• Archives of Plastic Surgery
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• v.41 no.4
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• pp.398-402
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• 2014

Background Non-incisional blepharoplasty is a simple, less invasive method for creating a more natural-appearing double eyelid than classical incisional blepharoplasty. However, in aging patients, non-incisional blepharoplasty is not effective due to more severe blepharochalasis. Traditionally, incisional blepharoplasty is a common surgical method used for older patients, but blepharoplasty in elderly patients typically results in prolonged recovery times, and final blepharoplasty lines may be located in unintended or asymmetrical positions. Here, we introduce a new modified combination technique for geriatric blepharoplasty. Methods A total of ten patients were treated from July 2010 through July 2012 using the combination method. First, we performed non-incisional blepharoplasty using tarsodermal fixation. Then, incisional blepharoplasty with additional elliptical excision of the upper eyelid skin was performed. We removed pretarsal tissue, fat, the orbicularis oculi muscle, and orbital fat. Telephone surveys were administered to all patients for follow-up. The questionnaire was composed of eight questions that addressed recurrence and satisfaction with aesthetics and the procedure. Results A total of nine patients (90%) responded to the telephone survey. All cases of moderate to severe blepharochalasia were corrected and there were no major complications. Patients who underwent blepharoplasty had higher satisfaction scores. All patients were satisfied with the postoperative shapes of their eyelids. Conclusions The advantages of the proposed technique include: ease of obtaining a natural-looking fold with symmetry at the desired point; reproducible methods that require short operation times; fast postoperative recovery that results in a natural-appearing double-eyelid line; and high patient satisfaction.

• Archives of Plastic Surgery
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• v.36 no.6
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• pp.773-778
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• 2009

Purpose: The authors propose the new classification of fatty - type gynecomastia(lipomastia) which can serve as a guide for modifying the periareolar technique. Methods: A retrospective analysis was made of 1000 cases of lipomastia operated on in the last 17 months. The extent of the clinical result, the technique employed, and the complications were observed. On the basis of this review the authors observed that at grade I(fat component < 50 ml, fibroglandular component < 3 g each breast), flattening of the thorax can be achieved by means of stab incision, ultrasound - assisted lipectomy(UAL), scavenging suction - assisted lipectomy(SAL) and tissue shaving. At grade II(50 < < 150 ml, 3 < < 5 g), stab incision, UAL, SAL and pull - out method(POM) using small curved scissors. At grade III(150 < < 300 ml, 5 < < 15 g and prominent inframammary fold(IMF)), minimal incision (5 - 6 mm), UAL, SAL and POM using small angulated scissors, and blunting IMF. At grade IV (300 < < 500 ml, 15 < < 30 g, and glandular ptosis), minimal incision (5 - 6 mm), UAL, SAL, fibroglandular excision using small angulated scissors, cutting IMF and fixation of nipple - areola complex(NAC) becomes necessary. At grade V (> 500 ml, > 30 g and ptosis), small incision (7 - 8 mm), UAL, SAL, fibroglandular excision using large angulated scissors, cutting IMF, upper repositioning of NAC and delayed circumareolar skin reduction or chest lifting becomes necessary. Results: The complications were minimal but there were hematoma (n = 7), infection (n = 3) and hypertrophic scar (n =13). Almost patients were satisfied with the outcome. Conclusion: This simple classification may help in choosing the most suitable treatment, thus avoiding insufficient or invasive treatments and undesirable scars.

• Journal of the korean academy of Pediatric Dentistry
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• v.26 no.4
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• pp.623-629
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• 1999

The definition of fascial spaces are latent spaces between fascial planes. If infections which spread from dental origin to soft tissue are mild, they are restricted by fascial planes. But, when infections are severe, fascial spaces are often used as a natural pathway which spread to the deep cervical region. If they are not treated at early stage, they may result in the fatal complications as followings; airway obstruction, septicemia, cerebral abscess, and thrombophlebitis etc. The early treatment of fascial space abscess is very important for young children. These case reports present the successful result of fascial space abscess treatment through intracanal drainage without surgical excision. It is proven that the treatment through intracanal drainage has some benefits to the surgical excision, which are as follows: 1) It is economic to the patients or their parents avoiding admission. 2) The treatment procedure is more simple. 3) Childrens can avoid the fearful environment.

• Archives of Plastic Surgery
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• v.34 no.2
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• pp.250-257
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• 2007

Purpose: Aging changes of midface include drooping of lower lid, wrinkles of malar area, orbitomalar groove and deepening of nasolabial fold from drooping of malar fat pad. Improvement of lower lid can be achieved through lower blepharoplasty, but improvement of cheek can not be gained. Superficial subciliary cheek lift(by Moelleken, 1996) is a method that lifts malar fat pad through extended subciliary incision. We obtained simultaneous improvement of lower lid, malar wrinkles and orbitomalar groove with modification of this technique. Methods: From December 2003 to January 2006, we performed this method on 21 patients among volunteers for lower blepharoplasty who wanted to correct orbitomalar groove and malar wrinkles. Under local anesthesia, lateral extension of subciliary incision is done 1cm from the lateral orbital rim. Skin-muscle flap is elevated, and dealing of orbital fat and septum is the same as with ordinary lower blepharoplasty. After downward subcutaneous dissection through extended incision, exposing the upper 1/3 level of malar fat pad, superolateral fixation is done to superior deep temporal fascia. Excision of the upper part of fat pad is performed, if needed. After excision of overlapped skin-muscle flap, skin closure is done. Results: We obtained satisfactory results with this simple method for improvement of orbitomalar groove and malar wrinkles among patients for lower blepharoplasty. During a follow-up period of 5 months on the average, no revision was performed. Conclusion: Under local anesthesia, lower blepharoplasty and improvement of orbitomalar groove and malar wrinkles can be achieved at the same time. It is good for patients who do not want conventional midface-lifting. But surgeons should select patients and perform cautiously for it may leave a scar of the extended incision that require over 2 months for maturation and it is insufficient for improvement of nasolabial fold compared to conventional mid face-lifts.

• Annals of Hepato-Biliary-Pancreatic Surgery
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• v.27 no.2
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• pp.151-157
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• 2023

Backgrounds/Aims: Cholangiocarcinoma (CCA) can be classified as intrahepatic CCA or extrahepatic CCA (eCCA). We intended to analyze and reports the survival outcomes for eCCA. Methods: Surveillance, epidemiology, and end results (SEER) registry, site recode C24.0, was used to select cases of eCCA from 2000 to 2018. Patients with incomplete data or ages <18 years were excluded. Results: Male (52.69%) and White race (77.99%) predominated. Compared with 2000-2006, survival increased in 2013 (adjusted hazard ratio [HRadj]: 0.68, 95% confidence interval [CI] 0.58-0.70; p < 0.01). Surgery with chemoradiotherapy (HRadj: 0.69, 95% CI 0.60-0.7; p < 0.01) and surgery with chemotherapy (HRadj: 0.72, 95% CI 0.62-0.83; p < 0.01) improved survival over surgery alone. Compared with surgery without lymph node (LN) removal, surgery of four or more regional LN reduced the risk of death by 58% (HRadj: 0.42, 95% CI 0.36-0.51; p < 0.01). Compared with patients without surgery, patients who underwent bile duct excision (HRadj: 0.82, 95% CI 0.72-0.94; p < 0.01), simple or extended lobectomy (HRadj: 0.85, 95% CI 0.75-0.95; p = 0.009), and hepatectomy (HRadj: 0.80, 95% CI 0.72-0.88; p < 0.01) significantly improved survival. Patients with distal CCA had a 17% higher survival than perihilar CCA (HRadj: 0.83, 95% CI 0.74-0.92; p < 0.01) and LN dissection was equally beneficial for both subgroups (p < 0.01). Conclusions: Surgery with chemoradiotherapy has a proven increase in the 5-year survival of the eCCA. LN resection, bile duct excision, lobectomy, and hepatectomy have better outcomes.

• Archives of Reconstructive Microsurgery
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• v.5 no.1
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• pp.147-150
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• 1996

In the benign bone tumor such a fibrous dysplasia, destructive lesion is generally treated by curettage and simple bone graft. Such lesions are unlikely to recur if treated local curettage with bone graft or simple excision of the lesion. When it is impossible to cure only with simple bone graft due to wide extent of tumor, vascularized fibular graft have been introduced for functional loss and appearance. The recurrence of the primary tumor in the grafted fibula is rare in benign bone lesion. We experienced a case of fibrous dysplasia which was recurred in the grafted fibula following the initial treatment with vascularized fibular graft. So we report a case of our experience.

• Journal of the korean academy of Pediatric Dentistry
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• v.31 no.1
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• pp.79-84
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• 2004

Pilomatricoma is a benign soft tissue tumor of hair follicle origin. They occur most commonly in the head and neck region and are usually found in girls during the first two decades of life. Although malignant transformation has been described, it is exceedingly rare. The clinical presentation is typically that of an asymptomatic, superfical, solitary, firm mass that is often accompanied by a reddish-blue discoloration of the overlying skin. Histopathologically pilomatricoma are seen as epithelial islands embedded in a cellular stroma. The epithelial component consist of two main cell types : basaloid cells and ghost cells. Intracellular and stromal calcification is reported in many cases. Diagnosis is usually suspected based on palpation of a superficial, rock-hard mass and confirmed by histopathologic examination. Surgical excision is both curative and the treatment of choice. Recurrence is rare. In this case, the radiographs showed a dense calcification, measuring about 1cm diameter. So simple excision was peformed intraorally, and resultantly the lesion was proved to be a pilomatricoma by histological examination.

• Journal of Yeungnam Medical Science
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• v.10 no.2
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• pp.380-387
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• 1993

Local excision and axillary dissection followed by radiation therapy to the breast has been shown to achieve equivalent local control and survival as mastectomy in an prospective randomized trials. We analyzed 28 cases of early breast cancer in order to evaluate the therapeutic effects of conservative surgery and definitive radiotherapy in the management of early breast cancer as possible alternative of simple mastectomy, retrospectively. Obtained results were as follows : 1. Treatment related acute side reactions are more prominant in the case of chemoradiotherapy group than radiotherapy alone group. 2. There were no cases of primary, regional or systemic failures on the last follow up examination. 3. Cosmetic results after treatment were satisfactory in 26 cases out of 28 cases on the last follow up examination. 4. There were no demonstrable differences of tumor control and cosmetic results between the treatment groups. Although, these results suggested that definitive radiotherapy after local excision would be a possible and desirable alternative instead of total mastectomy in the management of early breast cancers, analyzed cases were too small and follow up period was too short to evaluate the therapeutic effect of primary radiotherapy after local excision, exactly.

• The Journal of the Korean bone and joint tumor society
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• v.5 no.1
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• pp.56-62
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• 1999

Purpose : This study was conducted to analyze the clinical materials and treatment results of 13 cases of subungual exostosis. Materials and Methods : Thirteen subungual exostoses of the foot treated from January 1991 to December 1997 were studied. We analyzed the clinical data and results of treatment to identify the clinical characteristics of this disease. We investigated the location, shape and relation of exostosis to phalanx with simple x-ray of the foot to identify the radiological characteristics. All the cases were sent to pathologic examination after resection to determine the pathological characteristics. Results : The results of physical examination on presentation were various. Most cases were located at the dorsomedial side of the distal phalanx and were involved in the toe nail. Eleven cases were located at great toes and one each at the 2nd and 3rd toe. Causes of exostosis were not clear, but 2 cases were related to trauma. For the type of exostosis, 7 cases were sessile and 6 were stalk type. On histologic examination, 9 cases showed a cartilaginous portion with overlying proliferating fibrous tissue and underlying bone formation. There was a gradual maturation of spindle cell proliferation from cartilage to cancellous bone. The cartilage was moderately cellular with some pleomorphism, but true anaplasia was not present. Conclusion : The clinical presentation and findings of simple x-rays were most helpful in diagnosing subungual exostosis. Complete excision of the mass achieved complete relief of symptoms and recovery without recurrence in all cases.

• Clinics in Shoulder and Elbow
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• v.14 no.1
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• pp.84-88
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• 2011

Purpose: We report here on two cases of calcific tendinitis at the origin of the common extensor tendons of the forearm. Materials and Methods: A 42 year-old female complained of left elbow pain and flexion contracture. After obtaining the simple radiographs and MRI, surgical excision of the calcific deposits was done under the diagnosis of calcific tendinitis. A 25 year-old female complained of right elbow pain and a limited range of motion. Simple radiographs showed a calcific deposit just distal to the lateral epicondyle, and then she was managed with extracorporeal shock wave therapy. Results: The pain disappeared completely and both patients regained a full range of motion after treatments. Conclusion: Calcific tendinitis at the origin of the common extensor tendons of the forearm should be included in the differential diagnosis of the lateral elbow diseases that cause pain and a limited range of motion.