Technique for fabricating a mandibular suction denture with a plastic implant tray / 대한치과보철학회지

Even though implant overdentures are preferentially recommended to mandibular edentulous patients, many patients may select conventional complete dentures due to cost and general condition. Proper retention and stability of conventional complete dentures in patients with severe alveolar bone resorption is difficult to achieve. To overcome the limitations, mandibular suction dentures with the closed mouth impression technique have been used. However, the previous technique requires the Frame cut back tray, the Centric tray, and the Gnathometer M.This article introduces a technique for fabricating a mandibular suction denture with common dental materials.

Mandibular implant overdenture using Locator R-Tx attachment: A case report / 대한치과보철학회지

Severe mandibular bone resorption may cause difficulties in using a complete denture. An implant overdenture is a feasible and economical treatment option as it can improve retention, stability, and support. A Locator attachment has used successfully. Recently, the next generation of the Locator attachment launched. The purpose of this article is to describe the fabrication of an implant overdenture with a Locator R-Tx attachment as well as its features.

Hearing Outcomes and Prognostic Factors in Idiopathic Sudden Sensorineural Hearing Loss Patients with Combined Intratympanic and Systemic Steroid Therapy / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Hearing outcomes and prognostic factors of idiopathic sudden sensorineural hearing loss (SSNHL) were investigated in patients who underwent combined intratympanic and systemic steroid therapy. SUBJECTS AND METHOD: This study was performed by retrospective chart review. Clinical outcomes and prognostic factors were evaluated in 147 patients who received intratympanic steroid plus systemic steroid therapy. RESULTS: Complete hearing recovery was achieved in 36.7% (n=54) of the patients, partial recovery in 12.9% (n=19), slight recovery in 12.3% (n=18), and total recovery in 61.9% (n=91). Age was identified as an independent, negative prognostic factor for hearing recovery. The recovery rates of the down sloping and profound types were poorer than those of the up sloping type as determined by audiography. CONCLUSION: The results of this study suggest that the combined treatment of intratympanic and systemic steroids for idiopathic SSNHL results in high hearing recovery rates, and that the down-sloping and profound types of audiogram patterns and age are negative prognostic factors.

Failure of Conservative Treatment in Two Cases of Polyarteritis Nodosa with Superior Mesenteric Artery Involvement Presenting with Abdominal Pain

Polyarteritis nodosa (PAN) is a systemic necrotizing vasculitis affecting medium- or small-sized arteries. Its diagnosis may be delayed because it is a rare disease, and patients presenting with PAN demonstrate variable clinical manifestations and non-specific laboratory abnormalities. Gastrointestinal involvement occurs in 14~65% of patients with PAN and is a significant cause of morbidity and mortality. Thus, early diagnosis is very important in PAN with gastrointestinal involvement. We report two cases of rapidly progressive PAN presenting with abdominal pain, having failed conservative treatment.

A Pilot Randomized Comparative Study of Two Diathermy Power Settings for Monopolar Microdissection and Bipolar Hemostasis during Tonsillectomy / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Optimal electrical power required for diathermy during tonsillectomy has not been determined. The aim of this pilot study was to evaluate and compare surgical outcomes of using diathermy power settings at 15 watts (W) and 25W for monopolar microdissection and bipolar hemostasis during tonsillectomy. SUBJECTS AND METHOD: This prospective, single-center, single-blind, randomized study was conducted on 92 patients who underwent 15W or 25W monopolar microdissection and bipolar hemostasis for tonsillectomy. Operation times, post-operative pain severities, and rates of hemorrhage were compared between the 15W and 25W groups. RESULTS: The 92 patients were randomized equally into two study groups. The mean operation duration for the 15W group was significantly longer than in the 25W group (18.5±6.11 versus 13.4±6.04 minutes, p<0.01). The rate of minimal hemorrhage (defined as an episode of bleeding not significant enough for hospital visitation) for the 15W group was significantly higher than for the 25W group (41.3% versus 20.5%, p<0.05). No significant intergroup difference was observed between the rates of primary or secondary hemorrhage or postoperative pain scores. CONCLUSION: Twenty-five watt monopolar microdissection and bipolar hemostasis for tonsillectomy had a shorter mean operation time and a lower post-operative minimal hemorrhage rate than 15W monopolar microdissection and bipolar hemostasis.

A Digital Approach to a Definitive Immediate Denture: A Clinical Report

Even though an immediate denture (ID) is a practical prosthesis, fabricating an ID may be challenging, as unexpected removals of periodontally compromised teeth may occur during an impression procedure. This clinical report introduces a digital approach to a maxillary ID. An intraoral scanner was applied to prevent accidental extraction. A physical cast and a resin pattern of a framework were fabricated with rapid prototyping technology. A proper border and retention was also achieved by an altered cast impression.

Giant Brunner’s Gland Hamartoma of the Duodenal Bulb Presenting with Upper Gastrointestinal Bleeding and Obstruction

Brunner’s gland hamartomas are small benign lesions that are most commonly found in the bulb of the duodenum. They are very uncommon, and most are found incidentally during upper gastrointestinal series or esophagogastroduodenoscopy. The lesions tend to be asymptomatic, but patients may present with symptoms of duodenal obstruction or hemorrhage secondary to ulceration. Histologically, a Brunner's gland hamartoma consists of the components of Brunner's gland cells, as well as glandular, adipose and muscle cells. In this study, we report the case of a 30-year-old man who presented with upper gastrointestinal bleeding and obstructive symptoms due to a giant Brunner's gland hamartoma in the duodenal bulb. The hamartoma was successfully removed by endoscopic resection. No significant complications were observed. Microscopically, the lesion was found to be entirely composed of variable Brunner's glands and adipocytes.

Erratum: Tracheal Involvement in Crohn Disease: the First Case in Korea

The publisher wishes to apologize for incorrectly displaying the author (Ju Hyung Lee) name.

Fabricating a Ceramic-Pressed-to-Metal Restoration with Computer-Aided Design, Computer-Aided Manufacturing and Selective Laser Sintering: A Case Report

Even though a conventional metal ceramic restoration is widely in use, its laboratory procedure is still technique-sensitive, complex, and time-consuming. A ceramic-pressed-to-metal restoration (PTM) can be a reliable alternative. However, simplified laboratory procedure for a PTM is still necessary. The article is to propose a technique that reduces time and effort to fabricate a PTM with the aid of computer-aided design, computer-aided manufacturing and selective laser sintering technologies.

Diagnosis and Treatment of Temporal Bone Trauma / 대한이비인후과학회지

Trauma to temporal bone is common in head injury. The causes of temporal bone trauma are traffic accident, falling down injury, assault and gunshot etc. The main symptoms and signs of temporal bone trauma are facial nerve paralysis, hearing loss, vertigo and cerebrospinal fluid leakage. To avoid or minimize the complication, the physicians have to perform precise diagnosis. The tools of diagnosis include the history and physical examination, radiologic examination, audiologic examination, vestibular function test and electrodiagnostic methods for facial nerve. The physicians have to decide the early proper intervention, for example surgery or medication, for the patients suffered from acute facial palsy, dizziness and cerebrospinal fluid leakage. In this study, the authors have reviewed the pathophysiology, classification, symptom, diagnosis and treatment of the temporal bone trauma.

Outcomes and Prognosis of Patients Treated by Facial Nerve Decompression via Transmastoid Approach for Traumatic Facial Paralysis / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: The aim of this study is to evaluate the outcomes and prognosis of traumatic facial paralysis in patients treated with facial nerve decompression via transmastoid approach. SUBJECTS AND METHOD: The authors retrospectively reviewed 20 patients who suffered from temporal bone fractures resulting in facial paralysis and received surgical facial nerve decompression treatment via transmastoid approach from 2004 to 2012. RESULTS: In 14 patients, the House-Brackmann grade improved to 1, 2, or 3. The preoperative average House-Brackmann grade of 4.95 improved from 4.95 to the postoperative average House-Brackmann grade of 3.15. Statistically significant improvements were found in all groups whether the operation was performed within two weeks, or from two weeks to four weeks, or after four weeks. CONCLUSION: Postoperative results of facial nerve decompression in traumatic temporal bone fracture can be excellent. Surgeons can expect better outcomes with early diagnosis and lesser nerve damage.

A Case of Non-Hodgkin's Lymphoma in Patient with Coombs' Negative Hemolytic Anemia and Idiopathic Thrombocytopenic Purpura / Journal of the Korean Cancer Association, 대한암학회지

Coombs' negative autoimmune hemolytic anemia (AIHA) is a rare disease which shares similar clinical and hematological features with Coombs' positive AIHA, but its exact frequency remains unknown. There have been few reports of idiopathic thrombocytopenic purpura (ITP) and Coombs' negative AIHA associated with other lymphoproliferative disorders (LPDs). Since there is a well known association between LPDs and autoimmune phenomena, it is important to investigate the possibility of an underlying malignancy. We report a case of ITP and Coombs' negative AIHA associated with diffuse large B-cell lymphoma.

Multicenter clinical study on the hydrodynamic piezoelectric internal sinus elevation (HPISE) technique

OBJECTIVES: This study was to evaluate the effect of vertical bone gain and success rate and analyze the failure cases using the hydrodynamic piezoelectric internal sinus elevation (HPISE) technique. MATERIALS AND METHODS: Patients who had been operated in the three centers including Daegu Catholic University Medical Center were selected for this study. The mucoperiosteal flap was elevated, and the sinus floor was then broken by specially designed piezoelectric insert, with hydraulic pressure applied to the sinus membrane for even elevation. Afterward, implants were placed. Panoramic radiogram or computed tomogram was taken before and after surgery and at the second operation and prosthesis placement. Later, changes in vertical height were measured and compared. The survival rate was based on the criteria of Buser et al. and Cochran et al. RESULTS: In this study, 8 implants failed out of a total of 169 implants, resulting a success rate of 95.3%. These failure cases were due to insufficient initial stability or sinus membrane perforation. The mean of radiographic vertical height change at prosthesis placement was 5.7 mm (0.5-10.5 mm). CONCLUSION: In this study, HPISE technique was found to be a predictable treatment for atrophic maxilla and an alternative technique to the lateral approach.

Merlin; NF2 Tumor Suppressor and Regulator of Receptor Distribution/Signaling / 대한이비인후과학회지

Acoustic tumor is the most common tumor originating from cerebellopontine angle. Acoustic tumor is benign and main origin of this tumor is vestibular nerve. This tumor arises in Schwann cell (SC) and is encapsulated. Recently, the tumor is called vestibular schwannoma (VS). VS is classified to two type by epidemiology, sporadic form and neurofibromatosis type 2 (NF2). NF2 is autosomal dominant inherent disorder. This tumor is characterized bilateral VS, brain tumors such as meningioma and ependymoma, and spinal or cranial nerve schwannoma. Genetic studies suggested that NF2 is caused by abnormality or mutation of NF2 gene in chromosome 22q12. Both of them are known to develop the tumor by mutation of NF2 gene. Merlin is the cytoskeletal protein product of the NF2 tumor suppressor gene that mediates cell to cell contact information to regulate SC proliferation and survival. And merlin is highly homologous to ERM proteins. Merlin function is regulated by its conformation, adopting an inactive, growth permissive state following serine 518 (S518) phosphorylation. In NF2 patients, the precise mechanisms of developing the VS are unclear. But, the abnormalities of merlin are confirmed by many studies. And now, a lot of research about merlin function is progressing. In this study, the author would introduce about merlin (structure, function, molecular pathway, tumorigenesis and regulation) which leads to VS and molecular studies about merlin, and suggest the future direction of research.

A Case of Balanced Type Double Aortic Arch Diagnosed Incidentally by Transthoracic Echocardiography in an Asymptomatic Adult Patient

A 36-year-old male patient with no remarkable medical history was admitted to our hospital for a health check up. On chest radiography, bilateral aortic notches at the level of aortic arch were shown suggesting aortic arch anomaly without any clinical symptoms. Two aortic arches were almost same-in-size on suprasternal view of transthoracic echocardiography. In addition, multidetector computed tomography showed balanced type double aortic arch forming a complete vascular ring which encircled the trachea and esophagus. The trachea was slightly compressed by the vascular ring whereas the esophagus was intact. Nevertheless, the pulmonary function test was normal. The patient was discharged from hospital with instructions for periodic follow-up.

A Case of Peritonitis Due to Achromobacter xylosoxidans subsp. xylosoxidans in a Patient Undergoing Continuous Ambulatory Peritoneal Dialysis (CAPD) / 대한신장학회지

Bacterial peritonitis is a well-recognized complication of continuous ambulatory peritoneal dialysis (CAPD) in patients with end-stage renal failure. Achromobacter xylosoxidans subsp. xylosoxidans is a catalase and oxidase positive, motile, nonfermentative and gram-negative rod bacterium that is a rare pathogen in humans and has rarely been reported as an opportunistic human pathogen. We present a case of peritonitis due to unusual pathogens, Achromobacter xylosoxidans subsp. xylosoxidans. A 49-year-old diabetic man undergoing CAPD for 90 days developed the first peritonitis due to Achromobacter xylosoxidans subsp. xylosoxidans. A. xylosoxidans was detected from a culture of peritoneal fluid. Susceptible antibiotic treatment was provided.

New bone formation using fibrin rich block with concentrated growth factors in maxillary sinus augmentation

INTRODUCTION: This study examined the predictability of new bone formation in the pneumatized maxillary sinus using only fibrin-rich blocks with concentrated growth factors as an alternative to bone grafts. MATERIALS AND METHODS: Maxillary sinus augmentation was performed in thirty-three patients with a deficient alveolar bone height (mean 3.9 mm). All patients were treated consecutively with sinus membrane elevation via the lateral window approach and panoramic radiograms and cone-beam computed tomograms were taken to evaluate the remaining bone height and the new bone formation in the maxillary sinus, before and after surgery. Four biopsy specimens were taken at the time of implant consolidation (after an average of five months healing) and were stained by H & E and Trichrome staining. RESULTS: None of the patients had postoperative complications during implant consolidation. After an average of 5 months since sinus augmentation, newly formed bone was observed in all cases by a radiographic evaluation. In 4 biopsy samples, newly formed bone was observed along the floor of the replaced bony window. The osteoblast lining and well distinguished Osteocytes in the lacunas were observed in the newly formed bone. Of the 74 implants (4 different surfaced implants - resorbable blast media-surfaced (RBM), Hydroxyapatite (HA) coated, acid-etched, sintered porous-surfaced implant) placed, one RBM implant failed. The success rate was 98.6% after a mean of 15 months. DISCUSSION: These results suggest that maxillary sinus augmentation using fibrin rich block with concentrated growth factors is a successful and predictable technique.

Clinical evaluation of implant retained overdentures using two implant and Locator attachments in the fully edentulous mandibles / 대한치과보철학회지

PURPOSE: This study compared the marginal bone loss around dental implant that were placed in the canine areas of the mandibles and finded the survival rate of implants, marginal bone loss around implants and prosthetic complications in 10 patients treated with overdentures retained with Locator attachments. MATERIALS AND METHODS: Ten patients who had received implant retained overdentures in the mandibules using two implants and Locator attachments at Daegu Catholic University Medical Center from 2004 to 2010 were included in this study. Evaluations of the survival rate of implants, marginal bone loss and prosthetic complications were performed. RESULTS: Implants placed in this study showed a 100% survival rate and the average annual bone loss was 1.03 mm +/- 0.20 mm in the first year. The patients have verbally indicated that they are comfortable and that their overdentures function well. But, implant retained overdentures had various prosthetic complications such as male change, relining, rebasing and denture fracture. CONCLUSION: Implant retained overdentures using two implant and Locator attachments in the fully edentulous mandibles is considered as a stable way for long terms because of minimal invasive operation, simple prosthetic process and easy repair.

Cerebellar Venous Angioma Confused with Peripheral Vestibulopathy / 대한이비인후과학회지

Venous angioma is a congenital disease of vascular malformation, which is a mass like lesion consisted of dilated medullary veins. It is generally a silent lesion since it is found in normal brain tissues and tends to have low blood flow and pressure. The venous angioma could be diagnosed with magnetic resonance imaging and angiography, but most of them are incidentally diagnosed, because it is usually asymptomatic. The patients with venous angioma have nonspecific symptoms, such as headache, nausea and vomiting, seizures, progressive neurological deficit and hemorrhage. In particular, the venous angioma in cerebellum could cause hearing disturbance, tinnitus and dizziness. We report a case of venous angioma in cerebellum that had been mistaken for peripheral vestibulopathy in a patient complaining of dizziness

Efficacy of Rotating Chair Test And Caloric Test For The Diagnosis of Acute Unilateral Vestibular Neuritis

BACKGROUND AND OBJECTIVES: The acute unilateral vestibular neuritis is fairly a common disease and the precise diagnostic tool is needed for the selection of effective treatments. Therefore, we studied the clinical usefulness of the rotatory chair test and caloric test which have been commonly used in patient of acute unilateral vestibular neuritis. MATERIALS AND METHODS: One hundred and sixty four patients who were diagnosed with acute unilateral vestibular neuritis from August of 2004 to June of 2007 were included. Their medical records of the rotating chair test and caloric test were reviewed retrospectively to study the correlation of the two tests. RESULTS: Of 164 patients, 101 patients (61.6%) and 88 patients (53.7%) showed significant canal paresis (CP) and directional preponderance (DP) on the caloric tests that corresponded with the physical exam. 130 patients (79.3%) and 84 patients (51.2%) showed significant asymmetry and time constant (Tc) on the rotating chair test that corresponded with the predictive direction with spontaneous nystagmus. CONCLUSIONS: For acute unilateral vestibular neuritis patients, the asymmetry of the rotatory chair test showed the highest correlation with clinical findings. But physical exam should be preceded because neither rotator chair test nor caloric test yields a specific correlation with the physical exam. Especially, single test only may too many false negative results. For these tests can reduce false positive cases of the physical exam and raise the specificity of the diagnosis, the planning of proper treatments should be followed thereafter.