Syringomas are relatively common benign adnexal tumors that are usually located on the lower eyelids, although affecting other areas, including cheek, axillae, abdomen and vulva. Acral syringomas, located on distal extremities are vary rare and there is only one case reported in Korea. We report a case of a healthy 21-year-old woman with multiple, reddish brown syringomas located on both forearms and the dorsa of hands. The histologic findings were typical of syringomas.
Abdomen ; Axilla ; Cheek ; Extremities ; Eyelids ; Female ; Forearm ; Hand ; Humans ; Korea ; Syringoma* ; Vulva ; Young Adult

Appendicitis is the most common diagnosis of acute abdominal pain that may require surgical treatment, and 8.6% for men and 6.9% for women are at risk for this illness over the course of their lives. During the past century, appendectomy was the standard treatment for acute appendicitis. However, laparoscopic appendectomy has been used as the first-line treatment choice for appendicitis since the introduction of laparoscopic surgery. In cases of perforation or abscess, interval appendectomy and percutaneous drainage are recommended. Treatment strategies have become more diverse. In recent years, in some European countries, non-surgical treatment has been used for simple appendicitis without complications, and nonoperative treatment of appendicitis has become increasingly common in adults and children. In this article, nonoperative treatment of appendicitis is introduced, and guidelines for the selection of antibiotics according to appendicitis classification are summarized.

Appendicitis is the most common diagnosis of acute abdominal pain that may require surgical treatment, and 8.6% for men and 6.9% for women are at risk for this illness over the course of their lives. During the past century, appendectomy was the standard treatment for acute appendicitis. However, laparoscopic appendectomy has been used as the first-line treatment choice for appendicitis since the introduction of laparoscopic surgery. In cases of perforation or abscess, interval appendectomy and percutaneous drainage are recommended. Treatment strategies have become more diverse. In recent years, in some European countries, non-surgical treatment has been used for simple appendicitis without complications, and nonoperative treatment of appendicitis has become increasingly common in adults and children. In this article, nonoperative treatment of appendicitis is introduced, and guidelines for the selection of antibiotics according to appendicitis classification are summarized.
Abdominal Pain ; Abscess ; Adult ; Anti-Bacterial Agents ; Appendectomy ; Appendicitis ; Child ; Classification ; Diagnosis ; Drainage ; Female ; Humans ; Laparoscopy ; Male

The frontal cephalometric analysis has not gained its importance in maxillofacial surgery compared to the lateral cephalometric analysis. In general, the frontal cephalometric analysis is practicable in providing an accurate measurement of the horizontal position and the width of maxilla, zygoma, and mandible. It also provides an assessment in the horizontal and vertical asymmetry of the face. With this knowledge, it is reasonable to regard the frontal cephalometric analysis as a valuable tool in making accurate diagnosis, planning of operation and evaluation of the results for sophisticated maxillofacial surgery. In addition, a recent development of computer software provides an extra benefit in diagnosing and performing surgery which has been frequently used in the dental field, in contrast to its limited application in the plastic surgery. The authors measured the frontal cephalometry of 115 patients who had maxillofacial surgery in our hospital from January 2000 to October 2002. The total 124 operative procedures for the patients are as follows: 58 was angle contouring; 22 zygomatic reduction; 16 genioplasty; 11 sagital split ramus osteotomy; 4 anterior segmental osteotomy; 10 distraction osteogenesis, and 6 was two-jaw surgery. The detailed procedure of the measurement is as follows: Digital scanning of cephalometric films; Presentation of the digital images on computer software (Vceph(R), CyberMed Inc. Korea); Registration of 43 anatomic landmarks such as zygomatic arch, gonion, antegonion, jugular process, and the automatic analysis with a custom-modified computer software with 27 items including midline analysis, facial width and height analysis, ratio analysis, symmetry analysis, and mandibular analysis. The analyzed data can be depicted as in the figure and chart. With above the mentioned automatic analysis, we found it to be effective, time-saving and accurate in the diagnosis of the facial asymmetry and estimation of the ratio of the facial bone. In this study, the authors have devised the frontal cephalometric analysis for the plastic and reconstructive maxillofacial surgery and its automatically analyzed measurements by using the computer software. This modified frontal cephalometric analysis has proved to be useful and efficient for diagnosis, operation planning and evaluation of the result in maxillofacial surgery.
Anatomic Landmarks ; Cephalometry ; Diagnosis ; Facial Asymmetry ; Facial Bones* ; Genioplasty ; Humans ; Mandible ; Maxilla ; Osteogenesis, Distraction ; Osteotomy ; Surgery, Oral* ; Surgery, Plastic ; Surgical Procedures, Operative ; Zygoma

Urinary tumors include cancers that commonly occur throughout the population, such as bladder cancer, kidney cancer, ureter cancer, and prostate cancer. The incidence of urological tumors in Korea is increasing. As the treatments of patients with cancer, such as operation, target therapy, immunotherapy, and gene therapy, are being developed, the life expectancy has been increasing. However, significant number of patients experience disease progression despite of existing treatments. Therefore, symptom direct treatment is crucial in oncologic era. Symptoms of patients with cancer vary but pain is one of the most common symptoms. Therefore, proper pain management is essential for the patients to improve the quality of life. Pain in cancer has as many complex pathological and physical characteristics as various tumor types. Both pharmacological and nonpharmacological interventions are important to address the full spectrum of cancer pain in patients. Many approaches to pain control, including opioid analgesics, radiation, and interventional care, are included in pain control therapy. Clinicians working with urinary tumors should be familiar with these pain control options. This review is intended to provide practical help to clinicians in treating patients with urological tumors. Updates to current knowledge and concepts of cancer pain management are included.

White fibrous papulosis of the neck is a rare skin disease that manifests with tiny papules that are distributed on the neck. Thick collagen bundles in the papillary dermis and diminution of the elastic fiber are characteristic on histologic examination. It is thought to be a normal aging process of the skin or an associated disorder. We report here on a case of white fibrous papulosis of the neck of a 49-year-old Korean woman.
Aging ; Collagen ; Dermis ; Elastic Tissue ; Female ; Humans ; Middle Aged ; Neck ; Skin ; Skin Diseases

Purpose: Short bowel syndrome (SBS) is the most common etiology for intestinal failure (IF) and these patients are at high risk of developing micronutrient deficiencies. This study aimed at assessing the level of vitamins in adult SBS patients at different stages of their disease before the initiation of multidisciplinary intestinal rehabilitation. Methods: Patient data from November 2015 to March 2017 were retrospectively reviewed. Adult patients who underwent extensive bowel resection and were classified as SBS-IF were selected. Clinical data including age, sex, etiology of IF, biochemical data, nutritional status, nutrition support, and outcome of intestinal rehabilitation were analyzed. Results: Nine patients with SBS-IF were included in the analysis. There were 6 male patients and 3 female patients, with a median age of 55.0 years. Vitamin levels were analyzed at 306 days (median) after the development of SBS. At the time of vitamin levels screening, 4 patients were receiving daily intravenous vitamin supplementation. Five patients were not receiving vitamin supplementations, either intravenously or orally. Vitamin B12 was within the normal range in 6 patients and higher than normal in 3 patients. Vitamin D was within the normal range in 3 patients and lower than normal in 6 patients. Vitamin E was within the normal range in 7 patients and higher than normal in 2 patients. Folate was within the normal range in 8 patients (not checked in 1 patient). Ambulatory patients had significantly higher vitamin D levels compared to hospitalized patients (P=0.015). Conclusion Vitamin D levels had decreased in 67% of patients with SBS in Korea, while vitamin B12, folate, and vitamin E deficiencies were rarely seen.

Purpose: Short bowel syndrome (SBS) is the most common etiology for intestinal failure (IF) and these patients are at high risk of developing micronutrient deficiencies. This study aimed at assessing the level of vitamins in adult SBS patients at different stages of their disease before the initiation of multidisciplinary intestinal rehabilitation. Methods: Patient data from November 2015 to March 2017 were retrospectively reviewed. Adult patients who underwent extensive bowel resection and were classified as SBS-IF were selected. Clinical data including age, sex, etiology of IF, biochemical data, nutritional status, nutrition support, and outcome of intestinal rehabilitation were analyzed. Results: Nine patients with SBS-IF were included in the analysis. There were 6 male patients and 3 female patients, with a median age of 55.0 years. Vitamin levels were analyzed at 306 days (median) after the development of SBS. At the time of vitamin levels screening, 4 patients were receiving daily intravenous vitamin supplementation. Five patients were not receiving vitamin supplementations, either intravenously or orally. Vitamin B12 was within the normal range in 6 patients and higher than normal in 3 patients. Vitamin D was within the normal range in 3 patients and lower than normal in 6 patients. Vitamin E was within the normal range in 7 patients and higher than normal in 2 patients. Folate was within the normal range in 8 patients (not checked in 1 patient). Ambulatory patients had significantly higher vitamin D levels compared to hospitalized patients (P=0.015). Conclusion Vitamin D levels had decreased in 67% of patients with SBS in Korea, while vitamin B12, folate, and vitamin E deficiencies were rarely seen.

Multiple miliary osteoma cutis (MMOC) is a rare variant of osteoma, characterized by multiple eruptive hard nodules on the face. A 70-year-old female presented with multiple solid skin-colored papules on both cheeks, unresponsive to conventional medical treatments. She reported receiving an injection of an unknown cosmetic filler substance into her face by an unlicensed medical practitioner 20 years ago. Facial computed tomography showed multiple small calcifications immediately adjacent to foreign material assumed to be the filler substance in the dermis. Histological examination revealed osteoclasts, osteocytes, and eosinophilic bony tissue in the dermis, suggestive of osteoma cutis. Although the pathogenesis remains unclear, inflammation caused by injected foreign material may induce metaplastic transformation of multipotent mesenchymal cells into osteoblasts, resulting in heterotopic ossification. Dermatologists should be aware that MMOC may occur following injection of foreign material by unlicensed practitioners. Performing a detailed history and clinical evaluation may aid in the diagnosis of such recalcitrant skin lesions.