncope