Extraction socket sealing using palatal gingival grafts and resorbable collagen membranes / 대한악안면성형재건외과학회지

BACKGROUND: Socket sealing surgery is performed for the preservation of the form and volume of the soft tissue by covering the resulting socket with autogenous soft tissue graft or membrane barriers. This procedure is usually necessary to improve the esthetic results of the maxillary anterior or premolar areas. METHODS: This study retrospectively investigated cases involving the open membrane technique or socket sealing surgery with a palatal gingival graft or collagen membrane where implant placement and bone grafting were performed immediately after tooth extraction. From January 2005 to December 2008, socket sealing surgery was performed in 24 patients, and 25 implants were placed. RESULTS: All implants were successful in the follow-up period. In the palatal gingival graft group, the mean marginal bone loss was 1.17 mm during the mean follow-up period of 81.0 months. In the collagen membrane group, the mean marginal bone loss was 1.23 mm during the mean follow-up period of 76.9 months. There was no significant difference between the two groups. CONCLUSIONS: Consequently, socket sealing surgery is effective at minimizing the loss of soft tissue and alveolar bone.

A Patient with Distinct Evidences of Spontaneous Regression and Recurrence of Gastric Cancer for 13 Years

Spontaneous regression (SR) of malignancy is a rare phenomenon, especially in patients with gastric cancer. A 77-year-old male, who was already diagnosed with gastric adenocarcinoma by endoscopic biopsy from a private clinic, was referred to our hospital. Despite our strong recommendation, the patient refused surgical therapy. A follow-up endoscopy was performed 3 months later, which revealed that the ulcer had changed into a white scar. Endoscopic biopsy revealed only chronic inflammation. Two and 6 years later, cancer recurred, and SR was confirmed both times, histologically, at the gastric body. The patient is still alive without any gastrointestinal symptoms after 13 years of follow-up. The cause of SR is yet uncertain and there are only a few suggestions of scientific mechanisms. We, herein, report this very rare case of repeated recurrence and SR of gastric cancer without clear cause.

Typhoid Fever Complicated by Intussusception, Splenic Infarction, and Hepatitis

Salmonella typhi infections usually manifest with high fever and gastrointestinal symptoms, however, occurrence of severe complications in other organs, such as pneumonitis, bronchitis, hepatitis, nephritis, encephalitis, and osteomyelitis, is possible. Although common surgical complications include ileal perforation and gastrointestinal haemorrhage, few cases of intussusception have been reported. Splenic infarction is another uncommon complication. In this report, we present a case of typhoid fever complicated with simultaneous small bowel intussusception and splenic infarction. A 27-year-old male patient with no previous history of interest underwent examination for fever, acute abdominal pain, and watery diarrhea of seven days duration. Findings on the initial examination indicated fever of 39.1degrees C, a distended abdomen with direct and rebound tenderness of diffuse localization, and rigidity. Abdominal computed tomography showed hepatomegaly, multiple lymphadenopathies, multiple segmental splenic infarctions, and small bowel ileus with intussusception, however, findings from the small bowel enema study showed spontaneous resolution of the intussusception. Despite antibiotic therapy, abdominal symptoms continued, therefore, the patient underwent exploratory laparotomy with suspicion of intestinal perforation. Surgical findings included multiple enlarged lymphadenopathies and coarse appearance of the liver, but no perforation was found. Results of the Widal test showed positivity for flagellar (H), somatic (O) and A antigens (1:640 dilutions each). Blood cultures showed Salmonella typhi. lymph nodes and biopsy showed mesenteric lymphadenitis, with enlarged lymph nodes due to distension of the sinusoids by macrophages, which showed erythrophagocytosis and tingible bodies. In addition, liver biopsy showed a granulomatous aggregate comprised of macrophages with an epithelioid configuration. After intravenous administration of antibiotics, the patient showed progressive improvement and was discharged for outpatient department follow up.

Transformation of CD5-Negative Follicular Lymphoma into CD5-Positive Diffuse Large B-Cell Lymphoma: A Case Report / 대한내과학회지

Diffuse large B-cell lymphoma (DLBCL) is the most frequent subtype of aggressive lymphomas. Approximately 10% of DLBCL cases express CD5 as a surface antigen. CD5-positive DLBCL can occur as the de novo or secondary type. De novo CD5-positive DLBCL arises without previous lymphoproliferative disease, and secondary CD5-positive DLBCL may or may not manifest as Richter syndrome. The transformation of follicular lymphoma (FL) into DLBCL occurs in approximately one-third of all cases. The transformation of CD5-negative low-grade B-cell lymphoma to CD5-positive DLBCL is extremely rare. We report the clinical features of a rare case that presented with a transformation from CD5-negative FL to CD5-positive DLBL over 11 years. This is the second such case published in the English literature.

A Case of Diabetic Foot Infection due to Leclercia adecarboxylata / 임상당뇨병

Leclercia adecarboxylata is a motile, Gram-negative, facultative anaerobic bacillus of the Enterobacteriaceae family. L. adecarboxylata is an opportunistic human pathogen that phenotypically resembles Escherichia coli, although L. adecarboxylata has been rarely isolated from clinical specimens. Here we report a case of diabetic foot infection due to L. adecarboxylata, which has never been reported in Korea.

A Case of Clostridium bifermentans Bacteremia in a Patient with Myelodysplastic Syndrome

Cases of anaerobic bacteremia are rare, and the clinical impact of clostridial bacteremia remains to be clarified. Previous clinical reports have suggested that C. bifermentans is less virulent than other Clostridia species. This microorganism has occasionally been reported to cause septic arthritis, necrotizing pneumonia with empyema, brain abscesses, endocarditis, and metastatic osteomyelitis. Herein, we report on a case of C. bifermentans bacteremia in a patient with myelodysplastic syndrome in South Korea.

A Clinical Study on Lennox-Gastaut Syndrome

PURPOSE: Lennox-Gastaut syndrome is an intractable epilepsy which is comprised of several types of etiology and generalized seizures. It also combines with mental retardation. The present study was made to ascertain the clinical study on Lennox-Gastaut syndrome in Korea. METHODS: From January, 1985 to December, 1995, 31 children, diagnosed with Lennox-Gastaut syndrome at Kyung Hee University Hospital, were analyzed retrospectively. RESULTS: The ratio of male to female was 2.4:1. With regard to etiology, idiopathic form was found in 7 cases (22.6%) and symptomatic form in 24 cases (77.4%). Transition from West syndrome to Lennox-Gastaut syndrome was observed in 14 cases (45.2%). The most common type of seizure was tonic seizure which was seen in 19 cases (61.3%) and atypical absence, myoclonic seizure and atonic seizure were also observed. The most common clinical signs and symptoms were mental retardation, but others such as progressive loss of psychomotor function and attention deficit were also frequently associated with this syndrome. The EEG usually had abnormal background activity, slow spike and wave complexes and often showed multifocal abnormalities. In spite of intractable epilepsy, 18 cases (58.1%) were controlled with complex anticonvulsant therapy. CONCLUSION: Lennox-Gastaut syndrome manifested itself in children aged 1-6 years and had polyetiology. Most tonic seizures and mental retardation were observed. After complex anticonvulsant therapy with vigabatrin, complete remission was induced in many cases.