1.New proposal for skin grafts on tendon-exposed wounds
Jung Hwan UM ; Dong In JO ; Soon Heum KIM
Archives of Plastic Surgery 2022;49(1):86-90
Performing a skin graft is not feasible for tendon-exposed defect reconstruction because tendons are fibrous connective tissues with relatively poor blood supply. This study proposes a method to effectively perform skin graft surgery in tendon-exposed wounds. A 48-year-old male patient with diabetes mellitus had a very large left dorsal foot defect (8×8 cm). The wound bed had healthy granular tissue, with tendon exposure. The tendons were turned over so that the posterior side would behave as the anterior side. The edge of the paratenon was then fixed together to the surrounding granulation tissue or dense remnant fascia using absorbable sutures, and the close granulation tissue was approximated and buried. A split-thickness skin graft was performed after 1 week. The graft site was stably taken on postoperative day 3. A small disruption was then observed at the graft site within 1 week postoperatively, but conservative treatment was continued for 1 month, after which the defect site was completely restored. This technique can increase the success rate of skin grafts for defects with tendon exposure.
2.A Case of Tumor of Follicular Infundibulum in Parietal Scalp
Jung Hwan UM ; Soon Heum KIM ; Dong In JO
Korean Journal of Head and Neck Oncology 2021;37(2):57-60
Tumor of follicular infundibulum (TFI) is a rare benign cutaneous appendage tumor that does not have characteristic clinical features. It is mainly present in the head, neck, and trunk as a solitary lesion. In particular, TFI typically manifests as a plate-like proliferation with multiple thin epidermal connections comprise of monomorphic cells. TFI do not represent cutaneous characteristics, but have clinical significance because TFI is associated with basal cell carcinoma and Cowden's syndrome. We report a case of TFI in parietal scalp with a review of literatures.
3.A Case of Mucinous Cystadenocarcinoma in Labial Mucosa of Upper Lip
Jung Hwan UM ; Dong In JO ; Soon Heum KIM
Korean Journal of Head and Neck Oncology 2021;37(1):43-46
Mucinous cystadenocarcinoma (MCA) is a malignant tumor that mainly occurs in the breast or ovary, but MCA is internationally rarely reported in head and neck region. Especially MCA in minor salivary gland of oral cavity is even more rare. It is characterized by cystic spaces lining of epithelial cells containing intracytoplasmic mucin. We report a case of MCA in the labial mucosa of upper lip considered to develop from minor salivary gland with a review of literatures.
4.Meta-analysis of transanal versus laparoscopic total mesorectal excision for rectal cancer: a ‘New Health Technology’ assessment in South Korea
Sun-Ho KWON ; Yea-Il JOO ; Seon Hahn KIM ; Dae Ho LEE ; Jeong-Heum BAEK ; Soon Sup CHUNG ; Ji-Yeon SHIN ; Chang Soo EUN ; Nam Kyu KIM
Annals of Surgical Treatment and Research 2021;101(3):167-180
Purpose:
Under the South Korea’s unique health insurance structure, any new surgical technology must be evaluated first by the government in order to consider whether that particular technology can be applied to patients for further clinical trials as categorized as ‘New Health Technology,’ then potentially covered by the insurance sometime later. The aim of this meta-analysis was to assess the safety and efficacy of transanal total mesorectal excision (TaTME) for rectal cancer, activated by the National Evidence-based Healthcare Collaborating Agency (NECA) TaTME committee.
Methods:
We systematically searched Ovid-MEDLINE, Ovid-Embase, Cochrane, and Korean databases (from their inception until August 31, 2019) for studies published that compare TaTME with laparoscopic total mesorectal excision (LaTME). End-points included perioperative and pathological outcomes.
Results:
Sixteen cohort studies (7 for case-matched studies) were identified, comprising 1,923 patients (938 TaTMEs and 985 LaTMEs). Regarding perioperative outcomes, the conversion rate was significantly lower in TaTME (risk ratio, 0.19; 95% confidence interval, 0.11–0.34; P < 0.001); whereas other perioperative outcomes were similar to LaTME. There were no statistically significant differences in pathological results between the 2 procedures.
Conclusion
Our meta-analysis showed comparable results in preoperative and pathologic outcomes between TaTME and LaTME, and indicated the benefit of TaTME with low conversion. Extensive evaluations of well-designed, multicenter randomized controlled trials are required to come to unequivocal conclusions, but the results showed that TaTME is a potentially beneficial technique in some specific cases. This meta-analysis suggests that TaTME can be performed for rectal cancer patients as a ‘New Health Technology’ endorsed by NECA in South Korea.
5.A Case of Mucinous Cystadenocarcinoma in Labial Mucosa of Upper Lip
Jung Hwan UM ; Dong In JO ; Soon Heum KIM
Korean Journal of Head and Neck Oncology 2021;37(1):43-46
Mucinous cystadenocarcinoma (MCA) is a malignant tumor that mainly occurs in the breast or ovary, but MCA is internationally rarely reported in head and neck region. Especially MCA in minor salivary gland of oral cavity is even more rare. It is characterized by cystic spaces lining of epithelial cells containing intracytoplasmic mucin. We report a case of MCA in the labial mucosa of upper lip considered to develop from minor salivary gland with a review of literatures.
6.Meta-analysis of transanal versus laparoscopic total mesorectal excision for rectal cancer: a ‘New Health Technology’ assessment in South Korea
Sun-Ho KWON ; Yea-Il JOO ; Seon Hahn KIM ; Dae Ho LEE ; Jeong-Heum BAEK ; Soon Sup CHUNG ; Ji-Yeon SHIN ; Chang Soo EUN ; Nam Kyu KIM
Annals of Surgical Treatment and Research 2021;101(3):167-180
Purpose:
Under the South Korea’s unique health insurance structure, any new surgical technology must be evaluated first by the government in order to consider whether that particular technology can be applied to patients for further clinical trials as categorized as ‘New Health Technology,’ then potentially covered by the insurance sometime later. The aim of this meta-analysis was to assess the safety and efficacy of transanal total mesorectal excision (TaTME) for rectal cancer, activated by the National Evidence-based Healthcare Collaborating Agency (NECA) TaTME committee.
Methods:
We systematically searched Ovid-MEDLINE, Ovid-Embase, Cochrane, and Korean databases (from their inception until August 31, 2019) for studies published that compare TaTME with laparoscopic total mesorectal excision (LaTME). End-points included perioperative and pathological outcomes.
Results:
Sixteen cohort studies (7 for case-matched studies) were identified, comprising 1,923 patients (938 TaTMEs and 985 LaTMEs). Regarding perioperative outcomes, the conversion rate was significantly lower in TaTME (risk ratio, 0.19; 95% confidence interval, 0.11–0.34; P < 0.001); whereas other perioperative outcomes were similar to LaTME. There were no statistically significant differences in pathological results between the 2 procedures.
Conclusion
Our meta-analysis showed comparable results in preoperative and pathologic outcomes between TaTME and LaTME, and indicated the benefit of TaTME with low conversion. Extensive evaluations of well-designed, multicenter randomized controlled trials are required to come to unequivocal conclusions, but the results showed that TaTME is a potentially beneficial technique in some specific cases. This meta-analysis suggests that TaTME can be performed for rectal cancer patients as a ‘New Health Technology’ endorsed by NECA in South Korea.
7.Multiple nonmelanocytic skin cancers in multiple regions
Song Hyun HAN ; Soon Heum KIM ; Cheol Keun KIM ; Dong In JO
Archives of Craniofacial Surgery 2020;21(3):188-192
The most common forms of nonmelanocytic skin cancer (NMSC) are basal cell carcinoma (BCC) and squamous cell carcinoma (SCC). The growing incidence of skin cancer in the Republic of Korea has sparked increasing scientific interest in these types of tumors. In the case described herein, multiple NMSCs occurred asynchronously in various areas of the body in a single patient. A 67-year-old man presented with an ulcerative lesion on the right retro-auricle and multiple keratinized masses on the back and face. The right retro-auricular lesion was diagnosed as BCC, and the keratinized masses on the patient’s back and face were diagnosed as SCC. He subsequently presented with numerous pigmented skin lesions on the forehead, temple, pre-auricle, neck, right forearm, right hand, and both thighs. One lesion on the neck was diagnosed as BCC, and five lesions on the right hand and forearm were diagnosed as SCC. The patient was also diagnosed with supraglottic SCC and external auditory canal SCC. An otolaryngologist performed radical excision of the primary SCC. Suspected skin cancer lesions observed on the face and both ears were diagnosed as SCC. Patients with multiple NMSCs are at an elevated risk for additional skin cancers, making periodic follow-up important; furthermore, all suspicious lesions should be biopsied.
8.Staged excision of basal cell carcinoma arising from a tattooed eyebrow
Song Hyun HAN ; Dong In JO ; Soon Heum KIM
Archives of Craniofacial Surgery 2020;21(5):315-318
Side effects of tattoos can occur due to unexpected body responses. Concerns about the side effects of tattoos are growing concomitantly with the increasing number of tattooed individuals. We report a rare case of basal cell carcinoma (BCC) on a tattooed eyebrow. A 48-year-old woman with no family history or occupational risk of skin cancer had her eyebrows tattooed 6 years prior, and she noticed a black mass on her right eyebrow 1 year before presentation. Staged excision was planned due to the patient’s reluctance regarding the possibility of a wide scar. After the first surgical procedure, a histopathological examination confirmed BCC. Wide excision and primary closure were performed for remnant BCC, and no recurrence was observed. The mechanism of skin neoplasms involving tattoos has not been clearly identified. Unapproved tattoo inks contain carcinogenic substances, and previous case reports indicate that skin neoplasms may differ depending on the tattoo color. Therefore, the carcinogenic effects of these unknown components of tattoo ink might cause skin neoplasms. Accurate component analysis and systematic management of tattoo ink is necessary, and medical practitioners must also pay attention to this possibility because it is easy to overlook tattoos as a causal factor contributing to cancer.
9.Diabetic Foot and Soft Tissue Necrosis Caused by Moxibustion Burn Injury
Song Hyun HAN ; Dong In JO ; Cheol Keun KIM ; Soon Heum KIM
Journal of Korean Burn Society 2020;23(2):60-63
A 72-year-old man with diabetes, who underwent moxibustion, developed a foot wound but did not receive proper treatment.Examination showed a soft tissue defect (6×6 cm) on the dorsal aspect of the right foot with involvement of the first and second toes along with some phalangeal bone loss. The wound was treated with a skin graft and healed without complications.The right calf showed a raw surface (4×3 cm), which underwent epithelialization after conservative treatment. We observed four focal necrotic lesions (1.5×1.5 cm) on the right lower leg and anterior chest, which served as indicators of moxibustion, and debridement and primary closure were performed. Moxibustion is increasingly used as a therapeutic option; however, statistical data describing its adverse effects are limited. Moxibustion significantly increases skin temperature and can cause burn injuries. It is important to prevent moxibustion-induced adverse effects and avoid severe complications, particularly in patients with diabetes.
10.A novel cannula for uniform mixing of liquid substances
Seung Jun KIM ; Seung Min KIM ; Cheol Keun KIM ; Dong In JO ; Soon Heum KIM
Archives of Aesthetic Plastic Surgery 2019;25(4):167-170
Uniform mixing of liquid substances is difficult to attain. Recently, mixtures of fat and platelet-rich plasma (PRP) have been used extensively in autologous fat transfer. Although various methods have been utilized to mix the fat and PRP involved in this procedure, these methods still carry disadvantages in the time taken and the potential for cell damage, and it is questionable whether effective mixing can occur using these techniques. To facilitate mixing that is as uniform as possible, the authors of this study invented a special cannula. Use of the conventional luer-lock-to-luer-lock connector method has been found to cause cell damage and makes it difficult to achieve uniform mixing, while random injection-type mixing has been shown to have limited accuracy and effectiveness. We expect that the newly designed cannula will solve the problem detailed above.
Catheters
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Clothing
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Methods
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Platelet-Rich Plasma
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Stress, Mechanical

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