The Laugier-Hunziker syndrome represents a rare, acquired, benign, pigmentary disorder of the lips, oral mucosa, and nails. The nails are often involved with the development of melanonychia, which may be due to focal melanocyte activation. The lips and the mucous membranes show a variable number of flat, gray to brown-black lenticular spots, which are usually asymptomatic. We report the third case of Laugier-Hunziker syndrome in the Korean literatures.
Lip ; Melanocytes ; Mouth Mucosa ; Mucous Membrane

It is known that cases of osteomyelitis are less common than 5% in deep burn cases. This research presents a case of chronic osteomyelitis, presented 7 years after initial electrical burn injury. A 43-year-old male patient was admitted to the Department of Plastic Surgery, suffering from an 22900-voltage electrical burn on right medial malleolus in 2010. There was no postoperative complication for five years observation. In November 2016, he was admitted to the Plastic Surgery department, suffering from the skin and soft tissue defect on right medial malleolus without trauma history. The osteomyelitis on the right medial malleolus was found in bone scintigraphy. The medial malleolus was covered with a local flap two days after admission. Dehiscence was found after surgery and exudate was emerged continuously from the flap site. We decided to cover the raw surface with a perforator based propeller flap 22 days after admission considering reconstructive ladder. The flap survived successfully, and partial epidermal sloughing was healed completely by daily dressing at 51 days after the surgery. It is advisable to establish and access the prudent plan before surgery through many kinds of radiological tests and physical examinations considering vascular stability and delayed wound healing.
Adult ; Bandages ; Burns* ; Exudates and Transudates ; Humans ; Male ; Osteomyelitis* ; Physical Examination ; Postoperative Complications ; Radionuclide Imaging ; Skin ; Surgery, Plastic ; Wound Healing

No abstract available.
Humans

Volume deficiency and poorly defined cupid's bow of the upper lip are frequently encountered problems in secondary cleft lip deformities. In this report, we present the method of a periumbilical dermal graft for correcting secondary cleft lip deformity. A 17-year-old male patient presented with a poorly defined notching cupid's bow and volume deficiency of the upper lip. He had undergone cleft lip surgery when he was 2 years old. We planned to perform a periumbilical dermal graft. There were sufficient amount of periumbilical subdermis and fat tissue thickness to obtain abundant volume. The periumbilical contour was similar to the natural contour of the lip. Less scarring was expected. There was no need to change the posture during operation, making it easy to harvest. Postoperative evaluations showed vermilion symmetry. Ideal cupid's bow shape and position were achieved without color mismatch. As a result, we obtained an ideal volume of the upper lip. Therefore a periumbilical dermal graft is a good option for correcting volume deficiency of the lip with good aesthetic outcomes.
Adolescent ; Cicatrix ; Cleft Lip* ; Congenital Abnormalities* ; Dermis ; Humans ; Lip ; Male ; Methods ; Posture ; Transplants* ; Umbilicus

Maxillary sinus mucocele can occur due to many medical factors such as chronic infection, allergic sinonasal disease, trauma, and previous surgery. However, it occurs mainly after Caldwell-Luc operation, usually more than 10 years after surgery. There are a few cases of maxillary sinus mucocele with ocular symptoms. Also, a case causing ocular symptoms because of invasion to the orbital floor is rare. Therefore, we report a case of a 55-year-old male patient who underwent Caldwell-Luc operation about 30 years ago. Then, symptoms such as exophthalmos, diplopia, and visual disturbance developed suddenly 3 months prior to admission. Computed tomography showed a cyst invading the orbital floor which resulted in eyeball deviation. The orbital floor defect measured approximately 2.5×3.3 cm. Maxillary sinus mucocele was removed through an endoscopic approach. After this, we reconstructed the orbital floor through a subciliary incision. Observation was carried out after three years, and ocular symptoms such as diplopia and exophthalmos did not recur.
Diplopia ; Exophthalmos ; Humans ; Male ; Maxillary Sinus* ; Middle Aged ; Mucocele* ; Orbit*

Interstitial granulomatous dermatitis (IGD) is a rare skin condition commonly associated with autoimmune diseases.Lesions typically occur bilaterally on the lateral trunk and proximal extremities and present as variable cutaneous lesions. A 63-year-old female with a 1-year history of a skin rash on her face visited the dermatology department of our hospital. The patient had received a dermal filler injection with unidentified gradients on the face of an unlicensed practitioner 20 years before. The lesions on the left cheek were tender, violaceous, coalescing, and annular. A violaceous round nodule with tenderness was observed on the left chin and glabella. She denied having any systemic complaints. The biopsy specimen showed diffuse interstitial CD68＋ histiocytic infiltration involving the reticular dermis around the degenerative collagen bundles. The patient was diagnosed with IGD. The patient was treated with systemic steroids and showed clinical improvement. Herein, we report a case of IGD after an unknown dermal filler injection, along with a literature review.

BACKGROUND: Human papillomavirus (HPV) infection is the main cause of cervical cancer and with the advent of genotype specific vaccines, there is increased need for accurate, broad-spectrum and high-throughput methods for HPV genotyping. A MALDI-TOF mass spectrometry (MS)-based restriction fragment mass polymorphism (RFMP) assay has proven to accurately and reliably genotype a wide variety of HPV. METHODS: We evaluated the clinical utility of the RFMP assay in HPV genotyping by testing a total of 2,689 specimens taken from liquid-based cytology, which was composed of normal cytology, atypical squamous cells of undetermined significance (ASCUS), low grade squamous intraepithelial lesion (LSIL), high grade squamous intraepithelial lesion (HSIL) and invasive squamous cervical cancer (SCC). RESULTS: Overall HPV positive rate of total specimens was 32.5% and the high-risk positivity was 16.4%. The HPV positive rates were increased as increasing severity level of cervical lesion. Predominant high-risk HPV genotypes were found as following order; 52 (18.6%), 16 (13.7%), 18 (3.8%), 58 (3.4%), 56 (2.6%) and 31 (2.5%). The high-risk HPV positivities according to cytologic diagnosis were 10.7% (238/2229), 31.7% (76/240), 50.0% (88/176), 86.0% (37/43), 100% (1/1) in normal, ASCUS, LSIL, HSIL and SCC subgroups, respectively. The concordance rate and Kappa value between sequencing and RFMP assays were 96.6% and 0.932 (95%CI: 0.908-0.956). CONCLUSIONS: The RFMP HPV genotyping assays showed high concordance with sequencing. The assay is simple, and can accurately detect and identify HPV genotypes in samples with various levels of cytological lesions. The results demonstrated that RFMP assay should be clinically suitable for HPV genotyping in laboratories.
Dipeptides ; Genotype ; Humans ; Mass Spectrometry ; Uterine Cervical Neoplasms ; Vaccines

Tracheal diverticula are relatively rare disease characterized by single or multiple evaginations of the tracheal wall. The tracheal diverticulum may act as a reservoir for secretions, leading to recurrent respiratory tract infections associated with chronic cough and dyspnea. A 31-year-old man had complained of a chronic productive cough for several months. Methacholine bronchial provocation test was positive. Three-dimensional computed tomography showed an air-containing cystic structure extending right posterolateral aspect of the trachea. Fiberoptic bronchoscopy demonstrated ostium arising from the right posterolateral wall at mid-third of trachea. These findings made asthma and tracheal diverticulum the diagnosis. Medical treatment was performed and symptoms were relieved.
Adult ; Asthma* ; Bronchial Provocation Tests ; Bronchoscopy ; Cough ; Diagnosis ; Diverticulum* ; Dyspnea ; Humans ; Methacholine Chloride ; Rare Diseases ; Respiratory Tract Infections ; Trachea

OBJECTIVE: This study compared the efficacy and tolerability of clonazepam with other benzodiazepines in patients with anxiety disorders. METHODS: Inclusion criteria were as follows: age >20 years, diagnosis of anxiety disorder according to the Diagnostic and Statistical Manual of Mental Disorders 4th edition, text revision (DSM-IV-TR) criteria, taking only one type of antidepressant, and prescribed one of three oral benzodiazepines (alprazolam, clonazepam, or lorazepam). At baseline and week 6, clinical benefit was evaluated using the Clinical Global Impression-Severity Scale (CGI-S), Clinical Global Impression-Anxiety Scale (CGI-anxiety), and Clinical Global Impression-Sleep Scale (CGI-sleep). RESULTS: Among 180 patients, no differences in demographic characteristics among the three benzodiazepine groups were noted. After six weeks of treatment, all benzodiazepine groups showed significant improvements in CGI-S, CGI-anxiety, and CGI-sleep scores (p<0.001). There were no differences in mean changes in CGI-S, CGI-anxiety and CGI-sleep among the three benzodiazepine groups. The incidence of side effects was significantly lower in the clonazepam group than with the other benzodiazepines. The incidences of adverse events for the clonazepam, alprazolam, and lorazepam groups were 26.7% (n=20), 48.4% (n=31), and 43.9% (n=18), respectively. CONCLUSION: The present study suggests that clonazepam is as efficacious as other benzodiazepines for the treatment of various anxiety disorders. Furthermore, the safety profile of clonazepam was superior to the other benzodiazepines in this study.
Alprazolam ; Anti-Anxiety Agents ; Antidepressive Agents* ; Anxiety Disorders* ; Anxiety* ; Benzodiazepines ; Clonazepam* ; Diagnosis ; Diagnostic and Statistical Manual of Mental Disorders ; Humans ; Incidence ; Lorazepam

Idiopathic pulmonary alveolar proteinosis (PAP) is a rare disorder in which lipoproteinaceous material accumulates within alveoli. There were few reports on Asian populations with idiopathic PAP. We retrospectively reviewed 38 patients with idiopathic PAP in Korea. We assessed clinical features, therapeutic efficacy and outcomes of whole lung lavage in patients with idiopathic PAP. The mean age at diagnosis was 52 yr. Eighty six percent of patients were symptomatic at diagnosis. Dyspnea and cough were the most common symptoms. Crackles were the most common physical examination finding. On pulmonary function test, a mild restrictive ventilatory defect was common, with a predicted mean forced vital capacity (FVC) of 77% and forced expiratory volume in one second (FEV1) of 84.6%. Diffusing capacity was disproportionately reduced at 67.7%. Arterial blood gas analysis revealed hypoxemia with a decreased PaO2 of 69.0 mmHg and an increased D(A-a)O2 of 34.2 mmHg. After whole lung lavage, PaO2, D(A-a)O2 and DLCO were significantly improved, but FVC and total lung capacity (TLC) were not different. This is the first multicenter study to analyze 38 Korean patients with idiopathic PAP. The clinical features and pulmonary parameters of Korean patients with idiopathic PAP are consistent with reports in other published studies. Whole lung lavage appears to be the most effective form of treatment.
Adult ; Biopsy ; Bronchoalveolar Lavage ; Female ; Humans ; Korea ; Male ; Middle Aged ; Pulmonary Alveolar Proteinosis/diagnosis/pathology/*physiopathology/*therapy ; Respiratory Function Tests ; Retrospective Studies ; Survival Rate ; Treatment Outcome