The radiation exposure has multiple complication of various organs. Especially, the Food and Drug Administration has recently issued a bulletin warning of the risks of acute skin injury occurring during fluoroscopically guided procedures. Physicians need information about typical radiation doses during fluoroscopically guided various procedures and estimates of entrance skin dose must be monitored using thermoluminescent dosimetry, film badge dosimetry, pocket dosimetry and on-line computer system. Current National Council on Radiation Protection and Measurements recommended are that yearly total body dose should not exceed 50 mSv (5 rem) and that life time dose measured in millisieverts should not exceed one's age in years multiplied by 10. Types of skin injury are erythema, alopecia, dry desquamation, invasive fibrosis, dermal atropy, telangiectasia, moist desquamation, skin necrosis and secondary ulcer. Also, long-term exposure caused skin cancer. We experienced personally pigmentation on the finger nail and the hand after repeated fluoroscopically guided procedures. Thus, we report this case for giving warning to the physiatrist by the complications due to frequent exposure during procedures.
Alopecia ; Computer Systems ; Erythema ; Fibrosis ; Film Dosimetry ; Fingers ; Fluoroscopy ; Hand ; Humans ; Necrosis ; Pigmentation ; Radiation Protection ; Skin Neoplasms ; Skin* ; Telangiectasis ; Thermoluminescent Dosimetry ; Ulcer ; United States Food and Drug Administration

Incontinentia pigmenti (IP) is a rare multisystemic ectodermal disorder, which is characterized by vesicular, verrucous, and pigmented cutaneous lesions, and is frequently associated with various developmental defects of the eye, CNS, teeth, hair, and nail. It is regarded as an X-linked dominant genetic disorder. We recently experienced a case with IP, who presented with irregular, reticular, and slate-gray to brown colored pigmentation on the whole body at birth. Skin lesions were much improved by 6 month of age. The mother of this infant had the history of same cutaneous lesions in her neonatal period, suggesting that these lesions had familial tendency.
Ectoderm ; Hair ; Humans ; Incontinentia Pigmenti* ; Infant ; Mothers* ; Nuclear Family* ; Parturition ; Pigmentation ; Skin ; Tooth

Chronic recurrent multifocal osteomyelitis(CRMO) is an unusual inflammatory process involving multiple osseous sites. No causative agent can be consistently isolated from these lesions despite multiple biopsies and the affected child purses a clinical course of chronic remissions and exacerbations independent of antibiotic therapy. Biopsy of the lesions did not reveal any pathogens. Immunologic investigation revealed no abnormality common to the patient and there was no indication of a genetic etiology. The natural history of chronic recurrent multifocal osteomyelitis appears to be slow, spontaneous resolution of the osseous lesions without specific treatment. We experienced a case of CRMO in an 11-year-old girl who had complained of fever, pain on knee and wrist joints for several weeks. We studied the clinical, radiographic, histological findings in this patient and we report a case of CRMO with brief review of related literature.
Biopsy ; Child ; Female ; Fever ; Humans ; Knee ; Natural History ; Osteomyelitis* ; Wrist Joint

PURPOSE: The laparoscopic adrenalectomy has become the golden standard procedure for adrenal tumors because of its many advantages. The purpose of our study was to compare the outcomes for patients who underwent a transperitoneal laparoscopic adrenalectomy with those of patients who had a conventional open adrenalectomy. Similar to the open adrenalectomy, the laparoscopic adrenalectomy was divided into anterior (LA: Laparoscopic anterior) and posterior (LP: Laparoscopic posterior) approaches. METHODS: Between January 1991 and September 1998, a retrospective review of consecutive ad renalectomies performed at Kyung Hee University Hospital was done. Outcome measurements of operative indications, tumor size, operation time, first oral intake, postoperative stay, and postoperative complications were reviewed. RESULTS: Eleven(11) laparoscopic adrenalectomies (4 LAs and 7 LPs) were performed in 11 patients and 47 open adrenalectomies [24 with an anterior, OA (Open anterior), approach and 23 with a posterior, OP (Open posterior), approach] in 43 patients. The LA approach showed a significantly shorter time to first oral intake (1.8 vs 3.4 days p=0.001) and postoperative hospital stay (5.5 vs 12.8 days p=0.001) compared to the OA approach. The LP approach also showed a significantly shorter time to first oral intake (0.9 vs 1.6 days p=0.046) and postoperative hospital stay (5.9 vs 9.9 days p=0.004) compared to the OP approach. There were no differences in tumor size, operation time, and postoperative complications between laparoscopic adrenalectomies and open adrenalectomies. CONCLUSION: The laparoscopic adrenalectomy is superior to the open adrenalectomy when performed by appropriately trained and skilled surgeons.
Adrenalectomy* ; Humans ; Length of Stay ; Postoperative Complications ; Retrospective Studies

Phantom limbs are usually observed after amputation of extremities. In patients after a stroke, a similar but rarely occurring phenomenon consisting of the patient experiencing the presence of an additional limb has been described. This phenomenon, generally called supernumerary phantom limb (SPL), may be caused by lesions in the right or left cerebral hemisphere, but has been predominantly reported in patients who have had a right hemispheric stroke. We report two cases of atypical SPL and phantom limb pain (PLP) after pontine hemorrhage. The patients were treated conservatively and their symptoms lasted more than 1 month. This is the first report of SPLs after left pontine hemorrhage, and phantom perception and pain lasted longer than those in previously observed cases. Our results indicate that SPL may be more common than reported; therefore, thorough examinations are essential for the care of stroke patients.
Cerebral Hemorrhage/*complications ; Cerebral Infarction/complications ; Female ; Humans ; Male ; Middle Aged ; Pain/etiology ; Phantom Limb/*diagnosis/etiology/therapy ; Psychomotor Performance/physiology ; Stroke/complications ; Tomography, X-Ray Computed

PURPOSE: We compared the effects of newly developed diode laser (Bison 808 nm Diode laser) on the treatment of peri-implantitis with conventional products (Picasso 810 nm Diode laser) by comparing the surface temperature of titanium disc and bacterial sterilization according to laser power. MATERIALS AND METHODS: The titanium disc was irradiated for 60 seconds and 1 – 2.5 W using diode laser 808 nm and 810 nm. The surface temperature of the titanium disc was measured using a temperature measurement module and a temperature measurement program. In addition, in order to investigate the sterilizing effect according to the laser power, 808 nm laser was irradiated after application of bacteria to sandblasted large-grit acid-etched (SLA) and resorbable blast media (RBM) coated titanium discs. The irradiated disks were examined with scanning electron microscopy. RESULTS: Both 808 nm and 810 nm lasers increased disk surface temperature as the power increased. When the 810 nm was irradiated under all conditions, the initial temperature rise rate, the descending rate, and the temperature change before and after was higher than that of 808 nm. Disk surface changes were not observed on both lasers at all conditions. Bacteria were irradiated with 808 nm, and the bactericidal effect was increased as the power increased. CONCLUSION: When applying these diode lasers to the treatment of peri-implantitis, 808 nm which have a bactericidal effect with less temperature fluctuation in the same power conditions would be considered safer. However, in order to apply a laser treatment in the dental clinical field, various safety and reliability should be secured.
Bacteria ; Lasers, Semiconductor* ; Microscopy, Electron, Scanning ; Peri-Implantitis* ; Sterilization* ; Titanium

OBJECTIVE: To determine the relation between the latency and duration of the cutaneous silent period (CuSP) and ultrasonographic findings of patients with carpal tunnel syndrome (CTS). METHOD: Subjects included 50 hands of 33 patients with CTS with electrophysiologic evidence of CTS and 50 hands of 39 adults with no evidence of CTS. CuSP was measured on abductor pollicis brevis (APB) and adductor digiti minimi (ADM) by stimulation of digit 3. All subjects were examined with ultrasonography (US). Using US, the cross-sectional area (CSA) and flattening ratio (FR) of the median nerve were calculated under carpal tunnel. Analysis of differences between the control group and the CTS group was performed using ANOVA. RESULTS: Differences of CSA, FR, latency, and duration of CuSP in both APB, ADM muscles were observed between the two groups. Correlations were observed in the patient group in latency and duration of the APB muscle and only in duration of the ADM (p=0.048, r=0.159; p=0.035, r=-0.315; p=0.039, r=-0.293) muscle. Correlations were found only in duration of ADM (p=0.011, r=0.358) in the control group with respect to CSA. However, there was no correlation with FR. CONCLUSION: There seems to be a significant correlation between the CSA of the median nerve and the latency and duration of CuSP in patients with CTS. In addition, there seems to be a significant difference of CSA, FR, and latency in both APB and ADM between the two groups. CuSP and CSA might be useful for study that reflects intact small fibers in patients with CTS.
Adult ; Carpal Tunnel Syndrome ; Electromyography ; Hand ; Humans ; Median Nerve ; Muscles

The present study aims to evaluate the effect of a metallic magnetostrictive ultrasonic scaler tip on titanium surfaces. Eighteen identical disks were investigated, 12 (1-untreated and 3-treated group) for surface roughness and 6 for weight change. The power settings of the conventional insert were fixed as high, medium, and low in the blue zone. Surface topography analysis was conducted via scanning electron microscopy (SEM). Furthermore, surface roughness measurements of treated and untreated surfaces were compared using a profilometer. The profilometer showed different roughness findings depending on the applied power. SEM results showed that the damaged height was more pronounced from low to high power. Additionally, the weight change of the titanium was affected by the power setting. Therefore, the power setting must be carefully selected when using this scaler in clinical practice. Moreover, an in vitro study must be conducted under various clinical conditions in the future.

The present study aims to evaluate the effect of a metallic magnetostrictive ultrasonic scaler tip on titanium surfaces. Eighteen identical disks were investigated, 12 (1-untreated and 3-treated group) for surface roughness and 6 for weight change. The power settings of the conventional insert were fixed as high, medium, and low in the blue zone. Surface topography analysis was conducted via scanning electron microscopy (SEM). Furthermore, surface roughness measurements of treated and untreated surfaces were compared using a profilometer. The profilometer showed different roughness findings depending on the applied power. SEM results showed that the damaged height was more pronounced from low to high power. Additionally, the weight change of the titanium was affected by the power setting. Therefore, the power setting must be carefully selected when using this scaler in clinical practice. Moreover, an in vitro study must be conducted under various clinical conditions in the future.

The present study aims to evaluate the effect of a metallic magnetostrictive ultrasonic scaler tip on titanium surfaces. Eighteen identical disks were investigated, 12 (1-untreated and 3-treated group) for surface roughness and 6 for weight change. The power settings of the conventional insert were fixed as high, medium, and low in the blue zone. Surface topography analysis was conducted via scanning electron microscopy (SEM). Furthermore, surface roughness measurements of treated and untreated surfaces were compared using a profilometer. The profilometer showed different roughness findings depending on the applied power. SEM results showed that the damaged height was more pronounced from low to high power. Additionally, the weight change of the titanium was affected by the power setting. Therefore, the power setting must be carefully selected when using this scaler in clinical practice. Moreover, an in vitro study must be conducted under various clinical conditions in the future.