Frontal peripheral osteomas: a retrospective study

Background@#Osteomas are benign, slow-growing bone tumors that can be classified as central, peripheral, or extraskeletal. Central osteomas arise from the endosteum, peripheral osteomas from the periosteum, and extraskeletal osteomas within the muscle. Frontal peripheral osteomas are mainly encountered in plastic surgery. In this study, we retrospectively analyzed the clinical data of patients with frontal peripheral osteomas. @*Methods@#We retrospectively reviewed the medical records of patients who visited our hospital with frontal peripheral osteomas between January 2014 and June 2022. We analyzed the following variables: age, sex, tumor type (sessile or pedunculated), single or multiple, size, history of head trauma, operation, and recurrence. @*Results@#A total of 39 patients and 41 osteomas were analyzed, of which 29 osteomas (71%) were sessile and 12 osteomas (29%) were pedunculated. The size of the osteomas ranged from 4 to 30 mm, with an average size of 10 mm. The age of patients ranged from 4 to 78 years with a mean age of 52 years. There were seven men (18%) and 32 women (82%), and the man-to-woman ratio was 1:4.6. Two patients (5%) had multiple masses, with two osteomas in each, while only two patients (5%) had a history of head trauma. Twenty-nine patients (74%) underwent ostectomy by a direct approach, and none of the patients experienced recurrence. @*Conclusion@#The epidemiologic data of our study will help plastic surgeons encounter frontal peripheral osteomas in the field to provide proper management for their patients.

Effects of low-level laser therapy and adipose-derived stem cells on the viability of autologous fat grafts: a preliminary study

Background@#Autologous fat grafts are commonly used in cosmetic and reconstructive surgery, and various methods are used to improve their viability. Low-level laser therapy (LLLT) can enhance the proliferation, growth, and differentiation of various cell lines, including stem cells. Our study investigated and compared the effects of LLLT and the addition of adipose-derived stem cells (ADSCs) on the viability of fat grafts. @*Methods@#Twenty nude mice were divided into four groups: control (group 1), LLLT irradiation (group 2), ADSC addition (group 3), and LLLT irradiation+ADSC addition (group 4). ADSCs were combined with the fat tissue. LLLT irradiation was performed once daily for 1 week from the day of grafting. After 8 weeks, the weight, volume, histology, and Western blot findings of the grafted fat tissues were evaluated. @*Results@#The retention rate and volume of the fat tissue in groups 2, 3, and 4 were higher than that of group 1, but the difference was not statistically significant. The number of capillaries, histological parameters, and immunofluorescence staining analyses for CD68, CD31, fibroblast growth factor, and vascular endothelial growth factor (VEGF) showed no significant differences among the four groups. The expression level of VEGF was higher in group 2 than in the other groups, but not to a statistically significant level. @*Conclusions@#LLLT and ADSCs did not significantly improve the viability of autologous fat grafts. Therefore, further study is necessary to develop safe and effective methods to improve the viability of these grafts for clinical application.

Effects of COVID-2019 on plastic surgery emergencies in Korea

Background@#To fight the coronavirus disease 2019 (COVID-19) pandemic, many countries have implemented social distancing and lockdowns. We investigated the changes in the trauma patterns of emergency plastic surgeries in the midst of a pandemic. @*Methods@#A retrospective review of the medical records of all patients treated for emergency plastic surgeries was performed at our hospital in Seoul. We conducted the analysis between March 1 and June 30, 2020, and compared the data obtained with that of the same period in 2019. We also investigated changes in trauma patterns according to the social distancing level from July 2020 to February 2021. @*Results@#There was a total of 800 emergency plastic surgery patients from March to June 2020, which was less than the 981 in the corresponding period in 2019. The proportion of patients aged 7–17 years and ≥ 80 in 2020 showed a significant decrease. In 2020, patients presenting with facial trauma decreased and hand trauma, markedly laceration, increased significantly. In 2020, more injuries happened at home, whereas significantly fewer injuries happened on the streets. In 2020, slipping and sports injury decreased, whereas penetrating injury increased significantly. In the changes observed according to the social distancing level, there were significant differences in age classification, facial open wound, and the mechanism of injury. @*Conclusion@#Social distancing has caused a change in emergency plastic surgeries. To ensure safe and appropriate treatment, strict epidemiologic workup and protective equipment are required.

Effects of low-level laser therapy and adipose-derived stem cells on the viability of autologous fat grafts: a preliminary study

Background@#Autologous fat grafts are commonly used in cosmetic and reconstructive surgery, and various methods are used to improve their viability. Low-level laser therapy (LLLT) can enhance the proliferation, growth, and differentiation of various cell lines, including stem cells. Our study investigated and compared the effects of LLLT and the addition of adipose-derived stem cells (ADSCs) on the viability of fat grafts. @*Methods@#Twenty nude mice were divided into four groups: control (group 1), LLLT irradiation (group 2), ADSC addition (group 3), and LLLT irradiation+ADSC addition (group 4). ADSCs were combined with the fat tissue. LLLT irradiation was performed once daily for 1 week from the day of grafting. After 8 weeks, the weight, volume, histology, and Western blot findings of the grafted fat tissues were evaluated. @*Results@#The retention rate and volume of the fat tissue in groups 2, 3, and 4 were higher than that of group 1, but the difference was not statistically significant. The number of capillaries, histological parameters, and immunofluorescence staining analyses for CD68, CD31, fibroblast growth factor, and vascular endothelial growth factor (VEGF) showed no significant differences among the four groups. The expression level of VEGF was higher in group 2 than in the other groups, but not to a statistically significant level. @*Conclusions@#LLLT and ADSCs did not significantly improve the viability of autologous fat grafts. Therefore, further study is necessary to develop safe and effective methods to improve the viability of these grafts for clinical application.

Effects of COVID-2019 on plastic surgery emergencies in Korea

Background@#To fight the coronavirus disease 2019 (COVID-19) pandemic, many countries have implemented social distancing and lockdowns. We investigated the changes in the trauma patterns of emergency plastic surgeries in the midst of a pandemic. @*Methods@#A retrospective review of the medical records of all patients treated for emergency plastic surgeries was performed at our hospital in Seoul. We conducted the analysis between March 1 and June 30, 2020, and compared the data obtained with that of the same period in 2019. We also investigated changes in trauma patterns according to the social distancing level from July 2020 to February 2021. @*Results@#There was a total of 800 emergency plastic surgery patients from March to June 2020, which was less than the 981 in the corresponding period in 2019. The proportion of patients aged 7–17 years and ≥ 80 in 2020 showed a significant decrease. In 2020, patients presenting with facial trauma decreased and hand trauma, markedly laceration, increased significantly. In 2020, more injuries happened at home, whereas significantly fewer injuries happened on the streets. In 2020, slipping and sports injury decreased, whereas penetrating injury increased significantly. In the changes observed according to the social distancing level, there were significant differences in age classification, facial open wound, and the mechanism of injury. @*Conclusion@#Social distancing has caused a change in emergency plastic surgeries. To ensure safe and appropriate treatment, strict epidemiologic workup and protective equipment are required.

Functional MRI of Visual Cortex in the Patients with Occipital Lobe Ischemia

PURPOSE: To evaluate the usefulness of functional MRI(fMRI) of visual cortex in patients with ischemic infarction in the occipital lobe. MATERIALS AND METHODS: Four patients with the symptoms and signs of visual cortical ischemia were included. Functional MRI was performed by 2D-FLASH technique with the parameter of 90/56msec TR/TE, 40degrees flip angle, 240x240 FOV, 64x128 matrix number, 8.32 seconds acquisition time, 8mm slice thickness. An axial slice including both visual cortices was selected and alternative activation and resting of the visual cortex was performed using red color photostimulator. All patients undertook visual field test, and vascular abnormality was examined by MRA (n=4) and DSA (n=2). fMRI results were compared with the results of a visual field test, conventional MRI and cerebral angiography. RESULTS: On fMRI, decreased activity of the visual cortex was found in the occipital lobe corresponding to stenosis of the posterior cerebral artery or its branch noted on angiogram. However, 2 of 4 patients showed no abnormal findings on conventional MRI. Visual field defect was noted in 3 patients, one of whom showed no abnormality on conventional MRI and diffusion-weighted image, but revealed decreased activity in the corresponding visual cortex on fMRI. CONCLUSION: fMRI may be a sensitive method for detection of the status of decreased blood flow or vascular reserve which other methods can not.

Cerebral Blood Flow(CBF) Study on Moyamoya Disease

The author analyzed the r-CBF data of 19 patients who admitted to the Kyung Hee University Medical Center under the diagnosis of definite "Moyamoya" disease from 1983 to 1992. Seven of them were followed-up from 1 to 18 months. The results were as fllow : 1) In moyamoya disease patients, the mean hemispheric r-CBF has a tendency to be lower than that of healthy persons. 2) In moyamoya disease patients, the ipsilateral r-CBF also shows a tendency to be lower than that of contralateral side. 3) The 133Xe-inhalation method is one of useful methods to evaluate CBF in Moyamoya disease, especially for follow-up. 4) The results of follow-up study for Moyamoya disease by 133Xe-inhalation method corelate very well with the change in clinical status of the patients. 5) In Moyamoya disease patients, the follow-up by means of 133Xe-inhalation method is one of useful methods to select a good candidate for surgical treatment such as STA-MAC anastomosis.

Clinical Analysis of Spontaneous Subarachnoid Hemorrhagic Patients

From the young neurosurgeon's standpoint, the authors analyzed eighty patients of spontaneous subarachnoid hemorrhage who were admitted to the department of neurosurgery in Taejeon Eulji General hospital from May 1989 to Jan. 1992. The results of analysis were as follow: 1) Of 80 total cases, sixty six were managed from beginning to end, and forty two were operated on for neck clipping. The most common cause of SAH was aneurismal rupture(70%), and the idiopathic comprised 30%. The male versus female ratio was 1:1.7, and the most frequently involved decade was the 7th. 2) Fifty six of total aneurismal cases turned out to be ruptured prior to admission. Common locations of aneurysms were A-com., P-com., and M.C.A. in order of descending frequency. Mirror aneurysms were 4%, and the multiple, 21%. The smallest size of aneurysm that had already ruptured was 3mm in its largest diameter of sac. The giant cases were 2(4%). 3) The most common chief complaint was headache(62.5%), and the most common symptom and/or sign was vomiting(90%). The hypertension accompanied in 29% and the most common neurological sign was nuchal rigidity(71%). 4) The brain CT was performed with the frequency of 1.44 per patient, and it detected SAH in 86%, The most frequently obliterated cistern was basal cistern. In 11 cases(14%), there were no evidence of SAH at all. Contrastingly in 12 cases(15%), aneurismal sacs were directly visualized in post-contrast films. 5) The angiographic study was performed in 59 cases(74%) to detect abnormality in 54 cases all of which turned out to be aneurysms. The mean size of detected 69 sacs was 7.7mm in diameter, and of 26 cases(44%) of normal variation, hypoplasia was the most frequent type. It occurred most frequently at right A1 portion. 6) Of 66 patients who were managed from start to finish, the mortality was 43%, and that of 46 operated cases, 21%. The best operative results were harvested in delayed operation group, the next in intermediate one, and the worst in early one.

A Case of Giant Mucocele at Frontal Sinus

Authors report a case of giant mucocele at frontal sinus. It was so large that almost whole portion of ipsilateral frontal lobe was compressed. Nevertheless presenting symptom was exceptionally trivial. With brief review of literatures, we discuss the etiology, pathogenesis, and so on.

A Case of Lipomatous Meningioma

A case of lipomatous meningioma is described. On pre-enhanced CT study the lesion was radioluscent but after enhancement almost half of the lesion was strongly enhanced and the other half was still radioluscent. A review of the literatures showed few similar reported cases.

Moyamoya Disease Associated with Aneurysm

Three cases of cerebral rete mirabile associated with aneurysms are presented. In two cases the aneurysms were located at the anterior communicating arteries, and in one at the peripheral portion of the middle cerebral artery. For the anterior communicating artery aneurysms, operations were performed. Based on these experiences, the difficulties and necessities of operations for the aneurysms associated with cerebral rete mirabilies are briefly discussed.

Hereditary Hemorrhagic Telangiectasia with Pulmonary Arteriovenous Fistula

No abstract available.

Moyamoya Disease with Intraventricular Hemorrhage in a Child

No abstract available.

Clinical Observation of Double-Chambered Right Ventricle

Most congenital obstructions of right ventricular outflow occur at the infundibular, pulmonary valvular, or pulmonary arterial levels. Less frequently, stenosis is present in the sinus portion of the right ventricle and is caused by an obstructing aberrant muscle bundle or band crossing the chamber below the infundibulum. This abnormality has been called the double chambered right ventricle. We have reviewed our experience with 18 patients with a double chambered right ventricle who had been admitted to the SNUH. 1) Age distribution was from 2 to 36 years old with a mean age of 12.8 years. There were 13 female patients and 5 male patients with a 2.6:1 female to male ratio. 2) The chief complaints of the patients were dyspnea on exertion(50%), known congenital heart disease(27.8%), and cyanosis(16.7%), in that order. The physical findings were grade III-V/VI systolic murmurs and other findings of associated cardiac anomalies. 3) The electrocardiographic findings were as follow: left ventricular hypertrophy(33.3%), right ventricular hypertrophy(22.2%), and biventricular hypertrophy(22.2%), Pressure gradients within the right ventricle were noted in 13 cases(72.2%), and filling defects on right ventricular cineangiography were noted in 14 out of 15 cases(93.3%). The echocardiographic findings were not diagnostic, except for the associated cardiac anomalies. 4) 14 cases were operated with a result of aberrant muscle bundles in the right ventricular cavity. All were removed surgically. 1 case was confirmed by autopsy Other 3 cases(Who had pressure gradients within the right ventricular cavity and filling defects on the right ventricular cineangiogram) showed little symptoms, and there has been a continuous follow up on these patients. 5) The associated cardiac anomalies were as follows: 13 cases(72.2%) of ventricular septal defect, 1 case(5.6%) of bicuspid tricuspid valve, 1 case(5.6%) of persistent left sided superior vena cava, and 1 case(5.6%) of aortic regurgitation. There was 3 cases of isolated double chambered right ventricle(16.5%).

A Follow-up Study of Newborns who had Exchange Blood Transfusion for Hyperbilirubinemia

A follow up study was made of 59 cases of neonatal hyperbilirubinemia receving blood exchange transfusion at Kwangju Christian Hospital from early 1976 to early 1979, with the following results. 1. 42patients(71.2%) returned for followup: 12 patients(20.3%) did not return; and 5 patients(8.5%) had died. 2. Of those returning, developmental status was studied by D.D.S.T. 38 patients(90.5%) had normal development , 3(7.1%) were retarded, and 1(2.4%) was questionable. 3. There was no retardation among patients exchange-Transfused at the age of 5 days or less, except for one patients with severe dehydration. All the other retarded or dying patients were over 5 days at the time of exchange transfusion. 4. Serum bilirubin level was above 27 mg% in all retarded patients . Of the 5 patients dying, 3 had serum bilirubin levels of over 40mg%, one with S.B. of 25mg% had BET at 10 days of age, and one died of necrotizing enterocolitis without evidence of kernicterus. 5. In patients with normal development, 23 were male, and 15 were female. All females had normal development, whereas all four babies with retardation were male. 6. Because S.B. remained over 25mg%, three patients underwent a second BET, with good results. 7. ABO incompatibility was etiologically responsible in 23 cases (55.9%), followed by idiopathic hyperbilirubinemia in 16 cases (27.4%), Other causes of hyperbilirubinemia were infection, respiratory distress syndrome, immune neonatal thrombocytopenia, enclosed hemorrhage, small-for-date infant, etc. 8. Mean values with standard errors of pre BET serum bilirubin level were as follows. Normal development group: 28.10.69mg% Retarded development group: 30.21.15mg% There was a tendency toward higher S.B. levels in retarded development group. 9. Nine patients who had early signs of kernicterus on admission, developed normally after BET, but those patients , shown later to be retarded, had only transient improvement of early signs of kernicterus at the time of discharge. 10. Thirty-three patients had siblings, among whom 8 also had history of hyperbilirubinemia or mental retardation due to kernicterus, or had undergone blood exchange transfusion. All of the were cases of ABO incompatibility. 11. Motor distrubance was the predominant handicap in all 4 cases of typical cerebral palsy, but no speech disturbance or hearing loss was seen. Choreoathetosis was evident in two patients over 3 years of age, but it was not possible to classify the cerebral palsy in two patients less than 1 1/2years of age.

Clinical Observations on Tuberculous Meningitis in Childhood

A clinical study was carried out on patients with tuberculous meningitis who were admitted to the Department of Pediatrics, Kwangju Christian Hospital during a 9 year period from January, 1971 to December, 1979. The following results were obtained. 1) About 3/4 of all cases were under the age of 6, the majority being between the age of one and three. The male-to-female ratio was 1.3:1. 2) Seasonal incidence was in the order of spring, summer, winter and autumn, but no sign ificant differences were noted. 3) A family history of tuberculosis was found in 41.5%, usually in one of the parents. 4) A history of B.C.G. vaccination was found in 16.7% of tuberculous meningitis cases. The tuberculin test was positive in 28.9%. 5) The most frequent symptoms on admission were vomiting, fever, convulsion and headache, in that order. 6) The major neurologic findings were unconsciousness(34.0%), neck stiffness(76.4%), and positive Kernig's sign(63.2%). 7) Leukocytes in the C.S.F. on admission were generally elevated, but below the range of 500/mm3 in 74.5% of cases, and the mean count was 278.7/mm3 with 66.7% lymphocytes. Mean protein level in the C.S.F. was 162.5mg/dl, and 94.3% of all cases were over 50mg/dl. Sugar in the C.S.F. was definitely reduced to less than 120 mEq/L in 78.3%, with the mean level being 112.8mEq/L. 8) Chest X-ray revealed tuberculous lesions in 69.8% and miliary tuberculosis was found in 36.8% of cases. 9) The highest mortality was seen in young infants. Among 26 patients of clinical stage I on admission, 21(80.3%) recovered, and 35(79.5%) of 44 patients of stage II recovered, whereas only 13(36.1%) out of 36 patients of stage III were cured. Over-all mortality rate was 5.7% of those followed.

A Case of Male Turner Syndrome

We prsent here a 6 year old who has abnormalities of his genitalia, as well as other characteristic features typical of Turner syndrome. He has a small penis with hypospadias, hypolastic testes, and cryptorchi dism. He has short stature, an abnormal looking face, a wide, short webbed neck, and cubitus valgus. He was found to have hydronephrosis and hydroureter on I. V. P. Chromosomal analysis revealed anormal male karyotype with no apparent aberrations.