Pyoderma gangrenosum in a battered child

Pyoderma gangrenosum is an uncommon cutaneous ulceration, which continues to be a difficult disorder to diagnose and treat. A pediatric case of pyoderma gangrenosum with no associated systemic disorder is presented. The disease was precipitated by physical trauma. The disease was controlled with systemic corticosteroid therapy and then the wound was successfully covered with a split-thickness skin graft from the thigh without any healing problem at the donor site. Although pathergy is well described in the etiopathogenesis of the disease, this is the first case reported that was precipitated after physical assault.     

Infrared tympanic thermometer can accurately measure the body temperature in children in an emergency room setting

OBJECTIVE: The objective in this study was to compare the accuracy of the tympanic membrane infrared thermometer with the other conventional temperature measurement options. METHODS: One hundred and ten randomly selected pediatric patients who admitted to our emergency room were included in the study. Each child underwent simultaneous temperature measurement via rectum, axilla, and external auditory canal. The rectal and axillary measurements were performed using conventional mercury in glass thermometers. The aural measurement was performed using the non-contact infrared thermometer (Braun ThermoScan IRT 1020, Germany). RESULTS: On aural measurement, the results of both ears as well as the first, second and third measurements were similar (P<0.01). The mean results of the axillary, rectal and tympanic temperature measurements were 37.46+/-1, 38.18+/-1, and 38.01+/-1.1, respectively. The mean axillary temperature was 0.72 degrees C lower than the mean rectal temperature, and 0.55 degrees C lower than the tympanic temperature. The difference between the mean tympanic and rectal temperatures was 0.17 degrees C. The results of measurements via rectum, axilla and ear were similar (P<0.01). CONCLUSION: In conclusion, it is apparent that each of the temperature measurement options has some advantages and disadvantages. An optimal thermometer should have the following features; accurate temperature measurement; ease of application in a short while; safety and absence of potential risks; and tolerability by the patient. Since the aural infrared thermometer meets these criteria, its use in the routine clinical practice appears to be advantageous rather than or complementary to the conventional methods.     

Parachute Tricuspid Valve in a Patient with Atrial Septal Defect Detected by Two‐ and Three‐Dimensional Echocardiography

Atrioventricular valve parachute deformity was generally seen in the mitral position, which is called parachute mitral valve. Parachute deformity is also seen in the tricuspid position, but this has rarely been reported as sporadic cases. All of these cases were associated with other congenital defects, such as double outlet right ventricle, left to right shunt. We herein present two‐ and three‐dimensional echocardiographic features of a parachute tricuspid valve in a patient with atrial septal defect and prominent eustachian valve.     

Does abutment preparation affect abutment screw joint stability? An in vitro study

Statement of problemWhether preparation of an implant abutment decreases the stability of the abutment screw joint is unclear.PurposeThe purpose of this in vitro study was to evaluate the effect of the abutment preparation in laboratory conditions on the reverse torque value (RTV) of the abutment screw.Material and methodsSixty implants, implant analogs, and abutments obtained from 2 different manufacturers were used in the present study and divided into 2 groups (groups B and N) according to the manufacturer. Each group was then divided into 3 subgroups (n=10) according to the remaining wall thickness (control, 0.4 mm, 0.6 mm). All abutments were tightened to analogs with 15 Ncm, and standardized preparation was made with a custom-designed copy-milling system. All abutments were tightened to the implants with 30 Ncm, and then, the abutment screws were removed and RTVs were recorded. Subgroups were analyzed by using 1-way ANOVA (α=.05), and the independent-sample t test was used to compare groups. Relationships between categorical variables were analyzed by chi-square tests. One abutment screw from each subgroup was randomly selected and analyzed by using a scanning electron microscope.ResultsA statistically significant difference was found between RTVs of different manufacturers (group B=28.2 ±1.2 Ncm, group N=25.9 ±1.4 Ncm; P<.005). In group N, there was a significant difference among subgroups, control (26.7 ±1.4 Ncm), and 0.6-mm wall thickness (24.8 ±0.8 Ncm) (P<.05). A statistically significant relationship was found between preparation and RTV for the NucleOSS only (P<.05) and between manufacturer and RTV (P<.001). Scanning electron microscopy evaluations identified different screw head and thread designs.ConclusionsThe abutment screw joint stability of the BioHorizons implant was not affected by abutment preparation.     

RECONSTRUCTION OF MICROFORM CLEFT LIP

Partial cleft of the orbicularis oris muscle without skin and mucosa can also be called "discontinuity of the orbicularis oris muscle" or "subepithelial cleft". Microform cleft lip or mini-cleft lip are better definitions. We present two women aged 25 and 29 years old who complained of vermilion notching, vertical depression on the upper lip, and asymmetry of lower lateral cartilage of the nose. The "discontinuity of the muscle" was found at operation in both cases and reconstructed successfully.