A Case of Sjogren Syndrome in Parotid Gland

Sjogren syndrome is a chronic disorder characterized by immune-mediated destruction of exocrine glands predominantly but not exclusively on the lacrimal and salivary glands. The common clinical manifestations of Sjgren syndrome include xerophthalmia with secondary keratoconjunctivitis and xerostomia, with or without salivary gland enlargement. Minor salivary gland biopsy usually demonstrates heavy lymphocyte infiltration, although parotid gland biopsy may be more sensitive and specific. Rheumatoid factor and antinuclear antibodies are high in Sjgren syndrome patients. We report a case of Sjogren syndrome with parotid gland involvement in a 44-years-old female patient with xerostomia, xerophthalmia and Rheumatic arthritis. We did total parotidectomy in right parotid gland and superficial parotidectomy for left side parotid gland was done after 20 days. Histologic and immunohistochemical studies revelead multiple periductal lymphoid proliferation and chromic inflammation, lymphoid hyperplasia in parotid glands.

Simple Molding Method for Post-distant Flap Stated Finger by Using Surgical Rubber Gloves

In both cosmetic and functional aspects, loss of digital pulp is a common problem. Compound or composite defects of the hand and fingers with exposed denuded tendon, bone, joint, or neurovascular structures may require flap coverage. Most often these lesions can be repaired by using simple local flap, neurovascular flap, thenar flap, and cross-finger flap. But microvascular reconstruction is sometimes needed for large defects. But Authors do not recommend these procedures in case of severe crushing injuries involving multiple finger pulp losses because they have possibility of damage of the vascular network and infection. So we applied distant flaps such as chest flaps, groin flaps, abdominal flaps and etc. And then we applied surgical rubber gloves for remodeling the flap after cutaneous healing. We have acquired satisfactory results, after the simple molding method for distant flap finger by using surgical rubber gloves treatment.

The Clinical Experiences of Congenital Preauricular Fistulectomy including Cartilage Excision

The preauricular fistula is a congenital malformation of the ear with a small opening in the preauricular area. In general, this malformation should be treated by excision after its infection is brought under control with antibiotics. For cosmetic consideration, we performed a elliptic incision around opening, and then we dissected along the fistula tract to the cyst without sacrificing too much soft tissues. From March 2001 to March 2005, 90 patients with 102 cases of fistulas were excised including a small portion of auricular perichondrium and cartilage, where they adhered closely. Then, histologic findings of preauricular fistula were studied. The histologic findings reveal that the fistular tract is very close to auricular cartilage, and the thickness of fistular epithelium and perichondrium are about the same. There was no specific complications related to this procedure. The recurrence rate for the excision with cartilage was 2 out of 102(2%). Results of surgery in all cases were satisfactory. It is important, in preauricular fistular excision, perichondrium and auricular cartilage should be excised to prevent recurrence.

Restoration of the Injured Fingertip with Eponychial Cutaneous Flap

The restoration of the fingernail is not simple in case of amputated distal fingertip which involved the pulp and nail. The nail should maintain a length of at least 2mm from the eponychium for an adequate grip and decent appearance. Various methods to reconstruct the fingernail bed are available. The nail bed graft from amputated finger or great toe, and free onychocutaneous flap are commonly used. The nail bed of the injured tip tends to be atrophied, deformed and failed as a graft. And the great toe is often turned down as a donor. We have restored satisfactorily the nail beds of three injured finger tips with eponychial cutaneous flaps. The pulps were reconstructed with either a reverse dorsal digital island flap or free pulp graft. Repeated again. A mean follow- up was six months. The nail grew up to the average of 3.7mm. All patients were satisfied with the length of the nail and met with good cosmetic results. An eponychial cutaneous flap is useful to restore the nail of the distal fingertip amputation. The procedure is relatively simple and morbidity is minimum.