The internal biliary fistula between the gallbladder or bile duct and intestinal tract is a rare disease. Because symptoms and signs of biliary fistula are not specific, these patients are commonly investigated with computed tomography, endoscopic retrograde cholangiopancreatography (ERCP) and barium study. Among them, a cholecystogastric fistula is a very rare type of biliary fistula. We recently experienced a case of cholecystogastric fistula and transmigration of the gallstone to the stomach. A 53-year-old woman was transferred with the impression of gallbladder cancer. On evaluating the cause of right upper abdominal pain and nausea, we confirmed the cholecystogastric fistula with gastroscopy, upper GI series and ERCP. Cholecystectomy and the repair of the fistula was done.
Abdominal Pain ; Barium ; Bile Ducts ; Biliary Fistula ; Cholangiopancreatography, Endoscopic Retrograde ; Cholecystectomy ; Female ; Fistula* ; Gallbladder ; Gallbladder Neoplasms ; Gallstones* ; Gastroscopy ; Humans ; Middle Aged ; Nausea ; Rare Diseases ; Stomach

No abstract available.

As jaws of children differ from those of adults in the aspects of architectural and mechanical properties, site, form and treatment modality of pediatric fractured jaws are somewhat different from those of adults. This study takes stastics of 33 pediatric patients with mandibular fractures (55 fracture sites) who were admitted to the department of oral and maxillofacial surgery. Kyung-hee university from May 1986 to March 1995, aged up to 15years with primary or mixed dentition, by age, cause, site and treatment modality. The results are as follows. 1. The mandibular fracture has sexual predilection for male, 0 to 3 years group. 2. The main cause of mandibular fracture is falling from various position, followed by traffic accident. 3. The highest incidence of fracture site is symphysis and/or condyle area. 4. Circumferential wiring is widely used for pediatric mandibular fracture.
Accidents, Traffic ; Adult ; Child ; Dentition, Mixed ; Humans ; Incidence ; Jaw ; Male ; Mandibular Fractures* ; Surgery, Oral

Pneumosinus dilatans is a rare condition of paranasal sinus, which is most commonly found in males of the age between 20 to 40. That is defined hypersinus as the enlargement of a paranasal sinus beyond the upper limits of normal. The deformity is caused by an abnormal enlargement of the paranasal sinus by hyperpneumatization. A valve mechanism raising the pressure inside the sinus is regarded to be responsible for this condition. A preoperative computed tomography scan is used to illustrate the anatomical condition and possible etiologic mechanisms and the most commonly affected sinus is the frontal sinus. Numerous methods have been suggested to repair the anatomical deformities of frontal sinus and we represent a method of correction for pneumosinus dilatans, too. We approached the frontal sinus by using a bicoronal incision and exposed total frontal sinus to remove total outer wall at one piece. We remodeled outer wall of fontal sinus by one piece and fixed with absorbable plates and screws. Ten months after the successful operation, the patient was satisfied with a good cosmetic result without recurrence. The latest, this comsmetic surgery is attractive and we wanted to improve frontal sinus bossing commonly, but it is not usual. Here, we present a case of pneumosinus dilatans of the frontal sinus of the repair method.
Congenital Abnormalities ; Frontal Sinus* ; Humans ; Male ; Recurrence

Over the last 30 years, the use of chairside computer-aided design (CAD) and computer-aided manufacturing (CAM) systems has evolved and has become increasingly popular in dentistry. Although CAD/CAM restorations have been used in the anterior dentition, satisfying the esthetic requirements of clinicians and patients, where the restorations are limited to the chairside, remains a challenge. To reproduce multi-shades of CAD/CAM restorations in the clinic, a preliminary experiment to express several shades on A2 lithium disilicate (LS2) blocks using a staining kit was performed. After measurement of the CIE L*a*b* value of specimens, it was compared with that of the commercial shade guide. This report presents two cases with individual customization of shade and surface characterization of the CAD/CAM restorations using predictable methods based on the preliminary experimental data. The anatomical shape of restoration was obtained from ‘copy and paste technique’ and ‘mirror image acquisition technique’. All treatment procedures and fabrication of restorations performed in this report were executed in the clinic itself.

BACKGROUND AND OBJECTIVES: The purpose of this study is to identify the effectiveness of intratympanic (IT) steroids when used as an initial therapy in sudden sensorineural hearing loss (SSNHL), and when it is used as a salvage therapy in a refractory SSNHL. SUBJECTS AND METHODS: This retrospective study included 122 patients with SSNHL. First, patients were divided into three groups according to the initial treatment; IT steroid, systemic steroid and combined (systemic and IT steroid) groups. Second, patients were divided into two groups according to the salvage treatment in a refractory SSNHL; IT steroid and the control (non IT group). Fifty eight patients who did not respond to initial therapy were included in the second analysis. Hearing was assessed immediately before the treatment and 2 weeks, 4 weeks and 3 months after the treatments. Hearing recovery was defined as an improvement of >15 dB and the final hearing of 25-45 dB in the audiogram. RESULTS: When we analyzed the hearing recovery in initial treatment, the comparison of audiogram among three groups did not result in significantly different outcomes. There were no differences in the recovery rate in 2 and 4 weeks throughout all the frequencies. Also, the analysis of the salvage treatment demonstrated that neither IT steroid group nor control group was significantly effective in treating the refractory SSNHL. CONCLUSIONS: The results suggest that initial treatment of SSNHL with IT steroid alone is as effective as systemic steroid alone or a combination therapy. Also, salvage IT steroids for refractory SSNHL did not have any additional beneficial effects.
Hearing ; Hearing Loss, Sensorineural* ; Humans ; Retrospective Studies ; Salvage Therapy ; Steroids

The tumor lysis syndrome (TLS) commonly occurs in the lymphoproliferative disorder, either spontaneously or in response to therapy. TLS is uncommon in multiple myeloma. However, with the use of bortezomib in the treatment of multiple myeloma, cases of TLS have been reported. We report here threepatients who presented with TLS after the administration of bortezomib. Two of them presented mild symptoms and recovered with hydration only. However, death of the other patient was associated with TLS. We should monitor patients who had high tumor burden, especially in early phase of bortezomib therapy and appropriate prophylaxis for high risk patient is also needed.
Boronic Acids ; Humans ; Lymphoproliferative Disorders ; Multiple Myeloma ; Organothiophosphorus Compounds ; Pyrazines ; Tumor Burden ; Tumor Lysis Syndrome ; Bortezomib

Rectus sheath hematoma (RSH) is an uncommon condition caused by hemorrhage into the rectus sheath. RSH is characterized by abdominal pain and an abdominal mass. This condition is associated with old age, childbirth, abdominal surgery, severe coughing, severe sneezing, anticoagulation therapy, and/or coagulation disorders. We report herein a case of RSH and pelvic cavity hematoma that was induced by dalteparin injection in a 77-year-old woman with pulmonary embolism and deep vein thrombosis, and who was successfully treated by conservative management.
Abdominal Pain ; Aged ; Cough ; Dalteparin* ; Female ; General Surgery ; Hematoma* ; Hemorrhage ; Humans ; Parturition ; Pulmonary Embolism ; Sneezing ; Venous Thrombosis

Rectus sheath hematoma (RSH) is an uncommon condition caused by hemorrhage into the rectus sheath. RSH is characterized by abdominal pain and an abdominal mass. This condition is associated with old age, childbirth, abdominal surgery, severe coughing, severe sneezing, anticoagulation therapy, and/or coagulation disorders. We report herein a case of RSH and pelvic cavity hematoma that was induced by dalteparin injection in a 77-year-old woman with pulmonary embolism and deep vein thrombosis, and who was successfully treated by conservative management.
Abdominal Pain ; Aged ; Cough ; Dalteparin* ; Female ; General Surgery ; Hematoma* ; Hemorrhage ; Humans ; Parturition ; Pulmonary Embolism ; Sneezing ; Venous Thrombosis

PURPOSE: The purposes of this study was to evaluates shear bond strength between zirconia core and veneer-ceramic in order to examine the clinical practice of colored zirconia block fabricated by infiltration method into the metal chloride solution. MATERIAL AND METHODS: CNU block and Everest(R) ZS blank were used. VITA In-Ceram(R)2000 YZ Coloring liquid (LL1) and 3 aqueous metal chloride solutions containing chromium and molybdenum ingredients were used. 40 zirconia specimens were prepared into cuboid shape (5 x 5 x 10 mm). All specimens were divided into 5 groups by infiltrating into the coloring liquids. After that, porcelain was build up into the shape of 5 x 5 x 4 mm3, followed by sintering. The maximum loading and shear bond strength was measured. Failure patterns and failure sites were examined. RESULTS: 1. There were no statistical differences in shear bond strength between zirconia blocks (P > .05). 2. There were no statistically significant differences in shear bond strength between non-colored and colored zirconia blocks, while shear bond strength of non-colored zirconia blocks is higher than that of colored specimen (P > .05). 3. In the comparison with shear bond strength among colored zirconia blocks, there were no statistical differences according to kinds of coloring liquid (P > .05). 4. Mixed failure patterns were mainly observed in the failure between zirconia and veneering ceramic. The veneering ceramic failure of all specimens was observed in either interface of zirconia or veneering ceramic. CONCLUSION: Shear bond strength between colored zirconia and veneering ceramic shows lower tendency than non-colored zirconia, but there was clinically allowable value.
Ceramics ; Chromium ; Dental Porcelain ; Ethylnitrosourea ; Molybdenum ; Zirconium