The ear is a common site for keloid formation, usually after trauma or ear piercing. This study is a meta-analysis to identify effective treatments for ear keloids after surgical excision.
A ...systematic literature review and meta-analysis were performed using core databases. Postoperative adjuvant treatment modalities for ear keloids and recurrence rates were extracted and analyzed. Fixed and random effect models were applied.
Twenty-five studies published before August of 2015 were identified. The recurrence rate after surgical excision of an ear keloid in the triamcinolone group was estimated as 15.4 percent (95 percent CI, 9.4 to 24.1 percent; p < 0.001). The recurrence rate in the radiation therapy group was estimated as 14.0 percent (95 percent CI, 9.6 to 19.9 percent; p < 0.001).
Although a large-scale, randomized study is required for confirmation, both triamcinolone and radiation therapy provided outstanding treatment for ear keloids after surgical excision without a significant difference between the two treatments.
The World Health Organization defines a perivascular epithelioid cell tumor (PEComa) as a mesenchymal neoplasia composed of perivascular epithelioid cells with characteristic morphological and ...immunohistochemical features. Although PEComas have the potential to behave in a malignant fashion, malignant PEComas are extremely rare.
An 83-year-old man visited our clinic presented with palpable, painless, and movable mass in the right knee area.
Malignant PEComa was diagnosed by incisional biopsy. No metastases was confirmed by radiologic imaging including PET/CT, magnetic resonance imaging, high resolution computed tomography.
We performed wide excision of the mass and used an anterolateral thigh free flap to reconstruct the defect on the right knee.
The permanent histopathology showed malignant PEComa was totally resected. The flap which was performed to cover the defect was survived and the patient discharge without any complications.
PEComa can metastasize to various anatomical regions. Although there is no established standardized treatment, radical resection is still considered the cornerstone of treatment. Rapid and appropriate defect coverage is important to improve the patient's prognosis.
Limb amputation in diabetic patients raises important issues regarding low quality of life and survival rates. This meta-analysis aimed to identify predictive factors accompanying diseases with high ...major amputation rates in diabetic patients.
A systematic literature review and meta-analysis were performed using MEDLINE, EMBASE and Cochrane databases. Eight variables were extracted from the included studies and evaluated according to major amputation rates. The Newcastle–Ottawa scale (NOS) was utilized to assess the quality of the studies.
The search strategy identified 101 publications. After screening, 10 articles were selected for review. Hypertension, ischemic heart disease, cerebrovascular disease, and peripheral vascular disease were identified as predictive variables of higher major amputation rates.
Although further investigation of long-term and prospective studies is needed, we identified four variables as predisposing factors for higher major amputation in diabetic patients through meta-analysis.
Blowout fractures are common in midfacial trauma and often involve other parts of facial bones. Sometimes, patients have complications caused by inadequate management. Surgical indications, such as ...clinical symptoms, can be inaccurate owing to post-traumatic swelling or hematoma formation. Previous studies on the prediction of enophthalmos used the orbital volume ratio (OVR) or only the volume of herniated tissue. This study examined which of these values is more predictive of the degree of enophthalmos. In addition, the predictive values for a 2-mm enophthalmos in unoperated blowout fractures were assessed.
A total of 191 patients underwent nonoperative treatment for blowout fractures at our institution; they were divided into 2 groups according to the degree of enophthalmos (>2 mm vs 0 to 2 mm) and were further divided into 3 subgroups according to the location of the fracture (inferior, medial, or inferomedial). Multifactor logistic regression analysis was performed to determine the relationship between the degree of enophthalmos and these values.
We observed a correlation between the OVR and the degree of enophthalmos, as well as a correlation between the volume of herniated tissue and the degree of enophthalmos. Regarding the anatomic location of herniation, the orbital floor was found to be more correlated with the amount of enophthalmos.
The OVR is a more reliable predictor than measurement of the volume of herniated tissue. The relationship found between radiologic examination findings and the degree of enophthalmos can be used as a surgical indication in addition to consideration of the anatomic location.
This report outlines the treatment of an 82-year-old man with squamous cell carcinoma of the left cheek. The wide excision and simultaneous superficial parotidectomy were planned. Various incision ...methods have been widely introduced such as retroauricular hairline incision, modified Blair incision, or face-lift incision. For coverage of preauricular skin defect and parotidectomy, we modified retroauricular hairline incision that the end of the incision was bent to make transposition flap. The operation has been successfully finished using this extension of a retroauricular hairline incision.
Diabetic foot infection (DFI) should be treated by a multidisciplinary team to prevent amputation and morbid status. As physicians encountering DFI in outpatient clinic, a proper selection of ...antibiotic treatment and diagnostic approach for a vascular status is essential. We retrospectively investigated the patients with DFI from 2016 to 2017. All patients were examined for vascular status, wound status, and pathologic culture preceding the treatment. No statistical significance was observed between PEDIS grade 1 and 2 and 3 and 4 in culture status and culture results. Association analysis between vascular status and other variables, such as wound score and culture results, has no significant difference. Through these results, the helpful epidemiologic result of microbiology and necessity of examination for peripheral arterial disease were verified.
Various resorbable plates and screws were used for facial bone fractures because of several strengths. However, there are few studies on their clinical course and long-term follow-up concerning their ...degradation and resorption time. The authors present rare case of long term follow-up of resorbable plates and screws under the incision site.
There are many treatment modalities associated with osmidrosis. The purpose of this study was to identify and compare effective osmidrosis treatments.
A systematic literature review and meta-analysis ...were performed using MEDLINE, EMBASE, and Cochrane databases. The osmidrosis treatment modalities were extracted as predictor variables, and recurrence and complications were extracted as outcome variables. Subgroup analysis was performed with regard to combined curettage, and fixed and random effect models were applied.
Forty studies published prior to February 2016 were identified. The group that received surgery had the lowest incidence of recurrence as 3.0%, followed by the liposuction and laser groups (5.5%, 8.2%, respectively). The liposuction group had the lowest incidence of complications (hematoma, 1.6%; necrosis, 1.5%), followed by the surgery (hematoma, 1.9%; necrosis, 2.1%) and laser groups (hematoma, 3.1%; necrosis, 4.5%). When combining curettage, the recurrence rate was lower in the surgery (P = 0.06) and liposuction groups (P < 0.01).
Surgery treatment has been demonstrated as the most effective result for treating osmidrosis. Liposuction has been identified as the most effective treatment, with the lowest number of associated complications. Combining the curettage method was an effective option for lowering recurrence rate in surgery and liposuction treatments. Finally, laser treatment was not significantly associated with benefits.
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