Clinical Analysis of Result of Scar Revision According to Scar Hardness

Wound healing proceeds, fibroblasts play a major role in controlling the composition and amount of extracellular matrix and collagen metabolism. As the amount of collagen product is increased, the scar becomes more thicker and harder. Firmness of the scar can significantly influence the outcome of scar revision depending on the amount of collagen. This study aimed to classify the results of surgical scar revision according to the hardness of the scar and to compare histological differences and effectiveness in scar revision surgery between each classification. We selected subjects who had undergone scar revision and examined their scar pathology and surveyed the satisfaction levels of patients and Vancouver scar scale in each group. As the scar hardness increased from soft to hard, more collagen fiber bundle and elastic fiber tangling were noted. On the other hand, the satisfaction of patients was increased as the scar hardness was decreased from hard to soft. In this study, therefore, we concluded that as the scar becomes harder, the tangling of elastic fibers and the amount of collagen fiber bundles increase. Such patients revealed a robust collagen metabolism, and showed worse results of scar revision.

Self Induced Foreign Body Injection Patient: A Case Report

PURPOSE: In the past, laymen or beauty parlor employees commonly injected people with unproven foreign material such as paraffin, silicone, and cooking oil. We have treated a patient who injected foreign material into her face and neck. METHODS: For the last 20 years, a 43-year-old woman has been injecting herself in the face and neck with foreign material. There was no tenderness, erythema, pain, ulceration, or necrosis. However many visible, touchable subcutaneous masses were found. Her face was extremely ugly and disfigured by the foreign material. We could not recognize the boundary between her neck and mandible. The occipital scalp drooped extremely. Over the past 3 years, from February 2005 to October 2007, we performed 15 operations. RESULTS: We conducted a cephalometric facial analysis to compare preoperative and postoperative facial diameter. The patient's upper face diameter decreased from 67cm to 60 cm, the mid face diameter from 82cm to 59cm, the lower face diameter from 63 cm to 50cm, and the neck circumference diameter from 53cm to 44cm, respectively. The mid sagittal diameter decreased from 26 cm to 23cm. The total excised tissue weight was 4023.7 gram after 15 operations. CONCLUSION: Serial excision of face and neck masses in a patient who injected herself with foreign material resulted in a satisfactory outcome.

An imaging diagnosis of cerebral paragonimiasis: CT and MR findings and correlation with ELISA antibody test

To evaluate the CT and MR findings of cerebral paragonimiasis (PW) and to assess the diagnostic value of the specific antibody test by enzyme-linked immunosorbent assay (ELISA) for PW, 55 CT scans and 13 MR images of 57 patients with cerebral PW were reviewed retrospectively, and correlated with the serum/CSF antibody levels. We divided the into three groups, early active(n=21), chronic(n=32), and combined stage (n=4), on the basis of CT/MR findings. In the group of early active stage the most common and characteristic findings was multiple, conglomerated, ring-like enhancing lesions in the unilateral cerebral hemisphere, which was seen in 52% on CT and 44% on MR. Other non-specific findings included a solitary ring-like or irregular enhancing lesions, ill-defined low density lesions without enhancement, localized hemorrhage with or without enhancing lesions. In the group of chronic stage there were multiple calcifications of various shapes, most commonly 1-2cm sized round shape, and associated encephalomalacia. MR was superior to CT in detecting hemorrhage and in characterizing the central contents of ring-shaped calcifications, while it was inferior to CT in identifying small calcifications. Antibody levels of serum and CSF were positive in 86% and 82% in early active group, and in 48% and 31% in chronic sgage respectively. The positive rate was significantly different between the two groups (P=0.001). CT/MR findings were characteristic in only approximately half the cases in early active cerebral PW which can be cured by traziquantel therapy. Therefore, antibody test by ELISA is recommended as a complementary tool, particularly in patients with non-specific imaging findings.

An imaging diagnosis of cerebral paragonimiasis: CT and MR findings and correlation with ELISA antibody test

To evaluate the CT and MR findings of cerebral paragonimiasis (PW) and to assess the diagnostic value of the specific antibody test by enzyme-linked immunosorbent assay (ELISA) for PW, 55 CT scans and 13 MR images of 57 patients with cerebral PW were reviewed retrospectively, and correlated with the serum/CSF antibody levels. We divided the into three groups, early active(n=21), chronic(n=32), and combined stage (n=4), on the basis of CT/MR findings. In the group of early active stage the most common and characteristic findings was multiple, conglomerated, ring-like enhancing lesions in the unilateral cerebral hemisphere, which was seen in 52% on CT and 44% on MR. Other non-specific findings included a solitary ring-like or irregular enhancing lesions, ill-defined low density lesions without enhancement, localized hemorrhage with or without enhancing lesions. In the group of chronic stage there were multiple calcifications of various shapes, most commonly 1-2cm sized round shape, and associated encephalomalacia. MR was superior to CT in detecting hemorrhage and in characterizing the central contents of ring-shaped calcifications, while it was inferior to CT in identifying small calcifications. Antibody levels of serum and CSF were positive in 86% and 82% in early active group, and in 48% and 31% in chronic sgage respectively. The positive rate was significantly different between the two groups (P=0.001). CT/MR findings were characteristic in only approximately half the cases in early active cerebral PW which can be cured by traziquantel therapy. Therefore, antibody test by ELISA is recommended as a complementary tool, particularly in patients with non-specific imaging findings.