Perivascular epithelioid cell tumor (PEComa) is a mesenchymal tumor consisting of distinctive perivascular epithelioid cells, and is commonly detected in the uterus. The liver is an uncommon site for primary PEComa. In this study, we report a case of primary hepatic PEComa in a 36-year-old woman. Upon gross examination, the tumor was a well-defined, brownish solid mass, measuring 6.5x5.2x4.5 cm. Microscopically, the tumor consisted largely of epithelioid cells and some spindle cells with a clear to eosinophilic cytoplasm and a rich network of delicate capillaries in the stroma. With the exception of their relatively large size and microscopically sinusoidal infiltrative growth pattern, all other histopathologic features of the tumor were consistent with their being benign. The tumor cells were positive for human melanoma black-45 and smooth muscle actin, and negative for cytokeratin-cocktail and c-kit.
Actins ; Adult ; Capillaries ; Cytoplasm ; Eosinophils ; Epithelioid Cells ; Female ; Humans ; Liver ; Melanoma ; Muscle, Smooth ; Perivascular Epithelioid Cell Neoplasms ; Uterus

Perivascular epithelioid cell tumor (PEComa) is a mesenchymal tumor consisting of distinctive perivascular epithelioid cells, and is commonly detected in the uterus. The liver is an uncommon site for primary PEComa. In this study, we report a case of primary hepatic PEComa in a 36-year-old woman. Upon gross examination, the tumor was a well-defined, brownish solid mass, measuring 6.5x5.2x4.5 cm. Microscopically, the tumor consisted largely of epithelioid cells and some spindle cells with a clear to eosinophilic cytoplasm and a rich network of delicate capillaries in the stroma. With the exception of their relatively large size and microscopically sinusoidal infiltrative growth pattern, all other histopathologic features of the tumor were consistent with their being benign. The tumor cells were positive for human melanoma black-45 and smooth muscle actin, and negative for cytokeratin-cocktail and c-kit.
Actins ; Adult ; Capillaries ; Cytoplasm ; Eosinophils ; Epithelioid Cells ; Female ; Humans ; Liver ; Melanoma ; Muscle, Smooth ; Perivascular Epithelioid Cell Neoplasms ; Uterus

The authors report our experience of digital pulp reconstruction by free great toe pulp transfer. Twelve patients were treated with lateral great toe hemipulp. Twelve cases of digital pulp defect were reviewed, including 2 thumbs and 10 indices. There were 11 primary cases and 1 case of secondary reconstruction. We noted no necrosis and 5 patients suffered from cold intolerance. The flap sensibility, according to ASSH criteria, was excellent in 1 case, good in 10 cases, fair in 1 case and poor in no cases. The range of the stationary two-point discrimination test was between 4 and 15mm (mean S2-PD value; 7.2mm). The subjective evaluation found in 11 patients was satisfactory and dissatisfactory in 1. Performing this procedure during the acute phase may improve the management of trauma by reducing the time needed for cicatrisation and the length of disability. Furthermore, the principal advantages of this procedure are minimal donor site morbidity, as well as excellent functional and cosmetic gain.
Discrimination (Psychology) ; Humans ; Necrosis ; Thumb ; Tissue Donors ; Toes*

No abstract available.
Osteoma*

No abstract available.
Rhytidoplasty*

No abstract available.

For treatment of the pressure sore, varieties of methods have been developed such as skin graftings, local flap, myocutaneous or fasciocutaneous flap, etc.. Except mild cases, myocutaneous flaps have been used commonly for the best coverage and padding of the wound. But the gluteus maximus muscle is not an expendable muscle, so the myocutaneous flaps using gluteus maximus muscle result in significant functional loss in ambulatory patients. Various methods as fasciocutaneous flap to reserve a function of the gluteus maximus muscle have been developed. We especially designed a bilateral fasciocutaneous flap in the fashion of interdigitating extended V-Y advancement in sacral sore when the defect is fusiform transversely in shape. With this design, we obtained reduced tension in the midline suture with less dissection in medial portion of the fasciocutaneous flap and made the flap more rleliable by including more parasacral perforators within the flap. We have experienced the eight cases of gluteal fasciocutaneous V-Y advancement flap and obtained the excellent results without flap necrosis. We conclude that a bilateral fasciocutaneous flap in the fashion of interdigitating extended V-Y advancement is useful in sacral sore when the defect is fusiform transversely in shape.
Humans ; Myocutaneous Flap ; Necrosis ; Pressure Ulcer ; Skin Transplantation ; Sutures ; Wounds and Injuries

This retrospective study comprise 595 patients with facial bone fractures in various accidents and treated in the department of Plastic and Reconstructive Surgery, the Chung Buk National University Hospital between September 1991 and December 1997. The medical records of these 595 patients were reviewed and analyzed in order to obtain the clinical pattern and understand the therapeutic modalities. The following results were obtained. 1. The most prevalent age group was the third decade(35.1%). 2. The monthly incidence was the highest in September and the most common accident time was between 6:00 p.m. and midnight. 3. The most common etiology was motor vehicle accidents(59.5%) followed by assault(26.2%), fall(11.4%), sports(2.7%). 4. The male predominated over female in 4.27:1 ratio. 5. The most common fracture site was nose(30.0%) followed by mandible(26.7%), zygoma(23.3%), orbit(8.6%), maxilla(8.1%), frontal sinus(3.2%). 6. The most common fracture site of mandible was parasymphsis(34.9%) followed by angle(27.1%), condyle(23.4%), symphysis(14.5%). 7. The soft tissue injury was the most common associated injury(51.1%). Fcial soft tissue injuries were sustained by 53.3% in the highest rate associated with the associated injuries. 8. Open reduction was used for 63.7% of total cases while 33.8% of total cases required closed reduction, and 2.5% of total cases treated conservatively. 9. The complication rate was 14.1% and the ophthalmologic complication rate comprise 44.9% of all complications.
Chungcheongbuk-do ; Facial Bones* ; Female ; Humans ; Incidence ; Male ; Mandible ; Medical Records ; Motor Vehicles ; Plastics ; Retrospective Studies ; Soft Tissue Injuries

The dual muscle flap (Latissimus dorsi+ Serratus anterior muscle) based on the thoraco-dorsal vascular system for limb reconstruction has been infrequently reported. We have used this flap as a free flap for limb reconstruction in four patients (3 cases in lower linb, 1 in upper limb). A Latissmusi dorsi muscle or musculocutaneous flap and Serratus anterior muscle flap were used and all cases healed satisfactorily. The indications for this flap are to resurface two separate defects simultaneously or to resurface very large defects. It has the advantage of requiring anastomosis of one vascular pedicle only. This flap is particularly suitable for resurfacing defects wider than their length, in relation to the long axis of the limb.
Axis, Cervical Vertebra ; Extremities* ; Free Tissue Flaps ; Humans ; Myocutaneous Flap

The frontal sinus has importance from the aesthetic and functional points of view, so management of the frontal sinus should be conducted. The management may differ with the severity of displacement, the extent of displacement, as well as the involvement of the brain and nasofrontal duct. Fifteen patients with frontal sinus fracture were managed differently depending on the severity of their injuries for between 14 and 31 months, and then evaluated. During the follow-up period, encountered no complications and the overall result of the foreh ead contour was satisfactory.
Brain ; Follow-Up Studies ; Frontal Sinus* ; Humans