A 60-year-old woman has experienced of right upper quadrant abdominal discomfort. This partient took cholecytectomy due to gall stone 15 years ago. At that time microscopic finding the neck of gallbladder showed well differentiated papillary adenocarcinoma confined to superficial part of musele layer. 3 years before admission she took T-tube drainage due to obstructive jaundice. The microscopic finding af distal common bile duct showed well differentiated adenocarcinoma. Recently she complained of pain and discomfort on T-tube site and so we perforrned endoscopic retrograde biliary drainage after removal of T-tube. The computed tomogram showed no mass in liver or lymph node enlargement. 4 months after procedure of ERBD; we changed to the new catheter for the prevention of cloggiag of prosthesis. We report here a case of longterm survival over 15 years after the diagnosis of cancer of extrahepatic bile duct.
Adenocarcinoma ; Adenocarcinoma, Papillary ; Bile Ducts, Extrahepatic ; Catheters ; Common Bile Duct* ; Diagnosis ; Drainage ; Female ; Gallbladder* ; Gallstones ; Humans ; Jaundice, Obstructive ; Liver ; Lymph Nodes ; Middle Aged ; Neck ; Prostheses and Implants

A fabrication method of inner and outer crown using CAD/CAM is presented. The information of abutment teeth is transferred to a computer through a 3-dimensional scanner. A Konus inner and outer crown is designed on a computer and a real crown is machined based on this design using CAM. This method can save laboratory time and reduce inaccuracies compare to conventional casting procedure. A stone model with six prepared abutment teeth from a patient was used in this study. Three dimensional information from the model was transferred to a computer using a contact type 3dimensional scanner with a 25micrometer accuracy. All margins were identified on a computer image where there is a change in surface taper of a model. To provide a cement space, the image of a inner surface of a Konus inner crown was duplicated 25micrometer apart from the surface of a prepared abutment teeth image. The cement space was 20micrometer at the cervical margin. All Konus crowns were machined with a 10micrometer accuracy. It was concluded that this method can reduce working-time for the laboratory process and increase accuracy. A further research is required to make a simplified process for a more complex prosthesis.
Computer Graphics* ; Crowns* ; Humans ; Prostheses and Implants ; Tooth

No abstract available.
Asphyxia*

This study was to evaluate the fabrication method and marginal adaptation of the conical inner crown fabricated with CAD/CAM.The informations on abutment teeth were transferred to a computer with a micro contact digitizer,which had a 50mum accuracy on the master die.A conical inner crown was designed on a computer and a real crown was machined based on this design using CAM. The marginal fit of a computer-machined conical inner crown was assessed using electron microscopy. Measurement of the marginal gap between the conical inner crown and the abutment was performed on four different locations (mesial,distal,buccal,and lingual surfaces)of the finish line. The evaluation was based on 10 test specimens. The results were as follow. 1.The mean marginal gap between the conical inner crown and abutment tooth was 83.2 +/-43mum,28.9%of the specimen showed marginal gap over 100 m. 2.The fabrication method using CATRS and CAM provided clinically acceptable marginal fitness compared to conventional casting method (p<0.05).
Crowns* ; Microscopy, Electron ; Tooth

No abstract available.
Gastroenteritis*

Annular pancreas is a rare congenital anomaly with the descending duodenum encircled by a ring of pancreatic tissue, which may cause partial or complete obstruction of the duodenum. In newborn, the symptoms can be those of duodenal stasis resulting from partial intestinal obstruction secondary to some degree of duodenal stenosis. A male newborn weighing 2.0 Kg was born by C-section delivery at 37 weeks' gestation to a 27-year-old mother who had a hydramnios. He was in relatively good condition at birth except regurgitation of saliva and intermittent apnea. A plain film of the abdomen showed the double-bubble of gas filled stomach and proximal duodenum, and upper gastrointestinal series showed a dilated proximal duodenum, with a complete obstruction of the descending duodenum. Intraoperative finding revealed encirclement of the duodenal second portion by pancreatic tissue. Duodenojejunostomy was performed. After the operation, he had developed two serious complications, neonatal septicemia by Enterobacter cloacae on postoperative day 12 and systemic candidiasis on postoperative day 19, and been managed with ventilatory support, antibiotics, and antifungal agents with recovery.
Abdomen ; Adult ; Anti-Bacterial Agents ; Antifungal Agents ; Apnea ; Candidiasis ; Constriction, Pathologic ; Duodenum ; Enterobacter cloacae ; Humans ; Infant, Newborn ; Intestinal Obstruction ; Male ; Mothers ; Pancreas ; Parturition ; Polyhydramnios ; Pregnancy ; Saliva ; Sepsis ; Stomach

No abstract available.
Gestational Age* ; Intracranial Hemorrhages*

Esophageal duplication cysts are congenital anomalies of the foregut that are rarely found in the abdomen. An accurate preoperative diagnosis is not always possible, so the definitive diagnosis can be made by histologic examination of the surgical specimen. We experienced a case of Intra-abdominal esophageal duplication cyst in a 52-year-old female, who initially presented with an esophageal submucosal tumor on upper gastrointestinal endoscopy. She did not have any gastrointestinal symptoms. Barium esophagography, chest computed tomography scan and endoscopic ultrasonography demonstrated the cystic lesion in the intra-abdominal esophagus. Transhiatal enucleation of the lesion was performed successfully via the abdominal approach with no postoperative complications. Histologic study showed that the cyst wall contained a two-layered muscle coat and the surface of the lumen was lined by pseudo-ciliated columnar epithelium. The patient has been doing well without any complaints for 3 months of follow-up period.
Tomography, X-Ray Computed ; Radiography, Abdominal ; Middle Aged ; Humans ; Female ; Esophageal Cyst/*diagnosis/pathology/*surgery ; *Abdomen

We found an error in this article. The author's name should be corrected as following: from "Younsuk Koh" to "Younsuck Koh".

PURPOSE: This study was designed to assess the prognosis of pT3 transitional cell carcinoma of the renal pelvis(renal pelvic tumor) according to the parenchymal invasion pattern and adjuvant chemotherapy. MATERIALS AND METHODS: A total of 48(34 males and 14 females) patients were surgically treated for a renal pelvic tumor. Of these 48 patients, the 27 pT3 renal pelvic tumor patients who had over one year follow-up period were enrolled. The patients were divided into two groups according to the invasion pattern(Group 1: renal parenchymal invasion, Group 2: peripelvic fat invasion). Among these 27 patients, 15 patients received adjuvant chemotherapy following surgery, whereas the other 12 patients did not. The prognostic factors, including age, gender, laterality, tumor grade, size, lympho-vascular invasion, lymph node involvement, the invasion pattern and adjuvant chemotherapy, were analyzed with respect to disease-free survival. RESULTS: There were seventeen patients in Group 1 and 10 patients in Group 2. The mean duration of follow up was 39.4 months. Age, gender, laterality, tumor grade, size, lympho-vascular invasion, invasion pattern and adjuvant chemotherapy had no significant impact on disease-free survival on both the univariate and multivariate analyses. Only lymph node involvement(p=0.028, hazard ratio=20.98) was a prognostic predictor in this study. However, the incidence of renal parenchymal invasion was higher for the high grade tumors than for the low grade tumors. CONCLUSIONS: The renal parenchymal invasion pattern and adjuvant chemotherapy had no significant impact on disease-free survival on both univariate and multivariate analyses for the patients with pT3 renal pelvic tumor. Further studies are necessary to clarify this result.
Carcinoma, Transitional Cell* ; Chemotherapy, Adjuvant* ; Disease-Free Survival ; Follow-Up Studies ; Humans ; Incidence ; Kidney Pelvis* ; Lymph Nodes ; Male ; Multivariate Analysis ; Prognosis