No abstract available.
Stents

PURPOSE: The purpose of this study was to find an inclination slope of the screw thread that is favorable in distributing the stresses to alveolar bone by using three dimensional finite element analysis. MATERIALS AND METHODS: Three types modelling changed implant thread with fixed pitch of 0.8 mm is the single thread implant with 3.8degrees inclination, double thread implant with 7.7degrees inclination and the triple thread implant with 11.5degrees inclination. And three types implant angulation is the 0degrees, 10degrees and 15degrees on alveolar bone. The 9 modelling fabricated for three dimensional finite element analysis that restored prosthesis crown. The crown center applied on 200 N vertical load and 15degrees tilting load. RESULTS: 1. The more tilting of implant angulation, the more Von-Mises stress and Max principal stress is increasing. 2. Von-Mises stress and Max principal stress is increasing when applied 15degrees tilting load than vertical load on the bone. 3. When the number of thread increased, the amount of Von-Mises stress, Max principal stress was reduced since the generated stress was effectively distributed. 4. Since the maximum principal stress affects on the alveolar bone can influence deeply on the longevity of the implants. When comparing the magnitude of the maximum principal stress, the triple thread implant had a least amount of stress. This shows that the triple thread implant gave a best result. CONCLUSION: A triple thread implant to increase in the thread slope inclination and number of thread is more effective on the distribution of stress than the single and double thread implants especially, implant angulation is more tilting than 10degrees on alveolar bone. Thus, effective combination of thread number and thread slope inclination can help prolonging the longevity of implant.
Crowns ; Finite Element Analysis ; Longevity ; Prostheses and Implants

Interferon-alpha is an established therapy for the patients with myeloproliferative disease. Unusual immune-mediated side effects have been reported during treatment. Among them, renal and cardiac toxicities are rare complications. Recently we experienced a case of hemolytic uremic syndome found in a 40-year old male undergoing interferon-alpha therapy for chronic myelogenous leukemia, chronic phase. On admission, his chief complaints were generalized edema and azotemia. Bone marrow biopsy revealed transformation into accelerated phase. bcl/abl gene was positive. Peripheral blood smear showed hemolytic anemia. Despite prompt diagnosis, institution of plasmapheresis, and steroid, his renal function did not recover, as expected. Hemolytic uremic syndrome was a chronic form of renal toxicity due to interferon-alpha. In this case, renal function did not recovered to normal level. However, early detection of renal toxicity such as proteinuria or acute tubular necrosis, and the discontinuation of interferon-alpha could achieve the recovery of normal renal function. Therefore, periodic examination of renal function should be performed in the patients with the use of long-term interferon-alpha.
Adult ; Anemia, Hemolytic ; Azotemia ; Biopsy ; Bone Marrow ; Diagnosis ; Edema ; Hemolytic-Uremic Syndrome ; Humans ; Interferon-alpha* ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive* ; Male ; Necrosis ; Plasmapheresis ; Proteinuria

Endoscopic drainage of pancreatic pseudocysts is the initial treatment of choice for symptomatic pancreatic pseudocysts and nonresolving pseudocysts. Recently, endoscopic ultrasound (EUS) has been used as a guide for transmural entry and the safer drainage of pancreatic pseudocysts. We report a case of therapeutic linear array EUS-guided pseudocyst drainage without the use of fluoroscopy in a patient with portal hypertension.
Drainage* ; Fluoroscopy* ; Humans ; Hypertension, Portal ; Pancreatic Pseudocyst* ; Ultrasonography

Gallstone ileus is a mechanical obstruction caused by the impaction of one or more gallstones within the lumen of any part of the gastrointestinal tract. Gallstone ileus is frequently proceeded by an episode of acute cholecystitis. The resulting inflammation and adhesions facilitate the erosion of the offending gallstone through the gallbladder wall forming a cholecystoenteric fistula and allowing the passage of the gallstone. Fifty five-year-old, 71-year-old, and 74-year-old female patients were admitted to the Asan Medical Center for nausea, vomiting, and nonspecific abdominal pain. Erect abdominal plain film revealed several moderately dilated loops of small bowel with air fluid levels. Computed tomography showed the classic triad of findings of gallstone ileus. Dilated loops of small bowel, air in the biliary tree and an ectopic stone in the ileum were demonstrated. These impacted stones were removed by surgical intervention.
Abdominal Pain ; Aged ; Biliary Tract ; Cholecystitis, Acute ; Chungcheongnam-do ; Female ; Fistula ; Gallbladder ; Gallstones* ; Gastrointestinal Tract ; Humans ; Ileum ; Ileus* ; Inflammation ; Nausea ; Vomiting

Intraductal papillary mucinous tumor (IPMT) of the pancreas is a spectrum of conditions ranging from benign to malignant. It is known that the biologic behavior of IPMT is slower and less aggressive than that of pancreatic ductal carcinoma. We report a case of IPMT of pancreas resected 5 years after diagnosis. The carcinoma remained localized without evident stromal invasion or lymph node metastasis with the background of adenoma, suggesting a adenomacarcinoma sequence. This is a case report that may be helpful to study the natural history of IPMT, particularly slow progression of IPMT.
Adenoma ; Carcinoma, Pancreatic Ductal ; Diagnosis* ; Lymph Nodes ; Mucins* ; Natural History ; Neoplasm Metastasis ; Pancreas*

The mucin-hypersecreting bile duct tumor is rare and its clinical, radiologic, and pathologic features are not well known. We report the case of mucin-hypersecreting biliary papillomatosis with malignant transformation including review of 11 korean literatures. A 65-year-old female was admitted to our hospital with fever, chills, and right upper quadrant pain. A CT scan showed marked dilatation of left intrahepatic duct with intraductal filling defects. During endoscopic retrograde cholangiograpy, mucin from the ampulla was observed and dilated common bile duct with multiple amorphous filling defects was noted. Cholangioscopy revealed muliple coral-like mucosal papillary projections with large amount of mucin in the left intrahepatic ducts. The patient underwent left lobectomy, and the biopsy revealed intraductal papillary adenocarcinoma in the background of papillary adenoma.
Adenocarcinoma ; Adenocarcinoma, Papillary ; Adenoma ; Aged ; Bile Ducts ; Biopsy ; Chills ; Common Bile Duct ; Dilatation ; Female ; Fever ; Humans ; Mucins ; Papilloma* ; Tomography, X-Ray Computed

BACKGROUND/AIMS: Treatment of pancreatic duct stones by extracorporeal shockwave lithotripsy (ESWL) serves as a nonsurgical treatment modality in patients with stones that are located in upstream of the strictures or in patients with impacted stones. We present the results of ESWL in endoscopically unretrievable pancreatic duct stones in the past 2 years. METHODS: Between January 2002 and December 2003, 58 patients with chronic pancreatitis were treated by ESWL for pancreatic duct stones. ESWL was performed with an electrohydraulic lithotripter ultrasound focusing system. RESULTS: The mean number of shockwave treatments was 2.5, and the patients received 4,578 (1,527-10,155) shockwave discharges with a mean energy of 15.8 kV. Fragmentations of the stones were achieved in 54 patients (93.2%), and complete clearance of the stones were noticed in 27 patients (46.6%). Fragmentation of stones equal or less than 3 mm in diameter was associated with successful removal of stones (p<0.05). Complete relief of pain occurred in 32 patients (55.2%). The procedures were well tolerated and no patient had significant complications such as acute pancreatitis. CONCLUSIONS: ESWL is an effective and a safe procedure for endoscopically unretrievable main pancreatic duct stones. ESWL combined with endoscopic therapy can increase the success rate of nonsurgical removal of pancreatic duct stones in patients with chronic pancreatitis.
Adolescent ; Adult ; Aged ; Calculi/*therapy ; English Abstract ; Female ; Humans ; *Lithotripsy ; Male ; Middle Aged ; Pancreatic Diseases/*therapy ; *Pancreatic Ducts ; Pancreatitis, Chronic/complications

Colorectal carcinomas are extremely rare in childhood and adolescence; however, the colon is the most common site of a gastrointestinal carcinoma. Mucin secreting adenocarcinomas with signet ring formation is the most common type of colon cancer identified in children. An 11-year-old boy had abdominal pain and weight loss for three months, back pain and left thigh pain for two months, and hematochezia for four days. Colonoscopy showed an annular mass in the sigmoid colon and the histopathology revealed a signet ring cell carcinoma. A metastatic signet ring cell carcinoma was suspected from the findings of the bone scan, and confirmed later by a left scalp mass incisional biopsy and a bone marrow biopsy. We report a case of a metastatic signet ring cell carcinoma of the colon in a child.
Abdominal Pain ; Adenocarcinoma ; Adolescent ; Back Pain ; Biopsy ; Bone Marrow ; Carcinoma, Signet Ring Cell* ; Child* ; Colon* ; Colon, Sigmoid ; Colonic Neoplasms ; Colonoscopy ; Colorectal Neoplasms ; Gastrointestinal Hemorrhage ; Humans ; Male ; Mucins ; Scalp ; Thigh ; Weight Loss

OBJECTIVE: The 2010 New American College of Rheumatology/European League Against Rheumatism (ACR/EULAR) criteria for rheumatoid arthritis (RA) was raised to identify patients with early RA and replaced the 1987 ACR classification criteria. The aims of this study are to assess the availability of new classification criteria and to evaluate its potential limitation. METHODS: A total of 408 patients with newly diagnosed RA were included from 13 secondary or tertiary hospitals in South Korea. The symptom duration was less than 12 months before the diagnosis of RA. RA was defined as either 1987 ACR classification criteria or new 2010 ACR/EULAR criteria. We compared the full details of both classification criteria. RESULTS: The mean symptom duration was 5.1 months. The majority (76.2%) of the patients were female. Two hundred and seventy three patients (66.9%) fulfilled both of the 2010 and 1987 classification criteria. Forty-seven (14.7%) of the 320 patients fulfilling the 1987 criteria did not fulfill the new classification criteria. On the other hand, eighty-eight (24.4%) of the 361 patients fulfilling the 2010 ACR/EULAR classification criteria did not fulfill the 1987 ACR criteria. Thirty-six (55.4%) of the 65 patient with seronegative RA failed to meet the 2010 classification criteria. In case of seropositive RA (n=343), 85 additional patients (24.8%) could be diagnosed as RA using new classification criteria. CONCLUSION: The new 2010 ACR/EULAR classification criteria enable physicians to diagnose more patients with early RA via the help of serology. However, the sensitivity for the diagnosis of seronegative RA is projected to decrease.
Arthritis, Rheumatoid ; Female ; Hand ; Humans ; Republic of Korea ; Rheumatic Diseases ; Tertiary Care Centers