Radiographic Features of Facial Cosmetic Material: Report of Two Cases

Recently, the use of noninvasive facial cosmetic procedures has been widely disseminated. In the face, cosmetic fillers, threads, and implants are used to reduce or delay the effects of aging or adjust facial defects caused by trauma or disease. The dentist or dental specialist may encounter these materials in the radiographic images of their patients. There are few reports in the dental literature describing the radiographic appearance of some materials along with the diseases they mimic. As the procedures and materials advance and evolve, dentists and dental specialists must be aware of their radiographic appearance to avoid errors in diagnosis. This is a report of two cases that include panoramic radiography and CBCT scan. Among these cases, there is an unusual appearance of a cosmetic filler due to a subperiosteal injection method. Moreover, it will discuss common types of cosmetic materials used in the face and their imaginological appearance. This is the key to dentists and dental specialists due to increasing use of facial cosmetic materials and a parallel increase in the use of cone beam CT and chances to encounter such findings.

Perianal Inflammation or Something More?

Perianal fistulae are commonly complicated by abscesses and ramifications, which have well-recognized imaging morphology. Less commonly, atypical findings of solid enhancing mass-like lesions with no fluid component are associated with chronic and recurrent fistulae, the etiology of which includes inflammatory masses as well as locally aggressive malignancy. The latter predicts poorer prognosis and warrants extensive surgical resection. The reading radiologist must identify the unusual appearance, be aware of the possible etiologies, and if appropriate recommend prompt tissue sampling to exclude malignancy. This is pertinent as it determines surgical management, which is crucial in achieving a potential curative outcome.

Gastroschisis or exomphalos? An unusual abdominal defect

A baby with an antenatal diagnosis of exomphalos was born at term. The abnormality had a highly unusual appearance, a right-sided paraumbilical defect, similar to gastroschisis, but with a sac typical of exomphalos containing both abdominal contents and over 1 L of serosanguinous fluid. The sac was drained and suspended from the top of the incubator in silo fashion. Definitive closure was achieved at day 3 of life, and the patient had a non-eventful recovery. Despite exomphalos and gastroschisis normally being discrete entities, ambiguity in the presentation this case necessitated a composite management approach.

Clinical Diagnosis and Treatment Management of Normal Pressure Hydrocephalus

Inadequate absorption of cerebrospinal fluid (CSF) at the arachnoid granulation level during circulation results in an increase in CSF in the ventricle and certain neuropsychiatric clinical findings. This syndrome, which often presents with ventricular dilatation, progressive cognitive decline, walking difficulties, and urinary incontinence symptoms in elderly individuals, is called Normal Pressure Hydrocephalus (NPH). It is projected that as people’s quality of life improves and their life expectancy rises, more old people would develop this condition. Although a clear clinical triad has been defined, the identification of patients with NPH and the application of effective treatment modalities still pose a number of challenges for neurosurgeons today. However, despite all these difficulties, if diagnosed and treated early, the unusual appearance of these symptoms affecting elderly individuals can be prevented and significant improvements in quality of life can be achieved.

Children as Mischievous Spirits: Legitimizing Violence and Filicide in Contemporary Africa

The belief that certain humans are spiritual entities and the belief that some people are spiritually possessed can be found across histories and cultures. While these individuals are not always viewed in the negative or treated inhumanely, cases abound whereby degrading and inhumane treatments are meted out to some of them. In the African continent, certain groups of people, particularly children are linked to certain mischievous spirits due to their unusual appearance, aberrant behavior, disability, chronic illness, psychopathology or exceptional ability. Some are also suspected and consequently mistreated due to events surrounding their birth. Such children are known by different names in different parts of Africa. In this article, three groups of children (ogbanje, abiku and spirit children) considered as partly spirits and one group (child witch) considered as spiritually possessed, were explored. Each of these groups was described based on the traditional lore of the particular society where they are so labeled. The abuses, neglect and in some cases homicide against the children connected to the belief, were critically discussed. The article explored how the children are abused, neglected or killed due to the genuine belief that they pose a spiritual threat to their parents or carers and in some cases, the entire community. However, the article also provided insights into how such belief also serves as justification for parents with children present with any of the aforementioned characteristics to eliminate such a child through filicide for altruistic purposes. The article also explored how some parents and guardians exploit the belief to eliminate children seen as a burden. The cases of adult relatives who exploit the belief to eliminate orphans in their care for the purposes of inheriting properties belonging to the orphans’ parents were also explored. Recommendations were made on how to address these social problems.

The Obverse/Reverse Pavilion: An Example of a Form-Finding Design of Temporary, Low-Cost, and Eco-Friendly Structure

Temporary pavilions play an important role as experimental fields for architects, designers, and engineers, in addition to providing exhibition spaces. Novel structural and formal solutions applied in pavilions also can give them an unusual appearance that attracts the eyesight of spectators. In this article, the authors explore the possibility of combining structural novelty, visual attractiveness, and low cost in the design and construction of a temporary pavilion. For that purpose, an innovative structural system and design approach was applied, i.e., a membrane structure was designed in Rhino and Grasshopper environments with the use of the Kiwi!3D IsoGeometric analysis tool. The designed pavilion, named Obverse/Reverse, was built in Opole, Poland, for the occasion of World Architecture Day in July 2019. The design and the construction were performed by the authors in cooperation with students belonging to the Humanization of Urban Environment organization from the Faculty of Architecture Wroclaw University of Science and Technology. The resultant pavilion proved the potential of obtaining a low-budget but visually attractive architectural solution with the adaption of parametrical design tools and some scientific background with innovative structural systems.

The Obverse/Reverse Pavilion: An Example of Form-Finding With Isogeometric Analysis in the Design of Temporary, Low-Cost and Eco-Friendly Structure

Temporary pavilions play an important role as experimental fields for architects, designers and engineers, apart from providing exhibition spaces. Novel structural and formal solutions applied in pavilions also can give them unusual appearance that attracts eyesight of spectators. In this article authors explore the possibility of combination of structural novelty, visual attractiveness and low-cost by a design and construction of a temporary pavilion. For that purpose, an innovative structural system and design approach was applied, i.e. membrane structure designed in Rhino and Grasshopper environments with the use of Kiwi!3D IsoGeometric analysis tool. The designed pavilion, named Obverse/Reverse, was built in Opole, Poland, for the occasion of World Architecture Day in July 2019. Design and construction was performed by the authors in cooperation with students’ organisation Humanisation of Urban Environment from the Faculty of Architecture Wroclaw University of Science and Technology. The Rresultant pavilion proved the possibility of obtaining a low-budgets but visually attractive architectural solution with the adaption of parametrical design tools and some scientific background with innovative structural systems.

Unusual cause of gas complicating a biloma, postcholecystectomy

A 50-year-old man presented to the emergency department with abdominal pain, vomiting and fever. He had been admitted 6 months ago with acute cholecystitis when he underwent endoscopic retrograde cholangiopancreatography (ERCP) to remove ductal gallstones. Elective cholecystectomy was performed 3 days prior to the current admission. CT demonstrated a fluid and gas containing collection in the gallbladder fossa, biliary gas and free intra-abdominal gas. ERCP revealed a retained common bile duct gallstone and leakage from the cystic duct remnant. We postulate that the gas within the collection originated from intrahepatic gas post-ERCP or from a gas forming organism. The free intra-abdominal gas originated from the collection rather than an intraoperative bowel injury. This complicated case highlights an unusual appearance of a common complication. It demonstrates the importance of discussion with the clinical team to ensure that an accurate diagnosis is made and the correct treatment is provided.

Itchy Capillary Malformations: Unusual Appearance of Meyerson Phenomenon, a Case Series

Meyerson phenomenon, also known as “halo-eczema,” has been widely described over melanocytic and non-melanocytic lesions. However, its appearance over vascular anomalies is rarely observed and could lead to diagnostic errors. A case study of five patients aged between four months and two years is reported. These patients developed unique erythematous and pruritic scaly patches, being diagnosed and treated as fungal infections. Due to the lack of response to the treatment, they were referred to the pediatric dermatology practice, where the diagnosis of Meyerson phenomenon over capillary malformations was made. Topical treatment with corticosteroids led to improvement in all cases. Although Meyerson phenomenon developing over vascular anomalies is a rare condition, it is important for pediatricians and dermatologists to assess it as a part of the differential diagnosis when treating a patient with skin lesions. Recognizing this phenomenon will prevent diagnostic and therapeutic errors.

125 A Case of Mistaken Identity: An Obsolete Anti-Reflux Device in An Older Patient with Variable Gastrointestinal Symptoms

Background A frail 93-year-old lady presented with delirium and hypoxia, on a background of heart failure, constipation, cerebrovascular disease, and osteoporosis. A CTPA on admission revealed an unusual appearance of the left hypochondrium, leading to subsequent CT abdomen. This unexpectedly reported the presence of a gastric band. We therefore considered a possible misidentification as this procedure seemed unlikely in someone of her age. Her GP records revealed that she underwent surgical insertion of an Angelchik prosthesis in 1984. It transpired that our patient had experienced several longstanding symptoms, including reflux, bloating and constipation, which have all been observed in patients with Angelchik prostheses in situ. Discussion The Angelchik prosthesis is an anti-reflux device for patients with chronic reflux disease with or without hiatus hernia, introduced in 1979. It comprised of an elastomer shell ring filled with silicone gel, that was sited at the lower oesophagus and secured with DACRON tapes. It was initially lauded for its replicable insertion technique and promising early results with around 30,000 being inserted in mainly British and American Hospitals. However, over time it became apparent that a significant proportion of patients reported ongoing gastrointestinal symptoms due to device failure. Serious complications such as gastric perforations were also recognised. Surgical removal was noted to be technically complex, providing further challenges. The Angelchik prosthesis therefore fell from favour after a period of use of only fifteen years, and is now rarely encountered. We discovered that our patient had experienced multiple long-standing gastrointestinal complaints potentially linked to her prosthesis, though this association had not previously been considered. Whilst her frailty meant that removal would not be pragmatic, it is uncertain if this could have been a possible consideration in the past. This device is relevant to geriatricians as many recipients are now elderly, and may report ongoing symptoms.