• Archives of Plastic Surgery
• /
• v.38 no.6
• /
• pp.903-906
• /
• 2011

Purpose: Accessory tragus is a fairly common congenital malformation and usually located at pretragal area. Surgical removal is a common treatment of accessory tragus irrespective of location and morphology. Most accessory tragi do not have depression site around them, but some do. So in those cases, simple surgical excision was not enough to promote the aesthetic facial appearance. For depression site remodeling, the excess amount of skin and cartilage need to be remained partially instead of total excision. This method can achieve the symmetric contour of pretragal area. The authors excised the epidermis and cartilaginous tissue totally and remained the dermis for reconstruction of the depression site around accessory tragus. The depression site is filled with dermal turnover flap. The purpose of this report is to present new idea to promote cosmetic result in treatment of accessory tragus containing the depression site. Methods: Two patients had a pair of accessory tragi at pretragal area. One was a common featured accessory tragus, but the other was different. Depression site was found around accessory tragus. After epidermis and cartilaginous tissue were removed from it, dermis component was used as turnover flap for reconstruction of depression site. Results: After accessory tragus was removed and depression site was reconstructed, facial contour and cosmetic result was achieved. Complication such as flap necrosis and wound dehiscence was not observed. Conclusion: The accessory tragus has variant morphology and degree of invasive depth. And some has a depression site around them. In those cases, simple surgical removal results in morphological distorsion and do not promote facial symmetry. The authors suggest dermal turnover flap as reconstruction method of the depression site. This method improves both surgical outcome and cosmetic result.

• Journal of Microbiology and Biotechnology
• /
• v.21 no.4
• /
• pp.438-447
• /
• 2011

Deinococcus radiodurans is extremely resistant to various genotoxic conditions and chemicals. In this study, we characterized the effect of a sublethal concentration (100 ${\mu}M$) of cadmium (Cd) on D. radiodurans using a whole-genome DNA microarray. Time-course global gene expression profiling showed that 1,505 genes out of 3,116 total ORFs were differentially expressed more than 2-fold in response to Cd treatment for at least one timepoint. The majority of the upregulated genes are related to iron uptake, cysteine biosynthesis, protein disulfide stress, and various types of DNA repair systems. The enhanced upregulation of genes involved in cysteine biosynthesis and disulfide stress indicate that Cd has a high affinity for sulfur compounds. Provocation of iron deficiency and growth resumption of Cd-treated cells by iron supplementation also indicates that CdS forms in iron-sulfur-containing proteins such as the [Fe-S] cluster. Induction of base excision, mismatch, and recombinational repair systems indicates that various types of DNA damage, especially base excision, were enhanced by Cd. Exposure to sublethal Cd stress reduces the growth rate, and many of the downregulated genes are related to cell growth, including biosynthesis of cell membrane, translation, and transcription. The differential expression of 52 regulatory genes suggests a dynamic operation of complex regulatory networks by Cd-induced stress. These results demonstrate the effect of Cd exposure on D. radiodurans and how the related genes are expressed by this stress.

• Journal of Korean Dental Science
• /
• v.7 no.1
• /
• pp.38-42
• /
• 2014

Bisphosphonate-related osteonecrosis of the jaw (BRONJ) is defined as exposed necrotic bone without evidence of healing for at least 8 weeks in the maxillofacial area in a patient with history of bisphosphonate use. Obtaining complete coverage of the hard tissue by soft tissue in BRONJ patients is especially important. Therefore, managing the mucosa is one of the key factors in a successful outcome, but this is especially hard to achieve in BRONJ patients. Various applications of buccal fat pad in oral reconstruction-including the closure of surgical defects following tumor excision, repair of surgical defects following the excision of leukoplakia and submucous fibrosis, closure of primary and secondary palatal clefts, coverage of maxillary and mandibular bone grafts, and lining of sinus surface of maxillary sinus bone graft in sinus lift procedures for maxillary augmentation-have been studied. Eliminating all potential sites of infection and post-operative infection control is crucial in BRONJ. We present a case using the buccal fat pad pedicle for a stage 3 BRONJ defect. Uneventful total epithelialization of the buccal fat pad regardless of size was noted. In summary, the buccal fat pad has versatile application and various recipient sites for surgical utilization. It is an easy technique, with promising overall success rates. With careful selection and handling, buccal fat graft can resolve problems with soft tissue coverage in stage 2 or 3 BRONJ patients.

• Archives of Craniofacial Surgery
• /
• v.16 no.2
• /
• pp.63-66
• /
• 2015

Background: Preauricular sinuses represent a common congenital abnormality in children. Classically, a preauricular sinus manifests as a small opening, usually near the anterior limb of ascending helix. The difficulty in the surgical treatment of preauricular sinus is the high recurrence rate. The aim of this article is to review the outcomes of preauricular sinus and to introduce our surgical technique and its prognosis. Methods: A single-institutional retrospective review was performed for all patients who had undergone excision of congenital periauricular sinus between October 2007 and April 2014. Medical records were reviewed for demographic information, wound complication, and recurrence rate. The sinus tract was visualized with the aid of preoperative dye instillation and intraoperative probe insertion. The skin next to the sinus opening was incised elliptically, and the tract itself was dissected medially to the end of the sinus tract and posteriorly to the cartilage of the ascending helix. Results: The review identified 44 patients for a total of 57 preauricular sinus tracts. The mean age at time of operation was 16.3 years with a range from 9 months to 65 years. Unilateral preauricular sinus tract was present in 31 patients (11 right and 20 left preauricular tract), and 13 patients had bilateral sinus tract. None of the patients had experienced wound issues postoperative, and there were no recurrent sinus tract formation or infection. Conclusion: Using a combination of dye instillation, probe insertion, and modified dissection, we were able to achieve a recurrence free series of preauricular sinus tract excision among a heterogenous group of patients. A large patient series is necessary to replicate the results of this study.

• Advances in pediatric surgery
• /
• v.17 no.1
• /
• pp.35-44
• /
• 2011

Thyroglossal duct cysts (TGDC) are the most common type of congenital developmental anomaly encountered in the anterior midline of the neck in childhood. The aim of the study was to evaluate the clinical characteristics of TGDC and identify any factors that could be related to recurrence after surgery. This study consisted of a retrospective chart review of 45 patients treated at Kyungpook National University Hospital for TGDC between 1990 and 2008. All records were reviewed for age and sex, length of history, presentation, diagnostic methods, sizes and locations of cyst, surgical management, histopathology of the lesion and recurrences. The statistical analysis of risk factors for recurrence was made using the Fisher's exact test with a significance level of p (0.05. The male to female ratio was 2.2:1 with a male preponderance. The mean age at operation was 5 years and 2 months (4 months - 17 years). The most common presenting symptom was a nontender cervical mass (78 %). Most TGDC were found in the midline position. Twenty four were infrahyold, 17 were hyoid, and 4 were suprahyoid level. Forty one (91 %) patients received the Sistrunk operation, and 4(9 %) patients received Cyst excision. Postoperative a seroma developed in six patients in the early postoperative days. There were a total of 3(6.6 %) recurrences, 2 in patients who had excision only and in one patient who had the Sistrunk operation. Univariate analysis for risk factors with recurrence showed that there was no statistical relationship between the presence of preoperative infection and the development of recurrence. The removal of hyoid bone along with TGDC was a statistically significant risk factor for recurrent disease. This study suggests that the Sistrunk operation Is the treatment of choice for TGDC in order to reduce recurrence.

• Asian Pacific Journal of Cancer Prevention
• /
• v.15 no.20
• /
• pp.8917-8921
• /
• 2014

Objective: To observe and compare the effects of multi-patch biopsy under conventional white light imaging endoscopy (C-WLI) and precise targeted biopsy under magnifying narrow-band imaging endoscopy (M-NBI) on the endoscopic submucosal dissection (ESD) of early gastric cancers and intraepithelial neoplasias. Methods: According to the way of selecting biopsy specimens, patients were divided into C-WLI and M-NBI groups, 20 cases. The ESD operations of the 2 groups were compared quantitively. Results: The mean frequency of biopsy in M-NBI group was ($1.00{\pm}0.00$), obviously lower than in the C-WLI group ($4.78{\pm}1.02$) (P<0.01).The average total number of selected biopsy specimens was also fewer ($1.45{\pm}0.12$ and $7.82{\pm}2.22$, respectively, P<0.01). There was no significant difference in the time of determining excision extension, marking time and the time of specimen excision of 2 groups during the ESD (P>0.05), whereas submucosal injection time, mucosal dissection time, stopping bleeding time, wound processing time in the M-NBI group were significantly shorter than in the C-WLI group (P<0.01). Conclusion: Precise targeted biopsy under M-NBI can obviously shorten the time of ESD operation, with small quantity of tissues but high pathological positive rate.

• Asian Pacific Journal of Cancer Prevention
• /
• v.17 no.6
• /
• pp.2853-2856
• /
• 2016

Background: Many studies have pointed to strategies to cope with patient anxiety in colposcopy. Evidence shows that patients experienced considerable distress with the large loop excision of transformation zone (LLETZ) procedure and suitable interventions should be introduced to reduce anxiety. This study aimed to investigate the effects of music therapy in patients undergoing LLETZ. Materials and Methods: A randomized controlled trial was conducted with patients undergoing LLETZ performed under local anesthesia in an out patient setting at Ramathibodi Hospital, Bangkok, Thailand, from February 2015 to January 2016. After informed consent and demographic data were obtained, we assessed the anxiety level using State Anxiety Inventory pre and post procedures. Music group patients listened to classical songs through headphones, while the control group received the standard care. Pain score was evaluated with a visual analog scale (VAS). Statistical analysis was conducted using Pearson Chi-square, Fisher's Exact test and T-Test and p-values less than 0.05 were considered statistically significant. Results: A total of 73 patients were enrolled and randomized, resulting in 36 women in the music group and 37 women in the non-music control group. The preoperative mean anxiety score was higher in the music group (46.8 VS 45.8 points). The postoperative mean anxiety scores in the music and the non-music groups were 38.7 and 41.3 points, respectively. VAS was lower in music group (2.55 VS 3.33). The percent change of anxiety was greater in the music group, although there was no significant difference between two groups. Conclusions: Music therapy did not significantly reduce anxiety in patients undergoing the LLETZ procedure. However, different interventions should be developed to ease the patients' apprehension during this procedure.

• Archives of Plastic Surgery
• /
• v.42 no.3
• /
• pp.295-301
• /
• 2015

Background Glomus tumors were first described by Wood in 1812 as painful subcutaneous tubercles. It is an uncommon benign neoplasm involving the glomus body, an apparatus that involves in thermoregulation of cutaneous microvasculature. Glomus tumor constitutes 1%-5% of all hand tumors. It usually occurs at the subungual region and more commonly in aged women. Its classical clinical triad consists of pain, tenderness and temperature intolerance, especially cold sensitivity. This study reviews 15 cases of glomus tumor which were analyzed according to its anatomic location, surgical approach and histologic findings. Methods Fifteen patients with subungual glomus tumors of the hand operated on between January 2006 and March 2013, were retrospectively reviewed. Patients were evaluated preoperatively with standard physical examination including ice cube test and Love's test. Diagnostic imaging consisted of ultrasonography, computed tomography, and magnetic resonance imaging. All procedures were performed with tourniquet control under local anesthesia. Eleven patients underwent excision using the transungual approach, 3 patients using the volar approach and 1 patient using the lateral subperiosteal approach. Results Total of 15 cases were reviewed. 11 tumors were located in the nail bed, 3 in the volar pulp and 1 in the radial aspect of the finger tip. After complete excision, patients remained asymptomatic in the immediate postoperative period. In the long term follow up, patients exhibited excellent cosmetic results with no recurrence. Conclusions Accurate diagnosis should be made by physical, radiologic and pathologic examinations. Preoperative localization and complete extirpation is essential in preventing recurrence and subsequent nail deformity.

• Archives of Plastic Surgery
• /
• v.41 no.4
• /
• pp.366-373
• /
• 2014

Background The advent of skin-sparing mastectomy has allowed for the reconstruction of the breast and nipple with improved cosmesis. However, the nipple-areolar complex (NAC) in Asian patients is more pigmented and scars easily. Therefore, commonly described incisions tend to result in poor aesthetic outcomes in Asian patients with breast cancer. Methods We describe an algorithmic approach to skin-sparing mastectomy incisions in Asian patients on the basis of the location of the biopsy scar and the tumor site and size. Four incision types are described: peri-areolar, a peri-areolar incision with a second distant skin paddle, "racquet handle," and peri-areolar with adjacent skin excision. Results 281 immediate breast reconstructions were performed between May 2001 and February 2012 after skin-sparing mastectomy. The mastectomy incisions used included the peri-areolar design (n=124, 44%), peri-areolar design with a second distant skin paddle (n=39, 14%), "racquet handle" (n=21, 7.5%), and peri-areolar design with adjacent skin excision (n=42, 14%). The traditional elliptical incision and other variants where the NAC outline was not preserved were performed in the remaining 55 patients. The average follow-up was 44.7 months during which there was 1 case of total flap loss and 7 cases of partial flap necrosis; all remaining flaps survived. 24% of the patients (68/281) underwent subsequent nipple reconstruction. Conclusions Our algorithm avoids breast incisions that are randomly placed or excessively long and prevents the unnecessary sacrifice of normal breast skin. This allows skin-sparing mastectomy and immediate breast reconstruction to be performed with a consistently achievable aesthetic result in Asian women without neglecting oncological safety.

• Archives of Plastic Surgery
• /
• v.37 no.4
• /
• pp.485-488
• /
• 2010

Purpose: Paragonimiasis is infectious disease occurred by Paragonimus Westermani, which invades into human body as a final host. Habitual eating the freshwater crab or crawfish unboiled is one of the reason of infection. Paragonimiasis raged in 1970s in Korea, Japan, China and other Asian countries but the incidence decreased rapidly. Once people eat infected second host, parasite penetrates the duodenal wall and migrates to the lung. During this migration period, the parasite can migrate to other organ, such as brain, spinal cord, liver and subcutaneous tissue, but the cases are rarely reported. The objective of our study is to present our experience of the ectopic migration of parasite to the subcutaneous tissue of the abdomen, which was easily treated with excision and Praziquantel medication. Methods: A 59-year-old woman who likes eating unboiled freshwater crab was diagnosed as Paragonimiasis 15 months ago. Her symptoms were fever and cough, and she was treated with Praziquantel medication. 3 months after discharge, she visited our hospital with left pleuritic chest pain, cough with fever, and palpable mass formation on left lower quadrant of the abdomen. Wedge resection of the left lung and Praziquantel medication was maintained for a week. Nevertheless, fever persisted after the treatment. The patient received total excision of the abdominal soft tissue mass, and the fever was relieved. Results: Pathologic findings of the mass showed multiple cyst and abscess formation with crystal structure which is suspicious parts of the parasite or calcified egg shells. Uncontrolled fever was relieved after the operation, and there was no evidence of recurrent Paragonimiasis and ectopic migration for 1 year follow up period. Conclusion: Ectopic migration of Paragonimus is rare, but multiple organ can be involved. Patient with Paragominiasis who was refractory in fever control after Praziquantel medication or surgical evaluation of the lung should be considered as ectopic migration of the Paragonimiasis.