Peripheral cementifying fibroma is histomorphologically similar to the central cementifying fibroma, but this lesion is unique to the gingival mucosa and is only rarely seen in edentulous area. In most instances, it arise from interdental papilla, with 80% occurring anterior to molar region. This lesion appears to involve the maxilla and mandible equally, demonstrates the highest occurrence rate during the second decade of life, and affects female more frequently than male, with 4.3:1 to 3:2. Peripheral cementifying fibroma presents as firm, pedunculated or sessile mass with an intact or ulcerated surface depending on the presence of trauma. Microscopically, it reveals a highly cellular mass of connective tissue containing numerous plump, proliferating fibrolasts and several forms of calcification. Effective treatment requires deep excision, which includes the ligament and periosteum, followed by a thorough root scaling of the adjacent teeth. A reveiw of the literature and a report of a case of peripheral cementifying fibroma are presented.
Connective Tissue ; Dental Scaling ; Female ; Fibroma* ; Gingiva ; Humans ; Ligaments ; Male ; Mandible ; Maxilla ; Molar ; Mucous Membrane ; Periodontal Ligament* ; Periosteum ; Tooth* ; Ulcer

Some individuals may demonstrate a secondary phase nystagmus (SPN) following the caloric irrigation. It has been stated that if a SPN begins prior to 140 seconds after the onset of caloric stimulation and if the magnitude of the slow phase velocity is greater than 6 degrees/sec, then a premature reversal caloric nystagmus (PRCN) is said to exit. Thus far, there have been no reports describing PRCN in Korea. We described a typical PRCN in a patient with medulloblastoma within the 4th ventricle. The patient had a gaze-evoked horizontal and upbeating nystagmus. However, there was no indication of spontaneous nystagmus. A monothermal caloric test was administered. The initial left beating primary phase nystagmus was subsided at 60 seconds after right cold water stimulation and at 110 seconds, a right beating SPN with 14 degrees/sec of slow phase velocity was appeared and was continuous for 240 seconds. Although the precise mechanism of PRCN is unknown, vestibular nuclei damage may be related.
Caloric Tests ; Humans ; Korea ; Medulloblastoma ; Nystagmus, Physiologic* ; Vestibular Nuclei ; Water

In recent years, digital technology has been developed in dentistry, which denture frameworks can be manufactured using DMLS (Direct Metal Laser Sintering) technique. A traditional impression method can be replaced by oral scanning and wax pattern production process can be achieved by the use of CAD/CAM techniques. The designed STL files can be sent to DMLS devices to fabricate final components of removable partial dentures (RPD). The advantages of digital dentistry are concision and precision. In this case study, a fracture of occlusal rests providing support and indirect retention was repaired by DMLS and laser welding techniques. It shows satisfactory results in adaptation accuracy and functional properties of the repaired denture.

Sensory neuropathy is characterized by pure sensory dysfunction, ultimately evolving into areflexia and severe sensory ataxia in spite of the preservation of the other functions in the nervous system such as motor function. This disorder is known to be commonly found in cancer patients as a paraneoplastic syndrome, but nowadays many reports are made that sensory neuropathy is not merely related to malignancy but also with autoimmune disorders such as Sjogren's syndrome or polyclonal gammopathy, etc. Hence we report two patients who have been diagnosed as chronic idiopathic ataxic sensory neuropathy through electrophysiological and histopathological studies without any evidence of cancer or any other known cause.
Ataxia ; Humans ; Nervous System ; Paraneoplastic Syndromes ; Sjogren's Syndrome

We present a 50-year-old woman who sustained spastic left hemiplegia secondary to the right thalamic hemorrhage 6 years ago. She complained of persistent severe left calf pain after serial casting for the treatment of shortened plantar flexors of the left ankle. Two months later, magnetic resonance T1-weighted images showed diffuse high signal intensity involving the whole muscle bulk of the soleus and normal signal intensity of thin atrophied gastrocnemius. Needle electromyography of the soleus revealed myopathic patterns. Histologic findings of the soleus showed necrotic muscle fibers with phagocytosis, endomyseal collagen and fat deposition. We concluded that prolonged passive stretch of spastic plantar flexors of the ankle under serial casting induced soleus myopathy with segmental myonecrosis, and which developed left calf pain. Selective induction of soleus myopathy could be explained by the higher stretch tension produced by ankle dorsiflexion in the soleus compared to the gastrocnemius because of different proximal ends.
Ankle ; Collagen ; Electromyography ; Female ; Hemiplegia ; Hemorrhage ; Humans ; Middle Aged ; Muscle Spasticity ; Muscular Diseases* ; Needles ; Phagocytosis ; Stroke*

Degos disease, also referred to as malignant atrophic papulosis, was first described in 1941 by Köhlmeier and was independently described by Degos in 1942. Degos disease is characterized by diffuse, papular skin eruptions with porcelain-white centers and slightly raised erythematous telangiectatic rims associated with bowel infarction. Although the etiology of Degos disease is unknown, autoimmune diseases, coagulation disorders, and vasculitis have all been considered as underlying pathogenic mechanisms. Approximately 15% of Degos disease have a benign course limited to the skin and no history of gastrointestinal or central nervous system (CNS) involvement. A 29-year-old female with history of systemic lupus erythematosus (SLE) presented with a 2-year history of asymptomatic lesions on the dorsum of all fingers and both knees. The patient had only skin lesions and no gastrointestinal or CNS vasculitis symptoms. Her skin lesions were umbilicated, atrophic porcelain-white lesions with a rim of erythema. On the basis of clinical, histologic, and laboratory findings, a diagnosis of Degos-like lesions associated with SLE was made. The patient had been treated for SLE for 7 years. Her treatment regimen was maintained over a 2 month follow-up period, and the skin lesions improved slightly with no development of new lesions.
Adult ; Autoimmune Diseases ; Central Nervous System ; Diagnosis ; Erythema ; Female ; Fingers ; Follow-Up Studies ; Humans ; Infarction ; Knee ; Lupus Erythematosus, Systemic* ; Malignant Atrophic Papulosis ; Skin ; Vasculitis ; Vasculitis, Central Nervous System

Cushing's syndrome is produced by the hypersecretion of adrenal glucocorticoids and is characterized by moon face, central obesity, disappearance of diurnal variation of plasma cortisol and unsuppressibility of plasma cortisol by low-dose dexamethasone. On the other hand, hyperaldosteronism is produced by the hypersecretion of aldosterone and is characterized by hypertension and hypokalemia. We report a rare case of adrenal adenoma with concurrent hypercortisolism and hyperaldosteronism manifestated with hypertension, cushingoid appearance, left adrenal mass with low-normal plasma potassium. Laparoscopic unilateral tumor excision was performed and hypertension disappeared after the operation.
Adenoma* ; Aldosterone ; Cushing Syndrome* ; Dexamethasone ; Glucocorticoids ; Hand ; Hydrocortisone ; Hyperaldosteronism* ; Hypertension ; Hypokalemia ; Obesity, Abdominal ; Plasma ; Potassium

BACKGROUND: An epidermal cyst is a common keratin-filled epithelial-lined cyst. The treatment of choice for epidermal cysts is surgical excision. If the cyst becomes ruptured, inflamed, or infected, then incision and drainage together with oral antibiotic therapy or intralesional steroid injection treatment is required. Identification of ruptured and unruptured cysts is important for treatment decisions. OBJECTIVE: The purpose of this study was to evaluate the usefulness of ultrasonography in the diagnosis of epidermal cysts, and to analyze distinctive features that can differentiate between ruptured and unruptured epidermal cysts. METHODS: We reviewed the clinical and sonographic features of pathologically confirmed epidermal cysts from 2 subgroups of 66 patients: 30 with unruptured cysts and 36 with ruptured cysts. The sonographic features used in the analysis included tumor size, margin, shape, tumor texture, posterior echo, internal debris, and lesion vascularity on color Doppler sonography. RESULTS: The mean long diameter of the cysts was 10.95 mm in the unruptured cyst group and 12 mm in the ruptured cyst group. Some sonographic features, including heterogenous and hypoechoic echo texture, posterior echo enhancement, and internal hyperechoic and hypoechoic debris, showed no significant differences between the groups (p>0.05). The unruptured cyst group showed cysts with significantly higher frequencies of a well-circumscribed margin, an ovoid shape, and no vascular flow (p<0.05). In contrast, the ruptured cyst group usually had cysts with a poorly defined or slightly poorly defined margin, an irregular shape, peripheral vascular flow, and mild or moderate flow vascularity. CONCLUSION: The results of this study indicate that ultrasonography is helpful in differentiating between ruptured and unruptured epidermal cysts.
Diagnosis ; Diagnosis, Differential* ; Drainage ; Epidermal Cyst* ; Humans ; Ultrasonography*

BACKGROUND: An epidermal cyst is a common keratin-filled epithelial-lined cyst. The treatment of choice for epidermal cysts is surgical excision. If the cyst becomes ruptured, inflamed, or infected, then incision and drainage together with oral antibiotic therapy or intralesional steroid injection treatment is required. Identification of ruptured and unruptured cysts is important for treatment decisions. OBJECTIVE: The purpose of this study was to evaluate the usefulness of ultrasonography in the diagnosis of epidermal cysts, and to analyze distinctive features that can differentiate between ruptured and unruptured epidermal cysts. METHODS: We reviewed the clinical and sonographic features of pathologically confirmed epidermal cysts from 2 subgroups of 66 patients: 30 with unruptured cysts and 36 with ruptured cysts. The sonographic features used in the analysis included tumor size, margin, shape, tumor texture, posterior echo, internal debris, and lesion vascularity on color Doppler sonography. RESULTS: The mean long diameter of the cysts was 10.95 mm in the unruptured cyst group and 12 mm in the ruptured cyst group. Some sonographic features, including heterogenous and hypoechoic echo texture, posterior echo enhancement, and internal hyperechoic and hypoechoic debris, showed no significant differences between the groups (p>0.05). The unruptured cyst group showed cysts with significantly higher frequencies of a well-circumscribed margin, an ovoid shape, and no vascular flow (p<0.05). In contrast, the ruptured cyst group usually had cysts with a poorly defined or slightly poorly defined margin, an irregular shape, peripheral vascular flow, and mild or moderate flow vascularity. CONCLUSION: The results of this study indicate that ultrasonography is helpful in differentiating between ruptured and unruptured epidermal cysts.
Diagnosis ; Diagnosis, Differential* ; Drainage ; Epidermal Cyst* ; Humans ; Ultrasonography*

Cellular blue nevus is a rare type of blue nevus, which shows blue-gray or blue brown nodules or plaques of 1 to 3cm in diameter, usually located on the buttocks or sacrum. We report a case of cellular blue nevus in a 42-year-old female. She presented with a 1x3.5cm blue-black multilobulated plaque on the dorsum of left foot since childhood. Histopathologic examination showed mixed biphasic pattern with ovoid islands of polygonal cells showing somewhat clear cytoplasm alternating with bundles with spindle cells, which are densely pigmented. Mitosis and necrosis were not identified. Overall features are consistent with cellular blue nevus.
Adult ; Buttocks ; Cytoplasm ; Female ; Foot* ; Humans ; Islands ; Mitosis ; Necrosis ; Nevus, Blue* ; Sacrum