The Use of Medical Devices for Medical Skin Care and the Legal Issues / 대한피부과학회지

BACKGROUND: Medical skin care is essential for the treatment of skin diseases all over the world. Medical skin care is also part of medical practice and this must be differentiated from the simple skin care that is given for normal healthy skin. OBJECTIVE: We wanted to discuss medical skin care and the related medical devices and legal issues. METHODS: We reviewed the related laws and regulations, we consulted experts and associations and we analyzed the result of the survey. RESULTS: Legally, medical skin care and simple skin care are well classified. However, many illegal procedures are still performed by non-medical personnel and many adverse effects have been reported as a result. Furthermore, there are no legal restrictions for the performer based on the grade of each medical skin care procedure. CONCLUSION: For the best results and safe procedures, medical skin care must be performed by approved medical equipment under the supervision of a physician or medical personnel. Continuous control and guidance by the government is strongly needed.

Case Analysis of Side Effects following Illegal Therapeutic Attempts by Non-medical Personnel / 대한피부과학회지

BACKGROUND: Cases of patients presenting side effects after illegal therapeutic attempts by non-medical personnel have been increasing and the patterns of attempts and related side effects become complicated. OBJECTIVE: To analyze the causes and characteristics of illegal therapeutic attempts and its' side effects performed by non-medical personnel. METHODS: Between April 1, 2008 and April 30, 2008, a total of 120 case reports of patients who developed side effects after illegal therapeutic attempts by non-medical personnel were collected from the members of the Korean dermatological association and analyzed. RESULTS: Clinical diagnoses, suggested to have before receiving illegal therapeutic attempts, revealed that 44 (36.6%) patients presented various pigmentary disorders, such as acquired melanocytic nevi and melasma, 22 (18.3%) wanted to have tattooing for permanent make up, skin aging in 16 (13.3%) cases, and acne in 10 (8.3%). Illegal therapeutic attempts performed included tattooing for permanent make up in 22 (18.3%) cases, peelings 19 (15.8%), laser therapies 18 (15.0%), and filler injection 12 (10.0%). The various clinical diagnoses of the patients with side effects were suggested, such as contact dermatitis in 34 (25.6%) cases, scarring in 33 (24.8%), post-inflammatory hyperpigmentation 20 (15.0%), secondary infection 19 (14.3%), and acne or acneiform eruption 9 (6.8%). CONCLUSION: In this report, we demonstrated patterns of illegal therapeutic attempts by non-medical personnel and its' side effects. We suggest that more effort should be followed by dermatologists to inform patients the risks of the illegal therapeutic attempts by non-medical personnel and to increase public health awareness.

Radiologic Findings of Intraspinal Epidural Arachnoid Cyst

PURPOSE: To evaluate the radiologic findings of intraspinal epidural arachnoid cyst. MATERIALS AND METHODS: Six pateuts with surgically proven intraspinal epidural arachnoid cyst were included in this study. Four were freeof specific past history, but two had a history of trauma. All underwent examination by plain radiography,CT-myelography and MRI, and the following aspects were retrospectively analysed : vertebral pressure erosion,interpedicular distance, enlargement of neural foramina, as seen on plain radiograph, contrast-filling and lateralbulging of lesions through neural foramina on CT-myelograph, and signal intensity, size and shape of margin andepidural fat pattern, as seen on MRI. RESULTS: Three of four congenital intraspinal epidural arachnoid cysts weresingle in the thoracolumbar region, while in the other case, there were multiple cysts in the mid- and lowerthoracic regions. Cysts were equivaleut in size to between four and six vertebral bodies. Plain radiographicfindings of pedicular pressure erosion, widened interpedicular distance, and bilateral neural foraminalenlargement of several contiguous vertebrae were observed in all four cases. One showed posterior vertebralscalloping. On CT-myelograph, a contrast-filled cystic lesion occupying the posterior epidural space, with lateralbulging through neural foramina and anterior displacement of the contrast-filled thecal sac, was seen. On MRI,longitudinally elongated, well-demarcated cysts were seen to be present in the posterior epidural space; theirsignal intensity was the same as in CSF. An epidural fat cap pattern enveloping the upper and lower ends of thecysts was apparent in all cases. In two cases, traumatic intraspinal epidural arachnoid cysts were situated in thethoracolumbar and lumbosacral region, respectively, near a previously injured region and were smaller (equivalentto the height of three vertebral bodies). CT-myelograph and MRI showed that their effect on the thecal sac wascompressive only. CONCLUSION: When pressure erosion of vertebral odies and pedicles of contiguous severalvertebrae in the thoracic or thoracolumbar region is recognized on plain radiograph, intraspinal epiduralarachnoid cyst should be included in differential diagnosis, and for accurate evaluation, CT-myelograph and/or MRIare needed.

D-Squame(R) Disc with Image Analysis in Measuring Skin Dryness Induced by Sodium Lauryl Sulfate / 대한피부과학회지

No abstract available.

Clinical Analysis of Posterior Fossa Tumors

We analyzed the 43 cases of the posterior fossa tumors at the Busan Paik Hospital, Inje Medical College from January 1980 to December 1986. The posterior fossa tumors included 12 cases of cerebellar astrocytoma, 10 cases of acoustic neurinoma, 5 cases of medulloblastoma, 5 cases of brain stem glioma, 2 cases of meningioma, 2 cases of hemangioblastoma, 2 cases of tuberculoma, 1 case of glioblastoma multiforme, 1 case of oliodendroglioma, 1 case of rhabdomyosarcoma, 1 case of glomus jugulare tumor and 1 case of arteriovenous malformation. The posterior fossa tumors were occupied on the cerebellar hemisphere in 18 cases, the cerebellar vermis in 8 cases, the cerebellar pontine angle in 12 cases and the brain stem in 5 cases. The 25 cases out of the 43 cases of the posterior fossa tumors were accompanied with hydrocephalus. The 10 cases received the radiation therapy and/or the chemotherapy after operation. After treatment of the posterior fossa tumors, 52.6% favorable outcome, 34.2% unfavorable outcome and 13.2% mortality were estimated.

Two Stage Operation for Large Cerebral Arteriovenous Malformation

This report describes three cases of large arteriovenous malformation which were removed totally with two stage operation. When a large arteriovenous malformtaion had to be removed, prediction of profuse bleeding and brain swelling could be made. We clipped large feeding arteries and arteires and made a cleft around the AVM during the first operation, and the progressive reduction of the shunt flow by clipping the dominant peduncles on after the other diminished the risk of profuse bleeding and brain swelling. 7 to 10 days later, we removed AVM totally as the second operation. All three lesions were resected by microsurgical techniques, and the results were excellent. The rationale for the two stage operation for large cerebral AVM is discussed.

Intracranial Aneurysms in Identical Twins: Case Report

Intracranial aneurysms are usually regarded as congenital in origin but their etiology is unknown. The occurrence of familial aggregation of intracranial aneurysm is rare but well documented, and suggests a hereditary basis for some intracranial aneurysms. We experienced two cases of intracranial aneurysm in monozygotic twin brothers and reviewed literatures.

Clinical Analysis of Surgical Timing for Ruptured Intracranial Aneurysm

To evaluate the risk of definitive intracranial microsurgical aneurysm obliteration as a function of the timing of the operative intervention, we retrospectively reviewed 167 consecutive patients in the department of Neurosurgery of Busan Paik's Hospital, Inje medical college, from January 1980 to December 1983. The patients who were operated upon within the first 3 days of their most recent subarachnoid hemorrhage formed the early group;the patients operated upon after the 3 days were considered to have undergone the late surgery. On the base of their clinical outcome the patients were allocated to one of five outcome categories(excellent, good, fair, poor, death) both at the time of their hospital discharge and at their most recent clinical revaluation. The 83% favorable outcome estimated from early operation and 72% from late operation. The mortality was estimated 5% from early operation and estimated 11% from late operation. The optimal timing of surgery for ruptured intracranial aneurysms is currently unknown, but early operation is an effective and reliable method to reduce the occurrence of rebleeding, vasospasm, ischemic complication and medical complication etc. Recently, there has been a resurgence of interest in early operation and increasing numbers of surgeons have been adopting this modality, but prompt, accuate diagnosis and early referral to specialized centers is the only way in which significant advances in reducing the overall morbidity and mortality for majority of patients can be achieved.

A Case of Atlanto-axial Dislocation due to Os Odontoideum

A patient who had an atlanto-axial dislocation due to an os odontoideum is presented. She was operated on successfully with preliminary realignment of the dislocation by skeletal traction and subsequent posterior cervical fusion with wiring and iliac bone.

STA-MCA Anastomosis with Gradual Ligation of ICA in the Management of Aneurysm, Cavernous Portion

An aneurysm in the intracavernous portion was treated with EIAB and gradual ligation of ICA. Carotid ligation historically has been successful in controlling the mass effects from an aneurysm and in minimizing the risk of an acute, recurrent SAH. However, ICA ligation alone carries a higher risk, esp, ischemic complication. In an attempt to minimize these ischemic complications, EIAB procedure was added to the ICA ligation for the treatment of inoperable or inaccessible aneurysm.

Metastatic Spinal Cord Tumors: Originating from Thyroid

We have reported very rare two cases of motastatic spinal cord tumor originating from the thyroid. First case is obtained the best results as early diagnosis and surgical treatment were employed. Second case the least favorable results were obtained in case with rapid progression of neurological feature and multiple involvement at spinal cord and brain. The early diagnosis and treatment often prevent patients from becoming paraplegic. This paper is concerned with the discription of the clinical feature of spinal cord compression by malignant tumors and results of treatment.

A Case of Leptomyelolipoma

The case of 8 year old boy is presented, in whom huge mass on the lumbosacral region from birth and mild motor weakness of left leg with urinary incontinence. The operative using surgical microscope and pathological findings are discussed and reviewed of literature and a nosological classification of leptomyelolipoma given. The treatment underwent surgical microscope with good result. The importance of the surgical microscope is stressed.

3 Cases of Surgically Treated Arteriovenous Malformations of the Brain

Arteriovenous malformation of the brain is a congenital abnormal communication between arterial and venous channels without the interposition of the capillary system and it not infrequently cause severe intracranial hemorrhage and neurological deficits. The authors are reporting three cases of cerebral arteriovenous malformations which underwent surgical treatment using the operating microscope under mannitolization without hypotensive anesthesia.