No abstract available.
Humans* ; Melanocytes* ; Tretinoin*

Lichen striatus usually occurs in a solitary and unilateral fashion. Its multiple and bilateral distribution is a very rare finding. We report two cases of multiple lichen striatus. The first case is a 3 year-old boy, whose skin lesions were distributed bilaterally on both upper arms and buttock. The second case is a 6 year-old girl whose skin lesions were two separated linear lesions from left chest and left upper back to left arm.
Arm ; Buttocks ; Child ; Child, Preschool ; Female ; Humans ; Lichens* ; Male ; Skin ; Thorax

Syringoma is not a uncommon tumor of the skin. It is a benign adenoma, of intraepidermal eccrine ducts. It occurs predominantly in women at puberty or adolescence. The lesions usually are multiple and small, skin colored or slightly yellowish payules, usually only 1 or 3mm in size. The lesions usually are limited to the lower eyelids but may occur on cheek, axilla, abdomen, neck, anterior chest and vulva. Rarely these are generalized in distributior. A 23 years old healthy man has had widespread lesions over the face, anterior chest and abdomen. The lesions appeared at the age of 13 on the anterior chest and abdomen. These increased in number and extended slowly to the face On visiting our department, there were numerous, angular or round, skin colored papules on his face and anterior chest as well as yellowish brown colored papules on his abdomen. Diagnosis was confirmed by clinical and histopathological findings as generalized syringoma.
Abdomen ; Adenoma ; Adolescent ; Axilla ; Cheek ; Diagnosis ; Eyelids ; Female ; Humans ; Neck ; Puberty ; Skin ; Syringoma* ; Thorax ; Vulva ; Young Adult

BACKGROUND: Autologous epidermal grafting has been reported to be successfully used in the treatment of vitiligo by several authors and is in widespread use at present time. But, the incomplete repigmentation is common and remains stressful to the patients. OBJECTIVE: The purpose of this study is to evaluate the effectiveness of autologous epidermal grafting in the treatment of vitiligo and investigate the patient satisfaction with the result. MATERIALS AND METHODS: The evaluation was conducted on 42 patients with vitiligo who had been treated by autologous epidermal grafting using suction blistered epidermis. We also investigated the patient satisfaction by interviewing with several questions. RESULTS AND CONCLUSIONS: The effectiveness of the repigmentation objectively evaluated by two dermatologists is high and favorable repigmentation (more than 80 percent) was shown in 76.2% of all the patients. But, the subjective satisfaction of the patients proved not very good, compared with the objective clinical improvement and 40.5% of the patients were unsatisfied with the results. We think the doctors should make the patients understand the expectable results from the epidermal grafting for the best patient satisfaction.
Blister ; Epidermis ; Humans ; Patient Satisfaction* ; Suction ; Transplants* ; Vitiligo*

No abstract available.
Aluminum* ; Onychomycosis* ; Yttrium*

BACKGROUND: Laser therapy can be used as an alternative treatment for onychomycosis; however, there are somelimitations to its efficacy as a single agent. OBJECTIVE: To evaluate the effectiveness of combination therapy with 1,064-nm neodymium-doped yttrium aluminum garnet (Nd:YAG) laser and topical efinaconazole in onychomycosis treatment and identify factors influencing the therapeutic outcomes of combination treatment. METHODS: Big toenails with onychomycosis were treated by 1,064-nm Nd:YAG laser at 4-week intervals with daily application of topical efinaconazole. Therapeutic response was assessed through onychomycosis severity index (OSI) and percentage of nail infected (PNI), and its association with a variety of factors that may affect treatment outcome was evaluated. RESULTS: One hundred big toenails were included in the study and significant clinical improvements were observed after treatment (OSI improvement score = 76.68 ± 28.83, PNI improvement score = 72.37 ± 30.37). There was no difference in treatment response according to the number of laser treatments, onychomycosis clinical type, or initial severity. However, patient age was negatively correlated with clinical improvement (p = 0.019). Also, female patients had better therapeutic responses than male patients. CONCLUSION Combined treatment with Nd:YAG laser and topical efinaconazole has a significant therapeutic effect on onychomycosis. A randomized controlled trial is warranted in the future.

Objective: : In March 2020, World Health Organization declared a global pandemic caused by a novel coronavirus (SARS-CoV-2). The disease caused by this virus is called COVID-19. Due to its high contagiousness, many changes have occurred in overall areas of our daily life including hospital use by patients. The aim of this study was to investigate the impact of COVID-19 on volume of spine surgery in South Korea using the National Health Insurance database and compare it with the volume of a homologous period before the pandemic. Methods: : Data of related to spine surgery from January 2019 to April 2021 were obtained from the National Health Insurance and Health Insurance Review and Assessment Service database. Primary outcomes were total number of patients, rate of patients per 100000 population, and total number of procedures. The number of patients by hospital size was also analyzed. Results: : COVID-19 outbreaks occurred in South Korea in March, August, and December of 2020. Compared to the previous year, the total number of patients who underwent spinal surgery showed a decrease for 2–3 months after the first and second outbreaks. However, it showed an increasing trend after the third outbreak. The same pattern was observed in terms of the ratio of the number of patients per 100000 population. Between 2019 and 2021, the mean number of spine surgeries per month tended to increase. Mean annual medical expenses increased over the years (p=0.001). When the number of spine surgeries was analyzed by hospital size, proportion of tertiary general hospital in 2021 increased compared to those in 2019 and 2020 (vs. 2019, p=0.012; vs. 2020, p=0.016). The proportion of general hospital was significantly decreased in 2020 compared to that in 2019 (p=0.037). Conclusion : After the COVID-19 outbreak, patients tended to postpone spinal surgery temporarily. The number of spinal surgeries decreased for 2–3 months after the first and second outbreaks. However, as the ability to respond to the COVID-19 pandemic at the hospital and society-wide level gradually increased, the number of spine surgeries did not decrease after the third outbreak in December 2020. In addition, the annual number of spine surgeries continued to increase. However, it should be noted that patients tend to be increasingly concentrated in tertiary hospitals for spinal surgery.

PURPOSE: The aim of this study was to determine the feasibility and safety of laparoscopy-assisted gastrectomy (LAG) with lymph node dissection for gastric cancer according to the analysis of postoperative complications. METHODS: The authors attempted LAG with lymph node dissection in 117 consecutive patients with gastric cancer. The clinicopathologic characteristics of the patients, operative outcomes, preoperative comorbidities and postoperative morbidities and mortalities were evaluated using the stomach cancer database of Dong-A university hospital and medical charts. RESULTS: Among the 114 successful patients, 100 had early gastric cancer and 14 had advanced gastric cancer. The mean operation time was 259.2 minutes (range 150~415). The mean number of retrieved lymph nodes was 23.4 (range 6~66). The mean time to the first flatus and postoperative hospital stay were 3.7 and 10.0 days, respectively. The overall operative mortality rate, hospital death rate and the overall rate of postoperative complications were 0, 1.7 and 14.7%, respectively. The major and minor complication rate were 4.3 and 10.4%, respectively. CONCLUSION: LAG with lymph node dissection is technically feasible and receptive as surgical treatment for patients with gastric cancer, although various postoperative complications can arise in LAG as they do in open gastrectomy.
Comorbidity ; Flatulence ; Gastrectomy* ; Humans ; Length of Stay ; Lymph Node Excision* ; Lymph Nodes* ; Mortality ; Postoperative Complications ; Stomach Neoplasms*

Conventional removal of benign skin tumors with transverse or elliptical excision often results in depression, considerable dog ear formation and lengthening of the final scar. The resulting scar is always longer than the maximal diameter of the elevated skin tumor. Curvilinear transverse incision was designs on the center of the skin tumor, then on the center of transverse incision, the vertical limb incision was added to complete T-shaped incision. After local anesthetic solution was infiltrated through the designed lines, the mass was completely removed. To obliterate dead space, the mid point of the incision was approximated with a suture; there remained dog ears on both sides. To remove the dog ears, triangular flaps were advanced anteromedially, excised, and sutured. Resection of the skin tumors through T-shaped incision provides easy dissection, simultaneous dog ear and dead space repair and elimination of depression of the skin lesion site. To predict the length of the vertical limb incision, it was measured intraoperatively, the length of the vertical limb incision was ranged from 30% to 41% of the transverse incision. So, initially the length of the vertical limb incision was safely designed to remove dog ears and depression from one third of the transverse incision.
Animals ; Cicatrix ; Depression ; Dogs ; Ear ; Extremities ; Skin* ; Sutures

Recent studies of molecular biology have suggested that infection with human papillomavirus(HPV) is implicated in the pathogenesis of cervical carinoma. HPV infection alone, however, does not appear to be sufficient for the process of maliganant transformation, suggesting the requirement of additional cellular events. The mutation of p53, which is involved in negative control of cell proliferation, may play a role in the carcinogenesis of cervical carcinoma. The present study was designed to clarify the association between infection with HPV and p53 alteration in primary carcinoma of human uterine cervix. We investigated 46 prim-ary cervical carcinomas for the presence of HPV DNA by in situ hybridization(ISH) with probe specific for HPV 16/18, and examined the accumulation of p53 protein by immunohis-tochemistry(IHC) and the p53 alteration by polymerase chain reaction-single strand confor-mation polymorphism(PCR-SSCP) using formalin fixed, paraffin -embedded tissue. HPV DNA 16/18 was detected in 18 cases(39.1%) of 46 cervical carcinomas. The accumulation of p53 was identified in tumor cells: low level 43.5%(20/46) and high level 32.6% difference of positive reaction by IHC method. But there was no statistical significant between the infection of HPV and the accumulation of p53(p=0.847). Mutations in exons 4 through 9, where the vast majority of point mutations were reported in human neoplasms, were screened by PCR-SSCP analysis. Altered mobilities of the PCR product of p53 were also found in 9 cases(26.5%) of 34 cervical carcinoma: one in exon 4, four in exon 5/6, two in exon 7, and two in exon 8/9. The mutation of p53 was observed in 41.1%(19/46) respective of the result of IHC and PCR-SSCP, and there was slightly higher p53 alteration in HPV negative cases(23.8%, 11/46) than in HPV positive cases(17.4%, 8/46) without statistical significance(p=0.729). The conclusion of these observations suggests that HPV infection and alteration of p53 may play a critical role in tumorigenesis of carcinoma of the human uterine cervix independently, ant there is important difference in the tumorigenic pathway between two factors.
Ants ; Carcinogenesis ; Carcinoma, Squamous Cell ; Cell Proliferation ; Cervix Uteri ; DNA ; Exons ; Female ; Formaldehyde ; Genes, p53* ; Humans ; Molecular Biology ; Paraffin ; Point Mutation ; Polymerase Chain Reaction