No abstract available.

STATEMENT OF PROBLEM: Since the concept of osseointegrated dental implant by Branemark et al was first applied to mandibular full edentulous patients. Recently it is considerated the first treatment option on missing teeth. A common problem associated with dental implant restorations is loosening of screws that retain the prosthesis to the abutment and the abutment to the implant fixture. PURPOSE: This study is to examine the influence on screw loosening of implant-abutment designs. MATERIAL AND METHODS: External hex, cone screw, beveled hex, cam cylinder, cylinder hex by means of evaluating the loosening torques, with respect to a range of tightening torques after repeated loading. RESULT: 1. Cone screw, beveled hex groups are the highest initial tightening rate and cylinder hex, external hex groups are the lowest initial tightening rate(p<0.05). 2. Cone screw groups are the highest after repeated loading tightening rate and cylinder hex groups are lowest after repeated loading tightening rate(p<0.05). 3. Cone screw groups have the highest initial stability and final stability. 4. All groups are decreased tightening rate after repeated loading.
Dental Implants ; Dentistry* ; Humans ; Prostheses and Implants ; Tooth ; Torque

Malignant biliary or pancreatic duct stricture is dilatated using dilatating catheter or balloon catheter but a high grade stricture is difficult to dilate by general dilatating methods. Using Soehendra stent retriever is an effective method for exchanging an impacted stent. Recently, high grade malignant biliary strictures have been dilatated by Soehendra stent retriever. We report 3 cases of successful biliary drainage in high grade malignant biliary strictures using 7 Fr Soehendra stent retriever.
Catheters ; Constriction, Pathologic* ; Drainage* ; Pancreatic Ducts ; Stents*

A hepatic angiosarcoma is a rare primary malignant neoplasm, which accounts for only 2% of all primary hepatic tumors. The prognosis of a hepatic angiosarcoma is very poor, and most patients die within a year of the initial diagnosis. We report a case of a hepatic angiosarcoma in a 57-year-old man. Although a dynamic CT had suggested a carvenous hemangioma 12 months earlier, the tumor size increased and spontaneously ruptured, so surgical resection was mandatory. A pathological examination, including immunohistochemical studies, showed positive staining for CD34 and Factor VIII, which confirmed the diagnosis of an angiosarcoma. Although dynamic CT is an excellent modality for the diagnosis of a cavernous hemangioma of the liver, hepatic angiosarcomas should be ruled out in selected cases, because they may present with very similar CT findings to benign hemangioma.
Diagnosis ; Factor VIII ; Hemangioma ; Hemangioma, Cavernous* ; Hemangiosarcoma* ; Humans ; Liver ; Middle Aged ; Prognosis ; Rupture, Spontaneous

PURPOSE: To compare the clinical results of BRTO in the gastric varices with those of TIPS. MATERIALS AND METHODS: From January 2004 to March 2006, eight patients who had been followed up for more than 1 month after BRTO were enrolled in this study. This study compared the clinical efficacy of BRTO with that of TIPS in 13 patients who had undergone TIPS from January 2000 to March 2006. The change in laboratory parameters before and after each procedure and the incidence of rebleeding, encephalopathy, asictes and varices were analyzed after each procedure. Results:In the BRTO group, the level of albumin increased, and the levels of ammonia and the Child-Pugh score decreased. The TIPS group showed no improvement in the liver function. In the BRTO group, the gastric varices were eradicated in 7 patients. Gastric variceal rebleeding and encephalopathy did not occur. However, the esophageal varices worsened in 6 patients. In the TIPS group, rebleeding (n=4), encephalopathy (n=7) and a worsening of the gastric (n=5) or esophageal varices (n=2) occurred. CONCLUSION: BRTO improves the metabolic activity of the liver and has a lower incidence of encephalopathy. Hence, BRTO is a good alternative to TIPS in the gastric varices accompanied by a gastrorenal shunt although a treatment for a worsening of the esophageal varices may be needed after BRTO.
Ammonia ; Esophageal and Gastric Varices* ; Humans ; Incidence ; Liver ; Portasystemic Shunt, Surgical* ; Varicose Veins

Electrohydraulic lithotripsy (EHL) is a method used to breakup the stone by electric discharge in the presence of liquid medium. Recently we experienced a case of successful common bile duct stone removal after EHL during choledochoscopy via T-tube tract, which was the first case of EHL in biliary tract stone in Korea. A 65-year-old female patient was admitted to our hospital because of generalized pruritus after cholcystectomy with T-tube insertion. Obtained cholangiogram showed retained CBD stone which was implssible to remove by Dormian basket and tto dissolute by monooctanoin. After only one session of EHL, we can disintergrat CBD stone into several small pieces and removal of stone was easily done by Basket. After Small cut endoscopic sphincterotomy (EST) remained distal impacted stone was freely passed and control choledochoscopy and cholangiogram showed no remained stone. We think that EHL may be play a potential role in removal of biliary tract stones as in urinary tract stones.
Aged ; Biliary Tract ; Common Bile Duct ; Female ; Humans ; Korea ; Lithotripsy* ; Pruritus ; Sphincterotomy, Endoscopic ; Urinary Calculi

Hemosuccus pancreaticus describes the syndrome of gastrointestinal bleeding into the pancreatic duct, manifested by blood loss through the ampulla of Vater. Pancreatic arteriovenous malformation (AVM), while extremely rare, are frequently complicated by gastrointestinal bleeding. Endoscopy is essential to rule out other causes of upper gastrointestinal bleeding. In rare cases, active bleeding is seen from the duodenal ampulla. Selective celiac angiography is the only diagnostic test. Angiography is always necessary to facilitate tactics of treatment, even if diagnosis has been established by non-invasive imaging modalities. To obtain complete regression, total extirpation of the affected organ, or at least the involved portion, should be performed before this disease leads to the lethal complications of gastrointestinal bleeding and portal hypertension. Transcatheter arterial embolization is the only alternative treatment for the control of hemorrhage. We experienced a patient with upper gastrointestinal bleeding in which the diagnosis of hemosuccus pancreaticus secondary to a AVM in chronic pancreatitis was diagnosed preoperatively. We report our experience with a review of literatures.
Ampulla of Vater ; Angiography ; Arteriovenous Malformations* ; Diagnosis ; Diagnostic Tests, Routine ; Endoscopy ; Hemorrhage ; Humans ; Hypertension, Portal ; Pancreatic Ducts ; Pancreatitis, Chronic

Gastric antral vascular ectasia (GAVE) is a rare but important cause of chronic gastrointestinal bleeding. Endoscopically, it has characteristic thickened red vascular folds radiating from the pylorus to the antrum. Diagnosis is made primarily by endoscopy. Histologic examination of the endoscopic mucosal biopsies may confirm the endoscopic diagnosis. Many treatment modalities of the gastric antral vascular ectasia exist. One of them, the argon plasma coagulation (APC) is an excellent therapeutic tool. Inactive argon gas is converted to ionized form by means of electrical energy. Ionized argon plasma conducts high frequency electrical energy to tissues and leads coagulation necrosis of tissues. We experienced a case of gastric antral vascular ectasia presenting melena for about one month in a 72-year-old man treated endoscopically in four sessions with argon plasma coagulation.
Aged ; Argon Plasma Coagulation* ; Argon* ; Biopsy ; Diagnosis ; Endoscopy ; Gastric Antral Vascular Ectasia* ; Hemorrhage ; Humans ; Melena ; Necrosis ; Plasma ; Pylorus

BACKGROUND/AIMS: The Dieulafoy lesion is an important cause of gastrointestinal bleeding. The bleedings from caliber- persistent vessel or abnormally large and tortuous submucosal artery are usually located on proximal stomach. Endoscopic band ligation (EBL) is currently regarded as the treatment of choice of Dieulafoy lesions. This study reports on the clinical features, the efficacy and safety of EBL. METHODS: 10 patients with Dieulafoy-like lesion (median age: 47 yr range: 22~71, M:F 8:2 ) were treated using EBL. EBL was performed as the primary hemostatic tratment as follows in 8 cases of urgency and 2 cases of emergency. RESULTS: The location of all lesions (n=10) were in stomach, 8 in body (4 in posterior wall), 2 in fundus. The bleeding focuses were identified during the first endoscopy. Five lesions were bleeding, 5 had adherent clots or protruding vessels without active bleeding. Hemostasis were achieved with first session of EBL in 9 patients successfully, one case in the fundus was failed due to early band release. CONCLUSION: EBL is a simple, effective, and safe endoscopic method of Dieulafoy-like lesions and, it should be proposed as a primary option.
Arteries ; Emergencies ; Endoscopy ; Hemorrhage ; Hemostasis ; Humans ; Ligation* ; Stomach

BACKGROUND: Compared with classic achalasia, vigorous achalasia has been defined as achalasia with relatively high esophageal contraction amplitudes, often with minimal esophageal dilation and prominent tertiary contractions on radiographs and the presence of chest pain. The lesser success of pneumatic balloon dilation, also, has been reported for the subset with vigorous achalasia. Nevertheless, some authors have questioned the usefulness of making this distinction. We evaluated the difference of clinical manifestations and response to pneumatic balloon dilation between classic and vigorous achalaisia. METHODS: 28 cases involving patients with achalasia who underwent balloon dilation treatment were available for the review of their clinical findings, radiographic, manometric, esophageal scintigraphic parameters. Patients with vigorous achalasia [n=10] were defined by contraction amplitude >or=37 mmHg on esophageal manometry and patients with classic achalasia [n=18] as contraction amplitude <37 mmHg. RESULTS: Both groups of patients had substantial overlap in clinical findings, radiographic, manometric and esophageal scintigraphic parameters. The success rates of balloon dilation, also, were similar for both groups (classic vs vigorous, 78% vs 70%). CONCLUSION: It is concluded that the distiction of achalasia as classic and vigorous by an amplitude criterion is arbitrary and not useful.
Chest Pain ; Dilatation* ; Esophageal Achalasia* ; Humans ; Manometry