Analysis of the Foreign Worker Patients in Plastic Surgery

PURPOSE: According to the data presented by ministry of justice, a number of foreign workers in Korea is approximately 700 thousands and among them 22 thousands are illegal workers. We would like to provide the basic information the foreign workers by analyzing clinical contents. METHODS: 1456 patients who visited the hospital were reviewed by nationality, medical department, gender and age. 62 patients have visited plastic surgery department and they were additionally reviewed by diagnosis, chief complant and operation. RESULTS: Mongolians were 388 cases (26.7%), followed by Chineses with 452 cases (31.1%). General surgery had 264 visits (18.1%) followed by internal medicine with 388 visits (26.6%). In gender grouping, 781 patients were males and 675 patients were females. Hand, face and extremity injuries were common in plastic surgery field but many foreign worker patients also wanted to take aesthetic surgery such as scar revision, blepharoplasty and augmentation rhinoplasty. CONCLUSION: It has been twenty years since foreign workers have come to the Korean society. In the past foreign workers were mostly neglected. However with the vast improvement in labor and welfare related services, demands for plastic surgery, especially aesthetic surgery are increasing among foreign workers. Therefore plastic surgeons' continuous interest in foreign workers is required.

Median Nerve Entrapment Syndrome Due to Adhesion of Laceration Wound by Suicidal Attempt -A Case Report

PURPOSE: Median nerve entrapment syndrome within carpal tunnel is usually called carpal tunnel syndrome and it is the most common form of peripheral nerve entrapment syndrome. Many factors such as diabetes mellitus, hypothyroidism, hormonal replacement theraphy, corticosteroid use, rhematoid arthritis and wrist fractures may cause carpal tunnel syndrome. To the best of our knowledge, this is the first case report of median nerve entrapment syndrome due to adhesion of laceration wound after suicidal attempt. METHODS: A 28-year-old woman presented with a sensory change and thenar hypotrophy on her left hand. On her history, she attempted suicide by slashing her wrist. Initial electromyography (EMG) showed that the nerve conduction velocities of median nerve was delayed. Therefore, we performed surgical procedures. When exploration, Fibrous scar tissue observed around the median nerve but nerve had not been injured. Transcarpal ligament was completely released and adjacent fibrous tissue was removed to decompress the median nerve. RESULTS: The postoperative course was uneventful until the first year. Opposition difficulty and thenar hypotrophy were improved progressively after the surgery. Sensory abnormality was slowly improved over one year. CONCLUSION: We report a case of median nerve entrapment syndrome that was caused by adhesion of laceration wound after suicidal attempt. This is an unusual cause of median nerve entrapment syndrome, the symptoms were relieved after transcarpal ligament release and fibrous scar tissue removal.

Two Cases of Sebaceous Carcinoma on Scalp

PURPOSE: Sebaceous carcinoma is a rare malignant tumor derived from the adnexal epithelium of sebaceous glands. This tumor usually occurs on the eyelids, but uncommonly it may occur on the extraocular sites. It is characterized by a tendency of local recurrence and occasional metastasis. Surgical excision is appropriate treatment for patients with sebaceous carcinoma. While this kind of case is rare, we report two cases of sebaceous carcinoma developed on scalp. METHODS: Case 1 was a 69-year-old woman. She visited the hospital with a 1.5 x 2.5 cm sized reddish yellow-colored, slowly growing mass on the left parietal scalp. The mass began at birth and started growing 5 years ago. Case 2 was a 67-year-old woman. She had 2.5 x 3.0 cm sized yellow-colored mass on the right parietal scalp. It occurred at birth and started growing 3 years ago. And the masses had erythematous ulcer with sanguineous discharge. In the beginning, the masses were miliary nodule. RESULTS: CT scan and fine needle biopsy were done. Case 1 and 2 were diagnosed as sebaceous carcinoma. Wide excision with safety margin of 10 mm and split thickness skin graft was done. Histological examination revealed well demarcated, irregular, variable sized tumor lobules. Each lobule was composed of sebaceous and undifferentiated cells. Postoperatively, the patients did well and the lesion did not recur. CONCLUSION: Sebaceous carcinoma is an aggressive malignant tumor. It is often confused with other skin tumors. Authors experienced two rare cases of sebaceous carcinoma developed on scalp. We recommend early wide excision with enough safety margin as treatment of sebaceous carcinoma.

A Case of Bilateral Warthin's Tumor

Warthin's tumor is a benign neoplasm that most frequently occurs in the parotid gland. Warthin's tumor shows a tendency of bilateral occurrence, but most of bilateral tumors occur at different time. It usually affects older man and grows slowly. Surgical excision is appropriate treatment for patients with Warthin's tumor and rarely recurs after removal. We report a rare case of bilateral Warthin's tumor which detected at the same time. A 54-year-old man had painless, slowly growing masses on the both mandibular angles. The masses were detected ten years ago. CT scan, ultrasonographic evaluation and fine needle biopsy was performed for preoperative diagnostic study. Superficial parotidectomy was done one after the other at ten-day intervals. After excision, histological examination revealed a mixture of ductal epithelium and a lymphoid stroma. The overlying surface of lymphoid tissue was covered with epithelial cells that was abundant of eosinophilic cytoplasm. Both masses were diagnosed as Warthin's tumor. Postoperatively, the patient did well and had no evidence of recurrence of tumor for 2 years follow-up period. Authors experienced a rare case of bilateral Warthin's tumor which detected at the same time. We recommend stepwise superficial parotidectomy at one or two-week intervals as treatment of bilateral Warthin's tumor.