BACKGROUND: Von Recklinghausen disease or neurofibromatosis type 1 is an autosomal dominant genetic disorder of chromosome 17q11.2. The most common characteristic findings of NF 1 include multiple and recurrent cutaneous neurofibromas associated with psychosocial distress. METHODS: Sixteen patients (9 female, 7 male; average age, 31 years; range, 16 to 67 years) with multiple cutaneous neurofibromas between March 2010 and February 2012 were included in the study. All patients were treated with radiosurgical ablation and excision under general anesthesia. RESULTS: All 16 patients were satisfied with the results, when questioned directly during the outpatient department follow-up. The only complaint from a few patients was minimal scarring, but acceptable results were obtained in the end. CONCLUSIONS: The radiofrequency procedure is almost bloodless and quick, creating a smaller necrotizing zone. Therefore, instead of employing the time consuming traditional surgery, such as laser therapy and electrosurgical excision, that produces uncertain results and can affect normal adjacent tissue, treatment of neurofibromas with radiofrequency ablation and excision can be an alternative choice of treatment for patients with a large number of neurofibromas.
Catheter Ablation ; Cicatrix ; Female ; Follow-Up Studies ; Humans ; Laser Therapy ; Neurofibroma ; Neurofibromatoses ; Neurofibromatosis 1 ; Outpatients ; Skin

BACKGROUND: Dermatofibrosarcoma protuberans is a mesenchymal tumor of the skin of intermediate-grade which is a rare condition. The slow growing and aggressive invasion on local tissues are characteristic features of dermatofibrosarcoma protuberans. The treatment for dermatofibrosarcoma protuberans is mainly a surgical excision such as a wide excision and Mohs micrographic surgery. OBJECTIVE: The aim of this study was to compare the result of wide excision and Mohs micrographic surgery for the treatment of dermatofibrosarcoma protuberans at a single institution in Korea. METHODS: A retrospective review was done for 24 patients diagnosed with dermatofibrosarcoma protuberans and treated surgically from 1999 to 2010 at Chonbuk National University Hospital. Patient demographics, tumor features, surgical features, and recurrence during the follow-up period were evaluated. RESULTS: 13 patients were treated with wide excision, and 11 with Mohs micrographic surgery. There was no metastasis for all the cases. Mean operation time for the wide excision group was 83 minutes whereas 182 minutes for the Mohs micrographic surgery group, and it was a statistically significant difference. However, no significant difference was observed in post-operative defect size, advanced surgical repair and local recurrence in our study. CONCLUSION: We suggest that wide excision and Mohs micrographic surgery are both successful modalities for the surgical treatment of dermatofibrosarcoma protuberans. Hence, individualized patient and tumor characteristics should be concerned when determining the surgical options for dermatofibrosarcoma protuberans.
Demography ; Dermatofibrosarcoma ; Follow-Up Studies ; Humans ; Mohs Surgery ; Neoplasm Metastasis ; Recurrence ; Retrospective Studies ; Skin

The accepted method in treating deep burns and severe crushing injuries of dorsum of the hand is serial debridement and delayed closure. Delayed wound closure with skin graft, local flap or regional pedicle flap may produce joint stiffness, tendon adhesion, and immobility. Emergency free flap transfer suggests against these concepts by advocating radical debridement and early closure of these wounds. Early mobilization of the joints with emergency free flap transfer may produce better range of motion than delayed closure. The key to success in early coverage of these wounds is thorough debridement while sparing vital structures, such as nerves, tendons, and intact vessels. We discussed 3 cases, which were performed emergency free flap transfer using lateral arm flap in severe crushing injuries and deep burns of dorsum of the hand. All flaps survived without complications. Each joints had shown 95% range of motion of contralateral normal side on the average. Emergency free flap transfer allows early closure of acute soft tissue defect of dorsum of the hand, promoting early motion and possibly reducing the incidence of post-operative infection, flap failure and secondary operative procedures, and improving functional results.
Arm ; Burns* ; Debridement ; Early Ambulation ; Emergencies* ; Free Tissue Flaps* ; Hand* ; Incidence ; Joints ; Range of Motion, Articular ; Skin ; Surgical Procedures, Operative ; Tendons ; Transplants ; Wounds and Injuries

PURPOSE: Norepinephrine is initially used to increase blood pressure in patients with septic shock. It increases blood flow to vital organs but decrease the flow to end-organs resulting in ischemic changes in end-organs. We report five patients with ischemic necrosis of upper and lower extremities after using norepinephrine in septic shock. MATERIALS AND METHODS: We retrospectively reviewed medical record of five patients with ischemic necrosis of upper and lower extremities after treating septic shock from March 2010 to March 2011. RESULTS: Five patients developed ischemic necrosis of upper and lower extremities during intensive care. All patients experienced septic shock due to medical problems, which required norepinephrine to increase blood pressure. After conservative treatment, stump revision or below knee amputation were done. CONCLUSION: We believe that more active treatment and protection of the end-organs will be needed to prevent poor prognosis during the recovery of septic shock.
Amputation ; Blood Pressure ; Humans ; Critical Care ; Knee ; Lower Extremity ; Medical Records ; Necrosis ; Norepinephrine ; Prognosis ; Retrospective Studies ; Shock, Septic ; Upper Extremity

Stem cells can give rise to various cell types and are capable of regenerating themselves over multiple cell divisions. Pluripotency and self-renewal potential of stem cells have drawn vast interest from different disciplines, with studies on the molecular properties of stem cells being one example. Current investigations on the molecular basis of stem cells pluripotency and self-renewal entail traditional techniques from chemistry and molecular biology. In this mini review, we discuss progress in stem cell research that employs proteomics approaches. Specifically, we focus on studies on human stem cells from proteomics perspective. To our best knowledge, only the following types of human stem cells have been examined via proteomics analysis: human neuronal stem cells, human mesenchymal stem cells, and human embryonic stem cells. Protein expression serves as biomarkers of stem cells and identification and expression level of such biomarkers are usually determined using two-dimensional electrophoresis coupled mass spectrometry or non-gel based mass spectrometry.
*Electrophoresis, Gel, Two-Dimensional ; Genetic Techniques ; Humans ; Mass Spectrometry/*methods ; Neurons/*cytology/physiology ; Proteomics/*methods ; Stem Cells/*metabolism

BACKGROUND: The reconstruction of large skin and soft tissue defects on the lower extremities is challenging. The skin graft is a simple and frequently used method for covering a skin defect. However, poor skin quality and architecture are well-known problems that lead to scar contracture. The collagen-elastin matrix, Matriderm, has been used to improve the quality of skin grafts; however, no statistical and objective review of the results has been reported. METHODS: Thirty-four patients (23 male and 11 female) who previously received a skin graft and simultaneous application of Matriderm between January 2010 and June 2012 were included in this study. The quality of the skin graft was evaluated using Cutometer, occasionally accompanied by pathologic findings. RESULTS: All 34 patients showed good skin quality compared to a traditional skin graft and were satisfied with their results. The statistical data for the measurement of the mechanical properties of the skin were similar to those for normal skin. In addition, there was no change in the engraftment rate. CONCLUSIONS: The biggest problem of a traditional skin graft is scar contracture. However, the dermal matrix presents an improvement in skin quality with elastin and collagen. Therefore, a skin graft along with a simultaneous application of Matriderm is safe and effective and leads to a significantly better outcome from the perspective of skin elasticity.
Cicatrix ; Collagen ; Contracture ; Elasticity ; Elastin ; Humans ; Lower Extremity* ; Male ; Skin Transplantation ; Skin* ; Transplants*

Nicolau syndrome is a rare adverse reaction and characterized by the acute onset of necrosis of the skin and soft tissue following intramuscular drug injection. Conservative treatments with dressings, debridement, and pain control are the mainstay of therapy. Surgical intervention such as skin graft is rarely required. We report a case of 21-year-old man with this syndrome on the right buttock after an intramuscular injection of diclofenac in which skin graft was necessary. The lesion eventually required debridements and split-thickness skin graft for reconstruction because it was very extensive and not successfully treated by the conservative method for four months.
Bandages ; Buttocks ; Debridement ; Diclofenac ; Humans ; Injections, Intramuscular ; Necrosis ; Skin ; Transplants ; Young Adult