• Archives of Plastic Surgery
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• v.38 no.4
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• pp.523-526
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• 2011

Purpose: The odontogenic sinus and fistulous tracts is the most common draining sinus and fistulous tract of the head and neck region. These are often misdiagnoses by clinicions who are not familiar with cutaneous sinus, since most of patients do not have dental symptoms. Here we present two cases of odontogenic cutaneous sinus tract which have been diagnosed after excision of epidermal cyst. Methods: Two patients who presented with an odontogenic sinus tract draining to the skin at our institusion during the two years were enrolled in this study. We reviewed all the medical records of the patients and literature about odontogenic cutaneous sinus tract. Results: Odontogenic cutaneous sinus tracts of our cases were healed after treatment of periapical odontitis and extraction of the carious tooth. Conclusion: The cutaneous sinus tract of dental origin is well documented condition. But its diagnosis is not always easy unless the clinicians consider the possibility of its dental origin. An understanding of the pathogenesis of odontogenic cutaneous sinus tract will lead to early correct diagnosis and proper treatment without unnecessary surgery.

• Archives of Craniofacial Surgery
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• v.14 no.1
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• pp.41-45
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• 2013

Background: Merkel cell carcinoma (MCC) is a rare locally aggressive cutaneous neuroendocrine carcinoma with a high incidence of local recurrence, regional lymph node metastasis, followed by distant metastasis. Because of shortage of the retrospective study, standard treatment has not been established. The purpose of this study was to present the surgical treatment and outcome of 8 patients with MCC. Methods: We report our experiences with 8 patients who underwent treatment for MCC at our institution from 2000 through 2012. Two men and 6 women received treatment for MCC. The mean age was 76.4 years (range, 53 to 93 years). Results: The follow-up period ranged from 7 to 26 months (mean, 22.9). During the follow-up period, three of 8 patients had a relapse (mean time before recurrence, 10 months; 1 month, 7 months, and 22 months). After primary surgery, 3 patients underwent radiotherapy, and 1 patient received chemotherapy. Conclusion: MCC is an aggressive skin cancer with a high rate of local recurrence. Complete surgical excision is the mainstay of local treatment, but adjuvant radiotherapy should be considered for better local control.

• Journal of Plant Biotechnology
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• v.44 no.4
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• pp.379-387
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• 2017

Various sizes (0.2 ~ 1.2 mm) and developmental stages (referred to as Stage 1 ~ 3) of apical and lateral meristems were excised, together or separately, directly from dormant buds of apple 'Hongro'. They were mixed infected by Apple scar skin viroid (ASSVd), Apple chlorotic leaf spot virus (ACLSV), Apple stem pitting virus (ASPV) and Apple stem grooving virus (ASGV), which are major viruses attacking apples. A total of 31 callus lines (> 10 mm in diameter) were obtained by culturing the explants on Murashige and Skoog (MS) medium supplemented with 3% sucrose, 3.0 mg/L benzyladenine (BA) and 0.1 mg/L indole-3-butyric acid (IBA), and they were subjected to RT-PCR analysis for virus detection. A high rate of virus elimination (expressed as the percentage of calli that did not amplify during RT-PCR, i.e., RT-PCR negative calli per total number of calli obtained) was achieved for ACLSV (100%), ASSVd (93.7%), and ASPV (93.7%), whereas it was only 25.8% for ASGV. ASPV was detected in the presence of 2 ~ 3 bracts. Simultaneous virus elimination of ASSVd, ASPV, ACLSV, and ASGV occurred during the meristem culture, in which the early stages of the dormant buds (Stage 1) were used, because ASGV was mostly eliminated during that stage. The results of the present study will be valuable for the production of virus-free apple trees.

• Archives of Plastic Surgery
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• v.38 no.1
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• pp.73-76
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• 2011

Purpose: Congenital midline upper lip sinus is a rare lesion. There are two postulates that can account for the formation of the upper lip sinus based on two major theories of the development of the face: the fusion theory and the merging theory. However, congenital midline lower lip sinus is very rarely reported and described. We report a case of a congenital midline sinus of the lower lip in a 6-year-old female. Methods: A 6-year-old girl presented with a nipple like swelling on the midline lower lip. Physical examination revealed about $5{\times}5$ mm protruding round mass with a just small opening that was non-tender to palpation. The mass was not associated with any skin changes. It umbilicated at the apex and contains a fistulous tract, discharging clear fluid. Only, simple radiologic finding shows bony spur on the lower one third of mandibular symphsis. Results: A small transverse ellipse is made around the opening and elevated mass with sharpe dissection. The tract is excised using the probe and dye as the guide. The tract was extended to periosteum of the lower one third of the mandible. The tract and involved periosteum were excised en bloc, and removed protrusion of the mandibular bone using diamond burr. Microscopic examination of the resected sinus revealed the fistulous tract itself, consisting of fibrous connective tissue covered with cornified stratified squamous epithelium, was observed in the center of the sample. In 6 months follow-up, This patient had a good result was obtained by the method of fistulectomy alone. Conclusion: Midline cranoifacial fistulas represent rare lesions resulting from abnormal fusion of embryologic structures. Our case report describes the excision of a congenital midline sinus of the lower lip in a 6-year-old female. This case represents the first report of a lower lip sinus presenting in a girl as a mass in the skin of the chin with extension to the midline of the mandible. However, the etiology of this rare congenital sinus remains obscure.

• Archives of Plastic Surgery
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• v.35 no.6
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• pp.698-702
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• 2008

Purpose: Basal cell carcinoma is one of the most common cancers in the western population and the annual incidence rate is still on an increasing course. In Asian countries such as Korea, the incidence of basal cell carcinoma is reported to be remarkably low but is estimated to be in a steep increase nowadays. This study was to analyze the recent clinical trends of basal cell carcinoma in Korea by reviewing a single institution's experience. Methods: Throughout an 11-year period, the surgical excision of 143 cases of basal cell carcinoma was performed in our department. General data of these cases such as the primary site of cancer, age and sex of the patient, operative methods, recurrence rate were reviewed retrospectively. Results: Among the 143 patients included in this study, 82 patients were men and 61 patients were women. The ages ranged from 27 to 89 years with a mean age of 64.0 years. The head and neck region was the most frequently involved primary site for the cancer as 95.1% of the total cases occurred in this area. Especially the nose and perinasal area were the most frequent region, which was followed by the periorbital area, cheek, and perioral area. During this study period, 9 cases showed recurrence of the cancer as the overall recurrence rate was 6.3%. Conclusion: Gradual increase in the incidence of basal cell carcinoma was demonstrated in this study. Basal cell carcinoma showed high incidence in the old-age population as 68.5% of the total patients were more than 60 years of age. High recurrence rate was noted in the nasal region especially after local flap reconstruction. A more cautious approach is to be required when handing such high risk lesions. Multiple factors such as extended life span, increased outdoor leisure activity and exposure to sunlight, higher accessibility to medical services and increased understanding of the public about skin cancer are assumed to be the main reasons for this increase of basal cell carcinoma.

• Archives of Plastic Surgery
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• v.36 no.4
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• pp.512-515
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• 2009

Purpose: Neurofibromatosis(NF) is an autosomal - dominant systemic disease. Up to fifty percent of patients with NF are reported to have concomitant vascular abnormalities. In the resection of a larger NF, the risk of uncontrolled hemorrhage is much higher due to the difficulty of hemostasis of large vessels within the tumor. We ligated the base of the giant NF with a simple loop - shaped ligation before removal of the giant NF in both buttocks. And then we could successfully reduce the amount of hemorrhage during the operation. Methods: A 46 - year - old female patient presented for giant masses of both gluteal area, which has been growing slowly for the last ten years. Each mass was about $30{\times}20cm$ in size. After designing the elliptical resection margin, we tightened the tumor base by using continuous loop - shaped suture ligation(weaving the thread up and down in a loop - shaped pattern, leaving a space of 2 cm between each loop) with a straight needle and prolene 2 - 0. After skin incision, we proceeded the dissection toward the central and inferior side of the mass obliquely while we avoided breaking large vascular sinuses. We resected the tumor in a wedged - shape. Subcutaneous tissue was sutured layer by layer and skin was closed by vertical mattress and interrupted suture. The loop - shaped ligation of the base was removed and compressive dressing was done with gauzes and elastic bandages. Results: Postoperative complications such as infection, hemorrhage, hematoma, and dehiscense did not occur. Perioperatively the patient was sufficiently transfused with five units of blood and two units of fresh frozen plasma. During the subsequent 1 year follow - up, the functional and cosmetic result was excellent. Conclusion: A continuous loop - shaped suture ligation procedure along the base of the giant NF effectively reduced the amount of hemorrhage during the operation, made dissection and ligation of vessels easily and quickly, and shorten the operating time and postoperative recovery time.

• Tuberculosis and Respiratory Diseases
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• v.64 no.5
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• pp.374-378
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• 2008

Angiosarcoma is a rare but highly malignant tumorthat usually arises in the scalp or face of elderly males. Distant metastases favor the lung, liver, lymph nodes and skin. Metastatic pulmonary angiosarcoma commonly takes the form of a nodule but can sometimes appear as a thin-walled cyst. We report a case of 65 years-old male with a spontaneous pneumothorax, who underwent excision and radiotherapy for an angiosarcoma of the scalp 2 years ago. A chest CT scan revealed multiple cysts in the lung. The video-assisted thoracoscopic lung biopsy demonstrated subpleural cysts without tumor cells. A skin biopsy of the scalp showed an angiosarcoma. This case was diagnosed as a recurrence of an angiosarcoma with a supposed lung metastasis. This case suggests that a spontaneous pneumothorax in elderly people may be secondary to a pulmonary metastasis from an angiosarcoma of the scalp.

• Proceedings of the KOR-BRONCHOESO Conference
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• 1981.05a
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• pp.14.2-14
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• 1981

In 1859, Billroth used the term "Zylindrome" to describe a tumor arising in the paranasal sinuses. This neoplasm has been referred to by a variety of terms including cylindroma, basaloma, basaloid adenoma, cribriform adenocarcinoma, and "adenoid cystic carcinoma", now preferred by most authors. It most often arises in the major and minor salivary glands of the head and neck but has been noted in the trachea, lung, breast, skin and elsewhere. The tumors are characterized by a high incidence of local recurrence and ultimate distant metastases after agrressive attempts at surgical excision. Radiation therapy, while not curative, has proved uniformly useful in promoting tumor regression and pain relief as a palliative treatment. The present study was undertaken to review our experience with a group of 44 patients with adenoid cystic carcinoma of the head and neck, diagnosed at the Jeonju Presbyterian Medical Center between 1963 and 1980. The results are as follows: 1. Forty-four cases of adenoid cystic carcinoma represented 40% of the malignant salivary gland tumors during the same interval. 2. The most common primary sites were palate(8 cases) and submandibular gland (8 cases). 3. Thirteen patients (31%) had tumors. that arose in the major salivary glands; 29 (69%), minor salivary glands. 4. Of the 44 patients, there were 21 males. and 23 females. 5. Age at diagnosis ranged from 19 to 78 years; the average age was 50 years. 6. The tumor size was more than 4cm to 6cm in its greatest diamension in 10 patients. Clinically positive cervical lymph nodes were found in 7 patients; distant metastasis in one case at the time of diagnosis. 7. Radical excision was employed in 27 patients, 14 of whom combined with radiotherapy. 8. Of 29 patients available for follow-up the gross and determinate 3-year survival rates were 27.6% and 44.4%, respectively. Among twelve patients who received radical excision, the 3-year survival was 58%. 9. Ten of these 44 patients had local recurrence in an interval of 3 to 88 months. from the initial treatment. Of ten recurrences, 3 occured after 5 years. 10. Distant metastasis was found in 3 of the treated patients. All were pulmonary metastasis.

• The Journal of the Korean bone and joint tumor society
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• v.18 no.1
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• pp.7-13
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• 2012

Purpose: The purpose of this study is to compare general survival rate and survival rate according to expectable prognostic factors by analyzing the result of treating a patient of squamous cell carcinoma. Materials and Methods: From Mar. 1999 to Feb. 2011, 151 patients were pathologically confirmed as squamous cell carcinoma of limbs and body in our hospital, and among those patients, 51 patients underwent the surgical treatment. This study included 41 patients who underwent the surgical treatment and were followed-up for more than 12 months. The mean age of population was 64.4 years. 31 males and 10 females were included. Wide excision with following skin grafts or flaps for reconstruction (29 cases) was mostly performed, but amputation (12 cases) was also performed for cases with extremities where resection margin was difficult to obtain and cases with neural or vascular invasion. 8 patients underwent chemotherapy or radiotherapy after resection, and 33 underwent the operation only. Stages were classified by AJCC Classification, survival rate was calculated by Kaplan-Meier method and survival rate of groups was compared by Log-rank test. For the expectable prognostic factors related to survival rate, location of primary lesion, cause of disease, pathologic grade, staging, surgical method, additional anticancer therapy were examined and each survival rate was compared. Results: The average follow-up period was 65.2 (12-132) months. Thirty patients survived out of 41 patients till last follow up. The overall survival rate in 5 years was 77%. Three cases (7.3%) had local recurrence, and 7 cases (17.0%) had metastasis. The average period of recurrence from operation was 27 (18-43) months. Possible prognostic factors such as location of primary lesion, cause of disease, pathologic grade, staging, additional anticancer therapy showed no significant difference in survival rates. However, patients with amputation showed significantly lower survival rate than those with wide excision. Conclusion: In analysis the results of treating 41 cases of squamous cell carcinoma, the overall 5-year survival rate was 77%. And, among the several prognostic factors, only the surgical method was significant statistically.

• Archives of Plastic Surgery
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• v.36 no.3
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• pp.351-355
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• 2009

Purpose: Cervical necrotizing fasciitis tends to involve the deep soft tissues and spread caudally to the anterior chest and mediastinum, often resulting in major complications and death. It may rapidly spread into the thorax along fascial planes, and the associated diagnostic delay results in this descending necrotizing mediastinitis. So, aggressive multidisciplinary therapy with surgical drainage is mandatory. We present a very rare case of descending necrotizing mediastinitis with literature review. Methods: A 53 years old male visited our department 7 days after trauma in neck. His premorbid conditions and risk factors of necrotizing fasciitis were concealed hepatoma, trauma history, chronic liver disease, and nutrition deficit. Computed tomographic scans of the head and neck region were performed in this patient : signs of necrotizing fasciitis, were seen in the platysma, sternocleidomastoid, trapezius muscle and strap muscles of the neck. Fluid accumulations involved multiple neck spaces and mediastinum. At the time, he diagnosed as necrotizing fasciitis on his neck and anterior chest. Necrotic wound was excised serially and we treated this with the Vacuum - assisted closure(VAC, Kinetics Concepts International, San Antonio, Texas) system device. After appropriately shaping the sponge and achieving additional 3 pieces drainage tubes in the pockets, continuous negative pressure of 125 mmHg was applied. The VAC therapy was utilized for a period of 12 days. Results: We obtained satisfactory results from wide excision, abscess drainage with the VAC system, and then split thickness skin graft. The postoperative course was uneventful. Conclusion: The refined technique using the VAC system can provide a means of simple and effective management for the descending necrotizing mediastinitis, with better cosmetic and functional results. Finally, the VAC system has been adopted as the standard treatment for deep cervical and mediastinal wound infections as a result of the excellent clinical outcome.