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*

No abstract available.
Gastroenteritis*

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

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

PURPOSE: There is a predilection for subacute necrotizing lymphadenitis(SNL) in young Asian women. Few pediatric cases have been reported. This study was performed to evaluate clinical features of children with SNL. METHODS: We retrospectively analyzed clinical features of 23 cases of SNL under 15 years of age identified in Nowon Eulji Hospital from February 1995 to January 2002. Two cases were diagnosed by excisional biopsy and 21 cases by fine needle aspiration. RESULTS: The ages ranged from 14 months to 14 years(mean 8.1+/-3.8 years). The male to female ratio was 1 : 1.6. Ten cases(10/23) were diagnosed in 2000. The onset was more frequent in spring. The common presenting symptoms were neck mass(22/23), pain(12/20) and fever(8/18). Fever subsided within two weeks in seven out of eight and lymphadenopathy resolved within five months in 14 out of 15. The mean WBC count was 7,664+/-3,454/mm3. Elevated levels of ESR(10/ 12) and lactate dehydrogenase(5/6) and positive reaction for CRP(3/4) were frequent. Radiologically measured greatest diameter of the enlarged lymph nodes was less than 2 cm in 14 out of 15. One case occurred in a child with alopecia areata and one case with type 1 diabetes. Clinical outcomes were good in 23 cases. CONCLUSION: SNL should be considered in children with cervical lymphadenopathy regardless of fever or pain. SNL seems not rare in pediatric groups in Korea.
Alopecia Areata ; Asian Continental Ancestry Group ; Biopsy ; Biopsy, Fine-Needle ; Child* ; Female ; Fever ; Humans ; Korea ; Lactic Acid ; Lymph Nodes ; Lymphadenitis* ; Lymphatic Diseases ; Male ; Neck ; Retrospective Studies

Autoimmune hepatitis is a chronic necroinflammatory liver disorder of unknown cause associated with circulating autoantibodies and hypergammaglobulinemia. We report two pediatric cases of type 1 autoimmune hepatitis with normal serum immunoglobulin G levels who presented with fulminant hepatitis. The cases were associated with hereditary spherocytosis or atrioventricular septal defect. The first case was a 13-year-old boy with hereditary spherocytosis and gallstones. Acute cholecystitis and cholangitis developed during his clinical course and cholecystectomy, splenectomy and liver wedge biopsy were performed. The second case was an 8-year-old girl with repaired atrioventricular septal defect. In both cases, antinuclear antibody tests were positive and immunoglobulin G levels were normal. Interface hepatitis with moderate lobular inflammation were noted on their liver histology. They responded to the treatment of prednisolone and ursodeoxycholic acid.
Adolescent ; Antibodies, Antinuclear ; Autoantibodies ; Biopsy ; Child ; Cholangitis ; Cholecystectomy ; Cholecystitis, Acute ; Female ; Gallstones ; Hepatitis* ; Hepatitis, Autoimmune* ; Humans ; Hypergammaglobulinemia ; Immunoglobulin G* ; Immunoglobulins* ; Inflammation ; Liver ; Male ; Prednisolone ; Splenectomy ; Ursodeoxycholic Acid