Allopurinol is widely used for chronic tophaceous gout as a uric acid lowering agent. Hypersensitivity to allopurinol occurrs in about 10% of patients, which limits the usage of allopurinol. The successful oral and intravenous desensitization of allopurinol has been reported worldwide since 1976. We recently experienced a 51-year-old male patient with gouty arthritis and hyperuricemia, who had previously experienced skin rash after allopurinol treatment. When allopurinol was retried, erythematous and foliative skin rash developed on entire body. Because allopurinol was essential in controlling hyperuricemia, the oral desensitization of allopurinol was tried. We report successful rapid oral allopurinol desensitization in the patient with chronic tophaceous gout, who exhibited exfoliative dermatitis as allopurinol hypersensitivity.
Allopurinol* ; Arthritis, Gouty ; Dermatitis, Exfoliative* ; Exanthema ; Gout ; Humans ; Hypersensitivity ; Hyperuricemia ; Male ; Middle Aged ; Uric Acid

BACKGROUND: Transcatheter coil embolization has been described as a method of nonsurgical closure of variable pathologic vascular structures. This study was aimed to evaluate the outcome of transcatheter coil embolization in variable clinical conditions. METHODS AND RESULTS: We collected data from patients' medical record and their cardiac angiography films. From January 1995 to June 1997, coil embolization was attempted in 51 patients who were 38 patients with systemic-pulmonary collaterals (5 patients have venous collaterals, too), six patients with venous collaterals, nine patients with patent ductus arteriosus (PDA), one patient with Blalok-Taussig shunt (BT shunt), one patient with coronary-right atrial fistula and one patient with coronary-right ventricular fistula. In 38 patients with systemic-pulmonary collaterals, 123 coils were inserted to 70 collaterals, therefore mean 1.79+/-0.77 coils were inserted to one collateral. The results were complete occlusions (74%), incomplete occlusions (21%), and partial occlusions (4%). In six patients with venous collaterals, the outcomes were complete occlusions (50%) and incomplete occlusions (50%). In a patient with BT shunt, hemolytic anemia occurred in 1st attempt and in 2nd attempt, shunt was incompletely occluded and one coil was carried away and embolized the peripheral pulmonary artery. In nine patients with PDA, ten cases of transcatheter coil embolization was executed. Mean minimum ductal diameter was 2.1+/-0.85 mm. The results were initial occlusion (30%), occlusion within one month (66%), and occlusion within one year (75%). Left pulmonary artery stenosis owing to coil insertion was not found. In one case of coil malposition, retrieval and reinsertion of coil was successful. In two patients who have coronary artery fistula, coil embolization was successfully executed without any complications. CONCLUSIONS: Transcatheter coil embolization executed in variable clinical conditions without significant complications. It was effective and safe nonsurgical method.
Anemia, Hemolytic ; Angiography ; Child* ; Constriction, Pathologic ; Coronary Vessels ; Ductus Arteriosus, Patent ; Embolization, Therapeutic* ; Fistula ; Humans ; Medical Records ; Pulmonary Artery

BACKGROUND: Transcatheter coil embolization has been described as a method of nonsurgical closure of variable pathologic vascular structures. This study was aimed to evaluate the outcome of transcatheter coil embolization in variable clinical conditions. METHODS AND RESULTS: We collected data from patients' medical record and their cardiac angiography films. From January 1995 to June 1997, coil embolization was attempted in 51 patients who were 38 patients with systemic-pulmonary collaterals (5 patients have venous collaterals, too), six patients with venous collaterals, nine patients with patent ductus arteriosus (PDA), one patient with Blalok-Taussig shunt (BT shunt), one patient with coronary-right atrial fistula and one patient with coronary-right ventricular fistula. In 38 patients with systemic-pulmonary collaterals, 123 coils were inserted to 70 collaterals, therefore mean 1.79+/-0.77 coils were inserted to one collateral. The results were complete occlusions (74%), incomplete occlusions (21%), and partial occlusions (4%). In six patients with venous collaterals, the outcomes were complete occlusions (50%) and incomplete occlusions (50%). In a patient with BT shunt, hemolytic anemia occurred in 1st attempt and in 2nd attempt, shunt was incompletely occluded and one coil was carried away and embolized the peripheral pulmonary artery. In nine patients with PDA, ten cases of transcatheter coil embolization was executed. Mean minimum ductal diameter was 2.1+/-0.85 mm. The results were initial occlusion (30%), occlusion within one month (66%), and occlusion within one year (75%). Left pulmonary artery stenosis owing to coil insertion was not found. In one case of coil malposition, retrieval and reinsertion of coil was successful. In two patients who have coronary artery fistula, coil embolization was successfully executed without any complications. CONCLUSIONS: Transcatheter coil embolization executed in variable clinical conditions without significant complications. It was effective and safe nonsurgical method.
Anemia, Hemolytic ; Angiography ; Child* ; Constriction, Pathologic ; Coronary Vessels ; Ductus Arteriosus, Patent ; Embolization, Therapeutic* ; Fistula ; Humans ; Medical Records ; Pulmonary Artery

For treatment of partially edentulous patients, a treatment using implant is widely used. Treatment method using implant are implant fixed prostheses and removable partial dentures, and for patients with severe bone resorption, removable implant overdenture with the effects of aesthetic and reducing cost can be used as treatment options. Specially, prosthesis with milled-bar and attachment has the effect of being splinted between implant fixtures, higher retention and stability than conventional removable partial denture. And it has the effect of improvement of aesthetic through lip support by denture base. In this case, the patient with severe alveolar bone resorption and partial edentulous maxilla and mandible was treated by implant-assisted removable partial denture using Milled-bar and ADD-TOC attachment. The esthetic was improved by removing the clasp because of effects of additional retention by using the attachment, and reducing palatal coverage of implant-assisted removable partial denture. The clinical results were satisfactory on the aspect of aesthetic and masticatory function.

This case report presents an 81-year-old edentulous female patient with congenital cleft lip and palate, rehabilitated with a maxillary obturator and a mandibular complete denture. A defect in the hard palate causes nasal leakage and hypernasalization of speech. Velopharyngeal insufficiency due to a defect in the soft palate causes reflux during swallowing and decreased clarity of pronunciation.The anatomical structures, such as Passavant’s ridge, were considered to prevent respiratory problems when impression taking. We achieved satisfactory results including velopharyngeal closure for pronunciation, mastication, and swallowing, as well as improved aesthetics. Therefore, we report the process and considerations of the treatment.

This case report presents an 81-year-old edentulous female patient with congenital cleft lip and palate, rehabilitated with a maxillary obturator and a mandibular complete denture. A defect in the hard palate causes nasal leakage and hypernasalization of speech. Velopharyngeal insufficiency due to a defect in the soft palate causes reflux during swallowing and decreased clarity of pronunciation.The anatomical structures, such as Passavant’s ridge, were considered to prevent respiratory problems when impression taking. We achieved satisfactory results including velopharyngeal closure for pronunciation, mastication, and swallowing, as well as improved aesthetics. Therefore, we report the process and considerations of the treatment.

This case report presents an 81-year-old edentulous female patient with congenital cleft lip and palate, rehabilitated with a maxillary obturator and a mandibular complete denture. A defect in the hard palate causes nasal leakage and hypernasalization of speech. Velopharyngeal insufficiency due to a defect in the soft palate causes reflux during swallowing and decreased clarity of pronunciation.The anatomical structures, such as Passavant’s ridge, were considered to prevent respiratory problems when impression taking. We achieved satisfactory results including velopharyngeal closure for pronunciation, mastication, and swallowing, as well as improved aesthetics. Therefore, we report the process and considerations of the treatment.

This case report presents an 81-year-old edentulous female patient with congenital cleft lip and palate, rehabilitated with a maxillary obturator and a mandibular complete denture. A defect in the hard palate causes nasal leakage and hypernasalization of speech. Velopharyngeal insufficiency due to a defect in the soft palate causes reflux during swallowing and decreased clarity of pronunciation.The anatomical structures, such as Passavant’s ridge, were considered to prevent respiratory problems when impression taking. We achieved satisfactory results including velopharyngeal closure for pronunciation, mastication, and swallowing, as well as improved aesthetics. Therefore, we report the process and considerations of the treatment.

This case report presents an 81-year-old edentulous female patient with congenital cleft lip and palate, rehabilitated with a maxillary obturator and a mandibular complete denture. A defect in the hard palate causes nasal leakage and hypernasalization of speech. Velopharyngeal insufficiency due to a defect in the soft palate causes reflux during swallowing and decreased clarity of pronunciation.The anatomical structures, such as Passavant’s ridge, were considered to prevent respiratory problems when impression taking. We achieved satisfactory results including velopharyngeal closure for pronunciation, mastication, and swallowing, as well as improved aesthetics. Therefore, we report the process and considerations of the treatment.

One of the treatment options for edentulous state patients with residual ridge resorption is implant overdenture using milled bar and attachment. It not only provides improved retention and stability but can also reduce the coverage of palatal surface. In addition, when a small number of implants are used, milled bar has the effect of being splinted between implant fixtures, which makes it mechanically advantageous under functions such as mastication. The patient in this case was a maxillary edentulous state patient with a considerable amount of residual alveolar bone resorption after removing the existing failed implants. Three implants were planted on both sides and an implant overdenture was fabricated using milled bar and ADD-TOC attachment.