• Journal of the Korean Orthopaedic Association
• /
• v.55 no.3
• /
• pp.193-199
• /
• 2020

A gamma nail has been used to treat intertrochanteric fractures since 1988. Although such cephalomedullary nails have mechanical advantages over extramedullary fixation devices, such as sliding hip screw, their beneficial effects on treating the Arbeitsgemeinschaft für Osteosynthesefragen/Orthopaedic Trauma Association (AO/OTA) 31-A1 and 31-A2 fractures are still controversial. During their 30-year history, many problems have been overcome, and new types of cephalomedullary nails have been introduced in clinical practice. New cephalomedullary nail systems facilitate nailing procedures and enhance the purchase capability of the femoral head by a lag screw. On the other hand, the failure rate still depends on the hands of the orthopedic surgeons. This review article focused on the basic principle of medial support and restoration of a medial buttress during the treatment of trochanteric fractures using a cephalomedullary nail.

• Archives of Plastic Surgery
• /
• v.35 no.3
• /
• pp.312-315
• /
• 2008

Purpose: Amelanotic melanoma represents a melanoma with an absence or a small number of melanin pigments and comprises 2% of all melanomas. These melanomas are frequently misdiagnosed, probably because of its nonspecific clinical features and difficulty in diagnosis, resulting in delayed diagnosis and treatment. We report a patient with amelanotic melanoma, who underwent surgical treatment with sentinel lymph node biopsy using gamma probe. Methods: A 32-year-old female was presented with a slowly growing ill-defined, hypopigmented nonerythematous lesion with nail defect on right index finger tip. Preoperative punch biopsy was performed, showing an amelanotic melanoma. Sentinel lymph node biopsy was done using gamma probe(Crystal probe system, CRYSTAL PHOTONICS GmbH, Germany) and confirmed no evidence of regional lymph node metastases. The patient underwent amputation at the proximal interphalangeal joint. Results: Histopathologic findings showed superficial spreading melanoma. There were no melanin pigments in Hematoxylin & Eosin stain but positive immunohistochemical stainings for S-100 protein and Hmb45, which were consistent with amelanotic melanoma. Patient's postoperative course was uneventful without any complication and had no evidence of recurrence of tumor in 6 months follow-up period. Conclusion: Amelanotic melanoma is extremely rare subtype of malignant melanoma with histopathologic findings of atypical melanocytes without melanin pigments. Early detection is crucial since survival is strongly related to tumor thickness and tissue invasion at the time of diagnosis. Wide excision is the treatment of choice and other conjunctive therapy has not been successful.

• Restorative Dentistry and Endodontics
• /
• v.26 no.5
• /
• pp.372-378
• /
• 2001

The aim of this in vitro study was to analyze the composition of human tooth enamel in terms of three components, Ca, P, and F after demineralization and remineralization in acid buffer solution. A total of 8 human premolars without any defects and cracks were selected and buccal and lingual sides of the teeth were cleaned with an ultrasonic device and pumice without fluoride 5$\times$5mm windows were opened, and other areas were completely covered with 3-coats of nail varnish to prevent from being in contact with demineralized and remineralized solutions. After demineralization process, each tooth was sectioned into two slices, highly polished one of them with$\gamma$-alumina, and then analyzed the composition of the demineralized tooth with EPMA(electron probe micro-analyzer). The other slices were put into the remineralized solution for 10 days, polished, and analyzed in the same manner. These data were statistically analyzed with one sample t-test(p<0.05). The results were as follows. 1. Normal tooth enamel consists of 49.76% Ca, 39.80% P, and 0.28% F. 2. After demineralization, percentage of Ca and P ratio were decreased by about 5.57 and 5.07% respectively. Percentage of F ratio was also decreased by about 0.01%, which was not statistically significant. 3. After remineralization, percentage of Ca, P increased about by 4.47 and 4.35% respectively Percentage of F decreased by about 0.01%, which was not statistically significant. In conclusion, remineralized solution used in our study has the potential to induce the uptake the Ca and P into the pore sites of the demineralized enamel. But, in the oral cavity. there were rapid temperature change, organic matrix that inhibits the movement of the ions, and limitation of continuous contact with this remineralized solution. Therefore, further in vivo study is necessary.