• The Journal of Internal Korean Medicine
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• v.38 no.2
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• pp.131-137
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• 2017

Black hairy tongue is a benign medical condition, which is characterized by elongated filiform lingual papillae, with a typical carpet-like appearance on the dorsum of the tongue. We describe the case of a 70-year-old Korean female with black hairy tongue, who complained of black hairy tongue accompanied by xerostomia. The patient was treated with Jibaekjihwang-tang-gagambang and electric acupuncture for 13 days. Black hairy tongue was evaluated by its visual appearance and by calculating hue-saturation-brightness (HSB) and red-green-blue (RGB) values of images of the tongue using a photo-edit program. Salivary flow rate (SFR) was evaluated to evaluate oral dryness. After 13 days of treatment, the black fur disappeared, and the brightness and RGB values of the black fur increased. In addition, the SFR increased. We conclude that Korean medicine could be the treatment choice for black hairy tongue.

• Journal of Yeungnam Medical Science
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• v.33 no.2
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• pp.166-169
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• 2016

Afferent loop obstruction following gastrectomy is a rare but fatal complication. Clinical features of afferent loop obstruction are mainly gastrointestinal symptoms. A 56-year-old female underwent radical total gastrectomy with Roux-en-Y esophagojejunostomy for treatment of advanced gastric cancer. After fourteen months postoperatively, she showed gradual development of edema of both legs. Computed tomography (CT) scan showed disease progression at the jejunojejunostomy site and consequent dilated afferent loop, which resulted in inferior vena cava (IVC) compression. A drainage catheter was placed percutaneously into the afferent loop through the intrahepatic duct and an IVC filter was placed at the suprarenal IVC, and self-expanding metal stents were inserted into bilateral common iliac veins. With these procedures, sympotms related with afferent loop obstruction and deep vein thrombosis were improved dramatically. The follow-up abdominal CT scan was taken 3 weeks later and revealed the completely decompressed afferent loop and improved IVC patency. Surgical treatment should be considered as the first choice for afferent loop obstruction; however, because it is more immediate and less invasive, non-surgical modalities, such as percutaneous catheter drainage or stent placement, can be effective alternatives for inoperable cases or risky patients who have severe medical comorbidities.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.40 no.2
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• pp.76-82
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• 2014

Objectives: The aim of this study is to report the results of extracorporeal fixation in patients with mandibular condylar fractures and compare them with the clinical results of conservative treatment. Materials and Methods: The medical records of 92 patients (73 male [M] : 19 female [F], age 13-69 years, mean 33.1 years) treated for condylar fractures at the Department of Oral and Maxillofacial Surgery in Sun Dental Hospital (Daejeon, Korea) from 2007 to 2012 were reviewed. Patients were divided into three groups: group A (23 patients; M : F=18 : 5, age 21-69 years, mean 32.6 years), treated with extracorporeal fixation; group B (30 patients; M : F=24 : 6, age 16-57 years, mean 21.1 years), treated by conventional open reduction; and group C (39 patients; M : F=31 : 8, age 16-63 years, mean 34.4 years), treated with the conservative method ('closed' reduction). Clinical and radiographic findings were evaluated and analyzed statistically. Results: Occurrence of postoperative condylar resorption correlated with certain locations and types of fracture. In this study, patients in group A (treated with extracorporeal fixation) did not demonstrate significant postoperative complications such as malocclusion, mandibular hypomobility, temporomandibular disorder, or complete resorption of condyle fragments. Conclusion: In superiorly located mandibular condyle fractures, exact reconstruction of condylar structure with the conventional open reduction technique can be difficult due to the limited surgical and visual fields. In such cases, extracorporeal fixation of the condyle using vertical ramus osteotomy may be a better choice of treatment because it results in anatomically accurate reconstruction and low risk of complications.

• Archives of Plastic Surgery
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• v.35 no.3
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• pp.312-315
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• 2008

Purpose: Amelanotic melanoma represents a melanoma with an absence or a small number of melanin pigments and comprises 2% of all melanomas. These melanomas are frequently misdiagnosed, probably because of its nonspecific clinical features and difficulty in diagnosis, resulting in delayed diagnosis and treatment. We report a patient with amelanotic melanoma, who underwent surgical treatment with sentinel lymph node biopsy using gamma probe. Methods: A 32-year-old female was presented with a slowly growing ill-defined, hypopigmented nonerythematous lesion with nail defect on right index finger tip. Preoperative punch biopsy was performed, showing an amelanotic melanoma. Sentinel lymph node biopsy was done using gamma probe(Crystal probe system, CRYSTAL PHOTONICS GmbH, Germany) and confirmed no evidence of regional lymph node metastases. The patient underwent amputation at the proximal interphalangeal joint. Results: Histopathologic findings showed superficial spreading melanoma. There were no melanin pigments in Hematoxylin & Eosin stain but positive immunohistochemical stainings for S-100 protein and Hmb45, which were consistent with amelanotic melanoma. Patient's postoperative course was uneventful without any complication and had no evidence of recurrence of tumor in 6 months follow-up period. Conclusion: Amelanotic melanoma is extremely rare subtype of malignant melanoma with histopathologic findings of atypical melanocytes without melanin pigments. Early detection is crucial since survival is strongly related to tumor thickness and tissue invasion at the time of diagnosis. Wide excision is the treatment of choice and other conjunctive therapy has not been successful.

• Archives of Plastic Surgery
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• v.37 no.3
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• pp.239-244
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• 2010

Purpose: Intravascular papillary endothelial hyperplasia (IPEH), also known as Masson's pseudoangiosarcoma, is a rare disease which is now considered as a reactive process of the endothelium rather than a benign neoplasm. It can occur in any blood vessels in the body but more common in the head and neck region as a solitary, often tender, bluish or reddish nodule. IPEH is characterized by the development of endothelial-lined papillary projections in a vascular lumen, usually associated with thrombotic material, the endothelial cells in the papillary structures showing only slight atypia and occasional mitotic Figures, the absence of tissue necrosis. Methods: 8 patients with IPEH were enrolled in the study from 2002 to 2007. All 8 lesions were surgically excised for histopathologic diagnosis. Results: 4 patients were female. The duration of the lesions ranged from 3 months to 15 years. The tumors were first noted between the ages of 20 and 72 years. 4 patients had lesions on the head; 2 on the toe; 1 on the back; and 1 on the finger, respectively. All lesions were solitary, ranged in size from 2 mm to 27 mm. There were no recurrences. Conclusion: The clinical appearance of IPEH is not specific, presented as a primary neoplasm, and the diagnosis can be established by microscopic examination. Complete surgical excision is the best choice of therapy for patients with IPEH, and is both diagnostic and curative. Awareness of this lesion will prevent incorrect diagnosis and overly aggressive treatment.

• Archives of Plastic Surgery
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• v.41 no.6
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• pp.753-758
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• 2014

Background Extramammary Paget's disease (EMPD) is an intraepithelial carcinoma usually occurring on the skin or mucosa of the perineum. Clinically, it resembles eczema or dermatitis, and misdiagnosis and treatment delays are common. The treatment of choice for EMPD is a wide excision with adequate margins. Wide excision with intraoperative frozen biopsy and Mohs micrographic surgery are common methods; however, these are associated with a high recurrence rate and long operation time, respectively. Methods Between January 2010 and June 2013, 21 patients diagnosed with EMPD underwent mapping biopsy. Biopsy specimens were collected from at least 10 areas, 2 cm from the tumor margin. When the specimens were positive for malignancy, additional mapping biopsy was performed around the biopsy site of the positive result, and continued until no cancer cells were found. Based on the results, excision margins and reconstruction plans were established preoperatively. Results The patients (18 male, 3 female) had a mean age of 66.5 years (range, 50-82 years). Almost all cases involved in the perineal area, except one case of axillary involvement. Permanent biopsy revealed one case (4.8%) of positive cancer cells on the resection margin, in which additional mapping biopsy and re-operation was performed. At the latest follow-up (mean, 27.4 months; range, 12-53 months), recurrence had not occurred. Conclusions Preoperative mapping biopsy enables accurate resection margins and a preoperative reconstructing plan. Additionally, it reduces the operation time and risk of recurrence. Accordingly, it represents an effective alternative to Mohs micrographic surgery and wide excision with intraoperative frozen biopsy.

• International Journal of Industrial Entomology and Biomaterials
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• v.18 no.2
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• pp.69-75
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• 2009

Daba ecorace of Antheraea mylitta Drury (Lepidoptera: Saturniidae), the semi domesticated Indian tropical tasar silkworm being reared outdoor; the egg and silk yields are dependent of genotype environment interaction. The insufficient maintenance and multiplication of its P4 seed stock need a coherent as well as scientific strategy to safeguard breed potential, being commercially applied ecorace. The sort-out lines of P4 stock studied over five generations highlighting on commercial trait up gradation suits for a tropical crop season, revealed enhanced performance. The line with high pupal parents (T2) shown improved fecundity (12.9%) and the line with high shell parents (T3) recorded higher shell weight (40.0%) and silk ratio (24.1%). While, the line of high pupal female and high shell male (T4) reveal enhancement in fecundity (9.0%), egg hatching (14.1%), shell weight (50.0%), silk ratio (35.2%) and absolute silk yield (52.0%) indicating the need and role of varied basic seed stock lines. The approach could improve economically vital egg fecundity and cocoon shell weights besides balancing them in same line for commercial operation. The progressive show of lines (T1 to T4) along successive generations (G1 to G5), in spite of passing through seed crop (Jul-Aug) and commercial crop (Sep-Nov) seasons emphasize their compatibility. The study infers that the strategic plan of combining preferred parental phenotypes, methodical selection for desired commercial trait(s) through generations with best possible genotype environment interaction has enriched P4 stock with elevation in needy trait(s) besides assuring choice of suitable lines for seasons and regions and timely replenishment of basic seed of Daba ecorace.

• Journal of Korean Neurosurgical Society
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• v.58 no.3
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• pp.248-253
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• 2015

Objective : The treatment of giant cell tumor (GCT) is mainly performed surgically. However, GCT in spine seems difficult to treat because of the limited surgical accessibility and proximity. In this report, we analyzed the outcome of GCT treatment in spine. Methods : Between 2000 and 2012, 19 patients received treatment for GCT in spine. Median age at their first diagnosis was 31 years, 10 patients were male, and 9 female. Fourteen tumors were located in the sacrum, 1 in cervical, 1 in thoracic and 3 in lumbar spine. As primary treatment, gross total removal (GTR) was done in 6 patients, and subtotal removal (STR) in 13 patients. Radiation therapy (RT) as an adjuvant therapy was performed in 2 cases in GTR group and 10 cases in STR group. Results : During the follow-up, 7 patients had local recurrence (36.8%). The average period until recurrence after primary treatment was 14 months. No recurrence was detected in GTR group. Recurrence was noted in 7 out of 13 patients who underwent STR. These differences were statistically significant (p=0.024). A median of recurrence free period (RFP) was 84 months. Also average RFP of the RT group was 112 months, and non-RT group was 65 months. These differences were statistically significant (p=0.041). Conclusion : Treatment of choice for GCT in spine is a complete removal of tumor without neurological deficits. In case of incomplete removal, radiation therapy may be a useful adjuvant treatment modality.

• Nutrition Research and Practice
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• v.10 no.5
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• pp.524-529
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• 2016

BACKGROUND/OBJECTIVES: Use of smaller plates to control food intake is a commonly recommended strategy for restricting energy intake, despite conflicting results. Therefore, the aim of this study was to examine whether or not three different sizes of plates influence energy intake during a multi-itemed buffet meal in normal weight women. SUBJECTS/METHODS: This was a cross-over study conducted on 37 female participants aged 19-25 years with normal BMI levels. Participants were recruited from Hacettepe University and the surrounding community. On experimental days, participants ate a standard breakfast and were then randomly assigned to eat lunch using a small (19 cm), medium (23 cm), or large (28 cm) diameter plate. Visual analogue scale (VAS) scores on sensory and satiety outcomes were measured for all meals. Energy and macronutrient intakes during lunch were recorded. RESULTS: There was no evidence that use of a smaller plate size reduced energy or specific macronutrient intake during the free choice lunch meal. Multiple visits to the serving table were not associated with energy or macronutrient intake. Plate size did not affect VAS scores during the test days. CONCLUSIONS: Plate size did not influence energy intake, meal composition, or palatability in normal weight women during a multi-itemed open buffet lunch. Studies in natural settings at the population level are needed to clarify current outcomes.

• Journal of Korean Neurosurgical Society
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• v.53 no.4
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• pp.235-240
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• 2013

Fusiform aneurysms on the basilar artery (BA) trunk are rare. The microsurgical management of these aneurysms is difficult because of their deep location, dense collection of vital cranial nerves, and perforating arteries to the brain stem. Endovascular treatment is relatively easier and safer compared with microsurgical treatment. Selective occlusion of the aneurysmal sac with preservation of the parent artery is the endovascular treatment of choice. But, some cases, particularly giant or fusiform aneurysms, are unsuitable for selective sac occlusion. Therefore, endovascular coiling of the aneurysm with parent vessel occlusion is an alternative treatment option. In this situation, it is important to determine whether a patient can tolerate parent vessel occlusion without developing neurological deficits. We report a rare case of fusiform aneurysms in the BA trunk. An 18-year-old female suffered a headache for 2 weeks. Computed tomography and magnetic resonance image revealed a fusiform aneurysm of the lower basilar artery trunk. Digital subtraction angiography revealed a $7.1{\times}11.0$ mm-sized fusiform aneurysm located between vertebrovasilar junction and the anterior inferior cerebellar arteries. We had good clinical result using endovascular coiling of unruptured fusiform aneurysm on the lower BA trunk with parent vessel occlusion after confirming the tolerance of the patient by balloon test occlusion with induced hypotension and accompanied by neurophysiologic monitoring, transcranial Doppler and single photon emission computed tomography. In this study, we discuss the importance of preoperative meticulous studies for avoidance of delayed neurological deficit in the patient with fusiform aneurysm on lower basilar trunk.