Clinical problems of computer-guided implant surgery.

BACKGROUND: The utilization of a cone-beam computed tomography (CT)-assisted surgical template allows for predictable results because implant placement plans can be performed in the actual surgery. In order to assess the accuracy of the CT-guided surgery, angular errors and shoulder/apex distance errors were evaluated by data fusion from before and after the placement. METHODS: Computer-guided implant surgery was performed in five patients with 19 implants. In order to analyze differences of the implant fixture body between preoperative planned implant and postoperative placed implant, angular error and distance errors were evaluated. RESULTS: The mean angular errors between the preoperative planned and postoperative placed implant was 3.84° ± 1.49°; the mean distance errors between the planned and placed implants were 0.45 ± 0.48 mm horizontally and 0.63 ± 0.51 mm vertically at the implant neck and 0.70 ± 0.63 mm horizontally and 0.64 ± 0.57 mm vertically at the implant apex for all 19 implants. CONCLUSIONS: It is important to be able to utilize these methods in actual clinical settings by improving the various problems, including the considerations of patient mouth opening limitations, surgical guide preparation, and fixation.

Topical application of a cleanser containing extracts of Diospyros kaki folium, Polygonum cuspidatum and Castanea crenata var. dulcis reduces skin oil content and pore size in human skin.

The effects of skin pores on skin topographic features can be reduced by decreasing excessive production and accumulation of sebum and elimination of comedones. Therefore, a cosmetic cleanser that regulates sebum homeostasis is required. In the present study, the effects of a cosmetic cleanser that contained Diospyros kaki folium, Polygonum cuspidatum and Castanea crenata var. dulcis (DPC) was examined on the removal of sebum and on skin pore size. Healthy volunteers (n=23) aged 20-50 years were asked to apply the test materials to the face. Skin oil content, pore size, pore number and extracted sebum surface area were measured using various measurement methods. All the measurements were performed at pre- and post-application of the test materials. When the cosmetic cleanser containing DPC was applied to the skin, the oil content decreased by 77.3%, from 6.19 to 1.40. The number of skin pores decreased by 24.83%, from 125.39 to 94.23. Skin pore size decreased from 0.07 to 0.02 µm3 (71.43% decrease). The amount of extracted sebum increased by 335% when the DPC cleanser was used. Compared to the control cleanser, skin oil content was significantly decreased when the cleanser that contained DPC was used. The cleanser containing DPC also decreased pore size and number. Finally, the DPC cleanser easily removed solidified sebum from the skin.

Autoamputation of a giant colonic lipoma.

Most colonic lipomas are asymptomatic and need no treatment, whereas lesions larger than 2 cm can cause acute abdominal pain, changes in bowel habits, gastrointestinal bleeding, intussusception or bowel obstruction. Autoamputation of polypoid lesions in the gastrointestinal tract is indeed a rare phenomenon, and its precise mechanism remains unknown. It presumably occurs due to ischemic necrosis of the polyp by peristalsis-induced torsion or tension. Here, we report a case of autoamputation of a giant colonic lipoma in a 48-year-old man. In our case, colonoscopic examination showed a huge autoamputated mass in the rectum and a remnant long stalk in the transverse colon. The autoamputated mass in the rectum was completely removed after fragmentation using an electrosurgical snare, and the remnant long stalk located in the transverse colon was also resected safely by endoscopic snare polypectomy. To our knowledge, these endoscopic treatments for removal of an autoamputated mass and a remnant long stalk of colonic lipoma have not been reported previously.

[A case of large retroperitoneal lipoma mimicking liposarcoma].

Lipomas are the most common benign tumors of adipose tissue among adults. Lipomas can occur almost anywhere in the trunk, extremities, mediastinum, and pelvis, but retroperitoneal lipomas are extremely rare. It should be distinguished from well differentiated liposarcoma in order to provide the appropriate treatment and follow up. We experienced a case of 60-year-old patient with large retroperitoneal lipoma mimicking liposarcoma causing palpable abdominal mass and pain. Abdominal computerized tomography (CT) showed 33 x 22 cm sized bulky fat-containing mass with contrast enhanced solid portion in right retroperitoneum. Positron emission tomograpgy (PET) revealed increased 18F-FDG uptake at solid portion shown in abdominal CT. Imaging studies confirmed a high index of suspicion on liposarcoma. Laparotomy showed a large encapsulating tumor arising from retroperitoneum with fat necrosis. Pathologic examination of resected specimen revealed normal mature adipocytes without atypical cells, compatible with lipoma.