Background: Longitudinal melanonychia (LM) can be caused by a variety of benign and malignant conditions. Nail matrix biopsy is necessary for the diagnosis of LM; however, physicians hesitate to perform the nail matrix biopsy due to the risk of postoperative complications like permanent matrix damage. Therefore, biopsy methods that minimize the risk of postoperative complications are necessary. Objective: To investigate the efficacy and safety of the nail matrix shave biopsy using a razor blade. Methods: We reviewed the medical records, clinical photographs, and histopathologic slides of patients who underwent shave biopsy for the diagnosis of LM from January 2018 to March 2020 at Wonkwang University Hospital. Results: The entire pigmented lesion was removed completely by shaving only a partial thickness of the superficial matrix in all patients. The histopathologic diagnosis was melanocyte activation with no atypia in all cases. Eight patients were followed up for 7∼19 months. Resting pain after the shave biopsy improved in most cases (75%) within 1 week. One patient experienced numbness lasting for 3 months. Abnormal sensations, such as tingling and itching, were temporarily reported by two patients. One patient (12.5%) had temporary postoperative nail plate dystrophy, and three patients (37.5%) had recurrence of pigmentation. Conclusion Our protocol of shave biopsy showed a lower rate of postoperative nail dystrophy than the conventional shave biopsy. We suggest that the shave biopsy using a flexible stainless steel razor blade is a favorable alternative to the conventional shave biopsy.

PURPOSE: Sclerosing lipogranuloma is an unusal benign condition of the genitalia following injections into the genitalia with exogenous paraffin or mineral oil. A few cases have been reported in which sclerosing lipogranuloma of the lid was caused by paraffin- containing ointment plugs after the endonasal sinus surgery. A 52-year-old man presented with a painless hard mass of the right lower lid after the MRI scan at the Ophthalmology department. Nine months before, he had undergone right maxilla sinus surgery through the oral incision. And he was also gotten nasal packing with Vaseline gauze after the surgery. METHODS: The round shaped two masses in the Right lower lid were approximately 1.0x1.0cm in size. There were no size or color change, bleeding and ulceration. The MRI scan showed a suspicious part of an abscess of benign tumor. Also, He was planned cyst remove through the endonasal surgery due to the mucoid cyst in the right maxillary sinus in the ENT dept. Under the general anesthesia, the patient underwent surgical excision through a subcilliary incision with endonasal sinus surgery. The masses were in deep subcutaneous orbital fat with no connection with right maxillary sinus. RESULTS: The masses were excised 2.1x0.7cm in size including surrounding necrotic fatty tissue. Histopathological diagnosis was 'sclerosing lipogranuloma' due to paraffin or similar substance with fat necrosis and cystic change. This tissue was positive in PAS, S-100, CD68 reaction. CONCLUSION: It is extremely rare to find a granulomatous orbital lesion arising to a endonasal surgery. In conclusion, if sclerosing lipogranuloma is suspected excisional biopsy should be undertaken. Surgery should be reserved for recurrent or refractory cases when steroids have failed as first-line treatment at the 6-month follow-up examination, There was no complication or recurrence.
Abscess ; Adipose Tissue ; Anesthesia, General ; Biopsy ; Eyelids ; Fat Necrosis ; Follow-Up Studies ; Genitalia ; Granuloma ; Hemorrhage ; Humans ; Magnetic Resonance Imaging ; Maxilla ; Maxillary Sinus ; Middle Aged ; Mineral Oil ; Ophthalmology ; Orbit ; Paraffin ; Petrolatum ; Recurrence ; Steroids ; Ulcer

The authors describe three patients of syringomyelia associated with posterior fossa tumor. The lesions were diagnosed by magnetic resonance imaging. Total removal of tumor without decompression of foramen magnum was done and regression of syringomyelia and improvement of symptoms were demonstrated. It is suggested that the blockage of cerebrospinal fluid flow at the foramen magnum by tonsilar herniation may play an important role in syrinx formation.
Cerebrospinal Fluid ; Decompression ; Foramen Magnum ; Humans ; Infratentorial Neoplasms* ; Magnetic Resonance Imaging ; Syringomyelia*

Tumoral calcinosis is an ectopic calcification syndrome characterized by an irregular soft tissue mass. It has been reported mainly in large joints such as the hip, shoulder, knee, and elbow, but rarely in the hands. When it occurs on the dorsal side of the wrist, there are no specific symptoms except for localized tenderness. Therefore, it is difficult to differentiate the calcification from other common hand tumors, especially ganglions. We report a case of tumoral calcinosis that occurred on the dorsal side of the wrist with magnetic resonance imaging findings.

Tumoral calcinosis is an ectopic calcification syndrome characterized by an irregular soft tissue mass. It has been reported mainly in large joints such as the hip, shoulder, knee, and elbow, but rarely in the hands. When it occurs on the dorsal side of the wrist, there are no specific symptoms except for localized tenderness. Therefore, it is difficult to differentiate the calcification from other common hand tumors, especially ganglions. We report a case of tumoral calcinosis that occurred on the dorsal side of the wrist with magnetic resonance imaging findings.

PURPOSE: Radiocontrast media are widely used in medical imaging to improve diagnostic accuracy. However, studies on the adverse reactions of radiocontrast media in children are limited. We aimed to describe the characteristics of adverse reactions to radiocontrast media among children who had a computed tomography scan or magnetic resonance imaging in a tertiary university hospital. METHODS: We retrospectively collected data on adverse reactions to radiocontrast media by the reporting system of a tertiary university hospital. We selected data from children under the age of 19 from July 2011 to December 2017 and analyzed their characteristics. We focused mainly on the characteristics of the index case which is defined by the first adverse event of each subject. RESULTS: During the period, a total of 88,050 radiocontrast media-enhanced imaging studies were performed and 184 cases of adverse reactions were reported. A total of 71 were identified as index cases. Forty-nine (69.0%) were male and the mean age was 12.7±3.2 years. The incidence of radiocontrast media-related adverse reactions was 0.09% and severe reactions were 0.002%. The most common clinical feature was skin manifestations (54.9%), followed by gastrointestinal symptoms (40.8%) and neuropsychiatric symptoms (7.4%). CONCLUSION: Adverse reactions to radiocontrast media rarely occur in children and the incidence of severe reactions is low. Most reactions are mild and are related to the skin and gastrointestinal system. This report would provide good evidence for establishing a management strategy in children scheduled for imaging studies using radiocontrast media.
Child* ; Contrast Media* ; Diagnostic Imaging ; Humans ; Incidence ; Magnetic Resonance Imaging ; Male ; Retrospective Studies ; Skin ; Skin Manifestations

BACKGROUND: Heat shock proteins (HSP), especially the HSP 70 family, may play certain roles in the immunophysiology of some skin diseases such as psoriasis, pemphigus, and lichen planus. HSPs generally induce down-regulation of the process of apoptosis that is considered to be one of the acantholysis-producing pathways in pemphigus. OBJECTIVE: We planned to examine possible roles of HSPs 70/105 in the blistering process in pemphigus vulgaris (PV) and pemphigus foliaceus (PF), in connection with the detection results of apoptosis in local tissue specimens. METHODS: Immunohistochemical stainings and Western blot analysis were performed for the detection and semiquantitation of HSPs 70/105 in skin specimens from lesional, nonlesional, and normal control sites. Hoechst 33342 staining was simultaneously carried out to examine features of apoptosis in lesional skin specimens. RESULTS: The findings on expression of HSP were as follows. In PV, the expression of HSP 70 was minimum or negative; however, in PF, the expression was obvious and recognizable in lesional and perilesional normal skin. In contrast, HSP 105 was not detected in all cases of PV and PF. The features of apoptosis were evident at the lesional skin of all cases of pemphigus with acantholytic changes. CONCLUSION: PV and PF had different relative intensities of HSPs in lesional tissue stainings, especially in cases with HSP 70. This suggests that there may be subtle differences in the mechanisms causing acantholysis between PV and PF.
Acantholysis ; Apoptosis ; Benzimidazoles ; Blister ; Blotting, Western ; Down-Regulation ; Heat-Shock Proteins ; Hot Temperature ; HSP70 Heat-Shock Proteins ; Humans ; Lichen Planus ; Pemphigus ; Psoriasis ; Skin ; Skin Diseases

BACKGROUND: Settlements between doctors and patients provide a solution to complicated disputes. However, some disputes may be renewed as a result of negligence by both parties. The purpose of this study was to review the legal issues that may potentially arise during the preparation of settlement agreements and to propose a list of requirements for ensuring the effectiveness of these settlement agreements. METHODS: Data from 287 civil cases concerning aesthetic surgery that took place between 2000 and 2015 were collected from a court database in South Korea. Factors that influenced the effectiveness of settlement agreements were analyzed. RESULTS: Among the 287 court precedents, there were 68 cases of covenant not to sue. Eighteen cases were dismissed because the settlement agreements were recognized as effective, and 50 cases were sent forward for judgment on their merits because the agreements were not recognized as effective. The types of surgery and types of complications were classified by frequency. We evaluated the geographical distribution of the precedents, the settlement timing, and the effectiveness and economic impact of the settlements. We found that there was no statistically significant relationship among these factors. Four major factors that made a settlement agreement legally effective were identified, and the data showed that fee-free reoperations were not considered by the court in determining the compensation amount. CONCLUSIONS: When preparing a settlement agreement, it is advisable to review the contents of the agreement rather than to take the preparation of a settlement agreement per se to be legally meaningful.
Compensation and Redress ; Dissent and Disputes ; Humans ; Judgment ; Jurisprudence* ; Korea* ; Malpractice ; Plastics* ; Surgery, Plastic*

OBJECTIVES: Patients with schizophrenia are reported to exhibited a reduced level of responsivity to highly arousing negative emotional pictures and to demonstrate a threatening bias to facial stimuli. The aim of this study was to investigate whether patients with schizophrenia show impaired and biased responsivity to threatening emotional words stimuli. METHODS: Eighteen subjects with schizophrenia (M=10, F=8) and 18 healthy controls (M=8, F=10) were involved in this study. Emotional words stimuli (happy, sad, fearful, angry, surprising, and disgusting words) were selected from a Korean affective words list (Kim et al., Unpublished). All subjects were asked to rate feelings elicited by emotional words, using the seven point Likert scale for each of the six basic emotions. RESULTS: Patients with schizophrenia displayed less emotional responsivity to disgusting and angry words as compared to healthy controls, while there were no significant differences in response to happy, sad, or fearful words. Emotional responsivity bias to disgust and happiness was observed in patients with schizophrenia. CONCLUSION: Patients with schizophrenia may show reduced responsivity to disgust and anger words stimuli and biased responsivity to disgust and happiness. These findings are in line with previous findings of reduced reactivity to highly arousing emotional picture stimuli, social threatening bias, and Pollyanna tendencird in schizophrenia.
Anger ; Bias (Epidemiology) ; Happiness ; Humans ; Schizophrenia

PURPOSE: Squamous cell carcinoma(SCC) of the lower lip is the most common malignant tumor comprising 90% of all lip SCC. The typical picture of SCC of the lower lip is of an ulcerated lesion with raised margins. Surgery is the treatment of choice for SCC of lower lip. Depending on the location and size of the tumor, different types of flaps are used. We used new method ? 'both buccal mucosa transposition flap' for the reconstruction of the near total mucosal defect of the lower lip. METHODS: This 67-year-old men presented with the crusted 1x1cm sized ulceration of the lower lip that was arised 30 years ago. There were no size or color change, except the bleeding and ulceration. At first, We diagnosed the SCC through the incisional biopsy. Then We performed the wide excision of the tumor and reconstruction of the lower lip. After the excision of the whole tumor, the defect was measured at 8x3.5cm. We designed the buccal mucosa transposition flap taking care to avoid the parotid duct. The flap was made in a triangular shape for the reconstruction of defected lower lip. The donor site defect can be sutured primarily. RESULTS: A patient in this study had no postoperative complications such as necrosis, dehiscence, infection of the flap or donor site. Reconstructed lower lip is relatively close to that of the natural lip; More satisfactory aesthetic and functional results can be obtained by using this technique rather than other techniques. CONCLUSION: 'Both buccal mucosa transposition flap' is reliable method for the reconstruction of the large lower lip mucosal defect. The operation is simple and performed in one stage, with no postoperative complications. This technique can offer consistently good functional and esthetic outcomes after reconstruction of lower lip mucosal defect.
Aged ; Biopsy ; Hemorrhage ; Humans ; Lip ; Male ; Mouth Mucosa ; Necrosis ; Postoperative Complications ; Tissue Donors ; Ulcer