Although pancreatic leiomyosarcoma (PLM) is a rare malignant pancreatic cancer, it usually shows aggressive biological features such as invasion to an adjacent organ or distant metastasis at the time of diagnosis. Radical resection is the best treatment modality but effective chemotherapies have not been identified. A 58-year-old female was referred to us complaining of intermittent left upper quadrant abdominal discomfort. Imaging studies revealed a 10-cm mass in the pancreatic tail. The patient underwent laparoscopic distal pancreatectomy with splenectomy, and the pathological findings were consistent with PLM. Imaging studies 14 months after surgery revealed multiple liver metastases. Because the patient was young with a sufficient remnant liver, we performed laparoscopic metastatectomy without any postoperative complications. Patients with PLM need frequent check-ups, even after curative resection. The role of laparoscopic resection should be confirmed in the future.
Diagnosis ; Drug Therapy ; Female ; Humans ; Laparoscopy ; Leiomyosarcoma* ; Liver* ; Middle Aged ; Neoplasm Metastasis* ; Pancreatectomy ; Pancreatic Neoplasms ; Postoperative Complications ; Splenectomy ; Tail

Increasing the vertical dimesion affects not only functional problems but also the facial appearance. In particular, when restoring the reduced vertical dimension, it is important to evaluate facial appearance because the change affects the patient’s aesthetics. Cephalometric radiographs can predict changes in the facial appearance through skeletal and vertical classifications using anatomical indicators, and the changes before and after treatment can be easily observed, which could serve as good data in evaluating treatment success. In this study, comparative evaluation was performed through cephalometric radiography, and the aesthetic and functional improvement was confirmed.

Successful cases of the implant-assisted removable partial denture and implant overdentures are reported in which a few implants are additionally placed to secure the maintenance, support, and stability of the denture when there are a few residual teeth. When the lateral force applied to the tooth abutment and implant surveyed crown is minimized, the horizontal and rotational movement of the denture is significantly reduced which is an effective method that can improve the address in patients who complain of reduced retention and stability of their dentures. In this case, a small number of implants were placed to fabricate an implant-assisted removable partial denture with implant surveyed crown in the maxilla and implant overdenture with Locator® attachment in the mandible to improve the retention, stability, and support of the dentures. The patient was satisfied with both functional and aesthetic aspects after the final dentures were delivered.

Situs inversus totalis (SIT) is a rare condition in which the viscera are transposed in a mirror image reversal. We report two cases of laparoscopic cholecystectomy (LC) performed for SIT patients. A 63-year old male patient with SIT was diagnosed with symptomatic gallstones. We performed LC by 3-port method. The patient was discharged uneventfully on postoperative day 2. A 57-year old female patient with SIT underwent LC for acute cholecystitis. Due to severe inflammation an assistant was needed. The patient was discharged uneventfully on postoperative day 3. Over 80 cases of LCs in SIT patients have been reported so far and LC has become the standard treatment. The current report confirms the safety of laparoscopy in such cases. Laparoscopic cholecystectomy can be performed safely in SIT patients if care is taken. Surgeons need to be careful of reversed anatomy and unaccustomed working hand.
Cholecystectomy, Laparoscopic* ; Cholecystitis, Acute ; Female ; Gallstones ; Hand ; Humans ; Inflammation ; Laparoscopy ; Male ; Methods ; Situs Inversus* ; Surgeons ; Viscera

Computer-aided design–computer-aided manufacturing technology has been widely used in the manufacture of fixed prostheses including implants, but in the case of removable dentures, the analog method is still being used due to the errors such as a lack of fusion and over-fusion in selective laser meting process. With the recent development of CAD software, virtual surveying and framework design are made possible, and the designed file can be manufactured by milling or 3D printing. It replace the analog method of waxing and denture curing process and also can reduce the production time and cost. Therefore, this case is reported because good clinical results were obtained by digitally surveying on CAD software to produce a surveyed metal restoration and framework on maxillary and mandibular removable dentures.

In patients with myasthenia gravis, it is difficult to manufacture and maintain dentures because the muscles and nervous system in the oral cavity are not properly adjusted. In addition, excessively extended or thick dentures may cause muscle weakness by stimulating the muscles, so dentures should be manufactured in consideration of this. In this case, a denture was fabricated using the closed mouth technique in a patient with myasthenia gravis with mouth opening limitation. Using the closed mouth technique, the patient’s masticatory pressure and muscle movements were reproduced and denture with good retention were manufactured.

The concept of ‘Implant Supracrestal Complex (ISC)’ was introduced as a way to determine the impact of implant prosthetic design form on both short-term clinical outcomes and the long-term prognosis of bone and soft tissues around the implant.Implant-prosthesis-abutment complex design forms, such as implant-abutment design, junction, and location, can have important implications for the stable and healthy long-term maintenance of the tissues around the implant. In this case, a customized concave abutment and a prosthesis with an emergence angle of about 30 degrees were restored to a patient suffering from chronic soft tissue inflammation and pain after restoration of an implant prosthesis. It was confirmed that the new prosthesis improved complications by allowing sufficient bone and soft tissue space, achieved appropriate soft tissue sealing, and maintained the longterm stability of the implant.

Recently, computer-aided design and computer-aided manufacturing (CAD/CAM) environment have changed the clinician treatment method in the fabrication of prosthesis. The diagnostic wax-up by using digital technology simplifies the laboratory process and provides clinical efficiency and convenience. In this case, Digital diagnostic wax-up was superimposed on extra-oral photo to consider the patient’s facial appearance and utilized to produce the final prosthesis. It can be more efficient and esthetic than a diagnostic wax-up that was made only on a model. The digital diagnostic wax-up that superimposed on extra-oral photo not only visualizes the predicted outcome of prosthodontic treatment but also improves satisfaction and facilitates the communication between patient and dentist. We report aesthetically and functionally satisfactory results that obtained after restoration.

Fabrication of dentures using CAD/CAM system has the advantage of reducing the number of patient visits and reducing errors during laboratory work. After the extraction of maxillary residual teeth, this patient changed to a completely edentulous state and the stability and retention of the existing mandibular complete denture were insufficient due to the absorption of the mandibular residual ridge, so the restoration of the mandibular implant retained overdenture and maxillary complete denture were planned.By digitizing the concept of BPS (Biofunctional prosthetic system) that uses the patient’s functional movement in closed mouth technique, the vertical dimension was taken by Gnathometer CAD and digital facebow transfer was performed using UTS CAD. In this case, fabrication of maxillary complete denture and mandibular implant-retained overdenture using monolithic disc and CAD/ CAM system demonstrated favorable denture retention, stability, and support and the patient is satisfied with improved functions and esthetic of dentures.

Long-term use of inappropriate prosthesis often results in habitual closure or irregular mandibular movements. In that case, guide to the stable centric position is difficult. Therefore, by using a treatment denture, the muscles and TMJ should be stabilized and the jaw relation should be acquired with the treatment position. Compared to the conventional method, digital technology in fabrica-tion complete denture has the advantage of reproducing a stable tooth arrangement in cases of difficult tooth alignment, minimiz-ing laboratory errors and reducing denture fabrication time. Therefore, in this case, the final denture was fabricated by digitally re-producing the stable treatment position, vertical dimension, and lip support with a treatment denture, and satisfactory results wereobtained.