STATEMENT OF PROBLEM: Implant screw loosening remains a problem in implant prosthodontics. Some abutment screws with treated surfaces were introduced to prevent screw loosening and to increase preload. DLC(Diamond Like Carbon) film has similar properties on hardness, wear resistance, chemical stability, biocompatibility as real diamond materials. PURPOSE: The purpose of this study was to investigate the effect of lubricant layer on abutment screw and to discriminate more effective method between soft lubricant and hard lubricant to prevent screw loosening. MATERIAL AND METHOD: In this study, 1mum thickness DLC was used as protective, lubricating layer of titanium screws and 3 times removal torque was measured on the abutment screws to investigate the difference in 10 coated and 10 non-coated abutment screws. RESULTS: The results indicated that the implants with DLC coating group were not more resistant to the applied force in screw loosening. At 32Ncm, the 3 times removal torque in DLC group were 27.7+/-2.89, 25.85+/-2.35 and 26.2+/-2.57. The removal torque in no-coated abutment screws were 27.85+/-4.23, 27.35+/-2.81 and 27.9+/-2.31, respectively. CONCLUSION: The lubricant layer used in this study was Diamond Like Carbon(DLC) and it have a properties of hard and stable layer. The DLC coating layer was hard enough to prevent distortion of screws in the repeated unscrewing procedure in clinical situation. The reduced friction coefficient in hard DLC layer was not effective to prevent screw loosening.
Carbon* ; Diamond* ; Friction ; Hardness ; Prosthodontics ; Titanium* ; Torque*

The authors report a case of 21-year-old, neurologically normal female who presented with a teratoma contained in a cervical meningocele. The concurrence of a congenital neoplasm within the spine associated with spina bifida cystica seems to be a very rare event. The radiographic studies, histological examinations, treatment and follow up findings in this case are presented with a review of the literature.
Female ; Follow-Up Studies ; Humans ; Meningocele* ; Spina Bifida Cystica ; Spine ; Teratoma* ; Young Adult

BACKGROUND: The ideal vaginoplasty must be successful functionally as well as have a natural appearance, and also must retain its functionality and appearance over the long term. Conventional vaginoplasty techniques have functional limitations and are associated with recurrent complications, but rectosigmoid vaginoplasty is known to have a high satisfaction rate due to its functional similarity with the vagina. We conducted the present study to assess the usability of rectosigmoid vaginoplasty over the course of long-term follow-up. METHODS: From March 1992 to February 2014, 84 patients were treated with rectosigmoid vaginoplasty; 44 had gender identity disorder, 29 had vaginal agenesis, 8 had female pseudohermaphroditism, and 3 had gynecologic malignancies after radical pelvic surgery. This retrospective study was based on a review of the patients' records, clinical examinations, complications, and questionnaires about appearance, function, and sexual intercourse. RESULTS: All patients who underwent rectosigmoid vaginoplasty were discharged within 2 weeks without surgical flap loss. The early complications were partial flap necrosis, difficulty in defecation, mucous hypersecretion, and postoperative ileus. The late complications were vaginal introitus contracture, vaginal prolapse, and difficulty in urination. The mean length and diameter of the neovagina 3.4 years after rectosigmoid vaginoplasty were 13.2 cm and 3.8 cm, respectively. On questionnaires about satisfaction, 70% of patients reported excellent satisfaction, 11% good, 12% fair, and 7% poor. CONCLUSIONS: Rectosigmoid vaginoplasty is useful, safe, and well-accepted operative method with good functional and cosmetic results, such as natural lubrication and adequate vaginal length and width obtained without requiring the use of a dilator.
46, XX Disorders of Sex Development ; Coitus ; Contracture ; Defecation ; Follow-Up Studies ; Gender Identity ; Humans ; Ileus ; Lubrication ; Methods ; Necrosis ; Retrospective Studies ; Surgical Flaps ; Urination ; Uterine Prolapse ; Vagina

OBJECTIVES: Metabolic acidosis frequently develops in patients after neobladder reconstruction. However, the incidence of metabolic acidosis in patients with neobladder and the factors associated with the development of metabolic acidosis have not been well elucidated. We aimed to investigate the incidence and the potential predictors for the development of metabolic acidosis after neobladder reconstruction with intestinal segment. METHODS: We included patients who underwent neobladder reconstruction using intestinal segment at Ewha Womans University Mokdong Hospital between January 1, 2005 and December 31, 2014. A subgroup of patients according to the time of metabolic acidosis occurrence was further analyzed in order to characterize predictors for metabolic acidosis. RESULTS: Metabolic acidosis was encountered in 79.4% of patients with neobladder during follow up period. When patients were divided into 2 groups according to anion gap (AG), total CO2 (18.9+/-2.1 mEq/L vs. 20.0+/-1.3 mEq/L, P=0.001) and chloride (106.6+/-4.9 mE/L vs. 109.4+/-3.6 mEq/L, P<0.001) were significant different between groups with AG>12 and AG< or =12. Furthermore, when patients were divided into 3 groups; patients with metabolic acidosis at postoperative day (POD) 1; from POD 2 to 14 days; after 14 days, there was significant difference among those subgroups. CONCLUSION: Our study showed the rate of metabolic acidosis in patients underwent neobladder reconstruction and the difference between patients with metabolic acidosis and those without metabolic acidosis for the first time in Korea. In the future, well designed prospective study will be needed to prevent metabolic acidosis after neobladder reconstruction.
Acid-Base Equilibrium ; Acidosis* ; Cystectomy ; Female ; Follow-Up Studies ; Humans ; Incidence ; Korea ; Prospective Studies

BACKGROUND: Turbinate hypertrophy is one of the common causes of chronic nasal obstruction. In principle, therapeutic guidelines recommend medical treatment. Failure to treat turbinate thickening despite drug therapy may indicate the need for surgery. The main aim of this study was to determine the effect of radiofrequency surgery, among various other surgical procedures, on people with both nasal septal deviation and turbinate hypertrophy. METHODS: Among people with nasal deviation who visited the subject hospital between July 2008 to July 2014, 21 people with nasal septal deviation and severe turbinate hypertrophy before their surgery had undergone septoplasty with turbinoplasty using radiofrequency combined with septoplasty. The degree of the turbinate's hypertrophy was appraised in all the patients before and after the surgery using the rhinoscopy, and acoustic rhinometry was objectively carried out. The subjective effect of the turbinoplasty using radiofrequency was explored through the visual analog scale (VAS) score. RESULTS: The degree of contraction of the nasal mucosa after the rhinoscopy changed from Grades 3 and 4 (100%) to Grades 1 and 2 (95.2%) and Grades 3 (4.8%). The minimal cross-sectional area significantly increased from 0.44±0.07 to 0.70±0.07 cm² (p<0.05). The nasal cavity volume increased from 4.79±0.49 to 6.76±0.55 cm² (p<0.05). The subjective symptoms evaluated with VAS score a year after the surgery significantly improved (p<0.05). CONCLUSION: Turbinoplasty using Coblator with septoplasty is an effective treatment method because it expands nasal cavity, has a low incidence of complications, subjectively improves symptoms, and has short treatment duration.
Drug Therapy ; Humans ; Hypertrophy ; Incidence ; Methods ; Nasal Cavity ; Nasal Mucosa ; Nasal Obstruction ; Rhinometry, Acoustic ; Rhinoplasty ; Turbinates ; Visual Analog Scale

Hepatocellular carcinoma (HCC) is one of the most common malignancies. Many factors are considered to be etiology associated with HCC; the important factors are hepatitis B and C viruses and alcohol. Cirrhosis is present in the majority of patients with HCC. It is assumed that all diseases, which lead to liver cirrhosis, may be complicated by the development of HCC. We report a 36-year-old man with HCC which developed from cardiac cirrhosis caused by constrictive pericarditis in whom both hepatitis B virus and hepatitis C viral marker tests were all negative. CT scan of his heart showed pericardial calcification with diastolic dysfunction of right ventricle. Abdominal CT scan revealed mottled mosaic pattern of contrast enhancement of liver parenchyme and two hepatic lesions that were considered to be HCCs. Left lateral segmentectomy of liver was performed. There were two well-circumscribed masses which were confirmed to be HCC and the remaining hepatic parenchyma showed bridging fibrosis between central zonal regions. To our knowledge, this is the first case of HCC complicating cardiac cirrhosis in Korea.
Adult ; Bromhexine ; Carcinoma, Hepatocellular/*complications/radiography ; Humans ; Liver Cirrhosis/*complications/radiography ; Liver Neoplasms/*complications/radiography ; Male ; Pericarditis, Constrictive/*complications/radiography

No abstract available.
Intercostal Nerves* ; Neurilemmoma*

A solitary fibrous tumor is a relatively uncommon neoplasm that usually occurs in the pleura but occurs extremely rarely in the oral cavity. Reported herein is a rare case of a solitary fibrous tumor in the buccal cheek mucosa. A 50-year-old man visited the authors' hospital due to a buccal cheek mass whose size had increased. Excisional biopsy was done under local anesthesia. After the excisional biopsy, the patient was diagnosed to have a solitary fibrous tumor. In immunohistochemistry, the patient's solitary fibrous tumor was characterized by the expression of CD34 and CD99 on the neoplastic cells, and negativity for Bcl-2 and S-100. No recurrence or complication occurred for a period of 5 years. The growth of a primary solitary fibrous tumor in the buccal cheek mucosa is extremely rare and has been rarely reported in the South Korean medical literature. A solitary fibrous tumor must be distinguished from other spindle cell tumors. Presented herein is a case of primary solitary fibrous tumor in the buccal cheek mucosa. The relevant literature is briefly reviewed.
Anesthesia, Local ; Biopsy ; Cheek* ; Humans ; Immunohistochemistry ; Middle Aged ; Mouth ; Mouth Mucosa ; Mucous Membrane* ; Pleura ; Recurrence ; Solitary Fibrous Tumors*

No abstract available.
Arteriovenous Malformations* ; Axilla* ; Median Nerve*

PURPOSE: The H. pylori cagA gene, vacA gene and iceA gene are considered to be important virurence factors that have been implicated in the development of gastric adenocarcinoma. It was reported that the presence of IS605 elements may be responsible for rearrangements and lead to partial or total deletions of the cag pathogenicity island (PAI) and the virulence of cag PAI may be changed. However, different results regarding the association between these virulence factors and clinical disease have been reported from different geographic regions. This study evaluated the relationship between H. pylori virulence factors such as cagA, vacA, iceA, IS605 and gastric adenocarcinoma. MATERIALS AND METHODS: H. pylori isolates were obtained from 54 infected patients (24 cases of gastric adenocarcinoma, 30 cases of control). H. pylori isolates were identified by PCR with ureC gene and 16S rRNA. PCR was performed to examine cagA, vacA, iceA and IS605 genotypes. RESULTS: Significant difference was found in the negative rates of cagA between gastric adenocarcinoma group and control (62.5% vs. 33.3% P=0.033). No significant difference was found in the prevalence of iceA, vacA between gastric adenocar cinoma and control. The genotype of cagA+ vacA s1-m1 iceA1 was predominant in H. pylori isolates irrespective of the clinical outcome. IS605 in PAI was not found in gastric adenocarcinoma gruop and control. The positive rates of IS605 in genome were 33.3% in gastric adenocarcinoma group and 36.7% in control (P>0.05). In gastric carcinoma, the positive rate of cagA+/IS605- was lower than in control (12.5% vs. 40.0%, P=0.025) and the positive rate of cagA-/IS605- was higher than in control (54.2% vs. 23.3%, P=0.02). CONCLUSION: H. pylori virulence factors had not related significantly with gastric adenocarcinoma. Further study is needed to examine the specificity of H. pylori strains.
Adenocarcinoma* ; Genome ; Genomic Islands ; Genotype ; Helicobacter pylori* ; Helicobacter* ; Humans ; Polymerase Chain Reaction ; Prevalence ; Sensitivity and Specificity ; Virulence Factors ; Virulence*