Closed mouth impression technique by using bite tray is preferred for single tooth impression taking. However, for implant impression taking, open mouth impression technique by using single arch tray is generally used whether it is for single implant or multiple implant. Closed mouth impression technique by using bite tray can save time and materials. It also decreases the chance of error occurrence when a model is mounted on an articulator. In this case report, we tried to show a satisfying result of fabricating single implant fixed prosthodontics after bite tray impression taking by using two different copings for closed mouth impression.
Dental Articulators ; Mouth* ; Prosthodontics ; Tooth

Spinal epidural lipomatosis (SEL) is a rare condition that presents as a back pain with progressive neurologic symptoms. Most affected patients are obese and receiving steroid therapy, or have an endocrinopathies. We report a rare case of cauda equina syndrome caused by SEL in a non-obese healthy young man without any evident traumatic episode. A healthy 19-year-old man, who had experienced lower back pain for two months, visited our emergency room because of the sudden development of motor weakness and voiding difficulty. Lumbar magnetic resonance image revealed extradural fat compressing the cauda equina. Urgent decompression via posterior laminectomy and excision of excess epidural fat resulted in an immediate symptom improvement.
Back Pain ; Cauda Equina* ; Decompression ; Emergency Service, Hospital ; Humans ; Laminectomy ; Lipomatosis* ; Low Back Pain ; Neurologic Manifestations ; Polyradiculopathy* ; Young Adult

Unilateral pedicle stress fracture accompanying spondylolytic spondylolisthesis is rare even in the elderly. Most are associated with major trauma, previous spine surgery, or stress-related activity. Here, the authors describe an unique case of unilateral pedicle fracture associated with spondylolytic spondylolisthesis at the L5 level, which was successfully treated by posterior lumbar interbody fusion with screw fixation at the L5-S1 level. As far as the authors' knowledge, no such case has been previously reported in the literature. The pathophysiological mechanism of this uncommon entity is discussed and a review of relevant literature is included.
Aged ; Fractures, Stress ; Humans ; Spine ; Spondylolisthesis* ; Spondylolysis

Synovial cysts are recognized as an uncommon cause of radicular and myelopathic symptoms. They are most frequently found in the lumbar region. The cervical spine or cervicothoracic junction is a rare location for a degenerative intraspinal synovial cyst as compared with the lumbar spine. At given cervical spinal levels, synovial cysts probably share clinical features with disc herniation and stenosis. However, the pathogenesis of synovial cysts remains still controversial. Here, we report a rare case of a synovial cyst in the lower cervical spine presented as Brown-Sequard syndrome and include a brief review of the literature. To the best of our knowledge, no previous report has been issued in the English literature on a synovial cyst presenting with Brown-Sequard syndrome. Neurologic function recovered completely after complete removal of the cyst and expansive laminoplasty.
Brown-Sequard Syndrome* ; Constriction, Pathologic ; Lumbosacral Region ; Spine ; Synovial Cyst*

PURPOSE: To analyze the stress distribution of the implant and its supporting structures through 3D finite elements analysis for implants with different hexagon heights and to make the assessment of the mechanical stability and the effect of the elements. MATERIALS AND METHODS: Infinite elements modeling with CAD data was designed. The modeling was done as follows; an external connection type Phi 4.0 mm x11.5 mm Osste(R) USII (Osstem Co., Pusan, Korea) implant system was used, the implant was planted in the mandibular first molar region with appropriate prosthetic restoration, the hexagon (implant fixture's external connection) height of 0.0, 0.7, 1.2, and 1.5 mm were applied. ABAQUS 6.4 (ABAQUS, Inc., Providence, USA) was used to calculate the stress value. The force distribution via color distribution on each experimental group's implant fixture and titanium screw was studied based on the equivalent stress (von Mises stress). The maximum stress level of each element (crown, implant screw, implant fixture, cortical bone and cancellous bone) was compared. RESULTS: The hexagonal height of the implant with external connection had an influence on the stress distribution of the fixture, screw and upper prosthesis and the surrounding supporting bone. As the hexagon height increased, the stress was well distributed and there was a decrease in the maximum stress value. If the height of the hexagon reached over 1.2 mm, there was no significant influence on the stress distribution. CONCLUSION: For implants with external connections, a hexagon is vital for stress distribution. As the height of the hexagon increased, the more effective stress distribution was observed.
Dental Implants ; Molar ; Plants ; Prostheses and Implants ; Titanium

Implant prostheses were classified into screw-retained prosthesis and cement-retained prosthesis by their method of retaining, and there is screw and cement retained implant prosthesis (SCRP) which has been made reflecting the strengths of these two. The advantages of the SCRP technique are easy retrievability and passive fit of implant prostheses. However, the occlusal screw holes of implant prostheses can be thought as a disadvantage with respect to esthetics and occlusion. Inappropriately positioned implants also limited the use of the SCRP technique. The present study is reporting about the case where nine implants (US II, OSSTEM, Seoul, Korea) were placed in maxilla and eight in mandible respectively in fully edentulous patients. Then, the cement-retained prosthesis was applied for the part in which the screw hole positioned improperly, and screw-retained prosthesis for properly positioned implants so that the combined screw-cement prosthesis has been produced where the satisfying result has shown in both function and esthetics. Three-year follow-up has been done for the patient.
Denture, Partial, Fixed ; Esthetics ; Follow-Up Studies ; Humans ; Mandible ; Maxilla ; Prostheses and Implants

The familial environment may also play an important role in the epidemiology of HCV infection through vertical and horizontal transmission by infected household members. However, it is still controversial whether familial clustering of HCV occurs. We experienced a case of familial clustering of hepatitis C virus. A 10-year old girl presented with nausea, vomiting and anorexia for a month was diagnosed as hepatitis C. Her mother, grandmother, a maternal aunt and her daughter had contracted with HCV. Her laboratory findings showed AST/ALT 63/122 IU/L, positive anti-HCV Ab and HCV RNA (3.54 x 10(5) copies/mL). Pathologic findings of the liver biopsy revealed chronic hepatitis with minimal lobular activity, mild porto-periportal activity and mild portal fibrosis. After treatment with interferon-alpha 2b for 6 months, the clinical symptoms and laboratory findings were normalized.
Anorexia ; Biopsy ; Child ; Cluster Analysis* ; Epidemiology ; Family Characteristics ; Female ; Fibrosis ; Hepacivirus* ; Hepatitis C* ; Hepatitis* ; Hepatitis, Chronic ; Humans ; Interferon-alpha ; Liver ; Mothers ; Nausea ; Nuclear Family ; RNA ; Vomiting

Gallstone ileus is caused by mechanical obstruction of the gastrointestinal tract by the gallstone and accounts for 1~3% of all intestinal obstructions. Endoscopic sphincterotomy (EST) is the accepted treatment of choice for choledocholithiasis. Recognized complications of EST include bleeding, acute pancreatitis, retroperitoneal perforation. However, gallstone ileus is a rare complication of EST. A 70-year-old woman was admitted to our hospital with right upper quadrant pain. Abdominal ultrasound revealed single common bile duct (CBD) stone. ERCP was performed to remove the large CBD stone without mechanical lithotripsy. Nausea, vomiting and abdominal pain were developed after stone removal. Plain abdomen X-ray and computerized tomography represented marked dilatation of small bowel loops without definite obstructive lesion. Because the mechanical obstruction was sustained, explorolaparotomy was performed. On the operation, single stone was impacted at the distal ileum, narrowed by previous radiotheraphy. We reported a case of gallstone ileus after the removal of CBD stone following EST without lithotripsy.
Abdomen ; Abdominal Pain ; Aged ; Cholangiopancreatography, Endoscopic Retrograde ; Choledocholithiasis ; Common Bile Duct ; Dilatation ; Female ; Gallstones* ; Gastrointestinal Tract ; Hemorrhage ; Humans ; Ileum ; Ileus* ; Intestinal Obstruction ; Lithotripsy ; Nausea ; Pancreatitis ; Sphincterotomy, Endoscopic* ; Ultrasonography ; Vomiting

The present study was done to validate the two-site Semmes-Weinstein (SW) monofilament test in identifying patients at risk of lower-extremity complications in clinical setting. The SW monofilament test and nerve conduction study were conducted on type 2 diabetic patients (n=37) at Pusan National University Hospital in Korea. As the duration of diabetes mellitus was longer, neuropathy identified by nerve conduction study and complications of diabetes were more severe (p<0.01). The number of sites unable to perceive SW monofilament (p<0.001) was larger in patients with lower-extremity neuropathy symptoms than those without symptoms. Sensitivity and specificity at two sites (the third and fifth metatarsal head sites) were 93% and 100%, respectively. In conclusion, the two-site SW monofilament test was a sensitive, specific, simple, and inexpensive screening tool for identifying diabetic peripheral neuropathy in clinical setting.
Aged ; Comparative Study ; Diabetes Mellitus, Type II/complications* ; Diabetic Neuropathies/diagnosis* ; Female ; Human ; Male ; Middle Aged ; Neural Conduction ; Neurologic Examination/instrumentation* ; Neurologic Examination/methods ; Pressure ; Sensation Disorders/diagnosis* ; Sensation Disorders/etiology ; Sensitivity and Specificity ; Touch

Klippel-Trenaunay-Weber syndrome is a rare sporadically occurring congenital soft tissue anomaly characterized by cutaneous hemangiomata, hemihypertrophy and occasionally arteriovenous malformations(AVMs). No definite genetic defect has been identified. The appearance is a soft tissue mass of an extremity, usually affecting the adjacent trunk, hydrops fetalis, ascites, abdominal hemangiomatous masses, and hepatomegaly. When diagnosed prenatally, the disorder may be severe. Thrombocytopenia due to platelet consumption within the hemangioma and high output cardiac failure may complicate the outcome. Termination of pregnancy can be offered in severe forms, otherwise no alteration of management in expected. The management of newborns is primarily nonoperative, but some may benefit from surgical intervention. We report a case of Klippel-Trenaunay-Weber syndrome diagnosed prenatally by ultrasonogram in the second trimester and subsequently was terminated, with a brief review of literature.
Ascites ; Blood Platelets ; Extremities ; Female ; Heart Failure ; Hemangioma ; Hepatomegaly ; Humans ; Hydrops Fetalis ; Infant, Newborn ; Klippel-Trenaunay-Weber Syndrome* ; Pregnancy ; Pregnancy Trimester, Second ; Prenatal Diagnosis ; Thrombocytopenia ; Ultrasonography