No abstract available.
Epidermal Cyst*

PURPOSE: Laryngeal fracture is rare, but complications are frequent and severe. Controversy still exists in regards to its proper management. The aim of this study was to present the clinical findings and management of laryngeal fracture in Korea. MATERIALS AND METHODS: We analyzed the medical records of 22 patients with laryngeal fracture at a tertiary care trauma center from 2000 to 2010 retrospectively. RESULTS: In total, 22 patients (19 men and 3 woman) presented with laryngeal fractures caused by blunt (n=13) or penetrating (n=9) injury. Pain (68.1%), odynophagia (68.1%), hoarseness (18.1%), hemoptysis (13.6%), and subcutaneous emphysema (9%) were the common presenting symptoms and noncomminuted fracture was common. High velocity blunt trauma (mostly traffic accidents) patients had more extensive injury and poor voice outcomes. Penetrating trauma patients due to physical assault or suicide attempt demonstrated more frequently injuries on the left side. CONCLUSION: In driver-caused traffic accidents, where injuries in a wide area within the larynx occurred, poor voice results were seen, and these injuries required aggressive treatment. When endotracheal intubation was performed at experienced emergency centers with fiberoptic laryngoscopes, airway management was safely achieved. In addition, if the fractured laryngeal framework was corrected at appropriate times, voice results were good.
Accidents, Traffic ; Airway Management ; Cartilage ; Emergencies ; Hemoptysis ; Hoarseness ; Humans ; Intubation, Intratracheal ; Korea ; Laryngoscopes ; Larynx ; Male ; Medical Records ; Retrospective Studies ; Subcutaneous Emphysema ; Suicide ; Tertiary Healthcare ; Trauma Centers ; Voice

PURPOSE: Hypocalcemia is the most common complication after total thyroidectomy. The purpose of this study was to determine whether measurement of intact parathyroid hormone (i-PTH) level in thyroidectomy patients could predict hypocalcemia. MATERIALS AND METHODS: We performed a prospective study of patients undergoing total thyroidectomy. Serum concentration of i-PTH, total calcium (Ca), ionized calcium (Ca2+), phosphate (P), magnesium (Mg), and albumin were measured preoperatively and at 0 hour, 6 hours, 12 hours, 24 hours, 48 hours, and 72 hours postoperatively. RESULTS: 108 patients were recruited to the study. A total of 50 patients (46%) experienced hypocalcemia. The serum i-PTH concentration was linearly related to the time of measurement, while concentrations of P, Mg, albumin, Ca, and Ca2+ were not. We compared odds ratios, and found that the concentration of i-PTH at 6 hours post operation was the most closely related to the occurrence of hypocalcemic symptom. On ROC analysis using i-PTH level at 6 hours, an i-PTH level of 10.6 mg/dL was found to maximize both sensitivity and specificity at the same time point. CONCLUSION: We found that i-PTH was a predictor of hypocalcemia, and that the earliest predictor of hypocalcemic symptoms was an i-PTH concentration lower than 10.6 mg/dL obtained 6 hours after total thyroidectomy.
Calcium/blood ; Humans ; Hypocalcemia/*diagnosis ; Magnesium/blood ; Odds Ratio ; Parathyroid Hormone/*blood ; Phosphates/blood ; Postoperative Complications/blood/*diagnosis ; Prospective Studies ; Serum Albumin ; Thyroidectomy/*adverse effects

BACKGROUND: Treatments including intralesional corticosteroid injection, pressure therapy, cryotherapy, and various laser therapies have had limited success for keloids and hypertrophic scars. OBJECTIVE: This trial evaluated the efficacy of a combination of 578 nm copper bromide laser and the more traditional intralesional corticosteroid injection for the treatment of keloids and hypertrophic scars with respect to scar color. METHODS: Keloids or hypertrophic scars of 12 Korean patients were treated five times by the combined treatment at 4-week intervals. Clinical improvement was assessed by the physicians' global assessment (PGA) comparing pre- and post-treatment photographs, as well as 4 weeks after the last treatment. Erythema intensity was quantified using a mexameter. RESULTS: Most scars showed significant clinical improvement in PGA and decreased erythema intensity after 5 treatments. All patients showed improvements in symptoms like pruritus. CONCLUSION: The combined treatment is effective for keloids and hypertrophic scars, especially when the telangiectatic portion of the scars is prominent. The adjunctive use of 578 nm copper bromide laser decreased the telangiectatic side effects of an intralesional corticosteroid injection by reducing the vascular components of scars.
Cicatrix ; Cicatrix, Hypertrophic* ; Copper* ; Cryotherapy ; Erythema ; Humans ; Keloid* ; Laser Therapy ; Pilot Projects* ; Pruritus

Sorafenib (Nexavar(R), BAY 43-9006) is a novel, orally administered multi-kinase inhibitor that has recently been approved for the treatment of metastatic renal cell carcinoma. It is also used to delay disease progression in patients with advanced solid organ malignancies and metastatic melanoma. Sorafenib is associated with a relatively high incidence of dermatologic adverse events. The commonly occurring dermatologic adverse events associated with sorafenib include hand-foot skin reaction, facial erythema, splinter subungual hemorrhages, alopecia, pruritus and xerosis. We report here on a case of a 50-year-old man who was diagnosed with metastatic hepatocellular carcinoma. He developed both facial erythema and hand-foot skin reaction after the administration of sorafenib.
Alopecia ; Bays ; Carcinoma, Hepatocellular ; Carcinoma, Renal Cell ; Disease Progression ; Erythema ; Hemorrhage ; Humans ; Incidence ; Melanoma ; Middle Aged ; Niacinamide ; Phenylurea Compounds ; Pruritus ; Skin

Primary cutaneous mucinous carcinoma is a rare epithelial neoplasm that arises from the deepest portion of the eccrine duct. It most commonly occurs on the scalp and face with a preference for on the eyelids. The histopathologic characteristics are large mucinous pools with fibrous septae and clusters of tumor cells. We report here on a case of mucinous carcinoma that developed on the abdomen of a 47-year-old woman.
Abdomen ; Adenocarcinoma, Mucinous ; Eyelids ; Female ; Humans ; Middle Aged ; Mucins ; Neoplasms, Glandular and Epithelial ; Scalp

Primary cutaneous mucinous carcinoma is a rare epithelial neoplasm that arises from the deepest portion of the eccrine duct. It most commonly occurs on the scalp and face with a preference for on the eyelids. The histopathologic characteristics are large mucinous pools with fibrous septae and clusters of tumor cells. We report here on a case of mucinous carcinoma that developed on the abdomen of a 47-year-old woman.
Abdomen ; Adenocarcinoma, Mucinous ; Eyelids ; Female ; Humans ; Middle Aged ; Mucins ; Neoplasms, Glandular and Epithelial ; Scalp

Cutaneous metastases from gastric adenocarcinoma are extremely rare. When present, metastasis typically signifies disseminated disease with a poor prognosis. We report a case of an 80-year-old male with gastric cancer who presented with a single, erythematous plaque on the left palm, a very rare site for skin metastasis. Results of a skin biopsy demonstrated that the cutaneous metastasis originated from the stomach. This report emphasized the need for appropriate investigation into newly appearing, unusual, or persistent skin lesions.
Adenocarcinoma ; Aged, 80 and over ; Biopsy ; Humans ; Male ; Neoplasm Metastasis ; Prognosis ; Skin ; Stomach ; Stomach Neoplasms

The granular cell tumor (GCT) is an uncommon, benign lesion with a preference for subcutaneous sites. In the head and neck, the tongue is the most common site, followed by the larynx. We experienced a case of a 27-year-old woman with lingual squamous cell carcinoma (SCC) surrounded by GCT. The pathological findings established that the lesion was SCC covered by GCT in the midline of the tongue. The size of the mass was very small, however, so we excised it in a diamond shape. There is an interesting association between GCTs and other malignant neoplasms. However, no causal relationship between GCT and these other carcinomas has been established. Here we report on an SCC coexisting with GCT at the same site as a median tongue lesion and review the literature.
Adult ; Carcinoma, Squamous Cell ; Diamond ; Female ; Granular Cell Tumor ; Head ; Humans ; Larynx ; Neck ; Tongue

PURPOSE: The aim of this study was to compare a negative pressure drain with a natural drain in order to determine whether a negative pressure drainage tube causes an increase in the drainage volume. MATERIALS AND METHODS: Sixty-two patients who underwent total thyroidectomy for papillary thyroid carcinoma (PTC) were enrolled in the study between March 2010 and August 2010 at Gyeongsang National University Hospital. The patients were prospectively and randomly assigned to two groups, a negative pressure drainage group (n=32) and natural drainage group (n=30). Every 3 hours, the volume of drainage was checked in the two groups until the tube was removed. RESULTS: The amount of drainage during the first 24 hours postoperatively was 41.68+/-3.93 mL in the negative drain group and 25.3+/-2.68 mL in the natural drain group (p<0.001). After 24 additional hours, the negative drain group was 35.19+/-4.26 mL and natural drain groups 21.53+/-2.90 mL (p<0.001). However, the drainage at postoperative day 3 was not statistically different between the two groups. In addition, the vocal cord palsy and temporary and permanent hypocalcemia were not different between the two groups. CONCLUSION: These results indicate that a negative pressure drain may increase the amount of drainage during the first 24-48 hours postoperatively. Therefore, it is not necessary to place a closed suction drain when only a total thyroidectomy is done.
Adult ; Aged ; Carcinoma/*surgery ; Drainage/*instrumentation/*methods ; Female ; Humans ; Male ; Middle Aged ; Postoperative Care/methods ; Postoperative Complications/surgery ; Postoperative Period ; Pressure ; Prospective Studies ; Reproducibility of Results ; Surgical Procedures, Operative ; Thyroid Neoplasms/*surgery ; Thyroidectomy/*instrumentation/*methods ; Time Factors ; Treatment Outcome