Although several methods including composite resin restoration and microabrasion have been used for management of white spot lesion, tooth jewelry can be considered as another noninvasive option. This case report describes the management of white spot lesions by using tooth jewelry. This report also highlights the patients' preference for tooth jewelry as an esthetic concern.
Dental Caries ; Humans ; Jewelry ; Tooth

Trichloroethylene (TCE) is currently used as a degreasing agent in the jewelry manufacturing industry. The characteristic sign arising after the exposure of TCE are hepatitis and contact dermatitis. The incidence of toxicity is relatively rare, therefore, the mechanism of occurrence is considered as hypersensitivity. A previously healthy 21-year-old male began to work at jewelry industry. The solvent used in that place was TCE. Over the next month, he experienced symptoms of weakness, fever, dry skin, red rash and bumps, peeling face, and jaundice. At that time, he had marked liver enzyme elevation with evidence of cholestasis. After two weeks of avoidance of TCE exposure, his liver enzymes showed a marked reduction in ALT from a peak of 1132 to 131 IU/L. The total bilirubin reduced from 9.3 to 4.6 mg/dL. Tests for hepatitis A, B, and C, CMV, HIV were all negative. The patch test showed primary irritant reaction to TCE and its metabolite, trichloroethanol. This is the second report of TCE induced hepatotoxicity in Korea. We consider this case as a TCE induced hepatotoxicity due to possibly hypersensitivity mechanism.
Bilirubin ; Cholestasis ; Dermatitis, Contact ; Exanthema ; Fever ; Hepatitis A ; Hepatitis* ; HIV ; Humans ; Hypersensitivity ; Incidence ; Jaundice ; Jewelry ; Korea ; Liver ; Male ; Occupational Exposure* ; Patch Tests ; Skin ; Trichloroethylene ; Young Adult

BACKGROUND: Occupational exposure to crystalline silica is a potential risk factor for various systemic autoimmune diseases including systemic sclerosis. The etiology of systemic sclerosis is not conclusively known, but there are epidemiological studies that show the relationship between exposure to crystalline silica and risk of systemic sclerosis. Here we report, for the first time, two cases of crystalline silica-related systemic sclerosis in patients who worked in crystal processing in the jewelry-manufacturing field. CASE PRESENTATION: Case 1 is a 57-year-old man who had worked mainly in crystal processing for multiple jewelry-processing companies for 17 years, since the age of 15 years. He contracted tuberculosis at the age of 25 years and showed Raynaud's phenomenon of both the hands and feet at age 32 years. Digital cyanosis and sclerosis developed at approximately age 41 years. The patient was diagnosed with systemic sclerosis at age 48 years. Case 2 is a 52-year-old man who worked in crystal processing for various jewelry-processing companies for 7 years, since the age of 23 years. He first showed signs of cyanosis in the third and fourth digits of both hands at age 32 years, was diagnosed with Raynaud's syndrome at age 37 years, and was diagnosed with systemic sclerosis at age 38 years. Crystal processing is a detailed process that involves slabbing and trimming the selected amethyst and quartz crystals, which requires close proximity of the worker's face with the target area. In the 1980s and 1990s, the working hours were 12 h per day, and the working environment involved 15 workers crowded into a small, 70-m2 space with poor ventilation. CONCLUSION: Two workers who processed crystals with a maximum crystalline silica content of 56.66% developed systemic sclerosis. Considering the epidemiological and experimental evidence, exposure to crystalline silica dust was an important risk factor for systemic sclerosis. An active intervention is necessary to reduce exposure in similar exposure groups in the field of jewelry processing.
Autoimmune Diseases ; Crystallins* ; Cyanosis ; Dust ; Epidemiologic Studies ; Foot ; Hand ; Humans ; Jewelry* ; Korea* ; Middle Aged ; Occupational Exposure ; Quartz ; Risk Factors ; Scleroderma, Systemic* ; Sclerosis ; Silicon Dioxide* ; Tuberculosis ; Ventilation

AIMIt is our opinion that the CDC and the WHO have underestimated cross-contamination under examination gloves in dental clinics while wearing jewelry, such as finger rings. These agencies only "recommend" removing jewelry, and only washing hands for 15 seconds with soap and warm water before donning gloves. This study examined several washing procedures and finger rings using simulated microbes.

METHODOLOGYA gloved rubber hand manikin was made and fitted with a fresh disposable vinyl glove. Four fingers were fitted with rings or no ring, dusted with simulated microbes, and washed with a scrub brush for 5, 15, and 25 seconds under 20 degrees C and 40 degrees C water alone, or with liquid hand soap. Light levels (in lux) of fluorescent powder before and after washing were measured and delta scores calculated for changes in light levels, equivalent to effectiveness of hand washing procedures. A full-factorial, 3-factor analysis of variance (ANOVA) was used to test for differences among levels of the three study factors-time, temperature, and soap use. Tukey's post hoc honestly significant difference (HSD) test was applied to significant factors to examine pair-wise differences between factor levels.

RESULTSIt was found that the longer the hands with rings were washed with a scrub brush under flowing water, the more simulated microbes were removed. By 25 seconds, all methods were essentially the same. Simulated microbes were more difficult to remove from the palm compared to the back of the hand. The liquid hand soap used in this study was more effective with warm water than cold. When given a choice of washing with cold water up to 15 seconds, it would be preferable not to use soap to remove simulated microbes. Qualitatively, the outer surface of finger rings were more effectively cleaned than the crevice below the ring, and the ring with a stone setting appeared to accumulate and retain simulated microbes more than other rings.

CONCLUSIONThe most effective treatment was washing with warm water and liquid soap. Longer times were more effective. Rings should not be worn under examination gloves due to difficulty cleaning in the crevice under the ring, and the well-known consequences of cross-contamination between the patient and the health care worker.

Colony Count, Microbial ; Fingers ; microbiology ; Fluorescent Dyes ; Hand ; anatomy & histology ; microbiology ; Hand Disinfection ; methods ; Humans ; Jewelry ; microbiology ; Manikins ; Soaps ; therapeutic use ; Temperature ; Time Factors ; Water

Objective: To explore the treatment of penile incarceration with a metal ring. METHODS: Based on our experience in the successful management of a case of penile incarceration with a metal ring by coiling and bloodletting from the corpus cavernosum, we reviewed the relevant literature and analyzed the indications, advantages and disadvantages of different methods for the treatment of penile incarceration with a circular foreign body. RESULTS: The clamping and cutting methods were non-invasive, fast, effective, and with few complications, which could be applied to the treatment of penile strangulation at all levels. However, clamping was not desirable enough for a hard metal ring and the cutting method took a longer time and might increase the risk of unnecessary damage to the penile skin, urethra and cavernous body. Prepuce edema decompression and the thin tube-coiling method, with the advantages of minimal invasiveness, simple operation and no need of special tools, were suitable for penile strangulation injury under level 3, but might cause penile skin injury and potential postoperative erectile dysfunction. Surgical resection, as an invasive procedure, could be applied to severe penile strangulation at level 4 or 5. CONCLUSIONS The principle for the treatment of penile incarceration with a circular foreign body is to remove the foreign object as soon as possible and not to add secondary damage.
Bloodletting ; methods ; Constriction, Pathologic ; therapy ; Erectile Dysfunction ; prevention & control ; Foreign Bodies ; complications ; therapy ; Humans ; Jewelry ; adverse effects ; Male ; Penis ; blood supply ; injuries ; pathology ; Postoperative Complications ; prevention & control ; Urethra

BACKGROUND: Although lead neurotoxicity is a known phenomenon, it can often be missed at a primary or secondary care level especially if detailed environmental exposure history is missed. METHODS: This is an outbreak investigation where we observed 15 pediatric cases with neurologic signs and symptoms clustered in a slum area known for an unorganized artificial jewelry industry. Their clinical, biochemical, and epidemiological features were compared with 14 other children from the same region reporting with non-neurological symptoms who were considered as unmatched controls. RESULTS: Cases with neurological manifestations had a higher in-house lead smelting activity [OR 7.2 (95% CI 1.4-38.3)] as compared to controls. Toddlers below 3 years of age were more vulnerable to the effects of lead. CONCLUSION This study emphasizes that many focal sources of lead poisoning still remain especially in the unorganized sector. In cases presenting with unexplained neurotoxicity, specific occupational and environmental inquiry for chemical poisoning, with special consideration for lead, should be actively pursued.
Adolescent ; Air Pollution, Indoor ; adverse effects ; Case-Control Studies ; Child ; Child, Preschool ; Disease Outbreaks ; Female ; Humans ; India ; epidemiology ; Infant ; Inhalation Exposure ; adverse effects ; Jewelry ; poisoning ; Lead ; blood ; standards ; Lead Poisoning ; epidemiology ; pathology ; physiopathology ; Male ; Metallurgy ; Neurotoxicity Syndromes ; epidemiology ; pathology ; physiopathology ; Poverty Areas ; Risk Factors