Background: The longstanding and common use of hyaluronic acid (HA) has driven the expanded development of various commercial HA fillers. However, differences in the components of these HA fillers lead to variations in their effect. We compared the in vivo safety and efficacy of biphasic HA (BHA) and a new monophasic HA (MHA) for improving facial wrinkles. We investigated differences in outcomes after their injection into nasolabial folds (NLFs) using the Wrinkle Severity Rating Scale (WSRS), patient satisfaction using the Global Aesthetic Improvement Scale (GAIS), and pain using a visual analog scale (VAS). We also performed a safety assessment of the two fillers. Methods: This matched-pair, double-blind, randomized study compared the degree of temporal wrinkle improvement in the NLFs of 91 participants using the BHA filler versus the new MHA filler. Safety and efficacy were compared at 8 and 24 weeks. Results: At 24 weeks after application, the average WSRS scores were 2.17±0.72 (BHA) and 2.07±0.71 (MHA) (P=0.034). The average GAIS scores, as measured by a treating investigator at 8 weeks and 24 weeks, were 0.94±0.76 (BHA) and 0.98±0.78 (MHA) at 8 weeks (P=0.181), and 0.44±0.64 (BHA) and 0.49±0.69 (MHA) at 24 weeks (P=0.103). The VAS pain score was 0 points at 30 minutes after filler application in both groups. Conclusions Both the BHA filler and the new MHA filler were safe and effective for improving facial wrinkles in NLFs, but the new MHA filler was more effective for the cosmetic improvement of wrinkle severity than the BHA filler.

Trichilemmal cysts are common fluid-filled growths that arise from the isthmus of the hair follicle. They can form rapidly multiplying trichilemmal tumors-, also called proliferating trichilemmal cysts, which are typically benign. Rarely, proliferating trichilemmal cysts can become cancerous. Here we report the case of a patient who experienced this series of changes. The 27-year-old male patient had been observed to have a 1×1 cm cyst 7 years ago. Eight months prior to presentation at our institution, incision and drainage was performed at his local clinic. However, the size of the mass had gradually increased. At our clinic, he presented with a 5×4 cm hard mass that had recurred on the posterior side of his neck. The tumor was removed without safety margin, and the skin defect was covered with a split-thickness skin graft. The pathologic diagnosis was a benign proliferating trichilemmal cyst. The mass recurred after 4months, at which point, a wide excision (1.3-cm safety margin) and split-thickness skin graft were performed. The biopsy revealed a trichilemmal carcinoma arising from a proliferating trichilemmal cyst. This clinical experience suggests that clinicians should consider the possibility of malignant changes when diagnosing and treating trichilemmal cysts.
Adult ; Biopsy ; Diagnosis ; Drainage ; Epidermal Cyst ; Hair Diseases ; Hair Follicle ; Humans ; Male ; Neck* ; Skin ; Skin Neoplasms ; Transplants

Facial dimple creation is a simple surgical procedure. Nonetheless, several complications can occur. Actinomycosis is a rare chronic granulomatous infection caused by Actinomyces species. Some conditions that can cause actinomycosis are trauma, oral surgery, and poor dental hygiene. We report a case of actinomycosis that developed on a created facial dimple. A 51-year-old woman presented with a palpable mass on her left cheek that was approximately 1 cm in size. She had undergone facial dimple-creating surgery on both perioral areas at a local clinic 12 years previously. She had not experienced any problems until she was diagnosed with rheumatoid arthritis and diabetes mellitus about 2 years previously, for which she took leflunomide and methotrexate. The mass was completely excised through an intraoral approach. The specimen was grossly described as a gray-yellow cystic mass containing non-absorbable suture material. The filamentous nature of the Actinomyces organisms was observed in dark-stained foci on a histologic examination, confirming the diagnosis of actinomycosis. Indwelling non-absorbable suture materials may increase the risk for opportunistic infections, such as actinomycosis, in immunocompromised patients. Therefore, plastic surgeons should be aware of a patient's general hygiene, immune condition, and medical history when using these materials.
Actinomyces ; Actinomycosis* ; Arthritis, Rheumatoid ; Cheek ; Diabetes Mellitus ; Diagnosis ; Female ; Humans ; Hygiene ; Immunocompromised Host ; Immunosuppressive Agents ; Methotrexate ; Middle Aged ; Opportunistic Infections ; Oral Hygiene ; Plastics ; Surgeons ; Surgery, Oral ; Sutures

Dental implantation in the mandibular anterior region is considered a safe and reliable surgical procedure. On the other hand, several articles have reported that inadvertent hemorrhage of the sublingual artery can result in life-threatening airway obstruction. Surgical ligation under intubation or tracheostomy is the most widely used approach for controlling mouth floor bleeding in this highly vascular region. Nonetheless, surgically exploring the bleeding focus is difficult because of anatomical distortion followed by widespread edema and swelling. Since swelling of the mouth floor advances quickly, timely management is essential for favorable postoperative outcome. This paper reports a case of immediate hemorrhage control with angiographic embolization to perform rapid hemostasis before the ongoing swelling causes airway obstruction. Less invasive, angiographic embolization can prevent neurovascular damage during a surgical exploration of injured vascular structures on the mouth floor.
Airway Obstruction ; Angiography ; Arteries ; Dental Implantation ; Dental Implants ; Edema ; Hand ; Hemorrhage ; Hemostasis ; Intubation ; Ligation ; Mouth Floor ; Tracheostomy

Dental implantation in the mandibular anterior region is considered a safe and reliable surgical procedure. On the other hand, several articles have reported that inadvertent hemorrhage of the sublingual artery can result in life-threatening airway obstruction. Surgical ligation under intubation or tracheostomy is the most widely used approach for controlling mouth floor bleeding in this highly vascular region. Nonetheless, surgically exploring the bleeding focus is difficult because of anatomical distortion followed by widespread edema and swelling. Since swelling of the mouth floor advances quickly, timely management is essential for favorable postoperative outcome. This paper reports a case of immediate hemorrhage control with angiographic embolization to perform rapid hemostasis before the ongoing swelling causes airway obstruction. Less invasive, angiographic embolization can prevent neurovascular damage during a surgical exploration of injured vascular structures on the mouth floor.
Airway Obstruction ; Angiography ; Arteries ; Dental Implantation ; Dental Implants ; Edema ; Hand ; Hemorrhage ; Hemostasis ; Intubation ; Ligation ; Mouth Floor ; Tracheostomy

Purpose: Herein is reported our initial experience of the CyberKnife to show its safety and feasibility as a treatment modality for non-metastatic prostate cancer. Materials and Methods: Twenty patients, with biopsy-proven prostate cancers, were recruited into a phase I clinical trial using the CyberKnife. The distribution of clinical risks, as assessed using the ASTRO criteria, was as follows: low (4), intermediate (5) and high (11). The mean age and follow up of the patients were 71.4 years and 15 months, respectively. The patients received 7.5-9Gy of radiation in a single fraction for 4-5 days. The total radiation dose to the prostate was 34-37.5Gy, which approximates to 86.4Gy in 2Gy fractions. The rectal and bladder acute toxicities were graded using the criteria of the Radiation Therapy Oncology Group (RTOG). The results of acute toxicities were compared to those of the historical control, which had been treated with conventional four field box techniques (received median dose 70.2Gy). The prostate-specific antigen (PSA)- based short-term efficacy was described. Results: The acute rectal toxicity scores were 0, 1 and 2 in 13, 5, and 2 patients, respectively. The acute bladder toxicity scores were 0, 1 and 2 in 16, 3 and 1 patient, respectively. No grade 3 or 4 acute toxicity was noted. These figures contrast sharply with those found for the historical control. All toxicities spontaneously subsided within 3 months after treatment. Continuous PSA reduction was noted in all patients, and no PSA failure was noted during the follow up period. Conclusions: Our data show the feasibility of the CyberKnife in terms of its efficacy and acute toxicity. Moreover, the capability of using a hypo-fractionation schedule lead to marked improvement in patient convenience, with substantial resource savings.
Appointments and Schedules ; Follow-Up Studies ; Humans ; Income ; Prostate* ; Prostate-Specific Antigen ; Prostatic Neoplasms* ; Urinary Bladder

OBJECTIVES: Patients with poor insight are commonly observed among schizophrenics and they show poor drug compliance and prognosis. This study aimed at examining the characteristics of psychopathology in patients with schizophrenia who have no insight. Understanding the features of inner psychopathology in schizophrenic patients with poor insight, we assumed, could lead to insight-promoting clues. METHODS: The subjects consisted of 69 patients with schizophrenia diagnosed by DSM-IV criteria. For identifying insight level in the patients, Scale to Assess Unawareness of Mental Disorder(SUMD) was applied. After subjects were divided into two groups depending upon insight level, psychopathological differences were evaluated by Kyung Hee-Frankfruter Beschwerde Fragebogen(K-FBF), which was known as one of the subjective psychological tests for the schizophrenics. RESULTS: There was no significant differences in demographic variables, duration of illness, and dose of medication between two groups. However, significantly high rate of involuntary admission and tendency of high frequency of admission were revealed in schizophrenic patients with poor insight. And, also poor insight group showed significantly high scores in the factors of sensorimotor disorder(subscales of psychomotor disorder, perceptual disorder and blocking symptoms included) and in language-cognitive disorder factor(subscales of language disorder and cognitive floating included) compared with patients who have insight. CONCLUSION: We was assumed that lack of insight in schizophrenics could include one of the symptoms based on neuropsychological or neurobiological abnormalities in brain. Moreover, it was revealed that patients with poor insight evaluated themselves as having more serious psychopathologies than patients who had insight. It has been already known that schizophrenic patients who lack in insight are reluctant to taking psychiatric care and lack in awareness of their illness. However, this study suggests that their inner psychopathology associated with insight can be understood with the use of subjective psychological test, i.e. K-FBF. For understanding the schizophrenic patients who lack in insight, not only checking the insight but also applying the subjective test such as K-FBF seems to be helpful.
Brain ; Compliance ; Diagnostic and Statistical Manual of Mental Disorders ; Humans ; Language Disorders ; Perceptual Disorders ; Prognosis ; Psychological Tests ; Psychopathology* ; Schizophrenia

PURPOSE: To evaluate the role of [(18)F]fluorodeoxyglucose-positron emission tomography(FDG-PET) for the follow-up of patients with a renal cell carcinoma(RCC), and compare FDG-PET with conventional imaging modalities, including computerized tomography(CT), chest PA, bone scan and brain magnetic resonance imaging(MRI). MATERIALS AND METHODS: FDG-PET and conventional imaging techniques, includingCT, chest PA, bone scan and brain MRI, were performed on 69 patients who had undergone a radical nephrectomy and/or metastatectomy, with a final pathological diagnosis of a RCC. The final diagnoses of recurrences/metastases were established from the histopathological or clinical findings. RESULTS: Recurrences and metastases were present at 47 sites(34 patients). The results of FDG-PET were true positive and false negative in 44 and 3 of the 47 sites, respectively. The results of conventional imaging techniques were true positive and false negative in 40 and 7 of the 47 sites, respectively. The results of FDG-PET were true negative and false positive in 34 and 1 of the 35 patients, respectively. The results of conventional imaging techniques were true negative and false positive in 30 and 5 of the 35 patients, respectively. Therefore, FDG-PET was more sensitive, specific and accurate than conventional imaging techniques for the follow-up of patients with a RCC. CONCLUSIONS: FDG-PET accurately detected the postoperative recurrences and metastases in patients with a RCC. FDG-PET may have a role in the follow-up of patients with a RCC.
Brain ; Carcinoma, Renal Cell* ; Diagnosis ; Electrons* ; Fluorodeoxyglucose F18 ; Follow-Up Studies* ; Humans ; Magnetic Resonance Imaging ; Neoplasm Metastasis ; Nephrectomy ; Positron-Emission Tomography* ; Recurrence ; Thorax

[Objective] It makes a through study on the popularization and usefulness plan of Moxa Combustion, therefore popularizing practical use of that.
[Methods] It was based on the established treatises and books, in order to studying about the literature of Moxa Combustion.
[Results & Conclusions] It makes a through study on the whole of Moxa Combustion, the results as follows.
1. We explained (illustrated) the origin, history, classification and mechanism (effect) of Moxa Combustion.
2. The study of standardization plan of Moxa Combustion for popularization.
The thermal stimulation of Moxa Combustion was decided the characteristic pattern of combustion temperature by moxa burning and that makes a measure to grasp the effective action of Moxa Combustion upon human body. Thereupon it is necessary to continue further studies by analyzing the characteristic pattern of combustion temperature by moxa burning and there clinical effects in practice.
3. The usefulness of Moxa Combustion.
The therapeutic effect of Moxa Combustion are hematopoiesis (increase the blood), analgesic function, increase the immunity, antioxidant activity, diuretic action, control of hormone (endocrine gland), suppression of carcinogenesis, increase the self involution (natural healing), decrease of GOT/GPT, glucose, cholesterol level.

Gastric glomus tumors are rare submucosal lesions that originate from the modified smooth muscle cells of the glomus body. They usually present as a submucosal tumor on endoscopy and a heterogeneous hypoechoic tumor in the third or fourth sonographic layer of the gastric wall on endoscopic ultrasonography. So they are often confused with other submucosal tumors such as gastrointestinal stromal tumor, schwannoma, and leiomyoma. Immunohistochemistry helps in differentiating glomus tumors from other submucosal tumors. The treatment of choice for these tumors is complete surgical resection. Most of the gastric glomus tumors are essentially benign in nature, so preoperative recognition of this lesion may spare the patient a more extensive resection. Herein, we present three cases of gastric submucosal tumor that were treated by a laparoscopic wedge resection and confirmed as glomus tumor on final pathology.
Endoscopy ; Endosonography ; Gastrointestinal Stromal Tumors ; Glomus Tumor ; Humans ; Immunohistochemistry ; Leiomyoma ; Myocytes, Smooth Muscle ; Neurilemmoma ; Stomach