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PubMedDate not supplied

[Amalgam tattooing. Report of a case].

The authors describe a case of amalgam tatooing which was referred to their attention. Based on a careful revision of the literature on this pathology they describe the clinical aspects, localisation and etiopathogenesis, focusing in particular on the importance of histological analysis, the only means of distinguishing amalgam tatooing from a highly aggressive lesion such as melanoma.

Adult↗
PubMed1998

Comparison of two methods for anterior-posterior isocenter localization in pelvic radiotherapy using electronic portal imaging.

PURPOSE: The two setup methods commonly used to determine the anterior-posterior isocenter location in pelvic radiotherapy are to align lateral localization lasers with lateral skin tattoos on the patient, or to set the couch height so that the isocenter is at a fixed height (determined during simulation or treatment planning) above the couch top. This study was implemented to determine which technique gives more accurate patient treatment by comparison of the anterior-posterior setup variation measured with electronic portal imaging. METHODS AND MATERIALS: Eleven supine prostate patients were treated with tattoo localization and 159 left-lateral portal images were taken during the treatments. The field displacements were then determined by template matching. These patients were compared to nine patients (205 images) set up to a fixed isocenter height. Similarly, eight prone rectal patients (136 right-lateral images) set up to tattoos were compared to six patients (108 images) set up to a fixed height. The patients were not immobilized and were all treated with three field techniques on a hard couch top. The overall mean treatment position deviation and the standard deviation of the displacements (total setup variation) were calculated for each patient group along with the systematic (simulator-to-treatment) and the random (treatment-to-treatment) setup variation. RESULTS: The mean treatment position deviations were 3.3 mm anterior and 5.2 mm posterior with the tattoo method for the prostate and rectal patients, respectively. These mean position deviations were 0.4/0.1 mm anterior with the fixed height technique. The total setup variations were 4.6/5.2 mm (1 SD) with tattoo localization and 1.7/1.5 mm (1 SD) with the fixed height method. Similarly, random variation was 2.3/3.3 mm (1 SD) with the tattoo method compared to 1.3/1.2 mm (1 SD) with the fixed height method. Systematic variation was 3.7/4.5 mm (1 SD) compared to 1.2/1.1 mm (1 SD). CONCLUSION: The fixed height technique gives much more accurate localization of the anterior-posterior isocenter in pelvic radiotherapy than lateral skin tattoos.

Humans↗
PubMed2005

Use of a subepithelial connective tissue graft to treat an area pigmented with graphite.

BACKGROUND: Pigmentations of the oral cavity are commonly noted in clinical practice and may have physiologic, non-physiologic, or pathologic etiologies. The most common non-physiologic localized pigmentation is the amalgam tattoo; another, less common, non-physiologic pigmentation is the graphite tattoo. Graphite tattoos may easily be confused with amalgam tattoos but have only infrequently been reported in the literature. METHODS: This case report discusses a patient with a localized pigmented lesion involving the free gingiva, attached gingiva, and alveolar mucosa. The patient was referred for esthetic enhancement of the area in question. Dental history revealed trauma to the area involving falling on a pencil as a child. The lesion was excised and submitted for histologic examination; a subepithelial connective tissue graft was harvested and utilized to prevent an esthetic defect. RESULTS: Histologic evaluation confirmed graphite within the soft tissue as the etiology of the discoloration. At the 2-month postoperative appointment, a highly esthetic outcome was obtained utilizing a connective tissue graft. CONCLUSIONS: Although less common than the amalgam tattoo, the graphite tattoo may be encountered in the course of routine dental examinations and should be included in a differential diagnosis of any localized pigmented lesion. Although histologic evaluation is necessary to rule out pathology, if the dental history is consistent with the clinical impression of a nonpathologic lesion, such as the graphite tattoo in this case report, treatment with an autogenous connective tissue graft at the time of excision can produce a highly esthetic result and avoid additional surgical procedures in the future.

Adolescent↗
PubMed1996

Cosmetic laser surgery.

The fact that multiple wavelengths of light (and, therefore, different lasers) are needed to treat multicolored tattoos and several laser sessions are required for tattoo eradication in most instances, elimination of tattoos remains an expensive endeavor in terms of money and time. The obvious benefit of lasers in the treatment of tattoos, however, lies in their ability to eliminate tattoos without scarring or dyspigmentation. While no single commercially available laser system currently exists that can treat all tattoos, combination laser systems may make treatment of a wide range of tattoo colors a reality in the near future.

Humans↗
PubMed2006

Titanium, a major constituent of blue ink, causes resistance to Nd-YAG (1064 nm) laser: results of animal experiments.

A blue tattoo is more resistant to laser therapy than black or brown tattoos. This study aimed to confirm titanium as a key response-disturbing constituent in a blue tattoo ink after Nd-YAG (1064 nm) laser treatment by animal experiments. Rabbits' backs were tattooed with four ink colours, and the Nd-YAG (1064 nm) laser was used to remove the tattoos. The response to the laser treatment in the rabbits was evaluated and electron microscopic studies were also performed. Excellent to fair responses were observed for the black, brown and dark brown inks, but the blue ink responded poorly to the laser. Histological examination indicated that the blue pigments were unchanged even after the laser treatment. Quantitative energy dispersive spectrometry revealed that blue ink contained high amounts of titanium. Our animal experiments confirm that a blue tattoo ink containing titanium, is a key element in poor response to the Nd-YAG laser.

Animals↗
PubMed2005

Image-guided adaptive radiation therapy (IGART): Radiobiological and dose escalation considerations for localized carcinoma of the prostate.

The goal of this work was to evaluate the efficacy of various image-guided adaptive radiation therapy (IGART) techniques to deliver and escalate dose to the prostate in the presence of geometric uncertainties. Five prostate patients with 15-16 treatment CT studies each were retrospectively analyzed. All patients were planned with an 18 MV, six-field conformal technique with a 10 mm margin size and an initial prescription of 70 Gy in 35 fractions. The adaptive strategy employed in this work for patient-specific dose escalation was to increase the prescription dose in 2 Gy-per-fraction increments until the rectum normal tissue complication probability (NTCP) reached a level equal to that of the nominal plan NTCP (i.e., iso-NTCP dose escalation). The various target localization techniques simulated were: (1) daily laser-guided alignment to skin tattoo marks that represents treatment without image-guidance, (2) alignment to bony landmarks with daily portal images, and (3) alignment to the clinical target volume (CTV) with daily CT images. Techniques (1) and (3) were resimulated with a reduced margin size of 5 mm to investigate further dose escalation. When delivering the original clinical prescription dose of 70 Gy in 35 fractions, the "CTV registration" technique yielded the highest tumor control probability (TCP) most frequently, followed by the "bone registration" and "tattoo registration" techniques. However, the differences in TCP among the three techniques were minor when the margin size was 10 mm (< or = 1.1 %). Reducing the margin size to 5 mm significantly degraded the TCP values of the "tattoo registration" technique in two of the five patients, where a large difference was found compared to the other techniques (< or = 11.8 %). The "CTV registration" technique, however, did maintain similar TCP values compared to their 10 mm margin counterpart. In terms of normal tissue sparing, the technique producing the lowest NTCP varied from patient to patient. Reducing the margin size seemed the only sure way to reduce the NTCP significantly, irrespective of the IGART technique employed. In escalating the dose with the iso-NTCP constraint, the largest average gain in dose was observed with the "tattoo registration" technique, followed by the "CTV registration" and "bone registration" techniques. This is attributed to the fact that in three of the five patients, the "tattoo registration" technique yielded the lowest NTCP, hence a greater window of opportunity to escalate the dose was possible with this technique. However, the variation among the five patients was also largest with the "tattoo registration" technique where, in the case of one patient, the required dose actually needed to be below the original prescription dose of 70 Gy to satisfy the iso-NTCP constraint. This was not the case with the "CTV registration" technique where positive and similar dose escalation was allowed on all five patients. Based on these data, an attractive dose escalation strategy may be to implement the "CTV registration" technique (for consistent dosimetric coverage) for daily target localization in combination with a margin reduction (for increased normal tissue sparing).

Dose Fractionation, Radiation↗
PubMed1997

Knowledge of and attitudes to infection control of tattooists at registered premises in Victoria, 1994.

Historically, the relationship between health authorities and tattooists has been marked by suspicion and mutual distrust, with tattooists being stereotyped as having little concern for hygiene, and considered largely ineducable about infection control. In this study, a random sample of tattooists working at one-third of the 65 registered tattooing premises in Victoria completed a questionnaire that recorded demographic information and knowledge and attitudes to Standards of practice for tattooing 1990, which specifies guidelines for infection control in Victorian tattooing premises. Of these premises, 89 per cent participated and 36 of 37 tattooists working therein (22 metropolitan, 14 country) completed the questionnaire; 81 per cent were male. Reports by the tattooists indicated that: 50 per cent had not commenced immunisation for hepatitis B; that 78, 42 and 34 per cent either had not been tested or were unsure whether they had been tested for hepatitis C, hepatitis B and human immunodeficiency virus (HIV); and that no tattooist was a hepatitis B carrier or was positive for hepatitis C or HIV. Respondents acknowledged the potential for transmission of infectious diseases through tattooing, endorsed formal training in tattooing and infection control for new tattooists, and supported continuing education in infection control for existing tattooists. Most were critical of environmental health officers, particularly for inaction in not closing and prosecuting unregistered tattooists. Despite deficiencies in the knowledge and training of tattooists in infection control, they recognise its importance and are willing to attend appropriate training.

Adult↗
PubMed1998

The living canvas.

In the United States, body art has gradually moved from the fringes of society into the mainstream. This article focuses on the health issues surrounding this practice. The literature cites numerous infectious diseases and complications resulting from or linked to body art. Tattoos have been linked to skin neoplasms, piercing has been associated with hepatitis B and C risk, and branding is strongly associated with infection. Although it is a theoretical risk, no documented cases of HIV have been acquired from a tattoo or piercing. In general, tattooing, piercing and branding are unlicensed and unregulated industries. In many communities, tattoo artists and establishments are not subject to health inspections, body art practitioners are not required to be trained in anatomy, infection control or universal precautions, and the contents of tattoo dyes have never received FDA approval. Healing times for body art are variable, depending on type and location. Obtaining body art is a long-term commitment, and patients should be fully aware of this.

Art↗
PubMed1997

Perioperative tumor localization for laparoscopic colorectal surgery.

BACKGROUND: Because of the inability to palpate colonic tumors during laparoscopy, their location must be precisely identified before resection is undertaken. METHOD: A retrospective study was performed of 58 patients in order to be able to describe our methods of tumor localization for laparoscopic colorectal operations and to review their effectiveness. RESULTS: In all patients, the entire colon was examined preoperatively by colonoscopy. In one patient, preoperative colonoscopic localization was inaccurate. In 31 patients, tumors were easily detectable at surgery. In five patients with the tumor in the right colon, even though the lesion was not detectable at surgery, right colectomy was performed without marking because preoperative colonoscopy reliably identified the lesion adjacent to the ileocecal valve. Twenty-two patients required some type of procedure to localize the tumor. The procedures and their problems were as follows: preoperative tattoo (five)--tattoo not visualized (one); intraoperative colonoscopy alone (six), combined with intraoperative tattoo (four) or clip (three)--poor operative exposure due to bowel distension (nine), hard to see the clip (three), dislodged clip (two), inadequate resection margin (one); intraoperative proctoscopy alone (two), combined with laparoscopic stitch (two)--no problems. In no patient was tumor present at a resection line and in no patient was the wrong segment resected. CONCLUSIONS: Reliable preoperative identification of the tumor adjacent to the ileocecal valve can permit right colectomy without marking. Lesions in the upper rectum can be approached via intraoperative proctoscopy +/- suture placement. If the surgeon anticipates intraoperative localization may be difficult, lesions other than rectal or cecal ones should probably be marked by preoperative tattooing. Further studies regarding the technique of tattooing are warranted.

Colonoscopy↗
PubMed1983

Tissue reactions to the separate implantation of individual constituent phases of dental amalgam, including assessment by energy dispersive X-ray microanalysis.

Soft tissue degradation of the 3 principal amalgam phases have been investigated in relation to their role in the formation of the amalgam tattoo. Each phase, finely powdered, was implanted subcutaneously into the submandibular region of guinea-pigs for periods ranging from 1 week to 1 year. The rates of breakdown were assessed radiographically and the final lesions were examined by light and electron microscopy and X-ray microanalysis. gamma 2 (Sn7Hg) phase degraded rapidly, mainly extracellularly, and did not produce a tattoo. Both mercury and tin disappeared from the lesion. gamma 1 (Ag2Hg3) phase degraded less rapidly, both extra and intracellularly, and produced a small tattoo. Mercury was lost from the lesion. gamma (Ag3Sn) phase degraded slowly, intracellularly, and produced a large tattoo. Tattoos always resulted from persistence of minute particles of silver and sulphur associated with basal lamina and connective tissue.

Animals↗