A 30-year-old man developed basal cell carcinoma 3 years ago which showed as a pea sized, crusted nodule with extending pigmentation and telangiectasia on the inner side of the right lower eyelid. Five stages of Mohs micrographic surgery were required for the complete eradication of all tumor cells in the lesions of the nodule and extending pigmentation. The defect following the surgery was 4.5 × 3.5cm and was too large to repair with a primary closure or simple single flap. So, the defect was repaired with a combined flap of glabellar bilobed and cheek rotation. We report that the combined flap of glabellar bilobed and cheek rotation is a useful and relatively simple method for the reconstruction of a large defect on the inner side of the lower eye-lid area.
Adult ; Carcinoma, Basal Cell ; Cheek ; Eyelids ; Humans ; Methods ; Mohs Surgery* ; Peas ; Pigmentation ; Telangiectasis

No abstract available.
Hair*

BACKGROUND: Acne scars are not effectively corrected by a single treatment modality because of their widely varied depths and widths. OBJECTIVE: This study was performed to assess the effectiveness of staged combinations of several surgical modalities in the treatment of various acne scars. METHODS: Chemical peeling, CO₂ laserbrasion, scar excision, punch grafting, and dermabrasion were included in this study as surgical modalities. Initially, chemical peeling was performed on all patients and then CO₂ laserbrasion, scar excision and punch grafts were used for deep scars. Finally, dermabrasion was done for the remaining scars. Questionnaires were completed for clinical assessments by the patients and clinicians. RESULTS: Clinicians assessed the results as "excellent and good" in 75% of patients. However, only 53% of patients gave this same result. The degree of satisfaction escalated as the followup periods and number of chemical peeling procedures increased and as the sequence of the 3 staged operation progressed. CONCLUSION: We suggest that the principle of 3 staged operations would be effective in the treatment of patients with various types of acne scars.
Acne Vulgaris* ; Cicatrix ; Dermabrasion ; Follow-Up Studies ; Humans ; Transplants

BACKGROUND: In eczematous skin it is expected that altered defense mechanisms are employed against an injury, which mechanisms include alterations in the stratum corneum barrier function and lipid contents. OBJECTIVE: To investigaten aspect of pathophysiology of hand eczema by comparing the water holding capacities and transepidermal water loss(TEWL) after injuries on the skin and by comparing the epidermal lipid contents between hand eczema and normal subjects. METHODS: The water holding capacities were checked by corneometer, and the TEWL were checked after epidermal barrie! destruction with acetone or adhesive tapes. The epidermal lipids were extracted with acetone, ther (1: 1 v/v) mixture solvent and analysed by HP- TLC. RESULTS: The water holdingapacities were decreased in eczema of the palm, but the recoveries of TEWL and the lipid content did not differ between hand eczema and normal subjects. CONCLUSION: The water holding capacities were decreased in the eczematous skin. But there were no significant differencies in the recovery of destructed epidermal barrier and the epidermal lipid contents.
Acetone ; Adhesives ; Defense Mechanisms ; Eczema* ; Hand* ; Skin ; Water

BACKGROUND: Massive bleeding, inability to identify important landmarks and structures, and necessity for a blood transfusion have been the usual problems of hemangioma excision. OBJECTIVE: We introduce a CO2 laser excision technique as a surgical method for the treatment of hemangioma of the lips and demonstrate its benefits. METHODS: In 4 patients with nevus flammeus of hemiface and accompanying hemangioma of the lips, excision of the hemangioma was performed using a focused beam from a CO2 laser under local anesthesia. RESULTS: Excellent to good results were achieved with minimal blood losses in all patients. No or minimal post-operative pain and edema and no significant complications were observed. CONCLUSION:The CO2 laser excision technique is recommended since it renders less textural change, greater volume reduction, hemostasis and an overall good cosmetic outcome than defocused modes or conventional scalpel surgery.
Anesthesia, Local ; Blood Transfusion ; Edema ; Hemangioma* ; Hemorrhage ; Hemostasis ; Humans ; Lasers, Gas* ; Lip* ; Port-Wine Stain

The pseudolymphoma of the stomach is known to be a benign porliferation of lymphoid tissue, which can bemistaken hostoloigcally for malignant lymphoma. The etiology of pseudolymphoma is controversial, but it B believedto be a manifestation of chronic inflammatory process. Authors present 3 cases of gastric lymphoma. Impresssionsof upper gastrointestual series were as follows; lymphoma or chronic gastritis in one case, ulcerative carcinomain another case and early gastric carcinoma in the other case. Initial endoscopic findings suggested infiltratingcarcinoma, ulcerative carcinoma and two benign gastric ulcers, respectively. One case was associated wtih earlygastric carcinoma.
Gastritis ; Lymphoid Tissue ; Lymphoma ; Pseudolymphoma ; Stomach ; Stomach Ulcer ; Ulcer

Eccrine nevus is an unusual entity with various clinical manifestations. Histologically the eccrine apparatus appears simply increased in number and/or size, but structurally normal. We present a case of eccrine nevus on the dorsum of the left 3rd and 4th fingers in a 20 year-old female. The lesions were 3 × 2cm sized, well demarcated, smooth surfaced, brownish plaques with mild hyperhidrosis. Histological examination revealed hyperkeratosis in the stratum corneum and hyperpigmentation of basal layer, and an increased number of eccrine sweat glands and many eccrine coils in the dermis was seen.
Dermis ; Female ; Fingers ; Humans ; Hyperhidrosis ; Hyperpigmentation ; Nevus* ; Sweat Glands

Intra- and extrahepatic bile duct can be invaded by hepatocellular carcinoma (HCC). This is infrequent in HCC, but it can directly affect the clinical manifestation and prognosis. We present eight cases of HCCs with emphasis on the incidence and features of bile duct invassion on computed tomography (CT). Over a period of 22 months, abdominal CT was performed in 186 with HCC patients. Out of these, five cases of bile duct invasion by HCC were confirmed in our hospital and three in other hospitals. The eight cases were evaluated for the type, size and location. CT features of intraductal mass and ductal dilatation were evaluated. The incidence of bile duct invasion in HCC was 2.6%. Infiltrative type of HCC was seen in seven cases and six of these had mass 5-11 cm in size. The characteristic CT findings of bile duct invasion in HCC are mass in common hepatic duct with bulging contour(8/80, multiple intraductal masses in the intrahepatic ducts (5/8), and diffuse dilatation of intrahepatic ducts (7/8).
Bile Ducts* ; Bile Ducts, Extrahepatic ; Bile* ; Carcinoma, Hepatocellular* ; Dilatation ; Hepatic Duct, Common ; Humans ; Incidence ; Prognosis ; Tomography, X-Ray Computed

Eleven patients with proved Bronchiolo-aveolar cell carcinoma were found in the chest department of thenational menical center from 1975 to 1981. The incidence of Bronchiolo-alveolar cell carcinoma is recentlyincreased as primary lung carcinoma. The result as follow. 1. The ratio of male and female was 5:6 and anincidence of 4.4% among total primary lung cancer patients. The highest incidence (3 of cases) was seen in thesixth decade, and the remaining cases were evenly distributed in the third, fourth, and fifth decades of life.Among them youngest was 29 years old and the oldest was 66 years old. 2. Clinical and radiological initialdiagnosis prior to the final diagnosis were as follows; pulmonary tuberculosis; 7 cases, pneumonia; 1 case,bronchiectasis; 1 case, and lung cancer; 2 cases. 3. Radiological examination of chest presented several pictures;most commonly, homogenous or patchy infiltrations; 6 cases, nodular or mass like densities; 2 cases, disseminatednodular or military patterns; 2 cases, and reticular pattern; 1 case. 4. Bronchogram reveald no contributablefindings except one case of complete tappering obstruction of the segmental bronchus. Therefore we arrive at theconclusion that early diagnosis will result in increased resectability and improved survival so aggressivediagnositic work-up for suspicious pulmonary infiltrate is necessary.
Bronchi ; Diagnosis ; Early Diagnosis ; Female ; Humans ; Incidence ; Lung ; Lung Neoplasms ; Male ; Military Personnel ; Pneumonia ; Thorax ; Tuberculosis, Pulmonary

Pulmonary artery sling is a rare vascular anomaly in which the left pulmonary artery arises from the right pulmonary artery and then traverses between the esophagus and the trachea toward the hilum of the left lung. Despite the availability of a corrective operation, the mortality rate remains very high due to the high incidence of associated obstructive anomalies of tracheobronchial trees. We experienced a 8 month old female infant who was admitted because of recurrent pneumonia and expiratory wheezing. She was diagnosed as pulmonary sling by esophagography, echocardiography, computed tomography. We report this with a brief review and related literature.
Echocardiography ; Esophagus ; Female ; Humans ; Incidence ; Infant ; Lung ; Mortality ; Pneumonia ; Pulmonary Artery* ; Respiratory Sounds ; Trachea