• Archives of Plastic Surgery
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• v.38 no.3
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• pp.257-262
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• 2011

Purpose: In neurofibromatosis patients, complete surgical excision of the mass is almost impossible and surgical treatment usually consists of multiple serial excisions that only result in a debulking effect. Remnant tumor mass has a gravitational effect on facial soft tissues that leads to sagging of skin and soft tissue, and eventually, facial disfigurement and asymmetry. The purpose of our surgical method is to perform soft tissue lifting with longer lasting effect with less surgical risk of damaging facial nerve and vessels. With external fixation using K-wire or surgical screw, the procedure only called for a short incision length and had additional adhesive properties that enabled anchoring of soft tissue in a lifted position for a longer postoperative period. Methods: A total of 5 neurofibromatosis patients (NF-1) visited our clinic for mass reduction and face lifting. The age of patients ranged from 13 to 42 (mean 28.8 years), and most patients had a long history of multiple excisions in the past. Face lifting was performed in 2 different areas, the periorbital area in 3 patients, and the midface in 2 patients. The materials used in fixation of retaining ligament were K-wire (n=3) and titanium screw (n=2). Results: Follow up period was from 5 month to 3 years and 1 month (mean=2 years and 1 month). All patients conveyed satisfaction with the results and no major complications were reported. The lifting effect lasted for as long as 3 years, and there were no complaints of relapse of soft tissue depression or sagging within the operated area. 1 patient (M/13) needed secondary k-wire insertion and additional mass excision in 1 year and 10 months postoperatively due to tumor growth. In two patients with K-wire fixation, mild dimpling and tenderness were observed in the follow up period, but in about 2 months postoperatively, dimpling was relieved and there was no need for removal of fixating material. Conclusion: Surgical lifting in neurofibromatosis patients can be challenging, for mass excision cannot be done completely and gravitational effect by residual mass can be persistent. External fixation of the retaining ligament in patients with neurofibromatosis can give satisfactory results-for incision length is relatively shorter, and the lifting effect can last longer compared to other various face lifting techniques.

• Journal of Korean Physical Therapy Science
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• v.10 no.1
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• pp.198-205
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• 2003

We evaluated the effect of low power GaAsAl laser on re-epithelization in full-thickness excisional wound of rat skin. Two full-thickness excisions were made on the back of the experimental animals. Low power laser applications with 10mW intensity were treated experimental animals twice a day for 7 days. On the seventh postoperative day the quantitative analysis of re-epithelization was performed using immunohistochemical staining for proliferating cell nuclear antigen (PCNA). The majority of PCNA immunoreactive cells was observed at epithelial cells in the margin of full thickness excisional wound. The low power laser treatments significantly increased the number of PCNA immunoreactive cell as compared to that of non treated animal group (p<0.01). The shape of PCNA immunoreactive cell appeared as small dark, round to ovoid structures. Most PCNA immunoreactive cells exhibited a high intensity of staining that contrasted sharply with the surrounding background. In conclusion, these findings suggest that GaAlAs laser treatments effectively enhance the epithelial wound healing by the stimulating cell proliferation. Furthermore, the majority of cell proliferation occurred in the margin of full thickness excisional wound.

• Journal of Veterinary Clinics
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• v.19 no.4
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• pp.450-454
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• 2002

A five-year-old, female Great Dane dog with edema, localized trauma, mild pain, and lameness of the right hind limb was referred to the Veterinary Medical Teaching Hospital of Chungbuk National University. This dog had a history of mammary tumor excisions 6 months ago. Abnormal changes were not seen in the values of complete blood count and serum biochemical tests. But pedal direct lymphangiography using aqueous-based radiographic agent showed the obstructed lymph flow in right popliteal lymph node. Based on these observations, the dog was suspected as lymphedema resulted from lymph drainage flilure without any other possibilities of inflammation or other causes. Although recommended chemotherapy and physiotherapy had been applied for resolvinr presented problems for one month, there was no improvement on edema of damaged region and any other clinical signs. Therefore, the necropsy was performed after euthanasia under agreement of the owner of patient. In histopatholofical examination, the most characteristic lesions in the mass of femoral region were diffuse edema fibrosis and neoplastic cells in the lymphatics. Also, the neoplastic cells were very similar to those found in the tumor mass of mammary gland, which had diagnosed as fibrosing carcinoma. These facts suggested that the cause of obstructed lymph flow was the neoplasia in lymphatics of the right hind limb. With these results, a diagnosis of malignant lymphedema was made in this dog.

• Advances in pediatric surgery
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• v.13 no.2
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• pp.179-186
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• 2007

Lipoblastoma is a rare benign soft tissue tumor occurring in infancy and early childhood. It is characterized by fat lobules with varying degrees of maturity, multivaculoated lipoblasts, fibrocapillary networks and myxoid stroma. Lipoblastoma has a good prognosis with no metastases despite its potential for local invasion. From Jan, 1990 through April, 2007, 12 children underwent the operation for lipoblastoma, 7 boys and 5 girls, diagnosed at median 22 months (5 ~ 43 months). Median follow up was 6 year 7 months. Primary sites included back (n = 5), intraabdominal (n = 2) and one in each of buttock, chest wall, neck, nose and scalp. Tumors presented with a growing mass in 9 patients, abdominal distension in 2, and an incidental finding on chest radiography in one. Complete excisions were done in all patients. There was one recurrence in a patient with a scalp mass. After reoperation, he has been doing well without evidence of recurrence. Lipoblastoma has a favorable prognosis, but recurrence can occur even with complete excision. Regular follow up is necessary to detect recurrences.

• Tuberculosis and Respiratory Diseases
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• v.67 no.3
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• pp.229-233
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• 2009

Sparganosis is a zoonosis caused by the migrating larvae of cestode genus Spirometra. We report a rare form of sparganosis that invades the lung. A 44-year-old man presented with newly appeared pulmonary nodules that were found accidentally on regular medical checkup, and on sequential chest CT, which we checked at an interval of every 2 months, revealed that the pulmonary lesion had migrated. The patient had a medical history of having undergone surgical excisions for sparganosis in muscles and in subcutaneous tissues of the lower abdomen, perianus, thigh, right axilla, and scapula area, several times over 7 years. A right middle lobectomy was performed and the lesion was diagnosed as sparganosis based on the characteristic histological findings.

• The Journal of the Korean dental association
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• v.54 no.9
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• pp.684-691
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• 2016

The odontogenic cutaneous fistula in facial area is uncommon but, well defined disease. It is difficult to diagnose from the dental origin of cutaneous sinus tract. Most patients may visit to the dermatologists or general hospital without cause of disease. They usually be treated by repeated surgical excisions, biopsies, and antibiotic medications, but suffered from recurrences. We studied odontogenic cutaneous fistula through retrospective study in Jeju Special Self-Governing Province between 1 January 2009 and 12 December 2015. There were 3 males, 5 females from 14 to 78 years old with an average age of 50.4 years old. Only 2 patients felt the toothache, others didn't detect it. They suffered from recurrences and repeated treatments for 3 to 11 months with an average period of 7.9 months. They visited average 2.8 hospitals before a precise diagnosis in a dental clinic. All cases were fully healed endodontic treatment or extraction of origin teeth without recurrences. In conclusion, the cause of cutaneous fistula in facial area can be odontogenic. If dentists or doctors diagnose a patient with cutaneous fistula on face, they should check dental problems or take x-ray views for precise diagnosis. It could be helpful for differential diagnosis.

• Archives of Craniofacial Surgery
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• v.22 no.3
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• pp.135-140
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• 2021

Background: Wide surgical excision is the gold standard for basal cell carcinoma (BCC) treatment. Typically, resection requires a safety margin ≥ 4 mm. We aimed to confirm BCC excisions' cancer recurrence rate and safety on the facial region with new safety margins. Methods: We included patients with primary BCC on the facial region who underwent wide excision with 2- or 3-mm safety margins at our institution between January 2010 and December 2018. Medical records were reviewed to confirm the epidemiology and surgical information. Recurrence was confirmed by physical examination through regular 6-month follow-up. Results: We included 184 out of 233 patients in this study after applying the exclusion criteria. The mean age and follow-up period were 71.2±10.2 years and 29.3±13.5 months, respectively. The predominantly affected area was the nose (95 cases); a V-Y advancement flap was the most commonly used surgical method. There were two cases of recurrence in the 2 mm margin group and one recurrence in the group resected with 3 mm margins. Conclusion: In this large cohort study, we found 2-3 mm excision margins can yield enough safety in facial BCCs. The recurrence rates were found to be comparable with those reported after wider margins.

• Korean Journal of Head & Neck Oncology
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• v.39 no.1
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• pp.23-26
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• 2023

Basal cell carcinoma (BCC) is the most common skin cancer. Ultraviolet radiation exposure and genetic predisposition are known to be the most important etiological factors. Multiple BCC is often associated with genetic familial conditions such as BCC syndrome, basal cell nevus syndrome. We present a case of 54-year-old female who had multiple BCC that had reoccurred. She was completely cured after receiving radio-chemotherapy for leukemia 16 years ago. She had multiple lesions (scalp, left thigh, right popliteal fossa, and right buttock), and had underwent wide excisions of all lesions. All biopsies revealed BCC. Six years later, she had also multiple lesions; left forehead, frontal vertex scalp, parietal vertex scalp, right occipital scalp, and lower abdomen. We performed wide excision. Histopathological examination revealed BCC. She had no signs of any BCC associated syndrome. We report a rare case of nonsyndromic multiple BCC that reoccurred at the new site.

• Archives of Reconstructive Microsurgery
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• v.21 no.2
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• pp.86-91
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• 2012

Purpose: Mass can compress around tissue and cause deviation of normal anatomical structures. Often, mass grows toward neurovascular pedicle and encircles depending on the nature of mature mass. Neglecting neurovascular involvement of the mass is a serious problem not to be overlooked. Authors have performed microscopic approach regarding mass involving the neurovascular pedicle in the hand. Materials and Methods: From January 2007 through February 2012, retrospective analysis for nine cases of mass involving neurovascular pedicles was done. Patients were evaluated preoperatively by ultrasonography or MRI and checked intraoperative finding. Masses were evaluated by site, preoperative evaluation, involved neurovascular pedicle, histopathologic diagnosis, complication, and recurrence. Results: The site of mass involving neurovascular pedicles was 4 cases on the wrist, 2 cases on the palm, 2 cases on the finger, 1 case on the hand dorsum. Involved neurovascular pedicles were 3 radial arteries and nerves, 3 proper digital arteries and nerves, 1 radial artery, 1 superficial branch of radial nerve, 1 common digital artery and nerve. The histopathologic diagnosis of mass were 3 ganglions, 2 giant cell tumors, 2 epidermal cysts, 1 fibroma, and 1 benign spindle tumor. There were 2 cases of recurrence and secondary excisions were performed. Conclusion: Neurovascular pedicle injury can lead to serious complication like sensory and motor disorders, distal part ischemia, and so on. In case of mass suspected neurovascular invasion, accurate preoperative evaluation such as ultrasonography or MRI is necessary. To prevent any neurovascular related complication during mass excision, delicate surgical technique using a microscope becomes essential.

• Korean Journal of Head & Neck Oncology
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• v.18 no.2
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• pp.192-196
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• 2002

Objectives: Tuberculous cervical lymphadenitis is a frequently recurring disease when treated with chemotherapy alone without enough surgical removal of the tuberculous lesions. Authors reviewed retrospectively the treatment result of antituberculous chemotherapy following almost complete surgical removal of tuberculous foci in the neck. Materials and Methods: A retrospective clinical review and analysis was made in 127 cases of tuberculous cervical lymphadenitis patients treated during the past 10 years from 1989 to 1998 at the Department of General Surgery, Inje University Paik Hospital, Pusan. Results: 1) The peak age incidence was the 2nd decade(37.8%), and female was predominated over male by 2.3:1. 2) The time interval from the onset of symptoms to the first visit was less than 3 months in 60.6% of the patient. 3) The location of lymphadenitis was the right neck in 60%, the left neck 34%, and bilateral in 6% of the patient. 4) Signs on the first visit showed solitary masses(60%), abscess(25%) and both mixed(15%). 5) 25 patients(19%) had present or past history of tuberculosis; pulmonary tuberculosis 12 patients, tuberculous lymphadenitis 10 patients, and others 3 patients. 6) Locations of tuberculous lymphadenitis were posterior cervical triangle 70, supraclavicular 51, submandibular 19, anterior triangle 16 and others 4 cases. 7) The principle of treatment of cervical lymphadenitis was surgical management followed by chemotherapy. Surgical procedures were excision(s), curettage and drainage of abscess, combination of both, and biopsy in 60%, 22%, 12% and 6% respectively. Mean duration of antituberculous medication was 9 months after surgery. 8) The rate of recurrent and persistent tuberculous lymphadenitis was 9% in 4 years follow up. Conclusion: Tuberculous cervical lymphadenitis is a frequently recurring disease in young adult when only antituberculous chemotherapy was employed without almost complete removal of the lesions. It is considered that antituberculous medications for 6-9 months after removing the foci at a maximal extent by surgical excision and curettage will reduce the recurrence rate or persistence of tuberculous lymphadenitis.