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Background: Lipomas can be categorized into deep and superficial lipomas according to anatomical depth. Many cases of forehead lipomas are reported to be deep to the muscle layer. We analyze ultrasound in delineating depth of forehead lipomas. Methods: A retrospective review was performed for all patients who underwent excision of forehead lipomas between January 2008 and March 2013 and for whom preoperative ultrasound study was available. Sensitivity and specificity of ultrasound imaging was evalauted against depth finding at the time of surgical excision. Results: The review identified 42 patients who met the inclusion criteria. Preoperative ultrasound reading was 18 as deep lipomas and 24 as superficial. However, intraoperative finding revealed 2 of the 18 deep lipomas to be superficial and 13 of the 24 superficial lipomas to be deep lipomas. Overall, ultrasonography turned out to be 69% (29/42) accurate in correctly delineating superficial versus deep lipomas. Conclusion: Lipomas of the forehead tend to be located in deeper tissue plane compared to lipomas found elsewhere in the body. Preoperative ultrasonography of lipomas can be helpful, but was not accurate in identifying the depth of forehead lipomas in our patient population. Even if a forehead lipoma is found to be superficial on ultrasound, operative planning should include the possibility of deep lipomas. [ABSTRACT FROM AUTHOR]

The article discusses the case of a 29-year-old woman who complains of gradual swelling of her right upper eyelid and had a history of undergoing blepharoplasty in another hospital.

Background Adipose tissue damage of cryopreserved fat after autologous fat transfer is inevitable in several processes of re-transplantation. This study aims to compare and analyze the survivability of adipocytes after thawing fat cryopreserved at -20°C by using thawing methods used in clinics. Methods The survival rates of adipocytes in the following thawing groups were measured: natural thawing at 25°C for 15 minutes; natural thawing at 25°C for 5 minutes, followed by rapid thawing at 37°C in a water bath for 5 minutes; and rapid thawing at 37°C for 10 minutes in a water bath. The survival rates of adipocytes were assessed by measuring the volume of the fat layer in the top layers separated after centrifugation, counting the number of live adipocytes after staining with trypan blue, and measuring the activity of mitochondria in the adipocytes. Results In the group with rapid thawing for 10 minutes in a water bath, it was observed that the cell count of live adipocytes and the activity of the adipocyte mitochondria were significantly higher than in the other two groups (P< 0.05). The volume of the fat layer separated by centrifugation was also measured to be higher, which was, however, not statistically significant. Conclusions It was shown that the survival rate of adipocytes was higher when the frozen fat tissue was thawed rapidly at 37°C. It can thus be concluded that if fats thawed with this method are re-transplanted, the survival rate of cryopreserved fats in transplantation will be improved, and thus, the effect of autologous fat transfer will increase. [ABSTRACT FROM AUTHOR]

Purpose: We used the retroauricular area skin as an alternative full-thickness skin donor site in the hand reconstruction surgery. Methods: From January 2006 to March 2013, 55 patients observed more than 1 year, were recruited for the study. In case of requiring the skin graft on hand, we grafted skins were harvested from the retroauricular area on hand. To assess the subjective and objective satisfaction, the patients themselves and three doctors compared the skin graft area's color with adjacent skin and estimated the donor site scar on a five-point scale. Results: A partial necrosis was seen in one case who received skin graft because of a burn scar contracture, but it was cured with conservative treatment. In other cases, the skin graft was well taken without any specific problems. The retroauricular skin graft showed good color match with adjacent skin and less pigmentation. Donor site scar was not noticeable. As a result, the patient's subjective satisfaction (4.07) and doctor's objective satisfaction (4.18) about skin graft were very good. And the patient's subjective satisfaction (4.93) and doctor's objective satisfaction (4.98) about donor site scar were also very good. Conclusion: We obtained the favorable result and the patients satisfaction by using the retroauricular area as a full thickness skin graft donor site in hand. [ABSTRACT FROM AUTHOR]

Background Liposuction is a procedure to reduce the volume of subcutaneous fat by physical force. Intracellular storage fat is composed of triglyceride, whereas circulating fat particles exist as cholesterol or triglycerol bound to carrier proteins. It is unavoidable that the storage form of fat particles enters the circulation system after these particles are physiologically destroyed. To date, however, no studies have clarified the fatal characteristics of fat embolism that occurs after the subclinical phase of free fat particles. Methods A mixture of human lipoaspirate and normal saline (1:100, 0.2 mL) was injected into the external jugular vein of rats, weighing 200 g on average. Biopsy specimens of the lung and kidney were examined at 12-hour intervals until postoperative 72 hours. The deposit location and transport of the injected free fat particles were confirmed histologically by an Oil Red O stain. Results Inconsistent with previous reports, free fat particles were transported from the intravascular space to the parenchyma. At 24 hours after infusion, free fat particles deposited in the vascular lumen were confirmed on the Oil Red O stain. At 72 hours after infusion, free fat particles were accumulated compactly within the parenchymal space near the perivascular area. Conclusions Many surgeons are aware of the fatal results and undiscovered pathophysiologic mechanisms of free fat particles. Our results indicate that free fat particles, the storage form of fat that has been degraded through a physiological process, might be removed through a direct transport mechanism and phagocytotic uptake. [ABSTRACT FROM AUTHOR]

Purpose: Digits injured by punch press machines show peculiar types with segmental loss of middle part of digits. Although the distal parts of finger survived, thr results is frequently unfavorable with respect to function and appearance after inappropriate reconstruction. Methods: From August 2008 to February 2013, five digits injured by punch press machines in four patients were managed. Pinch strength, two-point discrimination and active range of motion were measured to evaluate finger function. Results: Three digits with a preserved amputated segment underwent replantation. Partial necrosis occurred in one digit in which local flap was performed. Secondary tendon graft was performed in the other digits. Two digits without segment was reconstructed by arthrodesis after shortening the length. The patients were generally satisfied with function and appearance. Conclusion: Reconstruction of digits injured by punch machines are technically difficult. Replantation is the best method in cases of preserved segment, while arthrodesis with shortening is appropriate in cases without segment. [ABSTRACT FROM AUTHOR]

Background Electrical burns are one of the most devastating types of injuries, and can be characterized by the conduction of electric current through the deeper soft tissue such as vessels, nerves, muscles, and bones. For that reason, the extent of an electric burn is very frequently underestimated on initial impression. Methods From July 1999 to June 2006, we performed 15 cases of toe tissue transfer for the reconstruction of finger defects caused by electrical burns. We performed preoperative range of motion exercise, early excision, and coverage of the digital defect with toe tissue transfer. Results We obtained satisfactory results in both functional and aesthetic aspects in all 15 cases without specific complications. Static two-point discrimination results in the transferred toe cases ranged from 8 to 11 mm, with an average of 9.5 mm. The mean range of motion of the transferred toe was 20° to 36° in the distal interphalangeal joint, 16° to 45° in the proximal interphalangeal joint, and 15° to 35° in the metacarpophalangeal joint. All of the patients were relatively satisfied with the function and appearance of their new digits. Conclusions The strategic management of electrical injury to the hands can be both challenging and complex. Because the optimal surgical method is free tissue transfer, maintenance of vascular integrity among various physiological changes works as a determining factor for the postoperative outcome following the reconstruction. [ABSTRACT FROM AUTHOR]

The article presents a case study of a 72-year-old woman with history of skin protuberance on toe who was subjected to histopathologic and physical examinations and diagnosed with soft tissue chondroma.

The article discusses the case of a 35-year-old man whose chief complaint is the painful swelling of his finger and is diagnose with chondromyxoid fibroma.

The article describes the case of a 54-year-old man with a nodular lesion as revealed by physical examination. Resection of the mass was performed following a tentative diagnosis of hypertrophic scar. Histopathologic examination and immunohistochemistry led to the diagnosis of superficial acral fibromyxoma (SAF), an asymptomatic soft-tissue tumor commonly appearing in the periungual or subungual areas of the fingers or toes. Incomplete resection as a cause of recurrence is also discussed.

The article describes the case of a basal cell carcinoma (BCC) that presents as a hypertrophic scar. A 39-year-old woman is presented whose chief complaint is a hypertrophic scar with history of acne-like pustules at the right supratip region, which was diagnosed as nodular BCC on histopathologic examination. The patient undergoing complete resection of the tumor and reconstruction using a bilobed flap are discussed, as well as the role of trauma in skin malignancies.

The article presents the case of a 27-year-old pregnant woman presented with a progressive growth of her left auricular keloid. This case illustrates the possible connection between keloid formation and hormonal changes during pregnancy. A core extirpation of the keloid was performed until 6 months after delivery, with the clinical result remained obviously acceptable. The patient returned 2 years later with a recurrent auricular keloids.

The article presents a case study of a 8-year-old girl with a complaint of nail deformity in the left thumb, and mentions that a fully developed Posttraumatic E unit separate from the normal one was founded and the ectopic nail plate was removed afterwards.