Nodular scalp mass as the first presentation of pulmonary large cell neuroendocrine carcinoma: a case report

Metastasis of lung cancer to the skin is uncommon, presenting in 0.22% to 12% of lung cancer patients, and it is extremely rare for skin metastasis to be the first clinical manifestation of lung cancer. In the few cases where skin metastasis has been reported as the first sign of lung cancer, the patients were typically heavy smokers or had preexisting respiratory diseases and symptoms. This prompted clinicians to consider skin metastasis of a pulmonary malignancy. Large cell neuroendocrine carcinoma (LCNEC) is a rare type of lung cancer that accounts for approximately 3% of lung cancers. LCNEC mainly metastasizes to visceral organs, such as the liver, bone, and brain, and it only shows metastasis to the skin in very rare cases. Herein, we report an unusual case of a metastatic skin lesion as the first sign of primary pulmonary LCNEC, in a 63-year-old woman with no pulmonary symptoms or personal history of smoking or pulmonary disease.

Diagnosis of split fractures of the mandible in adults

Background@#Mandibular split fractures, in which the fracture occurs exclusively in the posterior wall, are uncommon. This study aimed to enhance clinicians’ understanding of mandibular split fractures and offer insights for future research. @*Methods@#This study included six patients who visited our hospital between January 2020 and June 2023 and were diagnosed with mandibular split fractures. We retrospectively collected data from patients’ medical records on their age, sex, symptoms, mechanism, impact site, associated injuries, and treatment method, as well as the location, pattern, and number of fractures observed on computed tomography (CT) and panoramic images. The frequency of split fractures among all mandibular fractures was calculated. @*Results@#The six patients included three men (50%) and three women (50%), ranging in age from 20 to 71 years (mean age, 49.8 years). The split fractures were located in the symphysis in one patient (16.7%), symphysis to parasymphysis in two patients (33.3%), parasymphysis in one patient (16.7%), and parasymphysis to the body in two patients (33.3%). Four patients (66.7%) had condylar head fractures, while two patients (33.3%) had single split fractures. The mechanism of trauma was a slip-down incident in four cases (66.7%), while two cases (33.3%) were caused by motorcycle traffic accidents. Four patients (67%) underwent intermaxillary fixation, while two patients (33%) improved with conservative treatment. Split fractures were diagnosed in all six patients on CT, whereas the fracture line was not clearly visible on panoramic images. Mandibular split fractures accounted for 5.6% of all mandibular fractures. @*Conclusion@#This study provides insights into the clinical characteristics of rare mandibular split fractures and the diagnostic imaging findings. Furthermore, CT scans and three-dimensional image synthesis-instead of panoramic images-may be essential for accurately diagnosing mandibular fractures, including mandibular split fractures, in the future.

The Relationship between Social Network Service Use Motives and Subjective Well-Being: The Mediating Effect of Online and Offline Social Capital

Objective@#The purpose of this study was to examine the mediating effect of social capital on the relationship between Social Media use motives and subjective well-being. @*Methods@#In the study, online self-reporting surveys were conducted with Social Media users in their 20s, and data from 445 participants were used for structural equation modeling. @*Results@#The main findings of the study were as follows. First, the interpersonal motives for Social Media use had an indirect effect on subjective well-being by mediating offline bonding capital and online bonding capital. In addition, interpersonal motives had an indirect effect on subjective well-being by dual-mediating online and offline bonding capital. Second, the self-expression motive for Social Media use did not directly affect subjective well-being, but it indirectly affected subjective well-being by mediating offline bonding capital. Third, the information-seeking motive for Social Media use did not directly affect subjective well-being, but it indirectly affected subjective well-being by mediating offline bonding capital. @*Conclusion@#This study identified a specific mechanism for how motives for using Social Media affect subjective well-being. Furthermore, the results of this study suggest that the effect of Social Media use on subjective well-being may differ depending on the motive for Social Media use.

Basal cell carcinoma and squamous cell carcinoma in a single tumor in the anterior auricular area

The concurrence of basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) in a single tumor is rarely encountered. We report a case of BCC and SCC in a single tumor in the anterior auricular area. A 70-year-old woman had been diagnosed with BCC by a punch biopsy performed at a dermatology clinic. We performed wide excision of the tumor with an ulcer in the anterior auricular area. Analysis of the biopsy specimen revealed the presence of both BCC and SCC in the tumor. This case illustrates that it is necessary to establish a precise diagnosis and formulate appropriate surgical and treatment plans considering the possibility that two carcinomas may coexist, although the possibility is low in patients with skin cancer.

Rare Giant Upper Lip Epidermal Cyst in a Patient Wearing a Denture

Epidermal cysts are intradermal or subcutaneous cystic tumors that frequently occur in the face, scalp, neck, and body trunk. Acquired cases of epidermal cyst commonly occur as a result of various surgical operations, chronic irritation, or trauma, all of which may trigger the occurrence of the invagination of squamous epithelium. A 57-year-old man presented with a palpable mass 7 cm×2 cm in size in the upper lip. The patient had a 3-year history of wearing a denture to restore missing bilateral maxillary central and lateral incisors, accompanied by inflammatory findings on the buccal mucosa due to chronic lip irritation. The resected oval-shaped cyst had a size of 5.5 cm×3.0 cm×2.5 cm, and it was an encapsulated mass with a well-defined margin. The histopathology was typical of epidermal cyst. This case of a rare giant upper lip epidermal cyst in a patient wearing a denture may be of interest to clinicians.

Treatment of Tuberculous Empyema by Intrathoracic Transposition of a Latissimus Dorsi Muscle Flap

No abstract available.

Split-Rib Cranioplasty Using a Patient-Specific Three-Dimensional Printing Model

No abstract available.

Split-Rib Cranioplasty Using a Patient-Specific Three-Dimensional Printing Model

No abstract available.

A Modified Total Thigh Flap in the Reconstruction of Decubitus Ulcer

No abstract available.

A New Method for Forming the Pretarsal Fullness after Lower Blepharoplasty

No abstract available.

The Correlation between the Degree of Enophthalmos and the Extent of Fracture in Medial Orbital Wall Fracture Left Untreated for Over Six Months: A Retrospective Analysis of 81 Cases at a Single Institution

BACKGROUND: In patients with medial orbital wall fracture, predicting the correlation between the degree of enophthalmos and the extent of fracture is essential for deciding on surgical treatment. We conducted this retrospective study to identify the correlation between the two parameters. METHODS: We quantitatively analyzed the correlation between the area of the bone defect and the degree of enophthalmos on computed tomography scans in 81 patients with medial orbital wall fracture who had been left untreated for more than six months. RESULTS: There was a significant linear positive correlation between the area of the medial orbital wall fracture and the degree of enophthalmos with a formula of E=0.705A+0.061 (E, the degree of enophthalmos; A, the area of bone defect) (Pearson's correlation coefficient, 0.812) (P<0.05). In addition, that there were no cases in which the degree of enophthalmos was greater than 2 mm when the area of the medial orbital wall fracture was smaller than 1.90 cm2. CONCLUSIONS: Our results indicate not only that 2 mm of enophthalmos corresponds to a bone defect area of approximately 2.75 cm2 in patients with medial orbital wall fracture but also that the degree of enophthalmos could be quantitatively predicted based on the area of the bone defect even more than six months after trauma.

Marjolin's Ulcer Secondary to Tuberculous Tenosynovitis of the Wrist: A Case Report

Tuberculous tenosynovitis usually presents as a chronic, slowly progressive disease. It is difficult to detect in early phase and diagnosis frequently requires biopsy in addition to stain or culture. Authors describe a case who had a Marjolin's ulcer secondary to tuberculous tenosynovitis of the wrist.

Reduction of Zygomatic Fractures Using the Carroll-Girard T-bar Screw

Zygomatic fractures are the second most common facial bone fractures encountered and treated by plastic surgeons. Stable fixation of fractured fragments after adequate exposure is critical for ensuring three-dimensional anatomic reduction. Between January 2008 and December 2010, 17 patients with zygomatic fractures were admitted to our hospital; there were 15 male and 2 female patients. The average age of the patients was 41 years (range, 19 to 75 years). We exposed the inferior orbital rim and zygomatic complex through a lateral brow, intraoral, and subciliary incisions, which allowed for visualization of the bone, and then the fractured parts were corrected using the Carroll-Girard T-bar screw. Postoperative complications such as malar asymmetry, diplopia, enophthalmos, and postoperative infection were not observed. Lower eyelid retraction and temporary ectropion occurred in 1 of the 17 patients. Functional and cosmetic results were excellent in nearly all of the cases. In this report, we describe using the Carroll-Girard T-bar screw for the reduction of zygomatic fractures. Because this instrument is easy to use and can rotate to any direction and vector, it can be used to correct displaced zygomatic bone more accurately and safely than other devices, without leaving facial scars.

Synnemata Production Using Silkworm Variety, Female Yangwonjam by Isaria tenuipes

This study was conducted to confirm the possible use of female Yangwonjam as a host for synnemata production of Isaria tenuipes in eight local areas in Korea. Silkworm pupation rate, infection rate and synnemata characteristics of I. tenuipes were examined. Normal silkworms had a higher pupation rate than silkworms inoculated with I. tenuipes. The pupae survival percentage of normal silkworm in cocoons was 92.5~97.6%, whereas it ranged from 91.1~95.6% in silkworms sprayed with I. tenuipes. Female Yangwonjam showed the highest survival percentage at 97.6% among the silkworm varieties tested. I. tenuipes infection rate of larvae of 5th instar newly-exuviated silkworms was 89.2~90.7% in the spring rearing season and 98.2~99.3% in the autumn rearing season. Synnemata production of I. tenuipes was excellent in female Yangwonjam with an incidence rate of 98.0% followed by male Yangwonjam (94.1%) and Baegokjam (93.3%) in the spring rearing season. Synnemata living weight ranged from 1.44~0.94 g in the spring rearing season. The female Yangwonjam had the heaviest synnemata weight (1.44 g) in the spring rearing season. The synnemata of I. tenuipes produced on pupae were white or milky-white in color, and were similar in shape and color to wild synnemata collected in Korea.

Prevalence of Nosema and Virus in Honey Bee (Apis mellifera L.) Colonies on Flowering Period of Acacia in Korea

Honey production from approximately 1.6 million colonies owned by about 199,000 Korean beekeepers was almost 23,000 metric tons in 2009. Nosema causes significant losses in honey production and the virus decreases population size. We initiated a survey of honey bee colonies on the blooming period of Acacia to determine the prevalence of Nosema and virus in 2011. Most Korean beekeepers have moved from the south to north of Korea to get Acacia nectar for 2 mon. This provided a valuable opportunity to sample bees originating from diverse areas in one location. Twenty hives owned by 18 beekeepers were sampled in this year. Nosema spore counts ranged from zero to 1,710,000 spores per bee. The average number of nosema spores per bee was 580,000. Approximately 95% of the colonies were infected with Nosema, based on the presence of spores in the flowering period of Acacia. This indicates that Nosema is the predominant species affecting honeybee colonies. Also, the seven most important honeybee viruses were investigated by reverse transcription-PCR. Among them, four different viruses were detected in samples. Black queen cell virus was present in all samples. Chronic bee paralysis virus was detected in 10% of samples. Deformed wing virus was present in only 5% of the samples. Prevalence of Sacbrood virus was 15%. However, Cloudy wing virus, Israel acute paralysis virus and kashmir bee virus were not detected in any of samples.

Near Total Excision in Patients with Angiosarcoma on Scalp

PURPOSE: Angiosarcoma is a rare malignant neoplasm of endothelial type cells that line vessel walls. It tends to occur in aged male and the prognosis of angiosarcoma is very poor because of frequent local recurrence and early metastasis. The treatment regimen is yet to be established from its rare occurrence but the wide excision in early stage is known to be the most effective. The authors report two cases of near totally excised angiosarcoma with more than a safety margin of 5cm. METHODS: The two subjects were aged male patients, one of the two was diagnosed with angiosarcoma from our institution confirmed by the biopsy. The other one went through the wide excision with a safety margin of 2cm and split-thickness skin graft but local recurrence was observed. The two patients underwent near total excision with more than a safety margin of 5cm, leaving only the periosteum. After confirming that the angiosarcoma had not infiltrated the excision margin, reconstruction with split-thickness skin graft was performed. RESULTS: Based on 6 months and 24 months post-surgery assessment, no local recurrence or remote metastasis in the lungs, liver, bones, and lymph nodes at the neck, where remote metastasis is common, was reported by the two subjects who underwent near total excision with a safety margin of 5cm. CONCLUSION: Angiosarcoma has very poor prognosis from its frequent recurrence and metastasis. To enhance the survival rate of angiosarcoma patients, early diagnosis, timely surgical treatment, and radiotherapy after surgery are critical. In addition, authors suggest that it is necessary to further study the efficacy of wide excision using a wider safety margin as much as possible, and to apply this to more cases.

Correction of Depressed Nasal Base and Piriform Aperture Using Polyethylene Implants

Lower midface concavity due to depressed nasal base and pyriform aperture may be aesthetically displeasing. A relative deficiency in lower midface projection may be congenital or acquired, particularly after cleft surgery and trauma. People with normal occlusion associated with lower midface concavity due to depressed nasal base and pyriform aperture can be corrected with an autologous bone graft or artificial implants. The authors performed paranasal augmentation with an alloplastic implants using a porous polyethylene implants(Medpor(R)) on 430 patients who had visited authors' hospital for aesthetic correction of lower midface contour from January 2000 to June 2009. 425 patients were satisfied with the outcome, which gave them a natural contour. Complications such as dislocation, displacement, infection and extrusion were not observed. Only five patients had their implants removed due to displeasing and foreign body sensations. Alloplastic augmentation in the paranasal area is a very easy procedure and can simulate the visual effect as that of maxillary advancement osteotomy. Paranasal augmentation using a porous polyethylene implants(Medpor(R)) in patients having lower midface concavity with normal occlusion can contribute to the enhancement of the lower midface contour.

Fruit Body Formation on Silkworm by Cordyceps militaris

Injection inoculation protocols for fruit body formation of Cordyceps militaris (C. militaris) were investigated to improve the incidence of infection in the silkworm species Bombyx mori (B. mori). Injection, with suspensions of C. militaris hyphal bodies into living silkworm pupae, was used to test for fruit body production. Use of Daeseungjam rather than Baegokjam or Keumokjam varieties of B. mori is thought to be suitable for infection by C. militaris. From mounting, nine-day-old to 11-day-old pupae showed the best incidence of infection with a 100 microL injection volume. Silkworm pupae injected with a hyphal suspension concentration of more than 2 x 105 colony-forming unit (cfu) recorded a greater than 96% incidence of infection. Also, fruit bodies of C. militaris were induced and produced at a light intensity between 500 and 1,000 lx.

Breeding of a Silkworm Variety for Synnemata Production of Isaria tenuipes

This study was conducted out to select a silkworm variety suitable for synnemata production of Isaria tenuipes. Four kinds of the mulberry silkworm varieties, Bombyx mori, were hybridized using a Japanese parental line and a Chinese parental line, and used to test for synemata formation in I. tenuipes. The larval period of normal silkworms was 22 hr longer than the silkworms inoculated with this fungus. Among the silkworm varieties tested, Hachojam had the shortest larval period with 23.02 days. The non-cocooning silkworm had a shorter larval period than the cocoon producing silkworms. The pupation rate of normal silkworms was about 9% higher than that of silkworms sprayed with I. tenuipes. Hachojam had the highest infection rate at 99.8%, but no significant difference was observed for the infection rate by silkworm variety. The production of synnemata was the best in JS171 x CS188 with an incidence rate of 99.3%, followed by Hachojam, and Chugangjam. The synnemata produced from Hachojam were the heaviest and showed white or milky-white in color.

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.