Neonatal lupus erytematosus is a distinct subset of lupus erythematosus. It is characterized by cutaneous findings exhibiting the morphology of subacute cutaneous lupus erythematosus, congenital heart block, and anti-Ro/SSA and/or anti-La/SSB autoantibodies which result from the transplacental passage of maternal autoantibodies. We report a case of a 12-week-old female infant who presented with characteristic clinical and histopathological features of cutaneous neonatal lupus erythematosus but without evidence of congenital heart block. Initial serological studies reveled the presence of anti-La/SSB anti-bodies and antinuclear antibodies. 5 months later, follow-up serology was negative in accordance with a clinical remission.
Antibodies, Antinuclear ; Autoantibodies ; Female ; Follow-Up Studies ; Heart Block ; Humans ; Infant ; Lupus Erythematosus, Cutaneous

Nowadays shoulder ultrasound is commonly used in the assessment of shoulder diseases and is as accurate as magnetic resonance imaging in the detection of several pathologies. Operator dependence is the main disadvantage of shoulder ultrasound. After adhering to a strict examination protocol, good knowledge of normal anatomy and pathologic processes and an awareness of common pitfalls, it can be used as a focused examination providing rapid, real-time diagnosis, and treatment by ultrasound-guided interventions in desired clinical situations. Also shoulder ultrasound can help the surgeon decide whether treatment will be surgical or nonsurgical. If arthroscopy is planned, sonographic findings help to counsel patients regarding surgical and functional outcomes. If a nonsurgical approach is indicated, ultrasound can be used to follow patients. This review article presents the examination techniques, the normal sonographic appearances and the main pathologic conditions found in shoulder ultrasound. And also addresses a simplified approach to scanning and ultrasound-guided intervention. Knowledge of optimal techniques, normal anatomy, dynamic maneuvers, and pathologic conditions is essential for optimal performance and interpretation of images.
Arthroscopy ; Diagnosis ; Humans ; Magnetic Resonance Imaging ; Pathologic Processes ; Pathology ; Shoulder* ; Ultrasonography*

OBJECTIVES: Manganese is cytotoxic to the central nervous system including basal ganglia. Its toxic mechanism is related to oxidative stress, mediated by toxic free radicals but is specultives. In the present study, we have investigated to manifest apoptosis in manganese-induced cytotoxicity in primary neuronal cell culture of rat basal ganglia. METHOD: To detect apoptotic neuronal cells were stained by the terminal deoxynu-cleotide(TdT)-mediated dUTP nick end-labelling(TUNEL) method and apoptotic changes in nuclei of neurons were observed by electron microscopy. RESULTS: We showed that TUNEL immunostain showed brownish signal in the nuclei of apoptotic cells and the proportions of apoptotic cells in Manganese treatment groups were more higher than controls. On transmission electron microscopy, there were chromatine condensation with margination toward nuclear membrane and condensation of cytoplasm in the treated with luM MnC1, for 48 hours in a basal ganglia neurons. Apoptotic bodies were found and consisted of semilunar-like condensed nuclei with relatively intact cytoplasmic organelles. CONCLUSIONS: Apoptosis appears to be one mechanism in the manganese-induced neuronal cell death. Manganese intoxication is a convenient model for apoptosis study.
Animals ; Apoptosis* ; Basal Ganglia* ; Cell Culture Techniques* ; Cell Death ; Central Nervous System ; Chromatin ; Cytoplasm ; Free Radicals ; In Situ Nick-End Labeling ; Manganese* ; Microscopy, Electron ; Microscopy, Electron, Transmission ; Neurons* ; Nuclear Envelope ; Organelles ; Oxidative Stress ; Rats

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.
Cicatrix ; Cosmetics ; Diplopia ; Ectropion ; Enophthalmos ; Equipment and Supplies ; Eyelids ; Facial Bones ; Female ; Humans ; Male ; Orbit ; Postoperative Complications ; Reconstructive Surgical Procedures ; Zygomatic Fractures

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.
Biopsy ; Tenosynovitis ; Ulcer ; Wrist

The external laryngeal trauma is a rare but clinically important injury. The blunt trauma is more common than penetrating one. As other trauma, early suspicion and accurate diagnosis of acute laryngeal and tracheal injuries are crucial. If the airway obstruction is impending, secure airway should be made before diagnosis or treatment. The computed tomography scans play an important role in diagnosis and combined cervical esophageal injury should be evaluated. Proper restoration of the laryngeal framework with appropriately timed open reduction and internal fixation is critical for optimal recovery of the airway, voice, and swallowing.
Airway Obstruction ; Deglutition ; Diagnosis ; Larynx ; Trachea ; Voice

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.
Alveolar Ridge Augmentation ; Dislocations ; Displacement (Psychology) ; Foreign Bodies ; Humans ; Osteotomy ; Polyethylene ; Prostheses and Implants ; Sensation ; Transplants

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.
Aged ; Biopsy ; Early Diagnosis ; Glycosaminoglycans ; Hemangiosarcoma ; Humans ; Liver ; Lung ; Lymph Nodes ; Male ; Neck ; Neoplasm Metastasis ; Periosteum ; Prognosis ; Recurrence ; Scalp ; Skin ; Survival Rate ; Transplants

PURPOSE: Median nerve entrapment syndrome within carpal tunnel is usually called carpal tunnel syndrome and it is the most common form of peripheral nerve entrapment syndrome. Many factors such as diabetes mellitus, hypothyroidism, hormonal replacement theraphy, corticosteroid use, rhematoid arthritis and wrist fractures may cause carpal tunnel syndrome. To the best of our knowledge, this is the first case report of median nerve entrapment syndrome due to adhesion of laceration wound after suicidal attempt. METHODS: A 28-year-old woman presented with a sensory change and thenar hypotrophy on her left hand. On her history, she attempted suicide by slashing her wrist. Initial electromyography (EMG) showed that the nerve conduction velocities of median nerve was delayed. Therefore, we performed surgical procedures. When exploration, Fibrous scar tissue observed around the median nerve but nerve had not been injured. Transcarpal ligament was completely released and adjacent fibrous tissue was removed to decompress the median nerve. RESULTS: The postoperative course was uneventful until the first year. Opposition difficulty and thenar hypotrophy were improved progressively after the surgery. Sensory abnormality was slowly improved over one year. CONCLUSION: We report a case of median nerve entrapment syndrome that was caused by adhesion of laceration wound after suicidal attempt. This is an unusual cause of median nerve entrapment syndrome, the symptoms were relieved after transcarpal ligament release and fibrous scar tissue removal.
Adult ; Arthritis ; Carpal Tunnel Syndrome ; Cicatrix ; Diabetes Mellitus ; Electromyography ; Female ; Hand ; Humans ; Hypothyroidism ; Lacerations ; Ligaments ; Median Nerve ; Neural Conduction ; Peripheral Nerves ; Suicide, Attempted ; Wrist

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.
Blepharoplasty ; Cicatrix ; Ethnic Groups ; Extremities ; Female ; Hand ; Humans ; Internal Medicine ; Korea ; Male ; Rhinoplasty ; Social Justice ; Surgery, Plastic